Mark Hughes

Hi everyone. Two members of the Network have expressed an interest in how different PSPs report into their organisations, ahead of an internal meeting they have at their Trust at the end of this month (August). If you’d be happy to share your experience of this with them please do add this in the comments below.

Role descriptions from Norfolk and Waveney ICS and University Hospital Southampton NHS Foundation Trust.

PSPRoleDescription_NorfolkandWaveneyICS.doc Q&SPartnerRoleDescription_UniversityHospitalSouthampton.docx

Today NHS England and NHS Improvement have published their new Long Covid Plan 2021/22 which outlines 10 key next steps to be taken by the NHS to support people living with Long Covid.

This includes some new proposals such, including:

• Expanding the services available on the Your Covid Recovery platform "to allow anyone with symptoms to access a range of symptom management advice without needing a referral from a clinician".
• Establish 15 Long Covid assessment children and young people’s hubs across.

What are your thoughts on the proposals in this new plan?

Patient Safety Learning have published today a new blog which sets out the key points included in our response to the consultation: https://www.pslhub.org/learn/patient-safety-learning/patient-safety-commissioner-for-scotland-consultation-response-patient-safety-learning-r4739/

Just over a week ago NHS England and NHS Improvement announced the launch of a network of 40 Long COVID clinics over the coming weeks. While there still needs to be more details providing, particularly a clear timeframe for the roll-out of these and information on their locations, I was wondering if anyone has heard about whether there are similar plans for Northern Ireland, Scotland and Wales? From a little online research at the moment I've only found the following:

Northern Ireland

• No formal announcements from the Department of Health along these lines. The charity Northern Ireland Chest Heart & Stroke have set up their own Covid Recovery Service.

Scotland

• No immediately obvious proposals from this recent BBC News article covering the issue.

Wales

• Quotes from a BBC News article from the Welsh Government that 'it expected health boards to develop and improve access to rehabilitation services'. This also mentions that the 'Cardiff and Vale Health Board is the first in Wales planning to open a multi-disciplinary rehabilitation service.'

Have you heard or seen anything to suggest plans are in place in Northern Ireland, Scotland or Wales to move forward with a similar plan to the NHS in England? Or perhaps an alternative approach?

On the hub now there is new information from National Institute for Health and Care Excellence (NICE), Scottish Intercollegiate Guidelines Network (SIGN) and the Royal College of General Practitioners (RCGP) published today which gives more details about the forthcoming guideline on post-COVID syndrome which is planned to be published by the end of the year.

The guideline scope published today defines post-COVID syndrome (also known as Long COVID) as signs and symptoms that develop during or following an infection consistent with COVID-19 which continue for more than 12 weeks and are not explained by an alternative diagnosis. It says the condition usually presents with clusters of symptoms, often overlapping, which may change over time and can affect any system within the body. It also notes that many people with post-COVID syndrome can also experience generalised pain, fatigue, persisting high temperature and psychiatric problems.
 

The NHS have today announced a new five-point package of measures to support Long COVID patients. We've set out Patient Safety Learning's initial thoughts on this in this press statement and would be keen to hear the views of others: https://www.patientsafetylearning.org/press-releases/nhs-announces-five-point-package-to-support-long-covid-patients

You can now find a full transcript of yesterday's debate in the House of Commons on the hub via the link below: 

The Campaign Against Painful Hysteroscopy have highlighted on Twitter that they will be a Adjournment Debate in the UK House of Commons on this tabled by Lynne Brown MP later today. 

An Adjournment Debate runs for 30 minutes and takes place at the end of a day's session in the House of Commons. They provide a opportunity for MPs to raise an issue in the chamber and receive a ministerial response. The times for these debates are always a bit fluid, but its likely to take place between 4.00-5.30pm and you can watch this on www.parliamentlive.tv or the BBC Parliament Channel on Freeview. 

The full transcript of this debate will be posted on the hub when it becomes available.

On the hub now is a link to the transcript of Tuesday's debate in the Scottish Parliament on the Scottish Government's response to the First Do No Harm report. While no formal details were given about the nature of this role, other than it will be open to consultation, some notable comments in the debate included:

• Alex Neil MSP suggested the role should be 'a parliamentary appointment, not a Scottish Government or NHS appointment', calling for the role to have real powers and should be (unlike the Scottish Human Rights Commissioner) able to investigate specific cases.
• Kenneth Gibson MSP also concurred with the suggestion this should be a parliamentary appointment.
• Pauline McNeill MSP stressed that 'the independence of a patient safety commissioner is paramount'.
• Neil Findlay MSP said 'that person must carry the confidence of survivors of mesh, Primodos and sodium valproate, and I suggest that survivors should be heavily involved in the recruitment of that person'.

Earlier this summer the Independent Medicines and Medical Devices Safety Review, led by Baroness Cumberlege, published its report First Do No Harm, which looked at how the healthcare system in England responds to reports about the harmful side effects from medicines and medical devices.

One of the central recommendations of this report was the proposed appointment of a Patient Safety Commissioner who would “would champion the value of listening to patients and promoting users’ perspectives in seeking improvements to patient safety around the use of medicines and medical devices”. The UK Government has yet to respond to the recommendations of the report and on the specific suggestion of Patient Safety Commissioner the Care Quality Commission’s chief executive Ian Trenholm recently suggested he was not sure such a role was needed.

However today in their new Programme for Government the Scottish Government have confirmed that they will seek to “establish the role of a Patient Safety Commissioner”, following the Health Secretary Jeane Freeman suggesting they were looking into this in August.

While its still early days – we’re yet to hear details on the proposed Commissioner's responsibilities, resources and reporting lines – would be keen to hear other people’s thoughts on this. Do you think a proposed Patient Safety Commissioner in Scotland or any of the other three countries in the UK would be a positive development? If so, what would this type of role need in order to be successful and really make a difference?

Patient Safety Learning have now submitted our formal consultation response on Patient Safety Specialists which you can find on the hub below.

In this we've identified some key areas of the draft requirements for the role which we believe should be made more explicit (such as understanding human factors/ergonomics) and some key elements of this notable by their lack of detail (experience of engaging patients, families and carers in patient safety) or complete absence (how these role holders will engage with staff on the frontline).

We'd be keen to hear thoughts on this and share any other feedback that people have submitted as part of this consultation process.

On the issue of training for the police in regards to mental health, there’s been an interesting recent review on the broader issue from a police perspective by Her Majesty’s Inspectorate of Constabulary and Fire & Rescue Services (the body responsible for reporting on the efficiency and effectiveness of police forces in England and Wales).

Policing and Mental Health (November 2018) reflects on the increasing degree to which the police are responding to people living with mental health problems in variety of situations. It noted that while forces are investing in training, the quality of this remains inconsistent across England and Wales, stating:

• Only around a third of forces have invested heavily in mental health training (in terms of time allocated in the training calendar and the breadth of different areas of mental health the training covers).
• Many forces are too reliant on e-learning with less opportunities for face-to-face, instructor-led discussions to cover more complex topics.

The report also found ‘a general lack of understanding by forces of the extent and nature of their mental health demand’ and emphasised the need for more collaborative work with partner organisations to gain a clear picture and help plan out their approach.

Some of these findings do seem to ring true with the specific example cited here. Whether the officers should have been put in a position of needing to care for the people involved for several hours is obviously a question, but it appears as though there certainly isn't the capacity to do this, nor the appropriate training.

In terms of security staff, again there is a question of whether we should be reaching a situation where they are responsible for caring for people living with mental health problems for extended periods of time in these circumstances, but either way it would seem sensible that those working in health care settings do undertake appropriate training in this respect.

The National Association for Healthcare Security act as a professional body for security staff in the NHS, though I don't believe membership is mandatory for those carrying out these roles in the NHS, maybe this is an issue they are aware of and could help to take this forward.

It would be interesting to look in more detail at how politicians have engaged with patient safety in recent years, my suspicion would be that outside of the specific reports from regulators and major incidents such as the Mid-Staffs Inquiry it has been on quite an ad-hoc basis.

From a parliamentary perspective, a quick review of Hansard seems at first to suggest a low level of engagement, revealing that there have been only 4 debates on patient safety (3 in 2014, 1 in 2018) and 47 written ministerial statements in the last ten years.  However there have been numerous debates on issues such as dispensing errors, safety of medical devices and major incidents, so the main challenge may be harnessing these to help draw attention towards the bigger picture and need for changes at a system level.

Aside from the top down down role politicians have in setting priorities for the health care system they can also provide a conduit for increased patient engagement and input. If politicians can make the case for patient safety, providing a spotlight for their constituents in cases where mistakes are made and/or learning subsequently implemented, this could be really beneficial. An active All Party Parliamentary Group would certainly be one way of doing this, providing a platform for sharing stories and highlighting good and bad practice.