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Sam

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  1. Sam
    A UK oncologist with a world reputation is facing allegations by the General Medical Council that he provided medication inappropriately in an attempt to keep terminally ill patients alive.
    Justin Stebbing, professor of cancer medicine and oncology at Imperial College London, who has a private practice in Harley Street, faces allegations at a medical practitioners tribunal of failing to provide good clinical care to 11 patients between March 2014 and March 2017.
    Read full story (paywalled)
    Source: BMJ, 15 September 2020
  2. Sam
    A protective device against coronavirus for at-risk doctors is to be provided free to the NHS.
    The SNAP device for ear, nose and throat surgeons was created after Burton-upon-Trent consultant Amged El-Hawrani died with COVID-19 in March. He was one of the UK's first senior medics to die with the virus, his death showing that they were at serious risk.
    The device clips over patients' masks to prevent the virus spreading through coughs and sneezes. It was developed by surgeons Ajith George and Chris Coulson, with the help of Aston University, who said nasendoscopy procedures - where a small flexible tube fitted with a camera is inserted into the nose - often made patients cough, splutter and sneeze.
    It works by clipping on to either side of a normal surgical face mask, creating a hole for an endoscope to be inserted while keeping the patient's nose and mouth completely covered. When it is removed, a one-way valve closes the hole so no virus can escape.
    "We were concerned about the safety of doctors but also about the risk of missed diagnoses and opportunities for treatment of patients," Mr Coulson, an ENT surgeon working at the Queen Elizabeth Hospital in Birmingham, said.
    "Our aim has been to produce an easy-to-use, cheap device that would allow clinicians to return to routine practice."
    Read full story
    Source: BBC News, 16 September 2020
  3. Sam
    Tens of thousands of people may require kidney dialysis or transplants because of coronavirus, according to experts who warn the long-term effects of Covid are causing an “epidemic in primary care”.
    Up to 90% of coronavirus patients admitted to hospital may still experience symptoms two to three months later – from breathlessness to joint pain, fatigue and chest pain – scientists told the Lords science and technology committee on Tuesday.
    Donal O’Donoghue, a consultant renal physician at Salford Royal NHS trust, said damage to the kidneys was of major concern. It is believed the virus may attack the organ directly, he said, while the kidneys could also be injured by body-wide inflammation caused by the virus.
    “Normally we see maybe 20% of people that go on to intensive care unit need to have a form of dialysis. During Covid it was up to 40% – and 85% of people had some degree of kidney injury,” he said. “No doubt that is happening out in the community as well, probably to a lesser extent.”
    Tom Solomon, professor of neurology at the University of Liverpool, told the committee more needed to be done to support Covid survivors. “[GPs] are seeing lots of patients who are left over with problems from their Covid and they need to be able to refer them to get help in understanding what is going on,” he said, adding: “This is really the current epidemic in primary care.”
    Read full story
    Source: The Guardian, 15 September 2020
  4. Sam
    "It’s March and I’m lying awake at 3am struggling to breathe. There’s a heaviness in my chest. I’m terrified at the speed and inconsistency of my heartbeat, but I’m too afraid to call for medical help again. They’ve told me that it will get better and I need to persevere. I live on my own, and I’m trying to control my panic."
    Six months later Louise Cole is still dealing with the symptoms. Like thousands of others, it turns out she has “long Covid”. Like them, Louise has struggled to be taken seriously by doctors. 
    "While for some life is slowly returning to normal, the same cannot be said for long-term COVID-19 patients. Forgetting us is not an option — not least because the burden of caring for people like me is something the NHS and government will have to reckon with. Something must be done to ease our suffering — and that starts with paying us some attention."
    Read full story
    Source: Evening Standard, 11 September 2020
  5. Sam
    A damning report into Devon’s NHS 111 and out of hours GP service has revealed shocking stories of patients who have either had their health put at risk or tragically died due to the service being in need of urgent improvement.
    Devon Doctors Limited, which provides an Urgent Integrated Care Service (UICS) across Devon and Somerset, was inspected by independent health and social care regulator the Care Quality Commission (CQC) in July, after concerns were raised about the service.
    They included the care and treatment of patients, deaths and serious incidents, call waits, staff shortages, and low morale. Inspectors found 'deep rooted issues'. The CQC concluded it was not assured that patients were being treated promptly enough and, in some cases, they had not received safe care or treatment.
    It is calling for the service to make urgent improvements which will be closely monitored.
    Since August 2019, the report stated Devon Doctors had received 179 complaints. Nine had been identified by the service as incidents of high risk of harm and six had been identified by the service as incidents of moderate risk of harm.
    These had been recorded on the service’s significant event log. However, on review, the CQC identified an additional 30 events from the complaints log which could also have been classed as either moderate or high risk of harm.
    Read full story
    Source: Devon Live, 15 September 2020
  6. Sam
    A lack of coronavirus tests for NHS staff is leading to staff absences and services being put at risk, hospital bosses have warned.
    NHS Providers, which represents hospital trusts in England, said staff are having to self-isolate rather than work because they cannot get tests for themselves or family members. It comes after widespread reports of people struggling to get tested.
    The home secretary defended the system, saying capacity was increasing.
    The government's testing system - part of its test, track and trace operation which Prime Minister Boris Johnson promised would be "world-beating" - has faced criticism in recent weeks. An increase in demand for coronavirus tests has led to local shortages - with some people being directed to test sites hundreds of miles from their homes.
    One doctor working in a coronavirus hotspot said she applied for a test for herself and her partner after they developed coughs and fevers. After refreshing the website for five hours, she managed to get an appointment but on arrival was told no booking had been made.
    She had taken screenshots of a confirmation code but was not sent a QR code to scan. "I showed the screenshots but I was told that the appointments weren't happening," she said.
    "I have to say I burst into tears. I was meant to be seeing patients and I feel guilty."
    Dr Rachel Ward, a GP in Newbury, told BBC Breakfast she was seeing a lot of patients who were struggling to get tests, saying a lot of families were "at the end of their tether" as it was "very stressful when you are faced with two weeks off work".
    She said if the staff at her practice were unable to get tests and had to self-isolate it would have a "huge impact" on patients as some of their healthcare workers are booked in to administer 100 flu jabs in a day.
    Read full story
    Source: BBC News, 14 September 2020
  7. Sam
    A trust which accounted for one in eight of covid deaths in hospital during part of the summer has been criticised by the Care Quality Commission for its infection control.
    Staff did not follow social distancing rules in a staff room at East Kent Hospitals University Foundation Trust, did not always practise hand hygiene, and the trust had used incorrect PPE, the CQC said.
    In addition, two hourly cleans were not always carried out, soap and hand sanitiser were missing, and the emergency department at the William Harvey Hospital in Ashford did not have enough sinks for staff and visitors to wash their hands in. There was also a lack of hand hygiene guidance on display.
    Inspectors added that not all staff understood what needed to be done when a walk-in patient presented with covid symptoms, and the emergency department did not have an escalation plan if areas were crowded and patients could not socially distance.
    The CQC inspected the William Harvey Hospital on 11 August and took enforcement action after the visit. It has yet to publish the report but the initial feedback was summarised in the trust’s latest board papers, together with the trust’s response. 
    Read full story (paywalled)
    Source: HSJ, 14 September 2020
  8. Sam
    The Health Information and Quality Authority (HIQA) has today published an overview report on the lessons learned from notifications of significant incident events in Ireland arising from accidental or unintended medical exposures in 2019. 

    In 2019, HIQA received 68 notifications of significant events of accidental or unintended medical exposures to patients in public and private facilities, which is a small percentage of significant incidents relative to the total number of procedures taking place which can be conservatively estimated at over three million exposures a year.

    The most common errors reported were patient identification failures, resulting in an incorrect patient receiving an exposure. These errors happened at various points in the patient pathway which, while in line with previous reporting nationally and international data, highlights an area for improvement.

    John Tuffy, Regional Manager for Ionising Radiation, said “The overall findings of our report indicate that the use of radiation in medicine in Ireland is generally quite safe for patients. The incidents which were reported to HIQA during 2019 involved relatively low radiation doses which posed limited risk to service users. However, there have been radiation incidents reported internationally which resulted in severe detrimental effects to patients so ongoing vigilance and attention is required."
    John Tuffy, continued “As the regulator of medical exposures, HIQA has a key role in the receipt and evaluation of notifications received. While a significant event is unwanted, reporting is a key demonstrator of a positive patient safety culture. A lack of reporting does not necessarily demonstrate an absence of risk. Reporting is important, not only to ensure an undertaking is compliant but because it improves general patient safety in a service and can minimise the probability of future preventative events occurring.”
    Read full story
    Source: HIQA, 9 September 2020
  9. Sam
    A third of those who died with diagnosed or suspected COVID-19 in English hospitals did so at Tameside and Glossop Integrated Care Foundation Trust in the seven days to 10 September.
    The Greater Manchester Trust has seen a significant rise in COVID-19 deaths, from a weekly total of five on 4 September to 18 six days later. The total number of COVID-19 hospital deaths in the seven days to 10 September across England was 54.
    COVID-19 deaths at Tameside and Glossop had fallen to a weekly total of zero on 23 July, before beginning to climb steadily from 20 August. The last time the trust recorded 18 deaths in a seven-day period was in late April when the pandemic was still close to its first peak.
    The highest seven day figure recorded by the trust was 28, meaning the 10 September figure is equivalent to 64% of its peak covid-19 mortality. Nationally, hospital deaths with the virus are running at less than 1 per cent of the early-April peak.
    No other trust recorded more than three covid-19 deaths during the seven days to 10 September.
    Read full story (paywalled)
    Source: HSJ, 13 September 2020
  10. Sam
    The government has now officially recognised the long-term health implications some people can suffer after contracting coronavirus.
    Lung inflammation, gastrointestinal disturbance, and fatigue are just some of the listed long-term health effects published by Public Health England.
    But it’s no new revelation - as campaigners made up of politicians, expert clinicians and sufferers have fought hard over the past few months to bring what has become known as ‘long covid’ into the public domain.
    One of them is Jo Platt, former Labour MP for Leigh, who says the virus hit her ‘like a train’ in the week before lockdown in March - when it wasn’t possible to get a test. She's been left with symptoms months on - although recently tested negative twice for COVID-19.
    “It was like a train hitting me, like a switch, I felt so unwell for two days. I had general dizziness, fatigue but nothing you could pinpoint. I didn’t have a cough or a temperature, although I felt hot; had gastric trouble; shortness of breath; then it eased and I was okay and thought ‘thank goodness. It must have just been mild’,” Jo said.
    Two days later the symptoms came back, but that spell of illness lasted for two weeks. Jo said she couldn’t get out of bed, suffered intense headaches and a burning sensation in her lungs, was unable to concentrate and couldn’t read.
    “I’m not normally an anxious person, but then came anxiety", she said. "I felt a real sense of dread, a heightened pending sense of doom. It continued on and off for months, and particularly worsened at the weekend.
    The 48-year-old got in touch with her GP who said anxiety was bringing the symptoms on. It wasn’t until a week later when Jo read an article by Professor Paul Garner, of Liverpool School of Tropical Medicine, who talked about his fight with symptoms, that she realised she wasn't alone.
    “Everything he was saying was the same as what I was going through. I cried and cried. It was all validated. Then the journey began of finding other people - which does make it feel better,” said the mum-of-three.
    Prof Garner has described coronavirus as a 'very bizarre disease' that left him feeling 'repeatedly battered the first two months' and then experiencing lesser episodes in the subsequent four months with continual fatigue.
    “Navigating help is really difficult,” he said in a BMJ webinar.
    With the help of Jo's connections in parliament, Prof Garner, and meetings with the shadow cabinet health team, a support group for long covid sufferers has been formed, which has 20,000 members. They’re calling for recognition, which they finally got from the government on 7 September 7, research and rehab.
    Matt Hancock said at the Health and Social Care Committee the following day: “The long-term impacts of covid are not very strongly correlated with severity of the initial illness. While we have a significant amount of work going into supporting those who come out of hospital, this is not just about people hospitalised.
    “In fact, this is especially relevant for now with the latest rise largely among young people, it doesn't matter how serious your infection was the first time, the impact of long covid can be really debilitating for a long period of time, no matter if your initial illness wasn't all that severe.”
    The Health Secretary, when questioned on calls by the Royal College of GPs for covid clinics, said the NHS has set up clinics, but he is ‘concerned’ that not all GPs know how to ensure people know how to get into those services. “That’s something I am sure we can resolve,” he added.
    Read full story
    Source: Manchester Evening News, 13 September 2020
     
  11. Sam
    A survey of members of the Royal College of Physicians (RCP) has found that almost two thirds (60%) of doctors worry that patients in their care have suffered harm or complications following diagnosis or treatment delays during the pandemic, while almost all doctors (94%) are concerned about the general indirect impact of COVID-19 on their patients.
    This is also compounded by the difficulty doctors are finding in accessing diagnostic testing for their patients. Only 29% of doctors report experiencing no delays in accessing endoscopy testing (one of the main diagnostic tests used by doctors) for inpatients, decreasing to just 8% for outpatients.
    Only 5% of doctors feel that their organisations are fully prepared for a potential second wave of COVID-19 infection, and almost two thirds (64%) say they haven’t been involved in any discussions about preparations for a second wave of the virus.
    While the government’s promise to roll out flu vaccines to millions more people is welcome, the RCP recently set several more priorities to help prepare the health service for future waves of COVID-19, including the need to ensure the NHS estate is fully able to cope.
    Only 5% say they wanted an antibody test for COVID-19 but were unable to access one. Of those tested, a quarter (25%) were positive, with little or no difference when it came to gender, between white and BAME doctors, trainees and consultants or between London and the rest of England.
    Professor Andrew Goddard, president of the Royal College of Physicians, said: “Delays to treatment are so often a major issue for the NHS but as a result of the COVID-19 pandemic, it’s fair to say we’ve reached crisis point. Doctors are, understandably, gravely concerned that their patients’ health will have deteriorated to the point where they will need much more extensive treatment than previously, at a time when NHS resources are already incredibly depleted."
    “We also cannot underestimate the need to prepare for a second wave of COVID-19 infection, which threatens to compound the situation. Without careful and rigorous preparation, a second wave coupled with the winter flu season, could overwhelm the NHS.”
    Source: Royal College of Physicians, 5 August 2020
  12. Sam
    Almost 86% of doctors in England say they expect a second peak of coronavirus in the next six months, according to a new survey, as concern continues to grow over a recent rise in cases.
    On Friday, new results from a population-based study suggested the R number for England is now at 1.7, with infections doubling every 7.7 days. While the prevalence of the disease remains lower than it was in the spring, an R value above 1 means cases could grow exponentially.
    Sunday marked the third day in a row that new coronaviruses cases reported for the UK topped 3,000 – the highest figures since May – with 2,837 new cases reported in England alone. While testing has increased over the past months, experts have said this does not fully explain the recent surge.
    In a poll, the British Medical Association (BMA) asked more than 8,000 doctors and medical students in England what their top concerns were out of five possibilities, from a second peak of coronavirus to sickness and burnout among staff and winter pressures, including a possible flu outbreak. Almost 30% of respondents selected a second peak as their number-one worry.
    Overall, 86% of respondents said they believed a second peak of coronavirus during the next six months is either “quite likely” or “very likely”.
    When asked which of a range of factors might risk causing a second peak, almost 90% of respondents agreed or strongly agreed that failures of the test-and-trace system posed a risk, while a similar proportion cited a lack of infection-control measures in places like bars and restaurants, and 86% agreed or strongly agreed confusing messaging on public health measures was a risk.
    Read full story
    Source: The Guardian, 14 September 2020
  13. Sam
    The government has written to care home providers in England to warn them of a rise in new coronavirus infections within the sector.
    A letter from the Department of Health urged care bosses to take "necessary action to prevent and limit outbreaks". Cases were mainly among staff but risked spreading to residents, it said.
    It comes as a further 3,330 positive cases were recorded in the UK - the third consecutive day in which cases have been over 3,000. It brings the total number of confirmed cases to 368,504.
    Friday's letter from the Department of Health and Social Care said testing data had revealed an increase in the number of positive results in care homes and called on the care sector to work with the government.
    "You will know already that we are experiencing a rise in confirmed Covid-19 cases across the UK population," wrote Stuart Miller, director of adult social care delivery.
    "I need to alert you to the first signs this rise is being reflected in care homes too."
    "I am writing at the earliest opportunity, so we can work in partnership to prevent further spread of the disease. The rapid flow of data and information, to and from care providers, is vital to this effort."
    Mr Miller said the infections had been detected chiefly among staff but had been transmitted to residents in some cases. He went on to stress "the importance of regular testing and consistent use of PPE".
    Read full story
    Source: BBC News, 14 September 2020
  14. Sam
    GP practices are being told they must make sure patients can be seen face to face when they need such appointments.
    NHS England is writing to all practices to make sure they are communicating the fact doctors can be seen in person if necessary, as well as virtually. It's estimated half of the 102 million appointments from March to July were by video or phone call, NHS Digital said.
    However, the Royal College of GPs said any implication GPs had not been doing their job properly was "an insult".
    NHS England said research suggested nearly two thirds of the public were happy to have a phone or video call with their doctor - but that, ahead of winter, they wanted to make sure people knew they could see their GP if needed. Nikki Kanani, medical director of primary care for NHS England, said GPs had adapted quickly in recent months to offer remote consultations and "safe face-to-face care when needed".
    Prof Martin Marshall, chair of the Royal College of GPs, said general practice was "open and has been throughout the pandemic", with a predominantly remote service to help stop the spread of coronavirus.
    He said: "The college does not want to see general practice become a totally, or even mostly, remote service post-pandemic. However, we are still in the middle of a pandemic. We need to consider infection control and limit footfall in GP surgeries - all in line with NHS England's current guidance."
    He said most patients had understood the changes and that clinical commissioning groups had been asked to work with GP practices where face-to-face appointments were not possible - for example, if all GPs were at a high risk from coronavirus.
    "Any implication that they have not been doing their job properly is an insult to GPs and their teams who have worked throughout the pandemic, continued delivering the vast majority of patient care in the NHS and face an incredibly difficult winter ahead," he said.
    Read full story
    Source: BBC News, 14 September 2020
    Research from the college indicated that routine GP appointments were back to near-normal levels for this time of year, after decreasing at the height of the pandemic.
    "Each and every day last week an estimated third of a million appointments were delivered face to face by general practices across the country," added Prof Marshall.
  15. Sam
    Millions of people who are at risk of serious illness from COVID-19 could be asked to start shielding again if infection rates continue to rise, according to reports.
    Officials are planning to send out letters telling the most vulnerable either to stay at home or to follow advice specifically tailored to their health conditions.
    The Daily Telegraph  reports that the new programme will initially target those living in areas with dangerous levels of coronavirus but went on to quote an anonymous official as saying it could be applied to the whole of England if necessary.
    If so, it could affect up to 4.5 million people – more than double the number who were asked to shield at the start of the lockdown in March.
    The new shielding scheme is reportedly based on a "stratified risk model" which would target individuals based on factors such as their underlying health conditions, age, sex and weight. 
    Read full story
    Source: 13 September 2020
  16. Sam
    People across England have told BBC News they are struggling to access coronavirus tests.
    Health Secretary Matt Hancock said last week that no-one should have to travel more than 75 miles for a test, after the BBC revealed some were being sent hundreds of miles away.
    But dozens have now reported being unable to book a swab at all.
    The Department of Health and Social Care (DHSC) said testing capacity was targeted at the hardest-hit areas.
    A significant rise in demand for testing led the government to reduce the number of appointments available in areas of lower prevalence, to prioritise areas with outbreaks. This in turn led to people applying for tests being directed to centres sometimes hundreds of miles away.
    But last Thursday Mr Hancock pledged to put in "immediate" solutions to make sure people did not have to travel more than 75 miles, effective from last Friday. Since then, postcodes entered into the government's booking system return a message suggesting there are no testing centres or home kits available - even if you are an essential worker with symptoms.
    Frances, in Suffolk, tried to apply for a test when her daughter developed a high temperature. She didn't think it was coronavirus but "the rules are the rules". She had understood that anyone with a temperature should apply for a test, and was not able to send either of her children to school until she did.
    "Their teachers need to be kept safe, their classmates need to be kept safe, we need to do the right thing," she said.
    But Frances was also not able to get a home kit, and when she tried to get an appointment at a drive-through centre was told no test sites were found.
    Read full story
    Source: BBC News, 12 September 2020
  17. Sam
    Cases of coronavirus in England are doubling every seven to eight days, research has revealed in the latest figures to show a resurgence of COVID-19.
    The study, known as React-1, is a population surveillance study that began in May and uses swabs from about 120,000 to 160,000 randomly selected people in England across 315 local authority areas each month to track the spread of coronavirus using PCR analysis – the “have you got it now” test.
    “The prevalence of the virus in the population is increasing. We found evidence that it has been accelerating at the end of August and beginning of September,” said Steven Riley, professor of infectious disease dynamics at Imperial College London and a co-author of the work.
    The findings came as, elsewhere, the latest R figure for the UK was reported to be between 1.0 and 1.2, with the number of new infections somewhere between shrinking by 1% and growing by 3% every day.
    Previous rounds of the study revealed a falling prevalence of COVID-19, even as lockdown restrictions were eased: according to data for the period 19 June to 8 July, the prevalence of Covid in the general population was low, and halving every eight to nine days.
    However, the results from the fourth round of the survey suggest that is no longer the case. While the latest findings from the React study have yet to be peer-reviewed, researchers say out of more than 150,000 swabs collected between 22 August and 7 September, 136 tested positive for coronavirus, suggesting 13 people out of every 10,000 in the general population had COVID-19.
    Read full story
    Source: The Guardian, 11 September 2020
  18. Sam
    A hospital boss championed by Matt Hancock has been told to end “a toxic management culture” after doctors were asked to provide fingerprint samples to identify a whistleblower.
    The Royal College of Anaesthetists (RCoA) has urged the chief executive of West Suffolk hospital, Steve Dunn, who Hancock described as an “outstanding leader”, to take urgent action to improve the wellbeing of senior clinicians and “thereby the safety of patients”.
    In a strongly worded letter sent to Dunn in July, seen by the Guardian, the RCoA president, Prof Ravi Mahajan, reminded him that “undermining and bullying behaviour is unacceptable”.
    Following a three-day review of the hospital, Prof Mahajan’s letter said senior anaesthetists had complained about a “toxic management culture that risks impairing their ability to care safely for patients”.
    The incident, and other failings in patient safety, contributed to the hospital becoming the first ever to be relegated by Care Quality Commission (CQC) inspectors from “outstanding” to “requires improvement” in January.
    A spokesman for the trust said: “Ensuring our colleagues work in a supportive, safe environment is good for our staff and means better patient care, which is why we have done extensive work this year to act on feedback about our working culture, including taking action to address the concerns raised by the Royal College of Anaesthetists.”
    Read full story
    Source: The Guardian, 11 September 2020
  19. Sam
    PRESS RELEASE
    (London, UK, 11 September) – The charity Patient Safety Learning are calling on the NHS to publish details of post-COVID support clinics and clarify how these can be accessed by thousands of ‘Long COVID’ patients.
    Patient Safety Learning has written to Sir Simon Stevens, Chief Executive of the NHS, calling on him to take steps to publicise the locations and details of these services. This follows Matt Hancock MP, Secretary of State for Health and Social Care, expressing concerns in the Health and Social Care Select Committee on Tuesday that not all GPs know how to access these services.
    Helen Hughes, Chief Executive of Patient Safety Learning, said: “We have heard from many Long COVID patients that they are not clear on the location of these clinics, what services they offer and who is eligible for support. Some patients have been advised by their GP that there are no post-COVID clinics available within their area. Though the NHS launched the ‘Your COVID Recovery’ online portal for patients recovering from COVID, there is no clear indication of how the clinics fit into this and how patients can access the support they need.”
    Long COVID patients are those with confirmed or suspected COVID-19 who continue to struggle with prolonged, debilitating and sometimes severe symptoms months later. In their letter, the charity has identified a series of steps needed to provide greater clarity for these patients, including:
    Publishing a list of all existing post-COVID clinics and contact details. Confirming whether these clinics are accessed by referral from your GP or self-referral. If by GP referral, publish the guidance issued to GPs on this process. Confirming who is eligible for these services, whether they are restricted to those hospitalised by COVID-19 or open to those who are managing their symptoms at home. Confirm what services are available from these clinics. Specifically, whether they can help patients access clinical investigations, as well as treatment and rehabilitation. Clarify whether these services are available to all patients or only those who have had a confirmed positive test for COVID-19. Notes to editors:
    Patient Safety Learning is a charity, which helps 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. For more information: www.patientsafetylearning.org In the Health and Social Care Select Committee on Tuesday 8 September 2020, Matt Hancock commented that “The NHS set up Long COVID clinics and announced them in July. I am concerned by reports this morning from the Royal College of GPs that not all GPs know how to ensure that people can get into those services. That is something I will take up with the NHS and that I am sure we will be able to resolve.” The full transcript can be found here. Patient Safety Learning’s full letter to Sir Simon Stevens can be found here. Patient Safety Learning have previously set out patient safety concerns for Long COVID patients, outlining these issues in more detail. Read more here.  
  20. Sam
    The emergence of antimicrobial resistance (AMR), including drug-resistant bacteria, or “superbugs”, pose far greater risks to human health than Covid-19, threatening to put modern medicine “back into the dark ages”, an Australian scientist has warned, ahead of a three-year study into drug-resistant bacteria in Fiji.
    “If you thought Covid was bad, you don’t want anti-microbial resistance,” Dr Paul De Barro, biosecurity research director at Australia’s national science agency, the CSIRO, told The Guardian.
    “I don’t think I’m exaggerating to say it’s the biggest human health threat, bar none. Covid is not anywhere near the potential impact of AMR. We would go back into the dark ages of health.”
    WHO warns overuse of antibiotics for COVID-19 will cause more deaths
    While AMR is an emerging public health threat across the globe, in the Pacific, where the risk of the problem is acute, drug-resistant bacteria could stretch the region’s fragile health systems beyond breaking point.
    An article in the BMJ Global Health journal reported there was little official health data – and low levels of public knowledge - around antimicrobial resistance in the Pacific, and that high rates of infectious disease and antibiotic prescription were driving up risks.
    “A challenge for Pacific island countries and territories is trying to curtail antimicrobial excess, without jeopardising antimicrobial access for those who need them,” the paper argued.
    Read full story
    Source: The Guardian, 10 September 2020
  21. Sam
    A framework has been developed by the Royal College of Obstetricians and Gynaecologists, Royal College of Midwives and the Society and College of Radiographers, in partnership with NHS England and NHS Improvement, to support maternity services with the local reintroduction of hospital visitors and individuals accompanying women to appointments.
    During the pandemic, some Trusts in England have allowed partners to attend antenatal appointments and pregnancy scans, but there has not been a consistent approach across the country, leading to frustration and confusion among pregnant women and their partners.
    In a recent hub blog, Jules Mckoy, a Specialist Perinatal Mental Health Midwife at University Hospital Southampton, highlighted the huge rise in pregnant women reporting feelings of anxiety because of being isolated from friends and relatives and their concerns for the safety of their baby, themselves and their families. 
    Dr Edward Morris, President of the Royal College of Obstetricians and Gynaecologists, said: “We welcome the publication of this framework to support Trusts in England safely re-introduce measures enabling partners to attend to antenatal and postnatal appointments, including pregnancy scans. This is an important step for the health and wellbeing of pregnant women and their partners, who have understandably found it difficult not to share the experience of a pregnancy scan, attend important appointments, support women in early labour or spend time with their newborn babies on the postnatal ward."
    “With the re-introduction of partners in maternity settings, it’s important that anyone attending hospitals and clinics for appointments and scans wears a face covering and ensures they practice social distancing and regular hand washing. These measures are in place to keep pregnant women, partners and staff safe.”
    Gill Walton, Chief Executive of the Royal College of Midwives, said: “Visiting restrictions during the pandemic have been challenging for everybody, particularly for pregnant women and their families at an incredibly important and transformative time in their lives. These new guidelines are good news for them and for staff. They set out clearly the rules around visiting, providing much needed clarity about who can visit and the precautions they need to take to ensure visits can be done safely for themselves, for the people they are visiting, and for staff."
    “The guidance will also be welcome by maternity staff who have experienced some aggression from a small minority of visitors, unhappy and confused with varying and changing guidance.”
    Source: Royal College of Obstetricians and Gynaecologists, 8 September 2020
  22. Sam
    The number of patients with cancer referred from screening services has fallen to nearly a third of pre-covid levels, new data shows.
    A total of 2,604 patients had their cancer picked up by screening services between April to July. This compares to 7,204 in the same period last year.
    The NHS England data covers patients receiving treatment within two months of a referral from screening services. This means the April 2020 data is largely from screening carried out before cOVID-19 saw services being shut down.
    From May to July this year, 1,243 patients were treated after a referral from screening services, compared to 5,406 in the same period last time.
    NHS England which commissions screening services from trusts said no central decision had been taken to halt screening at the height of the outbreak but said: “We know that some local providers did take the decision to pause and in those cases plans are in place to get services fully up and running again.”
    The national screening programmes look for bowel, breast and cervical cancers.
    Head of policy at Macmillan Cancer Support Sara Bainbridge said: ”Behind every missed target is a real person whose prognosis and treatment options could be severely impacted by these delays. It’s vital that people see their GP if they have symptoms, and anyone who is worried about cancer needs to know that they’ll be seen promptly and safely."
    “Cancer must not become the forgotten ‘C’ during this pandemic – we urgently need the government to deliver the promised recovery plan and make sure the NHS has all the staffing and resources it needs to get cancer services back on track.”
    Read full story (paywalled)
    Source: HSJ, 10 September 2020
     
  23. Sam
    The coronavirus pandemic has made a "difficult situation even worse" for women trying to access contraception, a group of MPs and peers has warned. Their inquiry claims years of cuts means patients "have to navigate a complex system just to receive basic healthcare".
    It warns damage caused by the pandemic could see a rise in unplanned pregnancies and abortions. Sexual health doctors say the service is "overstretched and underfunded".
    The All Party Parliamentary Group (APPG) on Sexual and Reproductive Health says cuts to public health funding in England have had a wide-ranging impact, including:
    service closures reduced opening hours waiting lists staff cuts. The impact of these cuts is often felt by the most marginalised groups.
    The MPs' group is calling for a single commissioning body to improve accountability.
    Women are said to be "bounced from service to service" - like Louise, 32, who struggled for years to find a contraception which didn't cause adverse effects. In some cases during lockdown, even essential care provision like emergency fittings and removals of devices have been affected. Lisa's coil fitting in March was cancelled because of the pandemic. She is now pregnant.
    The inquiry says the underfunding of long-acting reversible contraceptives (LARCs) - intrauterine contraception and implants - means GPs are not incentivised to provide these services, which has contributed to a "postcode lottery" when it comes to services.
    Read full story
    Source: BBC News, 11 September 2020
  24. Sam
    COVID-19 may have contributed to the deaths of 18 people who contracted the infection while being treated at Weston general hospital in Somerset, an investigation has found. The layout of the hospital and the proximity of staff and other patients who had Covid but were asymptomatic may have been among the reasons for the 18 people acquiring the virus.
    The hospital temporarily stopped accepting new patients, including into its A&E department, on Monday 25 May following a Covid outbreak among patients. It fully reopened on 18 June.
    As part of its investigation, University Hospitals Bristol and Weston NHS foundation trust identified 31 patients who died after contracting Covid while they were in-patients from 5-24 May. A detailed review of each of the cases was undertaken and it concluded that in 18 patients, the infection may have contributed to their death.
    Dr William Oldfield, the trust’s medical director, said: “We are deeply sorry for this. We are already in contact with the families of these patients and have informed them of the outcome of the review. We have apologised unreservedly and have offered them support."
    “For each family concerned, we will undertake an investigation into the specific circumstances that led to the death of their loved one. We will invite them to help inform the investigation to ensure that any questions they have are addressed. We recognise that other patients and families may have concerns and we would like to provide reassurance to everyone that the safety of our patients and staff continues to be our main priority.”
    Read full story
    Source: The Guardian, 10 September 2020
  25. Sam
    The Royal College of GPs (RCGP) has stressed the importance of GPs having rapid access to testing results for patients, as newly-released research highlights the role general practice is playing during the coronavirus pandemic.
    Released by Queen Mary University of London, and published in the British Journal of General Practice, the research showed GPs and their teams were continuing to deliver frontline care to NHS patients with both Covid and non-Covid conditions.
    The active role of GPs in the COVID-19 response is nothing new or surprising, though notably the Queen Mary research focused in heavily on ‘suspected’ cases of Covid, due to limited community testing throughout the pandemic, giving a clearer picture of the primary patient group using general practice services.
    Responding to the research, Professor Martin Marshall, Chair of the RCGP, said: “This data shows the significant role GPs and our teams have played in tackling Covid-19 and delivering care to patients during the pandemic – and how the virus has impacted on all parts of the health and care services.
    “General practice has been open throughout the pandemic with GPs and our teams continuing to deliver the vast majority of NHS patient care to patients with both Covid and non-Covid conditions."
    Read full story
    Source: National Health Executive, 8 September 2020
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