Search the hub
Showing results for tags 'Consent'.
-
Content ArticleThis article discusses evidence that doctors-in-training and medical students are still performing pelvic exams on anesthetized women without their consent.
- Posted
-
- Consent
- Womens health
-
(and 1 more)
Tagged with:
-
Content ArticleIn 2015 the Supreme Court judgement in the case of Montgomery v Lanarkshire Health Board created a significant change to the law in regard to gaining informed, or valid, consent. The case concerned Nadine Montgomery, a pregnant lady of small stature with diabetes who delivered her son vaginally in 2001. Her son experienced a hypoxic insult as a result of shoulder dystocia and consequently suffered cerebral palsy with severe disabilities. She successfully argued that had she been informed of the risk of shoulder dystocia she would have opted to have an elective caesarean section. This is part of NHS Education for Scotland's Advanced Practice Toolkit repository for credible and supportive resources.
- Posted
-
- Consent
- Legal issue
-
(and 1 more)
Tagged with:
-
Content ArticleThis presentation was submitted by the patient group Campaign Against Painful Hysteroscopy, as an oral presentation to the British Society for Gynae Endoscopy’s Annual Scientific Meeting 2021. It includes patient testimonials and statistical data gathered around painful hysteroscopies and informed consent.
- Posted
-
1
-
- Obstetrics and gynaecology/ Maternity
- Womens health
- (and 3 more)
-
Content ArticleEmerging evidence indicates that there has been an increase in the prescription of antipsychotic medications for people living with dementia in care settings during the COVID-19 pandemic. In this blog, Patient Safety Learning explores the patient safety concerns relating to the use of antipsychotic medications for people with dementia and suggests areas for further investigation and action.
- Posted
- 1 comment
-
1
-
- Dementia
- Prescribing
-
(and 1 more)
Tagged with:
-
Content ArticleIn this blog Patient Safety Learning reflects on responses received from Robin Swann MLA, Minister of Health (Northern Ireland), Jeane Freeman MSP, Cabinet Secretary for Health and Sport (Scotland) and Vaughan Gething MS, Minister for Health and Social Services (Wales), regarding concerns about painful hysteroscopy procedures in the NHS.
- Posted
-
- Womens health
- Obstetrics and gynaecology/ Maternity
- (and 3 more)
-
Content Article
Patient blog - A tale of two MRIs (10 July 2020)
Patient-Safety-Learning posted an article in Patient stories
This blog by patient Lelainia Lloyd in the Journal of Medical Imaging and Radiation Sciences is a personal account of two starkly different MRI appointment experiences. In the first scan, the technologist said very little to Lelainia and the experience left her with significant anxiety about future MRIs. But her second experience was completely different, with the technologist communicating clearly, asking questions and making sure she felt comfortable throughout the process. Lelainia highlights the importance of communicating clearly and compassionately with patients to make them feel safe and able to ask for help. She outlines some practical steps for healthcare workers to help them engage with patients and ensure they are clearly consenting to all aspects of care and treatment.- Posted
-
- Consent
- Communication
-
(and 4 more)
Tagged with:
-
Content Article
NHSX information governance portal
Patient Safety Learning posted an article in NHS X
NHSX has launched a brand new information governance portal providing a 'one-stop shop' for NHS policies and guidance. -
Content Article
Patient Safety Movement: Informed consent blog
Patient Safety Learning posted an article in Consent issues
Clinicians often have competing priorities in the clinical setting which hinder their ability to provide time for thorough dialogue with patients. Often, this dialogue contains information about procedures or processes for which the patient needs a thorough understanding in order to make an informed decision. Due to the lack of time, sometimes this informed consent process is passed from the clinician to the medical assistant or nurse. Furthermore, clinicians are increasingly facing pressure to visit with more and more patients, thereby cutting the time with each one shorter and shorter. Therefore, typically only the most essential information is discussed with the patient during these short times and often, education doesn’t make the cut. This asymmetrical information makes it difficult for patients to make informed decisions about their care and may create situations with unforeseen consequences. These workflow barriers within the system itself make it extraordinarily difficult for clinicians to effectively explain and discuss informed consent with their patients.- Posted
-
- Information sharing
- Consent
-
(and 2 more)
Tagged with:
-
Content Article
Through the hysteroscope: Reflections of a gynaecologist
SairaS posted an article in Women's health
At Patient Safety Learning, we’ve been working with others to understand the issues surrounding painful hysteroscopies. In this interview, we talk to Obstetrics and Gynaecology consultant, Saira Sundar, about the process. She offers her clinical insight and highlights some of the challenges involved when it comes to managing pain during hysteroscopies. Saira also offers advice to colleagues and patients seeking to reduce anxiety and improve the patient experience.- Posted
- 7 comments
-
5
-
- Womens health
- Obstetrics and gynaecology/ Maternity
- (and 3 more)
-
Content ArticleIn this blog, Patient Safety Learning reflects on a recent response from Nadine Dorries MP, Minister of State for Mental Health, Suicide Prevention and Patient Safety, regarding concerns about painful hysteroscopy procedures in the NHS. Towards the end of last year, Patient Safety Learning published a blog outlining five calls to action that could be taken to improve the safety of hysteroscopy procedures in the NHS.[1] This has been an issue raised by patients, campaign groups and politicians in recent years, highlighting concerns that women having been suffering avoidable harm from hysteroscopies. We wrote to several key stakeholders in healthcare across England, Northern Ireland, Scotland and Wales, to raise awareness of this issue and call for urgent action to prevent future harm. While we welcome the Minister in her response supporting the general principles of informed consent and good practice guidance for hysteroscopy, we know that many women are still not being offered a choice of pain relief or given adequate information before consenting to the procedure. It remains unclear from her response whether the Government will take action to investigate the frequency of these experiences and respond to improve hysteroscopy safety.
- Posted
-
- Obstetrics and gynaecology/ Maternity
- Patient harmed
- (and 3 more)
-
Content ArticleFollowing the publication of Donna Ockenden’s first report: Emerging Findings and Recommendations from the Independent Review of Maternity Services at the Shrewsbury and Telford Hospitals NHS Trust on 11 December 2020, the NHS has issued this latest update. Read previous letter update
-
Content ArticleChoosing Wisely UK is part of a global initiative aimed at improving conversations between patients and their doctors and nurses.By having discussions that are informed by the doctor, but take into account what’s important to the patient too, both sides can be supported to make better decisions about care. Often, this will help to avoid tests, treatments or procedures that are unlikely to be of benefit.
- Posted
-
1
-
- Decision making
- Consent
-
(and 1 more)
Tagged with:
-
Content Article
Informed consent: what is it?
Julie EIDO Healthcare posted an article in Consent and privacy
Julie Smith is Content Director for EIDO Healthcare, an organisation that provides health professionals with resources and support around informed consent. In this blog, Julie explains what it means to give your ‘informed consent’ as a patient, and why it is so important to read the information given to you.- Posted
-
- Consent
- Decision making
-
(and 2 more)
Tagged with:
-
Content Article
NICE guidance on shared decision making
PatientSafetyLearning Team posted an article in Consent and privacy
Shared decision making is when health professionals and patients work together. This puts people at the centre of decisions about their own treatment and care. When making decisions together, it's important that: care or treatment options are fully explored, along with their risks and benefits different choices available to the patient are discussed a decision is reached together with a health and social care professional. The link below includes guidance and tools to support patients and healthcare staff with shared decision making. -
Content ArticleThis month, we’ve been looking back over 2020 and highlighting some of the key areas of health and care that Patient Safety Learning has worked in this year. First, Chief Executive, Helen Hughes, gave an overview, detailing some of the main ways we’ve been achieving our aims as an organisation. Following that, we looked at the impact of the COVID-19 pandemic on patient safety, and, earlier this week, we focused on advice and support for people living with Long COVID. In this blog, Patient Safety Learning reflect on the work we’ve been doing to highlight serious patient safety concerns relating to hysteroscopy procedures in the NHS and how we’ve been making the case for change.
- Posted
-
- Womens health
- Obstetrics and gynaecology/ Maternity
- (and 4 more)
-
News ArticlePatient Safety Learning Press Release 10th December 2020 Today the Independent review of maternity services at Shrewsbury and Telford Hospital NHS Trust published its first report on its findings.[1] The report made recommendations for actions to be implemented by the Trust and “immediate and essential actions” for both the Trust and the wider NHS. The Review was formally commissioned in 2017 to assess “the quality of investigations relating to new-born, infant and maternal harm at The Shrewsbury and Telford Hospital NHS Trust”.[2] Initially it was focused on 23 cases but has been significantly expanded as families have subsequently contacted the review team with their concerns about maternity care and treatment at the Trust. The total number of families to be included in the final report is 1,862. These initial findings are drawn from 250 cases reviewed to date. This is another shocking report into avoidable harm. We welcome the publication of these interim findings and the sharing of early actions that have been identified to make improvements to patient safety in NHS maternity services. We commend the ambition for immediate responses and action. Reflecting on the report, there are a number of broad patient safety themes, many of which have been made time and time again in other reports and inquiries. A failure to listen to patients The report outlines serious concerns about how the Trust engaged and involved women both in their care and after harm had occurred. This was particularly notable in the example of the option of having a caesarean section, where there was an impression that the Trust had a culture of wanting to keep the numbers of these low, regardless of patients’ wishes. They commented: “The Review Team observed that women who accessed the Trust’s maternity service appeared to have little or no freedom to express a preference for caesarean section or exercise any choice on their mode of deliver.” It also noted a theme in common with both Paterson Inquiry and Cumberlege Review relating to the Trusts’ poor response to patients raising concerns.[3] The report noted that “there have also been cases where women and their families raised concerns about their care and were dismissed or not listened to at all”. The need for better investigations Concerns about the quality of investigations into patient safety incidents at the Trust is another theme that emerges. The review reflected that in some cases no investigation happened at all, while in others these did take place but “no learning appears to have been identified and the cases were subsequently closed with it deemed that no further action was required”. One of the most valuable sources for learning is the investigation of serious incidents and near misses. If these processes are absent or inadequate, then organisations will be unable to learn lessons and prevent future harm reoccurring. Patient Safety Learning believes it is vital that Trusts have the commitment, resources, and frameworks in place to support investigations and that the investigators themselves have the right skills and training so that these are done well and to a consistently high standard. This has not formed part of the Report’s recommendations and we hope that this is included in their final report. Lack of leadership for patient safety Another key issue highlighted by the report is the failure at a leadership level to identify and tackle the patient safety issues. Related to this one issue it notes is high levels of turnover in the roles of Chief Executive, executive directors and non-executive directors. As part of its wider recommendations, the Report suggests trust boards should identify a non-executive director who has oversight of maternity services. Good leadership plays a key role in shaping an organisations culture. Patient Safety Leadership believes that leaders need to drive patient safety performance, support learning from unsafe care and put in place clear governance processes to enable this. Leaders need to be accountable for patient safety. There are questions we hope will be answered in the final report that relate to whether leaders knew about patients’ safety concerns and the avoidable harm to women and their babies. If they did not know, why not? If they did know but did not act, why not? Informed Consent and shared decision-making The NHS defines informed consent as “the person must be given all of the information about what the treatment involves, including the benefits and risks, whether there are reasonable alternative treatments, and what will happen if treatment does not go ahead”.[4] The report highlights concerns around the absence of this, particularly on the issue of where women choose as a place of birth, noting: “In many cases reviewed there appears to have been little or no discussion and limited evidence of joint decision making and informed consent concerning place of birth. There is evidence from interviews with women and their families, that it was not explained to them in case of a complication during childbirth, what the anticipated transfer time to the obstetric-led unit might be.” Again this is another area of common ground with other recent patient safety reports such as the Cumberlege Review.[5] Patient Safety Learning believes it is important that patients are not simply treated as passive participants in the process of their care. Informed consent and shared decision making are vital to respecting the rights of patients, maintaining trust in the patient-clinician relationship, and ensuring safe care. Implementation for action and improved patient safety In its introduction, the report states: “Having listened to families we state that there must be an end to investigations, reviews and reports that do not lead to lasting meaningful change. This is our call to action.” Responding with an official statement in the House of Commons today, Nadine Dorries MP, Minister for Mental Health, Suicide Prevention and Patient Safety, did not outline a timetable for the implementation of this report’s recommendations. In 2020 we have seen significant patient safety reports whose findings have been welcomed by the Department of Health and Social Care but where there has subsequently been no formal response nor clear timetable for the implementation of recommendations, most notably the Paterson Inquiry and Cumberlege Review. Patient Safety Learning believes there is an urgent need to set out a plan for implementing the recommendations of the Ockenden Report and these other patient safety reports. Patients must be listened to and action taken to ensure patient safety. [1] Independent review of maternity services at Shrewsbury and Telford Hospital NHS Trust, Ockenden Report: Emerging findings and recommendations form the independent review of maternity services at Shrewsbury and Telford Hospital NHS Trust, 10 December 2020. https://www.ockendenmaternityreview.org.uk/wp-content/uploads/2020/12/ockenden-report.pdf [2] Ibid. [3] The Right Reverend Graham Jones, Report of the Independent Inquiry into the Issues raised by Paterson, 2020. https://assets.publishing.serv...; The Independent Medicines and Medical Devices Safety Review, First Do No Harm, 8 July 2020. https://www.immdsreview.org.uk/downloads/IMMDSReview_Web.pdf [4] NHS England, Consent to treatment, Last Accessed 16 July 2020. https://www.nhs.uk/conditions/consent-to-treatment/ [5] Patient Safety Learning, Findings of the Cumberlege Review: informed consent, Patient Safety Learning’s the hub, 24 July 2020. https://www.pslhub.org/learn/patient-engagement/consent-and-privacy/consent-issues/findings-of-the-cumberlege-review-informed-consent-july-2020-r2683/
-
EventThis conference focuses on delivering effective consent practice and ensuring adherence to the new 2020 guidance from the General Medical Council. This timely conference will focus on ensuring adherence to The Seven Principles as outlined by the New GMC Guidance. The conference will also update delegates on implications of recent legal developments. Further information and to book your place or email kate@hc-uk.org.uk Follow the conversation on Twitter #Consentpractice We are pleased to offer hub members a 10% discount. Email: info@pslhub.org for the code.
-
Content ArticleDr. Donna Prosser is joined by Dr John James, a patient safety advocate, and the author of A New, Evidence-Based Estimate of Patient Harms Associated with Hospital Care. The team discusses the meaning of informed consent for clinicians and patients, the steps to a genuine shared decision making dialogue, and the components that should be addressed in the decision making process. Informed consent cannot be separated from the person-centeredness of an organization. While the shared decision making between clinicians and patients and loved ones does require time, attention, and attentiveness to the patient's wishes and goals, it should be a priority for all healthcare organisations.
- Posted
- 1 comment
-
1
-
- Consent
- Patient engagement
- (and 3 more)
-
Content ArticleHysteroscopy is a diagnostic gynaecological procedure traditionally requiring administration of general anaesthesia, but more frequently completed using local anaesthesia within a day-case (ambulatory) setting. Advantages associated with this transition include decreased completion times, fewer risks, and lower clinical costs. Numerous services advertise the procedure as being either pain free or low pain; however, it is estimated that 25% of patients report experiencing intense or intolerable pain. For severe pain, local anaesthetic can be administered, but this does not guarantee effective pain management. This research, published in the British Journal of Anaesthesia, found that very few patients feel no pain and a significant number felt pain of greater than 7/10. It also found a disconnect between the patient's experience of pain and the clinician's perception of it. This research paper is paywalled, but can be purchased via the link below.
- Posted
-
- Womens health
- Pain
- (and 4 more)
-
Content ArticleThe Campaign Against Painful Hysteroscopy is a campaign group raising awareness of the safety flaws that exist within the processes surrounding hysteroscopy procedures for women. On 20 October 2020, they wrote to Matt Hancock MP, Secretary of State for Health and Social Care and Nadine Dorries MP, Minister for Patient Safety, Suicide Prevention and Mental Health. In their letter they used both empirical data and the personal stories of women to illustrate the prevalence and seriousness of the issue.
- Posted
- 1 comment
-
2
-
- Womens health
- Obstetrics and gynaecology/ Maternity
- (and 4 more)
-
Content ArticleInvolving patients in decisions about their care is of fundamental importance to effectively managing long-term conditions and improving patient safety. In 2020, AbbVie brought together patient groups, health and social care services, national organisations, policymakers, and parliamentarians to a Showcase at Westminster celebrating exemplar projects that promote shared decision making practices from across the country. The link below contains the posters from the projects showcased on the day, showcasing the creative work taking place across the UK in the shared decision-making space.
- Posted
-
- Decision making
- Consent
-
(and 1 more)
Tagged with:
-
Content Article
Mesh Down Under
PatientSafetyLearning Team posted an article in Women's health
Across the world, people are suffering from life-altering and serious chronic pain conditions caused by surgical mesh complications.Mesh Down Under are a New Zealand based campaign group whose mission is to:raise awareness amongst New Zealanders about the complications that are not rare with the use of surgical mesh. provide information to enable anyone considering having surgical mesh surgery, particularly women having pelvic floor or bladder sling repairs, to be fully informed before consenting to this surgery.shout out to our health professionals and government bodies so that patient stories are no longer 'news to them' but an acknowledged public health issue that needs to be addressed.highlight the importance of reporting adverse events associated with medical devices.Follow the link below to find out more.- Posted
-
- Patient harmed
- Consent
-
(and 1 more)
Tagged with:
-
EventWhether your role is in the NHS or in private healthcare, it is vitally important to take consent for any intervention safely. This webinar brings together clinical and legal perspectives, advising healthcare professionals of all levels how to take consent safely to avoid litigation and improve patient safety. Receive guidance from NHS Consultant, Michael Kelly, who has provided expert witness evidence at Court, combined with input from Andrew Bershadski, a highly experienced Barrister who has proceeded to Trial and won for the medical profession on a number of separate informed consent cases. Ed Glasgow, a Partner specialising in Healthcare Law, will Chair the event, which it is hoped will provide valuable practical insight.
-
News ArticleAn urgent investigation into blanket orders not to resuscitate care home residents has been launched amid fears some elderly people may still be affected by the “unacceptable” practice. After COVID-19 cases rose slightly in care homes in England in the last week, with 116 residences handling at least one infection, the Care Quality Commission (CQC) said it was developing the scope of its investigation “at pace” and it would cover care homes, primary care and hospitals. In March and April, there were reports that some GPs had applied “do not attempt resuscitation” (DNAR) notices to groups of care home residents that meant people would not be taken to hospital for potentially life-saving care. This was being done without their consent or with little information to allow them to make informed decisions, the CQC said. Cases emerged in care homes in Wales and East Sussex. Care homes said the blanket use of the orders did not appear to be as prevalent ahead of a possible second wave of infections and families were reporting fewer concerns, although that could be because visiting restrictions meant they had less access to the homes and were getting less information. There are also concerns that steps may not have been taken to review DNAR forms added to care home residents’ medical files, and so they could remain in place, without proper consent. The CQC review will examine the use of “do not attempt cardiopulmonary resuscitation” (DNACPR) notices, which only restrict chest compressions and shocks to the heart. Dr Rachel Clarke, a palliative care expert in Oxford, has described the CPR process as “muscular, aggressive, traumatic” and said it often resulted in broken ribs and intubation. The review will also investigate the use of broader do not resuscitate and other anticipatory care orders. “We heard from our members about some pretty horrific examples of [blanket notices] early in the pandemic, but it does not appear to be happening now,” said Vic Rayner, the executive director of the National Care Forum, which represents independent care homes. “DNAR notices should not be applied across settings and must be only used as part of individual care plans.” It will also investigate the use of broader do not resuscitate and other anticipatory care orders. Read full story Source: The Guardian, 12 October 2020
-
Content ArticleIn this guest blog for mumsnet, Nadine Montgomery talks about her journey to the Supreme Court to cement patients’ right to make an informed decision. Nadine highlights the lack of information she was given around potential birth risks as a diabetic pregnant women and how, if better informed, she would have made different choices which could have prevented her baby from suffering harm.
- Posted
-
- Obstetrics and gynaecology/ Maternity
- Maternity
- (and 5 more)