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Sam

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  1. Sam
    An NHS trust has been urged to publish the full findings of an independent review of its services after it released a heavily redacted report.
    University Hospitals Sussex has refused to reveal the recommendations made after a review by the Royal College of Surgeons in 2019.
    A patients' group said the findings should be "in the public domain".
    The trust said the review of its neurosurgery department "did not highlight any safety concerns".
    The review was discovered as part of a BBC Panorama investigation into unpublished patient safety reports. A heavily edited report was released under freedom of information laws.
    It showed the trust asked the Royal College of Surgeons to look at "concerns raised in respect of clinical outcomes, allocation of sub-specialties and governance arrangements".
    All issues and recommendations were obscured, with only positive feedback disclosed.
    Read full story
    Source: BBC News, 20 May 2021
  2. Sam
    Safety and quality, as well as integration and leadership, will be a “core focus” for the Care Quality Commission’s (CQC) ratings of integrated care systems (ICS), health secretary Matt Hancock has indicated.
    In a letter to health and social care committee chair Jeremy Hunt, Mr Hancock said the Department of Health and Social Care is working with the CQC and NHS England to develop “detailed proposals” on how ICSs will be regulated. The CQC is due to be given “new powers” to rate ICSs under the government’s proposed health and social care bill.
    The confirmation that the CQC’s ratings of ICSs will include a focus on safety and quality comes days after former health secretary Mr Hunt warned the NHS could take a “big step back” if ICSs are not rated on these domains.
    In the letter published today, Mr Hancock said: “I see these new powers for the CQC as an excellent opportunity not only to inform the public about the quality of health and care in their area, but also as a way to review progress against our aspirations for delivering better, more joined up care across integrated care systems.
    “I note your recommendation that quality and safety of care should be a core domain of the CQC reviews and would like to assure you that, alongside integration and leadership, quality and safety will be a core focus when rating integrated care systems."
    Read full story (paywalled)
    Source: HSJ, 25 May 2021
  3. Sam
    Hospitals have been accused of “unnecessary secrecy” for refusing to disclose how many of their patients died after catching Covid on their wards.
    The Patients Association, doctors’ leaders and the campaign group Transparency International have criticised the 42 NHS acute trusts in England that did not comply fully with freedom of information request for hospital-acquired Covid infections and deaths.
    The Guardian revealed on Monday that up to 8,700 patients lost their lives after probably or definitely becoming infected during the pandemic while in hospital for surgery or other treatment. That was based on responses from 81 of the 126 trusts from which it sought figures.
    The British Medical Association, the main doctors’ trade union, said the 42 trusts that did not reveal how many such deaths had occurred in their hospitals were denying the bereaved crucial information.
    “No one should come into hospital with one condition, only to be made incredibly ill with, or even die from, a dangerous infectious disease,” Dr Rob Harwood, chair of the BMA’s hospital consultants committee, said.
    “Families, including those of our own colleagues who died fighting this virus on the frontline, deserve answers. We will only get that if there is full transparency."
    Read full story
    Source: The Guardian, 25 May 2021
  4. Sam
    Serious patient safety concerns have been raised about a third major specialty at a struggling acute trust, with inspectors also flagging wider leadership issues.
    The Care Quality Commission (CQC) has issued an immediate warning notice in relation to the stroke service at University Hospitals of Morecambe Bay Foundation Trust, following an inspection earlier this month.
    A full report will be published later this year, but the immediate issues have been outlined within various documents published ahead of the trust’s board meeting on 26 May.
    According to a summary within the papers, the CQC warning notice has flagged “a range of incidents… identifying poor care that requires investigation”, governance concerns around the grading of incidents, poor levels of training and competencies, and worrying delays around administering thrombolysis.
    The problems were predominantly found at Royal Lancaster Infirmary.
    Read full story (paywalled)
    Source: HSJ, 25 May 2021
  5. Sam
    Almost as soon as the pandemic struck early last year, NHS England recognised that patients catching Covid-19 while they were in hospital for non-Covid care was a real risk and could lead to even more deaths than were already occurring. Unfortunately their fears have been borne out by events since – every acute hospital in England has been hit by this problem to some extent.
    Over the last 15 months various NHS and medical bodies have looked into hospital-acquired Covid and published reports and detailed guidance to help hospitals stem its spread. They include the Healthcare Safety Investigation Branch (HSIB) and Public Health England (PHE). Last May, for example, PHE estimated that 20% of coronavirus infections in hospitalised patients and almost 90% of infections among healthcare staff may have been nosocomial, meaning they were caught in a hospital setting.
    Before the pandemic the NHS was over-stretched and resources were limited. The crisis distorted it further out of shape and despite NHS staff making huge efforts to contain the virus in extremely challenging circumstances, too often they were overwhelmed.
    There are many other reasons, including inadequate ventilation, the sharing of equipment, and nurses and doctors having to gather at nurses’ stations and in doctors’ messes. Some bereaved relatives also cite hospitals deciding – inexplicably – to put their Covid-free loved ones in a bay or ward with one or more people who had the disease, sometimes resulting in tragedy.
    While some of these inherent weaknesses have been addressed, others remain, leaving further infections and even more deaths in this way a distinct possibility if the NHS is hit by another Covid surge.
    Read full story
    Source: The Guardian, 24 May 2021
  6. Sam
    Research has found that people who go to A&E following self-harm receive varying quality of care and this has a significant impact on what they experience subsequently.
    The study in BMJ Open, which was codesigned and co-authored with people who have lived experience of self-harm and mental health services, found negative experiences were common, and revealed stigmatising comments about injuries from some hospital staff. Some participants reported being refused medical care or an anaesthetic because they had harmed themselves. This had a direct impact on their risk of repeat self-harm and suicide risk, as well as their general mental health.
    According to the research, the participants who received supportive assessments with healthcare staff reported feeling better, less suicidal and were less likely to repeat self- harm.
    "This research highlights the importance of learning from the experiences of individuals to help improve care for people who have harmed themselves. We involved patients and carers throughout the entire process and this enabled us to gain a greater insight into what patients want after they present to hospital having harmed themselves", said Dr Leah Quinlivan.
    Read full story
    Source: University of Manchester, 25 May 2021
  7. Sam
    People who remain chronically ill after Covid infections in England have had to wait months for appointments and treatment at specialist clinics set up to handle the surge in patients with long Covid.
    MPs called on Matt Hancock, the health secretary, to explain the lengthy waiting times and what they described as a “shameful postcode lottery” which left some patients facing delays of more than four months before being assessed at a specialist centre while others were seen within days.
    NHS England announced in December that people with long Covid, or post-Covid syndrome, could seek help at more than 60 specialist clinics. But despite government assertions in January that the network of 69 centres was already operating, the all-party parliamentary group on coronavirus found that some clinics were still not up and running three months later.
    Freedom of information requests submitted to NHS trusts revealed that while some clinics had opened and were seeing patients, others had been delayed by the second wave of infections in January. 
    Read full story
    Source: The Guardian, 30 May 2021
  8. Sam
    An online trend that involves using tiny magnets as fake tongue piercings has led the NHS to call for them to be banned amid people swallowing them.
    Ingesting more than one of them can be life-threatening and cause significant damage within hours.
    In England, 65 children have required urgent surgery after swallowing magnets in the last three years.
    The NHS issued a patient safety alert earlier this month and is now calling for the small metal balls to be banned.
    It said the "neodymium or 'super strong' rare-earth magnets are sold as toys, decorative items and fake piercings, and are becoming increasingly popular". It added that unlike traditional ones, "these 'super strong' magnets are small in volume but powerful in magnetism and easily swallowed".
    The online trend sees people placing two such magnets on either side of their tongue to create the illusion that the supposed piercing is real.
    But when accidentally swallowed, the small magnetic ball bearings are forced together in the intestines or bowels, squeezing the tissue so that the blood supply is cut off.
    Read full story
    Source: BBC News, 30 May 2021
  9. Sam
    Thousands of hospital patients were allowed to return to their care homes without a Covid test despite a direct plea to the government from major care providers not to allow the practice, the Observer has been told.
    As the crisis began to unfold in early March 2020, providers held an emergency meeting with department of health officials in which they urged the government not to force them to accept untested residents. However, weeks later, official advice remained that tests were not mandatory and thousands of residents are thought to have returned to their homes without a negative Covid result.
    The revelation will heap further pressure on the health secretary, Matt Hancock, who has admitted some care residents returned from hospital without a test. It comes after Dominic Cummings, the prime minister’s former senior adviser, last week accused Hancock of misleading the prime minister over the policy, during his unprecedented evidence in parliament.
    Some 25,000 people were discharged to care homes between 17 March and 15 April, and there is widespread belief among social care workers and leaders that this allowed the virus to get into the homes.
    Read full story
    Source: The Guardian, 29 May 2021
  10. Sam
    A new national service has been established to improve the quality and management of healthcare construction and refurbishment projects across NHS Scotland.
    NHS Scotland Assure brings together experts to improve quality and support the design, construction and maintenance of major healthcare developments. This world first interdisciplinary team will include microbiologists, infection prevention and control nurses, architects, planners, and engineers.
    Commissioned by the Scottish Government and established by NHS National Services Scotland, the service will work with Health Boards to ensure healthcare buildings are designed with infection prevention and control practice in mind, protecting patients and improving safety.
    Cabinet Secretary for Health and Social Care Humza Yousaf said:
    “NHS Scotland Assure will support a culture of collaboration and transparency to provide the reassurance patients and their families deserve to feel safe in our hospitals. This service is unique to Scotland and is leading the way in risk and quality management across healthcare facilities.
    “With services designed with patients in mind, we can make a real, positive difference to people’s lives.”
    Read full story
    Source: Scottish Government, 1 June 2021
  11. Sam
    A second “mutilated” patient left with life-changing injuries after botched hospital surgery has described how she was left in urine-soaked bed sheets for days by nurses who called her lazy when she was unable to get out of bed.
    Lucy Wilson told The Independent she believes she would have been better looked after at a veterinary practice compared to the level of care she received from nurses at Norfolk and Norwich Hospital Trust in January last year.
    She was one of three patients harmed by surgeon Camilo Valero in the same week and almost died after Dr Valero and other staff failed to recognise her life-threatening injuries following the operation to remove her gall bladder.
    Dr Valero is under investigation by the General Medical Council but is still practising under supervision at the trust, which has refused to say whether the third patient survived their ordeal.
    After requests by The Independent, bosses at the NHS trust have now committed to publishing details of a secret review carried out by the Royal College of Surgeons into Dr Valero’s work and the wider surgical services at the trust.
    Read full story
    Source: The Independent, 31 May 2021
  12. Sam
    The Care Quality Commission may in future be notified when ‘secretive’ external reviews have looked at patient safety issues within trusts.
    Last summer, HSJ revealed guidance for trusts to publish summaries of royal colleges’ reviews was being widely ignored, with some even failing to inform the CQC.
    A recent BBC Panorama programme has again raised the issue, with Academy of Medical Royal Colleges chair Helen Stokes-Lampard saying she was “dismayed” the body’s guidance was not being followed.
    But she has now told HSJ of “advanced discussions” with the CQC about changes which would see the royal colleges routinely inform the regulator when reviews raise patient safety issues.
    Read full story (paywalled)
    Source: HSJ, 3 June 2021
  13. Sam
    More than 20 healthcare organisations, including those representing nurses, doctors, surgeons and therapists, are calling for stricter UK guidelines to be introduced on face masks and other personal protective equipment (PPE).
    In a virtual meeting with officials, they will say existing rules leave them vulnerable to infection through the air, especially by new Covid variants.
    The unprecedented appeal will see them argue that other countries, such as the United States, protect their health workers with higher-grade equipment.
    It is thought to be the first time health and care organisations have united on a single issue in this way - a sign of the desperation many feel about the need for staff to be kept safe.
    The delegation will include representatives of the British Medical Association, the Royal College of Nursing and many other professional organisations and unions.
    On the government side will be about 20 of the most senior officials from all four UK nations, many involved in setting the guidelines on personal protective equipment (PPE).
    Read full story
    Source: BBC News, 3 June 2021
  14. Sam
    Oversight failures, a fearful workplace culture and lax quality standards for years at a Veterans Affairs hospital in Arkansas, USA, allowed a pathologist who was routinely drunk on the job to misdiagnose thousands of veterans — sometimes with dire or deadly consequences, a new investigation has found.
    Hospital leaders “failed to promote a culture of accountability” that would have led more of the doctor’s colleagues to come forward with accounts that his behavior was putting patients at risk, according to the report released Wednesday by VA’s Office of Inspector General. But the staff members at the Veterans Health Care System of the Ozarks in Fayetteville feared that reporting their concerns would lead to retaliation from their bosses.
    “Any one of these breakdowns could cause harmful results,” Inspector General Michael Missal’s staff wrote in an 86-page report about the failures to stop the pathologist, Robert Morris Levy. “Together and over an extended period of time, the consequences were devastating, tragic, and deadly.”
    Read full story
    Source: The Washington Post, 2 June 2021
  15. Sam
    Self-harm among the over-65s must receive greater focus because of the increased risks associated with the pandemic, a leading expert has said.
    Loneliness, bereavement and reluctance to access GPs can all be causes in older adults, said Prof Nav Kapur, who has produced guidelines on the subject.
    He warned that in over-65s, without the right help, self-harm can also be a predictor of later suicide attempts.
    The NHS's mental health director said it had expanded its community support.
    Claire Murdoch added that its services, including face-to-face appointments, had "continued for all who needed them", and 24/7 crisis lines had been established.
    Over-65s are hospitalised more than 5,000 times a year in England because of self-harm and self-poisoning, figures obtained from NHS Digital show.
    Read full story
    Source: BBC News, 3 June 2021
  16. Sam
    A woman was subjected to an unnecessary invasive procedure in an NHS outpatient clinic after she was confused for another patient, a safety watchdog has found.
    The Healthcare Safety Investigation Branch has called for a review of how the NHS can avoid the mishap happening again after investigating the case of a 39-year-old woman who was subjected to an unnecessary cervical examination.
    HSIB said a better system was needed as the number of outpatient appointments has increased from 54 million to 94 million during the last 10 years with many clinics carrying out more invasive procedures.
    According to its latest investigation, the female patient was attending a gynaecological outpatient clinic for a fertility treatment assessment.
    The error happened when she was called through from the waiting room as another patient had a similar sounding name.
    Read full story
    Source: The Independent, 2 June 2021
  18. Sam
    The boss of a NHS trust that asked hospital staff for fingerprints and handwriting samples as it hunted a whistleblower is stepping down.
    Dr Stephen Dunn will leave West Suffolk NHS Foundation Trust in the summer after seven years as chief executive.
    An independent inquiry into the way management handled the affair is expected to report in the autumn.
    In 2018, Jon Warby received a letter two months after the death of his wife, Susan. It claimed mistakes were made during her bowel surgery. An inquest into her death was subsequently told how she had been given glucose instead of saline fluid via an arterial line.
    The Doctors' Association described the hospital's attempt to find the author of the letter a "witch-hunt".
    A subsequent Care Quality Commission (CQC) inspection said the way internal investigations had been conducted by the hospital was "unusual and of concern".
    Read full story
    Source: BBC News, 28 July 2021
  19. Sam
    A review into the work of a locum consultant radiologist has so far identified "major discrepancies" affecting 12 cases.
    A full lookback review of 13,030 radiology images was launched last month.
    The doctor worked at hospitals run by the Northern Health Trust between July 2019 and February 2020.
    The review steering group chair said it was "images in levels one and two that we are most concerned about".
    "To date there are 12 level ones and twos [approximately 0.5% of the total number reviewed]," said Dr Seamus O'Reilly, the Northern Trust medical director.
    "Most of these concern CT scans where inaccurate initial reading of the scans could, or is likely to, have had an impact on the patient's clinical treatment and outcome."
    More than 9,000 patients have been contacted as part of the review, which is looking at radiology images taken in Antrim Area, Causeway, Whiteabbey and Mid Ulster Hospitals as well as the Ballymena Health and Care Centre.
    Read full story
    Source: BBC News, 28 July 2021
  20. Sam
    Scotland's booster jag rollout has hit a major snag after some of the country's most vulnerable people were given half their third vaccine.
    In total, 140 people who were given their extra dose of the Moderna COVID-19 vaccine in the Gorebridge vaccine centre in Midlothian were affected by the error.
    Health authorities have maintained there is no risk to individuals due to the error and that half a dose will provide sufficient protection.
    The individuals affected were all immunosuppressed, the Midlothian Health and Social Care Partnership said, meaning they are more vulnerable to infection and at higher risk from serious complications caused by COVID-19.
    The Midlothian Health and Social Care Partnership apologised for the mistake and any anxiety caused.
    Read full story
    Source: The Scotsman, 19 October 2021
  21. Sam
    Some acute trusts have failed to report large numbers of hospital-acquired covid infections as patient safety incidents, despite NHS England describing this as ‘fundamental’. 
    HSJ examined the numbers of “infection control” patient safety incidents reported to the national reporting and learning system in 2020-21, and compared this to separate NHS England data on covid infections most likely to have been acquired in hospital.
    The number of incidents reported to the NRLS in the 12-month period should in theory be higher, as it covers all types of hospital-acquired infections, while the NHSE data only covered covid infections in the last seven months of the year. 
    This appears to hold true nationally, with almost 59,000 incidents reported to the NRLS, compared to around 36,000 likely hospital-acquired covid infections suggested by the NHSE data. But for around a third of trusts, the incident numbers reported to the NRLS were smaller, with some appearing to report very low numbers.
    Helen Hughes, chief executive of patient safety charity Patient Safety Learning, said: “The scale of the under-reporting set out in these findings is particularly concerning.”
    “As this data informs assessment of performance at both organisational and national levels, it is possible that this could create a false assurance about the extent of harm in this period,” Ms Hughes said.
    “Where organisations are now retrospectively completing serious incident reports, there are obvious questions as to whether key insights will have been lost as memories of incidents fade over time and their causes.”
    “However, they rely on the capacity and commitment of staff behind them. The pandemic has placed an enormous strain on the health service and we have heard from staff the time constraints this has put on them to report patient safety incidents,” she added. 
    Read full story (paywalled)
    Source: HSJ, 15 October 2021
  22. Sam
    Police forces will be able to “strong-arm” NHS bodies into handing over confidential patient data under planned laws that have sparked fury from doctors’ groups and the UK’s medical watchdog.
    Ministers are planning new powers for police forces that would “set aside” the existing duty of confidentiality that applies to patient data held by the NHS and will instead require NHS organisations to hand over data police say they need to prevent serious violence.
    Last week, England’s national data guardian, Dr Nicola Byrne, told The Independent she had serious concerns about the impact of the legislation going through parliament, and warned that the case for introducing the sweeping powers had not been made.
    Now the UK’s medical watchdog, the General Medical Council (GMC), has also criticised the new law, proposals for which are contained in the Police, Crime and Sentencing Bill, warning it fails to protect patients’ sensitive information and could disproportionately hit some groups and worsen inequalities.
    Read full story
    Source: The Independent, 18 October 2021
  23. Sam
    Cases of psychosis have risen significantly in England during the pandemic, according to new NHS data.
    The number of people referred to mental health services for their first suspected episode of psychosis increased by 75% between April 2019 and April 2021, figures showed.
    The data, which has been analysed by the charity Rethink Mental Illness, showed that much of the increase in referrals has happened over the last year, after the first national lockdown.
    The charity, Rethink Mental Illness, said that the data offers some of the first concrete evidence of the impact of the pandemic on the mental health of the population.
    It is calling on the government to invest more in early intervention for psychosis to halt the further deterioration in people’s conditions.
    The NHS defines psychosis as “when people lose some contact with reality”. This could involve seeing or hearing things that other people cannot see or believing things that are not actually true.
    People experiencing symptoms of psychosis need to seek medical help very quickly and charity Rethink Mental Illness is campaigning to get people faster access to vital treatment.
    Read full story
    Source: The Independent, 18 October 2021
  24. Sam
    A new study by Staffordshire University shows that people who understand their ‘heart age’ are more likely to make healthy lifestyle changes.
    50 preventable deaths from heart attack or stroke happen every day and Public Health England’s online Heart Age Test (HAT) allows users to compare their real age to the predicted age of their heart.
    The tool aims to provide early warning signs of cardiovascular disease (CVD) risk, encouraging members of the public to reduce their heart age through diet and exercise and to take up the offer of an NHS Health Check.
    CHAD Research Associate Dr Victoria Riley, who led the study, said: “Deaths from heart attack or stroke are often preventable and so addressing health issues early is incredibly important. Our findings show that pre-screening tests, such as the HAT, can encourage individuals to evaluate their lifestyle choices and increase their intentions to change behaviour.”
    Read full story
    Source: Brigher Side of News, 10 October 2021
  25. Sam
    On Tuesday, there were 356 COVID-19 patients being treated in intensive care wards throughout Australia. Of those, 25 were fully vaccinated.
    While the data points to the extraordinary efficacy of COVID-19 vaccines in preventing people from becoming severely unwell, being hospitalised and dying, it does raise the question: why do a small number of people become seriously ill and, in rare cases, die, despite being fully vaccinated?
    An intensive care unit staff specialist at Nepean hospital in Sydney, Dr Nhi Nguyen, said those who are fully vaccinated and die tend to have significant underlying health conditions. Being treated in intensive care, where people may be on a ventilator and unable to move, added to any existing frailty, especially in elderly people, she said.
    “If we think about intensive care patients in general, whether they are there due to COVID-19, pneumonia or any other infection, we know that those who have underlying disorders, those who are frail, and those with co-morbidities will have a higher risk of dying from whatever the cause of being in intensive care is,” she said.
    “Being fully vaccinated against Covid protects you from getting severe disease, yes, but it doesn’t completely protect you from getting Covid. So if you are someone with chronic health conditions, what might be a mild disease or mild infection in a young person or a person who is in good health, will have a greater impact on you.”
    She said this was why the Australian Technical Advisory Group for Immunisation (Atagi) had recommended boosters for those people who are severely immunocompromised. On Wednesday the government said it intended booster shots to be rolled out to the aged care sector within weeks, and to be available to the whole population by the end of the year.
    Read full story
    Source: The Guardian, 20 October 2021
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