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Found 177 results
  1. Content Article
    This factsheet from the General Medical Council sets out some of the key legislation and case law relating to medical decision making and consent in the UK. It is not intended to be a comprehensive list, nor is it a substitute for independent, up-to-date legal advice.
  2. Content Article
    Primary care services are the front door to the NHS - they are the first port of call when we feel unwell and the main coordinator of care when we are living with health conditions. The primary care team have an important role in making people feel welcomed, listened to and taken seriously. Yet we often hear examples about people who have not had their communication needs met within primary care. This includes people with sensory impairments, people with learning disabilities, autistic people, people living with dementia, people who don’t speak English fluently, people with low or no literacy, people who are digitally excluded, people living nomadically, people experiencing homelessness and many others.   This report sets out the key issues faced by people with specific communication needs within primary care and what they feel would make the biggest difference, as well as key actions primary care leaders and teams can take to support inclusive communication. 
  3. Content Article
    Doctors are taught from medical school about the benefits of IUDs, and often encourage patients that they are a good contraceptive option. However, recent media attention on the pain that some women suffer when having their IUDs fitted has started conversations about the need for cervical blocks and more honest counselling of women about the procedure. Rebekah Fenton, adolescent medicine fellow at Lurie Children's Hospital of Chicago, joins us to talk about how she counsels her patients, and why the most important thing is to make sure women are in charge of their reproductive healthcare decisions.
  4. Content Article
    Personalised Care will benefit up to 2.5 million people by 2024. It aims to give people the same choice and control over their mental and physical health that they have come to expect in every other aspect of their life. Personalised care is based on ‘what matters’ to people and their individual strengths and needs. This webpage by NHS England contains information about the following aspects of personalised care: Patient choice Shared decision making Patient activation and supported self-management Social Prescribing and community based support Personalised care and support planning Personal health budgets
  5. Content Article
    David Wilson was admitted to Pinderfields Hospital on 27 December 2022 and subsequently underwent a CT scan which indicated an inflammation in the distal section of his colon. To identify the cause of this he underwent a flexible sigmoidoscopy, during which there was a colonic perforation which resulted in his death the following day.
  6. Content Article
    Age-Friendly Health Systems (AFHS) is an initiative that aims to follow evidence-based practices while minimising harm in older patients. The evidence-based elements of high-quality care are known as the 4Ms: What Matters Medication Mentation Mobility During the early days of the Covid-19 pandemic, a team from the Oregon Health & Science University (OHSU) decided to examine the equity of their care for older adults. The resulting study published about the age-friendly work at OHSU is the first to include data about health equity as part of AFHS outcomes and illustrates the importance of creating equitable care at clinical and institutional policy levels. This blog looks at the process the team went through to assess and collect data about age-related equity.
  7. Content Article
    Digital delivery of information is the new normal and it’s important that healthcare providers adapt quickly. Informed consent in the UK needs to be backed up by the BRAN principle: Benefits, Risks and Alternatives including the option of doing Nothing.  In this blog, Julie Smith, Content Director at EIDO Healthcare, will use the same principles to consider the use of digital solutions for patient information. This blog is not exhaustive but will hopefully provide some food for thought around the patient safety considerations relating to digital information. 
  8. Content Article
    Data from NHS Resolution indicates that the number of claims with a primary cause of ‘Fail to warn - Informed consent’ have increased from 128 to 248 claims per year in 2011–2012 and 2021–2022 respectively. This letter in the British Journal of Surgery highlights the impact of failures in both the process and documentation of informed consent. The writers call for further research to investigate unwarranted variation in claims and develop processes to standardise and improve the quality of consent.
  9. Content Article
    A patient shares her experience of life-changing complications after a hysterectomy she had at a private hospital and the lack of follow up and help she's received since. She highlights the actions she would like to see in place for private hospitals around informed consent, follow up and support after surgery, and accountability. The patient wishes to remain anonymous.
  10. Content Article
    In this blog, Patient Safety Learning considers key patient safety issues relating to complications from surgical mesh implants, highlighting further sources of opinion and research on the hub.
  11. Content Article
    This book published by the US Food and Drug Administration (FDA) looks at risk communication—the communication approach used for situations when people need good information to make sound choices. It is distinguished from public affairs (or public relations) communication by its commitment to accuracy and its avoidance of spin. Effective risk communication between healthcare professionals and patients is important to ensure patient safety, and in various chapters of the book, the authors look at how to maximise effective communication in healthcare scenarios.
  12. Content Article
    A doula, according to Doula UK (2022), provides ‘support in pregnancy, birth and in the postnatal period by providing information, advocacy, and practical and emotional support to the whole family’. This blog by the Healthcare Safety Investigation Branch (HSIB) maternity team outlines why HSIB decided to investigate the role of doulas in maternity safety and the results of their investigation. It highlights discrepancies in doula training and several cases where doulas stepped outside of the boundaries of their role. HSIB argues that there is a need for further work to understand how families view the role of doulas during pregnancy and birth.
  13. Content Article
    This report outlines the results of the Patient Information Forum's (PIF's) 2022 survey and sets out progress made in the crucial areas of health and digital literacy since the Covid-19 pandemic.
  14. Content Article
    This webinar hosted by the Patients Association looked at the benefits to patients of accessing their GP health records online, and answered questions from patients about how to access this information. 
  15. Content Article
    The following account has been shared with Patient Safety Learning anonymously. We’d like to thank the patient for to sharing their experience to help raise awareness of the patient safety issues surrounding outpatient hysteroscopy care.
  16. News Article
    The high-profile Australian neurosurgeon Charlie Teo admits making an error by going “too far” and damaging a patient, but maintains she was told of the risks. The doctor on Monday appeared at a medical disciplinary hearing to explain how two women patients ended up with catastrophic brain injuries. Teo also defended allegations that he acted inappropriately by slapping a patient in an attempt to rouse her after surgery, contrasting it with Will Smith’s notorious slap of Chris Rock at the Academy Awards last year. “It wakes them up and it wakes them up pretty quickly. And I will continue to do it.” Charlie Teo tells inquiry he ‘did the wrong thing’ in surgery that left patient in vegetative state One of the issues the panel of legal and medical experts is considering is whether the women and their families were adequately informed of the risks of surgery. Both women had terminal brain tumours and had been given from weeks to months to live. They were left in essentially vegetative states after the surgeries and died soon after. “We were told he could give us more time,” one of the husbands said, according to court documents. “There was never any information about not coming out of it". Read full story Source: The Guardian, 27 March 2023
  17. Content Article
    In this article, Bevan Brittan Trainee Solicitor Angus Kirkwood draws on his past experience working as a physiotherapist whilst discussing the topic of informed consent in medical practice. Informed consent is a key issue in medical practice. In this article, he briefly consider the law around informed consent and reflects on his previous experience working as a physiotherapist for 7 years to explore the challenges in clinical practice. Angus concludes by providing some practical advice designed to assist practitioners with meeting their legal duties.
  18. Content Article
    Consent to treatment such as operations and diagnostic procedures can only be truly informed if the patient understands the risks, benefits and alternatives. They also need to have considered what will happen if they choose not to have any treatment at all. A failure to obtain informed consent is not only unlawful, but can contribute to lasting physical and psychological harm. In this blog, hub Topic Leader Julie Smith looks at the different areas to consider when creating written information that is genuinely useful to the patient. Julie’s advice also helps readers understand how they can provide information that is medico-legally sound.
  19. Content Article
    Sex and gender bias in health and social care results in poor outcomes for patients and has a negative impact on safety during care and treatment. For the last two International Women’s Days, Patient Safety Learning has highlighted patient safety concerns on this topic, considering the broader risk to safety posed by this bias and the impact on outcomes and safety of women being historically underrepresented in clinical trials and medication research.[1] [2] The theme of this year’s International Women’s Day is #EmbraceEquity. In support of this aim, there are seven different missions which have been identified to help forge a gender-equal world, including one focused specifically on health: “To assist women to be in a position of power to make informed decisions about their health”[3] This year we will focus on this mission, considering the relationship between women’s health, informed consent and patient safety. We will first set out what we mean by informed consent, before discussing how failures in consent can have a negative impact on women’s health. Then we will consider the UK Women’s Health Strategy in relation to these issues, and discuss what is needed to improve patient safety.
  20. Content Article
    Risk assessment during the maternity pathway relies on healthcare professionals recognising a change in a pregnant woman/person’s circumstances that may increase the level of risk. Risk assessments are undertaken during the numerous contacts pregnant women/people have with a team of healthcare professionals throughout the maternity pathway. This thematic review draws on findings from the Healthcare Safety Investigation Branch's (HSIB's) maternity investigation programme to identify key issues associated with assessing risk during pregnancy, labour and birth (known as the ‘maternity pathway’). It examined all reports undertaken by the HSIB maternity investigation programme from April 2019 to January 2022, with the aim of identifying key learnings about risk assessment. A total of 208 reports that had made findings and recommendations to NHS trusts about risk assessment during the maternity pathway were included. The review identified an overarching theme around the need to facilitate and support individualised risk assessments for pregnant women/people to improve maternity safety. Within this, seven specific ‘risk assessment themes’ within the maternity care pathway were identified as commonly appearing in HSIB reports. These seven themes require a focus from the healthcare system to help mitigate risks and enable NHS trusts and clinicians to deliver safe and effective maternity care to pregnant women/people.
  21. Content Article
    Hysteroscopy is a procedure used as a diagnostic tool to identify the cause of common issues such as abnormal bleeding, unexplained pain or unusually heavy periods. It involves a long, thin tube being passed through the vagina and cervix, into the womb, often with little or no anaesthesia.  Studies indicate that some women do not find hysteroscopy procedures painful. However, it is now widely recognised that many women experience severely painful and traumatic hysteroscopies.[1-5]  At Patient Safety Learning, we have worked with patients, campaigners, clinicians and researchers to understand the barriers to safe care and call for improvements.[6] We believe that no woman should have to endure extreme pain or trauma when accessing essential healthcare.  In this blog we will:  outline the key safety concerns around hysteroscopy procedures summarise recent national discussions highlighting these concerns reflect on the new national guidance outline six calls for action. 
  22. Content Article
    This ethnographic qualitative study in the BMJ aimed to describe how patients are engaged with cancer decisions in the context of multidisciplinary teams (MDT) and how MDT recommendations are carried out in the context of a shared decision. The study was carried out at four head and neck cancer centres in the north of England. The authors found that the current model of MDT decision-making does not support shared decision-making, and may actively undermine it. They recommend the development of a model that allows the individual patient more input into MDT discussions, and where decisions are made on potential treatment options rather than providing a single recommendation for discussion with the patient. Deeper consideration should be given to how the MDT incorporates the patient perspective and/or delivers its discussion of options to the patient.
  23. Content Article
    The OptiBreech project is a research study exploring the feasibility of evaluating a new care pathway for women with a breech pregnancy. About 1 in 25 babies are born bottom-down (breech) after 37 weeks of pregnancy. Women who wish to plan a vaginal breech birth have asked for more reliable support from an experienced professional. This aligns with national policy to enable maternal choice. In this video, Dr Shawn Walker explains why the combination of meconium and tachycardia, particularly in the first stage of labour, indicates increased risk in breech births.
  24. Content Article
    Co-produced by young people and researchers from the University of Bristol and London School of Hygiene and Tropical Medicine, ‘EDUCATE’ will help teach students about the human papillomavirus (HPV) vaccine and provide reassurance about receiving the vaccine, which is usually offered to teenagers at school as part of the national vaccination programme.
  25. Content Article
    The word 'controversy' almost always accompanies any reference to electroconvulsive therapy (ECT). It has a dark history and remains a deeply contentious practice. For many, ECT is seen as outdated, forever linked with frightening images of medical abuse, cruelty and even punishment. In this programme for BBC Radio 4, Professor Sally Marlow met her friend Dr Tania Gergel at King’s College London, which forced her to reassess everything she thought she knew about ECT. Tania told Sally that ECT had saved her life on numerous occasions and that ECT is the only treatment that can bring her back to health after episodes of severe depression, psychosis and mania. Tania is Director of Research at Bipolar UK. She’s a philosopher and an internationally respected medical ethicist. She also lives with a serious mental illness; an unusual mixed type of bipolar disorder. During her last period of illness a year ago, Tania kept an audio diary., which she shares extracts from throughout the programme in order to break down stigma around both mental illness and ECT.
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