Patient_Safety_Learning

What is a Westminster Hall debate? Westminster Hall debates give Members of Parliament (MPs) an opportunity to raise local or national issues and receive a response from a government minister. Any MP can take part in a Westminster Hall debate. Hysteroscopy procedures in the NHS In this debate Lyn Brown MP noted the significant number of women who experience extreme levels of pain when undergoing hysteroscopy, highlighted by groups such as the Campaign Against Painful Hysteroscopy. She shared several patient testimonies, raising concerns about healthcare professionals dismissing and ignoring patient feedback and emphasised the need for NHS trusts to offer patients who need a hysteroscopy a choice of appropriate pain relief. Key issues raised in this debate included: Concerns patients who have negative experiences in relation to hysteroscopy may be afraid to access important health procedures in future, with a long-term impact on their health. A lack of formal data collection by the NHS on cases of painful hysteroscopy. Concerns that a new proposed target of aiming for 90% of hysteroscopy happening within outpatient rooms, which has emerged from the Getting It Right First Time programme, may exacerbate the number of cases where patients do not receive appropriate pain relief options. That new good practice guidance from the Royal College of Obstetricians and Gynaecologists (RCOG) on this issue is due to be published imminently. That more research is needed into hysteroscopies, particularly for post-menopausal women. Concerns about the need to challenge potentially embedded views among gynaecologists in regards to pain and patient experiences of this procedure. Feryal Clark MP recounted her personal experience of having a painful hysteroscopy procedure. This debate was responded to on behalf of the Government by Maria Caulfield MP, Minister for Mental Health and Women’s Health Strategy. Key points in her response included: She was planning to meet with the Campaign Against Painful Hysteroscopy group to discuss these issues further. The importance of the new RCOG best practice guidelines being rolled out in practice, and ensuring this brings clinical change on the ground. That hysteroscopy had not been included in the initial priorities of the Women’s Health Strategy as the Government wanted to wait on the new RCOG guidance before acting. There is a space being set up on the NHS website for women’s health so that women who are going for a procedure can easily access all relevant information. She has asked Professor Dame Lesley Regan, the Government’s Women’s Health Ambassador, to discuss the issues surrounding hysteroscopies further with Dr Henrietta Hughes, the Patient Safety Commissioner for England. Watch the debate in full Read the transcript Join the conversation Are you a healthcare worker with insights to share on this topic? Are you a patient who has had a hysteroscopy? Perhaps you are a researcher or have a different perspective to add? You can join the conversation here or get in touch with us directly by emailing content@pslhub.org. Related reading Patient Safety Learning, Improving hysteroscopy safety, 6 November 2020. Patient Safety Learning, Through the hysteroscope: Reflections of a gynaecologist, 26 January 2021. Patient Safety Learning, Guidance for outpatient hysteroscopy: Consultation Response, 16 March 2022. Richard Harrison, “Pain-free hysteroscopy”, a blog by Dr Richard Harrison, 6 November 2020.

NHS England in their collaborative work with the Heads of Patient Experience (HOPE) network have focussed on how narrative and stories can be used to make improvements to experiences of delivering and receiving care. Part of this work has been to use digital stories and to explore the use of broader storytelling activities. Digital stories are a method of sharing personal experiences; encouraging people to share their story in the first person, working in partnership to process and edit an audio recording, then overlay it with pictures and/or art to create a 3-to-5-minute digital story. In this first session they explore the how stories are used in Trusts and at a strategic level in NHSE to start improvement work, how this is being done working in partnership with the people who share their stories and how stories are shaping future policy. They will update on progress and share their approach to measuring impact and outcomes. You will hear from people who have shared personal stories about what it has meant to them and from staff who have worked in partnership to improve services. They will also share how stories are unpeeling the layers of other more traditional sources of data and how multiple data sources can enhance our understanding and improve care. Join for a packed session of learning, insight, and networking the first of series of sessions across the month of March. Reserve your place

Click on each heading to access the relevant content. 1. Presenting complaint: use of language that disempowers patients In this BMJ article, Caitríona Cox and Zoë Fritz argue that outdated medical language that casts doubt, belittles, or blames patients jeopardises the therapeutic relationship and is overdue for change. 2. NIHR - Health information: are you getting your message across? This resource collection from the National Institute for Health and Care Research includes research on the impact of unclear health messages, how we can help people understand health information and which groups of the population may need extra support. 3. The Obs Pod, by obstetrician Florence Wilcock (Episodes 22 and 23: Language) In episodes 22 and 23 of the Obs Pod podcast, obstetrician Florence Wilcock discusses how the language used in her field can have a detrimental impact on the women and families being cared for. 4. NHS England - Language Matters: language and diabetes This guidance by NHS England sets out practical examples of language that will encourage positive interactions with people living with diabetes and subsequently positive outcomes. 5. Why language matters in social care “Words can invite people in, or keep them out”. Listen to this five minute podcast about why language matters and the impact this has on people who access services, hosted by Linda Doherty from Think Local, Act Personal. 6. "We couldn’t talk to her”: a qualitative exploration of the experiences of UK midwives when navigating women’s care without language Women with little-to-no English continue to have poor birth outcomes and low service user satisfaction. When language support services are used it enhances the relationship between the midwife and the woman, improves outcomes and ensures safer practice. This study aims to understand the experiences of midwives using language support services. 7. Lost for words: Healthwatch evidence on how language barriers contribute to health inequalities Based on research conducted by Healthwatch, this report examines the difficulties that patients with little or no English encounter at every stage of their healthcare journey. Have your say Have you ever been affected by the language used in healthcare? Perhaps you've felt excluded or offended by the words used. Or maybe you have an example of how clear and inclusive language made you feel safer as a patient? You might be a member of staff who has made changes to the way they communicate face-to-face or in writing to help improve outcomes and strengthen patient-provider relationships. Please let us know your thoughts by commenting below (register for free here first). Or you can get in touch with us directly to share your insights at content@PSLhub.org

The Motherhood Group presents Black Maternal Health Conference UK, spotlighting bridging the gap between Community, Service providers and Industries. This interactive event will support in rebuilding the trust between the community and service providers, exploring the role of systemic racism, human rights and structural change, and how to effectively engage with Black mothers. Discussing barriers, de-stigmatising mental health, highlighting what unconscious bias looks like in maternity care, how this impacts mothers, and addressing inequalities affecting ethnic minority women in pregnancy care - access and effective intervention. They will be highlighting the gaps within the system and disparities - but providing nuance and further reiterating the importance of Black women receiving health care that is respectful, culturally competent, safe and of the highest quality. Putting the voices of lived- experience to the forefront, through engaging discussions, informative presentations , interactive sessions and a space for applied learning. Hosted by Sandra Igwe (CEO of The Motherhood Group, and Author of My Black Motherhood: Mental Health, Stigma, Racism and the System), with headline sponsor, Leigh Day, ranked The Times top 100 law firm. You will hear from the following speakers on the day: Please see list of confirmed speakers: Dr Natalie Darko - Associate Professor Social Sciences (Health Inequalities) Dr Karen Joash - Consultant in Obstetrics and Gynaecology Dr. Ria Clarke - Obstetrics and Gynaecology Registrar Kadra Abdinasir - Associate Director for CYP Mental Health Carol King-Stephens - Equality Diversity Inclusion Lead Midwife Marley Hall - Midwife Marley, Author, Midwife and Educator Afua Hagan, Black Womens Rights Journalist & Broadcaster Mars Lord - Founder, Abuela Doulas and Inclusion Consultant Stacy Moore - Chartered Psychologist & Founder of The Nesting Coach Jayde Edwards - Project Manager at The Mental Health Foundation Stacy Gacheru - Practitioner, Qualified Counsellor and Mentor Jennifer Ogunyemi - Founder of Muslim community organisation Caroline Bazambanza - PHD Student Anna Horn - Doctoral Researcher Jenny Okolo - Occupational therapist Dr Karen Joash - Consultant in Obstetrics and Gynaecology Complimentary lunch and refreshments will be served, networking opportunities Register here

Hi Mandy, can you tell us more about yourself and your role? I have worked as a Community Learning Disability Nurse and counsellor for people with a learning disability since 1995. In the last few years, my role has involved completing mortality reviews for the NHS service improvement programme LeDeR (Learning Disability Mortality Review Programme), as well as leading a project to support health initiatives and improved health outcomes for adults with a learning disability in Primary Care. What are some of the health inequalities affecting people with a learning disability? People with learning disabilities face serious health inequalities and have lower life expectancy, dying on average 25 years sooner and often from treatable and avoidable conditions. They experience higher levels of physical ill health and often present with complex and multiple health conditions, including: hearing and visual impairments epilepsy early onset dementia constipation respiratory conditions. People with a learning disability were also found to be 4.5 times more likely to die from Covid-19. They are most likely to die from respiratory related conditions but also less likely to access immunisation screening programmes, including flu. Access to National cancer screening programmes is equally poor. What are the barriers and challenges to improving outcomes? There are number of challenges when making improvements in this area. Below are a few key things to consider when seeking to design a patient-centred experience for people with learning disabilities. People with a learning disability often experience communication difficulties, which limit their ability to express pain, discomfort or feelings of being unwell. This can lead to delays or problems with diagnosis or treatment, identifying their needs or providing appropriate care. Medical appointments also often go out in written format, which is difficult for people who have limited reading ability, and this might result in missed appointments. People with a learning disability might struggle to engage with a particular test or medical intervention due to lack of understanding and fear, all of which have the potential to create additional barriers and cause delays in diagnosis and treatment. There can be confusion about mental capacity and consent amongst medical professionals. Health concerns are also sometimes attributed to the person’s learning disability and behaviour, and not fully investigated. Attending busy GP practices or vaccination centres might prove problematic due to long waits, high noise levels and lots of people. “My son would not have coped going to a hub. Having the vaccine at home by someone who knew how to talk to him was brilliant.” Parent. What can GPs practices do to improve health outcomes for people with a learning disability? Make sure your records are up to date Identification of people with a learning disability within each GP practice is key as this enables the right people to be targeted for specific learning disability initiatives, like the Learning Disability Annual Health Check or immunisations. If the patient requires any “reasonable adjustments”, such as easy read correspondence or longer appointments, this information can be flagged on the patient’s medical records. Sharing the register with Adult Social Care and regular cross-referencing data will help to support accuracy. Equip yourself with the right knowledge and networks People with a learning disability are often a very small percentage of a GP practice caseload and staff might have limited experience and understanding of their needs. Learning Disability Awareness training, as well as good access and close working relationships with the local Learning Disability Team, are essential to support person-centred care. Learning Disability Nurses are ideally placed to work alongside Primary Care and provide on-going guidance, help and support. “The learning disability liaison role has been so helpful particularly at a time when inequities for people with LD are having a spotlight shone upon them. Having someone who understands the complexities involved and can offer advice and training for our primary care teams is invaluable and has really helped to increase the physical health checks in this population and ensure good COVID vaccine uptake.” Salford GP. Build trust and make adjustments Building a relationship of trust, flexibility and giving a person with a learning disability time to express their concerns, absorb information or ask questions in a way that works for them is essential. Using accessible information to support communication, demonstration of equipment, repeat or longer appointments, availability of home visits and application of Mental Capacity Act Principles can help to improve understanding and engagement, develop trust and significantly support effective care and treatment. (Above photo: Sean Dempsey receiving his Covid vaccination) “Mandy came to my house. It helped that I already knew her. She made me feel more confident and helped me feel calm, just by being herself. It was brilliant, it will keep me safe.” Sean Dempsey. What needs to happen nationally to improve health outcomes for people with a learning disability? Mandatory Learning Disability Awareness Training has literally just been launched for all Health and Social Care staff (Oliver McGowan Mandatory Training in Learning Disability and Autism) which is huge progress. In addition, I would like to see: Investment in the recruitment, training and employment of more learning disability nurses Recruitment of Learning Disability Nurses in general medical settings e.g., hospitals and Primary Care Investment in programmes/initiatives to support application of reasonable adjustments in specific areas of care e.g., dedicated screening services for those that cannot access mainstream services (breast cancer screening, cervical cancer screening). What is the most rewarding part of your work? There is no greater feeling than seeing a person with a learning disability access a medical intervention/treatment that could improve their well-being or potentially save their life. Especially when this was initially ruled out due to concerns about complexity or engagement. It is extremely rewarding to know that each of these successes help to change and positively shape the opinions and practice of medical professionals into the future. Do you have a patient safety story to share? Are you a patient, relative or member of staff interested in improving outcomes for people with a learning disability? If you would like to share your insights, please comment below (activate your membership for free first) or get in touch with us directly by emailing content@pslhub.org