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Clive Flashman

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  1. Clive Flashman
    The safety of maternity services in the NHS are to be investigated by MPs after a string of scandals involving the deaths of mothers and babies highlighted by The Independent.
    The Commons health select committee, chaired by former health secretary Jeremy Hunt, has announced it will hold an inquiry looking at why maternity incidents keep re-occurring and what needs to be done to improve safety.
    The committee will also examine whether the clinical negligence process needs to change and the wider aspects of a “blame culture” in the health service and its affects on medical advice and decision making.
    Read the full article here
  2. Clive Flashman
    NHS People Plan provides a stop-gap but leaves glaring omissions
    'Two years after it was first promised, the NHS is still waiting for a long-term workforce plan. Some of the measures announced in today’s People Plan are positive. As the plan acknowledges, it is important to learn from the impressive changes made by NHS staff during the pandemic. And improving support for people from black and minority ethnic communities – who make up one fifth of the NHS workforce – is rightly a top priority. 
    'But there are glaring omissions. The NHS went into the pandemic with a workforce gap of around 100,000 staff, yet the plan does not say how this will be addressed in the medium term. This is particularly concerning at a time when our recruitment of nurses from abroad has dropped dramatically. These details are missing because the NHS is still waiting on government to set out what funding will be available to expand the NHS workforce – without which the NHS cannot recruit and retain the doctors, nurses and other staff it needs. 
    'While this plan at least provides a stop-gap to help get the NHS through the winter, there is no equivalent plan for social care – a sector suffering from decades of political neglect and the devastating impact of COVID-19 on care users and staff. A comprehensive workforce plan for both the NHS and social care is needed now more than ever'.
  3. Clive Flashman
    Staffing shortages remain a pervasive challenge for the NHS, risking patient safety, care standards and the pursuit of innovation. 
    There are now 106,000 vacancies across the NHS in England, with over 44,000 vacancies in nursing. Overseas staff are a crucial way of filling those vacancies, but the message to potential workers is confused to say the least.
    Read full story
    Source: Health Europa, 14 February 2020
  4. Clive Flashman
    Queen Elizabeth Hospital Kings Lynn carried out a transparent review of 389 Covid infections
    An NHS trust has apologised to hundreds of families whose relatives caught Covid-19 in hospital and died, after a review found a lack of private rooms contributed to the spread of the virus.
    The Queen Elizabeth Hospital (QEH) in Kings Lynn, Norfolk, has carried out a review of all 389 cases of patients who either definitely or probably contracted Covid while in the hospital between March 2020 and February this year. Of those, 151 patients died. 
    The trust is the only NHS trust to have carried out a full and transparent review of hospital acquired infections of Covid-19 with staff speaking with each family to understand their concerns and views.
    Read full article here
    Source: Independent
  5. Clive Flashman
    ·        Trusts told to identify actions to “immediately stop all delays” ·        Letter calls for issue to be discussed at every board meeting ·        It follows concern over harm to patients from delays Trusts and integrated care systems are being told by NHS England and Improvement to take urgent action to ”immediately stop all delays” to ambulance handovers, which will require “difficult choices”.
    A letter yesterday from NHS England’s medical director, director for emergency and elective care, and its regional directors was sent to all local chief executives and chairs yesterday.
    It also says they should discuss the issue of ambulance handovers at every board meeting they hold, warns that “corridor care” is “unacceptable as a solution”, and says ambulances should not be used as “additional ED cubicles”.
    The move comes amid signs of large numbers of very long handover delays, and concern about the risk to patients from this and the knock-on damage to ambulance response times.
    Read the full article here (paywalled)
    Original source: Health Service Journal
  6. Clive Flashman
    NHSX have revealed that they will fund and support 14 new projects across the country to help half a million people receive care at home using digital technology. This will include remote cardiac rehabilitation services and digital self-management systems, as well as parental support services for families of children with eating disorders.
    Tara Donnelly, Chief Digital Officer at NHSX, said: “Through our Digital Health Partnership Award, these organisations will have access to the expertise and support they need to adopt or expand their digital capabilities safely and effectively, allowing many more patients with long term conditions to receive their care from the comfort of their homes rather than always having to attend primary and acute settings.”
    In addition to innovation in digital technology, a number of the projects build on existing services to ensure more patients can benefit from remote services.
    One of the projects also includes the expansion of secure video services at Great Ormond Street Hospital for Children, which will make it possible for patients and carers, as well as their doctors, to share seizure videos across their neurology service. Cambridgeshire Community Services are also expanding their remote health monitoring service.
    Read the full article here
    Source: National Health Executive
  7. Clive Flashman
    Every pharmacist must report adverse drug reactions using the yellow card scheme, says chair of the Community Pharmacy Patient Safety Group, Janice Perkins
    Polypharmacy, when different medications are used by an individual at the same time, is becoming increasingly common because people are living for longer and with multiple different illnesses. One study, published in 2018 by the Oxford University Press, found that over half (54%) of those aged 65 years and above who took part in the study had two or more long-term conditions, for which they could have been taking a range of medicines.
    Read full story
    Source: Community Pharmacy News, 17 February 2020
  8. Clive Flashman
    One of the best doctors in the UK died on an understaffed Manchester hospital ward after falling sick with a condition he was an expert in treating, an inquest has heard.
    Professor Amit Patel was among the ‘best doctors in the UK’, the first person in the country to be qualified in stem cell transplantation and cellular therapy, and intensive care medicine. He was also a beloved husband and father-of-two.
    “He looked liked a corpse, 70 per cent of his blood was in his lungs, he was freezing cold and he looked like he was dead," his heartbroken wife told an inquest at Manchester Coroners Court. "I told my daughters, ‘daddy is dead’ – I didn’t have much hope he would be able to come out of that.”
    Professor Patel's condition was being investigated by doctors at Wythenshawe Hospital, Manchester Royal Infirmary, and across the country. But, he was in the unimaginable position of being a nationally recognised expert in the illness. During his career, he had formed ‘national guidance’ on the illness and sat on the national multi-disciplinary panel to which the most serious cases, including his own, were referred.
     The court heard how he was experiencing the symptoms of hemophagocytic lymph histiocytosis (HLH) – a rare and life-threatening immune disorder where the body reacts inappropriately to a 'trigger’, such as an infection or cancer, and leads to inflammation. Patients can be predisposed to HLH by Still’s disease, another rare autoimmune condition also causing inflammation, which Professor Patel was suspected to have had.
    Full article here.
  9. Clive Flashman
    Inspectors raise ‘serious concerns’ about medical wards and emergency care at Shropshire NHS trust
    A patient bled to death on a ward at Shrewsbury and Telford Hospitals Trust after a device used to access his bloodstream became inexplicably disconnected, The Independent has learnt.
    The incident came to light as new concerns arose about quality of care at the Shropshire trust, with the Care Quality Commission (CQC) warning of “serious concerns” about its medical wards and emergency department following an inspection last month.
    Although the report from the inspection has not yet been published, it is understood that the trust has been served with a legal notice by the regulator to comply with more than a dozen conditions. It remains in special measures following the inspection and is rated inadequate overall.
    See full article in The Independent here
  10. Clive Flashman
    Patients Know Best has launched an education programme which can be used by medical schools. 
    Among the first to use the programme are undergraduate Pharmacy students at Liverpool John Moores University (LJMU).
    The Patients Know Best platform, which recently became the first personal health record to be fully integrated into the NHS App, has been incorporated into the curriculum to facilitate simulated interactions between patients and pharmacists.
    This has involved training the students to use Patients Know Best to enable their use of the platform to interact and collaborate with each other.
    Read the full article here.
  11. Clive Flashman
    New analysis published by the Health Foundation shows that while the waiting list for hospital care continues to grow, so too does the number of ‘missing' patients who have not yet been added to the list. There were 7.5 million fewer people referred for routine hospital care between January 2020 and July 2021 than would have been expected based on numbers prior to the pandemic. These ‘missing patients’ are in addition to the record 5.6 million people already on the waiting list.  
    This lower than expected number of people referred for hospital care, including for routine procedures such as hip or knee surgery, is likely to be due to a number of reasons. Some people may not have sought treatment for health concerns during the pandemic, while others may have seen their GP but not yet been referred due to the pressure on hospital services during the pandemic. In some instances, care may no longer be needed. 
    The analysis comes alongside a BBC Panorama documentary (Monday 27 September) revealing the scale of the elective care backlog and the impact delays are having on people’s lives. The Health Foundation analysis, shared with Panorama, also shows that the pandemic had a much worse effect on the hospital care provided in some areas of England than it did in others. The analysis of 42 local integrated care systems (ICSs) shows that the pandemic significantly reduced the level of routine hospital care performed across the country – in the worst affected area routine hospital care dropped by 37% while in the least affected area there was a 13% reduction.  
    Read the full article here
    Source: The Health Foundation
  12. Clive Flashman
    Female health monitoring apps are putting women at risk by "coercing" them into disclosing - and then poorly handling - highly sensitive data, according to new research.
    The study examined the privacy policies and data safety labels of 20 of the most popular of these kind of apps, which are commonly used to help women conceive. It found a host of poor data-management practices, including some apps not having a delete function, even for highly personal information such as menstrual cycles and miscarriages. Its authors say it is the most extensive evaluation its kind completed to date. They say the apps are used by hundreds of millions of people.
    The BBC has contacted a number of app providers - none have responded to a request for comment.
    "While female health apps are vital to the management of women’s health worldwide, their benefits are currently being undermined by privacy and safety issues," the lead author of the study, Dr Ruba Abu-Salma, from King's College London, told the BBC.
    Other key findings from the study include:
    35% of apps claimed not to share personal data with third parties but contradicted this in their privacy policies 50% assured users that health data would not be shared with advertisers, but were ambiguous about other data collected 45% of privacy policies denied responsibility for third-party practices, despite claiming to vet them. Female-focused technology has boomed in recent years, with the market expected to exceed $75 billion by 2025. But Lisa Malki, another of the study's authors, said the industry needed to get better at protecting the women whose data it was using.
    Read full article on the BBC here.
  13. Clive Flashman
    A group of potent synthetic opioids called nitazenes have been linked to a rise in overdoses and deaths in people who use drugs, primarily heroin, in England over the past two months, drug regulators have warned.
    The Office for Health Improvements and Disparities has issued a National Patient Safety Alert on potent synthetic opioids implicated in heroin overdoses and deaths.
    In the past 8 weeks there has been an elevated number of overdoses (with some deaths) in people who use drugs, primarily heroin, in many parts of the country (reports are geographically widespread, with most regions affected but only a few cities or towns in each region).
    Testing in some of these cases has found nitazenes, a group of potent synthetic opioids. Nitazenes have been identified previously in this country, but their use has been more common in the USA. Their potency and toxicity are uncertain but perhaps similar to, or more than fentanyl, which is about 100x morphine.
    The National Patient Safety Alert provides further background and clinical information and actions for providers.
  15. Clive Flashman
    What does whistleblowing in a pandemic look like? Do employers take concerns more seriously – as we would all hope? Does the victimisation of whistleblowers still happen? Does a pandemic compel more people to speak up? We wanted to know, so Protect analysed the data from all the Covid-19 related calls to theirr Advice Line. They found:
    * 41% of whistleblowers had Covid-19 concerns ignored by employers
    * 20% of whistleblowers were dismissed
    * Managers more likely to be dismissed (32% ) than non-managers (21%)
     
    They found that too many whistleblowers feel ignored and isolated once they raise their concerns and that these failing are a systematic problem.
    Protect, which runs an Advice Line for whistleblowers, and supports more than 3,000 whistleblowers each year, has been inundated with Covid-19 whistleblowing concerns, many of an extremely serious nature. Its report, The Best Warning System: Whistleblowing During Covid-19 examines over 600 Covid-19 calls to its Advice Line between March and September. The majority of cases were over furlough fraud and risk to public safety, such as a lack of social distancing and PPE in the workplace.
     
  16. Clive Flashman
    Hospital trust ‘truly sorry that mistakes were made in care’ of Luchii Gavrilescu, who died after being sent home from hospital with undiagnosed tuberculosis.
    An NHS trust investigated over maternity care failings has apologised after a six-week-old child was found to have died due to mistakes at one of its hospitals.
    East Kent Hospitals University Trust was embroiled in a major scandal after The Independent revealed the trust had seen more than 130 babies over a four-year period suffer brain damage as a result of being starved of oxygen during birth. A report into the trust concluded in April that there had been “recurrent safety risks” at its maternity units.
    Read full article here.
  17. Clive Flashman
    Smartphone apps designed to detect the risk of skin cancer are poorly regulated and “frequently cannot be relied upon to produce accurate results”, according to a new analysis. They found the apps may cause harm from failure to identify potentially deadly skin cancers, or from over-investigation of false positive results such as removing a harmless mole unnecessarily.
    Read full story
    Source: Digital Health, 14 February 2020
  18. Clive Flashman
    Where Healthcare Is Improving and Where It Needs More Work
    While the public discourse on health equity has increased in recent years, there are still many problems in health disparities research and in care delivery. Health systems are struggling to tackle health equity issues as highlighted by a recent study that evaluated online consumer reviews of hospitals and experiences of racism. 

    However, organizations are making a positive impact toward health equity in a variety of areas. Walmart is partnering with virtual care company Grand Rounds Health and Doctor On Demand on a digital health program aimed at tackling health disparities among African American workers. Women's health company Tia is looking to welcome female-identifying patients in an effort to improve inclusivity in health tech. For more content on companies that are addressing health equity gaps, including specialized care for women and individuals with female biologies, check out the recent blog post where we collaborated with Rock Health: Building comprehensive women+ digital health: Eight sectors serving women+ needs. 
  19. Clive Flashman
    Presymptom Health’s technology provides early and reliable information about infection status and severity in patients with non-specific symptoms, helping doctors make better treatment decisions. The company’s tests can be run on NHS PCR platforms, which were widely deployed during the COVID pandemic and are now often under-utilised. By detecting true infection and sepsis earlier, it’s possible to save lives and significantly reduce the incorrect use of antibiotics.
    When it comes to sepsis, Presymptom’s technology could revolutionise treatment. According to The UK Sepsis Trust, every 3 seconds, someone in the world dies of sepsis. In the UK alone, 245,000 people are affected by sepsis with at least 48,000 people losing their lives in sepsis-related illnesses every year.
    This is more than breast, bowel and prostate cancer combined. When diagnosed at a late stage, the likelihood of death increases by 10% for every hour left untreated. Yet, for many patients, with early diagnosis it is easily treatable.
    “We’re confident that our first product can play a big part in tackling Anti-Microbial Resistance (AMR), which has been identified by the World Health Organisation as  one of the top 10 global public health threats,” said Dr Iain Miller, CEO of Presymptom Health.
    “By understanding the presence, or absence, of infection as early as possible, doctors can be more confident in their diagnosis and avoid unnecessarily prescribing antibiotics – something that is a growing concern in the NHS and globally.
    “If we take Sepsis as an example. Sepsis diagnostics hasn’t moved on in more than a century, and currently doctors can only diagnose it when advanced symptoms and organ failure are present – which is often too late. Our technology enables doctors to diagnose both infection and sepsis up to three days before formal clinical diagnosis, radically transforming the process and preventing unnecessary deaths.
    The science behind Presymptom’s technology is based upon 10 years of work conducted at Defence Science and Technology Laboratory (Dstl) and originated from £16m of sustained Ministry of Defence investment in a programme of research designed to help service personnel survive infection from combat injuries.
    The technology is currently undergoing clinical trials at nine NHS hospitals in the UK, with results anticipated later in 2024. In addition, Presymptom is working on additional UK and EU trials.
  20. Clive Flashman
    Minority ethnic people in UK were ‘overexposed, under protected, stigmatised and overlooked’, new review finds.
    Structural racism led to the disproportionate impact of the coronavirus pandemic on black, Asian and minority ethnic (BAME) communities, a review by Doreen Lawrence has concluded.
    The report, commissioned by Labour, contradicts the government’s adviser on ethnicity, Dr Raghib Ali, who last week dismissed claims that inequalities within government, health, employment and the education system help to explain why COVID-19 killed disproportionately more people from minority ethnic communities.
    Lady Lawrence’s review found BAME people are over-represented in public-facing industries where they cannot work from home, are more likely to live in overcrowded housing and have been put at risk by the government’s alleged failure to facilitate Covid-secure workplaces.
    She demanded that the government set out an urgent winter plan to tackle the disproportionate impact of Covid on BAME people and ensure comprehensive ethnicity data is collected across the NHS and social care. The report, entitled An Avoidable Crisis, also criticises politicians for demonising minorities, such as when Donald Trump used the phrase “the Chinese virus”.
    The report, which is based on submissions and conversations over Zoom featuring “heart-wrenching stories” as well as quantitative data, issued the following 20 recommendations:
    Set out an urgent plan for tackling the disproportionate impact of Covid on ethnic minorities Implement a national strategy to tackle health inequalities Suspend ‘no recourse to public funds’ during Covid Conduct a review of the impact of NRPF on public health and health inequalities Ensure Covid-19 cases from the workplace are properly recorded Strengthen Covid-19 risk assessments Improve access to PPE in all high-risk workplaces Give targeted support to people who are struggling to self-isolate Ensure protection and an end to discrimination for renters Raise the local housing allowance and address the root causes of homelessness Urgently conduct equality impact assessments on the government’s Covid support schemes Plan to prevent the stigmatisation of communities during Covid-19 Urgently legislate to tackle online harms Collect and publish better ethnicity data Implement a race equality strategy Ensure all policies and programmes help tackle structural inequality Introduce mandatory ethnicity pay gap reporting End the ‘hostile environment’ Reform the curriculum Take action to close the attainment gap Read full story 
    Source: The Guardian, 28 October 2020
  21. Clive Flashman
    The redeployment of health visitors to support the national coronavirus response has left remaining staff with increased workloads, worsened mental health and fears that the needs of children are being missed, a new survey has revealed.
    In the wake of Covid-19, University College London (UCL) gathered the views of 663 health visitors in England to find out how the pandemic had affected their work. Overall, 60% of respondents reported that at least one member of their team had been redeployed between 19 March and 3 June. Of teams that had lost staff, 41% reported that between six and 50 colleagues had been moved elsewhere during that period.
    The combination of increased caseloads and limited face-to-face contacts left “widespread concern” among health visitors that the needs of many children would be missed in the peak of the outbreak, found the survey. Study authors raised concerns about the “significant negative impacts” that increased workload and pressures had on staff wellbeing and mental health.
    Read the full article here.
  22. Clive Flashman
    Talking Medicines, a social intelligence company for the pharmaceutical industry, has secured £1.1 million funding deal to scale up its AI-based platform for measuring patient sentiment.
    Tern, an investment company specialising in the Internet of Things (“IoT”), is the lead investor in a syndicated funding round alongside The Scottish Investment Bank, Scottish Enterprise’s investment arm.
    Led by CEO Jo Halliday alongside co-founders Dr Elizabeth Fairley and Dr Scott Crae, Talking Medicines will use the funds to support the launch and roll-out of a new AI data platform, which will translate what patients are saying into intelligence by providing a global patient confidence score by medicine. As part of these plans, the business intends to immediately recruit 9 new employees to the NLP data tech team.
    Formed in 2013 to create new ways of capturing the voice of the patient, the Glasgow-based firm uses a combination of AI, machine learning and Natural Language Processing (NLP) tech tools to capture and analyse the conversations and behaviours of patients at home, with the aim of transforming big pharma’s understanding of patient sentiment. Through mapping the patient voice from social media and connected devices to regulated medicine information, it is able to build data points to determine trends and patterns of patient sentiment across medicines.
    The round brings the total raised by the firm to £2.5m, including three previous seed funding rounds with previous investors including impact investor SIS Ventures and the Scottish Investment Bank. Talking Medicines CEO Halliday, said: “This investment will scale our team and the development of our AI, ML, NLP tech tools to translate what patients are saying into actionable pharma grade intelligence through our global patient confidence score by medicine.”
  23. Clive Flashman
    Almost half of all staff absence linked to coronavirus in parts of northern England
    Tens of thousands of NHS staff are off sick or self-isolating because of coronavirus, according to data shared with The Independent as the second wave grows.
    In some parts of northern England, more than 40% – in some cases almost 50% – of all staff absences are linked to COVID-19, heaping pressure on already stretched hospitals trying to cope with a surge in virus patients. The problem has sparked more calls for wider testing of NHS staff from hospital leaders and nursing unions who warned safety was being put at risk because of short staffing on wards.
    Across England, more than 76,200 NHS staff were absent from work on Friday – equivalent to more than 6% of the total workforce. This included 25,293 nursing staff and 3,575 doctors.
    Read full article
    Source: The Independent, 1 November 2020
  24. Clive Flashman
    PRESS RELEASE - 1 July 2019
    Patient Safety Learning identifies that reduced performance in two aspects of patient experience may increase the safety risks patients face as in-patients.
    The Care Quality Commission’s (CQC) recently published 2018 annual in-patient survey shows that improvement in two areas of patient experience has stalled while a range of issues that matter to patients have worsened. The charity, Patient Safety Learning, has identified that deteriorating performance in two of these issues is likely to make patient safety risks worse.
    Fewer patients informed properly when discharged home
    The CQC’s sixteenth annual survey of people who stayed as an in-patient in hospital was published on 20 June 2019. It shows that most people had confidence in the doctors and nurses treating them, and felt that staff answered their questions clearly.
    However, the survey reports that 40% of patients were discharged from hospital without written information about how to look after themselves following treatment. This is up 2% from 2017. Of patients who had been given medication to take home, 44% were not told of possible side effects for which they should watch.
    Fewer patients report being involved in their own care
    Only 54% of patients report that they are involved as much as they want to be in decisions about their care and treatment, down from 56% in 2017. The number of patients reporting that their views had been sought on the quality of care they received was down by a quarter compared with 2017, from 20% to 15%.
    An increasing challenge to safety
    Giving patients written information about how to look after themselves on discharge is clearly a patient safety issue. If this practice is reducing, then the inherent risk to patients must be increasing.
    Patient Safety Learning’s recent report, A Blueprint for Action, cited a wide range of evidence that communication with patients – listening to them and acting on what is heard – has a demonstrable effect on improving patient safety. The evidence from the CQC survey indicates, however, that such practice is reducing, not increasing, with corresponding implications for patient safety.
    Patient Safety Learning Chief Executive, Helen Hughes, said, “Effective communication and engagement with patients is essential for safe care. The CQC’s survey is a valuable tool for assessing this. It is concerning that their report evidences that communication with patients is reducing in ways that have the potential to increase the risk to patient safety. Patient safety is a core part of the purpose of healthcare and action is needed to share good practice across the wider health system.”   /ENDS
    Note to editors
    Patient Safety Learning is a charity. We help transform safety in health and social care, creating a world where patients are free from harm.
    We identify the critical factors that affect patient safety and analyse the systemic reasons they fail. We use what we learn to envision safer care. We recommend how to get there. Then we act to help make it happen. 
    Patient Safety Learning’s latest report, A Blueprint for Action, can be downloaded here: www.patientsafetylearning.org/resources/blueprint.
    For more information, contact
    Margot Knight, Marketing and Communications Manager, Patient Safety Learning
    E: margot@patientsafetylearning.org
    Or
    Helen Hughes, Chief Executive, Patient Safety Learning
    T: +44 (0) 7793 550855
    E: helen@patientsafetylearning.org
    Patient Safety Learning
    SB 220
    China Works
    100 Black Prince Road
    London SE1 7SJ
    www.patientsafetylearning.org
  25. Clive Flashman
    There is always a lot happening with patient safety in the NHS (National Health Service) in England. Sadly, all too often patient safety crises events occur. The NHS is also no sloth when it comes to the production of patient safety policies, reports, and publications. These generally provide excellent information and are very well researched and produced. Unfortunately, some of these can be seen to falter at the NHS local hospital implementation stage and some reports get parked or forgotten. This is evident from the failure of the NHS to develop an ingrained patient safety culture over the years. Some patient safety progress has been made, but not enough when the history of NHS policy making in the area is analysed.
    Lessons going unlearnt from previous patient safety event crises is also an acute problem. Patient safety events seem to repeat themselves with the same attendant issues.
    Read full story
    Source: Harvard Law, 17 February 2020
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