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Found 76 results
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Content ArticleThis cohort study in JAMA Network explored the incidence of and factors associated with inappropriate diagnosis of pneumonia in hospitalised patients. The results showed that older patients, those with dementia and those presenting with altered mental status had the highest risk of being inappropriately diagnosed. For those who were inappropriately diagnosed, full antibiotic duration was associated with antibiotic-associated adverse events.
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Content ArticleSpina bifida is a developmental condition affecting the brain and spine, often leading to physical and cognitive impairments, and bladder and bowel issues. Widely regarded as one of the most severe conditions compatible with life, open spina bifida can result in significant morbidity, with numerous body systems and tissues affected.
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Content Article
The King's Fund: Mental health 360 (21 February 2024)
Patient Safety Learning posted an article in Mental health
The King's Fund 'Mental health 360' aims to provide a ‘360-degree’ review of mental health care in England. It focuses on nine core areas, bringing together data available at the time of publication with expert insights to help you understand what is happening in relation to mental health and the wider context. The nine core areas covered are: Prevalence Access Workforce Funding and costs Quality and patient experience Acute mental health care for adults Services for children and young people Inequalities Data. -
Content ArticleThis document from the Department of Health and Social Care (DHSC) sets out how health and care systems should work together to support discharge from all mental health and learning disability and autism inpatient settings for children, young people and adults. It sets out best practice on: how NHS bodies and local authorities should work closely together to support the discharge process and ensure the right support in the community, and provides clarity in relation to responsibilities patient and carer involvement in discharge planning.
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Content ArticlePressure ulcers are a significant challenge for the patients who develop them and the healthcare professionals involved in their prevention and management. They can result in serious complications and avoidable harm, with patients with mobility difficulties at particularly risk from this. This guidance is designed to help practitioners and managers across health and care organisations to provide caring and quick responses to people at risk of developing pressure ulcers.
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Content ArticleThe framework has been produced to guide organisations providing residential or supported living accommodation to adults with a learning disability who may have been impacted by a trauma history. Whilst it can be difficult to assess the impact of trauma for many people with a learning disability, particularly those with a more severe/profound learning disability, it is important to recognise the possibility of the impact of psychological trauma. Providing care practices that are trauma informed, person-centred and growth promoting are less likely to be re-traumatizing for those already exposed to trauma.
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Content ArticleThis study published in JAMA Internal Medicine looked at how often diagnostic errors happened in adult patients who are transferred to the intensive care unit (ICU) or die in the hospital, what causes the errors, and what are the associated harms. In this cohort study of 2428 patient records, a missed or delayed diagnosis took place in 23%, with 17% of these errors causing temporary or permanent harm to patients. The underlying diagnostic process problems with greatest effect sizes associated with diagnostic errors, and which might be an initial focus for safety improvement efforts, were faults in testing and clinical assessment.
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Content ArticleThe economic impact of managing Long Covid in primary care is unknown. In a study published in BMC Primary Care, Tufts et al. estimated the costs of primary care consultations associated with Long Covid and explored the relationship between risk factors and costs. The study found that costs of primary care consultations associated with Long Covid in non-hospitalised adults are substantial. Costs are significantly higher among those diagnosed with Long Covid, those with Long Covid symptoms, older adults, females, and those with obesity and comorbidities.
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Content ArticleNEWS is a tool developed by the Royal College of Physicians which improves the detection and response to clinical deterioration in adult patients and is a key element of patient safety and improving patient outcomes. In December 2017, an updated version of NEWS, NEWS2 was published. NEWS2 has been endorsed by NHS England and NHS Improvement – for use in acute and ambulance settings. NEWS2 has seen widespread uptake across the NHS in England – at present 100% of ambulance trusts and 76% of acute trusts are using NEWS2, with other early warning scores in place in other areas. However, confusion caused by the current variation in practice can compromise patient safety, something that would be eliminated by use of a common tool. Through standardisation of NEWS2, we can reduce the number of patients whose conditions deteriorate whilst in hospital, and potentially save over 1,800 lives a year.
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News ArticleHundreds more middle-aged adults have been dying each month since the end of the pandemic, as obesity and NHS backlogs drive a surge in excess deaths. New analysis of official statistics has revealed that there were an extra 28,000 deaths in the UK during the first six months of 2023, compared with levels in the previous five years. The biggest rise in unexpected deaths has been among adults aged 50 to 64, who are increasingly dying prematurely from preventable conditions including heart disease and diabetes. The Covid inquiry is now being urged to shift its focus from “tactical decisions made by politicians” and to examine the lasting disruption that has kept deaths persistently high since the virus peaked. Experts believe that difficulties in accessing GPs since lockdown and record NHS waiting lists mean that middle-aged patients are missing out on life-saving preventative treatment such as blood pressure medication. Unhealthy lifestyles, obesity and widening health inequalities are also contributing to a rise in avoidable deaths. Professor Yvonne Doyle, who led Public Health England during the pandemic, warned that the official Covid inquiry risks “missing the point” by focusing on the drama and WhatsApps of Westminster politicians. In an article for The Times, Doyle, who gave evidence to the inquiry six weeks ago, says that the tens of thousands of excess deaths since Covid “represent an underlying pandemic of ill health” that should be addressed. Read full story (paywalled) Source: The Times, 13 December 2023
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Content ArticleThe Government's 10-year vision set out in People at the Heart of Care, published in 2021, focuses on three objectives for people who draw on formal care and support, their families, unpaid carers and the social care workforce: People have choice, control and support to live independent lives. People can access outstanding quality and tailored care and support. People find adult social care fair and accessible. In April 2023, the Department of Health and Social Care (DHSC) announced that it would establish an innovation and improvement unit to develop and define clear priorities for innovation and improvement across adult social care. This document sets out the Government's priorities for innovation and scaling in care and support, including identifying, recognising and supporting unpaid carers.
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Content ArticleHospitalised adults whose condition deteriorates while they are on hospital wards have considerable morbidity and mortality. Early identification of patients at risk of clinical deterioration has traditionally relied on manually calculated scores, and outcomes after an automated detection of clinical deterioration have not been widely reported. The authors of this article published in The New England Journal of Medicine developed an intervention program involving remote monitoring by nurses who reviewed records of patients who had been identified as being at high risk. Results of this monitoring were then communicated to rapid-response teams at hospitals. They compared outcomes among hospitalised patients whose condition reached the alert threshold at hospitals where the system was operational, with outcomes among patients at hospitals where the system had not yet been implemented. The authors found that using an automated predictive model to identify high-risk patients, for whom interventions could then be implemented by rapid-response teams, was associated with decreased mortality.
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Content ArticleAn estimated 90,000 people are living with dementia in Scotland, with that number expected to increase to 164,000 by 2036. These national clinical guidelines from Health Improvement Scotland, the first to be published in nearly 20 years, provide recommendations on the assessment, treatment and support of adults living with dementia. It calls for greater awareness of pre-death grief for people with dementia, their carers and their loved ones, as they fear the loss of the person they know. To accompany the guidelines, a podcast has been produced by Health Improvement Scotland speaking to professionals, including Dr Adam Daly, Chair of Healthcare Improvement Scotland’s Guideline Development Group and a Consultant in old age psychiatry, and Jacqueline Thompson, a nurse consultant and the lead on pre-grief death for the guideline. We also hear from Marion Ritchie, a carer who experienced pre-death grief while caring for her husband.
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Content ArticleThe aim of this investigation and report is to help improve the inpatient care of adults with a known learning disability in acute hospital settings. It focuses on people referred urgently for hospital admission from a community setting, such as a person’s home or residential home. In undertaking this investigation, the Health Services Safety Investigations Body (HSSIB) looked to explore the factors affecting: The sharing of information about people with a learning disability and their reasonable adjustment needs following admission to an acute hospital. How ward-base staff are supported to delivery person-centred care to people with a learning disability.
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Content ArticleThis report provides a comprehensive analysis of the adult social care workforce in England and the characteristics of the 1.52 million people working in it. Topics covered include: recent trends in workforce supply and demand, employment overview, recruitment and retention, demographics, pay, qualification rates, and future workforce projections.
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Content ArticleMonitoring and responding to deterioration in social care settings is critical to providing safe, effective and responsive care. Front-line staff are pivotal for highlighting change to wider teams and managing low to medium risk individuals in their place of residence. However, there is a core set of principles that most systems use which may not be used by non-clinical staff in residential settings. This case study explores an intervention to empower non-clinical staff to take observations. The Whzan blue box contains a digital tablet and equipment to take temperature, pulse, oxygen saturation levels and blood pressure measurements. Staff were trained and supported on site to use the system and set up a digital platform to share measurements with wider teams. Staff fed back that they felt empowered and able to better engage in conversation with health care professionals, highlighting the importance of having a common language. This case study was submitted to the Care Quality Commission (CQC) by North East and North Cumbria ICB.
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Content ArticleThis study in Intensive and Critical Care Nursing examined the association between safety attitudes, quality of care, missed care, nurse staffing levels and the rate of healthcare-associated infection (HAI) in adult intensive care units (ICUs). The authors concluded that positive safety culture and better nurse staffing levels can lower the rates of HAIs in ICUs. Improvements to nurse staffing will reduce nursing workloads, which may reduce missed care, increase job satisfaction, and, ultimately, reduce HAIs.
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News Article
ADHD and autism campaigners plan legal action against NHS over referral limits
Patient Safety Learning posted a news article in News
Campaigners are planning to launch legal action after NHS chiefs in North Yorkshire placed limits on which adults can get referrals for autism and attention deficit hyperactivity disorder (ADHD) assessments. North Yorkshire and York Health and Care Partnerships introduced a pilot programme in March in which adults seeking an NHS assessment for autism or ADHD are triaged via an online screening tool. NHS chiefs say this screening process prioritises those with the most severe needs, rather than processing referrals in chronological order. These priority needs reportedly include the patient being at risk of immediate self-harm or harming others, at risk of being unable to have lifesaving hospital treatment or care placement, or an imminent risk of family court decisions being determined on diagnosis. Those who do not meet the criteria are given guidance and signposted to other support networks. But campaigners say that in practise that means that most people cannot get a referral for an assessment – GPs can no longer make referrals themselves. Read full story Source: The Big Issue, 19 July 2023 Related reading on the hub: Long waits for ADHD diagnosis and treatment are a patient safety issue -
News Article
System admits 10-year diagnostic waits
Patient Safety Learning posted a news article in News
Adults across an integrated care system area are facing ‘unacceptable’ 10-year waits for an NHS assessment for attention deficit hyperactivity disorder, the longest known wait for such services in England. Herefordshire and Worcestershire integrated care board has warned in board papers of “exceptionally high waiting times for ADHD assessment and treatment for Worcestershire patients (10 years+), with workforce challenges and service fragility compromising service delivery”. HSJ understands the long waits for ADHD diagnosis, which is a national problem, is predominately affecting adults with approximately 2,000 people on Herefordshire and Worcestershire’s ADHD list alone. Local provider Herefordshire and Worcestershire Health and Care Trust also warned on its website that its paediatric services were also “experiencing unprecedented demand”. Read full story (paywalled) Source: HSJ, 19 July 2023 -
Content ArticleThere are an estimated 363,000 adults experiencing multiple disadvantage in England—they may be experiencing a combination of homelessness, substance misuse, mental health issues, domestic abuse and contact with the criminal justice system. The Changing Futures programme works in partnership in local areas and across government to test innovative approaches and drive lasting change across the whole system, in order to provide better outcomes for adults experiencing multiple disadvantage. This prospectus provides information for partnerships interested in submitting an expressions of interest to be part of the Changing Futures programme.
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Content ArticleHealth and care services in England are not always able to provide individualised, equitable and coordinated palliative and end of life care (PEoLC) to meet the holistic needs of people and their families. To understand the impact of inconsistent palliative care, the Healthcare Safety Investigation Branch (HSIB) looked at the case of Dermot, a 77-year-old cancer patient. Dermot's case shows the gap between what is needed and what is available. HSIB make three safety recommendations to NHS England aimed at improving the delivery of palliative and end of life care.
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Content ArticleThis framework sets out what good digital working looks like for care providers and local authorities with responsibility for adult social care in England.
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News Article
Study finds rise in psychological distress in young adults
Patient Safety Learning posted a news article in News
There has been a rise in the number of young adults in England who report feelings of severe distress, according to a new survey. The study found one in five 18 to 24-year-olds said they experienced severe distress at the end of 2022, compared to around one in seven in 2021. The research suggested reports of severe distress rose across all age groups, except for those over 65. Experts have pointed to the pandemic, cost of living and healthcare crisis. Researchers used a point-based score during telephone interviews to assess severe distress for the survey. People had not necessarily sought clinical help or a diagnosis at this point. The research team, including academics from King's College London and University College London (UCL), say the rise in reports needs to be urgently addressed. Read full story Source: BBC News, 7 July 2023 -
Content ArticleA study from Jackson et al. looked at how the prevalence of psychological distress in the adult population of England has changed since 2020. The study found that the proportion reporting any psychological distress was similar in December 2022 to that in April 2020 (an extremely difficult and uncertain moment of the COVID-19 pandemic), but the proportion reporting severe distress was 46% higher. These findings provide evidence of a growing mental health crisis in England and underscore an urgent need to address its cause and to adequately fund mental health services.
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Content ArticleHealth Education England (HEE) commissioned the Royal College of Physicians (RCP) to undertake the development of a training programme to meet the medical needs of adults with a learning disability. The training programme consists of two modules and applicants are expected to complete both modules which will result in a post graduate certificate. The second module is under development but will be available in the autumn of 2023. Funded places for both modules are available.
