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News ArticleA drug developed over 20 years ago to treat cancer could help patients living with crippling pain, according to new research. Kenpaullone switches on a gene that douses chronic inflammation, say scientists. Experiments on mice and humans found it was remarkably successful at alleviating nerve injury and bone tumour symptoms. The US team is hopeful clinical trials will see equally successful results in humans suffering a host of conditions. Up to 8 million people in the UK live with chronic pain. Major causes include arthritis and spine damage. Lead author Professor Wolfgang Liedtke said: “New drugs and other therapies against chronic pain need to be safe, i.e., the fewer side effects the better. “It’s especially important they be non-addictive and non-sedative, while being effective against nerve injury pain and cancer pain, preferably with a minimal time to official approval." Read full story Source: The Independent, 27 October 2021
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News Article
Cancer patients face ‘perfect storm’ as Covid piles pressure on NHS
Patient Safety Learning posted a news article in News
Progress in clearing the NHS cancer treatment backlog in England has gone into reverse amid high Covid cases and staff shortages, analysis suggests. The NHS has been striving to catch up with the pandemic backlog of cancer care but the analysis by Macmillan Cancer Support of official data suggests the drive has recently suffered a setback, with growing numbers of potential cancer diagnoses missed. Four key cancer measures have fallen back, with two dropping to their worst ever recorded level. Figures published by NHS England, and analysed by Macmillan for the Guardian, show the number of patients starting treatment in August following a decision to treat fell to 25,800. The figure was above 27,000 in June and July. The proportion of patients who began treatment within one month of the decision to treat fell to 93.7% – the lowest percentage ever recorded. Data published last week also shows that in August there was a record-high number of patients forced to wait for more than two months after an urgent referral from their GP before they started cancer treatment. Macmillan said it was concerned that rising Covid hospitalisations were making it “even harder for the system to cope”. Efforts to tackle the backlog are also being hit by a shortage of cancer nurses, the charity said. Steven McIntosh, the executive director of advocacy at Macmillan, said: “We know that many patients are entering an overstretched system that was on its knees even before the pandemic. This risks a perfect storm, as the system experiences a considerable influx of patients alongside an overwhelmed workforce struggling to provide the care and support that people urgently need.” Read full story Source: The Guardian, 22 October 2021 -
News Article
24 children wait year for first cancer appointment in Northern Ireland
Patient Safety Learning posted a news article in News
Twenty-four children in Northern Ireland with confirmed or suspected cancers had to wait over a year for a first appointment, a review has found. The figure, for April, is in a review of child health waiting lists by the Northern Ireland Commissioner for Children and Young People. More than 17,000 children were waiting more than a year to see a hospital consultant for the first time. The commissioner said the waiting times were "terrifying". The review examined official waiting list data for children's health services not published as part of the Department of Health's statistical bulletins. Koulla Yiasouma said that waiting for any health service treatment can and does have a "profound impact on a child's health outcomes, emotional and mental well-being". She said it was "shocking not only for the child but their families too". "Each and every single one of them is a child and each and every single one of them is a child whose life has almost been put on hold, and a family whose life has been put on hold, because they are not getting the most fundamental right of healthcare that they deserve," she said. Read full story Source: BBC News, 19 October 2021 -
News Article
Charities say Covid booster rollout for immunosuppressed is ‘chaotic failure’
Patient Safety Learning posted a news article in News
The programme of giving third Covid vaccinations to people with compromised immune systems has been a “chaotic failure”, charities have said, with fewer than half of those eligible contacted about a third jab before an NHS deadline this month. Surveys by Blood Cancer UK and Kidney Care UK found that for both groups of patients, between 55% and 60% had yet to be invited to get a third injection, seen as particularly vital for conditions which affect people’s immune systems, as they are generally less protected by two jabs. The charities said many of those who responded were desperately worried and were struggling to get information about a third vaccination. Some people with blood cancer had resorted to going to vaccination centres without an appointment, pleading for a third dose, Blood Cancer UK said. Official figures show there were 45,066 confirmed new Covid cases in the UK on Thursday, the highest daily total since mid-July. Kidney Care UK said the poor communication highlighted what seemed to be a “woeful lack of preparation” for the programme, the guidance for which was agreed on 2 September. The third dose programme for people with compromised immune systems is separate to the wider rollout of booster jabs being offered to everyone over 50, and others with clinical vulnerabilities, which started on 15 September. Read full story Source: The Guardian, 15 October 2021 -
Content ArticleThe Healthcare Safety Investigation Branch (HSIB) identified a patient safety risk caused by delays in diagnosing lung cancer. Lung cancer is the third most common cancer diagnosed in England, but accounts for the most deaths. Two-thirds of patients with lung cancer are diagnosed at an advanced stage of the disease when curative treatment is no longer possible, a fact which is reflected in some of the lowest five-year survival rates in Europe. Chest X-ray is the first test used to assess for lung cancer, but about 20% of lung cancers will be missed on X-rays. This results in delayed diagnosis that will potentially affect a patient’s prognosis. The HSIB investigation reviewed the experience of a patient who saw their GP multiple times and had three chest X-rays where the possible cancer was not identified. This resulted in an eight-month delay in diagnosis and potentially limited the patient’s treatment options.
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News Article
One in four women under 40 have never checked themselves for breast cancer
Patient Safety Learning posted a news article in News
One quarter of women under 40 have never checked themselves for breast cancer – believing they are too young, or they don’t think it will affect them, or they are just too busy. And half of all women do not regularly check their breasts for signs of cancer. The study of 2,000 women found those aged 18 to 39 are the least likely to look for signs of cancer, with a tenth believing they are not old enough to suffer the illness. But a quarter admit they do not have the confidence to inspect themselves, while 1 in 10 put it off in case they find a lump. It also emerged women from South Asian backgrounds are the least likely to examine themselves compared to other ethnicities, with 40% admitting to never checking at all. This drops to 27% of black women and just 13% cent of those of other ethnicities. Of the South Asian women polled who don’t check themselves for signs of breast cancer, more than a third said they forget or don’t know what they are looking for. While more than 1 in 20 (7%) don’t feel comfortable checking themselves due to cultural reasons. Barriers to going to the doctor when noticing a lump or change in breasts vary – from not wanting to waste their doctor’s time, the fear of not being taken seriously, concerns that a female doctor won’t be available, and not wanting to know what caused the change. Read full story Source: The Independent, 11 October 2021 -
News ArticleGPs are failing to urgently refer patients with “red flag” signs of suspected cancer to a specialist, research suggests. Six out of 10 patients in England with key symptoms indicating possible cancer did not receive an urgent referral for specialist assessment within two weeks, as recommended in clinical guidelines, according to a new study. Nearly 4% of these patients were subsequently diagnosed with cancer within the next 12 months. The findings were published in the journal BMJ Quality & Safety. In the study, researchers analysed records from almost 49,000 patients who consulted their GP with one of the warning signs for cancer that should warrant referral under clinical guidelines. Of the 29,045 patients not referred, 1,047 developed cancer within a year (3.6%). Early diagnosis and prompt treatment is crucial to survival chances. Every four-week delay in cancer treatment increases the risk of death by 10%. Read full story Source: The Guardian, 5 October 2021
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News ArticleThe number of women in the UK who have not had vital NHS breast screening, which can stop people dying from breast cancer, has risen by an estimated 50% - to nearly 1.5 million women - since services resumed, the leading UK breast cancer charity warns during Breast Cancer Awareness Month. Breast Cancer Now reveals an alarming increase of around half a million women who haven’t been screened since services restarted in summer 2020, estimating that around 1,480,000 fewer women in the UK had breast screening between March 2020 and May 2021, compared to pre-pandemic levels. This comes a year after the charity reported that almost one million women had missed breast screening due to COVID-19 seeing services paused. According to the charity, nearly 12,000 people in the UK could have been living with undiagnosed breast cancer at the end of May 2021, due to the impact of the pandemic on breast screening services and fewer women being referred to specialists with possible symptoms of the disease since March 2020 – a frightening prospect when early detection can stop people dying from the disease. Full article here Source: Breast Cancer Now Also covered in the Independent
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Content ArticleClinical guidelines advise GPs in England which patients need urgent referral for suspected cancer. This study in BMJ Quality & Safety used linked primary care, secondary care and cancer registration data to assess: how often GPs follow the guidelines on cancer referral whether certain patients are less likely to be referred how many patients were diagnosed with cancer within one year of non-referral. The study included patients who presented for the first time with blood in the urine, breast lump, difficulty swallowing, iron-deficiency anaemia and post-menopausal or rectal bleeding during 2014–2015. The authors found that the majority of patients presenting with common possible cancer symptoms were not being referred by GPs in line with clinical guidelines. They also found that a significant number of these patients went on to develop cancer within a year, and suggest that improvement is needed in the cancer diagnosis process.
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Content ArticleThe pandemic has severely disrupted cancer services in England with major consequences for survival rates for lung, breast and colorectal cancer. This paper from the Institute for Public Policy Research examines the impact of the pandemic on cancer pathways, highlighting widespread disruption across screening, referrals, diagnostic and treatment services. The authors also highlight that the 'missing patient' backlog is difficult to predict and that there is a lack of qualified staff to increase capacity and aid service recovery.
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Content Article
Mesothelioma UK Research Centre: Mesothelioma and gender video
Patient Safety Learning posted an article in Cancers
Mesothelioma UK has published a short animation on gender differences in experiences of mesothelioma to help support professionals The GEMS study aims to explore the experiences of men and women with mesothelioma, their family carers as well as the various staff they meet. It seeks to understand why any differences that are identified occur. Their goal is to establish with participants how services should best be delivered to be accessible and acceptable to both men and women. The full report can be accessed here. -
News Article
Cancer backlog could take a decade to clear
Patient Safety Learning posted a news article in News
It could take more than a decade to clear the cancer-treatment backlog in England, a report suggests. Research by the Institute for Public Policy Research (IPPR) estimated 19,500 people who should have been diagnosed had not been, because of missed referrals. If hospitals could achieve a 5% increase in the number of treatments over pre-pandemic levels, it would take until 2033 to clear the backlog. However, if 15% more could be completed, backlogs could be cleared by next year. Between March 2020 and February 2021, the number of referrals to see a specialist dropped by nearly 370,000 on the year before, a fall of 15%. Behind these figures are thousands of people for whom it will now be too late to cure their cancer, the report, with the CF health consultancy, warns. And it estimates the proportion of cancers diagnosed while they are still highly curable - classed as stage one and two - has fallen from 44% before to pandemic to 41%. IPPR research fellow Dr Parth Patel said: "The pandemic has severely disrupted cancer services in England, undoing years of progress in improving cancer survival rates. "Now, the health service faces an enormous backlog of care, that threatens to disrupt services for well over a decade. We know every delay poses risks to patients' chances of survival." Read full story Source: BBC News, 24 September 2021 -
News ArticleA major acute trust in the East Midlands has been forced to restrict how much chemotherapy it is able to offer due to staff shortages. Nottingham University Hospitals Trust confirmed in a statement its chemotherapy service has been affected by long-term staff sickness and staff vacancies. A trust spokeswoman said: “We continue to provide chemotherapy to patients who benefit most from the treatment and the small number of patients affected have been contacted directly by their specialist cancer team and offered support.” She added: “We are recruiting to posts as well as working with neighbouring NHS and private providers to ensure that any delays are minimal.” The trust added all its patient care decisions adhered to national guidance aimed at helping chemotherapy centres categorise and prioritise treatments when these situations arise. The Nottingham Post first reported the difficulties facing the trust, suggesting the restrictions would specifically affect palliative care patients who receive chemotherapy at NUH’s City Hospital site. Read full story (paywalled) Source: HSJ, 23 September 2021
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News ArticleAt least three people died and more came to ‘severe harm’ after treatment delays across three specialties at one hospital trust, new reports have revealed. King’s College Hospital Foundation Trust commissioned harm reviews due to problems with a lack of capacity and poor management of waiting lists in endoscopy, dermatology and ophthalmology pre-pandemic. Most of the problems relate to the trust’s southern site, Princess Royal University Hospital, and took place before the current executive team took over. The most recent board papers revealed a review of 614 cases at the PRUH’s endoscopy service found seven cases of “serious harm”. This category includes death and the document revealed three patients had died. The review also “highlighted delays in endoscopy leading to delayed diagnoses of cancer” in 2018-19 and 2019-20. Investigators also found a dermatology patient came to “severe harm” after being lost to follow-up twice by the trust. Read full story (paywalled) Source: HSJ, 17 September 2021
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Event
16th Annual Asbestos Awareness and Prevention Conference
Sam posted an event in Community Calendar
untilThe world’s leading experts in medicine, public health, trade unions, environmentalists, and more, virtually come together for an interdisciplinary, international learning opportunity about the latest asbestos policy, prevention efforts, and medical advancements in the United States and around the world. ADAO's conference is perfect for victims, scientists, health and safety professionals, the medical community, and health and environmental activists. This year ADAO introduce our Friday “Art, Advocacy, and Shared Stories” Film Festival. Register -
News ArticleSurgical hubs, new technology and innovative ways of working will help tackle waiting lists and treat around 30% more elective care patients by 2023 to 2024. Backed by a new £36 billion investment in health and social care over the next 3 years, ‘doing things differently’ and embracing innovation will be the driving force to get the NHS back on track. The funding will see the NHS deliver an extra 9 million checks, scans and operations for patients across the country, but it’s not enough to simply plug the elective gaps. The NHS will push forward with faster and more streamlined methods of treatments. Surgical hubs already being piloted in a number of locations, including London, are helping fast-track the number of planned operations, including cataract removal, hysterectomies and hip and knee replacements, and will be expanded across the country. Located on existing hospital sites, surgical hubs bring together the skills and resource under one roof while limiting infection risk and providing a COVID-secure environment, with more planned to open in the coming year. The NHS has been trialling a range of new ways of working in 12 areas, backed by £160 million, to accelerate the recovery of services. This includes setting up pop-up clinics so patients can be treated quickly, in person, and discharged closer to home, as well as virtual wards and home assessments to allow patients to receive medical support from the comfort of their home, freeing up beds in hospitals. GP surgeries are using artificial intelligence to help prioritise patients most in need and identify the right level of care and support needed for patients on waiting lists. The latest cancer tests being deployed across the NHS are also helping speed up diagnosis and spot cancer early on. Thanks to the hard work of staff, a quarter of a million people were checked for cancer in June – the second highest number on record – and more than 27,000 people started treatment for cancer in the same period. Professor Steve Powis, NHS England medical director, said: "Although the pandemic is still with us and we will have to live with the impact of COVID for some time, the NHS has already made effective use of additional resources to recover services. From adopting the latest technologies to more evening and weekend working, NHS staff are going to great lengths to increase the number of operations carried out. The further funding announced this week will support staff to deliver millions more vital checks, tests and operations, so if you have a health concern, please do come forward to receive the care and treatment you may need." Read full story Source: 8 September, Department of Health and Social Care
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News Article
Post-illness symptoms like long Covid are probably more common than we think
Patient Safety Learning posted a news article in News
In recent months, long Covid has received a great deal of media and public attention. Research has found that as many as one in four of those infected with Covid suffer from chronic long-term symptoms, including headaches, dizziness, abdominal pain, heart problems, fatigue, anxiety, depression, cognitive impairment and other conditions. It is a difficult and complex illness, and we must do much more to help those who are struggling with it. At the same time, it is important to realise that rather than being a strange special case, long Covid is probably part of a broader phenomenon that affects many more people. In recent years, doctors and researchers have increasingly realised that many of those who survive an illness of any kind, or who go through serious physical trauma, are at high risk for a range of debilitating and chronic physical, cognitive and mental health symptoms – problems that closely resemble long Covid. As medicine has advanced, clinicians have learned how to save hundreds of thousands of severely ill or injured patients who would have previously died. Although this is a remarkable accomplishment, however, in many cases, survival does not mean complete recovery: some patients find that their bodies, brains and psyches continue to bear the scars of what they have gone through. One non-Covid study found that a year after hospitalisation, a third of patients with severe respiratory failure or shock had significant cognitive impairment. Another found that between a quarter and a third of patients who were treated in the ICU had significant and long-lasting symptoms of anxiety, depression or PTSD. Researchers have found similar results for survivors of other medical conditions, including cancer, multiple sclerosis and ALS. Unfortunately, people with long Covid, as well as other chronic post-illness symptoms, often find that the medical establishment doesn’t understand their experience, and so minimises or questions it. This is not surprising: clinicians tend to pay less attention to how patients with severe illness do once they are out of mortal danger, or once symptoms extend beyond an arbitrary time frame. Read full story Source: The Guardian, 12 September 2021 -
News Article
Hospital admits patient care is being compromised as cancer operations delayed
Patient Safety Learning posted a news article in News
Cancer operations at one of England’s largest hospital trusts are being delayed as bosses admit patient care on wards is being compromised. Nottingham University Hospitals Trust has been forced to convert one of its few remaining wards for cancer surgery patients into an emergency medical ward to cope with an influx of patients. The Independent understands the trust’s A&E department is regularly overcrowded with 40 or more patients waiting for a bed at the start of most days. In a leaked message to staff sent on Friday and shared with The Independent, bosses at the hospital said the trust was facing an “exceptionally difficult time” which was “probably the most challenging position we have been in since the pandemic began”. It added: “There is no doubt that we are having to compromise the quality of care we are providing to some patients to ensure that we are able to maintain a service for the whole population.” “Our emergency department is over capacity continuously, which means that patients are waiting for extended periods on trolleys with little privacy and dignity because they do not have a bed to go to. We are having to make difficult decisions every day as to whether we can proceed with cancer and urgent operations and we are not able to tell some patients when they will get their operation." Read full story Source: The Independent, 13 September 2021 -
News Article
Early CT scans deliver huge fall in lung cancer deaths, study shows
Patient Safety Learning posted a news article in News
Screening smokers and ex-smokers could dramatically reduce deaths from lung cancer – Britain’s biggest cancer killer – a major new study has found. Low-dose computerised tomography (CT) scans can detect tumours in people’s lungs early and cut deaths by 16%, according to the UK Lung Cancer Screening Trial (UKLS). The findings have prompted renewed calls from lung cancer experts for the government to bring in routine screening across the UK of all those who are at risk because of their smoking history. They say that early detection means patients can have potentially curative surgery or radiotherapy. “Lung cancer early detection and surgical intervention saves lives,” said Professor John Field of Liverpool University, an author of the trial. Read full story Source: The Guardian, 12 September 2021 -
News ArticleFailures by a health board led to eight cancer patients not being appropriately monitored or included in treatment targets after being referred to England, the ombudsman has found. Of the 16 patients on Wale's Betsi Cadwaladr health board's prostatectomy waiting list in August 2019, eight were referred to England for treatment. None of those treated in England met the health board's targets. The health board, which covers north Wales, has apologised to the patients. It said it had accepted the findings of the report and agreed to implement its recommendations. The investigation was launched after a report into the case of a prostate cancer patient raised suspicion there were further incidents. Public Services Ombudsman for Wales Nick Bennett said: "Clearly there's consequences for any type of cancer treatment, where people who are treated in England do not receive the same monitoring, do not receive the same harm reviews... "Going forward, this must never happen again." Read full story Source: BBC News, 9 September 2021
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Content ArticleGetting It Right First Time (GIRFT) is designed to improve the quality of care within the NHS by reducing unwarranted variations. By tackling variations in the way services are delivered across the NHS, and by sharing best practice between trusts, GIRFT identifies changes that will help improve care and patient outcomes, as well as delivering efficiencies such as the reduction of unnecessary procedures and cost savings.
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News Article
Nurse shortage ‘delaying treatment for 21% of UK cancer patients’
Patient Safety Learning posted a news article in News
More than 600,000 cancer patients in the UK are facing treatment delays or missing out on vital support because of a shortage of specialist nurses, a new report from Macmillan Cancer Support reveals. One in five of all those living with cancer (21%) are lacking dedicated support. The NHS is suffering from a “shocking” shortfall of 3,000 specialist nurses in England alone, according to the analysis by Macmillan Cancer Support. As a result, cancer patients are struggling with medication, having hospital appointments cancelled because there are not enough staff or experiencing devastating delays to chemotherapy. In some cases, patients are ending up in A&E. Patricia Marquis, England director of the Royal College of Nursing, warned the workforce crisis was having a “devastating impact” on people living with cancer. “Expertise built up over many years is lost very quickly and it is patients who pay the price, as this report shows,” she added. Read full story Source: The Guardian, 8 September 2021 -
Content ArticleThe Covid-19 pandemic has both laid bare and exacerbated the strain the cancer workforce has been under for many years. When the pandemic hit, some services were forced to pause, whilst others had to quickly adapt and many have still not ‘returned to normal’. Some cancer nurses were also deployed to care around the clock for the half a million people admitted to hospital with coronavirus. The practical and emotional impact of this disruption on people living with cancer has been profound. Macmillan’s new research establishes that cancer nurses are being stretched too thinly, trying to be there at our time of greatest need, and coping with the physical and emotional toll of the pandemic. Cancer and the devastating impact it has on lives should not be forgotten, and neither should our nurses and NHS. In this report, Cancer nursing on the line: why we need urgent investment across the UK, Macmillan is calling for Governments across the UK to invest a total of around £170 million to fund the training costs of creating nearly 4,000 additional cancer nurses required by 2030 to provide the care people need.
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News Article
Northern Ireland health system "one step from chaos"
Patient Safety Learning posted a news article in News
"Bodies would have been piling up" if the Covid vaccine had not been available, the director of intensive care at Belfast City Hospital has said. Dr George Gardiner, a consultant, also said his biggest fear would be having to stop routine cancer surgery. He has called for an end to "tribal politics" in Northern Ireland to allow transformation of the health service, so that cancer and coronavirus can be tackled in tandem. He said the system was currently "one step from chaos" and warned hospitals will not cope with winter if Covid numbers continue to rise. "We need to get everyone who can take a vaccine to take it now before the winter pressures are on us," Dr Gardiner added. "The cancer surgery that we are doing at the minute is life saving. A few more Covid admissions, which could be prevented, will cause us to stop operating because we simply haven't got the capacity to do both." Read full story Source: BBC News, 7 September 2021 -
News Article
Worcestershire NHS managers knew cancers missed due to X-ray backlog
Patient-Safety-Learning posted a news article in News
According to reports, senior managers at an NHS trust knew up to 30 cancers may have gone undetected two years before an official probe into a backlog of thousands of X-rays. Although the Care Quality Commission (CQC) and Healthwatch made investigations in 2016, neither one were told of potential harm to patients. The backlog was publicly exposed by Ken Hall, who approached the Care Quality Commission in 2016, where it then identified 11,000 X-rays had not been processed, but was subsequently struck off after allegations of fraud. "These go through a rigorous quality assurance process and the Care Quality Commission would not publish any statement in an inspection report that it did not believe to be true." Said the CQC when asked about its findings of no harm after being shown the 2014 trust management committee reports, the CQC also told the BBC it could find no record of inspectors having had sight of them. Read full story. Source: BBC News, 27 August 2021
