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Sam

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  1. Sam
    Concerns are mounting over the number of coronavirus patients being admitted to hospitals in London as another NHS trust in the capital issued an urgent warning over its oxygen supplies.
    On Tuesday afternoon, the North Middlesex University Hospital Trust warned clinicians the numbers of coronavirus patients it was treating “was putting a strain” on the oxygen system, sparking several alarms.
    The trust currently has around 200 patients using oxygen with the trust consuming 2,400 litres of oxygen a minute. It normally uses around 1000 litres a minute and has a limit of 3,000 above which the system could cut out.
    It is only the latest hospital to face the problem – which is caused by the sheer demand for oxygen by sick Covid patients, which is more than the hospital piping can physically deliver.
    Read full story
    Source: The Independent, 30 December 2020
  2. Sam
    The Oxford-AstraZeneca vaccine has been approved for use in the UK, with the first doses due to be given on Monday amid rising coronavirus cases.
    The UK has ordered 100 million doses - enough to vaccinate 50 million people.
    This will cover the entire population, when combined with the full order of the Pfizer-BioNTech jab, Health Secretary Matt Hancock said.
    It comes as millions more people in England are expected to be placed under the toughest tier four restrictions.
    On Tuesday, 53,135 new Covid cases were recorded in the UK - the highest single day rise since mass testing began - as well as 414 more deaths within 28 days of a positive test.
    Read full story
    Source: BBC News, 30 December 2020
  3. Sam
    A major incident has been declared in Essex amid fears the number of COVID-19 cases could overwhelm the county's health services.
    The Essex Resilience Forum (ERF) said "growing demand" was putting stress on hospitals and social care settings.
    On Tuesday Mid and South Essex NHS Trust placed all three of its hospitals on critical alert.
    All of Essex is in tier four and the south of the county has some of the worst-affected districts in England.
    Essex Police Chief Constable BJ Harrington, who is co-chairman of the ERF, said declaring a major incident allowed it "to seek further support from the government to address the severe pressures which the health system is under".
    The forum said the number of patients being treated for Covid in the county had exceeded the levels seen at the peak of the first wave and "these levels are likely to increase further in the coming days".
    The ERF - comprised of health services, blue light responders and councils - said issues included "critical care and bed capacity, staff sickness/self-isolation levels and the system's ability to discharge patients quickly into safe environments".
    Mr Harrington urged the public to continue only dialling 999 or attending A&E in an emergency.
    Read full story
    Source: BBC News, 30 December 2020
  4. Sam
    The flagship Nightingale hospital is being dismantled as medics warn that there are not enough staff to run the facilities despite the NHS being at risk of being overwhelmed by coronavirus.
    Amid surging virus case numbers, elective surgery is being cancelled as the number of patients in hospitals in England passes the peak of the first wave in April. 
    Although the NHS is "struggling" to cope, the majority of the seven Nightingale hospitals, created at a cost of £220 million, have yet to start treating COVID-19 patients during the second wave. The Exeter Nightingale has been treating Covid patients since mid-November. 
    The facility at London's Excel centre has been stripped of its beds and ventilators.
    The NHS has told trusts to start preparing to use the overflow facilities in the coming weeks, but bosses have failed to explain how they will be staffed.
    Read full story (paywalled)
    Source: The Telegraph, 28 December 2020
  5. Sam
    All vulnerable people will have been offered a coronavirus vaccination by “late spring” the head of NHS England has said as he warned the health service was “back in the eye of the storm.”  
    In a New Year message, Sir Simon Stevens described 2020 as the “toughest year” and he paid tribute to nurses, doctors, therapists and other NHS staff including hospital cleaners, carers and volunteers as well as care home staff.
    Sir Simon visited a new vaccination centre on Monday saying: “We think that by late spring with vaccine supplies continuing to come on stream we will have been able to offer all vulnerable people across this country Covid vaccination. That perhaps provides the biggest chink of hope for the year ahead.”
    His comments came as the NHS in London was said to be “teetering on the edge” as latest data showed the numbers of hospital admissions in the capital jumped more than 200 per cent since the end of lockdown on 2 December.
    Read full story
    Source: The Independent, 29 December 2020
  6. Sam
    Cases of anorexia and other eating disorders have quadrupled in some areas during the coronavirus pandemic, doctors say.
    The Royal College of Paediatrics and Child Health (RCPCH) issued an alert to parents, saying the Christmas and new year period can be stressful for young people who struggle with disordered eating.
    That comes on top of massive disruption to schooling and other areas of life due to Covid-19 which has led to a loss of physical and social activity, plus money worries and bereavement for some.
    “In our tier 4 under 13s mental health inpatient unit we have seen a three- to fourfold increase in children referred to our service with eating disorders, and they are just the tip of the iceberg.” Dr Nancy Bostock, a consultant in Cambridge, said in a statement provided by the college.
    Read full story
    Source: The Independent, 29 December 2020
  7. Sam
    Health workers are "back in the eye of the storm" as coronavirus cases continue to rise, NHS England's chief executive Simon Stevens has said.
    It has been the "toughest year" for the NHS, which has treated 200,000 severely ill Covid-19 patients, he added.
    Hospitals in England are currently treating more Covid patients than at the peak of the first wave in April.
    A government scientific adviser has warned national restrictions are needed to prevent a "catastrophe".
    On Monday, a record 41,385 new Covid cases were reported in the UK, though it is thought the infection rate was higher during spring when testing was much more limited.
    NHS England said 20,426 people were being treated for the virus in hospitals in England on Monday, which is higher than the previous peak of about 19,000 in April.
    Read full story
    Source: BBC News, 29 December 2020
  8. Sam
    With the excitement of the Covid vaccine’s arrival, it may be easy to forget and ignore those of us with “long Covid”, who are struggling to reclaim our previous, pre-viral lives and continue to live with debilitating symptoms. Even when the NHS has managed the herculean task of vaccinating the nation, COVID-19 and the new mutant variants of the virus will continue to circulate, leaving more people at risk of Long Covid. Data from a King’s College London study in September suggested as many as 60,000 people in the UK could be affected, but the latest statistics from the Office for National Statistics suggest it could be much higher.
    Joanna Herman is a consultant in infectious diseases. "Long Covid' is anything but a mild illness". Nine months on from having the virus, she is seriously debilitated. She explains how the new NHS clinics need to help the thousands of people with Long Covid.
    Read full story
    Source: The Guardian, 27 December 2020
  9. Sam
    New planning guidance asks local NHS organisations to prepare for a major waiting-list catch-up by seeking “top quartile performance in productivity”, but also to “safely mobilise all… available surge capacity over the coming weeks” as the service battles rising covid levels “in almost all parts of the country”. 
    An end-of-year planning letter was issued by NHS England to local NHS chief executives last night.
    It warns: “With covid-19 inpatient numbers rising in almost all parts of the country, and the new risk presented by the variant strain of the virus, you should continue to plan on the basis that we will remain in a level 4 incident for at least the rest of this financial year and NHS trusts should continue to safely mobilise all of their available surge capacity over the coming weeks.
    “This should include maximising use of the independent sector, providing mutual aid, making use of specialist hospitals and hubs to protect urgent cancer and elective activity and planning for use of funded additional facilities such as the Nightingale hospitals, Seacole services and other community capacity.”
    Read full story (paywalled)
    Source: HSJ, 24 December 2020
  10. Sam
    Staff at a teaching hospital which has struggled with emergency care pressure this winter have warned that patient safety is being compromised as crowding is becoming “normalised”.
    A letter sent by a group of clinical staff at Cambridge University Hospitals Foundation Trust to the trust board calls for immediate action to tackle concerns.
    It says: “The normalisation of crowding, the lack of effective flow management and the lack of effective escalation policies and procedures are resulting in patient safety, dignity and comfort being repeatedly and seriously compromised.”
    Details of the letter were shared with HSJ but it is unclear how many and which staff it is signed by.
    Read full story (paywalled)
    Source: HSJ, 23 December 2020
  11. Sam
    NHS England has told hospitals to begin planning for the use of Nightingale Hospitals as the numbers of coronavirus patients in hospitals is expected to surge in coming weeks.
    In a letter sent on Wednesday night hospitals were told to activate all of their emergency capacity to cope with the expected pressures over the coming weeks.
    This is likely to mean the mass redeployment of staff and designating wards, surgical theatres and recovery areas as makeshift intensive care units for patients.
    NHS England did not explain how the Nightingale Hospitals would be staffed if the decision was made to activate them.
    Read full story
    Source: The Independent, 24 December 2020
  12. Sam
    More than a quarter of a million patients living with heart failure could be eligible for a new drug that reduces deaths and hospitalisation after medical regulators gave it the greenlight.
    The National Institute for Health and Care Excellence (Nice) has approved dapagliflozin, made by AstraZeneca, for use on the NHS.
    It can help treat patients with a form of chronic heart failure that means their blood does not pump blood out to the body as well as it should.
    It is estimated almost one million people are living with heart failure in the UK which causes an estimated 65,000 unplanned hospital admissions a year. Around half of patients will die within five years of being diagnosed.
    Evidence from a clinical trial shows that adding dapagliflozin to standard care lowers the risk of dying from heart disease and decreases hospitalisation or an urgent outpatient visit because of heart failure by 26% compared with standard care alone.

    Read full story
    Source: The Independent, 24 December 2020
  13. Sam
    An ambulance crew had to wait seven hours to hand over a patient in the West Midlands, it has been revealed.
    The case on 11 December was highlighted in the West Midlands Ambulance Service's in-house magazine, which said average waits had "ballooned".
    It said average waits at one hospital were running at nearly three hours in early December.
    The ambulance service said it hoped to put another 40 crews on the road by January.
    Delays in hospitals taking over care of patients is considered "risky", NHS England said, because it not only delayed patients receiving specialist assessment and treatment, but also reduced the number of ambulances available to respond to emergencies.
    The West Midlands trust's weekly briefing magazine, published on 17 December, said only the East of England trust had experienced a similar level of "horrendous" delays. It added that another four hospitals in the West Midlands had average delays of about two hours.
    The "knock-on" effect it said was some high-risk patients were waiting longer for an ambulance than they should.
    Meanwhile, some staff had to work late beyond their shifts and missed meal breaks.
    Read full story
    Source: BBC News, 23 December 2020
  14. Sam
    Women are undergoing “painful and distressing” diagnostic tests as doctors use the COVID-19 pandemic as an excuse not to offer them their choice of pain relief, HSJ has been told.
    At least 70 women who have had hysteroscopies this year in English NHS hospitals said they were left in extreme pain following the procedures, with many suffering trauma for several days, according to a survey by the Campaign Against Painful Hysteroscopies group.
    Some women claimed doctors used COVID-19 as an “excuse” not to offer sedation or general anaesthetic. Others said they were offered an inpatient appointment with general anaesthetic, but were also told it would be a long wait and would likely be cancelled due to covid pressures.
    Women also said they were told an outpatient procedure would reduce the time spent in hospital and consequently reduce the risk of contracting covid. The only pain relief on offer was often just ibuprofen and some women said facilities like recovery rooms were unavailable.
    The vast majority of the women surveyed — more than 90% — said they were traumatised for a day or longer by the pain from the procedure,
    A RCOG spokeswoman said: “We are concerned to hear that women are going through painful and distressing hysteroscopy procedures and that they feel COVID-19 is being used as an excuse not to offer a choice of anaesthetic."
    “The covid-19 pandemic has put incredible strain on the health services, and the risk of transmission of the virus has meant they’ve had to adapt their procedures. Whilst all women should be offered a choice of anaesthesia and treatment settings for hysteroscopic procedures, an outpatient setting avoids hospital admission and reduces the risk of exposure to the virus."
    “The RCOG guidance on this is very clear — all pain relief options should be discussed with women, as well as the risks and benefits of each. Women should be given the choice of a local or general anaesthetic. If the procedure is still too painful, no matter what anaesthetic options are chosen, it must be stopped and a further discussion of pain relief options should then take place. It’s vital that women are listened to and their choice is fully supported.”
    Read full story
    Source: HSJ, 21 December 2020
  15. Sam
    A major London trust’s critical care staff have urged leaders to review elective work targets amid serious concerns over workload, safe staffing and burnout, HSJ  has learned.
    In a letter to Guy’s and St Thomas’ Foundation Trust’s board, staff represented by trade union Unite said they had “repeatedly” raised concerns about the provider’s approach to elective work, as well as winter pressures and second wave planning, and the implications this has had for “the health, safety and wellbeing of both staff and patients”. 
    The letter — which was also addressed to the trust’s health and safety committee and has been seen by HSJ —  said: “Our primary concern is that the trust’s endeavours, and understandable need to square these circles, may be unrealistic given the current pressures on staffing and the high rates of sickness and burnout the trust is continuing to experience.
    “This is especially in critical care, where we are concerned this may compromise patient safety and is already damaging staff wellbeing and morale.”
    Read full story (paywalled)
    Source: HSJ, 18 December 2020
  16. Sam
    Think 2020 has been awful for the NHS? Next year is shaping up to be far worse – and most of the huge hole it’s in was dug long before Covid. The virus has merely finished off the job.
    The health service does not have the beds, staff or equipment to recover the ground it lost during the first two waves of the coronavirus pandemic, but the government is blocking desperately needed improvements, and another round of organisational upheaval is on its way.
    Roughly one in 11 clinical posts are vacant, and it would hardly be a surprise to see many staff rush for the retirement door once the worst of the pandemic is behind us. The NHS can’t solve the problem without long-term certainty over funding for staff.
    Around 140,000 patients in England have been waiting more than a year for surgeries such as a hip replacements, up a hundredfold from a year ago. With the whole system beset by delays long before we had even heard of coronavirus, the lack of spare capacity means it will take years to help many patients.
    Unprecedented interruptions and delays to cancer tests and treatments have been exacerbated by the pitiful state of diagnostic equipment. Access to CT and MRI scanners is far behind countries with a fraction of our wealth, such as Slovenia and Slovakia. Y
    In the midst of all this turmoil, the NHS in England faces another round of legislative and organisational upheaval next year, the likely arrival of a new chief executive, and a potential fight with Downing Street over the extent of political control.
    Read full story
    Source: The Guardian, 18 December 2020
  17. Sam
    The year 2020 has been extraordinary. It would have been inconceivable 12 months ago that the process of developing and testing medicines would be a topic of intense political and public interest. The UK pharmaceutical sector has taken centre stage, with more support than ever before for Britain’s gold-standard regulatory framework. 
    After a difficult year, this winter has seen a steady drumbeat of positive news about COVID-19 vaccines, demonstrating that the pharmaceutical industry can deliver world-leading clinical research at pace and at scale within the UK’s regulatory system.
    As the crisis of the COVID-19 pandemic hopefully eases over the coming months and the transition period for Britain’s exit of the EU comes to an end, we must seize the opportunity to strengthen this framework.   
    Read full story
    Source: New Statesmen, 14 December 2020
  18. Sam
    Research by a group of doctors has found ‘major deficiencies’ around infection control within hospitals in the North West region.
    The study looked at trusts’ adherence to Public Health England guidance around limiting the spread of COVID-19 within orthopaedic services.
    The study found patients were routinely being allocated to hospital beds before they had been confirmed as covid-negative, “thus allowing spread of COVID-19 not only between patients but also between nursing and medical staff”.
    Fewer than half of patients were nursed with the appropriate screens in place, while it was uncommon for doctors to be tested regularly.
    Separate statistics published by NHS England suggest almost 20 per cent of new covid cases in North West hospitals from August to December were likely to be nosocomial, meaning they were acquired on the wards.
    This was a higher proportion than any other region.
    Read full story
    Source: HSJ (paywalled), 16 December 2020
  19. Sam
    Pre-existing social inequalities contributed to the UK recording the highest death rates from Covid in Europe, a leading authority on public health has said, warning that many children’s lives would be permanently blighted if the problem is not tackled.
    Sir Michael Marmot, known for his landmark work on the social determinants of health, argued in a new report that families at the bottom of the social and economic scale were missing out before the pandemic, and were now suffering even more, losing health, jobs, lives and educational opportunities.
    In the report, Build Back Fairer, Marmot said these social inequalities must be addressed whatever the cost and it was not enough to revert to how things before the pandemic. “We can’t afford not to do it,” he said.
    Read full story
    Source: The Guardian, 15 December 2020
  20. Sam
    Throughout the pandemic, people with learning disabilities and autism have consistently been let down. A lack of clear, easy-to-understand guidance, unequal access to care and illegal “do not resuscitate” instructions have exacerbated the inequalities many people have long faced. It is crucial we do not forget those who have constantly been at the back of the queue: people with learning disabilities and autism.
    The impact cannot be ignored: research shows that 76% of people with learning disabilities feel they do not matter to the government, compared with the general public, during the pandemic. And data shows the danger of contracting COVID-19 for people with learning disabilities and autism is much higher than for the wider population.
    Public Health England has said the registered COVID-19 death rate for people with learning disabilities in England is more than four times times higher than the general population. But experts estimate the true rate is likely to be even higher, since not all deaths of people with learning disabilities are registered in the databases used to collate the findings.
    The reasons the pandemic has impacted people with learning disabilities so disproportionately are systemic, and a result of inequalities in healthcare services experienced for generations. Yes, some individuals are more clinically vulnerable, on account of the co-morbidities and complications associated with their learning disability. For many people, however, poorer outcomes after contracting the virus are due to non-clinical issues and inequalities in accessing healthcare services. This is inexcusable.
    The government must prioritise vaccinations for the 1.5 million people with learning disabilities and 700,000 with autism. Putting this long-overlooked group at the top of the vaccine queue would help address the systemic health inequalities learning disabled people face.
    Read full story
    Source: The Guardian, 15 December 2020
  21. Sam
    Trusts’ infection control measures will be put under greater scrutiny by the Care Quality Commission (CQC), HSJ has been told. 
    In an effort to cut hospital-acquired COVID-19, the CQC will carry out focused inspections which will assess “in more detail the leadership and delivery of infection prevention control”.
    According to NHS England/Improvement figures, around 9% of covid inpatients definitely caught the virus in hospital. However, the number could be higher as NHSE/I figures — released on Friday — showed 21% of COVID-19 patients in hospitals were “probably” acquired in hospitals. 
    HSJ understands the CQC plans to carry out up to 20 infection control focused inspections in the early part of 2021. 
    The CQC told HSJ it is reviewing local nosocomial infection rates on a weekly basis, using the data alongside “wider intelligence” from other sources to monitor trusts’ risk, with inspections carried out at providers where specific concerns are picked up.
    Read full story (paywalled)
    Source: HSJ, 14 December 2020
  22. Sam
    Health checks should be offered to people from black, Asian and minority ethnic backgrounds from the age of 25, a report has recommended.
    MPs examined the disproportionate impact of the Covid pandemic on people from black and Asian backgrounds. They said NHS checks, currently available to 40-70-year-olds in England, could pick up conditions which are linked to severe coronavirus.
    The role of inequalities in employment and housing was also emphasised. The report, produced by the Women and Equalities Committee, said the government should act to tackle these wider causes of poor health.
    The committee heard evidence during the course of its investigation that showed 63% of healthcare workers who died after contracting the virus had come from black, Asian or other ethnic minority backgrounds.
    And during the first peak of the virus, data from the Intensive Care National Audit and Research Centre showed 34% of coronavirus patients in ICUs were from an ethnic minority background, whereas they made up 12% of viral pneumonia admissions.
    Office for National Statistics (ONS) data has also shown that black people were almost twice as likely to die from Covid-19 as white people, with those of Bangladeshi and Pakistani ethnicity about 1.7 times as likely.
    The report raised concerns the pandemic was entrenching "existing health inequalities".
    Read full story
    Source: BBC News, 15December 2020
  23. Sam
    A new variant of coronavirus has been found which is growing faster in some parts of England, MPs have been told.
    Health Secretary Matt Hancock said at least 60 different local authorities had recorded Covid infections caused by the new variant.
    He said the World Health Organization had been notified and UK scientists were doing detailed studies.
    He said there was "nothing to suggest" it caused worse disease or that vaccines would no longer work.
    Read full story
    Source: BBC News, 14 December 2020
  24. Sam
    Strong leadership, challenging poor workplace culture, and ringfencing maternity funding are key to improving safety. That’s the message from two leading Royal Colleges as they respond to the independent review of maternity services at Shrewsbury and Telford NHS Trust led by Donna Ockenden.
    The RCOG and the Royal College of Midwives (RCM) have today welcomed the Ockenden Review and its recognition of the need to challenge poor working relationships, improve funding and access to multidisciplinary training and crucially to listen to women and their families to improve learning and to ensure tragedies such as those that have happened at Shrewsbury and Telford NHS Trust never occur again. 
    The Colleges have said that the local actions for learning and the immediate and essential actions laid out in this report must be read and acted upon immediately in all Trusts and Health Boards delivering maternity services across the UK.
    Commenting, Dr Edward Morris, President of the Royal College of Obstetricians and Gynaecologists, said: 
    “This report makes difficult reading for all of us working in maternity services and should be a watershed moment for the system. Reducing risk needs a holistic approach that targets the specific challenges of fetal monitoring interpretation and strengthens organisational functioning, culture and behaviour."
    Read press release
    Source: RCOG, 10 December 2020
  25. Sam
    Patient Safety Learning Press Release
    10th December 2020
    Today the Independent review of maternity services at Shrewsbury and Telford Hospital NHS Trust published its first report on its findings.[1] The report made recommendations for actions to be implemented by the Trust and “immediate and essential actions” for both the Trust and the wider NHS.
    The Review was formally commissioned in 2017 to assess “the quality of investigations relating to new-born, infant and maternal harm at The Shrewsbury and Telford Hospital NHS Trust”.[2] Initially it was focused on 23 cases but has been significantly expanded as families have subsequently contacted the review team with their concerns about maternity care and treatment at the Trust. The total number of families to be included in the final report is 1,862. These initial findings are drawn from 250 cases reviewed to date.
    This is another shocking report into avoidable harm.
    We welcome the publication of these interim findings and the sharing of early actions that have been identified to make improvements to patient safety in NHS maternity services. We commend the ambition for immediate responses and action.
    Reflecting on the report, there are a number of broad patient safety themes, many of which have been made time and time again in other reports and inquiries.
    A failure to listen to patients
    The report outlines serious concerns about how the Trust engaged and involved women both in their care and after harm had occurred. This was particularly notable in the example of the option of having a caesarean section, where there was an impression that the Trust had a culture of wanting to keep the numbers of these low, regardless of patients’ wishes. They commented:
    “The Review Team observed that women who accessed the Trust’s maternity service appeared to have little or no freedom to express a preference for caesarean section or exercise any choice on their mode of deliver.”
    It also noted a theme in common with both Paterson Inquiry and Cumberlege Review relating to the Trusts’ poor response to patients raising concerns.[3] The report noted that “there have also been cases where women and their families raised concerns about their care and were dismissed or not listened to at all”.
    The need for better investigations
    Concerns about the quality of investigations into patient safety incidents at the Trust is another theme that emerges. The review reflected that in some cases no investigation happened at all, while in others these did take place but “no learning appears to have been identified and the cases were subsequently closed with it deemed that no further action was required”.
    One of the most valuable sources for learning is the investigation of serious incidents and near misses. If these processes are absent or inadequate, then organisations will be unable to learn lessons and prevent future harm reoccurring. Patient Safety Learning believes it is vital that Trusts have the commitment, resources, and frameworks in place to support investigations and that the investigators themselves have the right skills and training so that these are done well and to a consistently high standard. This has not formed part of the Report’s recommendations and we hope that this is included in their final report.
    Lack of leadership for patient safety
    Another key issue highlighted by the report is the failure at a leadership level to identify and tackle the patient safety issues. Related to this one issue it notes is high levels of turnover in the roles of Chief Executive, executive directors and non-executive directors. As part of its wider recommendations, the Report suggests trust boards should identify a non-executive director who has oversight of maternity services.
    Good leadership plays a key role in shaping an organisations culture. Patient Safety Leadership believes that leaders need to drive patient safety performance, support learning from unsafe care and put in place clear governance processes to enable this. Leaders need to be accountable for patient safety.
    There are questions we hope will be answered in the final report that relate to whether leaders knew about patients’ safety concerns and the avoidable harm to women and their babies. If they did not know, why not? If they did know but did not act, why not?
    Informed Consent and shared decision-making
    The NHS defines informed consent as “the person must be given all of the information about what the treatment involves, including the benefits and risks, whether there are reasonable alternative treatments, and what will happen if treatment does not go ahead”.[4] The report highlights concerns around the absence of this, particularly on the issue of where women choose as a place of birth, noting:
    “In many cases reviewed there appears to have been little or no discussion and limited evidence of joint decision making and informed consent concerning place of birth. There is evidence from interviews with women and their families, that it was not explained to them in case of a complication during childbirth, what the anticipated transfer time to the obstetric-led unit might be.”
    Again this is another area of common ground with other recent patient safety reports such as the Cumberlege Review.[5] Patient Safety Learning believes it is important that patients are not simply treated as passive participants in the process of their care. Informed consent and shared decision making are vital to respecting the rights of patients, maintaining trust in the patient-clinician relationship, and ensuring safe care.
    Implementation for action and improved patient safety
    In its introduction, the report states:
    “Having listened to families we state that there must be an end to investigations, reviews and reports that do not lead to lasting meaningful change. This is our call to action.”
    Responding with an official statement in the House of Commons today, Nadine Dorries MP, Minister for Mental Health, Suicide Prevention and Patient Safety, did not outline a timetable for the implementation of this report’s recommendations.
    In 2020 we have seen significant patient safety reports whose findings have been welcomed by the Department of Health and Social Care but where there has subsequently been no formal response nor clear timetable for the implementation of recommendations, most notably the Paterson Inquiry and Cumberlege Review.
    Patient Safety Learning believes there is an urgent need to set out a plan for implementing the recommendations of the Ockenden Report and these other patient safety reports. Patients must be listened to and action taken to ensure patient safety.
    [1] Independent review of maternity services at Shrewsbury and Telford Hospital NHS Trust, Ockenden Report: Emerging findings and recommendations form the independent review of maternity services at Shrewsbury and Telford Hospital NHS Trust, 10 December 2020. https://www.ockendenmaternityreview.org.uk/wp-content/uploads/2020/12/ockenden-report.pdf
    [2] Ibid.
    [3] The Right Reverend Graham Jones, Report of the Independent Inquiry into the Issues raised by Paterson, 2020. https://assets.publishing.serv...; The Independent Medicines and Medical Devices Safety Review, First Do No Harm, 8 July 2020. https://www.immdsreview.org.uk/downloads/IMMDSReview_Web.pdf
    [4] NHS England, Consent to treatment, Last Accessed 16 July 2020. https://www.nhs.uk/conditions/consent-to-treatment/
    [5] Patient Safety Learning, Findings of the Cumberlege Review: informed consent, Patient Safety Learning’s the hub, 24 July 2020. https://www.pslhub.org/learn/patient-engagement/consent-and-privacy/consent-issues/findings-of-the-cumberlege-review-informed-consent-july-2020-r2683/

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