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Patient-Safety-Learning

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News posted by Patient-Safety-Learning

  1. Patient-Safety-Learning
    A statutory inquiry into deaths of mental health patients will now cover fatalities that took place as late as December 2023.
    The inquiry’s investigations are focused “on the trusts which provide NHS mental health inpatient care in Essex”. This includes: “Essex Partnership University Foundation Trust, and the North East London Foundation Trust and their predecessor organisations, where relevant.”
    NELFT was not specifically mentioned in the original terms of reference although the inquiry told HSJ it had been within the original scope. The inquiry will also now cover deaths of NHS patients from Essex who died when under the care of private sector providers.
    The inquiry’s previous terms of reference covered a period ending in 2020. However, the inquiry’s chair, Baroness Kate Lampard, proposed extending the inquiry’s scope last year due to “ongoing concerns” over services at EPUFT. 
    Read full story (paywalled)
    Lampard Inquiry: Terms of reference
    Source: HSJ, 11 April 2024
  2. Patient-Safety-Learning
    Delays in people leaving hospital in England could be costing an average of £395 per night, according to researchers at a health think tank.
    The direct costs of delayed discharges, where patients are considered medically fit to leave hospital, is estimated to be around £1.89 billion for the past financial year, the King's Fund said. This estimate does not count extra costs, including cancelled operations or staff time spent arranging care packages. Ambulance handover delays are often linked to a shortage of space caused by people who no longer need to be in hospital beds.
    The most recent PA analysis of NHS figures showed an average of 13,300 beds per day in the week to March 26 were filled by people ready to be discharged, compared with 12,643 at that point last year. Overall, 42% of medically fit patients in England were discharged, though the rate varied between regions, from 31% in the North West to 52% in eastern England.
    Read full story
    Source: Medscape, April 2023
  3. Patient-Safety-Learning
    A new study focused largely on unvaccinated or partially vaccinated people has found the Delta variant is more likely to cause hospitalisation than the Alpha variant.
    The Delta variant, first identified in India, is already understood to be far more infectious than the previously dominant Alpha variant that was initially detected in Kent. 
    Dr Gavin Dabrera, one of the study’s lead authors and a consultant epidemiologist for Public Health England has said, “This study confirms previous findings that people infected with Delta are significantly more likely to require hospitalisation than those with Alpha, although most cases included in the analysis were unvaccinated.”
    Read full story.
    Source: The Guardian, 27 August 2021
  4. Patient-Safety-Learning
    Female survivors of breast cancer living in the most deprived areas have a 35% higher risk of developing second, unrelated cancers, compared with those from the most affluent areas, research shows.
    Breast cancer is the most commonly diagnosed cancer in the UK, with about 56,000 people being told they have it each year. Improved diagnosis and treatments mean that five-year survival rates are now 86% in England. People who survive breast cancer have a greater likelihood of second primary (unrelated) cancer, but until now the exact risk has not been clear.
    A team of researchers led by the University of Cambridge analysed NHS data from almost 600,000 patients in England and found, compared with the general female population, women who had survived breast cancer had an increased risk of developing 12 other primary cancers. Compared with the most affluent, the least well-off female survivors of breast cancer had a 166% greater chance of developing lung cancer, a 78% higher risk of stomach cancer, more than 50% increased risk of bladder and oesophagus cancers, 48% higher risk of head and neck cancer and 43% increased risk of kidney cancer.
    Read full story
    Source: Guardian, 24 April 2024
  5. Patient-Safety-Learning
    WHO epidemiologist Maria Van Kerkhove wrote in her notebook before a keynote address "the world needs a reality check" after becoming increasingly concerned about the rise in coronavirus infections. 
    Reports have found Covd-19 has been rising rapidly in places where there has been a low vaccine uptake and it has been confirmed the delta variant is the most transmissible than earlier strains. However, despite this, there has been a lack of social distancing and mask wearing from the public. 
    “We’re getting further away from the end than we should be. We’re in a bad place right now globally,” Van Kerkhove has said.
    Read full story.
    Source: The Washington Post, 17 July 2021
  6. Patient-Safety-Learning
    New data has revealed doctors are experiencing “worrying levels of abuse” during the Codi-19 crisis. 
    In a survey, doctors (51% of respondents) have reported that they have witnessed violence and abuse against other staff, with 67% showing this was particularly high for those working in general practice. 
    We cannot let people take out their frustration at a system on individual doctors or their colleagues, who truly are doing their best in the most difficult of situations. Even before the pandemic we were vastly understaffed, and abusive behaviour will drive more and more talented and experienced doctors away from the NHS at a time when we need them most . . . We urge our patients to afford the same compassion to staff that they are shown in hospital, after what has been the most horrific year of our careers.” Said The chair of the BMA’s Consultants Committee, Vishal Sharma. 
    Overall results for the abuse questions are here, and broken down by healthcare setting here.
    Read full story.
    Source: BMJ, 10 August 2021
  7. 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
  8. Patient-Safety-Learning
    A doctors union has said some Covid measures should remain after the 19th July. 
    The British Medical Association has said use of face masks should continue in addition to new ventilation standards. The call to protect the NHS comes after a rise in cases has been observed.
    On Thursday, the Prime Minister Boris Johnson has said he hopes restrictions can be lifted in England on 19th July but that there may be a need to take extra precautions. 
    Read full story.
    Source: BBC News, 3 July 2021
  9. Patient-Safety-Learning
    The new head of NHS England has urged people not to ignore the signs of cancer and encourages people to get checked out if symptoms emerge, such a cough or stomach pain that won't go away.
    Experts believe certain cancers such as abdominal cancers - throat, stomach, bowel, pancreatic, ovarian - and urological cancers - prostate, kidney and bladder - are the most likely to go unrecognised and suggest anyone with symptoms to tell their GP. 
    "People should not feel like they cannot trouble the NHS, which is open and ready to treat people." NHS England chief executive Amanda Pritchard has said.
    Read full story.
    Source: BBC News, 15 August 2021
  10. Patient-Safety-Learning
    Just three “slightly unhealthy traits” in mid-life increase the risk of early death by a third, research suggests.
    The study found people carrying extra weight in their 40s and 50s who also had slightly raised blood pressure, cholesterol or blood sugar levels were also 35 per cent more likely to have a heart attack or stroke over the next three decades.
    Researchers warned that middle-aged people with this “cluster of slightly unhealthy traits” – known as metabolic syndrome – typically had a heart attack or stroke two years earlier on average than healthier people the same age.
    Dr Lena Lönnberg, of Västmanland County Hospital, Sweden, who was lead researcher for the study, said: “Many people in their 40s and 50s have a bit of fat around the middle and marginally elevated blood pressure, cholesterol or glucose but feel generally well, are unaware of the risks and do not seek medical advice. “In fact, most people live with slightly raised levels for many years before having symptoms that lead them to seek healthcare.”
    She warned that because the individual “unhealthy traits” did not usually make people feel unwell, most people were unaware of the risks combined with excess weight.
    An estimated one in four UK adults has metabolic syndrome, with rising obesity levels one of the main drivers.
    On their own, diabetes, high blood pressure, and obesity can damage the blood vessels. 
    But even if patients only have mild versions of each condition, experts warn having the three together can be particularly dangerous.
    Read full story (paywalled)
    Source: The Telegraph, 25 August 2023
  11. Patient-Safety-Learning
    A Scottish research firm set up by a dementia expert who quit the NHS because of insufficient “infrastructure” has developed a blood test to allow doctors to identify Alzheimer’s disease earlier.
    Scottish Brain Sciences, based in Edinburgh, announced it will collaborate with Roche Diagnostics on a series of projects, which the former’s founder, Craig Ritchie, said could have “big impacts”. Ritchie, who has led dozens of drug trials and pilots a European network on preventing Alzheimer’s, had been advocating the need to create new brain health centres across Scotland.
    Read full story (paywalled)
    Source: The Times, 14 August 2023
  12. Patient-Safety-Learning
    Eight hospitals have reported that at least 1 in 10 beds are now occupied by a patient with coronavirus, HSJ can reveal. 
    Operational information seen by HSJ showed the 8 Trusts were, Queen Elizabeth Hospital; Gateshead, South Tyneside and Sunderland Foundation Trust, North Tees and Hartlepool Foundation Trust, Barnsley Hospital, The Rotherham Foundation Trust, Pennine Acute Hospitals Trust, across several hospitals in north Manchester, Oldham and Bury, Whittington Health Trust, and Sandwell and West Birmingham. 
    Having 10 per cent or more beds occupied by Covid patients has a big impact on how the hospital is able to run due to the need to ensure the patients are in appropriate wards and isolated from patients who are negative for the virus. Compared to previous waves, current patients are much younger and healthier and have been found to have a shorter length of stay in hospital. 
    Read full story (paywalled).
    Source: HSJ, 26 July 2021
  13. Patient-Safety-Learning
    The ambition to diagnose cancer in its earliest stages in England is “seriously off target”, according to a new report by QualityWatch, a research programme by the Nuffield Trust and The Health Foundation
    A rise in urgent referrals in recent years has contributed to delays, along with patients finding it difficult to raise concerns about cancer with GPs. Inequalities in diagnosis, particularly among young people, those in deprived areas, and patients from ethnic minorities, was also highlighted by researchers.
    Experts said that while family doctors are “highly trained” to identify cancers, the issue remains a challenge in primary care because some symptoms can be vague.
    The NHS Long Term Plan said the health service is aiming to diagnose 75% of cancer patients when the disease is in its early stages by 2028.
    However, analysis of NHS data by QualityWatch said “our current course shows we are seriously off target”.
    More than 320,000 people in England were diagnosed with cancer in 2021 – the equivalent of some 900 a day – the report said, with the number of urgent cancer referrals rising since 2009 to more than two million in 2020/21.
    Read full story
    Source: Medscape, 24 April 2024
  14. Patient-Safety-Learning
    The number of new ambulances in England will be far less than the hundreds promised by the government, a Freedom of Information request has revealed.
    In January, 800 new ambulances were announced, with a 10% fleet increase. But vehicles being ordered by trusts are mostly replacements they were prevented from purchasing because of procurement changes and the pandemic.
    In response to a written question in February, DHSC said the "over 800 new ambulances" advertised equated to about 350 extra vehicles, plus 100 mental health ambulances. However, the FOI responses from England's ambulance trusts suggest the number of extra vehicles will be far fewer.
    Read full story
    Source: BBC News, 4 April 2023
  15. Patient-Safety-Learning
    A trust is experiencing severe problems with its electronic patient record system two years after it was installed, HSJ research has revealed.
    A “preliminary review” into the Oracle Cerner electronic patient record – called Surrey Safe Care – at Ashford and St Peter’s Hospitals (ASPH) Foundation Trust in Surrey found the emergency department was still spending “significant time” using the system, an electronic bed board was not updated in real-time, and there were booking and workflow errors in clinics.
    The review, which was released to HSJ after a Freedom of Information Act request and carried out in recent months, found problems stemming from limited system training, configuration issues and insufficient technology available on wards and in clinics. The EPR went live in May 2022.
    The trust also had “insufficient analysts” to provide comprehensive management information. Also, performance, utilisation and management information were described as still being “under construction.”
    In a statement, ASPH said, “Annual reviews will be carried out to monitor the continual progress of this project. A new working group of clinical, operational, and digital staff will agree how we use existing resources to improve staff training, add extra functionality to the EPR, invest in appropriate technology and additional analysts.”
    Read full story (paywalled)
    Source: HSJ, 15 May 2024
  16. 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
  17. Patient-Safety-Learning
    The charity Birthright have launched an inquiry into why women from ethnic minority backgrounds are experiencing higher maternity risks. 
    Evidence in the inquiry will be gathered from parents, anti-racist campaigners, midwives and obstetricians. 
    The NHS has said it is working on a new strategy to address inequalities, maternity and neonatal care. 
    Read full story.
    Source: BBC News, 23 June 2021
  18. Patient-Safety-Learning
    The European Commission is recommending measures EU countries should adopt to increase the uptake of two vaccines that prevent viral infections that can cause cancer, it said on Wednesday.
    The two vaccines are against the human papillomaviruses (HPV) that can cause many cancers, including cervical cancer, and against hepatitis B (HBV), which can lead to liver cancer.
    As part of Europe's Beating Cancer Plan, the European Union wants member countries to reach HPV vaccination of 90% for girls by 2030 and significantly increase the rate for boys.
    "Many Member States are well below 50% HPV vaccination coverage for girls with limited data available for boys and young adults, and there is a significant lack of data on HBV vaccination rate," the Commission statement said, adding it was as low as 1% in some countries.
    Read full story
    Source: Medscape UK, 31 January 2024
  19. 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
  20. 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
  21. 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
  22. Patient-Safety-Learning
    The Royal College of Nursing has written to the Prime Minister demanding continued protective measures after the loosening of restrictions on July 19th.
    In a joint letter with the British Medical Association, the Royal Pharmaceutical Society, British Dental Association and College of Optometrists, they ask for support and protection for healthcare staff.
    The letter says “The need to recognise health and care settings as unique environments for the care and safety of the most vulnerable is paramount. While you state that you would expect the public to continue wearing face coverings in healthcare settings, we ask that this is translated into action".
    Read full story.
    Source: RCN, 14 July 2021
  23. Patient-Safety-Learning
    Thirty families are starting legal action against the government, care homes and several hospitals in England over the deaths of their relatives in the early days of the Covid pandemic.
    The families argue not enough was done to protect their loved ones from the virus.
    They are claiming damages for loss of life and the distress caused.
    The government says it specifically sought to safeguard care home residents using the best evidence available.
    The legal claims focus on the decision in March 2020 to rapidly discharge hospital patients into care homes without testing or a requirement for them to isolate.
    The cases follow a 2022 High Court judgement that ruled the policy was unlawful - as it failed to take into account the risk to elderly and vulnerable care home residents of asymptomatic transmission of the virus.
    One of the cases is being brought by Liz Weager, whose 95-year-old mother Margaret tested positive for the virus in her care home in May 2020 and died later in hospital. "What was happening in the management of those care homes? What advice were they having?" Liz asks. "It goes back to the government. There was a lack of preparedness, which then translated down to the care home."
    Read full story
    Source: BBC News, 25 August 2023
  25. Patient-Safety-Learning
    Federal regulators have decided to authorise a second omicron-specific coronavirus vaccine booster shot for people who are at least 65 or have weak immune systems in an effort to provide additional protection to high-risk individuals, according to several officials familiar with the plan. 
    The Food and Drug Administration is expected to announce the step in the next few weeks, and the Centers for Disease Control and Prevention is expected to move quickly to endorse it, said the officials, who spoke on the condition of anonymity because they were not authorised to publicly discuss internal discussions. Eligible individuals will be able to receive the dose as long as it has been at least four months since their first shot of what’s known as the bivalent booster, which targets omicron subvariants BA.4 and BA.5 as well as the original novel coronavirus. The expectation is that consumers will consult with their health-care providers about whether to get the extra booster, the officials said.
    John P. Moore, a professor of microbiology and immunology at Weill Cornell Medicine in New York, said an extra booster could benefit people who are in poor health or have an impaired immune system. But he was skeptical everyone older than 65 needs it. Boosters lead to “a short-term boost against mild infection but protection against severe disease is still pretty robust” because of previous shots, he said.
    Read full story (paywalled)
    Source: Washington Post, 3 April 2023
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