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Content Article
The truth for Gaia Young
Patient Safety Learning posted an article in Patient stories
Previously well, Gaia died aged 25 years of an unexplained brain condition hours after admission to University College Hospital London. Her death has been the subject of hospital investigations and an inquest. Over one year later her death remains unexplained. Why? This is her mother’s (Dorit) search for the truth: information is provided to stimulate medical crowd thinking – to ask the right questions and to get the right answers. Read the narrative of Gaia’s final illness in her mother’s story and in the memorandum from the link below. See also: Serious Incident Report: Unexpected deterioration of a young woman on the Acute Medical Unit: updated report (February 2022) -
Content ArticleIn this BMJ article, Anna Tylor describes the assumptions she faces as someone who is visually impaired, and how healthcare professionals can make information accessible for blind and partially sighted people.
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Content ArticleEvidence shows that when patients are treated as partners in their care, then safety, patient satisfaction and health outcomes improve. To mark World Patient Safety Day 2023, this podcast episode discusses the importance of engaging with patients and how it contributes towards increased patient safety in health and social care settings. Healthcare Improvement speak to a number of professionals from Healthcare Improvement Scotland, as well as Lisa McDowall, a Senior Charge Nurse at Jubilee Hospital in Grampian. We also spoke with Gareth Bourhill who lost his mum in the Vale of Leven c-difficile outbreak of 2007 to 2008, and is now a public partner with our organisation’s Excellence in Care team.
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Content Article
This year’s World Patient Safety Day on Sunday 17 September 2023 focused on engaging patients for patient safety, in recognition of the crucial role that patients, families and caregivers play in the safety of healthcare. This webinar provided an opportunity for those involved in patient safety to hear from patient safety leaders and discuss the opportunities and barriers to increased patient engagement. It was co-hosted by the Patient Safety Commissioner for England and the charity Patient Safety Learning. -
Content ArticleThe relationship between patients and their data is deeply personal. This report by The Patients Association shows that patients recognise that the potential for data use to improve care is huge, and that there is widespread support for realising this potential if patients’ concerns are acknowledged and addressed. It proposes the development of a data pact to outline the relationship between patients, their data and the health system. This could be a useful first step in informing patients about how data is used in the health and care system and a starting point in improving patient confidence. To do this, the pact needs to acknowledge that the system is not perfect, as one part of building public confidence is acknowledging the reasons why at present, confidence may be low.
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Content ArticleThe adoption of virtual consultations, catalysed by the COVID-19 pandemic, has transformed the delivery of primary care services. Owing to their rapid global proliferation, there is a need to comprehensively evaluate the impact of virtual consultations on all aspects of care quality. This study aims to evaluate the impact of virtual consultations on the quality of primary care. It found that virtual consultations may be as effective as face-to-face care and have a potentially positive impact on the efficiency and timeliness of care; however, there is a considerable lack of evidence on the impacts on patient safety, equity, and patient-centeredness, highlighting areas where future research efforts should be devoted. Capitalising on real-world data, as well as clinical trials, is crucial to ensure that the use of virtual consultations is tailored according to patient needs and is inclusive of the intended end users. Data collection methods that are bespoke to the primary care context and account for patient characteristics are necessary to generate a stronger evidence base to inform future virtual care policies.
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Content Article‘Compassionate communication, meaningful engagement’ is a handbook for all NHS staff which aims to improve collaboration with patients, their families and carers following a patient safety event. Developed with NHS Trusts across England in partnership with Making Families Count, the guide includes principles of compassionate engagement, roles and responsibilities of healthcare professionals, and information about the processes following an incident. It also brings together a range of signposting information and resources for families and staff.
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Content ArticleThe important issue of a patient’s right to a second medical opinion has recently hit the headlines with Martha’s Rule, which relates to the tragic death of 13-year-old Martha Mills in NHS care and the circumstances surrounding this. There is a groundswell of support for Martha’s Rule, with Health and Social Care Secretary Steve Barclay committed to introducing the rule in England. This is excellent news, but development and implementation must not be rushed writes John Tingle, Dr Dita Wickins-Drazilova and Steve Gulati from the University of Birmingham.
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Content ArticleThe idea of patient feedback as an essential tool for improving the safety of services is a familiar one. In recent years there has been a more fundamental shift towards recognising patients not just as commentators on the safety of the healthcare they experience, but as contributors to improving the safety of care. In this blog, Kate Eisenstein, Director of Strategy at the Parliamentary and Health Service Ombudsman (PHSO) looks at the ways in which patients and their families contribute to safe care. She also highlights the fact that in many cases, their voices are still being ignored, with catastrophic consequences for individual patients and the system as a whole.
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Content ArticleThis article in the Nursing Times looks at how a sincere and prompt apology, using appropriate language and tone, can help those involved come to terms with something that has gone wrong. Nurses may be concerned that saying sorry will make litigation more likely, but the evidence is that patients are less likely to resort to the courts if they feel they have been listened to and have been offered a "proper" apology.
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Content Article
The Forgiveness Project
Patient Safety Learning posted an article in Suggest a useful website
The Forgiveness Project shares stories of forgiveness in order to build hope, empathy and understanding. -
Content ArticleAs this year’s World Patient Safety Day celebrates the theme ‘Engaging patients for patient safety’, Dr Alan Fletcher, the National Medical Examiner for England and Wales, explains the connection between medical examiners and patient safety, and particularly the support they provide for bereaved people, whose insights and experiences can be crucial in supporting the NHS to learn and improve.
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Content ArticleChris Wardley has shared his useful summary of Learn Together's '5 stage process' in involving patients and families in patient safety investigations.
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Content Article
The SACCIA approach by Professor Annagret Hannawa
Patient-Safety-Learning posted an article in Culture
Achieving shared interpersonal understanding between healthcare professionals, patients and families is a core patient safety challenge around the world. The SACCIA model promotes safe communication practice amongst healthcare teams and between providers patients. It was developed by Professor Annagret Hannawa, Director of the Center for the Advancement of Healthcare Quality & Safety in Switzerland. The interpersonal processes that are captured in the SACCIA acronym are considered 'safe' because they lead to a shared understanding between all care participants: Sufficiency Accuracy Clarity Contextualization Interpersonal Adaptation The five SACCIA competencies emerged from a communication science analysis of hundreds of critical healthcare incidents. They were identified as common deficient interpersonal processes that often cause and contribute to preventable patient harm and insufficient care. They therefore represent an evidence-based set of core competencies for safe communication, which constitute the vehicle to patient care that is safe, efficient, timely, effective and patient-centred. -
Content Article
Chris Turner: When rudeness in teams turns deadly (TEDx, 2019)
Patient-Safety-Learning posted an article in Culture
How we treat each other at work has an enormous impact on how teams perform—with potentially fatal consequences if you work in healthcare. Chris Turner, consultant in emergency medicine and founder of Civility Saves Lives, reveals the shocking impact of rudeness in the workplace. He highlights the importance of understanding the complex realities of practice and communication between healthcare professionals in different team environments, if we are to learn from patient safety incidents. -
News Article
NHS Scotland to improve patient safety through 'compassionate communication'
Patient Safety Learning posted a news article in News
A study conducted by NHS Education for Scotland and Health Improvement Scotland found patients felt safer by having someone listen to their experiences after adverse events. The findings were published in the BMJ and have been positively received by NHS boards across the country. Healthcare Improvement Scotland’s Donna Maclean said: “The compassionate communications training has seen an unprecedented uptake across NHS boards in Scotland, with the first two cohorts currently under way and evaluation taking place also.” Clear communication and a person-centred approach was seen as being central to helping those who have suffered from traumatic events. Researchers found many said their faith was restored in the healthcare system if staff showed compassion and active engagement. This approach is likely to enhance learning and lead to improvements in healthcare. Health boards were advised that long timelines can have a negative impact on the mental health of patients and their families. Rosanna from Glasgow, who was affected by an adverse event, said: “I believe this study and its findings are crucial to truly understanding patients and families going through adverse events. “Not only does the study capture exactly what needs to change, but it also highlights the elements that are most important to us: an apology and assurance that lessons will be learnt is all we really want. Read full story Source: The National, 30 May 2022 -
News Article
Website to show NHS delays
Patient Safety Learning posted a news article in News
A website that tells patients how long they are likely to wait for NHS treatment will be made available in Scotland this summer. Humza Yousaf, the Scottish health secretary, said people queuing for tests and procedures and their doctors would be able to access information about any delays in their area using the software. Many patients living in pain are waiting years to have common operations such as hip and knee replacements. In theory, the SNP guarantee hospital treatment within 12 weeks of patients joining the waiting list, but this law was broken extensively before the pandemic and has now been breached hundreds of thousands of times. One orthopaedic surgeon, who did not wish to be named, said he was operating on patients whose joints had entirely collapsed after a two-year wait for a limb replacement made their case an emergency. Other patients who did not reach crisis faced even longer delays, he said. Dr Sandesh Gulhane, a GP and health spokesman for the Scottish Conservative Party, asked Yousaf, during a meeting of the Scottish Parliament’s health committee yesterday: “Why can’t we have in the future, in the [recovery] plan, indicative waiting times which are relatively live so we can all go on a website and see how long we need to wait.” Yousaf said it was fair for patients and NHS staff to expect to have information on waiting times, and that a website to provide this was being developed. “We are working closely with Public Health Scotland, we are working closely with boards to develop the infrastructure in order to collate and publish this data,” he said. “It’s an ambition of ours to have that available in a way that is easy to find, easy to understand, both for the patient but for the health professional too.” Read full story (paywalled) Source: The Times, 11 May 2022 -
News Article
NHSE director calls out trust over ‘speak English’ rule
Patient Safety Learning posted a news article in News
An ‘outstanding’ London trust has come under fire for asking staff to communicate ‘only in English’ when around other people. A document published under the ‘trust values’ section of Homerton University Hospital Foundation Trust’s website, says: “I will only communicate in English in the presence of others.” The document has been widely shared on social media in the last 24 hours, with many criticising the trust for its wording. The document itself is dated 2014, but was reposted by the trust in 2019, and remained on its website as of midday today. NHS England’s director of equality – medical workforce, Partha Kar, who is also NHSE’s diabetes lead, questioned the document on Twitter. He also said: “I am not aware of any NHS England ‘diktat’ suggesting we must all only speak in English to uphold NHS values.” It follows a separate notice being posted on Twitter yesterday signed simply by “Matron”, by a doctor who claimed her friend saw it at her “hospital placement”. It seemingly threatened staff with “disciplinary action” if they spoke any other language other than English. It reads: “English is the only language to be spoken in the ward area – this includes the kitchen. Disciplinary action will be taken against staff who do not comply, including agency and bank.” The documents have prompted a backlash on Twitter, with many criticising them and raising concerns about racism and inclusivity of staff. NHSE’s chief nursing officer, Ruth May, has publicly queried where the document is from. Read full story (paywalled) Source: HSJ, 16 March 2022 -
News ArticleMore than 200 women were affected by failures in Ireland’s CervicalCheck screening system. It emerged in 2018 that 221 women and families were not told about misreported smear tests. The Minister for Health said that non-disclosure issues which arose in the cervical check screening controversy will be legislated for to prevent it from happening again. Stephen Donnelly said new legislation will address the negligence issues and ensure that the failure to inform the women of the clinical audit of their screening will “never happen again”. Mr Donnelly was discussing a number of amendments at the committee stage of Ireland's Patient Safety Bill. The new legislation will require the mandatory open disclosure of serious patient safety incidents, and sets out a list of incidents which must be reported to the health watchdog, Health Information and Quality Authority (HIQA). Mr Donnelly said that he will introduce an amendment at the report stage of the Bill that will provide for non-disclosure and will deal with issues around delayed diagnosis and delayed screening. Mr Donnelly said: “I’ve had lengthy discussions with the department on this and it doesn’t fit neatly with this Bill because the serious patient safety issues which result in death or serious harm, they are very clear and binary. “Legislating around delayed diagnosis and delayed screening, it is really complex and doesn’t fit neatly in this Bill, however my view is that the non-disclosure that happened in cervical check, even though it doesn’t neatly fit here, should still be legislated for." Read full story Source: The Independent, 11 March 2022
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News Article
British Sign Language to be used in NHS mental health service
Patient Safety Learning posted a news article in News
The charity SignHealth has been awarded a national contract with NHS England to supply the mental health service Talking Therapies in British Sign Language. The new specialist service will help to support deaf people who are experiencing anxiety, depression and other mental health issues. This marks the first time NHS England have granted a national contract to a deaf specialist service and will hope to bridge the gap and tackle the health inequalities recognised after a recent freedom of information (FOI) request found that around 100 NHS trusts do not comply with accessible information standards (AIS). Prior to the contract, deaf people experiencing mental health related issues would have to rely on funding from their Clinical Commissioning Group (CCG) to approve additional communication assistance on an individual basis. Waiting for approval of the funding for British Sign Language (BSL) therapy services meant that many deaf patients were having to wait considerably longer than their able hearing counterparts. Many CCGs do not grant additional funding and would not offer these kinds of services to deaf people, often resulting in ‘postcode lottery’. Dr Sarah Powell, Clinical Lead at SignHealth, said: "Deaf people are twice as likely to experience mental health challenges such as depression and anxiety compared to hearing people. This is a serious and sometimes life-threatening health inequality. Therapy delivered in sign language has been proven to have higher recovery rates and we are delighted that this contract removes the funding barrier so that more Deaf people are able to access life-changing treatment." Read full story Source: NHE, 9 March 2022 -
News Article
RCN launches toolkit to help nursing staff raise concerns
Patient Safety Learning posted a news article in News
The Royal College of Nursing (RCN) has designed a 'Raising Concerns toolkit', which includes information to help members navigate the process of escalation, from identifying a potential concern through to formally reporting it to senior colleagues. It’s been designed to help members decide when to escalate a workplace issue and includes a flowchart to support them in deciding what, when and how to report concerns. The toolkit outlines the types of concerns that might be raised such as staffing and patient safety, a lack of support or training, as well as cultural or criminal issues. It supports nursing staff to understand the importance of remaining factual, staying neutral and keeping records of events. RCN Deputy Director of Nursing Eileen Mckenna said: “We know that raising a concern at work isn’t easy, but it safeguards nursing staff and can provide learning opportunities. Our Raising Concerns toolkit can be used by nurses, nursing associates, students and health care support workers in the NHS and independent sector to help them through the process of escalating an issue. “All workplaces that employ nursing staff should have a culture of safety and focus on system learning, not individual blame in the event of a mistake being made. We will always support members who challenge unsafe practices, processes or conditions at work in the interests of their own safety and that of patients. It’s an important skill that promotes psychological safety, a positive learning environment and wellbeing.” Read full story Source: RCN, 2 March 2022 -
News ArticleMedical records contain a plethora of information, from a patient’s diagnoses and treatments to marital status to drinking and exercise habits. They also note whether a patient has followed medical advice. A health provider may add a line stating that the patient is “noncompliant” or “non-adherent,” signalling that the patient has been uncooperative and may exhibit problematic behaviours. Two large new studies in the US found that such terms, while not commonly used, are much more likely to appear in the medical records of Black patients than in those of other races. The first study, published in Health Affairs, found that Black patients were two and a half times as likely as white patients to have at least one negative descriptive term used in their electronic health record. About 8% of all patients had one or more derogatory terms in their charts, the study found. The most common negative descriptive terms used in the records were “refused,” “not adherent,” “not compliant” and “agitated.” The second study, published in JAMA Network Open, analysed the electronic health records of nearly 30,000 patients at a large urban academic medical centre between January and December 2018. The study looked for what researchers called “stigmatising language,” comparing the negative terms used to describe patients of different racial and ethnic backgrounds as well as those with three chronic diseases: diabetes, substance use disorders and chronic pain. Overall, 2.5% of the notes contained terms like “nonadherence,” “noncompliance,” “failed” or “failure,” “refuses” or “refused,” and, on occasion, “combative” or “argumentative.” But while 2.6% of medical notes on white patients contained such terms, they were present in 3.15% of notes about Black patients. Looking at some 8,700 notes about patients with diabetes, 6,100 notes about patients with substance use disorder and 5,100 notes about those with chronic pain, the researchers found that patients with diabetes — most of whom had type 2 diabetes, which is often associated with excess weight and called a “lifestyle” disease — were the most likely to be described in negative ways. Nearly 7% of patients with diabetes were said to be noncompliant with a treatment regimen, or to have “uncontrolled” disease, or to have “failed.” The labels have consequences, warns Dr. Schillinger, who directs the Center for Vulnerable Populations at San Francisco General Hospital and Trauma Center. “Patients whose physicians tend to judge, blame or vilify them are much less likely to have trust in their doctors, and in the medical system overall,” Dr. Schillinger said. “Having health care providers who are trustworthy — who earn their patients’ trust by not judging them unfairly — is critical to ensuring optimal health and eliminating health disparities.” Read full story (paywalled) Source: The New York Times, 20 February 2022
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News ArticleThe mother of Martha Mills, whose preventable death in hospital has led to calls for extra patients' rights, has said she is to meet the health secretary to discuss "Martha's Rule". If introduced, it would give families a statutory right to get a second opinion if they have concerns about care. Merope Mills said patients needed more clarity and to feel empowered. Her daughter, Martha, died two years ago after failures in treating her sepsis at King's College Hospital. She had entered hospital with an injury to her pancreas after falling off her bike. The injury was serious but should never have been fatal. Within days she had died of sepsis. In an interview on Radio 4's Today programme, Mrs Mills said she had raised concerns but doctors told her the extensive bleeding was "a normal side-effect of the infection, that her clotting abilities were slightly off". The King's College Hospital Trust said it remained "deeply sorry that we failed Martha when she needed us most" and her parents should have been listened to. Read full story Source: BBC News, 12 September 2023
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News Article
NHS ombudsman calls for Martha's rule to give power to patients
Patient Safety Learning posted a news article in News
Top boss of NHS complaints in England has told the BBC he wants Martha's rule to be introduced to give patients the power to get an automatic second medical opinion about hospital care, when they think things are going wrong. Rob Behrens said he had been moved by the plea of Merope Mills, who shared the story of her daughter's death. Martha was 13 when she died from sepsis. Merope Mills wants hospitals around the country to bring in Martha's rule, which would give parents, carers and patients the right to call for an urgent second clinical opinion from other experts at the same hospital, if they have concerns about their current care. It is something that Parliamentary and Health Service Ombudsman Rob Behrens fully supports. He told BBC Radio 4's Today programme: "Along with many others, I was moved and in great admiration for what Merope has said and done and I give unambiguous support. "Unfortunately, as tragic as this case is, it's not the first and there have been many cases where patients have been failed by their doctors because they haven't been listened to." Read full story Source: BBC News, 5 September 2023 -
News Article
All GP surgeries in England to have digital phone lines by March 2024
Patient Safety Learning posted a news article in News
Patients at all general practices across England will soon benefit from new digital phone lines designed to make booking GP appointments easier. Backed by a £240 million investment, more than 1,000 practices have signed up to make the switch from analogue systems - which can leave patients on hold and struggling to book an appointment - to modern, easy-to-use digital telephones designed to make sure people can receive the care they need when they need it. It is expected every practice in the country will have the new system in place by the end of this financial year, helping put an end to the 8am rush - a key pillar of the Prime Minister’s primary care recovery plan to improve patient access to care. Patients will be able to contact their general practice more easily and quickly - and find out exactly how their request will be handled on the day they call, rather than being told to call back later, as the government and NHS England deliver on the promises made in the primary care recovery plan announced in May. If their need is urgent, they will be assessed and given appointments on the same day. If it is not urgent, appointments should be offered within 2 weeks, or patients will be referred to NHS 111 or a local pharmacy. The upgraded system will bring an end to the engaged tone, see care navigators direct calls to the right professional, and the use of online systems will provide more options and help those who prefer to call to get through. Read press release Source: Department of Health and Social Care, 18 August 2023
