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Patient-Safety-Learning

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News posted by Patient-Safety-Learning

  1. Patient-Safety-Learning
    A health board has been fined £180,000 for failing to protect a vulnerable pensioner who died after repeatedly falling in hospital. Colin Lloyd, 78, was assessed as posing a high risk of falling and required one-to-one care after being admitted to Raigmore Hospital in Inverness.
    Despite repeated requests for more nursing staff none were made available and the pensioner suffered falls on the ward, which caused fatal injuries.
    Fiona Hogg, NHS Highland’s director of people and culture, said: “We are deeply sorry for the failures identified in our care. Our internal review following the incident identified several areas of improvement and we have made a number of changes to our practice.”
    Read full story (paywalled)
    Source: The Times, 15 February 2023
  2. Patient-Safety-Learning
    The number of GPs seeing patients outside standard surgery hours in Scotland has dropped by almost a quarter in three years.
    Nurses and paramedics have had to fill in for doctors in the out-of-hours urgent care centres because GPs could not be found to cover the shifts. Some health boards have had to close their centres and send patients to overstretched A&Es instead because of the GP shortage.
    Dr Andrew Buist, chairman of the British Medical Association’s Scottish GP committee, said, “Patient demand is outstripping GP capacity across the whole service, including out-of-hours. We simply do not have enough GPs in Scotland. Those who are working in out-of-hours may be doing more hours now than they perhaps did in 2019 which comes as no surprise if there are fewer GPs to go around but it is unsustainable and puts those working in the service at risk of exhaustion and burnout.”
    Read full story (paywalled)
    Source: The Times, 15 February 2023
  3. Patient-Safety-Learning
    Healthcare leaders have been warned by nearly 200 doctors that plans to give more work to private hospitals will “drain” money and staff away from NHS services, leaving the most ill patients at risk.
    In a letter seen by The Independent, almost 200 ophthalmologists urged NHS leaders to rethink plans to contract cataract services to private sector hospitals, as to do so “drains money away from patient care into private pockets as well as poaching staff trained in the NHS”. The doctors have called for “urgent action” to stop a new contract from being released, which would allow private sector hospitals to take over more cataract services.
    Professor Ben Burton, consultant ophthalmologist and one of the lead signatories of the letter, said, “What is needed is a long-term sustainable solution rather than a knee-jerk reaction which risks the future of ophthalmology as an NHS service. The long-term solution will be achieved by investing in NHS providers to deliver modern, efficient care, and the private sector only used as a last resort.”
    Read full story
    Source: The Independent, 10 February 2023
  4. 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
  5. Patient-Safety-Learning
    Around half of the largest trusts are not buying all their electricity from renewable sources despite a national requirement to do so, as prices of this type of energy rocket.
    NHS England previously committed to the service purchasing only renewable energy from April 2021, as part of efforts to meet its target to be net zero for emissions it can control–including electricity–by 2040.
    However, NHSE information seen by HSJ shows that nine of the largest 20 trusts have not been buying 100 per cent renewable electricity this financial year, amid soaring costs. Several trusts told HSJ they had abandoned previous decisions to only use electricity which was “guaranteed” to be renewable.
    Read full story (paywalled)
    Source: HSJ, 15 February 2023
  6. Patient-Safety-Learning
    A Conservative MP has blamed “far too many overpaid and utterly useless senior managers” for what he described as the “shambles of the NHS.”
    Philip Davies, MP for Shipley in Yorkshire, said in an email that the NHS is “appallingly run”, with many senior managers “who wouldn’t be able to get a similar job in the private sector.”
    He claimed the NHS “shambles” “is not a problem created by the government,” as “the government’s job is to fund that NHS,” while running the services is done by NHS England and individual trusts.
    However, recent analysis indicates that managers make up just 2 per cent of the NHS workforce, compared with 9.5 per cent of the UK workforce. NHS Confederation has said the NHS is “as a whole under, not over, managed,” despite “persistent and misleading media headlines.”
    Read full story (paywalled)
    Source: HSJ, 16 January 2023
  7. Patient-Safety-Learning
    Prostate cancer patients across the UK face a “postcode lottery” of care, a charity has warned, with men in Scotland almost three times more likely to be diagnosed at a late stage compared with men in London.
    Prostate Cancer UK said the proportion diagnosed when the disease may be too advanced to treat varied hugely depending on where patients lived. Health leaders called the findings “shocking”. In Scotland, more than a third (35%) of men are only diagnosed when the disease is classed as stage 4, meaning the cancer has spread to another part of the body – known as metastatic cancer. In London, the figure is 12.5%.
    Chiara De Biase, director of support and influencing at Prostate Cancer UK, said, "We can’t say for sure what’s behind this gap in diagnosis, but it’s clear that men are more likely to be diagnosed at an earlier stage in areas with higher rates of PSA blood testing. That means the key way to tackle this is by raising awareness – especially in places like Scotland which are worst-affected."
    Read full story
    Source: The Guardian, 12 January 2023
  8. Patient-Safety-Learning
    A senior doctor has told Scottish ministers to drop “patient-blaming language” over “unnecessary attendances” at emergency departments.
    Lailah Peel, the deputy chairwoman of the British Medical Association in Scotland, said the phrase suggested that patients were responsible for the problems and showed a misunderstanding of the issues.
    Patients have waited 30 hours for beds in overcrowded A&E units while ambulances have queued outside hospitals waiting to hand over patients to overstretched staff.
    Sturgeon, announcing measures to ease the strain, said: “To reduce the pressures in hospital and the knock-on impacts at the front door we need to do more firstly to avoid unnecessary attendances at hospital and second to speed up the discharge of patients from hospital.”
    Read full story (paywalled)
    Source: The Times, 12 January 2023
  9. Patient-Safety-Learning
    Some hospitals in Scotland have been told to postpone surgeries to ‘decongest’ the system as the crisis in the health service deepens.
    A group of NHS hospitals has stopped routine surgery for three weeks in an unprecedented step, as pressures mount on the health service. Health bosses at the NHS Ayrshire & Arran trust warned of “extremely high demand” across the system, as they also asked GPs to see only urgent cases.
    Rishi Sunak has repeatedly urged trusts to avoid cancelling elective surgery, urging hospitals not to repeat the errors made in the pandemic, which resulted in record backlogs.
    Clare Burden, the chief executive of NHS Ayrshire & Arran, said the cancellations were necessary "due to a combination of staff absence across the system, high bed occupancy levels in our acute and community hospitals, high levels of flu and Covid in our community, some delayed transfers of care, and high volumes of frail patients whose recovery includes complex care.”
    Read full story (paywalled)
    Source: The Telegraph, 11 January 2023
  10. Patient-Safety-Learning
    Trusts have been told today by NHS England that they must book appointments by the end of this month for all patients who have been waiting longer than 78 weeks. A letter from NHS England sent to trust leaders set out the new orders and represents system leaders’ attempt to ramp up progress on this cohort of patients, which the NHS and government elective recovery plan commits to eliminating by March.
    The appointments must be issued this month, and be dated before the end of March, for these pathways, of which about 48,000 are recorded nationally. The letter also warns trusts that, while NHSE will accept some inpatient cancellations are unavoidable, cancelling outpatient appointments — even during strike action — is viewed as less acceptable.
    Read full story (paywalled)
    Source: HSJ, 12 January 2023
  11. Patient-Safety-Learning
    Ambulance bosses have apologised to the family of a man who died after he had a heart attack but no ambulance came.
    Martin Clark, 68, started suffering with chest pains at his home in East Sussex on 18 November - before any strike action started in the NHS.
    His family rang three times for an ambulance and after waiting 45 minutes drove him in their car to hospital. When they arrived, the father of five went into cardiac arrest and, despite receiving medical attention, died.
    Dr Sonya Babu-Narayan of the British Heart Foundation (BHF), said cases such as the Clarks' were "incredibly distressing".
    "The difference between life and death can be a matter of minutes when someone is having a heart attack or stroke," she said. "Extreme delays to emergency heart and stroke care cannot become a new normal. Healthcare staff are doing all they can—but there aren't enough of them and many will be working in difficult conditions without fit-for-purpose facilities."
    Read full story
    Source: BBC News
  12. Patient-Safety-Learning
    No new Ebola infections have been detected in Uganda for 42 days, and so on Wednesday, the World Health Organization and the Ugandan Ministry of Health officially declared that the country’s most recent outbreak of the deadly virus is at an end.
    Since the outbreak was officially recognised on September 20, 164 people have had confirmed or probable Ebola infections; there 55 deaths confirmed by lab testing, with another 22 deaths suspected of being caused by the virus.
    Those who have recovered from the virus will receive ongoing support and will be closely monitored to help scientists understand the long term impacts of the Sudan strain of the virus, for which there are currently no treatment or prevention options.
    The Ugandan government has also set a goal of finally identifying the animal reservoir for Ebola.
    Read full story
    Source: CNN, 11 January 2023
  13. Patient-Safety-Learning
    An inspection of a hospital has found all wards were understaffed, while ‘tearful [and] exhausted’ clinicians raised patient safety concerns to the Care Quality Commission (CQC).
    The CQC’s visit to Colchester hospital, run by East Suffolk and North East Essex Foundation Trust, also found patients going unfed because of low staffing ratios and patient confidentiality concerns.
    The concerns were raised in a letter sent by the CQC to the trust, which also runs Ipswich hospital, ahead of publication of an inspection report for older people’s medical services, which is due later this month.
    The CQC’s letter, published in board papers for a meeting on Thursday, said: “All wards’ actual staffing levels and skill mix meant staff were often overstretched. All staff we spoke with expressed concern about the impact on patient care and personal wellbeing. Some staff we spoke with were tearful, reported feeling exhausted and concerned that they were unable to care for patients well enough to keep them safe.”
    The letter also said significant positives were found. Inspectors “found staff to be welcoming, hardworking and supportive of each other… We found staff at all levels working together with the aim of putting the patients first and providing a safe and effective service”.
    Read full story (paywalled)
    Source: HSJ, 11 January 2023
  14. 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
  15. Patient-Safety-Learning
    Black patients wait up to six months longer for an organ transplant than the general population, new NHS data shows.
    The best match comes from someone of the same ethnicity - but only 2% of donors in 2021/22 were black, while black people are 4% of the population.
    Black families are also less likely to agree to organ donation than white families, the figures show. The NHS says there's an "urgent need" for more people from ethnic minorities to donate.
    Winnie Andango from NHS Blood and Transplant said, "Black people wait longer because there's less people coming forward to give their organs from their ethnic group. During covid, so many patients were suspended but those have been added back onto the list, and that means if we had less organs for this ethnic minority group, we have even less right now."
    Health Minister Neil O'Brien said: "We need more people, especially those from black and Asian heritage, to register their organ donation decision and share it with their family so loved ones can follow their wishes."
    Read full story
    Source: BBC News, 12 January 2023
  16. Patient-Safety-Learning
    An investigation by The Independent has revealed that the number of patients waiting more than 12 hours in A&E for treatment has exceeded 50,000 a week for the first time.
    Leaked NHS data shows that last month as many as one in eight patients faced a “trolley wait”—the time between attending A&E and being admitted—longer than 12 hours, as the health service comes under ever greater strain.
    Sources across the country told The Independent that hospitals are having to “squeeze” patients into spaces other than normal wards or A&E, with no direct oxygen lines. Meanwhile patients wait for hours in ambulances outside emergency departments.
    Read full story
    Source: The Independent, 11 January 2023
  17. Patient-Safety-Learning
    The UK's health system is buckling under the weight of staff shortages and a lack of beds. In France, meanwhile, there are more doctors and many more nurses, yet its healthcare system is still in crisis.
    President Emmanuel Macron has promised to change the way its hospitals are funded, and to free doctors from time-consuming administration, in a bid to break what he called a "sense of endless crisis" in its health service.
    A series of eye-catching measures over the past few years - such as signing-up bonuses of €50,000 (£44,000) for GPs in under-served areas, and ending a cap on the number of medical students in France - have failed to plug healthcare gaps. 
    Some hospitals are reporting up to 90% of their staff on "sick leave protest" at the conditions. And France's second-largest health union has called an "unlimited walkout" this week, following a fortnight of strikes by French GPs.
    Guillaume Garot, a Socialist MP leading a cross-party bill to tackle the problem of medical deserts, said, "Eight million French people live in a medical desert, and six million don't have an attending doctor," he says. "It takes six months, on average, to find an appointment in my department of Mayenne; in Paris it takes two hours."
    Read full story
    Source: BBC News, 12 January 2023
  18. Patient-Safety-Learning
    Five million children worldwide died before their fifth birthday in 2021, with almost half (47%) dying during their first month, according to new UN figures.
    Most of the deaths could have been prevented with better healthcare, say campaigners, adding that deaths among newborn babies haven’t reduced significantly since 2017.
    Children born in sub-Saharan Africa are 15 times more likely to die in childhood than children in Europe and North America.
    UN figures also show that 1.9 million babies were stillborn during 2021, more than three-quarters (77%) in sub-Saharan Africa and in south Asia. The risk of a woman having a stillborn baby in sub-Saharan Africa is seven times greater than for women in Europe and North America.
    Read full story
    Source: The Guardian, 10 January 2022
  19. Patient-Safety-Learning
    Patients have suffered cardiac and respiratory arrests because of errors using oxygen cylinders, NHS England has warned, citing more people being cared for in “areas without access to medical gas pipeline systems” such as corridors and ambulances queuing outside A&E.
    A patient safety alert issued by NHS England today identifies 120 incidents in the past year related to oxygen cylinder use, including cylinders either being empty at point of use, not switched on, inappropriately transported, or inappropriately secured. 
    Some of the incidents involved “compromised oxygen delivery to the patient, leading to serious deterioration and cardiac or respiratory arrest” the alert said, and at least 43 caused harm.
    Read full story (paywalled)
    Source: HSJ, 10 January 2023
  20. Patient-Safety-Learning
    Novel strains of the coronavirus are creating new health concerns around the world as fresh descendants of the highly-transmissible Omicron variant now make up 40 per cent of cases in the US.
    The two strains, XBB and XBB.1.5 have seen a surge in cases in countries worldwide. The World Health Organisation has warned the new and “recombinant” Covid variant XBB.1.5 is the “most transmissible yet.” It has been nicknamed 'Kraken' on social media.
    XBB.1.5 has now been found in 25 countries and is a mutated version of Omicron XBB, which was first found in India in August. XBB can get past the body’s immune system and XBB.1.5 is just as able at doing so. It is also better at “binding” to cells, so it can spread with much more ease. Whether or not the so-called Kraken will trigger a new Covid surge in the UK remains to be seen, but reports suggests that a rise in cases may well be seen.
    Read full story
    Source: Independent, 11 January 2023
  21. Patient-Safety-Learning
    A record number of people in England are waiting longer than ever for cancer treatment, as the total waiting more than three months surpassed 12,000 for the first time.
    More than 4% of the 287,000 people on cancer waiting lists had waited more than 104 days to receive treatment after diagnosis, despite 2,000 of those being considered urgent patients, according to NHS England figures for the week ending on 1 January, seen by Health Service Journal.
    Michelle Mitchell, Cancer Research UK’s chief executive, said that missing waiting time targets–which have not been fully met since December 2015–was “unacceptable when a matter of weeks can be enough for some cancers to progress”. She called on the government to publish an “ambitious and fully funded” 10-year cancer plan. “Only then will we see significant improvements in early diagnosis and survival,” she said.
    Read full story
    Source: The Guardian
  22. Patient-Safety-Learning
    A “most accomplished fraudster” was paid between £1m and £1.3m by the NHS during the nearly two decades she posed as a qualified doctor after forging a degree certificate, a court has heard.
    Zholia Alemi, believed to be 60 years old, worked as a psychiatrist in the UK for 19 years after claiming to have qualified at the University of Auckland in New Zealand, a trial at Manchester crown court heard. The defendant is accused of 20 offences, including forgery and fraud, which she denies.
    The jury heard Alemi’s case was that she was appropriately qualified and documents demonstrating her qualifications were genuine.
    She denies 13 counts of fraud, three counts of obtaining a pecuniary advantage by deception, two counts of forgery and two counts of using a false instrument.
    Read full story
    Source: The Guardian (paywalled)
  23. Patient-Safety-Learning
    More than 650,000 deaths were registered in the UK in 2022 - 9% more than 2019. This represents one of the largest excess death levels outside the pandemic in 50 years.
    Though far below peak pandemic levels, it has prompted questions about why more people are still dying than normal. Data indicates pandemic effects on health and NHS pressures are among the leading explanations.
    Although the ongoing impact of the pandemic is a contributing factor, a number of doctors are blaming the wider crisis in the NHS. On 1 January 2023, the president of the Royal College of Emergency Medicine suggested the crisis in urgent care could be causing "300-500 deaths a week".
    Read full story
    Source: BBC News, 10 January 2023
  24. 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
  25. Patient-Safety-Learning
    Ambulance staff will take part in their second day of strike action this winter on Wednesday 11 January. Alongside paramedics, call-centre staff will walk out across England and Wales in the dispute over pay. These workers play a vital role, taking calls from the public and assigning ambulance crews.
    An ambulance dispatcher at the North West Ambulance Service, who wishes to stay anonymous, has described working amid the extreme pressures of this winter. They said, "The thought of going in and having to manage those calls just fills me with absolute dread. I have seen people leave the ambulance service - they have had enough. We are physically and mentally exhausted."
    Most frustrating, the dispatcher says, is the number of crews stuck outside hospital waiting to hand patients over to accident-and-emergency staff. In the last week of 2022, more than 40% of crews in England had waits of more than 30 minutes - it should take 15.
    Read full story
    Source: BBC News, 10 January 2023
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