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Found 220 results
  1. Content Article
    The concerns that health and care workers and the public share with the Care Quality Commission (CQC) about health and care services are critical to its work. It is also vital that CQC listens to its own staff. This review explores whether there are areas of culture or process within CQC that need to be improved in relation to listening, learning, and responding to concerns. The review focused on these key areas: Organisational findings Reviewing how well we listen to whistleblowing concerns. Reviewing our Freedom to Speak Up policy. Learning from the tribunal case. Reviewing how we listen to our staff. Reviewing the expectations and experiences of people who raise concerns with us.
  2. News Article
    A father-of-two died of sepsis three days after being sent home from A&E with antibiotics for a suspected urinary tract infection, an inquest heard. Alex Blewitt, 48, died in July 2022 after suffering a cardiac arrest caused by a perforated bowel and sepsis. Senior coroner for Milton Keynes, Dr Sean Cummings, said Mr Blewitt's death was avoidable. The coroner recorded a narrative conclusion and said he intended to issue a prevention of future deaths report. Mr Cummings said: "The doctor, who saw and assessed Mr Blewitt in the emergency department, did not read the Urgent Care Centre communication that was provided and did not record important factual information in the clinical note. "Mr Blewitt was discharged, but returned two days later when suffering with sepsis due to a previously undiagnosed bowel perforation." Mr Blewitt's widow, Amy Blewitt, said: "Alex was in such pain and kept asking the hospital for help, but they sent him home. "My plea to the hospital is please, please don't let this type of mistake ever happen to anyone else ever again." Read full story Source: BBC News, 22 March 2023
  3. News Article
    Acute trusts are reporting high demand at emergency departments (EDs) despite junior doctor strikes, which in some cases threaten to lead to overflowing wards and long ambulance handover delays. Chief executives and directors from trusts around England told HSJ their EDs had been as busy or busier than usual. Many had hoped prominent media coverage and NHS announcements about the strikes would lead to reduced demand, helping them cope with fewer doctors on duty. Several claimed it showed national communications about the strikes were lacking. NHS England has said some hospitals saw their busiest Monday of the year so far yesterday, which it said “presents a major challenge as our staff continue to do all they can to mitigate the impact of the industrial action for patients.” Read full story (paywalled) Source: HSJ, 14 March 2023
  4. News Article
    A couple whose baby died after he was starved of oxygen during a home birth are campaigning for risky breech deliveries to be spotted earlier. Arthur Trott was an undiagnosed breech baby, born after a planned home birth in Burgess Hill on 24 May 2021. A breech delivery is when a baby's bottom or feet will emerge first. An inquest into his death found a delay in transfer to hospital "materially contributed" to his brain injury. The South East Coast Ambulance Service Trust said it welcomed "any changes to national breech birth guidance". Arthur's parents believe a breakdown in communication between the paramedics who attended and their control room meant Mrs Trott was kept at home too long. Arthur's father, Matt Trott, said: "You could hear the panic and confusion in everyone's voices. One minute they were told to go to hospital, the next minute to stay." As a result of Arthur's death, all planned home births in Sussex are being offered a presentation scan at 38 weeks. Read full story Source: BBC News, 14 March 2023
  5. News Article
    A mother-of-one died after a breathing tube was put into her food pipe, despite staff raising concerns it was inserted incorrectly, an inquest heard. Emma Currell, 32, had just received dialysis and was heading home to Hatfield, Hertfordshire, in an ambulance when she had a seizure. An anaesthetic team was called to sedate her as her tongue had swelled and she was bleeding from the mouth. Dr Sabu Syed, who was a trainee anaesthetist, told the hearing: "I used suction to remove blood and I was able to push the tongue to the side and got a partial view." She said she believed she inserted the tube into the trachea - the windpipe - and had asked her senior colleague Dr Prasun Mukherjee to check the position of the tube. "Dr Mukherjee was busy doing other tasks," she added. Technician Nicholas Healey said he flagged his concerns when there was no carbon dioxide reading on the ventilator, which was not faulty. He said that both he and Dr Syed had raised concerns about the tube being in the wrong place. The court heard the hospital had drawn up a guideline checklist for trachea procedures since Ms Currell's death and staff were due to have "no trace = wrong place" training on the warning signs of incorrect insertion. Read full story Source: BBC News, 27 February 2023
  6. News Article
    A new report has condemned ‘serious issues’ with NHS referral processes, amid findings that one in five patient referrals made by GPs went into a ‘black hole’. Healthwatch England said that 21% of people they spoke to with a GP referral to another NHS service were rejected, not followed up on or sent back to general practice. The watchdog said that more support should be given to help GP and hospital teams to reduce the numbers of people returning to general practice due to ‘communication failures’ following a referral. According to the findings, the failures were due to GP teams not sending referrals, referrals going missing between services, or being either booked or rejected by hospitals without any communication. Louise Ansari, Healthwatch England’s national director, said that thousands of people told the watchdog that the process is ‘far from straightforward.’ She said: "Falling into this “referrals black hole” is not just frustrating for patients but ultimately means people end up going back to their GP or visiting crowded A&E departments to get the help they need. "This adds more burden to already stretched services, making things even harder for the doctors and nurses trying to provide care." Read full story Source: Pulse, 20 February 2023
  7. Content Article
    GP services are the first point of call for many health issues and the gateway to NHS specialist support.  GP teams are highly skilled and may decide that treatment without specialist care is the best action. But when you need specialist support, such as hospital tests or treatment, you may need a referral from your GP team first. New research from Healthwatch highlights that it can be very hard for some people to get a GP referral to another NHS service. And for 21% of people we spoke to, even when they get referrals, they can be lost, rejected or not followed up on. When services don't process referrals properly, it can cause significant frustration, unnecessary anxiety, and even cause harm to patients.  It can also lead to increased demand for either more GP appointments or help from healthcare teams in other parts of the NHS, putting more pressure on already overstretched services.
  8. News Article
    Rana Abdelkarim died at Gloucestershire Royal Hospital in March 2021 after suffering a bleed post-birth. The Healthcare Safety Investigation Branch (HSIB) found there were delays in calling for specialist help. Her husband, Modar Mohammednour, said that in March 2021 his wife attended the maternity unit at 39 weeks into her pregnancy for what she thought was a routine check-up. Mr Mohammednour said due to language barriers his wife thought she was going "for a scan and to check on her health" and then "come back home", but in fact she was being sent to be induced. "Immediately" after the labour, Ms Abdelkarim suffered heavy bleeding and her condition deteriorated - something Mr Mohammednour said he was "unaware of", until he was eventually called into the hospital to speak to a doctor. According to the investigation by the HSIB, the obstetric team of senior doctors were not told about the drastic change in her condition for almost 30 minutes. An investigation into her death by the HSIB found that once Ms Abdelkarim had been given a drip to speed up labour, regular support from midwives and assessments could not be given to her because the maternity ward was so busy. It also found there was a 53-minute delay from the point of bleeding to administering the first blood transfusion. HSIB also found Ms Abdelkarim was "uninformed" about the reason for her admission, "consent to induce labour was not given" and because she was thin and small, staff underestimated how much relative blood volume she was losing. Read full story Source: BBC News, 7 February 2023
  9. News Article
    An acute trust has discovered an IT issue which appears to have led to ‘very high’ numbers of patients not turning up for their appointments. Bedfordshire Hospitals Foundation Trust discovered appointment letters were being lost, and not sent to patients, during intermittent server failures, its board was told yesterday. The trust’s “did not attend“ rate has been between 10% and 12% over the last year, compared to the national average of 7%, according to its board papers. The issue relates to patients with appointments booked at Luton and Dunstable Hospital. It is not yet clear how many patients were affected. The trust is now planning to ensure every patient with an appointment booked this year receives a new appointment letter, and an apology if they did not previously receive one. Read full story (paywalled) Source: HSJ, 2 February 2023
  10. News Article
    A woman who died shortly after giving birth to her daughter did not receive the correct medication, a coroner has ruled. Jess Hodgkinson, 26, from Chesterfield, died from a pulmonary embolism in 2021. Assistant coroner Matthew Kewley said there was a "failure" to ensure Ms Hodgkinson received blood thinners right up until the birth. Chesterfield Coroner's Court heard Ms Hodgkinson had a high risk pregnancy due to severe hypertension. On 21 April 2021, a consultant in Chesterfield prescribed a prophylactic dose of tinzaparin due to an increased risk of clotting, the inquest heard. During the inquest, the consultant said the intention was for Ms Hodgkinson to continue to receive a daily dose of anticoagulant medication up until birth. Ms Hodgkinson was transferred to a hospital in Sheffield the next day, but there was a "failure to communicate" the medication plan, Mr Kewley said. After being discharged, clinicians in Chesterfield "failed to identify" Ms Hodgkinson was no longer receiving the medication, the coroner said in his ruling. On 13 May, Ms Hodgkinson attended Chesterfield Royal Hospital and a decision was made to carry out an emergency Caesarean section. The procedure was successful and Ms Hodgkinson's baby was born. But after delivery, Ms Hodgkinson went into cardiac arrest and later died. In his concluding remarks, Mr Kewley said: "There was a failure to ensure that Jess received anticoagulant medication that a clinician had intended should be taken until birth. This failure made a more than minimal, negligible or trivial contribution to Jess' death". Read full story Source: BBC News, 31 January 2023
  11. News Article
    A major London trust has been criticised for ‘underplaying’ the problems caused by a ‘catastrophic’ IT outage, a new report has revealed. The Guy’s and St Thomas’ Foundation Trust report also noted one patient suffered “moderate harm” and several others “low” level harm after last July’s incident, which was caused by a combination of a heatwave and ageing infrastructure. However, the trust said there was no evidence the “underplaying” of issues was deliberate. The report identified one incident of “moderate” patient harm, in which a patient was unable to receive a pancreas transplant due to staff being unable to safely monitor critical observations. The patient has since had a successful operation, the trust’s report stated. Another 20 “low” harm incidents were reported, which included delays in patients receiving their test results and/or medicines, while the report added the trust could not rule out that “further harm events may be identified” amidst an ongoing harm review. Read full story (paywalled) Source: HSJ, 27 January 2023
  12. News Article
    An invitation to a cervical screening test upon your 25th birthday has become a necessary but often unwanted coming-of-age present. Despite years of education and advocacy about the benefits of screening, many women still do not attend. About 16 million women in the UK aged 25-64 are eligible for testing, but only 11.2 million took a test in 2022, the lowest level in a decade. There unfortunately remains a false narrative that there are good reasons to be nervous about cervical screening tests. In reality, the test is not physically painful for the vast majority of women, although it can be a bit uncomfortable. However, the test can be needlessly emotionally painful, and for no good reason. This is in part because some women go through the experience of sitting with legs spread apart and “private parts” out, and then hear the nurse call for “the virgin speculum” to be used. This is the archaic and unnecessarily sexualised term for the extra-small speculum. It should have no place being used in 2023, and it clearly creates feelings of vulnerability. Next week it is Cervical Cancer Awareness week, and campaigners are hoping to shine a light on barriers to cervical screening testing that must be removed. By creating feelings of vulnerability around testing, we are allowing cervical cancer to continue to go undetected. All women should be aware of the importance of attending their cervical screening test and do so with confidence, regardless of their sexual status. This will play a valuable role in reducing the mortality rate. Read full story Source: The Guardian, 19 January 2023 Further hub reading: Doctors’ shocking comments reveal institutional misogyny towards women harmed by pelvic mesh Misogyny is a safety issue: a blog by Saira Sundar Gender bias: A threat to women’s health (August 2020)
  13. News Article
    A doctor in Cambridge is spearheading a project to help to reform "blunt" medical language that patients and their families can find upsetting. Ethicist Zoe Fritz said language that "casts doubt, belittles or blames patients" was long overdue for change. Sixteen-year-old Josselin Tilley from Wiltshire has charge syndrome that reduces her life expectancy. Her mother Karen said Josselin's death was often referred to in correspondence "like she's not a person. "It's not person-centred at all, it's like she's just nothing." The example she gave was an extract from a typical letter in November that she was copied in to by a community paediatrician addressed to colleagues. "Death below 35: On discussion with Josselin's mum early death has been discussed with her, and there is plan, discussed with Josselin's mother about a wishes document being done." Mrs Tilley, from Westbury, said she objected to the use of language that "very bluntly discusses Josselin's death like she's something going off in the fridge". Doctor Fritz said the reason she and doctor Caitriona Cox were running the campaign at Cambridge University was because they recognised language regularly used by clinicians was often problematic for anyone outside of medical practice. "Even just (the term) presenting [a] complaint. Patients coming into hospital with whatever's bothering them we [doctors] talk about as a complaint and I think that infantilises the patient. They're not complaining when telling us what's going on." Read full story Source: BBC News, 17 January 2023 Further reading on the hub: Presenting complaint: use of language that disempowers patients
  14. News Article
    The BBC has come under fire from scientists for interviewing a cardiologist who claimed certain Covid vaccines could be behind excess deaths from coronary artery disease. Experts have criticised Dr Aseem Malhotra’s appearance on the BBC's news channel last Friday, accusing him of pushing “extreme fringe” views, which are “misguided”, “dangerous” and could mislead the public. Scientists have described the doctor as “hijacking” an interview on statins to air his views, causing BBC staff to be “alarmed and embarrassed” by their booking. Malhotra recently retweeted a video by the MP Andrew Bridgen, who had the Tory whip removed on Wednesday after comparing the use of Covid vaccines to the Holocaust. After criticising new guidance on statins, he cited British Heart Foundation (BHF) figures that suggested there had been more than 30,000 excess deaths linked to heart disease since Covid first arrived. Malhotra, a cardiologist at ROC Private Clinic, claimed mRNA Covid vaccines play a role, saying his “own research” showed “Covid mRNA vaccines do carry a cardiovascular risk”. He added that he has called for the vaccine rollout to be suspended pending an inquiry because of the “uncertainty” behind excess deaths. Read full story Source: The Guardian, 13 January 2023
  15. News Article
    Fewer women who gave birth in NHS maternity services last year had a positive experience of care compared to 5 years ago, according to a major new survey. The Care Quality Commission’s (CQC) latest national maternity survey report reveals what almost 21,000 women who gave birth in February 2022 felt about the care they received while pregnant, during labour and delivery, and once at home in the weeks following the arrival of their baby. The findings show that while experiences of maternity care at a national level were positive overall for the majority of women, they have deteriorated in the last 5 years. In particular, there was a notable decline in the number of women able to get help from staff when they needed it. Many of the key findings from the survey include a drop in positive interactions with staff and lack of choices about the birth. Just over two-thirds of those surveyed (69%) reported 'definitely' having confidence and trust in the staff delivering their antenatal care. Results were higher for staff involved in labour and birth (78%). In addition, while the majority of women (86%) surveyed in 2022 said they were 'always' spoken to in a way they could understand during labour and birth, this was a decline from 90% who said this in 2019. The proportion of respondents who felt that they were 'always' treated with kindness and understanding while in hospital after the birth of their baby remained relatively high at 71%, however had fallen from 74% in 2017. Just under a fifth of women who responded to the survey (19%) said they were not offered any choices about where to have their baby. Also, less than half (41%) of those surveyed said their partner or someone else close to them was able to stay with them as much as they wanted during their stay in hospital. Read full story Source: Medscape, 13 January 2023
  16. Content Article
    On the 5 February 2020 an inquest was opened into the death of Hayley Smith. The jury concluded on 9 March 2022 with a narrative conclusion “The deceased died from complications of anorexia nervosa.” Hayley had developed severe and enduring anorexia nervosa at around the age of nine or ten and was resistant to treatment including several hospital admissions both voluntary, and at times compulsory treatment under the Mental Health Act. She was repeatedly admitted to hospital. On the 23 December 2019 Hayley had not eaten, became confused and unwell, and an ambulance was called. The correct emergency treatment was provided but Hayley responded quickly and regained consciousness and refused further treatment or admission to hospital. On 24 December she became unwell again and this time was taken to Queen Elizabeth the Queen Mother hospital where she again refused treatment and discharged herself against medical advice. The responsible medical officer from the Kent Eating disorder team gave evidence that had the team known of either of these episodes they would have taken steps to admit her and treat her.] On Christmas Day 2019 she collapsed for a final time and this time, had an out of hospital cardiac arrest, and was admitted to Queen Elizabeth the Queen Mother hospital and transferred to Intensive care where she was diagnosed as suffering from hypoxic brain damage as a result of her cardiac arrest due to severe hypoglycaemia as a consequence of her Anorexia Nervosa. She died on 29 December 2019 at the age of 27.
  17. News Article
    A GP surgery accidentally told patients they had aggressive lung cancer instead of wishing them a merry Christmas. Askern Medical Practice sent the text message to people registered with the surgery in Doncaster on 23 December. Sarah Hargreaves, who was waiting for medical test results, said she "broke down" when she received the text, only to be later told it was sent in error. The first text told recipients they had "aggressive lung cancer with metastases", a type of secondary malignant growth. It directed patients to fill out a DS1500 form, which allows people with terminal diseases to claim certain benefits. However, about an hour later people received a second text telling them it was an error and it was meant to wish them a merry Christmas instead. Read full story Source: BBC News, 29 December 2022
  18. Content Article
    This guide by the Patient Information Forum (PIF) provides practical support for translating health information. It offers tips on overcoming key challenges and links to useful resources. It is mainly focused on foreign language translation, but the principles can also be applied to British Sign Language and Braille. Research shows that in the UK, up to a million people cannot speak English well or at all, and these people have a lower proportion of good health than English speakers. Providing culturally appropriate, translated health information can help people manage their own health and take part in shared decision making. Translation is consistently raised as a key challenge by health information producers. Please note, you will need to join PIF to view this content.
  19. News Article
    ‘Rubbish’ communications on Group A Strep from government agencies made A&Es more ‘risky’ over the weekend, after services were flooded with the ‘worried well’, several senior provider sources have told HSJ. On Friday the UK Health Security Agency, successor to Public Health England, issued a warning on a higher than usual number of cases after the deaths of five children under 10 in a week. Several senior sources in hospital, 111/ambulance, urgent care and primary care providers, told HSJ they were not warned UKHSA were making an announcement that would also see services flooded by the worried well. NHS England’s clinical lead for integrated urgent care issued a letter, seen by HSJ, saying a “considerable increase” in 111 demand over the weekend was “in part due to Group A Strep concerns”. Sources in the sector said the increase in demand was “heavily” Strep-related. One senior accident and emergency leader told HSJ that when parents could not get through on 111 they brought their children to emergency departments. “The media messaging has been handled terribly”, they added. They added: “Huge numbers of ‘worried well’ makes the A&E a much more dangerous place. We are just not equipped to deal with the volume of patients. [There is a] much greater chance we would miss one seriously unwell child when we are wading through a six-hour queue of viral, but otherwise well, kids.” Read full story (paywalled) Source: HSJ, 6 December 2022
  20. News Article
    Patients are struggling to understand their doctors because of confusing medical jargon, a study has found. Almost 80% of people do not know that the word 'impressive' actually means 'worrying' in a medical context. Critics said using the word borders on 'disrespectful' because 'we're describing something as impressive that is causing real harm for patients'. More than one in five of respondents could not work out the phrase 'your tumour is progressing', which means a patient's cancer is worsening. And the majority of participants failed to recognise that 'positive lymph nodes' meant the cancer had spread. The word 'impressive' means something admirable to most people. But when physicians describe a chest X-ray as impressive, they actually mean it is worrying. Some 79% of study participants did not get this meaning. Only 44 participants correctly understood that a clinician was actually giving them bad news. Read full story Source: Mail Online, 1 December 2022
  21. Content Article
    This study from Gotlieb et al. looked at how well adults understand common phrases clinicians use when communicating with patients. The study surveyed 215 adults in the USA and found that participants frequently misunderstood and often assigned meaning opposite to what the clinician intended. These findings suggest that use of common medical phrases may lead to confusion among patients affecting health outcomes.
  22. Content Article
    An expert review of the clinical records of 44 deceased patients who had been under the care of neurologist Dr Michael Watt has found there were “significant failures” in their treatment and care. Dr Watt, a former Belfast Health and Social Care Trust consultant neurologist, was at the centre of Northern Ireland’s largest ever recall of patients, which began in 2018, after concerns were raised about his clinical work. More than 4,000 of his former patients attended recall appointments. At the direction of the Department of Health, in August 2021, the Regulation and Quality Improvement Authority (RQIA) commissioned the Royal College of Physicians to undertake an expert review of the clinical records of certain deceased patients who had been under the care of Dr Watt, with the intention to understand his clinical practice, to ensure learning for others and to help make care better and safer in the future.
  23. News Article
    The death of a three-day-old baby could have been avoided if medical professionals had acted differently, a coroner concluded. Rosanna Matthews died three days after being delivered at Tunbridge Wells Hospital in Kent in November 2020. The hospital trust apologised, saying the level of care for Ms Sala and her daughter “fell short of standards”. Ms Sala told the inquest midwives were "bickering" and appeared confused during her labour. She claimed that if she had been allowed to start pushing when she wanted to, instead of waiting as midwives advised, Rosanna would have lived. Rachel Thomas, then deputy head of gynaecology and midwifery, said there had been "errors in communication". Following the conclusion of the inquest, the coroner ruled Rosanna died following a “prolonged period of avoidable hypoxia”, which led to brain damage. The coroner, sitting in Maidstone, also found midwives at the hospital failed to recognise that Rosanna was already unwell with congenital pneumonia. Ms Sala said her daughter could have lived had medical professionals acted differently on the day of her birth. Read full story Source: BBC News, 8 November 2022
  24. Content Article
    This guide is aimed at policymakers and communicators whose efforts may be frustrated by false narratives and misinformation. In healthcare, that can apply to important issues such as vaccination and mask-wearing, as well as to spurious 'cures' for serious illnesses. But the techniques explored in the guide can also apply to more day-to-day matters such as handwashing in healthcare settings. The starting point is the 'wall of beliefs' - the various influences from which we construct our belief systems, and, to some extent, our personal identities. The point here is that belief is not simply built on facts. It also comes from social conventions, peer pressure, religious faith and more. The guide offers a strategy matrix, based on understanding how strongly or weakly beliefs are held, and whether the resulting behaviour is harmful or not. A corresponding set of tactics looks at incentives and barriers for desired behaviour, along with communications that can address harmful beliefs without backing the intended audience into a corner.
  25. News Article
    Hysteroscopy Action says thousands of women are in extreme pain during and following the invasive procedures to treat problems in the womb, with many suffering for days. It says some are left with symptoms of post-traumatic stress and subsequently feel unable to have intimate relationships with partners. Others avoid important examinations such as smear tests. The group has written to Women’s Minister, Maria Caulfield, to raise its concerns. In its letter, it claims women are not always given the choice of intravenous sedation or general anaesthetic to reduce pain because of an NHS drive to cut costs. Some are given local anaesthetic which is often painful and doesn’t work. Others are given no drugs at all and expected to cope with distraction techniques - known as “vocal locals.” Hysteroscopy Action has urged Ms Caulfield to open more theatre space for women to have procedures under general anaesthetic as well as offering women the choice of intravenous sedation. Yet Hysteroscopy Action, which has been in touch with thousands of patients who have undergone such examinations, says women are not made aware of this. Last week RCOG President Dr Edward Morris, said it was “working to improve clinical practice around outpatient hysteroscopy”. He added: “No patient should experience excruciating pain and no doctor should be going ahead with outpatient hysteroscopy without informed consent.” "Hysteroscopy Action has collated more than 3,000 accounts of “brutal pain, fainting and trauma during outpatient hysteroscopy.” Hysteroscopy Action's spokeswoman, Katharine Tylko said: “We are counselling hundreds of patients with PTSD, who for various medical reasons find the procedure extremely painful, some even find it torturous." “This does not happen for other invasive procedures such as colonoscopy. We urge the Women’s Minister to act and are demanding an end to this gender pain-gap.” The letter, which has over 20 signatories, including Helen Hughes, Chief Executive of the Patient Safety Learning charity, Baroness Shaista Gohir, civil rights campaigner, and women’s rights activist, Charlotte Kneer MBE, calls for women to be given informed consent and choice about whether and what type of sedation they want. Read full story Source: Express, 6 November 2022 Read hub members experiences of having a hysteroscopy in the Community thread and Patient Safety Learning's blog on improving hysteroscopy safety.
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