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Sam

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  1. Sam
    A woman has become blind after her monthly eye injections were delayed for four months during lockdown.
    Helen Jeremy, 73, said everything she enjoyed doing has "gone out of the window" after losing her eyesight. She has glaucoma and was diagnosed with age-related macular degeneration four years ago.
    Monthly injections controlled the condition and meant she could still drive and play the piano. However, her appointments were cancelled when the pandemic struck and her eyesight deteriorated.
    "I was panicking. It was terrifying. Because I'm a widow I'm on my own and it was awful," she said.
    "Suddenly my eyesight was basically gone. By the time of my next appointment I was told there was no point in going on with these injections because the damage had been done to the back of my eye."
    Thousands more people in Wales are at risk of "irreversible sight loss" because of treatment delays, RNIB Cymru warns.
    The Welsh Government said health boards are working to increase services.
    Read full story
    Source: BBC News, 27 November 2020
  2. Sam
    Health experts have expressed fears over the impact tighter Covid restrictions in England could have on cancer patients as alarming new figures reveal that the number taking part in clinical trials plummeted by almost 60% during the pandemic.
    Almost 40,000 cancer patients in England were “robbed” of the chance to take part in life-saving trials during the first year of the coronavirus crisis, according to a report by the Institute of Cancer Research (ICR), which said COVID-19 had compounded longstanding issues of trial funding, regulation and access.
    Figures obtained from the National Institute for Health Research by the ICR show that the number of patients recruited on to clinical trials for cancer in England fell to 27,734 in 2020-21, down 59% from an average of 67,057 over the three years previously. The number of patients recruited for trials fell for almost every type of cancer analysed.
    Health experts said the relentless impact of Covid on the ability of doctors and scientists to run clinical trials was denying many thousands of cancer patients access to the latest treatment options and delaying the development of cutting-edge drugs.
    Read full story
    Source: The Guardian, 9 December 2021
  4. Sam
    Injured NHS patients have spoken out about the human cost of clinical negligence in a new report published as MPs examine how to cut the health service’s bill for causing harm.
    The House of Commons Health and Social Care Select Committee is gathering evidence for its inquiry on NHS litigation reform.
    “There is a fixation on the financial cost of clinical negligence, rather than on the human cost and the reasons why injured patients have to make a claim for compensation at all,” said Guy Forster of the Association of Personal Injury Lawyers (APIL) a not-for-profit group which campaigns on behalf of injured patients and their families.
    “There are a lot of voices and opinions in any debate which concerns the NHS and patient safety, but they are almost never the voices and opinions of the patients. This is why APIL has commissioned The Value of Compensation report,” said Mr Forster.
    Patients who took part in the research cite mounting debt; uncertainty about their future health; isolation; abandoned careers; relationship breakdowns; and loss of independence, as some of the many far-reaching side effects of injuries sustained through failures in care.
    “Patients are devastated to have trusted the NHS with their health and then have to live with the pain and suffering of an injury which should have been avoided,” said Mr Forster. “This report provides new insight on how compensation can help rebuild their lives.”
    “None of them relish having to make a claim for compensation. I cannot stress enough that the money is never, ever a ‘windfall’ for an injured patient,” he went on.
    “It is obvious that full and fair compensation is critical for injured patients. It should go without saying that the cost of compensation would be cut if the harm were not caused in the first place. But it is critical that when things go wrong, injured people are cared for properly and have the chance to get back on track.”
    Read press release
    Source: APIL, 12 January 2022
  5. Sam
    COVID-19 patients have active and prolonged gut viral infection, even in the absence of gastrointestinal symptoms, scientists in Hong Kong showed.
    The coronavirus may continue to infect and replicate in the digestive tract after clearing in the airways, researchers at the Chinese University of Hong Kong said in a statement Monday. The findings, published in the medical journal GUT, have implications for identifying and treating cases, they said.
    SARS-CoV-2 spreads mainly through respiratory droplets -- spatters of virus-laden discharge from the mouth and nose, according to the World Health Organization. Since the first weeks of the pandemic, however, scientists in China have said infectious virus in the stool of patients may also play a role in transmission.
    The finding “highlights the importance of long-term coronavirus and health surveillance and the threat of potential fecal-oral viral transmissions,” Siew Chien Ng, associate director of the university’s Centre for Gut Microbiota Research, said in the statement.
    Read full story
    Source: Bloomberg, 7 September 2020
  6. Sam
    National bodies can provide systems and policies for the NHS, but safety is improved at the point of care. Lauren Mosley, Head of Patient Safety Implementation, and Donna Forsyth, Head of Investigation, describe the new Patient Safety Incident Response Framework (PSIRF).
    Read full story
    Source: NHS Improvement, 2 July 2019
  7. Sam
    When 60-year-old Milind Ketkar returned home after spending nearly a month in hospital battling COVID-19, he thought the worst was over.
    People had to carry him to his third-floor flat as his building didn't have a lift. He spent the next few days feeling constantly breathless and weak. When he didn't start to feel better, he contacted Dr Lancelot Pinto at Mumbai's PD Hinduja hospital, where he had been treated.
    Dr Pinto told him inflammation in the lungs, caused by Covid-19, had given him deep vein thrombosis - it occurs when blood clots form in the body and it often happens in the legs.
    Fragments can break off and move up the body into the lungs, blocking blood vessels and, said Dr Pinto, this can be life-threatening if not diagnosed and treated in time.
    Mr Ketkar spent the next month confined to his flat, taking tablets for his condition. "I was not able to move much. My legs constantly hurt and I struggled to do even daily chores. It was a nightmare," he says.
    He is still on medication, but he says he is on the road to recovery.
    Mr Ketkar is not alone in this - tens of thousands of people have been reporting post-Covid health complications from across the world. Thrombosis is common - it has been found in 30% of seriously ill coronavirus patients, according to experts. These problems have been generally described as "long Covid" or "long-haul Covid".
    Awareness around post-Covid care is crucial, but its not the focus in India because the country is still struggling to control the spread of the virus. It has the world's second-highest caseload and has been averaging 90,000 cases daily in recent weeks.
    Dr Natalie Lambert, research professor of medicine at Indiana University in the US, was one of the early voices to warn against post-Covid complications.
    She surveyed thousands of people on social media and noticed that an alarmingly high number of them were complaining about post-Covid complications such as extreme fatigue, breathlessness and even hair loss.
    The Centre for Disease Control (CDC) in the US reported its own survey results a few weeks later and acknowledged that at least 35% of those surveyed had not returned to their usual state of health.
    Post-Covid complications are more common among those who were seriously ill, but Dr Lambert says an increasing number of moderately ill patients - even those who didn't need to be admitted to hospital - haven't recovered fully.
    Read full story
    Source: BBC News, 28 September 2020
  8. Sam
    A nurse who was threatened by colleagues for speaking out about care failings at Mid Staffordshire Foundation Trust has said bullying remains a “real problem” in the NHS.
    Helene Donnelly has told MPs that more than 10 years on from the scandal – commonly known as Mid Staffs – she was still seeing “echoes” of what she experienced happening across the country.
    “Although it is in the minority, as we saw at Mid Staffs the results can be absolutely catastrophic”
    She called for the development of a national body to improve workplace cultures in the NHS and “stamp out bullying once and for all”.
    The inquiry into poor standards of care and deaths at Mid Staffordshire indentified issues around staff behaviour, inadequate staffing levels and skills, and lack of effective leadership and support.
    Ms Donnelly told a Health and Social Care Committee hearing today that there were “real negative behaviours” at the trust that created a “real bullying culture of fear and intimidation”.
    “There was not a culture that encouraged and enabled staff to speak up and if they did as I did, we were bullied and threatened,” said Ms Donnelly, who now holds the roles of ambassador for cultural change and lead Freedom to Speak Up Guardian at the organisation where she works.
    Read full story (paywalled)
    Source: The Nursing Times
  9. Sam
    A hospital A&E department has been downgraded by regulators amid fears of “significant risk of harm” to patients after inspectors found some were crammed “head to toe” on trolleys during a surge in coronavirus cases.
    The Care Quality Commission (CQC) has told bosses at the Royal Oldham Hospital to urgently improve its A&E service after the November inspection found staff were not following infection rules and patients were at risk of catching the virus.
    The inspection confirms reports, revealed by The Independent last year, that patients in the A&E unit were being forced to wait close together for long periods. Whistleblowers from the trust said the practice was unsafe and the president of the Royal College of Emergency Medicine, Katherine Henderson, said it was a “potentially lethal” situation.
    The CQC visited the emergency department on 30 November after it said concerns were raised over the safety of patients.
    Read full story
    Source: The Independent, 10 February 2021
  10. Sam
    The next few months will be full of grim updates about the spread of the new coronavirus, but they will also be full of homecomings. Patients hospitalised with severe COVID-19, some having spent weeks breathing with the help of a mechanical ventilator, will set about resuming their lives.
    Many will likely deal with lingering effects of the virus — and of the emergency treatments that allowed them to survive it.
    “The issue we’re all going to be faced with the most in the coming months is how we’re going to help these people recover,” says Lauren Ferrante, a pulmonary and critical care physician at the Yale School of Medicine.
    Hospital practices that keep patients as lucid and mobile as possible, even in the throes of their illness, could improve their long-term odds. But many intensive care unit doctors say the pandemic’s strain on hospitals and the infectious nature of the virus are making it hard to stick to some of those practices.
    Read full story
    Source: Science, 8 April 2020
  11. Sam
    Researchers are calling on five million UK adults to join what they hope will be one of the biggest studies in the world, to create the most detailed picture ever of the nation's health.
    The aim is it to find better ways to prevent, spot and treat illnesses like cancer and dementia early on. It will involve collecting health and genetic data and creating a long-term repository of health information.
    Our Future Health is part-funded by government, industry and charities. They hope to get their first set of results in the next few years.
    Chairman of the programme, Prof Sir John Bell, said the ambition is to use the results to fundamentally shift the focus of healthcare systems to earlier diagnosis and prevention.
    Invitations will go out this autumn to more than three million people in London, West Yorkshire, West Midlands and Greater Manchester. Over time it will be open to all UK adults.
    Volunteers will:
    fill in questionnaires about their lifestyles and any health problems have blood tests for measurements such as blood sugar and cholesterol have their height, weight and blood pressure measured take genetic tests consent to share their NHS records. According to the plans the information will be used in a number of different ways.
    Scientists will collate and combine this information and store it so that people cannot be identified, building up a bank of health and genetic data.
    Read full story
    Source: BBC News, 24 October 2022
  12. Sam
    Lessons learnt in relation to increasing uptake of the COVID-19 vaccine among ethnic minority groups should now be applied to the booster programme, a government progress report recommends.
    This includes continuing to use respected local voices to build trust and to help tackle misinformation, the report from the government’s Race Disparity Unit says. Such approaches should also be carried over to the winter flu and childhood immunisation programmes and be applied to the work to tackle longer standing health disparities.
    In June 2020 the minister for equalities was asked to look at why COVID-19 was having a disproportionate impact on ethnic minority groups and to consider how the government response to this could be improved. This latest report is the final one of four.
    Taken together the reports identified that the main factors behind the higher risk of COVIDd-19 infection for ethnic minority groups include occupation, living in multigenerational households, and living in densely populated urban areas with poor air quality and high levels of deprivations.
    Read full story
    Source: BMJ, 3 December 2021
  13. Sam
    Hundreds of people are dying in care homes from confirmed or suspected coronavirus without yet being officially counted, the Guardian has learned.
    More than 120 residents of the UK’s largest charitable provider of care homes are thought to have died from the virus in the last three weeks, while another network of care homes is reported to have recorded 88 deaths.
    Care England, the industry body, estimated that the death toll is likely to be close to 1,000, despite the only available official figure for care home fatalities being dramatically lower.
    The gulf in the figures has prompted warnings that ministers are underestimating the impact of Covid-19 on society’s most frail, and are failing to sufficiently help besieged care homes and workers.
    Read full story
    Source: The Guardian, 7 April 2020
     
     
  14. Sam
    Patients' lives are being put at risk because of delays giving them treatment for sepsis, experts are warning. Hospitals are meant to put patients on an antibiotic drip within an hour when sepsis is suspected, but research by BBC News suggests a quarter of patients in England wait longer. However, NHS England said there were signs performance was improving and that hospitals were getting better at spotting those at risk sooner. 
    Dr Ron Daniels, of the UK Sepsis Trust, said the "concerning" figures showed patients were being put at risk. In some hospitals, over half of patients face delays. Dr Daniels said the one-hour window was "essential to increase the chances of surviving". "There is no reason really why it should take longer," he added.
    Read full story
    Source: BBC News, 4 July 2019
  15. Sam
    NHS Improvement and NHS England have published their NHS Patient Safety Strategy. The publication out today describes how the NHS will continuously improve patient safety, building on the foundations of a safer culture and safer systems. The strategy sets out what the NHS will do to achieve its vision to continuously improve patient safety. 
     
  16. 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
  17. Sam
    One of the largest studies of its kind suggests that most pregnant women who become infected with the coronavirus will have mild cases but suffer prolonged symptoms that may linger for two months or longer in some cases.
    The study, published in the journal Obstetrics and Gynecology, found that most women who participated had mild cases of COVID-19 — a finding consistent with previous studies. Among the nearly 600 women followed, only 5% were hospitalised and 2% were admitted to intensive care units.
    Despite the mildness of their cases, 25% of the participants continued to experience symptoms eight weeks after becoming sick. The median length of symptoms was 37 days. Although pregnancy is known to cause major changes to the immune system, the length of time for continuing symptoms was surprising, said co-principal investigator Vanessa Jacoby, vice chair of research in the obstetrics, gynecology and reproductive sciences department at the University of California at San Francisco.
    Read full story
    Source: The Washington Post, 10 October 2020
  18. Sam
    Death has become “over medicalised” and the public should be encouraged to discuss dying and grief, experts have said.
    There's a call for shift in attitude towards palliative care, with more emphasis on compassion and less on giving medication that may prolong pain.
    According to a new Lancet commission, an overemphasis on aggressive treatments to prolong life, global inequities in palliative care access, and high end-of-life medical costs have led to millions of people suffering unnecessarily at the end of their life.
    The authors also note that the pandemic has made death and dying more prominent in daily life, while health systems have been “overwhelmed” when trying to care for those dying.
    People often died alone, with families unable to say goodbye to loved ones or grieve together, the commission said – the effects of which will “resonate for years to come”.
    The researchers argue that many people, mainly in low- and middle-income countries, have no access to end-of-life care, and particularly to opioids, while those in high-income countries may be overtreated.
    Attitudes towards death and dying should be “rebalanced”, the authors conclude, away from a medicalised approach towards a “compassionate community model”, where families work with health and social care services to care for those dying.
    Read full story (paywalled)
    Source: The Telegraph, 31 January 2022
  19. Sam
    Yesterday marked the second World Patient Safety Day, and this year’s theme shined a light on health worker safety – those on the frontline of the pandemic have been selfless in their sacrifices to care for an ailing global population. What has become ever clearer is that a health system is nothing without those who work within it and that we must prioritise the safety and wellbeing of health workers, because without safe health workers we cannot have safe patients.
    Improving maternity safety has been a priority for some time – although rare, when things go wrong the consequences are unthinkable for families and the professionals caring for them. Maternity negligence makes up 50% of the total value of negligence claims across all NHS sectors, according to the latest NHS Resolution annual report and accounts. It states there were claims of around £2.4 billion in 2019/20, which is in the region of £6.5 million a day. This cost says nothing of the suffering families and professionals associated.
    However, without investing in the maternity frontline we cannot hope to make integral systemic changes to improve maternity safety and save mothers’ and babies’ lives, writes Sara Ledger, head of research and development at Baby Lifeline in the Independent.
    "We owe it to every mother and baby to rigorously and transparently scrutinise the safety of maternity services, which will be in no small way linked to the support staff receive."
    Read full story
    Source: The Independent, 17 September 2020
  20. Sam
    A child safeguarding expert who faced vilification after raising concerns about the safety of children undergoing treatment at a London NHS gender identity clinic has won an employment tribunal case against the hospital trust.
    Sonia Appleby, 62, was awarded £20,000 after an employment tribunal ruled the NHS’s Tavistock and Portman trust’s treatment of her damaged her professional reputation and “prevented her from proper work on safeguarding”.
    Appleby, an experienced psychoanalytical psychotherapist, was responsible for protecting children at risk from maltreatment.
    The tribunal heard evidence she raised concerns about the treatment of increasing numbers of children being referred to the trust’s Gender Identity Development Service (Gids). The service in Hampstead has been at the heart of a controversy over its treatments, including the provision of drugs known as puberty blockers to children as young as 10.
    The tribunal heard evidence that after she raised the concerns, instead of addressing them, the trust management ostracised her and attempted to prevent her from carrying out her safeguarding role, by sidelining her. Appleby said the management’s action amounted to a “full-blown organisational assault”.
    Read full story
    Source: The Guardian, 4 September 2021
  21. 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
  22. 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
  23. Sam
    Guidance from NHS England that doctors may lawfully use video assessments during the pandemic to decide whether patients should be detained in hospital under the Mental Health Act was wrong, two High Court judges have ruled.
    The act makes it a legal requirement that doctors must “personally examine” a patient before recommending detention. A code of practice requires “direct personal examination of the patient and their mental state.” But guidance from NHS England just after the start of the first lockdown last March said that “temporary departures from the code of practice may be justified in the interests of minimising risk to patients, staff, and the public.” Revised guidance in May 2020 included a section drafted jointly by NHS England and the Department of Health and Social Care for England (DHSC) “for use in the pandemic only.” This stated, “It is the opinion of NHS England and NHS Improvement and the DHSC that developments in digital technology are now such that staff may be satisfied, on the basis of video assessments, that they have personally seen or examined a person ‘in a suitable manner.’ ”
    The guidance added, “While NHS England and NHS Improvement and the DHSC are satisfied that the provisions of the Mental Health Act do allow for video assessments to occur, providers should be aware that only courts can provide a definitive interpretation of the law.” It went on, “Even during the COVID-19 pandemic it is always preferable to carry out a Mental Health Act assessment in person. Decisions should be made on a case-by-case basis and processes must ensure that a high quality assessment occurs.”
    Read full story
    Source: BMJ, 25 January 2021
  24. Sam
    The NHS must think “very radically” about how it redesigns its elective pathways following the coronavirus pandemic, Sir Simon Stevens has told HSJ. 
    Speaking at the HSJ Leadership Congress yesterday, NHS England’s chief executive said the service should ensure as much elective work is done as possible, while covid prevalence is low, while at the same time thinking about “different ways of doing things”.
    He declined to outline how many very long-waiters the service had or would have in coming months, explaining that some predictions have been “significantly off” in the past, and that future demand is unknown.
    The NHS chief stressed that other areas of the service would also face post-covid pressures, announcing a further investment in and expansion of long-covid clinics.
    “We want to see equivalent attention paid to the increased needs we’ve seen in mental health services, including eating disorders, and we want to make sure that the health service continues to expand its offer for long covid,” he said.
    “To that end we have 69 clinics identified last year, we will have 83 long covid clinics in place by the end of this month, so a significant expansion there.” There will be at least one in each integrated care system area, he said.
    Read full story (paywalled)
    Source: HSJ, 14 April 2021
  25. Sam
    NHS organisations have been told to prepare for redeploying or dismissing thousands of unvaccinated staff without an exit payment, and to raise the alarm about services which may be rendered unsafe.
    NHS England today issued guidance on ‘phase two’ of the government’s “vaccination as a condition of deployment”, which requires all patient-facing staff to have had two covid vaccinations by 1 April. 
    Tens of thousands of staff are believed to still be unvaccinated, and the cut off for having a first dose is 3 February.
    The guidance said efforts should be made to adjust roles or redeploy staff, but added: “From 4 February 2022, staff who remain unvaccinated (excluding those who are exempt) should be invited to a formal meeting chaired by an appropriate manager, in which they are notified that a potential outcome of the meeting may be dismissal.”
    It continued: “Whilst organisations are encouraged to explore deployment, the general principles which apply in a redundancy exercise are not applicable here, and it is important that managers are aware of this.”
    Employers will “not be concerned with finding ‘suitable alternative employment’ and there will be no redundancy entitlements, including payments, whether statutory or contractual, triggered by this process”.
    Trusts also do not have to “collectively consult” with staff being dismissed — as they would with a restructure — although this is “ultimately a decision for each organisation to take”.
    Read full story (paywalled)
    Source: HSJ, 14 January 2022
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