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Patient-Safety-Learning

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News posted by Patient-Safety-Learning

  2. Patient-Safety-Learning
    Junior doctors across England will walk out for 72 hours in March if a ballot for industrial action is successful, the British Medical Association has told ministers.
    The BMA confirmed the move ahead of the opening of its ballot on Monday (9 January). The union is calling for real terms pay cuts over the past decade to be reversed, claiming the last 15 years have led to a 26 per cent decline in the value of junior doctors’ pay. 
    Robert Laurenson and Vivek Trivedi, co-chairs of the BMA’s junior doctors committee, said: “Pay erosion, exhaustion and despair are forcing junior doctors out of the NHS, pushing waiting lists even higher as patients suffer needlessly.”
    Read full story (paywalled)
    Source: HSJ, 8 January 2023
  3. Patient-Safety-Learning
    The government has ‘a week to 10 days’ to distribute the £200m it is committing to speed up hospital discharge if the initiative is to have a meaningful impact on reducing the 13,000 patients who are medically fit to leave hospital, national healthcare leaders have told HSJ.
    Health and social care secretary Steve Barclay announced this morning that the government was effectively reintroducing the national discharge scheme used to fund “short-term care placements” earlier in the covid pandemic, which was scrapped in April last year.
    NHS Confederation chief executive Matthew Taylor said: “We await the full details of the proposed hospital discharge fund with interest. Given the ongoing delay in distributing the delayed discharge fund announced last autumn any funds will need to be rapidly deployed.”
    Read full story (paywalled)
    Source: HSJ, 9 January 2023
  4. Patient-Safety-Learning
    TV presenter Dr Hilary Jones has blasted the Prime Minister over his handling of the NHS, warning it is at risk of collapse.
    Speaking on ITV’s Good Morning Britain, the GP shared the experiences of “heartbroken” frontline doctors and said if the situation “doesn’t change very quickly, the NHS is finished”.
    Dr Jones referred to a group chat between 13,000 doctors who work on the front line and in primary care, where members are sharing stories that show patients experiencing very long delays in receiving treatment. He described how staff are in tears at the end of their shift “and when they return to the next shift, the same patient is still waiting to be seen after 24 hours”.
    He added: “For Rishi Sunak and the Government to pretend that this is not a crisis when more than a dozen trusts have announced critical incidents is not only delusional, as the BMA say, I would say at the very best it’s ill-informed misjudgment, at the very worst it’s total irresponsibility and incompetence. I have never known anything like this.”
    Read full story
    Source: Independent, 5 January 2023
  5. Patient-Safety-Learning
    More than 100,000 people with type 1 diabetes in England are to be offered an artificial pancreas, which experts believe could become the “holy grail” for managing the disease.
    The groundbreaking device uses an algorithm to determine the amount of insulin that should be administered and reads blood sugar levels to keep them steady.
    A world-first trial on the NHS found it was more effective at managing diabetes than current devices and required far less input from patients. The device is now set to be rolled out across the NHS in England after it won approval from the National Institute for Health and Care Excellence (NICE).
    Prof Partha Kar, national specialty adviser for diabetes at NHS England, said: “This technology has been proven to give the best control for managing type 1 diabetes and should make things like amputations, blindness, and kidney problems possibly a thing of the past.”
    Read full story
    Source: The Guardian, 10 January 2023
  7. Patient-Safety-Learning
    Thousands of NHS patients in England will be moved into care homes as part of the government's plan to ease unprecedented pressure on hospitals.
    The NHS is being given £250m to buy thousands of beds in care homes and upgrade hospitals amid a winter crisis. The move aims to free up hospital beds so patients can be admitted more quickly from A&E to hospital wards.
    The plans will be included in an emergency package to be unveiled by Health Secretary Steve Barclay.
    Helen Whately, minister for care, said, "Getting people out of hospital on time is more important than ever. It's good for patients and it helps hospitals make space for those who need urgent care."
    Read full story
    Source: BBC News
  8. Patient-Safety-Learning
    Scarlet fever cases have surged by tenfold in a year, official data shows, as pharmacists grapple with a shortage of antibiotics during a Strep A outbreak. Strep A bacteria usually only causes mild illness, including scarlet fever and strep throat, which is treated with antibiotics. But in rare cases, it can progress into a potentially life-threatening disease if it gets into the bloodstream.
    Infections are higher than normal for this time of year, and at least nine children have died after contracting the bacteria in recent weeks. Pharmacists say they are struggling to get their hands on antibiotics to treat Strep A infections – despite the government insisting there is no shortage.
    “We are worried because we are having to turn patients away,” said Dr Leyla Hannbeck, the head of the Association of Multiple Pharmacies (AIMP).
    Read more
    Source: The Independent, 8 December 2022
  9. Patient-Safety-Learning
    The NHS should “urgently investigate” after Byline Times uncovered “disturbing” figures showing that more than 4,000 patients, visitors and NHS staff were raped or sexually assaulted in hospitals over the past four years, the Shadow Health and Social Care Secretary has said.
    An investigation by Byline Times has unearthed that 4,100 patients, visitors and NHS staff were raped (1,364) or sexually assaulted (at least 2,744) in a hospital setting between January 2019 and September 2022–with 633 raped or assaulted while on a hospital ward. At least three of the incidents were against a female child aged under 13. 
    Data from 31 police forces in England and Wales based on reported rapes and assaults revealed the scale of sexual violence within hospital settings, with victims including patients and staff members.
    Labour’s Shadow Health and Social Care Secretary Wes Streeting said, “Hospitals ought to be safe places for patients and staff, but these disturbing findings show that is not the case for far too many people. The NHS should urgently investigate why these disgusting crimes are allowed to happen and on such a widespread scale.”
    Read more
    Source: Byline Times, 5 December 2022
  10. Patient-Safety-Learning
    Covid is causing liver damage lasting months after infection, according to new research.
    Researchers at Massachusetts General Hospital, Boston, discovered Covid-positive patients had a “statistically significant” higher liver stiffness than the rest of the population.
    Liver stiffness could indicate long-term liver injury such as inflammation or fibrosis, the buildup of scar tissue in the liver.
    Dr Firouzeh Heidari a Research Fellow at Massachusetts General Hospital, said their findings show damage caused by Covid persists for a long time. She said, “Our study is part of emerging evidence that Covid-19 infection may lead to liver injury that lasts well after the acute illness. We don’t yet know if elevated liver stiffness observed after Covid-19 infection will lead to adverse patient outcomes.”
    Read more
    Source: The Independent, 4 December 2022
  11. Patient-Safety-Learning
    The NHS in Wales could move to a model in which most or all nursing care is outsourced to private companies, if its increasing reliance on agency staff continues, a union report has claimed.
    According to the Royal College of Nursing, the Welsh health service risks moving to a situation where it no longer directly employs staff to provide patient care. NHS Wales spent between £133m and £140m on agency nursing during 2021-22, based on different freedom of information (FOI) requests and official figures, the RCN’s report suggested.
    RCN Wales said, “If this trend continues, Wales will move to a situation where NHS Wales no longer directly employs staff to provide patient care and instead moves to a model in which most or all nursing care is outsourced to private companies.”
    Read more
    Source: Nursing Times, 4 December 2022
  12. Patient-Safety-Learning
    A new report by the World Health Organization shows evidence of a higher risk of premature death and illness among many persons with disabilities compared to others in the society. 
    The Global report on health equity for persons with disabilities published today shows that because of the systemic and persistent health inequities, many persons with disabilities face the risk of dying much earlier—even up to 20 years earlier—than persons without disabilities.
    They have an increased risk of developing chronic conditions, with up to double the risk of asthma, depression, diabetes, obesity, oral diseases, and stroke.  Many of the differences in health outcomes cannot be explained by the underlying health condition or impairment, but by avoidable, unfair and unjust factors.
    Read more
    Source: WHO, 2 December 2022
  13. Patient-Safety-Learning
    Whistleblowers at one of England's worst performing hospital trusts have said a climate of fear among staff is putting patients at risk.
    Former and current clinicians at University Hospitals Birmingham (UHB) NHS Trust allege they were punished by management for raising safety concerns, a BBC Newsnight investigation found. One insider said the trust was "a bit like the mafia."
    The trust said it took "patient safety very seriously." It said it had a "high reporting culture of incidents" to ensure accountability and learning.
    Staff concerns included a dangerous shortage of nurses and a lack of communication leading to some haematology patients dying without receiving treatment, an investigation by BBC Newsnight and BBC West Midlands found.
    Read more
    Source: BBC News, 2 December 2022
  14. Patient-Safety-Learning
    In September, Shine Lawyers won a $300 million settlement in two class actions over the failed mesh products by Johnson & Johnson Medical and Ethicon. However, the law firm is proposing to take up to $99.5 million from the payout in costs, just under a third of the total sum.
    Of 11,000 women involved in the class action, Janelle Gale is one of 200 who is not happy with Shine Lawyers' compensation proposal. Representatives of the group said there was mass confusion over what compensation they might be eligible for and how many hoops they would have to jump through to receive a payment.
    Despite having barely any leakage before her 2014 surgery, afterwards Janelle became heavily incontinent. She was a drag-racing champion, but that came to a halt. She said it destroyed her marriage, she couldn't have sex and she still can't work.
    Read more
    Source: ABC News, 3 December 2022
  15. Patient-Safety-Learning
    The NHS faces an “exodus” of female doctors who are struggling to work due to a lack of menopause support, a report has warned.
    The Medical Protection Society, which helps doctors in legal and ethical disputes, said that many quit or reduce their hours over fears that their menopause symptoms, such as brain fog, insomnia and hot flushes, will cause them to accidentally harm patients. A survey found that 36 per cent of female doctors have considered reducing their hours because of menopause symptoms, while one in five have considered early retirement.
    “With females making up most of the healthcare workforce, it is crucial that they can access the support they need to avoid an exodus from the profession,” the report said.
    Read full story (paywalled)
    Source: The Times, 26 October 2022
  16. Patient-Safety-Learning
    Harm to patients has become “normalised” as burned-out paramedics are working without breaks, the national care watchdog has warned.
    Concerns over the pressures on staff at South East Coast Ambulance Service have been raised by the Care Quality Commission (CQC).
    Senior staff told the CQC that patients were being adversely affected by ambulance delays but it was now being seen as “part of the culture”.
    The CQC found pressures on staff within the South East Coast Ambulance Service, such as long waits outside of the emergency department, had led to low morale and staff feeling they were not valued.
    It said: “Staff described feeling frustrated and burnout and that senior leaders did not understand or respond to the challenges or concerns they raised. Some local senior managers described that harm to patients, caused by delays in reaching them, had become normalised as a culture.”
    “At times there were many outstanding category 3 [urgent] patients awaiting an ambulance or assessment by a paramedic practitioner. At busy times, these patients waited for extended lengths of time for crews and callbacks. Therefore, this group of patients were at risk of deterioration whilst they were waiting for a response.”
    Read full story
    Source: The Independent, 26 October 2022
  17. Patient-Safety-Learning
    Children’s hospitals are under strain in the United States as they care for unusually high numbers of kids infected with RSV and other respiratory viruses.
    Respiratory syncytial virus, a common cause of cold-like illness in young children known as RSV, started surging in late summer, months before its typical season from November to early spring. This month, the United States has been recording about 5,000 cases per week, according to federal data, which is on par with last year but far higher than October 2020, when more coronavirus restrictions were in effect and very few people were getting RSV.
    Jesse Hackell, a doctor who chairs the committee on practice and ambulatory medicine for the American Academy of Pediatrics, said, "It’s very hard to find a bed in a children’s hospital — specifically an intensive care unit bed for a kid with bad pneumonia or bad RSV because they are so full.”
    Read full story
    Source: The Washington Post, 21 October 2022
  18. Patient-Safety-Learning
    People with suspected cancer in England are facing a higher risk of “worrying” outcomes owing to unacceptable delays in being referred to hospital, experts have said, as figures show seven in 10 NHS trusts are failing to hit a key target.
    The number of NHS trusts missing the national target for urgent cancer referrals is the highest it has been for at least three years, according to analysis of NHS data.
    In England, the maximum waiting time for a hospital appointment for suspected cancer is two weeks from the day the hospital receives a referral letter from a GP. At least 93% of patients should be seen within 14 days, according to the NHS. But analysis by the PA news agency, using data from August 2019 to August 2022, shows this target is routinely being missed, putting patients at greater risk of poor outcomes.
    Minesh Patel, head of policy at Macmillan Cancer Support, said: “There are huge pressures even at that early stage of the cancer pathway, let alone when you get to treatment, and it is really worrying for somebody’s prognosis. If somebody starts treatment later, the more worrying the outcome could be in terms of their ability to survive their cancer, to have minimal after-effects after a treatment. This is about survival and giving people the best chance and improving their quality of life, ultimately.”
    Read full story
    Source: The Guardian, 26 October 2022
  19. Patient-Safety-Learning
    Cuts to public health budgets will hit poorest communities the hardest, the new government is being warned.
    Directors of public health say local authorities - which pay for initiatives such as smoking cessation services - are on a financial cliff edge.
    Rising inflation means ventures will cost more to run. Any reduction in funding in next week's spending announcement will have a direct impact on the lives of the most vulnerable, they said.
    David Finch, assistant director of healthy lives at The Health Foundation, said: "Public health interventions have been shown to be really cost effective. Investing in these preventative measures that help to keep people in good health in the first place means you're protecting against future costs to the economy and society by keeping people healthy and reducing poor health in the future."
    Read full story
    Source: BBC News, 26 October 2022
  20. Patient-Safety-Learning
    The cost of living crisis could force dying patients to move into hospice beds as they can no longer afford to heat their homes, it is claimed.
    The stark warning comes as the care sector faces soaring energy bills of its own, with the industry predicting a huge hike in costs next year.
    Speaking about the impact the cost of living crisis is having on patients, Paul Marriot, Chief Executive of North East hospice St Cuthbert’s, said: “Here in the North East, for example, many of our patients are already on low incomes and the fact that they are ill increases their costs. The key thing is that they are in a time in life when they’ve got less choice around what they do about [costs]. So it’s not an opportunity for them to switch off the heating, it’s not an option for them, just to wear more clothes, it’s not an option for them to see it out until the spring, because they may not be here in the spring."
    Read full story
    Source: The Independent, 17 October 2022
  21. Patient-Safety-Learning
    An “institutionalised” and “counterproductive” system of hiring and firing trust leaders was a contributory factor to care failings which caused the death of at least 45 babies an inquiry has concluded. 
    The inquiry into maternity care at East Kent Hospitals University Foundation Trust, chaired by Bill Kirkup, discovered what it described as the latest ”major service failure” in NHS maternity care. It concluded that successive chairs and chief executives were “wrong” to believe the trust had provided adequate care for more than a decade and urged they be held accountable. But he added the churn of senior management had been “wholly counterproductive” for the trust.
    His report said: “We have found at chief executive, chair and other levels a pattern of hiring and firing, initiated by NHS England. The practice may never have been an explicit policy, but it has become institutionalised. In response to difficult problems, pressure is placed on a trust’s chair to replace the chief executive, and/or to stand down themself."
    Read full story
    Source: HSJ, 20 October 2022 (paywalled)
  22. Patient-Safety-Learning
    The deadline for the NHS to move to a new system for safety incident reporting has been delayed after widespread concerns the rollout could be a ‘disaster’.
    A memo from NHS England to local teams yesterday, seen by HSJ, says the deadline to transition to the new “learning from patient safety events” database has been pushed back by six months to September 2023.
    The creation of LFPSE is a key strand of NHSE’s safety strategy, along with the overhaul of how serious incidents are investigated. It aims to make it easier for staff across all healthcare settings to record safety events, as the service will be expanded to include primary care.
    It will replace the current national reporting and learning system, a central database created in 2003 to help identify trends and maximise learning from mistakes. The new system is part of a national strategy that pledges to save 1,000 extra lives and £100m in care costs each year from 2023-24.
    Multiple patient safety managers at local trusts had raised concerns to HSJ about the previous March deadline, with one patient safety lead saying it would have been a “disaster” if enforced.
    Helen Hughes, chief executive of charity Patient Safety Learning, said NHSE also needs to change its way of working, as well as the deadline extension. She said:
    “We believe that NHS England needs to seriously reconsider their approach to engaging with trust leaders and staff on this issue, so that improvements can be made to the new LFPSE service to ensure it has the best possible chance of success, and to enable patient safety improvement.”
    Read full story (paywalled)
    Source: HSJ, 20 October 2022
  23. Patient-Safety-Learning
    An expert panel convened by the US Food and Drug Administration voted 14-1 on Wednesday to recommend withdrawing a preterm pregnancy treatment from the market, saying it does not work.
    During the sometimes contentious three days of hearings, the drugmaker Covis Pharma, backed by some clinicians and patient groups, had argued there is evidence to suggest the drug, called Makena, might work in a narrower population that includes Black women at high risk of giving birth too soon.
    But FDA experts and others said the data does not support such a view. In closing arguments, Peter Stein, director of the Office of New Drugs at the FDA’s Center for Drug Evaluation and Research, agreed on the urgent need for a drug to reduce the incidence of preterm birth — a leading cause of infant mortality in the United States. But he said the data indicates that Makena is not that drug.
    Stein said, “Hope is a reason to keep looking for options that are effective,” he said. “Hope is not a reason to take a drug that is not shown to be effective, or keep it on the market.”
    Read full story
    Source: The Washington Post, 19 October 2022
  24. Patient-Safety-Learning
    Patients in England are being put at risk because of the unacceptably poor service they receive from GPs, MPs say.
    The House of Commons' Health Committee blamed the failure to tackle doctor shortages, which had led to a decline in the GP-patient relationship.
    Seeing a GP should not be like booking an Uber with a driver you are unlikely to see again, the MPs said. The warning comes just weeks after ministers launched a drive to improve access to GP services. But the cross-party group of MPs said more needed to be done.
    Louise Ansari, from the patient group Healthwatch England, said, "The impacts of poor access can be huge, with people feeling abandoned and suffering in silence and not getting referred to hospitals for more specialised treatment."
    Read full story
    Source: BBC News, 20 October 2022
  25. Patient-Safety-Learning
    The main corridor of an acute hospital has been closed to patients and staff and turned into a ‘makeshift ward’, in what sources describe as an ‘absolutely unprecedented’ situation.
    The move by Aintree Hospital comes after staff clashed with paramedics last week about whether ambulance patients could be brought into the crowded emergency department.
    One staff member, who wished to remain anonymous, said: “It’s exceptional for this to happen, but I can see it happening more over winter. It’s a rock and a hard place… either you wait in the ambulance if the queue is too long, or you wait in the main hospital corridor. Neither option is ideal.”
    Dr Adrian Boyle, president of the Royal College of Emergency Medicine, said: “Across the country, the urgent and emergency care system is in unprecedented crisis. Emergency medicine teams and our paramedic colleagues are doing their very best to deliver effective care in exceptionally difficult circumstances. Circumstances like these require ICB leaders to engage, take control of the situation and accept their responsibility. This will both help to de-escalate the situation and ensure the right decision is made for the patients, the ED teams and ambulance crews."
    Read full story
    Source: HSJ, 19 October 2022 (paywalled)
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