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Clive Flashman

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  1. Clive Flashman
    To help stop the spread of the coronavirus that causes COVID-19, the majority of hospitals have stopped or severely restricted visits. This article explains how you can still help a loved one even when you can't see them face to face.
    During the coronavirus crisis, most hospitals and care homes in the UK have stopped visits. If you have a loved one in a healthcare setting, not being able to go to see them will be incredibly difficult. But these temporary measures have not been taken lightly. Restricting visits to hospitals and care homes is important to reduce the spread of the virus that causes COVID-19 as much as possible. This way hospital and care home residents, and healthcare staff, can be better protected during the pandemic.
    Read the full article here
  2. Clive Flashman
    A new report has highlighted how point-of-care scanning in the NHS can help to improve patient safety, saving the NHS millions of pounds.
    Six NHS hospital trusts which implemented regular point-of-care scanning have ensured complete traceability of healthcare items to help improve patient safety while securing millions of pounds of savings and releasing thousands of hours of clinical time, a new report reveals.
    ‘A scan of the benefits: the Scan4Safety evidence report’ details the results at hospital trusts that took part in a national two-year programme, known as Scan4Safety, to investigate the benefits of point-of-care barcode scanning in the NHS.
    Full article here
    We wonder if @Richard Price might like to post more about what the impact of Scan4safety has been at University Hospitals Plymouth. Perhaps here:
    https://www.pslhub.org/learn/commissioning-service-provision-and-innovation-in-health-and-care/digital-health-and-care-service-provision/other-health-and-care-software/ 
  4. Clive Flashman
    A national investigation has been launched into the equipment used by NHS staff to monitor babies heart rates during labour because of concerns they could be contributing to deaths and disabilities.
    The independent Healthcare Safety Investigation Branch (HSIB), which investigates systemic safety risks in the NHS, has opened an inquiry after reviewing hundreds of maternity incidents.
    It found equipment used to record cardiotocographic (CTG) traces were linked to 138 maternity investigations since 2018 with more than 238 separate findings referencing the use of CTG as a factor in the error.
    Read the full article here
  5. Clive Flashman
    "I'm not sure I want to be a nurse anymore," she tells me. "I've seen more people die in the past two months than in the whole six years."
    Some 70% of health workers dealing with COVID-19 in Italy's hardest-hit areas are suffering from burnout, a recent study shows. "This is actually the hardest moment for doctors and nurses," says Serena Barello, the author of the study.
    Read story
    Source: BBC News, 26 May 2020
  6. Clive Flashman
    New study results in more precise language in the federally mandated warning about this possibility. (Article from the USA)
    Women who choose to use an intrauterine device, or IUD, for birth control should be aware of the very small possibility that the device could puncture their uterus. They should know how to recognize that circumstance if it occurs, according to a new study published in The Lancet.
    The U.S. Food and Drug Administration mandated the study to evaluate women's risks when an IUD is placed in the year after giving birth and when an IUD is placed during the period that a woman is breastfeeding a baby. These results were compared, respectively, with non-postpartum insertions and insertions in non-breastfeeding individuals, explained UW Medicine’s Dr. Susan Reed, the study’s lead author.
    Across the study cohort of 327,000 women, the percentage of perforation cases diagnosed within five years of IUD insertion was 0.6 %, the study concluded.
    The risk of perforation increased by nearly seven times if it was inserted between four days and six weeks postpartum, and increased by about one-third if inserted during the span of breastfeeding. The risk of an IUD-related perforation was relatively lower when inserted in women who were more than a year beyond delivery, in women who had never had a baby, and when the insertion occurred at delivery. Read full article here
  7. Clive Flashman
    In the largest independent randomized controlled trial (RCT) of its type, a multimodal digital therapy program for patients with non-specific chronic low back pain has outperformed standard-of-care treatment across all medical outcomes.
    Results of the study, published in the Journal of Pain Research, show that patients using Kaia, the back pain management app developed by leading digital therapeutics company Kaia Health, reduced pain levels, anxiety, depression, stress, and improved wellbeing and body functionality significantly more compared to standard-of-care treatments, e.g. pain killers, surgeries, physical therapy.
    “This large-scale study demonstrates the significant benefits for people managing low back pain when using Kaia to deliver a multimodal treatment through a digital device, such as a smartphone,” says Thomas R. Toelle, M.D., Ph.D., Head of the Pain Center of the Technical University Munich, Germany. “These results add to the growing body of medical evidence that supports the use of digital multimodal treatments for chronic conditions, such as back pain.”
    Low back pain is one of the leading causes of global disability, with an enormous cost for healthcare systems worldwide. 1,2 According to a 2018 report on the impact of musculoskeletal pain on employers, chronic pain, including back pain, accounts for 188.7 million lost work days, and $62,4 billion in lost productivity cost.3
    Kaia is an app-based, multimodal digital therapy program for chronic back pain, which focuses on Physical therapy, Relaxation exercises, and Medical education.
  8. Clive Flashman
    "We are the NHS: People Plan 2020/21 – action for us all, along with Our People Promise, sets out what our NHS people can expect from their leaders and from each other.  It builds on the creativity and drive shown by our NHS people in their response, to date, to the COVID-19 pandemic and the interim NHS People Plan. It focuses on how we must all continue to look after each other and foster a culture of inclusion and belonging, as well as take action to grow our workforce, train our people, and work together differently to deliver patient care.
    This plan sets out practical actions for employers and systems, as well as the actions that NHS England and NHS Improvement and Health Education England will take, over the remainder of 2020/21. It includes specific commitments around:
    Looking after our people – with quality health and wellbeing support for everyone Belonging in the NHS – with a particular focus on tackling the discrimination that some staff face New ways of working and delivering care – making effective use of the full range of our people’s skills and experience Growing for the future – how we recruit and keep our people, and welcome back colleagues who want to return The arrival of COVID-19 acted as a springboard, bringing about an incredible scale and pace of transformation, and highlighting the enormous contribution of all our NHS people. The NHS must build on this momentum and continue to transform – keeping people at the heart of all we do."
  9. Clive Flashman
    A healthy population is one of any nation’s most important assets. We have known for a long time that not everyone has the same opportunity to access the things they need to lead a healthy life, such as good quality work and safe secure stable housing. Now we can see that the COVID-19 pandemic is replicating and exacerbating deep-rooted health inequalities. Without concerted action, this health crisis will also become a health inequalities crisis.
    The COVID-19 pandemic has brought health inequalities into sharp focus. While every part of the population has been affected by the current crisis, some communities have been hit much harder both by the virus itself and by the measures taken to control its spread.
    Evidence is starting to emerge, for example, of the unequal impact of the shutdown of the economy. For example a recent survey of UK households found that the lowest earners have been worst hit by loss of earnings, with the most severe losses for single parents.
    The uneven impact of COVID-19 has also highlighted the inequalities faced by Black, Asian and minority ethnic communities. Recent data shows that some ethnic groups are at much higher risk of dying from COVID-19 than the rest of the population (e.g. Black men are four times more likely to have died of COVID-19 than their White peers).
    Read full article here.
  10. Clive Flashman
    Leeds Teaching Hospitals has launched a support fund for patients, their relatives and volunteers who may be struggling financially due to the coronavirus pandemic.

    The fund is intended to assist (but is not limited to):
    Bereaved relatives facing immediate financial pressures until their personal financial affairs are sorted eg having weekly bills to meet and no immediate access to bank accounts Patients isolating for 14 days in advance of admission to hospital and suffering income loss, excess cost or other financial hardship as a result Patients, their immediate families or volunteers who have experienced significant household income loss as a result of the pandemic and are struggling with financial obligations Those experiencing significant increases in costs as a direct result of the pandemic, eg increased childcare costs Read the full article here
  11. Clive Flashman
    Lego could be used as a practical tool to train doctors in anesthetic skills according to new research that has shown a simple task using the building bricks can help improve technical skills—a finding that could improve medical training and patient safety.
    Scientists from the University of Nottingham's School of Psychology and School of Medicine developed a task where people copied shapes using bricks that they could see in a mirror. They found this simple training improved student performance in an ultrasound-guided regional anesthesia task. The results of the study have been published in British Journal of Anesthesia
    Read the full article here
  12. Clive Flashman
    Coronavirus patients who have lived with symptoms for up to five months have spoken about the huge impact it has had on their lives.
    "Long Covid" support groups have appeared on social media and the government says "tens of thousands" of people have long-term problems after catching the virus, such as extreme fatigue.
    Daliah, from Borehamwood, Hertfordshire, said: "It's scary because we don't know how permanent this is. There are times where I feel like life will never be normal again, my body will never be normal again."
    The NHS has launched a Your Covid Recovery website to offer support and advice to people affected.
    See video here
  13. Clive Flashman
    Health and social care secretary Matt Hancock delivered a ‘future of healthcare’ speech to the Royal College of Physicians on Thursday and laid out seven lessons from the health and care response to Covid-19 that he wants to see retained. If followed through, some of his points would mark significant shifts in policy and Conservative thinking. However, Hancock said it was important to “build better” in the way that London was built better after the Great Fire in 1666.

    Hancock’s seven points were: the NHS must value people and ‘bust bureaucracy’ that gets in their way; the future is “collaboration not competition”; “better technology means better healthcare”; the NHS must be open to other sectors; planning and funding will be “system first”; and social care and public health need more attention. On tech, Hancock said consultations will be digital first, and there will be a new focus on interoperability and data sharing.
  14. Clive Flashman
    Mental health patients who were discharged from or admitted to acute mental health services during the first Covid-19 lockdown experienced loneliness and social isolation, according to a new study. Published in the British Journal of Psychiatry Open the 34 patients, carers and clinical staff were interviewed by a team of researchers from The University of Manchester. 
    Mental health service users also reported ‘working harder’ to avoid admission due to fears around environmental safety as a result of COVID-19.  “Even before the pandemic, there are lots of safety concerns associated with recent discharge from inpatient mental health services, for example suicide and self-harm,“ said lead author Dr Natasha Tyler, researcher at the GM PSTRC and The University of Manchester. Dr Tyler added: ‘Our patients and carers felt that because of the national need to free-up hospital beds, the quality of discharge and admission planning was compromised at times. “That meant discharging patients from hospitals who were not ready to cope in the community or not admitting patients who needed in-patient care. “The closure of most community support services meant patients had minimal opportunities for accessing care via alternative routes.  This worsened  their feelings of helplessness and loneliness.” 
    Full article here
    Source: Greater Manchester Patient Safety Translational Research Centre
  15. Clive Flashman
    There is a mental health crisis in England, with rates of depression doubling since the COVID pandemic began. Strategies of “speaking up”, mindfulness sessions at work, and national “happiness” campaigns have been touted as an effective approach to tackling mental health at work, but therapists are unconvinced.
    But what of mental health services offered by the state? This has been equally unconvincing. Over the past decade or so, mental health services in England have been undergoing a process of “Uberisation”. This refers to how services are effectively treated as commodities marketed through online platforms, changing the way they are delivered as well as making the jobs of the people delivering them more precarious – similar to the effect of ride-hailing apps on taxi drivers.
    Specifically, this has happened through the introduction of a standardised and digitalised model of therapy called Increased Access to Psychological Therapies (IAPT). This Uberisation appears to be contributing to a mental health crisis within the therapy profession itself.
    IAPT, which was introduced in 2008, provides psychotherapy for depression and anxiety to over a million people each year – the largest NHS programme in England. It uses a model of cognitive behavioural therapy – made up of short-term interventions of four to 12 sessions – that use techniques, such as relaxation exercises, to encourage positive mood and behaviour.
    With extremely high levels of depression and anxiety among therapists, there is a genuine question about patient safety that is being overlooked. If the mental health model itself is broken, are services deepening the mental health crisis, rather than solving it?
    Read the full article here
    Source: The Conversation
  16. Clive Flashman
    Most people in England, about 30 million, are to be offered a free flu vaccine this year, the government says.
    It is to prepare for a winter that could see the annual flu season coincide with a surge in coronavirus.
    The traditional flu programme will include all over-50s for the first time, as well anyone on the shielding list and the people they live with.
    Also for the first time, children in their first year of secondary school will all be offered the vaccine.
    Plans for Scotland, Wales and Northern Ireland have not yet been announced.
    Read full article here
  17. Clive Flashman
    Doctors and surgeons’ leaders have issued a warning that the NHS must not shut down normal care again if a second wave of Covid-19 hits as that would risk patients dying from lack of treatment. Here, one patient tells her story.
    Marie Temple (not her real name) was distraught when her MRI was cancelled in March, shortly after the UK went into lockdown and Boris Johnson ordered the NHS to cancel all non-urgent treatment.
    Temple, who lives in the north of England, was diagnosed with a benign brain tumour last year after suffering seizures and shortly afterwards had surgery to remove it. She had been promised a follow-up MRI scan in late March to see if the surgery had been a success, but she received a letter saying her hospital was dealing only with emergency cases and she didn’t qualify.
    Read the full article here.
  18. Clive Flashman
    New analysis by the Health Foundation reveals the devastating impact the pandemic has had on social care in England. The independent charity says the findings provide further evidence that the government acted too slowly and did not do enough to support social care users and staff, and that protecting social care has been given far lower priority than the NHS.
    The Health Foundation finds that policy action on social care has focused primarily on care homes and that this has risked leaving out other vulnerable groups of users and services, including those receiving care in their own homes (domiciliary care). It also notes that the shortcomings of the government’s response have been made worse by longstanding political neglect and chronic underfunding of the social care system.
    Since March there have been more than 30,500 excess deaths* among care home residents in England and 4,500 excess deaths among people receiving domiciliary care. While high numbers of excess deaths of people living in care homes have been well reported, the analysis shows there has been a greater proportional increase in deaths among domiciliary care users than in care homes (225% compared to 208%). And while deaths in care homes have now returned to average levels for this time of year, the latest data (up until 19 June) shows that there have continued to be excess deaths reported among domiciliary care users.
    The Health Foundation says that decades of inaction by successive governments have meant that the social care system entered the pandemic underfunded, understaffed, and at risk of collapse.
    Read full article here.
  19. Clive Flashman
    The latest edition of the Wolters Kluwer Journal of Patient Safety has just been published.
    Original studies include:
    Is There a Mismatch Between the Perspectives of Patients and Regulators on Healthcare Quality? A Survey Study The Ideal Hospital Discharge Summary: A Survey of U.S. Physicians Impact of an Original Methodological Tool on the Identification of Corrective and Preventive Actions After Root Cause Analysis of Adverse Events in Health Care Facilities: Results of a Randomized Controlled Trial Detach Yourself: The Positive Effect of Psychological Detachment on Patient Safety in Long-Term Care Patient Safety Activity Under the Social Insurance Medical Fee Schedule in Japan: An Overview of the 2010 Nationwide Survey Sustaining Teamwork Behaviors Through Reinforcement of TeamSTEPPS Principles Prescribing Errors With Low-Molecular-Weight Heparins Development and Psychometric Evaluation of the Speaking Up About Patient Safety Questionnaire Descriptive Analysis of Patient Misidentification From Incident Report System Data in a Large Academic Hospital Federation Medication Errors at Hospital Admission and Discharge: Risk Factors and Impact of Medication Reconciliation Process to Improve Healthcare Reducing and Sustaining Duplicate Medical Record Creation by Usability Testing and System Redesign Full articles are payalled but the abstracts may be viewed free of charge.
    Access the Journal here
  21. Clive Flashman
    Guy’s and St Thomas’ NHS Foundation Trust will work with Omnicell to develop a European technology-enabled inventory optimisation and intelligence service which will be initially implemented across South East London Integrated Care System (ICS). This partnership will encompass all six acute hospital sites within the South East London ICS, including Guy’s & St Thomas’, Kings College Hospital NHS Foundation Trust and Lewisham & Greenwich NHS Trust.
    The project will have the following goals:
    Develop analytics and reporting tools with a goal of improving patient safety, achieving increased operational efficiency and cost efficiencies Utilize the analytics and reporting tools with a goal of achieving agreed efficiencies and cost reductions Demonstrate the impact of managing clinical supplies and medicine spend together at scale Build a service model for the ICS which can be scaled up and adopted by other hospital groups in the UK Read the full article here
  22. Clive Flashman
    Looking to improve practice through learning
    Errors, mishaps and misunderstandings are surprisingly common in medicine and around one in 10 patients suffer avoidable harm, impacting on patients, their families, health care organisations, staff and students. However a research project seeking to improve patient safety across Europe, led by Newcastle-based Northumbria University, has received international acclaim as it looks to improve practice through learning.
    The SLIPPS (Shared Learning from Practice to improve Patient Safety) project is Co-funded by the Erasmus+ Programme of the European Union, and is led by Professor Alison Steven, a Reader in Health Professions Education at Northumbria University.  Professor Steven has a longstanding interest in the use of education to raise standards of care and ensure patient safety. Considering the rapid spread of Covid 19, she says improving patient safety and standards of care across Europe and beyond, has never been more important.
    Read full article here
  23. Clive Flashman
    A new app has been piloted in North East London to help district nurses document chronic wound management more efficiently. The tech has been used in community services and stores a catalogue of photographs to accurately document chronic wounds. 
    District nurses can use the app on a smartphone – making it lightweight, portable and easy to clean. Using two calibration stickers placed either side of the wound, the app can scan it and capture its size and depth to build a 3D image. Nurses can then fill out further characteristics on the software such as colour, pain level, location and smell to give a full picture of the wound’s development.
    Read full story
    Source: Nursing Times,  12 February 2020
  24. Clive Flashman
    The Doctors’ Association UK has compiled stories from 602 frontline doctors which expose a startling culture of bullying and overwork in the NHS.
    The stories include:
    a pregnant doctor who fainted after being forced to stand up for 15 hours straight and being denied water. The junior doctor was subsequently shouted at in front of colleagues and patients on regaining consciousness and told it was her choice to be pregnant and that ‘no allowances would be made’. a doctor who told us that a junior doctor hung themselves in a cupboard whilst on shift and was not found for 3 days as no-one had looked for them. His junior doctor colleagues were not allowed to talk about his suicide and it was all ‘hushed up’. a doctor who was denied a change of clothes into scrubs after having a miscarriage at work despite her trousers being soaked in blood. Full press release  
  25. Clive Flashman
    NHS England has said that there is no ‘widespread issue’ with the national booking system for Covid vaccinations, despite eligible patients claiming they have been unable to book their booster jabs.
    It comes as Sajid Javid yesterday urged people to ‘come forward’ for their Covid vaccines if they are eligible and have not had an invite six months after their second jab, and the Government launched a new campaign to promote boosters and flu vaccines.
    Daisy Cooper, liberal democrat MP for St Albans, said yesterday in the House of Commons: ‘Many of my constituents are desperate to get their third jabs and their boosters. The Minister said that if their invitation has not arrived, they can book on the national booking service or 119, but that is simply not working. 
    ‘When they get on to the national booking service, it says they are not eligible if they have not received an invitation letter. If they call 119, it is telling them it cannot override the system.’
    Vaccines minister Maggie Throup assured Ms Cooper: ‘I will definitely look into that. If there is a problem in the system, we will get it fixed.’
    But NHS England told Pulse: ‘There isn’t a widespread issue with the system not recognising people who are eligible.’
    The NHS website currently says: ‘If you haven’t received an invite by 6 months and 1 week, you can try to book your appointment online without an invite.’
    Patients have also taken to Twitter to complain about not being able to book Covid boosters, despite receiving invitations to do so.
    Read full article here
    Original source: Pulse Today
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