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Sam

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Everything posted by Sam

  1. News Article
    More than 1,500 breast cancer patients in UK face long waits to have reconstructive surgery after hospitals could not operate on them during the pandemic because they were tackling COVID-19. The women are facing delays of “many months, possibly years” because the NHS has such a big backlog of cases to get through, according to research by the charity Breast Cancer Now. When the lockdown began in March the NHS stopped performing breast reconstructions for women seeking one after a mastectomy as part of its wider suspension of care. That was because so many operating theatres were being used as overflow intensive care units and because doctors and hospital bosses feared that patients coming into hospital might catch Covid. The NHS started doing them again in July, but not everywhere and not in the same numbers as before. “We are deeply concerned by our finding that over 1,500 breast cancer patients may now face lengthy and extremely upsetting delays for reconstructive surgery,” said Delyth Morgan, the chief executive of Breast Cancer Now. “This will leave many women who want to have reconstruction with one breast, no breasts or asymmetric breasts for months, possibly even years.” Lady Morgan said: “Reconstructive surgery is an essential part of recovery after breast cancer for those who choose it. “Women with breast cancer have told us these delays are causing them huge anxiety, low self-esteem and damaged body confidence, and all at a time when the Covid-19 pandemic has denied them access to face to face support from healthcare professionals and charities.” Read full story Source: The Guardian, 18 September 2020
  2. News Article
    Accidents on maternity wards cost the NHS nearly £1 billion last year, Jeremy Hunt, the chairman of the Commons health committee, has revealed. The former health secretary said the bill for maternity legal action was nearly twice the amount spent on maternity doctors in England. It was part of the NHS’s £2.4 billion total legal fees and compensation bill, up £137 million on the previous year. Mr Hunt has also told the Daily Mail there is evidence that hospitals are failing to provide details of avoidable deaths despite being ordered to do so three years ago as he highlighted “appalling high” figures which showed that up to 150 lives are being lost needlessly every week in public hospitals. Responding to the figures, Mr Hunt said: "Something has gone badly wrong." In 2017, he told trusts to publish data on the number of avoidable deaths among patients in their care. But freedom of information responses from 59 hospital trusts, about half the total, found less than a quarter gave meaningful data on avoidable deaths. Mr Hunt cited “major cultural challenges” which he blamed for preventing doctors and nurses from accepting any blame. He blamed lawyers who get involved “almost immediately” once something goes wrong with a patient’s care. “Doctors, nurses and midwives worry they could lose their licence if they are found to have made a mistake. Hospital managers worry about the reputation of their organisation,” he added. Mr Hunt said: “We have appallingly high levels of avoidable harm and death in our healthcare system. We seem to just accept it as inevitable.” An NHS spokesman said: “Delivering the safest possible health service for patients is a priority, and the national policy on learning from deaths is clear that hospitals must publish this information every three months, as well as an annual summary, so that they are clear about any problems that have been identified and how they are being addressed. Read full story Source: The Telegraph, 18 September 2020
  3. News Article
    An investigation into the outbreak of a bacterial infection that killed 15 people has found there were several “missed opportunities” in their care. Mid Essex Clinical Commissioning Group has released the outcome of a 10-month investigation into a Strep A outbreak in 2019, which killed 15 people and affected a further 24. The final report was critical of Provide, a community interest company based in Colchester, as well as the former Mid Essex Hospital Services Trust (now part of Mid and South Essex Foundation Trust). It said: “This investigation has identified that in some cases there were missed opportunities where treatment should have been more proactive, holistic and timely. These do not definitively indicate that their outcomes would have been different.” Investigators found that 13 of the 15 people that died had received poor wound care from Provide CIC. They reported that inappropriate wound dressings were used and record keeping was so poor that deterioration of wounds was not recognised. Even wounds that had not improved over 22 days were not escalated to senior team members for help or referred to the tissue viability service for specialist advice, with investigators told this was often due to concerns over team capacity. The report, commissioned by the CCG and conducted by consultancy firm Facere Melius, said: “[Some] individuals became increasingly unwell over a period of time in the community, yet their deterioration either went unnoticed or was not acted upon promptly. Sometimes their condition had become so serious that they were very ill before acute medical intervention was sought”. Other findings included delays in the community in the taking of wound swabs to determine if the wound was infected and by which bacteria. It said in one case nine days elapsed before the requested swab took place. Even after Public Health England asked for all wounds to be swabbed following the initial outbreak, this was only conducted on a single patient. In other cases there were delays in patients being given antibiotics and this “could have had an adverse impact on the treatment for infection”. It also found that sepsis guidelines were not accurately followed, wounds were not uncovered for inspection in A&E, and some patients were given penicillin-based antibiotics despite penicillin allergies being listed in their health records. Read full story (paywalled) Source: HSJ, 17 September 2020
  4. News Article
    More patients and healthcare staff will benefit from single electronic patient records as 7 hospital trusts receive a share of £8.7 million to introduce digital records and e-prescribing, Minister for Patient Safety Nadine Dorries announced today on World Patient Safety Day. The roll-out has already been introduced to over 130 NHS trusts, and is part of a £78 million investment to deliver the ambition set out in the NHS Long Term Plan to introduce electronic prescribing systems across the NHS. NHS trusts will now be able to more quickly access potentially lifesaving information on prescribed medicines and patient history, and build a more complete, single electronic patient record, which reduces duplication of information-gathering, saves staff time and can reduce medication errors by up to 30%. The funding was announced at a virtual conference organised by Imperial College London to mark World Patient Safety Day. Read press release Source: Gov.uk, 17 September 2020
  5. Event
    until
    The story of Alison Bell, and her family's uncovering of the truth about what happened to her in the care of an NHS Trust will be told by her brother Tom. He will describe the nature of the various investigations that were held into Alison's death and the role of the prevailing cultures within the public sector organisations they have dealt with; the NHS, Police, CPS and Regulatory Bodies. This true and ongoing story shines a light on the personal, emotional and financially costly impact that public sector service cultures can have on the lives of their service-users and their own bottom-line. Tom’s lived and current experience will help us to explore the implications for our own practice and the organisations we might seek to influence, manage and lead. Registration
  6. Event
    There is growing concern that a significant number of COVID-19 patients continue to experience persistent physical and mental symptoms weeks and months after first contracting the virus. Chaired by RSM President Professor Roger Kirby, this webinar will tackle the topic of ‘Long COVID’, hearing insights from Dr Alastair Miller, Deputy Medical Director at the JRCPTB, Dr Nisreen Alwan, Associate Professor in Public Health at the University of Southampton and Long COVID sufferer, and Dr Carolyn Chew-Graham, GP Principal in Central Manchester and Professor of General Practice Research at Keele University. The panel will look at the symptoms and diagnosis of Long COVID, discuss current research and evidence, hear experiences of living with Long COVID, and ask what needs to be done to manage this significant healthcare concern. The webinar will include plenty of opportunities for questions. All views expressed in this webinar are of the speakers themselves and not of The RSM. Please note this webinar will be recorded and stored by The RSM and may be used in the future on various internet channels. Registration
  7. News Article
    Today, the nonpartisan nonprofit Patient Safety Movement Foundation will lead a demonstration in the nation’s capital to raise awareness for the patient safety crisis that claims more than 200,000 lives annually in the U.S. due to preventable medical harm. The demonstration begins from Freedom Plaza and participants will walk down Pennsylvania Avenue to the Capitol Lawn, where they will hold a remembrance of loved ones lost needlessly to preventable medical errors. The demonstrators will also demand the creation of a National Patient Safety Board to implement data-driven standards, transparency, accountability, and aligned incentives. “COVID-19 has exposed the safety gaps in our healthcare system that already cause 200,000 deaths a year,” said Dr. David B. Mayer, CEO of the Patient Safety Movement Foundation. “Many of us also have very personal stories of loss and tragedy related to preventable medical harm. Now is the time for change and improvement as we work toward zero preventable patient deaths by 2030.” Read full story Source: Patient Safety Movement
  8. News Article
    People requiring A&E will be urged to book an appointment through NHS 111 under a trial in parts of England. The aim is to direct patients to the most clinically-appropriate service and to help reduce pressure on emergency departments as staff battle winter pressures, such as coronavirus and flu. The pilots are live in Cornwall, Portsmouth, Hampshire and Blackpool and have just begun in Warrington. If they are successful, they could be rolled out to all trusts in December. However, people with a life-threatening condition should still call 999. Under the new changes, patients will still be able to seek help at A&E without an appointment, but officials say they are likely to end up waiting longer than those who have gone through 111. More NHS 111 call handlers are being brought in to take on the additional workload, alongside extra clinicians, the Department of Health and Social Care said. A campaign called Help Us Help You will launch later in the year to urge people to use the new service. Read full story Source: BBC News, 17 September 2020
  9. News Article
    Health inspectors have uncovered multiple problems with infection control and the use of personal protective equipment (PPE) in care homes in England ahead of a second spike in COVID-19, which is starting to be detected in care facilities across the country. The Care Quality Commission (CQC) found homes where PPE was not being worn and that had out-of-date infection prevention policies and were failing to take steps to protect black and minority ethnic residents and staff who have been identified as potentially more vulnerable to the virus. The checks took place last month in 59 English care homes and were triggered by concerns about safety and quality or complaints by residents, staff and relatives. The checks precede a government announcement within days of a winter infection control fund that is expected to broadly match the £600m already committed this year. The fund will pay additional staff costs stemming from using fewer highly mobile temporary workers, who have been shown to spread the virus. However, the CQC inspections found PPE being worn inconsistently by staff members, limited supplies of masks in some places, and a failure to store PPE safely away from infection risk. “We found examples of infection prevention and control policies that were out of date,” the inspectors said. “Some had been updated early on in the Covid-19 outbreak but had not been amended since and so contained out-of-date information. This posed a risk to the staff and people who live in the care home. Others had not been updated since 2019. One care home had completed a [contingency] plan, but it only covered the hot weather and did not include preparations for autumn and winter.” Read full story Source: The Guardian, 16 September 2020
  10. News Article
    Thousands of stroke patients have suffered avoidable disability because NHS care for them was disrupted during the pandemic, a report claims. Many people who had just had a stroke found it harder to obtain clot-busting drugs or undergo surgery to remove a blood clot from their brain, both of which need to happen quickly. Rehabilitation services, which are vital to help reduce the impact of a stroke, also stopped working normally as the NHS focused on Covid, the Stroke Association said. It is concerned “many could lose out on the opportunity to make their best possible recovery”. Juliet Bouverie, the charity’s chief executive, said: “Strokes didn’t stop because of the pandemic. Despite the tireless efforts of frontline clinicians who have gone to herculean efforts to maintain services under extremely difficult conditions, some treatments still became unavailable and most stroke aftercare ground to a halt. This means more stroke survivors are now living with avoidable, unnecessary disability.” Read full story Source: The Guardian, 17 September 2020
  11. News Article
    Detainees held in an immigration centre in the US have been subjected to potentially unnecessary hysterectomies performed without informed consent, a nurse whistleblower has alleged. Dawn Wooten, who filed a whistleblower complaint with the inspector general of the Department of Homeland Security, says she was demoted and her hours slashed after she complained about substandard medical care, questionable surgeries on women, and failure to protect detainees and staff from COVID-19. A report of the charges1 was filed by four non-profit rights and welfare groups on behalf of the detained immigrants at the Irwin County Detention Center in Georgia, which is operated by the private prison company, LaSalle Corrections. Read full story (paywalled) Source: BMJ, 16 September 2020
  12. News Article
    Ministers have given the green light for NHS England and Improvement to consult before December on a proposed new basket of metrics to replace the four-hour accident and emergency target. The Department of Health and Social Care announced the move, a significant step towards ditching the target, while confirming another batch of winter capital funding allocations, and confirming a national “111 first” model. The announcement does however mean the process of replacing the four-hour target with new A&E standards will move slower than NHSE/I had outlined this summer. It said in July it wanted the new A&E standards in place before winter, a plan also backed by the Royal College of Emergency Medicine as revealed by HSJ. These moves come amid mounting concern that people unable to get COVID-19 tests are heading to emergency departments; and that some emergency departments are now becoming busy with growing non-covid demand. The proposals for the consultation have not yet been finalised. HSJ understands they will consist of work largely drawn up by NHSE’s clinical review of standards group before March but put on hold when the COVID-19 outbreak hit the UK. Likely choices for the metrics are: time to initial clinical assessment in A&E, time to emergency treatment for critically ill, mean waiting time, and a new 12-hour metric where the clock starts from when the patient arrives at the emergency department rather than at decision to admit as is currently the case. Read full story (paywalled) Source: HSJ, 17 September 2020
  13. News Article
    An acute hospital in Greater Manchester is now experiencing a spike in coronavirus patients, following weeks of high infection rates in the community. Figures released by Bolton Foundation Trust today said it currently has 26 suspected covid patients, including three in critical care. These are the highest numbers reported by the trust since the end of May.For most of July, August and early September, the trust had fewer than five covid patients on its wards at any one time. The borough of Bolton has reported high infection weeks for several weeks, with the latest figures suggesting 200 infections per 100,000 people, the highest rate in the country. Dr Francis Andrews, the trust’s medical director, said: “We are seeing more people being admitted with confirmed or suspected covid-19 as a result of the very high rate of infections in Bolton. “This is not a shift we want to see. The situation at the hospital is under control and we were well prepared for this. However, the rate continuing to rise is of concern, and we continue to urge the people of Bolton to consider others when making decisions that could jeopardise their safety." Read full story (paywalled) Source: HSJ, 15 September 2020
  14. News Article
    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
  15. News Article
    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
  16. Event
    Join Save the Children to mark the World Patient Safety Day to reaffirm their commitment to enhance the quality of medical services and the safety of frontline medical staff globally. They will be joined by a distinguished panel of three global experts who will share their perspectives on patient safety and quality of care, followed by a Q&A session. Registration
  17. News Article
    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
  18. News Article
    "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
  19. News Article
    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
  20. Event
    until
    Human rights are central to proper mental health care and treatment. Legally, people working in public service, “public officials” (such as NHS staff, local authority staff and the police), have to protect, respect and fulfil your human rights in all of their decisions and actions. This duty to uphold human rights has not changed during the COVID-19 pandemic. This duty to protect human rights is as important as ever, as services are facing increased stress due to the pandemic. COVID-19 has meant that many of the support networks that we all used to use no longer exist in the same way. Added to this some of the changes to mental health law affect the safeguards put in place for people who are receiving mental health care and treatment. For example, changes to the way mental health tribunals are being held in Wales and England. However, any changes that are made to existing laws, even if temporary still need to be compatible with our human rights law. The emergency laws for the COVID-19 period to not provide and opt-out of human rights laws. This means that it is more important than ever that both staff and people accessing mental health services know about human rights and the legal duties of public officials to protect, respect and fulfil them. It is important for all of use to know that our human rights must still be respected, protected and fulfilled during all of our interactions with public services. This webinar, led by Professor Tim Kendall is designed to provide policy makers and the wider health community with the latest evidence on the impact of COVID-19 on mental health and how to address it. Registration
  21. News Article
    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
  22. News Article
    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
  23. News Article
    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
  24. Content Article
    Since January 2019, the Health Information and Quality Authority (HIQA) has been the competent authority for regulating medical exposure to ionising radiation in Ireland and receives incident notifications of significant events arising from accidental or unintended medical exposures. As part of its role, HIQA is responsible for sharing lessons learned from significant events. HIQA has 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. This report provides an overview of the findings from these notifications and aims to share learnings from the investigations of these incidents.
  25. News Article
    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
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