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Content ArticleMedicines talk is a website hosting a collection of stories to inspire new avenues for discussion between healthcare professionals and their patients about their medicines and care. Story 1: Life is meant for laughing Story 2: What is it all for? Story 3: 'Keeping going': Are my medicines a help or a hindrance? Story 4: I look after myself Story 5: Is there anything we can stop today? Story 6: A glimpse of the future? Story 7: Polluting the planet The stories were co-authored by Professor Deborah Swinglehurst and Dr Nina Fudge, based on research conducted between 2016 and 2021 at Queen Mary University of London (QMUL). The researchers studied 24 people aged 65 or older who had been prescribed ten or more different items of regular medication, through home visits, interviews and attending appointments for up to two years. They also observed and spoke with health professionals in three general practices and four community pharmacies.
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Content ArticleSince the 2007 landmark report on Preventing Medication Errors from the US National Academy of Medicine, effective interventions have been developed to address medication errors. Despite this, medication errors persist as the most common source of harm for patients worldwide. In this Editorial, Albert Wu looks at whether WHO's “The 5 Moments for Medication Safety” as a patient engagement tool has reached its intended audience.
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News Article
Physician associates told they must not call themselves doctors
Patient Safety Learning posted a news article in News
Staff without medical training who fill gaps in the NHS workforce must tell patients they are “not a doctor” when introducing themselves, under new guidance. The advice has been issued to “physician associates” (PAs), a type of clinical role that requires less training than doctors receive, amid a row over their use in the NHS. PAs complete a two-year postgraduate qualification, but no medical degree, and can diagnose and treat patients. They can work in A&E or GP surgeries. NHS England has set out plans to expand the number of PAs to deal with staff shortages, with a workforce of 10,000 PAs wanted over the next decade. The plan has been met with opposition from doctors’ leaders, who say the growing use of PAs instead of fully qualified doctors is leading to missed diagnoses and deaths. Guidance published by the Faculty of Physician Associates, a part of the Royal College of Physicians, said that PAs must not mislead patients into thinking they are doctors. Read full story (paywalled) Source: The Times, 6 October 2023 -
News Article
Be careful of celebrating staff as ‘heroes’, NHSE advises trusts
Patient Safety Learning posted a news article in News
Trusts haven been warned to be careful of “contentious” approaches to staff recognition, such as those that mimic the “clap for carers” initiative organised during the pandemic. NHS England has published a Staff Recognition Framework which stresses marking staff achievements is important. However, it also warns staff could also be demoralised by recognition they felt was derisory. The framework says: ”During the pandemic, studies suggested the weekly 8pm ‘clap for carers’ movement and use of the word ‘heroes’ were contentious approaches to staff recognition. The NHS is always in the media spotlight. Don’t let this put you off but do consider the broader political and economic context.” Recent strikes saw clinicians make the point that organised clapping was no substitute for increase-linked pay increases. The document for senior leaders recommends “developing a recognition strategy” which takes a triple track “formal, informal and everyday” approach to celebrating staff achievement. It said “evidence shows that pay alone will not influence staff wellbeing, engagement, and retention in the long-term – praise and social approval have also proved to be critical factors”. Read full story (paywalled) Source: HSJ, 12 October 2023 -
News Article
East Kent NHS Trust: Lessons not learned at maternity trust, mum says
Patient Safety Learning posted a news article in News
Lessons still have not been learned at a Kent hospital trust which was criticised in a damning report, a mother has said. Dr Bill Kirkup's review found at least 45 babies might have survived with better care at East Kent NHS hospitals. Victoria, whose six-year-old daughter needs 24-hour support, said: "I've had no contact from anyone from the trust." Her case was one of 202 that were examined by Dr Kirkup in his report, which was published exactly a year ago. Victoria, whose daughter is living with the consequences of failings in her care during her birth, said: "Our children have become unwell because of what has happened to them. "I don't feel lessons have been learned whatsoever. "Treatment hadn't been made available as easily as it should have done for children that are still living this experience every day." Read full story Source: BBC News, 19 October 2023 -
News Article
Health Secretary backs Martha’s Rule giving right to second medical opinion
Patient Safety Learning posted a news article in News
The government has backed Martha’s rule, a campaign to give families and patients the right to a second assessment if they feel their concerns are not being taken seriously. Health secretary Steve Barclay said ministers are “committed” to implementing the rule, insisting the case for it is “compelling”. Martha Mills died after developing sepsis while under the care of King’s College Hospital NHS Foundation Trust in south London. Mr Barclay said the case set out by Ms Mills, was “compelling”. “For everyone that has heard it, it is an absolutely heartbreaking case,” he told the BBC. Mr Barclay said: “I’m determined that we ensure we learn the lessons from it and very keen to learn from best international practice.” Mr Barclay said there are “international lessons”, particularly from Ryan’s Rule in Australia, giving patients a direct line to a second opinion. “And I particularly want to give much more credence to the voice of patients,” Mr Barclay said. He added: “I think a key part of this measure is ensuring that patients feel heard and can get a second opinion.” Read full story Source: The Independent, 14 September 2023 -
Content ArticleThis document from the Patient Experience Library aims to map the evidence base for patient experience in digital healthcare. We shine a spotlight on areas of saturation, we expose the gaps and we make suggestions for how research funders and national NHS bodies could steer the research to get better value and better learning.
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Content ArticleNHS England wants to find out how people would choose to tell the NHS about things that go wrong in healthcare, to help the NHS do things better. NHS England wants to hear from people of all ages and backgrounds, who use all kinds of NHS services. They want to know how people would choose to give feedback if something went wrong in their care, or in the care of someone they look after, so the NHS can learn. NHS England will use what you tell them to help design a new online service to make care better. Click on the link below to find out more and take the survey. Closing date: 31 December 2023
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Content ArticleWorld Patients Alliance is the umbrella organisation of patients and patients’ organisations around the globe. They seek to ensure that all patients have access to safe, high quality, and affordable healthcare everywhere in the world. These videos produced by World Patients Alliance provide information for patients on the following topics: How do you talk to your healthcare provider? An introduction to medication safety How many medications are too many?
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Content ArticleMonitoring and responding to deterioration in social care settings is critical to providing safe, effective and responsive care. Front-line staff are pivotal for highlighting change to wider teams and managing low to medium risk individuals in their place of residence. However, there is a core set of principles that most systems use which may not be used by non-clinical staff in residential settings. This case study explores an intervention to empower non-clinical staff to take observations. The Whzan blue box contains a digital tablet and equipment to take temperature, pulse, oxygen saturation levels and blood pressure measurements. Staff were trained and supported on site to use the system and set up a digital platform to share measurements with wider teams. Staff fed back that they felt empowered and able to better engage in conversation with health care professionals, highlighting the importance of having a common language. This case study was submitted to the Care Quality Commission (CQC) by North East and North Cumbria ICB.
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Content Article
HPV is a common infection that is spread by skin-to-skin contact, including sexual contact, which can lead to the development of cancers affecting both women and men, including cancers of the cervix, vulva, vagina, penis, anus, and oral cavity. In England, young people aged 12 to 13 years are offered immunisation against HPV as part of the NHS vaccination programme. Research has shown that in England cervical cancer has almost been eliminated among young women who were offered the HPV vaccine. However, research by the National Institute for Health and Care Research (NIHR) Health Protection Research Unit in Behavioural Science and Evaluation at the University of Bristol has identified sustained inequalities in uptake by area and minority ethnic groups. It has also identified unmet information needs among young people in schools where vaccination uptake is low, with implications for obtaining consent and vaccination uptake. This web page contains a number of information videos to address information needs about HPV among young people. They were coproduced with young people from disadvantaged backgrounds and diverse ethnic groups. -
Content ArticleRecognition is about thanking people for their contribution at work. It is embedded in the organisational values of the NHS. By improving recognition we can deliver the NHS Long Term Workforce Plan’s ambition to attract and retain the workforce we need to deliver improved patient care. One of the seven elements of the NHS People Promise is, ‘we are recognised and rewarded’. It defines recognition as: “A simple thank you for our day-to-day work, formal recognition for our dedication…” It is important that we recognise our staff because evidence shows that pay alone will not influence staff wellbeing, engagement, and retention in the long-term – praise and social approval have also proved to be critical factors. The NHS and wider health and care sector has faced unprecedented workforce shortages and pressures in recent years. Yet, the most recent NHS staff survey illustrates that approximately half of staff do not feel recognised at work. NHS England has drawn on research and evidence and has worked with NHS organisations to develop this framework. It provides simple, easy-to-follow guidance and ideas for organisations to inform their own strategies and approaches.
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Content ArticleMuch has been written recently about Martha’s rule—the proposal to allow patients in hospitals in England and their families the right to demand an urgent second opinion if their condition is deteriorating. In this BMJ opinion piece, Helen Haskell outlines some principles for creating an effective family activated system, including breadth, urgency, continuity, independence and feedback.
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Content ArticleSometimes groups of patients who may not engage easily with healthcare services are labelled 'hard to reach'. This graphic by artist Sonia Sparkles highlights that there are barriers in healthcare that can prevent different groups accessing services—ranging from physical access needs to lack of cultural appreciation. These barriers are often created by healthcare staff and organisations who, when designing services, fail to consider the diverse nature of the population their services are for. A wide range of graphics relating to patient safety, healthcare and quality improvement is available on the Sonia Sparkles website.
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Content ArticleFor many years the NHS has talked about the need to shift to a more personalised approach to health and care—where people have choice and control over the way their care is planned and delivered, based on “what matters” to them and their individual strengths, needs and preferences. In this HSJ article, Ben Wilson, product solution director at Orion Health, discusses the progress, benefits and future possibilities for an integrated, patient-centric healthcare system.
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Content ArticleIn this interview, Derek Feeley, IHI President Emeritus and Senior Fellow shares the work of the Health Improvement Alliance Europe (HIAE) workgroup related to curiosity. He outlines five simple rules linked to complexity theory, which states that if you are trying to make sense of a complex situation, you should create simple, order-generating rules. The five simple rules are: Ask rather than tell. Listen to understand rather than to respond. Hear every voice rather than only those easiest to hear. Prioritise problem framing rather than problem solving. Treat vulnerability as a strength rather than a weakness.
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Content Article
Patient and public involvement (PPI) is, these days, a given in healthcare policy and practice. Providers, commissioners, policymakers and researchers all state the importance of hearing from service users about what matters to them. This "involvement imperative" has given rise to a plethora of guidance notes, checklists, frameworks and toolkits, all purporting to show what good practice in PPI looks like. The Patient Experience Library decided to carry out a mapping exercise, to see how much guidance there is, and to see if they could make sense of it all. -
Content ArticlePhysician associates (PAs) are healthcare professionals who work as part of a multidisciplinary team under the supervision of a named senior doctor (a General Medical Council (GMC)-registered consultant or GP). While they are not medical doctors, PAs can assess, diagnose and treat patients in primary, secondary and community care environments within their scope of practice. PAs are part of NHS England’s medical associate professions (MAPs) workforce grouping. MAPs add to the breadth of skills within multidisciplinary teams, to help meet the needs of patients and enable more care to be delivered in clinical settings. PAs do not fall under the allied health professions (AHPs) or advanced practice groups. The Faculty of Physician Associates has created this guidance to provide clarity around the role of PAs. It provides practical examples of how physician associates should describe their role and is aimed at increasing understanding for patients, employers, other healthcare professionals and the public. It is important that PAs take all reasonable steps to inform patients and staff of their role and to avoid confusion of roles. This includes considering the potential for verbal and written role titles to be misunderstood and taking the time to explain their role in any clinical interaction.
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News Article
Messages revealed healthcare workers were drugging patients
Patient Safety Learning posted a news article in News
Two healthcare workers who exchanged vile texts while needless drugging sick people to ‘keep them quiet’ have been found guilty of ill-treating patients. Senior nurse Catherine Hudson, 54, was found to have regularly tranquillised patients unnecessarily for her own amusement and to have an ‘easy’ shift. While Charlotte Wilmot, 48, an assistant practitioner, wrote vile texts encouraging her to carry out the dangerous acts, with complete disregard for the consequences. Preston Crown Court heard the pair worked on the stroke unit at Blackpool Victoria Hospital and had carried out needless sedations between 2017 and 2018. Restrictions on prescription drugs were so lax in the stroke unit that staff would help themselves and self-medicate or steal drugs to supply to others, the court heard. Drugs such as Zopiclone, a powerful medicine used to treat insomnia, were often stolen and used to drug multiple patients. Police launched an investigation in November 2018 after a student nurse raised concerns about the treatment of patients in the stroke unit. A number of staff members were arrested during the course of the investigation and their mobile devices were seized. Read full story Source: The Independent, 6 October 2023 -
Content ArticleThis infographic by artist Sonia Sparkles was produced for Portsmouth Hospitals NHS Trust to outline what patients can expect from healthcare staff when attending an appointment at or staying in hospital. It covers navigating he hospital, what to expect from an appointment and standards for staff attitudes. A wide range of graphics relating to patient safety, healthcare and quality improvement is available on the Sonia Sparkles website.
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Content ArticleHealthcare can be confusing. This book, published by the US-based Patient Safety Authority, is a tool to help patients communicate their wants and needs in a way their care team can understand. The Patient’s Companion covers common healthcare topics like what to do if you’re told you have a chronic (long-term, often incurable) disease or when and how to get a second opinion. The book is available in English and also a Spanish version.
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Content ArticleThe UK government's commitment to implement “Martha’s rule,” is good news for patients. It will give patients and their families an explicit right to request a second opinion if a patient’s health condition is getting worse and they feel their concerns are not being taken seriously. However, all patients are familiar with the power imbalance when they encounter health professionals. Patients and carers are key partners in the quest to make care safer, argues Tessa Richards in this BMJ opinion piece. Although actively co-designing research and policy on patient safety with patients and carers is now widely seen as best practice, there is still a long way to go. In her article, Tessa highlights two recent webinars with Henrietta Hughes, Patient Safety Commissioner, who is responsible for implementing Martha’s rule in NHS hospitals, and discusses patient advocacy and the new Patient Safety Partners. Watch the Patient Safety Learning webinar with Henrietta Hughes.
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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.
