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Patient-Safety-Learning

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  1. Patient-Safety-Learning
    A new report commissioned by the House of Commons finds NHS staff and social care workers are suffering from burnout at 'emergency levels'. The report has said problems with burnout among the NHS and care staff already existed but was increased due to the Covid-19 pandemic. 
    Staff shortages have been indicated as one of the causes of burnout as the work days became longer and the pressure on staff grew. It was also found that staff felt overwhelmed after lockdown ended as patients who had not been to see their GP during lockdown were now coming in with an array of health problems. NHS and care staff felt insufficiently equipped to deal with the incoming patients due to a lack of proper staffing support in the workforce. 
    Read the full story
    Read the full report here
     
    Source: BBC News, 8 June 2021
  2. Patient-Safety-Learning
    Eighteen more hospitals in England contain potentially crumbling concrete, bring the total affected to 42, the Department of Health has confirmed.
    The reinforced autoclaved aerated concrete (Raac) has also been found in 214 schools and colleges in England as well as thousands of other buildings. NHS Providers, which represents hospitals, said the concrete "puts patients and staff at risk".
    Full structural surveys are taking place at all newly confirmed sites. The government said it was committed to eradicating Raac from NHS buildings completely by 2035. Seven of the worst-affected hospitals will be replaced by 2030 as part of the programme to build 40 new hospitals in England, it added.
    Sir Julian Hartley, chief executive of NHS Providers, said there had been fears that more of the material would be found following surveys of NHS buildings. "Trusts are doing everything they can, at huge cost, to keep patients safe where this concrete is found," he said.
    Read full story
    Source: BBC News, 21 October 2023
  3. Patient-Safety-Learning
    A mother of two prescribed antidepressants after complaining of fatigue was devastated when she learned she had stage four bowel cancer and had just nine months to live.
    Helen Canning complained of anaemia and low energy for more than a year, but as a 37-year-old with two children under the age of five, her symptoms were put down to prolonged postnatal depression and work stress.
    “At the end of the school day, I’d sit at my desk and lose half an hour of my time just sitting and staring,” the A-level science teacher from Suffolk said. “I was so tired. Then I would get even more stressed because I was getting behind on my work.”
    She went to the GP because she was concerned about her symptoms. Despite being told her iron was low, she said she was never offered a blood test to investigate this further. As well as prescribing antidepressants, the GP referred her to a gynaecologist for an ultrasound scan on her left side in December 2020, but the scan did not detect anything.
    But less than a year later in August 2021, she was diagnosed with bowel cancer after she was rushed into A&E with a “crippling, stabbing pain” and violent vomiting, the night before her ninth wedding anniversary. She was told she had advanced colorectal cancer, a primary tumour in the right side of her colon, with secondary growths on her ovaries, liver, and peritoneum.
    Though Mrs Canning was given only nine months to live after her diagnosis, the mother of two leaned on her family for strength as she started chemotherapy. It has now been over two years and she continues to fight. Now she is determined to raise awareness of the common signs and symptoms of bowel cancer, and urges people to “know their own ‘normal’ and not be afraid to keep pushing for further testing and answers when doctors don’t”.
    Read full story
    Source: Independent, 22 October 2023
  4. Patient-Safety-Learning
    More support is needed to prevent babies and young children developing mental health problems in later life, leading doctors say.
    Their report shows there is growing evidence that intervening very early on - from conception to the age of five - may help stop conditions arising or worsening. The Royal College of Psychiatrists is calling for more specialist services. The government says the mental health of children and parents is paramount.
    Officials say they are investing more in expanding NHS services, alongside funding programmes designed to support children and caregivers.
    NHS data shows about 5% of two to four-year-olds struggle with anxiety, behavioural disorders and neurodevelopmental conditions including ADHD.
    The Royal College of Psychiatrists' report suggests half of mental health conditions arise by the age of 14, and many start to develop in the first years of life, making early action "vital".
    Dr Trudi Seneviratne, from the Royal College of Psychiatrists (RCPsych), said the majority of under-fives with mental health conditions were not receiving the level of support needed "to help them become productive, functioning adults and reach their full potential. The period from conception to five is essential in securing the healthy development of children into adulthood. Unfortunately, these years are often not given the importance they should be, and many people are unaware of what signs they should be looking out for. Parents, carers and society as a whole have a critical role to play. This includes securing positive relationships and a nurturing environment that supports the building blocks of a child's social, emotional and cognitive development."
    Read the RCPsych report Infant and early childhood mental health: the case for action
    Read full story
    Source: BBC News, 21 October 2023
  5. Patient-Safety-Learning
    The Gaza Strip’s health-care system stands on the brink of collapse as bombings damage hospitals and ambulances and as generators run out of fuel, highlighting how quality medical care is a casualty of war.
    Dire scenarios await Gaza’s medical professionals. They face dwindling basic resources such as power, water and anesthesia, compelling doctors to confront wrenching decisions on whose lives to save. The growing humanitarian crisis is plunging health-care workers into the critical emergency planning that follows both human-made and natural disasters — assessing staffing and other resources, managing existing health needs on top of gruesome new ones, and looking out for their own welfare.
    “When we are in a disaster setting or conflict, we usually have more patients than resources. We have to be very creative to be able to provide the best care for the most number of people,” said Lindsey Ryan Martin, who is director of global disaster response and humanitarian action at Massachusetts General Hospital in Boston and has been monitoring the situation in Gaza.
    The health-care crisis extends beyond Tuesday’s deadly blast at al-Ahli Hospital in Gaza City. Aid organizations say the war continues to imperil an already beleaguered health-care system.
    Gaza’s Health Ministry said five hospitals were out of service as of Thursday and an additional 14 health facilities have closed because they lack fuel and electricity.
    Read full story
    Source: The Washington Post, 19 October 2023
     
  6. Patient-Safety-Learning
    The drive to cut NHS waiting lists are becoming ‘disproportionately reliant’ on the private sector, experts have warned, as new data suggests rapid growth in the elective activity carried out by non-NHS providers.
    Internal figures for activity commissioned by integrated care boards and NHS England, seen by HSJ, suggests the value-weighted activity carried out by private providers has increased by around 30 per cent on pre-covid levels. The value-weighted elective activity carried out by NHS providers rose by just three per cent over the same three-month period, from April to June 2023.
    The figures relate to activity measured under the “elective recovery fund”, which accounts for the bulk of elective activity. NHSE said it was right to make use of “all available capacity” to treat long-waiters. However, experts said the NHS would struggle to bring down waiting lists without significantly increasing the amount of elective work it did.
    Waiting list analyst Rob Findlay said independent sector outsourcing was “not genuine backlog clearance, but a way of plugging some of the recurring shortfall in core NHS capacity.”
    Read full story (paywalled)
    Source: HSJ, 23 October 2023
  7. Patient-Safety-Learning
    The Health Services Safety Investigation Branch has been accused of taking “divisive potshots” at NHS finance directors.
    Speaking at an event to mark the watchdog becoming an independent body, HSSIB chief investigator Rosie Benneyworth said: “We need a position where finance directors in every organisation are as responsible for safety as the person leading the safety agenda and vice versa… Often you see the finance director and safety lead don’t work effectively together and we need to change that.”
    Dr Benneyworth said progress on safety would not be made unless it was tackled “in the same breath” as operational and financial matters.
    In response, the Healthcare Financial Management Association said Ms Bennyworth’s views had “incensed” its members.
    Commenting below the story, HFMA chief executive Mark Knight said: “I have been contacted by a number of finance directors who are incensed by the comments in this article. To gain a fuller picture of the views of the newly created HSSIB we will be asking for a meeting with Dr Benneyworth and [HSSIB chair Ted] Baker. The HFMA would like to understand the evidence on which the assertions in the article are based, which are completely at odds with how I know the vast majority of finance directors and their teams behave.”
    Read full story (paywalled)
    Source: HSJ, 23 October 2023
  8. Patient-Safety-Learning
    An ambulance spent 28 hours outside a hospital after an "extraordinary incident" was declared due to delays.
    The Welsh Ambulance Service said 16 ambulances had waited outside the emergency department at Morriston Hospital, Swansea, at one time.
    It said multiple sites across Wales were affected, "specifically" in the Swansea Bay health board area.
    Lee Brooks, director of operations, told BBC Radio Wales Breakfast the situation was "heart-breaking".
    The service said people should only call 999 if their emergency was "life or limb threatening".
    Judith Bryce, assistant director of operations at the Welsh Ambulance Service, said on Sunday the service was experiencing "patient handover delays outside of emergency departments. This is taking its toll on our ability to respond within the community."
    Read full story
    Source: BBC News, 23 October 2023
  9. Patient-Safety-Learning
    A 25-year-old who died from a heart haemorrhage after being diagnosed with a panic attack had been seen by a non-medical school trained physician associate (PA) but not a doctor, it has emerged.
    Ben Peters, 25, attended the emergency department at Manchester Royal Infirmary on the morning of 11 Nov 2022 with chest pain, arm ache, a sore throat and shortness of breath.
    While waiting, he endured a “severe episode of vomiting”.
    Peters was diagnosed with a panic attack and gastric inflammation by the PA and sent home with two medications, after a supervising consultant, who the coroner found never reviewed the patient in person, agreed with the diagnosis.
    Less than 24 hours later, Peters died from a rare complication of the heart that had resulted in a tear of the heart’s major artery, known as aortic dissection, and led to a fatal haemorrhage.
    The Aortic Dissection Charitable Trust (TADCT) says around 2,000 people in Britain die from the condition each year, which can be “reliably diagnosed or excluded” using a CT scan, but “misdiagnosis affects one-third of patients”.
    A prevention of future deaths notice issued by Chris Morris, the area coroner for Greater Manchester South, written to Manchester University Foundation Trust, said: “It is a matter of concern that despite the patient’s reported symptoms, in view of his age and extensive family history of cardiac problems, Mr Peters was discharged from the Ambulatory Care Unit without being examined or reviewed in person by a doctor."
    Read full story
    Source: The Telegraph, 21 October 2023
  10. Patient-Safety-Learning
    An inquest jury has found there were “gross failings in care amounting to neglect” before a woman had a heart attack at a private mental health hospital due to complications from drinking excessive amounts of water.
    Lillian Lucas, 28, known as Lily to her family and friends, died in September 2022 after being found unresponsive in her room on Milton ward at the Cygnet hospital in Kewstoke, near Weston-super-Mare, where she had been an inpatient since June.
    An inquest jury at Avon coroner’s court found on Wednesday that opportunities were missed by staff to render care that would have prevented Lucas’s death, including a failure to monitor her worsening condition and inadequate response to her deterioration.
    On 8 September 2022 she was found unresponsive in her room after drinking excessive amounts of water and transferred to Bristol Royal Infirmary (BRI), the jury heard. She died the following day. Postmortem examinations found she died of a heart attack and the impact of psychogenic polydipsia, when due to a mental disorder a person experiences an uncontrollable urge to drink water.
    The jury concluded on Wednesday that there were “gross failings in her care amounting to neglect”. In the record of the inquest, the jury said the Milton ward was “understaffed at a level deemed to be unsafe”.
    Read full story
    Source: Guardian, 24 April 2024
  11. Patient-Safety-Learning
    Hundreds of breast cancer patients have travelled more than 100 miles for diagnosis and treatment after waiting times soared at another health board because of staffing shortages.
    NHS Grampian, which previously received NHS Tayside patients because of staffing problems in Dundee, is now sending its own cases to Larbert, near Falkirk, because its breast cancer department can no longer cope.
    About 520 people from the Aberdeen area urgently referred to hospital with breast cancer symptoms have travelled to the Forth Valley Royal Hospital for diagnosis with some going on to receive their treatment miles away from home. It is anticipated that at least another 330 Grampian patients will be sent to Forth Valley while the waiting lists are brought under control in Aberdeen.
    Read full story (paywalled)
    Source: The Times, 2 May 2024
  12. Patient-Safety-Learning
    A health system has stopped sending mental health patients to the country’s largest single provider of out-of-area placements.
    Southern Hill Hospital in Norfolk provided more than 18,000 bed days classed as OAPs for NHS patients last year, with Greater Manchester Integrated Care System (GM) being the main contributor to that total.
    However, HSJ has learned that GM’s integrated care board and mental health providers have decided not to send any more patients to the provider.
    The move comes after a recent visit to and review of the service at Southern Hill by GM commissioners. This, in turn, followed concerns about the “co-ordination” of patient care at Southern Hill received by GM. The exact nature of the concerns is unclear, and the ICB said in a statement “no significant safety or quality concerns were found and feedback from patients was positive,” when it carried out its review.
    The ICB said the decision to cease placements at Southern Hill shortly after the concerns were raised was a coincidence, and that the move was part of its strategy to reduce OAPs.
    Read full story (paywalled)
    Source: HSJ, 2 May 2024
  13. Patient-Safety-Learning
    A 15-year-old child was prescribed dangerous levels of hormones by an unregulated online clinic without speaking to a doctor, a court ruling has revealed.
    Now 16, the teenager, known as J, was born female but identifies as a boy and has an autism diagnosis.
    J got a prescription for testosterone and puberty blockers from Singapore-registered GenderGP in late 2022. He had previously been unable to get the treatment through the NHS.
    Judge Sir Andrew McFarlane said: "There must be very significant concern about the prospect of a young person such as J accessing cross-hormone treatment from any off-shore, online, unregulated private clinic."
    The judgement highlights the lack of NHS gender services for children and young people in England and Wales, after the closure of the Tavistock Gender Identity and Development Service (Gids) in April. Gids, rated as "inadequate" by inspectors in 2021, was the only specialist gender clinic for children and young people in the two countries. The judgement says that, as a result: "There is no relevant NHS service available for J."
    Although the prescription was from a private doctor, J was given injections of testosterone by his local NHS GP every six weeks between January and August 2023. 
    An expert witness in the case, Australia-based consultant paediatric endocrinologist Dr Jacqueline Hewitt, was critical of the lack of physical and psychological checks carried out by GenderGP on J. Dr Hewitt also raised concerns about the size of the doses of testosterone given to J, describing the level of the hormone in his blood during his treatment as "dangerously high".
    Read full story
    Source: BBC News, 2 May 2024
  14. Patient-Safety-Learning
    An acute trust chief executive has warned that his organisation will struggle to “provide high-quality, timely, and financially affordable care” over the winter.
    The alert was contained in a message from University Hospitals of Leicester Trust CEO Richard Mitchell to the trust’s system partners.
    The large trust is among the worst performers against the four-hour accident and emergency target in England, and its emergency care pathway costs are already driving a deterioration in its financial deficit before the winter period.
    He wrote: “I am extremely concerned about our ability to provide high-quality, timely, and financially affordable care to patients this year.” Stressing the urgency of the issue, Mr Mitchell added: “There are 48 days until the start of the NHS winter (1 October) and 145 days until Monday 6 January 2025, which is likely to be the most difficult day of the period.”
    Speaking to HSJ, the UHL CEO said: “The UEC pathway is our greatest financial risk at UHL and any growth in demand has a negative impact on our financial position. Providing safe and effective patient care is our priority, and we were stretched to the limit in delivering that last winter. While the industrial action context has changed, and we have plans in place to improve flow and capacity, the overall picture is not different enough to alter our assessment that this year will be incredibly tough again. We need to be honest with our stakeholders and communities about that challenge.”
    Read full story (paywalled)
    Source: HSJ, 22 August 2024

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