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Patient-Safety-Learning

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News posted by Patient-Safety-Learning

  1. Patient-Safety-Learning
    The boss of Scotland's biggest health board tried to persuade a top doctor not to blow the whistle about patient safety concerns, a public inquiry has heard.
    Dr Penelope Redding, a former clinical director at NHS Greater Glasgow and Clyde (GGC), claimed the board's chief executive Jane Grant "urged me not to do it".
    Dr Redding was one of a number senior doctors who raised infection control concerns at the Queen Elizabeth University Hospital (QEUH) in Glasgow.
    In a submission to the Scottish Hospitals Inquiry, Dr Redding claimed there was a "profound culture of fear and bullying" at the board which put more people off speaking out.
    The inquiry is investigating the construction of the £870m QEUH campus in Glasgow, which includes the Royal Hospital for Children.
    It was set up after a number of patient deaths including that of 10-year-old cancer patient Milly Main.
    Dr Redding worked as an infection control doctor until 2008. She was involved in the preliminary planning for the QEUH, which opened in 2015, and was a whistleblower before she stepped down as a consultant microbiologist in 2018.
    In evidence to the hearing, the retired doctor criticised "a culture of not putting things in writing, in emails, not putting things in minutes, an atmosphere of intimidation and bullying" within the NHS. She said she only felt comfortable speaking out as she was approaching retirement.
    A spokesperson for NHS GGC said: "The current Scottish Hospitals Inquiry hearings have yet to hear from various key staff. A number of staff being mentioned during these hearings will also provide evidence and will endeavour to support the Inquiry to fully establish the facts."
    Read more about the Scottish Hospitals Inquiry on the hub.
    Read full story
    Source: BBC News, 4 September 2024
  2. Patient-Safety-Learning
    The number of deaths and patients seriously harmed due to alleged clinical negligence at a scandal-hit trust is “just the tip of the iceberg”, an NHS whistleblower has claimed.
    Several hundred more cases are likely to come under Operation Bamber, a formal investigation into multiple deaths and injuries at the Royal Sussex County Hospital between 2015 and 2021, according to sources close to the inquiry.
    The operation was initially launched in June 2023 after two consultant surgeons who reported concerns over surgical standards were dismissed by the University Hospital Sussex NHS trust (UHS), which runs the hospital. Police then expanded the operation to investigate 105 cases of alleged medical negligence but, insiders have said they expect that number to reach “many hundreds” the longer the inquiry goes on.
    Michael Swinn, a Surrey-based consultant urological surgeon who blew the whistle on bad practice at his own trust, said he has been approached by senior clinical staff across the country, including Brighton, since publishing a book about his own experience. Some have blown the whistle on poor practice already, others are considering it and seeking advice.
    Mr Swinn, 58, told inews: “The reports about Brighton say the police are looking at around 100 cases. I’m told it is many, many more. Potentially several hundred."
    Sussex Police said it is continuing to investigate allegations of medical negligence relating to neurosurgery and general surgery at the Royal Sussex.
    A spokesperson for the force said: “A number of cases from within the specified NHS departments and during the specified time period have been assessed and are forming part of the ongoing investigation… Sussex Police is committed to conducting a thorough and transparent investigation. Due to the complex nature of the enquiries, this is likely to take some time to complete.”
    Among the cases forming part of the investigation is the death of Lewis Chilcott, 23, who suffered a fatal arterial haemorrhage after an alleged error in his tracheostomy led to infection. A review by the Royal College of Surgeons found that it was likely that the low position of the inserted tube caused the fatal damage.
    Read full story
    Source: inews, 2 September 2024
  3. Patient-Safety-Learning
    Victims of the infected blood scandal can receive support for life, while those who were subjected to “unethical” research will get up to £15,000 extra, under changes to a multibillion-pound compensation plan.
    Payouts under the scheme will start by the end of the year for survivors, and by next year for affected people such as family members under a second set of regulations. Claims for those who have already died – of which there are more than 3,000 – because of the disaster can be made through their estate.
    Support scheme payments – including for bereaved partners – will continue for life as part of the plan, the Government said, as it announced it had accepted the “majority” of recommendations from an independent review.
    Victims who were used for research without their knowledge will also be eligible for an extra £10,000, with a higher award of £15,000 for those who underwent treatment as children in a notorious case at Lord Mayor’s Treloar’s College.
    Infected people – both living and dead – will start receiving payments through the new framework by the end of this year, while for others affected by the scandal, payments will begin in 2025, the Cabinet Office said on Friday.
    It comes after senior barrister and interim chairman of the compensation authority Sir Robert Francis KC made 74 proposals to address concerns with the current compensation plans.
    These included an enhanced award for those involved in a “particularly egregious” case of unethical testing at the Treloar school and an increase in the “social impact” payment for some of those affected. Pupils at the college were treated for haemophilia using plasma blood products infected with HIV and hepatitis, and NHS clinicians continued with treatments to further their medical research despite knowing the dangers, the Infected Blood Inquiry found.
    Jason Evans, who set up the Factor 8 campaign group after losing his father to the scandal aged four, said: “Compensation for those impacted by the infected blood scandal has taken far too long and too many have died waiting.
    “Today, the picture of what compensation might look like has become clearer, and now it must be delivered.”
    Read full story
    Source: Medscape, 16 August 2024
  4. Patient-Safety-Learning
    Federal authorities are preparing to approve updated coronavirus vaccines targeting the latest virus variants late next week, a move that could make shots available before Labor Day, according to a federal health official and a person familiar with the plans who spoke on the condition of anonymity to discuss a confidential process.
    The mRNA shots manufactured by Pfizer-BioNTech and Moderna designed to target the KP.2 variant can hit the market within days of approval by the Food and Drug Administration. A third protein-based vaccine made by Novavax, preferred by people who are cautious about mRNA vaccines or who have had bad reactions to them, will probably take longer to be approved and will be distributed in subsequent weeks, according to the federal health official.
    The arrival of new vaccines comes three months after the start of a summer covid wave that is receding in some places.
    The timing of the release is too late for Americans who were looking to shore up their immunity before summer travel and the return of the school year, or for those who face heightened risk because of their age or underlying conditions. In recent weeks, some people weighed whether to get an outdated vaccine for partial protection more quickly or to hang on for the updated version. And those who didn’t want to wait discovered existing shots were no longer easy to find.
    “That’s simply unfortunate timing, given the high levels of covid-19 circulating now and the large number of vulnerable people due for vaccination who didn’t get it months ago and are now motivated and anxious,” said Kelly Moore, president and CEO of Immunize.org, an organization that educates clinicians about vaccines.
    Read full story (paywalled)
    Source: Washington Post, 16 August 2024
  5. Patient-Safety-Learning
    System leaders have warned that too many nationally set targets focusing on acute trusts are “constricting” efforts to tackle widening gaps in healthy life expectancy.
    An NHS Confederation and Institute for Public Policy Research report published today  shows the gap in health life expectancy – the number of years a person can expect to live in full health – has now grown to more than 20 years between local authorities across the UK.
    System leaders told the report, which has been shared with HSJ, that national targets for ICSs too focused on acute rather than preventive outcomes are “constricting change” around improving health expectancy.
    The report adds that a “smaller set of targets may be beneficial” to tackle the widening health expectancy gap between local areas. 
    It says: “Despite rhetoric on subsidiarity, local systems are still subject to a proliferation of targets. In turn, those targets tend to be focused on acute rather than preventative outcomes, constricting change.”
    The report engaged with four integrated care systems – West Yorkshire, North East London, Sussex and Coventry and Warwickshire – and the Hywel Dda University Health Board in Wales. It found that health inequalities are “highly localised” meaning that systems are key to progress. 
    However, it argued that ICS long-term working can be “blown off course by what politicians see as burning priorities”. This is usually waiting lists and emergency department performance “rather than population health outcomes that take time to change and deliver prosperity. High turnover of health secretaries, short-termism in Treasury and the politicisation of the NHS are all challenges here. Providing long-term funding, space to experiment and political acknowledgement that real change takes time would be useful,” the report continued.
    Read full story (paywalled)
    Source: HSJ, 16 August 2024
  6. Patient-Safety-Learning
    The number of children being treated for an eating disorder has doubled over the past eight years, with some waiting more than a year for treatment, NHS data has revealed.
    In the past school year there were 10,606 children beginning treatment for an eating disorder, compared with 5,240 patients in 2016-17.
    Waiting times for treatment are rising, with 12 per cent waiting more than three months for an appointment, compared with 1 per cent three years ago, according to information disclosed by the House of Commons Library. It is three times longer than the NHS waiting times standard, which states that children should wait no longer than four weeks for treatment to commence and no longer than one week following an urgent referral.
    However, some are waiting for more than a year. The longest time that a patient spent on the waiting list to receive treatment for their eating disorder was 378 days at Coventry and Warwickshire Partnership NHS Trust, according to data uncovered by Freedom of Information requests submitted by the Liberal Democrats.
    The Lib Dems are pushing to establish walk-in mental health hubs for young people in every community and mental health professionals in every primary and secondary school.
    Hope Virgo, a mental health campaigner who survived anorexia and founded the DumpTheScales campaign, said many medical professionals do not believe children when they come for help. “Through my campaigning every day I hear more and more stories of young people and adults being diagnosed with eating disorders and unable to get support,” she said. “People with eating disorders are often being told they are not sick enough for treatment and by the time they come back for support, they are told they are too sick.”
    Read full story (paywalled)
    Source: The Times, 19 August 2024
    Related reading
    In conversation with Hope Virgo: “The withdrawal of treatment from people with eating disorders is a national crisis that’s being ignored.”
  7. Patient-Safety-Learning
    People travelling to areas affected by the recent mpox outbreak in Africa have been urged to get vaccinated by the EU’s public health body.
    European Centre for Disease Prevention and Control (ECDC) updated its advice to people going to “epidemic areas” to “consult their healthcare provider or travel health clinic regarding eligibility for vaccination against mpox”.
    The alert comes after the World Health Organization (WHO) declared a global emergency as cases of the disease surge. This week WHO director-general Tedros Adhanom Ghebreyesus described the emergence and spread of a new variant of mpox as “very worrying”.
    More than 17,000 mpox cases and at least 571 deaths have been confirmed in Africa this year alone, and at least two cases have now been confirmed outside of the continent.
    A new strain, named clade 1, has been identified and is spreading through physical contact. WHO says it has been identified in Burundi, Kenya, Rwanda and Uganda – all countries that have never reported cases of mpox before.
    One case of this new strain has now been detected in Sweden, the country’s public health agency has confirmed. They say the person, who is now in isolation, had contracted it during a stay in an African country where other cases have been reported.
    Mpox belongs to the same family of viruses as smallpox but causes milder symptoms like fever, chills and body aches. People with more serious cases can develop characteristic lesions on the face, hands, chest and genitals.
    Pamela Rendi-Wagner, director of ECDC, said: “As a result of the rapid spread of this outbreak in Africa, ECDC has increased the level of risk for the general population in the EU/EEA and travellers to affected areas. Due to the close links between Europe and Africa, we must be prepared for more imported clade I cases.”
    Read full story
    Source: Independent, 19 August 2024
  8. Patient-Safety-Learning
    GPs in England have launched a work-to-rule action in a dispute with the government over what they say is a lack of funding. It threatens to bring chaos to the system.
    The British Medical Association (BMA) announced the action earlier this month, and surgeries are now taking a variety of steps, with some limiting the number of patients each GP can see to 25 per day. That could reduce the number of available appointments by a third.
    But with many patients already finding it difficult to get to see a doctor, there's increasing concern it could put patients at risk.
    Dr Tom Gorman says taking part in the work-to-rule is a last resort, but he feels compelled to do it to protect his patients. The 41-year-old has been a GP for eight years and says the system is at “breaking point”. He said, “We can't deliver for our patients. They’re struggling to get appointments. We don't want to take action but we’re being forced to protect our patients and staff.”
    As a partner in a practice in Newcastle, Dr Gorman is in charge of deciding what action to take next. That is because GPs are effectively independent businesses – so this is not a strike or campaign of industrial action in the traditional sense.
    The British Medical Association (BMA) has suggested GPs can pick-and-choose from a range of options. These include capping the number of patients that are seen each day, not doing tests and check-ups for hospitals, ignoring rationing guidelines which could result in a deluge of referrals for hospital care, and refusing data-sharing requests.
    NHS England has warned this work-to-rule action could push more people into seeking help from A&Es as well as having a wider impact on the system, such as delaying discharges from hospital.
    And patient watchdog Healthwatch England believes this could ultimately harm patients. “GP access is the most common issue we hear about," says chief executive Louise Ansari. “We’re worried the work-to-rule could make problems worse or even deter people from seeking help altogether. Any delay to care can have a huge impact on people’s physical and mental health.”
    Read full story
    Source: BBC News, 19 August 2024
  9. Patient-Safety-Learning
    A new vaccination programme aimed at protecting newborn babies and older adults against a dangerous respiratory disease is now being rolled out in Scotland.
    The Respiratory Syncytial Virus (RSV) immunisation programme begins on Monday morning, and will be offered in the other UK nations from September.
    RSV is common and highly infectious. It affects the breathing system and can cause severe illness in vulnerable groups, including infants and older people. It is the leading cause of emergency respiratory admissions to hospital in infants.
    In 2022-23, more than 1,500 infants under the age of one and more than 500 people aged 75 and over were hospitalised with RSV, according to Public Health Scotland.
    Across the UK as a whole it results in 25-30 infant deaths each year. While for many the symptoms are mild, the infection is easily spread and 90% of children will catch it within the first two years of their lives.
    The vaccine is being administered on the advice of the UK's Joint Committee on Vaccination and Immunisation (JCVI). Doses are being offered to women from 28 weeks into their pregnancies, to protect newborns, as well as those aged 75 and as a one-off catch up for those aged 75 to 79.
    Dr Sam Ghebrehewet, head of immunisation and vaccination at Public Health Scotland, said: "RSV can be very serious for those who are more vulnerable, such as newborns, infants and older adults. If you are eligible, getting vaccinated is the best and simplest thing you can do to protect yourself or your newborn baby from RSV."
    Read full story
    Source: BBC News, 12 August 2024
  10. Patient-Safety-Learning
    About 400 million people worldwide have been afflicted with Long Covid, according to a new report by scientists and other researchers who have studied the condition. The team estimated that the economic cost—from factors like health care services and patients unable to return to work—is about $1 trillion worldwide each year, or about 1 percent of the global economy.
    The report, published Friday in the journal Nature Medicine, is an effort to summarize the knowledge about and effects of long Covid across the globe four years after it first emerged.
    It also aims to “provide a road map for policy and research priorities,” said one author, Dr. Ziyad Al-Aly, the chief of research and development at the V.A. St. Louis Health Care System and a clinical epidemiologist at Washington University in St. Louis. He wrote the paper with several other leading long Covid researchers and three leaders of the Patient-Led Research Collaborative, an organization formed by long Covid patients who are also professional researchers.
    Read full story (paywalled)
    Read the research study, Long COVID science, research and policy
    Source: New York Times, 9 August 2024
  11. Patient-Safety-Learning
    A debilitating virus originating in sloths and spread by midges has been reported for the first time in Europe, officials have confirmed.
    In June and July, 19 imported cases of the Oropouche virus were reported in Europe, according to the European Center for Disease Control. Twelve were reported in Spain, five in Italy, and two in Germany.
    The disease is mainly spread by insect bites - including mosquitos - and originates in pale-throated sloths, non-human primates and birds.
    There is currently no vaccine to treat the virus, which comes from the same family of diseases that includes Zika virus and Dengue Fever.
    Dr Danny Altmann, a professor of Immunology at Imperial College London, told The Telegraph: “We should definitely be worried. Things are changing and may become unstoppable.”
    Read full story
    Source: Independent, 11 August 2024
  12. Patient-Safety-Learning
    A doctor warned three years before the Nottingham attacks that Valdo Calocane's mental illness was so severe he could "end up killing someone."
    This was one of a series of missed opportunities over three years that could have prevented the killings, Calocane's mother and brother told BBC Panorama in their first interview. The doctor's warning appeared in a 300-page summary of medical records the family received only after Calocane was sentenced for the killings, which they have shared with Panorama.
    The chief executive of Nottinghamshire's NHS trust said he would do everything he could to stop such a tragedy happening again.
    Calocane was diagnosed with paranoid schizophrenia in 2020 and was sectioned four times in less than two years.
    In June 2023, he went on a rampage through the streets of Nottingham, killing students Barnaby Webber and Grace O’Malley-Kumar, both aged 19, with a knife as they returned from a night out, before stabbing to death Ian Coates, 65, near the school where he worked as a caretaker. Calocane then stole his van and crashed into three other people, inflicting serious injuries.
    The warning was given by one psychiatrist while the medical team reviewed Calocane on the ward and was set down in medical records held by Nottinghamshire NHS trust.
    Elias and Celeste, Calocane's brother and mother, said the mental health system was "broken" and led to a "tragedy that could have been prevented."
    Read full story
    Source: BBC news, 12 August 2024
  13. Patient-Safety-Learning
    The government has offered junior doctors a pay uplift worth around 20 per cent over two years to end their long-running industrial action.
    The British Medical Association’s junior doctors committee is set to recommended the offer to members who will vote on whether to accept and end their dispute, several reports said.
    HSJ understands the deal is worth a 22.3% cash terms pay increase over two years.
    Reports said it included a backdated pay rise of 4.05% for 2023-24, on top of the existing deal of 8.8-10.3% depending on role or level. Then for 2024-25, the offer is for a 6% rise, and an additional one-off consolidated £1,000 payment—equating to a 7-9% rise.
    If the deal is rejected by members, then industrial action could continue until at least September, when the junior doctors’ latest mandate is due to expire, days before the Labour party’s annual conference in Liverpool. The first strike was in March 2023.
    The Government has not yet confirmed details of the offer, nor how it will be funded. NHS funding assumptions for 2024-25 only cover uplifts of 2%.
    Read full story (paywalled)
    Source: HSJ, 29 July 2024
  14. Patient-Safety-Learning
    Industrial action by GPs could have a “catastrophic” impact on A&E units, the 111 telephone advice service and mental healthcare, a senior NHS leader has told the Guardian.
    Family doctors who run GP surgeries across England are about to finish voting on whether to reduce the care they provide – including limiting the number of patients they see to 25 a day – in protest at the previous government increasing their budget by only 1.9% this year.
    The ballot of GP partners being run by the British Medical Association (BMA) closes on Monday, with the result known soon afterwards. They are expected to vote in favour of taking industrial action – but not striking – that would start on Thursday.
    The outcome of the ballot could pose another headache for Wes Streeting, the health secretary, who is holding talks with junior doctors aimed at resolving their long-running pay dispute during which they have gone on strike 11 times over the past 17 months in pursuit of a 35% rise.
    In his first major policy announcement since replacing Victoria Atkins on 5 July, Streeting pledged to increase the share of the NHS budget that goes to general practice.
    Referring to the prospect of industrial action by GPs, a source close to Streeting said: “This is just the latest example of the mess left by the Conservatives. We are determined to work with the profession to rebuild general practice, which is critical to making the NHS fit for the future. We will increase the proportion of resources going into primary care over time and help address the issues GPs face.”
    There is huge concern across the NHS that GPs capping their patient contacts to 25 a day would cause significant disruption, with family doctors referring more patients than usual to already-overstretched hospitals as another tactic to force NHS England and ministers into a rethink. It could also extend waiting times for diagnostic tests and non-urgent hospital care, NHS chiefs fear.
    “If all GPs implemented the patient cap, that could have a catastrophic effect on the entire healthcare system”, said Matthew Taylor, the chief executive of the NHS Confederation. “General practice is now supporting more patients than before the Covid pandemic, so any reduction in their activity will put more pressure on other services, including A&E.”
    Read full story
    Source: The Guardian, 28 July 2024
  15. Patient-Safety-Learning
    The NHS has issued an urgent plea for blood donors after warning national supplies are set to run out within hours.
    Doctors urged people with O-type blood to donate, with national stocks of O-Negative projected to run out by Saturday. The health service said it has less than 5 days stock of all types of blood in what it described as an “unprecedented” shortage.
    They called on people with the universal blood group O-negative, as well as O-positive donors, to urgently book into donor centres. 
    Just 8 per cent of the population have type O-Negative but it makes up for around 16 per cent of hospital orders, according to NHS Blood and Transplant (NHSBT).
    The health service said it was facing a “perfect storm” after a cyber attack impacted London hospitals in June.
    Dr Gail Miflin NHSBT’s chief medical officer said: “Three blood donations are needed every minute in hospitals to deal with emergencies, childbirth and routine treatments. Blood only has a shelf life of 35 days so the NHS needs blood all year round. There are just under 800,000 regular blood donors, 108,000 of whom are O Negative. Ultimately, we need more people to be regular blood donors and come to one of our 25 donor centres.”
    Read full story
    Source: Independent, 27 July 2024
  16. Patient-Safety-Learning
    More Americans are learning of devastating health diagnoses through their phones and computers instead of personally from their doctors because of a federal requirement that people receive immediate access to medical test and scan results, from routine bloodwork to MRIs.
    This shift has sparked a debate in the medical community about whether instant information empowers patients or harms them.
    The new medical landscape resulting from a bipartisan law promoting transparency has exposed fault lines in a stressed health-care system where the promises of technological advancements are undercut by the heavy workloads foisted on medical professionals.
    As more people receive troubling results online at the same time as their doctors—often waiting days or weeks for treatment plans—medical associations have been pushing to give doctors more time to release records revealing cancer and other grim diagnoses so patients don’t have to bear the news alone.
    The idea of medical transparency undergirding provisions in the 2016 Cures Act is broadly supported. But implementation of the regulations expanding access to medical records, which took effect in 2021, has been more divisive.
    Congress has taken little interest in this issue, and federal health officials have stood by the rules, arguing that concerns will be resolved as technology improves and as medical practices adjust how they prepare patients for results.
    “There is just a moral imperative here, which is for patients, this is their information. They ought to be able to access it whenever they want,” said Micky Tripathi, the national coordinator for health information technology whose office crafted the requirement for the Department of Health and Human Services. “They also pay for it. They ought to be able to get things they pay for.”
    Read full story (paywalled)
    Source: Washington Post, 26 July 2024
  17. Patient-Safety-Learning
    Managers and staff are suffering a “huge emotional toll”—while trusts are facing extra costs—due to very long delays to hold employment tribunals.
    A lack of judicial capacity following mass cancellations during covid means waiting times for a hearing are reaching as long as 18 months from initial claim, and more hearings are being cancelled at the last minute, meaning trusts are incurring significant financial costs, lawyers said.
    Minutes from a Courts and Tribunals Judiciary meeting showed, as of this spring, some regions were listing three-five day employment tribunal hearings as far as two years away (early 2026), while others were being scheduled for the second half of 2025, despite recent signs of a falling caseload.
    One senior employment law source, who did not want to be named, told HSJ both the staff making claims, and their organisations/managers, were being “hugely impacted” by the delays “because they are living in some of the worst moments of their lives”.
    They said: “Equally, for those against whom claims are brought, some really serious allegations of discrimination, they’ve put a huge pressure on those people. They’re living with that hanging over them. That emotional toll is huge. We’ve had people who have retired and moved overseas. Who wants to come back from there for a tribunal claim relating to issues from six years ago? It has a really significant impact.”
    Read full story (paywalled)
    Source: HSJ, 29 July 2024
  18. Patient-Safety-Learning
    Blood testing partnership Synnovis has warned that its hacked blood transfusion services may not be fully functioning again until the autumn.
    Its systems fell victim to ransomware hackers and the pathology partnership says, external it has rebuilt many of the 60 which were affected.
    The hackers made systems unusable unless a payment was received and caused significant disruption, with hundreds of operations and thousands of appointments cancelled.
    Synnovis said the blood transfusion services would "continue to be stabilised over the summer".
    The situation is also part of the reason the NHS made an urgent appeal for blood donors after warning stocks had dropped to "unprecedently low" levels.
    Synnovis is a partnership between Guy’s and St Thomas’ NHS Foundation Trust, King’s College Hospitals NHS Trust and Synlab, a commercial testing firm.
    It said more of its laboratories could now be reconnected to systems that enabled the service to receive test orders and return results electronically.
    Core chemistry and haematology services have been restored at King’s College and Princess Royal University Hospitals, with Guy’s and St Thomas’, Royal Brompton and Harefield Hospitals to follow "in days". As a result it expected "to be able to increase the numbers and types of tests shortly".
    Dr Chris Streather, medical director for NHS London, welcomed the news but said: “It will take further time for this to roll out, but we will soon start to see faster turnaround times for most routine blood tests." He said the delay in restoring blood transfusion services meant "that there will be a continued impact on planned operations and a need for hospitals to help each other by taking patients where needed".
    Read full story
    Source: BBC News, 26 July 2024
  19. Patient-Safety-Learning
    The body responsible for regulating NHS and care services in England is not fit for purpose, the health secretary has said.
    Wes Streeting's intervention comes after an independent review found significant failings at the Care Quality Commission (CQC), according to headline findings released by the government.
    The CQC inspects everything from hospitals and GP practices through to care homes and dental surgeries, covering 90,000 different services. Wes Streeting said he was “stunned” by the scale of the problems as he announced a set of emergency measures.
    The CQC said it accepted the findings in full.
    Among the failings identified were:
    Inspectors lacking the necessary experience – including some being asked to inspect hospitals without ever having been into one before Care home inspectors who had never met a person with dementia A backlog of assessments with one in five services never having been given a rating – this is thought to include new care providers, GPs and private health clinics that have opened in the last five years One NHS hospital having gone more than 10 years since its last inspection A lack of consistency with assessments The full interim report is due to be published on Friday.
    Among the measures being taken is the appointment of Sir Mike Richards, a vastly experienced cancer doctor who has previously worked in government as national director of cancer care and spent four years as the chief inspector of hospitals from 2013, to work with senior leaders at the CQC and conduct a "rapid review" of the watchdog.
    The regulator has just appointed an interim chief executive, Kate Terroni, who was deputy chief executive until last month when Ian Trenholm announced he was stepping down as head of the CQC.
    Mr Streeting told BBC Breakfast he was also looking to appoint a new chief executive and chief inspector of hospitals who the government "can work with to turn the regulator around."
    Read full story
    Read the Independent review into the operational effectiveness of the Care Quality Commission: interim report
    Source: BBC News, 26 July 2024
  20. Patient-Safety-Learning
    A type of cancer treatment used in the NHS appears to be biased against non white European patients, research has found.
    A review by the NHS Race and Health Observatory in partnership with Liverpool University – findings from which have been shared with HSJ –  looked into crucial genetic tests carried out before a type of drugs to treat cancer (fluoropyrimidines) is administered.
    If a patient has certain gene variants, using the medicines can harm them, leading to severe side-effects that affect the bone marrow, bowel and skin, and in some cases can cause death. If the variants are present, other treatments have to be used.
    However, the research by the RHO found that the NHS is testing for four variants, which are typically found in white Europeans. But the researchers found 53 additional relevant variants, which are not tested for, were present in patients from 12 countries and five ethnic groups – African American, East Asian, Latin American, Middle Eastern and South Asian.
    Although their two-year research project is still ongoing, the RHO and Liverpool University team have decided to issue a call for an extension of this type of genetic testing (which seeks to identify a deficiency of the dihydropyrimidine dehydrogenase enzyme). A further recommendation for genetic testing for a variant found in those from African backgrounds is now under NHS review, which could be included in the National Genomic Test Directory, the RHO said.
    RHO chief executive Professor Habib Naqvi said, “There is a duty to ensure every patient has access to the best available treatment when they are unwell."
    Read full story (paywalled)
    Source: HSJ, 26 July 2024
  21. Patient-Safety-Learning
    Staff at a hospital in Nottingham missed two opportunities to treat a woman found dying under a coat in a crowded emergency department, a coroner has concluded.
    An inquest into the death of Inga Rublite, 39, found she died of natural causes but medical staff failed to recognise “persistent and escalating symptoms of brain haemorrhage” as she waited in A&E for more than eight hours.
    Dr Elizabeth Didcock, an assistant coroner for Nottinghamshire, said Rublite should have been assessed by a senior doctor and sent for a head scan when she arrived at Queens medical centre (QMC) just after 10.30pm on 19 January this year.
    When Rublite was next assessed by a nurse, at about 2am, and reported to be in severe pain, this should have been escalated to a doctor, she said.
    “[Rublite] had persistent and escalating symptoms of brain haemorrhage that were not recognised,” said Didcock, adding that the department was “excessively busy” that night. “There were 76 patients waiting to be seen, and reduced medical staff generally across the department.”
    Didock concluded Rublite suffered a second severe bleed on the brain shortly before she was found, which caused her death. “If she had been admitted for close monitoring, as she should have been, she would still have had [a] second rapid and devastating bleed.”
    Read full story
    Source: The Guardian, 25 July 2024
  22. Patient-Safety-Learning
    Those going to Greece for their summer holidays have been warned of a spike in Covid cases related to the new FLiRT variant.
    The increase has been reported by the Mediterranean country over the last 20 days.
    In its latest report Greece’s National Public Health Organization, EODY, said it had seen an increase in hospital admissions, with 669 new Covid patients admitted from July 8 to 14, 2024. The report adds that this was a 44% increase in the average weekly number of new admissions over the previous four weeks. In total 26 Covid deaths were recorded.
    Greece has recently struggled with heatwaves that has left many vulnerable people shielding from high temperatures inside. 
    Last week the Metaxa Oncology Hospital in Piraeus, the port area of Athens, reintroduced masks and other protective measures within its wards. Visitors are limited to two per patient and there is a 48-hour rapid test requirement for those visiting.
    The symptoms of the FLiRT and LB.1 variants are generally like those of earlier Covid-19 strains. Common symptoms include fever, cough, fatigue, loss of taste or smell, sore throat, muscle or body aches, shortness of breath, headache, and a runny nose.
    Last week, the World Health Organization released a statement indicating Covid-19 is still responsible for around 1,700 deaths per week globally. WHO encouraged vulnerable populations to get vaccinated.
    Read full story
    Source: Independent, 25 July 2024
  23. Patient-Safety-Learning
    The Nursing and Midwifery Council (NMC) has set out the next steps towards change, having accepted all the recommendations of an independent review into its culture.
    In the short-term , the NMC will take the following immediate actions, supported by external advice, to help it make the right decisions, address its cultural issues and follow through on change.
    An external Empowered to Speak Up Guardian is now in place to support NMC staff to raise concerns and ensure they get independent support from a trained professional. The NMC has invested in a partner to help improve psychological safety within the organisation, starting in Professional Regulation directorate. It has started the process of appointing an equality, diversity and inclusion (EDI) advisor to its executive board, to support decision making. It has also made some immediate commitments:
    The NMC will co-opt one or more senior independent advisers to the Council to increase the challenge and support that the Council receives, to ensure the necessary cultural changes are delivered and to prevent a recurrence of the findings in the report. It has committed to increasing the diversity of its executive board. It will double the amount it spends on staff learning and development so that by October 2024, it can roll out improvements in leadership, line management, safeguarding, casework and tackling poor behaviours identified in the report. It will develop a competency and behaviour framework, to launch in September, that will support recruitment, career progression and performance management. It will offer extended decompression support to staff working on sensitive casework. In the medium term, the NMC is reviewing its existing plans in light of the independent report’s recommendations. It is also working to enhance its approach to safeguarding, people and equality, diversity and inclusion (EDI). In the longer term, the organisation will focus on wider culture change, including the full implementation of Nazir Afzal and Rise Associates’ recommendations over a projected two-year period.
    Helen Herniman, Acting Chief Executive and Registrar, said, “The independent report on our culture made difficult reading for everyone at the NMC and for many outside our organisation, including our stakeholders, the professionals on the register and members of the public who have engaged in our regulatory work. We are sincerely sorry to everyone we have let down. We are committed to delivering a change programme rooted in the report’s recommendations, and we are confident this will help us to make a step change in both culture and performance."
    Read full story
    Read The Nursing and Midwifery Council Independent Culture Review (9 July 2024)
    Source: Nursing and Midwifery Council, 24 July 2024
  24. Patient-Safety-Learning
    A quarter of social care staff in Scotland leave their jobs within three months, while vacancies are at their height, a report has found.
    The bodies responsible for delivering health and care services across the nation, known as Integration Joint Boards (IJBs), are grappling with a projected funding gap that is up by 187 per cent.
    The Accounts Commission, a watchdog, has warned of “unprecedented pressures” on IJBs amid dwindling funds and surging demand for services.
    IJBs play a crucial role in planning and commissioning essential community-based health and care services across Scotland. Their remit includes supporting disabled adults, social work with the elderly, GPs, pharmacists, mental health care and drug and alcohol services.
    The report also underscored an “unsustainable” dependence on Scotland’s estimated 800,000 unpaid carers.
    Colin Poolman, Scotland director of the Royal College of Nursing (RCN), said: “This damning report sets out the challenges facing community health and social care services. Too often, the focus is on the crisis in acute hospitals, but hospital overcrowding is a symptom of the lack of investment and prioritisation of community services. The whole system is at breaking point.”
    Read full story
    Source: The Times, 25 July 2024 (paywalled)
  25. Patient-Safety-Learning
    One of the NHS’s least digitised teaching hospitals has been forced to carry out “a full forensic investigation” after a cyber attack last week, HSJ has learned.
    Norfolk and Norwich University Hospitals Foundation Trust said the incident occurred last Wednesday. It was unrelated to the Microsoft outage, which disrupted some NHS IT systems, mostly in general practice, at the end of last week, the trust said.
    A trust spokesman told HSJ: “No patient systems are compromised, and [at] this point in the investigation, we do not have any evidence of compromise of patient data. However, the investigation is ongoing and is extremely complex.”
    NNUH chief digital information officer Ed Prosser-Snelling said the attack had been “detected and terminated [and] all emergency care, elective and outpatient services at our hospitals are continuing to run as normal.”
    Read full story
    Source: HSJ (paywalled), 24 July 2024

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