Search the hub
Showing results for tags 'Care assessment'.
Found 54 results
-
News Article
GPs should regularly review self-harm patients, says draft NICE guidance
Patient Safety Learning posted a news article in News
GPs should regularly review self-harm patients and offer a specific CBT intervention, according to a consultation on the first new guidance for self-harm to be drawn up in 11 years. The new draft guidance emphasises the importance of referring patients to specialist mental health services, but stresses that, for patients who are treated in primary care, continuity is crucial. If someone who has self-harmed is being treated in primary care, GPs must ensure regular follow-up appointments and reviews of self-harm behaviour, as well as a medicines review, the draft guideline say. They must also provide care for coexisting mental health issues, including referral to mental health services where appropriate, as well as information, social care, voluntary and non-NHS sector support and self-help resources. The guidance says that referring people to mental health services would ‘ensure people are in the most appropriate setting’. However, the committee agreed that ‘if people are being cared for in primary care following an episode of self-harm, there should be continuity of care and regular reviews of factors relating to their self-harm to ensure that the person who has self-harmed feels supported and engaged with services’. The draft guidance, out for consultation until 1 March, also says ambulance staff should suggest self-harming patients see their GP to maximise the chance of engagement with services. It says: ‘When attending a person who has self-harmed but who does not need urgent physical care, ambulance staff and paramedics should discuss with the person (and any relevant services) if it is possible for the person to be assessed or treated by an appropriate alternative service, such as a specialist mental health service or their GP.’ It notes that ‘ambulance staff often felt that the emergency department was not the preferred place that the person who had self-harmed wanted to be taken. They agreed that referral to alternative services could facilitate the person’s engagement with services’. Read full story Source: Pulse, 18 January 2022 -
News Article
NHSE orders health check blitz to stop mortality gap growing
Patient Safety Learning posted a news article in News
NHS England is urging health systems to ramp up physical health checks for people with severe mental illnesses to address a widening life expectancy gap caused by covid, according to a letter seen by HSJ. In a letter circulated to integrated care system leads, chairs, mental health and community trust executives on Wednesday, national commissioners warn the impact of the pandemic may widen current gaps in life expectancy for people with SMI and learning disabilities even further, without “decisive and proactive action”. The letter, circulated by national mental health director Claire Murdoch, learning disability and autism director Tom Cahill and inequalities director Bola Owolabi, quotes NHS data suggesting people with SMI are five-and-a-half times more likely to die prematurely and those with learning disabilities three times more likely to die from an avoidable cause of death. It says: ”The health inequalities faced by people living with SMI and people with a learning disability are stark… The impacts of the pandemic will widen this gap further unless we take decisive and proactive action to address inequalities… These checks are a key lever to address the reduced life expectancy for both groups.” It calls on primary care teams, already delivering thousands of covid vaccinations as part of the booster programme, to prioritise annual physical health checks alongside the rollout, “even as we continue with a level 4 national incident” caused by the omicron variant. Read full story (paywalled) Source: HSJ, 14 January 2022 -
News Article
Mothers and babies at risk as vital health services in England stay shut
Patient Safety Learning posted a news article in News
Mothers and babies are being put at risk as vital health checks and support services remain shut months after lockdown was lifted, health professionals and charities have warned. Face-to-face services for new families stopped when lockdown began in March last year and have not come back in many parts of the country. Now experts fear the spread of the Omicron variant and the reintroduction of some restrictions means the reopening will be delayed further. Missing services include drop-in baby-weighing clinics, tongue-tie clinics, face-to-face breastfeeding support and council-run baby classes and playgroups. Experts have accused the government of failing to prioritise the needs of a generation of babies and their parents, with cost-cutting and a shortage of midwives and health visitors blamed for the closures. Health visitor drop-in clinics are “no longer running” in nearly a third of areas, and around 28% of newborn checks are being carried out via phone or video call, according to the No One Wants to See My Baby report by charities the Parent-Infant Foundation, Home-Start UK and Best Beginnings. The Institute of Health Visiting said different interpretations of government guidance meant some areas had brought back full services while others had not, creating a “postcode lottery of support for families”. It questioned official advice that routine checks could continue to be done via video and telephone calls, warning there was no evidence these were “safe or effective”. Executive director Alison Morton said: “Alongside the concerns of parents, there is a growing body of evidence that childhood conditions and disabilities are being missed, and vulnerable babies and young children are being harmed, as they are invisible to services when these assessments are not completed face to face.” Read full story Source: The Guardian, 12 December 2021 -
News Article
Covid: Doctors' leaders back postponed health checks
Patient Safety Learning posted a news article in News
Doctors' leaders have welcomed plans to allow GPs in England to defer some services to deliver Covid booster jabs instead. Practices can postpone minor surgery and routine health checks for over-75s and new patients until 31 March. All adults in England are expected to be offered boosters by the end of January in response to the emergence of the Omicron variant. A further 75 Omicron cases were confirmed in England on Friday. On Saturday the UK reported a further 42,848 cases of coronavirus and 127 deaths within 28 days of a positive Covid test while 372,557 booster jabs were administered on Friday. Dr Farah Jameel, the GP committee chair of the British Medical Association, said the new measures would release GPs from "filling out paperwork" and chasing unnecessary and often undeliverable targets. She told BBC Radio 4's Today programme: "We have been struggling with significant prevailing workforce pressures - backlog pressures, winter pressures, pandemic pressures. "Whilst these changes make a difference and start to create some time, I think every single practice will have to look at just how much time it does release." Read full story Source: BBC News, 5 December 2021 -
News Article
Covid inquiry must look at NHS 111 ‘mishandling’, bereaved families say
Patient Safety Learning posted a news article in News
The inquiry into the government’s handling of the Covid pandemic should look at the “mishandling” of the NHS 111 service, families bereaved during the crisis have said. In a scathing report, the COVID-19 Bereaved Families for Justice group said the service was inappropriately used to “alleviate the burden on the NHS” with “horrific” consequences. The report, based on a survey of families, said many believed that the service “failed to recognise how seriously ill their relatives were and direct them to appropriate care”. They argue that the service was also quickly “swamped” during the first wave despite the addition of 700 new call handlers, many of who were making life or death decisions with just 10 weeks training. The phone line is one of a number of areas the groups want the government’s inquiry to cover. Other areas include No 10’s level of pandemic preparedness, particularly PPE shortages, as well as an investigation into the disproportionate impact on ethnic minority groups and those with disabilities. Read full story Source: The Independent, 30 November 2021 -
News ArticleFailings by NHS 111 contributed to the death of an autistic teenager, a coroner has ruled. Hannah Royle, 16, suffered a cardiac arrest as she was driven to hospital by her parents after a 111 algorithm failed to notice she was seriously ill. A coroner said her death had exposed a risk people were being misled about the capability of the system and its staff. An NHS spokesperson said it would act on the findings and learnings "where necessary". Hannah's father Jeff Royle said he regretted dialling 111 and wished he had taken his daughter straight to hospital. "I feel so dreadful, that I have let her down and she has been let down by the NHS," he said. Read full story Source: BBC News, 20 October 2021
-
News Article
111 First to go live imminently amid ‘vehement’ opposition in some EDs
Patient Safety Learning posted a news article in News
Emergency care leaders are warning it will take up to six more months to determine whether pilots of a radical change to accident and emergency are working, even though it is due to go live nationally next week, HSJ has learned. HSJ understands the new “111 First” system — where walk-in patients not in medical emergencies call 111 to “book” urgent care — is set to “go live” across England from next week following pilots in acute trusts which have been run since the summer. From 1 December, people will be able to call NHS 111 from anywhere in the country and have urgent care “booked” for them if needed, it is understood. NHS England has been pursuing the 111 First model to help reduce overcrowding and the risk of nosocomial infections in A&Es. The service is also intended to be able to book them into GP practice appointments. Well-placed sources confirmed most acute trusts have now implemented some form of 111 First and the model is set to be part of their standard operations when the national system “goes live” next week. A national advertising campaign is expected to promote the approach. But the Royal College of Emergency Care Medicine said there was a “vocal minority” of clinicians who are “vehemently against” 111 First as they believe it will increase demand in emergency departments. Read full story (paywalled) Source: HSJ, 25 November 2020 -
News Article
Maternity scandal hospital fined for not triaging A&E patients fast enough
Patient Safety Learning posted a news article in News
An NHS hospital which has faced repeated criticism by regulators for poor standards of care has been fined £4,000 for failing to assess A&E patients quickly enough. The Shrewsbury and Telford Hospitals Trust has been fined by the Care Quality Commission (CQC) after patients were not triaged within 15 mimutes of arrival in A&E – in breach of conditions set by the regulator last year and a national target. The care of emergency patients at the hospital trust, which is also facing an inquiry into poor maternity care, has been a long running concern for the watchdog which has rated the trust inadequate and put it in special measures in 2018. Earlier this year the CQC’s chief inspector of hospitals, Professor Ted Baker, wrote to NHS England warning of a “worsening picture" at the Midlands hospital and demanding action be taken. The CQC said it had issued the fixed penalty notice to the trust because it failed to comply with national clinical guidance that all children and adults must be assessed within 15 minutes of arrival. It also failed to implement a system that ensured all children who left the emergency department without being seen were followed up. After inspections in April 2019 and November 29 the CQC imposed seven conditions on the hospital over emergency care. The regulator said it was now clear the trust had not stuck to the conditions and had breached them both at Royal Shrewsbury Hospital and Princess Royal Hospital. Professor Baker said: "The trust has not responded satisfactorily to previous enforcement action regarding how quickly patients are assessed upon entering the urgent and emergency department." “We have issued a penalty notice due to the severity of the situation and to ensure the necessary, urgent improvements are made. It is essential that patients are seen in a timely way when they arrive at an emergency department; failure to do so could result in deteriorating health, harm, or even death, which is why national guidelines exist and must be followed." Read full story Source: The Independent, 12 October 2020 -
News ArticleDelays at the Great Ormond Street Hospital led to a boy dying an agonising death, a health watchdog has found. Arvind Jain, 13, who had Duchenne Muscular Dystrophy, died in August 2009 after waiting months for an operation. The ombudsman's report found he had "suffered considerable distress" and criticised referral procedures as "chaotic and substandard". The Great Ormond Street Hospital said there were "failings in clinical care". Arvind's sister Shushma said: "To read that he was suffering all the time, that was disgusting. He had been asking us repeatedly if he would get the operation and we would be constantly reassuring him that he would not die." The degenerative disease Arvind, who lived in Cricklewood, north London, suffered from was not immediately life threatening but in January 2009 his condition had become acute enough for him to struggle with swallowing and feeding. He had a temporary medical solution where a tube was inserted through his nose to help him get the required nutrition. He also experienced a number of other medical complications although none of these was considered life-threatening. The permanent solution recommended by his consultant paediatric neurologist was a gastrostomy insertion which would allow Arvind to feed through his stomach. The Great Ormond Street Hospital Trust (GOSH) excels in such procedures, however, a series of communication errors meant despite repeated and urgent requests from his neurological consultant, proper investigations were not carried out into Arvind's suitability for the operation. After five months of delays he and his family were reassured that as soon as he got the operation he would be much more comfortable. Another hospital also offered to carry out the operation in the event that the delays continued. But the surgical team that was due to carry out the operation never managed to assess Arvind. His condition deteriorated to the point where he was not well enough to be operated on and Arvind died on 9 August 2009. The Parliamentary and Health Service Ombudsman's report said he "suffered considerable distress and discomfort". It also describes a series of basic shortcomings in Arvind's care. The report said: "The standard of care provided for Arvind fell so far below the applicable standards as to amount to service failure." Read full story Source: BBC News, 23 September 2020
-
News ArticleGuidance 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
-
EventThe Professional Records Standard Body (PRSB) are holding a workshop on 4 March to help us develop a shared decision-making standard, so that individuals can be more involved in the decisions that affect their health, care and wellbeing. The online workshop will bring together health and care professionals, patients and system vendors to focus on different topics including diabetes and other long-term conditions, mental health, child health, gynaecology, colorectal cancer, genetic conditions, multi-medications and orthopaedics. We will be asking questions about the way information about treatment and care options are discussed and decisions recorded. This would include consent for treatment, when it is agreed, and any pre-operative assessments and requirements. By standardising the process, it will ensure that information can be shared consistently using any digital systems. If you’re interested in getting involved in the project, please contact info@theprsb.org
-
Content ArticleThe Office for Health Improvement and Disparities, part of the UK Government Department of Health and Social Care, highlighted an emerging signal of increased non-COVID-19-related deaths in England between July and October, 2021, with a potentially disproportionate higher increase in people with diabetes. Valabhji et al. aimed to substantiate and quantify this apparent excess mortality, and to investigate the association between diabetes routine care delivery and non-COVID-19-related-mortality in people with diabetes before and after the onset of the pandemic. They examined whether completion of eight diabetes care processes in each of the two years before the index mortality year was associated with non-COVID-19-related death. Results of the study show an increased risk of mortality in those who did not receive all eight care processes in one or both of the previous two years. These results provide evidence that the increased rate of non-COVID-19-related mortality in people with diabetes in England observed between 3 July and 15 October 2021 is associated with a reduction in completion of routine diabetes care processes following the pandemic onset in 2020.
-
Content ArticleAlexander James Davidson was aged 17 years and 6 months when he died at the Queens Medical Centre on 26 February 2018. Alex was previously fit and well before suddenly taking ill with abdominal pain on 17 January 2018. Between that date and his admission to the Queens Medical Centre on 8 February 2018, Alex made contact with his GP on three occasions, had four telephone triage assessments undertaken by the NHS 111 service and two admissions to his local Accident & Emergency Department at the Kingsmill Hospital. Alex’s symptoms of sudden onset acute abdominal pain, tachycardia, and vomiting and diarrhoea were attributed either to stress or to a bout of gastroenteritis. At no stage prior to 8 February 2018 was gallstones or pancreatitis considered as a differential diagnosis. When Alex was eventually admitted to the Queens Medical Centre Emergency Department on 8 February 2018, he was found to be septic as a result of an infected and necrotic pancreatic pseudocyst, which had evolved as a complication of gallstone pancreatitis, a rare condition in someone of Alex’s age. Despite medical intervention, Alex did not survive. The inquest explored the medical treatment and intervention that Alex received in the six weeks prior to his death. The medical evidence concluded that the pancreatic pseudocyst had likely formed by the time Alex began vomiting on 18 January 2018, and from that point onwards, it was unlikely he would survive even with treatment on account of the high mortality rate associated with this condition
-
Content Article
Prevention of Future Deaths: Sebastian Hibberd (23 August 2019)
Sam posted an article in Coroner reports
Sebastian Hibberd, 6 years old, became ill on Saturday 10 October having developed intussusception of the bowel. He deteriorated over the weekend. His father sought medical advice on the Monday from NHS 111 and from his GP's surgery. Sebastian's condition went unrecognised as being life threatening. There were several missed opportunities for him to receive life saving treatment. Sebastian suffered a cardiac arrest and transferred to Derriford Hospital where he sadly died in the Emergency Department shortly after his arrival on the 12 October. -
Content ArticleMyla Deviren had congenital intestinal malrotation and developed a volvulus on 26 August 2015. Her mother checked the NHS Symptom finder on line and the advice was to take her to A&E but she called 111 for advice. The Health Assistant who took the call did not appreciate the significance of key symptoms due to multiplicity of symptoms described at the outset. He passed the caller on a “ warm” transfer to the Clinical Adviser whose initial reaction on hearing that the symptoms included blue lips and breathlessness was to call an ambulance, ignored her instincts and took mum through a series of digital pathways re lesser symptoms. When directly asking about the breathlessness Myla's mum put the phone close to her daughter enabling the Clinical Adviser to hear the rapid breathing herself however they did not appreciate the significance of it and did not call an ambulance. She did however pass the call to the Out Of Hours Nurse who decided that this was a case of gastroenteritis early in the call and did not appreciate the description of a child with worsening signs. Whilst the precise point at which Myla stopped breathing is not known it was sometime between when she was last seen alive approximately 06.00 and then found unresponsive at 08.00 on the 27 August 2015. She was then taken by ambulance to Peterborough City Hospital where, despite attempts at resuscitation, she did not recover a heartbeat and she died. Post mortem revealed small bowel infarction from untreated small intestinal volvulus. It is probable that with earlier transfer to hospital by ambulance and with appropriate treatment Myla would have survived.
-
Content ArticleLast November’s HSJ Patient Safety Virtual Congress focused on the COVID-19 virtual ward model, which enables the early identification and timely management of deteriorating patients in the community - a critical step in reducing avoidable deaths from all conditions. If you missed the vital discussion, you can check it out below.
-
Content ArticleIn April 2009 a ‘considerative checklist’ was developed to ensure that all important aspects of care on a team's routine and post-take general internal medicine ward rounds had been addressed and in order to answer the question: How long should a ward round take, when conducted to high standards of quality and safety at the point of care? The checklist has been used on 120 ward rounds: 90 routine ward rounds and 30 post-take ward rounds. Overall, the average time per patient was 12 minutes (10 minutes on routine rounds and 14 minutes on post-take rounds). The considerative checklist has encouraged and enabled documented evidence of high quality and safe medical care, and anecdotally improved team working, communication with patients, and team and patient satisfaction.
-
Content ArticleGood foot health and care play an important role in improving overall health and wellbeing of the general population. However, the observations of nurses and podiatrists suggest that people experiencing homelessness, particularly rough sleepers, experience worse foot health than the wider population. This guidance, from the Queens Nursing Institute, was developed in partnership with podiatrists with experience of working with people who are homeless, and is intended as a resource for community nurses and allied health professionals. It can be used as a reference by others with an interest in the health of people who are homeless, such as hostel staff, day-centre staff and support workers.
-
Content ArticleOur experience of attending the Patient Safety Learning Annual Conference and entering our patient safety initiative into the awards.
-
Content Article
Safer outcomes for people with psychosis
Dorit posted an article in By patients and public
Dorit describes the assessment and subsequent death of her much loved daughter-in-law who died during a psychotic episode having been discharged the previous evening. Her story raises a number of questions: How should families be included in making judgements and assessments about the patient and their well-being? What support do they need to care for a very distressed loved one? Why aren't written care and contingency plans provided to the patient and their family? What more needs to be done to ensure standard practices are in place to protect patients with psychosis? -
Content ArticleFollowing the inquest into the death of former patient Amy Allan and the subsequent Preventing Future Deaths report given to Great Ormond Street Hospital for Children, Chief Executive Matthew Shaw would like to outline how the hospital is learning from this and what action has been taken to address the concerns that have been raised.
-
Content ArticleThe Care Quality Commission (CGC) is the independent regulator of health and adult social care in England. They make sure that health and social care services provide people with safe, effective, compassionate, high-quality care and encourage care services to improve. Independent acute hospitals play an important role in delivering healthcare services in England, providing a range of services, including surgery, diagnostics and medical care. As the independent regulator, the CQC, hold all providers of healthcare to the same standards, regardless of how they are funded.
-
Content Article
What it feels like working with unsafe staffing
Anonymous posted an article in Florence in the Machine
This blog has been written by a healthcare worker and demonstrates the reality of what it is like caring for patients and families while being chronically low on staff. They describe the impact this has on staff morale and the impact it has on patients, patients family members and the relationship between staff and patients.- Posted
- 2 comments
-
- (and 15 more)
-
Content ArticleThe 4AT, developed in the UK, is now widely used internationally as a clinical tool for delirium detection in routine, non-specialist care, with increasing adoption for this specific use as well as in research studies. It has been validated in several published studies.
-
Content Article
Delirium - What NOT to do
Claire Cox posted an article in Care settings
This infographic designed by Dr Dan Thomas and Dr Lynda Dykes gives advice on what NOT to do if your patient has delirium.
