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Patient-Safety-Learning

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  1. Patient-Safety-Learning
    Some cancer patients have been left in limbo with their surgeries after the unlocking of the nation on the 19th July. Ms DePastino, who was scheduled to have surgery on Monday to remove cancer from her womb was told it had to be rearranged due to the number of Covid patients being admitted into the Princess Alexandra Hospital in Harlow. So far, Ms DePastino has not been given a new date or allowed to speak to her consultant. 
    “People have got this idea they want to get back to normal but what about people like me whose normal has been ripped away from them? Our only chance at normal is now being delayed or taken away so that people that are completely healthy can go about their business. If we’re going to get back to normal that means people who need care should be able to get care; it can’t be one or the other, that’s not right.” Said Ms DePastino, who also says her pleas to be referred to somewhere else have been ignored. 
    Read full story.
    Source: The Independent, 1 August 2021
  2. Patient-Safety-Learning
    Barnsley Hospital declares 'black alert' as their A&E becomes overwhelmed with patients. 
    The hospital has seen more than 300 patients in one day, putting pressure on staff to free up beds. 
    It has been understood that the surge in numbers is due to other illnesses and not Covid-19 related. 
    Read full story.
    Source: The Independent, 22 June 2021
  3. Patient-Safety-Learning
    2.45 million has been pledged by the government to improve childbirth care which is due to happen this year. 
    It has been announced that the funding is intended to help NHS maternity staff to improve the safety of the women and babies they care for.
    Maternity safety minister Nadine Dorries said "I am determined to make sure as many mums as possible can go home with healthy and happy babies in their arms".
    Read full story.
    Source: Department of Health and Social Care, 4 July 2021
  4. Patient-Safety-Learning
    The government has announced £250m in funding to provide an extra 5,000 NHS hospital beds in England this winter. Ministers say 900 new beds should be ready by January, with the remainder to follow soon after, boosting capacity and helping lower record waiting lists.
    The increase will mean nearly 100,000 permanent beds on wards and in A&E, available at the busiest time of the year - a 5% rise on current levels. NHS Providers said the extra capacity was needed "before winter begins".
    Miriam Deakin, director of policy and strategy at NHS Providers, said trusts would welcome the support but cautioned any new beds would need to be staffed. She added that, since winter is the busiest time of the year for urgent and emergency care, trust leaders would be concerned that the promised extra capacity is only expected to be in place by January. "For the best results, trusts would need these new beds before winter begins," she said.
    Pat Cullen, from the Royal College of Nursing, added: "The elephant in the room is who will staff these additional beds? Nursing staff are already spread too thinly over too many patients."
    Read full story
    Source: BBC News, 15 August 2023
  5. Patient-Safety-Learning
    Integrated care boards and local authorities are cutting their voluntary contributions to the better care fund by more than £500m compared to a high point in 2021-22.
    It appears to be caused by the funding squeeze in both the NHS and local government; extra pressure on ICBs to focus on hospital admissions and discharge; a shift away from pooled budgets as a method of integration; and restructure, with ICBs taking over from clinical commissioning groups in 2022.
    Local BCF pooled budgets are made up of mandatory “minimum” funds from ICBs and local government – the largest share, which the government has generally ordered to grow steadily each year – and from the “additional” voluntary contributions.
    In the past government has said it wants the sum pooled across the NHS and councils to grow and to ultimately account for most NHS and adult social care spending, to help join up services and decision making.
    But figures published on Tuesday by NHS England show the voluntary income going backwards. At its high point in 2021-22, ICBs and councils planned a discretionary ”additional” contribution of £3bn, and the actual spend turned out to be £3.2bn – £2bn from the NHS and £1.2bn from councils.
    The newly published figures show the total was planned to fall to £2.8bn in 2023-24 and £2.7bn in 2024-25 – £500m less than the 2021-22 peak spend.
    Read full story (paywalled)
    Source: HSJ, 8 May 2024
  6. Patient-Safety-Learning
    England's Chief Nurse has announced every pregnant woman will be able to access their maternity records from their smart phone. 
    The move has been made so that pregnant women will be able to have more control over their pregnancy and will be able to see all the decisions and information made via a smart phone. 
    GPs and health professionals will also be able to access this information, it is hoped that by doing so, it will mean pregnant women will no longer have to repeat information to different clinicians they see whilst pregnant, which may also help improve safety.  
    Read full story
    Source: NHS England, 17 June 2021
  7. Patient-Safety-Learning
    A report by MPs has said 1,000 babies die every year as a result of lessons not being learned and blame being shifted despite a number of high profile cases involving maternity scandals. 
    Jeremy Hunt who chairs the committee has said “Despite a number of high-profile incidents, improvements in maternity safety are still not happening quickly enough".
    The report also found that women from ethnic minority backgrounds are more likely to experience a higher rates of stillborn and neonatal deaths. 
    The Department of Health and Social Care has been approached for comment. 
    Read full story.
    Source: The Guardian, 6 July 2021 
  8. Patient-Safety-Learning
    1.6 million people in England have been told to self-isolate in a week and the government say it is unlikely the Covid app will adjusted to make it less sensitive. 
    Robert Jenrick, communities secretary told the BBC, “It is important we have the app, that we take it seriously and that when we do get those messages, we act accordingly”. 
    According to reports, UK coronavirus cases climbed to 48,553 on Thursday, the highest since January. Concerns have now been raised about the climbing number of cases with fears there may be chaos to come. 
    Read full story.
    Source: The Guardian, 16 July 2021
  9. Patient-Safety-Learning
    It has been announced that the UK is set to launch 15 new research programs to study 'Long Covid', allocating nearly 20 million pounds to the projects. 
    The research programs are aiming to understand the condition better as well as identify it and evaluate different treatments. 
    The Department for Health and Social Care have said, "Those people who have long COVID will benefit from the latest  research revealed, which will help to understand the condition better, improve diagnosis and find new treatments."
    Read full story.
    Source: The Day Chronicle, 18 July 2021
  10. Patient-Safety-Learning
    More than 7,000 nurses at two major New York City hospitals walked off the job Monday, arguing immense staffing shortages are causing widespread burnout and hindering their ability to properly care for their patients.
    The nurses say they are working long hours in unsafe conditions without enough pay – a refrain echoed by several other nurses strikes across the country over the past year. The union representing the nurses said an offer of 19% pay hikes isn’t enough to solve staffing shortages.
    This is the latest in a series of strikes in the health care industry in recent years. Those union members who were on the front lines during the three-year battle with the Covid pandemic say the system is no longer able to function with the widespread shortages that arose during those years.
    “We’ve been fighting for working under safer conditions,” Warren Urquhart, a transplant nurse at Mount Sinai, told CNN Monday while on the picket line. “We do the best we can every day. There’s something wrong inside the hospital. That’s why we’re outside the hospital.”
    Read full story
    Source: CNN, 9 January 2023
  11. Patient-Safety-Learning
    In the most deprived areas of England and Scotland, the nearest 24/7 accessible defibrillator is on average a round trip of 1.8 km away—over a mile—according to a pioneering study supported by the British Heart Foundation (BHF).
    The researchers, led by Dr Chris Wilkinson, senior lecturer in cardiology at Hull York Medical School, used data from national defibrillator network The Circuit to calculate the median road distance to a defibrillator with unrestricted public access across Great Britain's 1.7 million postcodes.
    Among the 78,425 defibrillator locations included, the median distance from the centre of a postcode to a 24/7 public access defibrillator was 726.1 metres – 0.45 miles. In England and Scotland, the more deprived an area was, the farther its average distance from a 24/7-accessible defibrillator – on average 99 metres more in England, and 317 metres farther in Scotland for people living in the most compared with the least deprived areas. There was no link between defibrillator location and deprivation in Wales.
    The researchers said they hoped the findings, presented at the European Society of Cardiology (ESC) Congress in Amsterdam and published in the journal Heart, would lead to more equal access to defibrillators. They noted that there were over 30,000 out-of-hospital cardiac arrests (OHCA) annually in the UK; in England nearly 30% happened at weekends, and 40% between 6pm and 6am. 
    Read full story
    Read research study: Automated external defibrillator location and socioeconomic deprivation in Great Britain (28 August 2023)
    Source: Medscape, 29 August 2023
  12. Patient-Safety-Learning
    A new BBC report has found ambulance crews are unable to respond to calls quickly due to the pressure on hospitals to find free beds. Some paramedics are even spending most of their 12 hour shift waiting in the back of their ambulance, waiting to be called. 
    "We know there are people in the community that are screaming out for an ambulance, but as you can see, a lot of ambulances are waiting here. It never ever used to be like this. We used to bring poorly patients in, and we were out on the road again in 15 minutes. We could do 10 jobs a shift, today we've done two. It's so demoralising" Paramedic Osian Roberts has said. 
    Read full story.
    Source: BBC News, 11 August 2021
  13. Patient-Safety-Learning
    The headline A&E target was missed in March despite NHS England’s controversial last-ditch attempts to deliver it.
    Four hours A&E performance was 74.2 per cent in March—1.8 percentage points lower than NHSE’s 76 per cent threshold—but up from 71.5 per cent in the same month last year.
    NHSE’s attempts to improve four hours performance ahead of a year-end deadline—which included new cash incentives, asking directors to sign personal commitments, and encouraging trusts to focus on less sick patients—saw March performance 3.3 percentage points higher than 70.9 per cent in February.
    Around a third of acute trusts (38 of 119) met the 76 per cent target in March–more than double the number of trusts above the threshold in February (15).
    An interim ambulance response time for category 2 incidents, set at 30 minutes, was also missed in 2023-14—despite some improvement, and despite the government providing significant extra funding.
    The average response time across the year was 36m 23s—better than 2022-23 when it was 50m—but much worse than the pre-covid average of 21m 47s in 2018-19 and 23m 50s in 2019-20.
    Many ambulance trusts have continued to struggle with delays in handovers to A&E departments and South Western Ambulance Service Foundation Trust – which has seen some of the worst delays over the winter—averaged 45m 54s for category 2 incidents in March.
    Read full story (paywalled)
    Source: HSJ, 11 April 2024
  14. Patient-Safety-Learning
    The Care Quality Commission has closed mental health hospital, Eldertree Lodge, in Staffordshire after inspectors saw evidence of patients being abused.
    The hospital, which looked after 40 adults with learning disabilities and autism, was found to have unprofessional and abusive staff members, with incidents being recorded on CCTV where staff slammed doors on patients. Staff were also found to pull or drag a patient in an attempt to move them to a ward seclusion room.
    Commenting on the latest report, Debbie Ivanova, CQC deputy chief inspector for people with a learning disability and autistic people, said, “In some cases, people were subjected to abuse and interactions that lacked compassion, dignity or respect. This is unacceptable and people deserved better. Additionally, the environment was unhygienic and poorly maintained, as well as blighted by blind spots, which undermined staff observation of patients.
    Read full story.
    Source: The Independent, 11 August 2021
  15. Patient-Safety-Learning
    Some doctors say that however reasonable guidelines may seem, their cumulative burden causes “constant frustration” to medical practice.
    A team of doctors wrote a study last year for the Journal of General Internal Medicine which suggested that if an American doctor followed all of the guidelines for preventive, chronic and acute disease care issued by well-known medical groups, it would require nearly 27 hours per day.
    Guidelines have become “a constant frustration,” said Dr. Minna Johansson, a general practitioner in Uddevalla, Sweden, who also directs the Global Center for Sustainable Healthcare at the University of Gothenburg. “A lot of guidelines may seem reasonable when considered in isolation, but the cumulative burden of all guideline recommendations combined is absurd.”
    Read full story (paywalled)
    Source: New York Times, 14 February 2022
  16. Patient-Safety-Learning
    Now, almost two years after a consultation on inquests into stillbirths was delivered, the government has yet to respond. 
    It has recently been reported by MPs that 1,000 babies die preventable deaths each year due to understaffing and a culture of blame among the maternity ward workforce. 
    However, despite pressure from campaigners and a promise by the government that a response would come in September 2019, it is yet to be published. 
    The Department for Health and Social Care has told Byline Times, “work on analysing the responses to the consultation on coronial investigations of stillbirths has been delayed during the COVID-19 pandemic”.
    Read full story.
    Source: Byline Times, 14 July 2021
  17. Patient-Safety-Learning
    Roughly three in 10 adults have been addicted to opioids or have a family member who has been, and less than half of those with a substance use disorder have received treatment, according to a new survey conducted by KFF, a health policy research group.
    The survey, which polled more than 1,300 adults in July, underscores the broad and often harmful influence of opioid addiction across the nation, which recorded around 110,000 fatal drug overdoses last year alone.
    And the findings suggest that some proven medications for helping curb drug cravings, such as buprenorphine and methadone, are still not getting to those who need them. Only 25 percent of participants in the poll who said they or someone in their family had an opioid addiction reported receiving medication for themselves or family members.
    Mollyann Brodie, the executive director of KFF’s polling program, said that the numbers might be an undercount, as some survey participants might have been hesitant to share histories of opioid addiction.
    Addiction cuts across class, race and geography, the KFF researchers found. Rural and white Americans were the likeliest to report personal or family opioid addiction, but significant percentages of Black, Hispanic, urban and suburban families did, as well. White families were more likely than Black or Hispanic families to say that they had received treatment. Overdose fatality rates among Black Americans have climbed substantially in recent years, the Centers for Disease Control and Prevention found in a study last year.
    Dr. David Fiellin, an addiction physician at the Yale School of Medicine, said the survey showed the need for a stronger federal response to substance use disorders, akin to the one for AIDS. He said, “There’s often a misunderstanding of what treatment actually looks like and what it is—people often look to a quick fix,” he said, referring to a detox strategy. “Effective treatment tends to be much more long term and requires addressing the denial that can be part of the condition.”
    Read full story (paywalled)
    Source: New York Times, 15 August 2023
  18. Patient-Safety-Learning
    Adult transgender clinics in England are facing a Cass-style inquiry into how they treat patients after whistleblowers raised concerns about the care they provide.
    NHS England has announced that it is setting up a review of how the seven specialist services operate and deliver care after past and present staff shared misgivings privately during a previous investigation.
    As a first step, NHS England will send “external quality improvement experts” into each of the clinics to gather evidence about how they care for patients, to help guide the inquiry’s direction.
    The move follows the publication on Wednesday of a landmark review by Dr Hilary Cass, a former president of the Royal College of Paediatrics and Child Health, which recommended sweeping changes in the way that the health service treats under-18s who are unsure about their gender identity.
    In a letter responding to Cass’s report, which NHS England sent on Tuesday to the seven trusts that host adult gender dysphoria clinics (GDCs), it told them: “We will be launching a review into the operation and delivery of the adult GDCs, alongside the planned review of the adult gender dysphoria service specification.”
    Robbie de Santos, director of campaigns and human rights at Stonewall, an LGBT rights charity, said: “Gender healthcare for adults in the UK is, simply put, not fit for purpose. Many trans adults are being forced to go private at great personal expense to avoid waiting lists in excess of half a decade. We would welcome a review aimed at tackling this unacceptable state of affairs and building capacity into the system.”
    Read full story
    Source: Guardian, 10 April 2024
  19. Patient-Safety-Learning
    An agency providing last-minute freelance nurses to NHS hospitals is routinely charging up to £2,000 a shift, BBC News has discovered.
    Glen Burley, chief executive of an NHS trust, said that Thornbury Nursing Services is targeting areas in England where nurses are in short supply. He says it is "profiteering" from an overstretched NHS, but Thornbury says it offers a valuable, flexible service.
    The government says new measures will end the use of expensive agencies. However, Labour has said the high costs are a result of the "Conservatives' failure to train enough nurses over the past 14 years".
    Under NHS rules, hospital managers are obliged to use staffing agencies that work within an agreed framework, with a limit or cap on how much should be paid. But when last-minute essential cover is needed, trusts may use off-framework agencies, such as Thornbury. These are not legally obliged to abide by pre-agreed pay scales.
    Workload pressures in the NHS and a desire for more flexibility over shifts are thought to be driving more nurses to work for such agencies, which tend to pay the people on their books more while also taking a payment for themselves.
    BBC News has discovered Thornbury charges almost £2,000 for a 12-hour bank holiday shift by a specialist paediatric nurse - an area of expertise where there are known staff shortages. Of that, BBC News calculates the nurse receives about £1,050 - meaning nearly £800 goes to the agency. 
    Read full story
    Source: BBC News, 8 May 2024
  20. 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)
  21. Patient-Safety-Learning
    The mother of a seven-year-old girl who died at Perth Children's Hospital says she pleaded with staff to help her daughter but was not taken seriously.
    Aishwarya Aswath died in April last year after attending the Perth Children's Hospital (PCH) with a high temperature and cold hands.
    The Perth Coroner's Court on Wednesday heard a statement from Aishwarya's mother Prasitha Sasidharan, who described how she grew increasingly worried about her daughter while in the hospital waiting room. She approached staff five times while they were in the waiting room for almost two hours. "I feel like I was ignored and not taken seriously," she said. The court heard from both parents on Wednesday, the start of an eight-day inquest. After Aishwarya died her father wanted to hold her but was only allowed to do so for a brief time. In his statement, read to the court, he said there were "many missed opportunities to save her."
    Former PCH chief executive Aresh Anwar said the hospital was grappling with a rise in mental health presentations and a shortage of staff when Aishwarya died.
    Read full story
    Source: ABC News (24 August 2022)
  22. Patient-Safety-Learning
    In this article, an Alabama doctor describes how her unvaccinated patients are dying from Covid-19. 
    Dr Brytney Cobia, a hospitalist at Grandview Medical Center in Birmingham said in a Facebook post on Sunday, “I’m admitting young healthy people to the hospital with very serious COVID infections. One of the last things they do before they’re intubated is beg me for the vaccine. I hold their hand and tell them that I’m sorry, but it’s too late.”
    Read full story.
    Source: Advance Local, 21 July 2021
  23. 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)
  24. Patient-Safety-Learning
    The Care Quality Commission (CQC) has sounded the alarm over a “concerning decline” in women’s experiences with maternity services.
    Fewer women feel they always got the help they needed during labour and birth, many were disappointed at the amount of time their partners could stay with them after the delivery of their babies, and a significant number reported that they did not feel listened to when they raised concerns.
    The CQC said it has noticed a “deterioration” over the last five years in the ratings women gave their care. 
    It came as a major new national poll showed a “statistically significant downward trend” on most measures examined to track maternity care across the country. In particular, concerns were raised about staff availability, confidence and trust, as well as kindness and understanding of staff. Ratings also tumbled for whether women felt they had been treated with dignity and respect, the amount of information provided to mothers, and their concerns about being listened to.
    Victoria Vallance, from the CQC, said: “These results show that far too many women feel their care could have been better. This reflects the increasing pressures on frontline staff as they continue in their efforts to provide high-quality maternity care with the resources available.”
    Read full story
    Source: The Guardian, 11 January 2023
  25. 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
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