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Content ArticleEurocontrol’s HindSight magazine is a magazine on human and organisational factors in operations, in air traffic management and beyond. This issue has articles from front-line staff and specialists in safety, human factors, and human and organisational performance, in aviation and elsewhere. The articles cover all aspects of everyday work, including routine work, unwanted events, and excellence. The authors discuss a variety of ways to learn from everyday work, including observation, discussion, surveys, reflection, and data analysis. There are articles on specific topics to help learn from others’ experience, including from other sectors in ‘views from elsewhere’
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Content ArticleResearchers writing in the Journal of the Royal Society of Medicine say that while UK life expectancy has increased in absolute terms over recent decades, other, similar countries are experiencing larger increases. In 1952, when Queen Elizabeth II came to the throne, the UK had one of the longest life expectancies in the world, ranking seventh globally behind countries such as Norway, Sweden and Denmark. In 2021 the UK was ranked 29th. The researchers show the rankings of the G7 countries at each decade from 1950 to 2020. The G7 is a collection of countries with advanced economies (UK, Canada, France, Germany, Italy, Japan and the U.S.) that represent about half of global economic output.
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Content ArticleConcerns about Covid-19 related mental health are substantial, but the sheer volume of low quality evidence has posed a barrier to evidence synthesis and decision making. In this systematic review, Thombs et al. synthesised results of mental health outcomes in cohorts before and during the Covid-19 pandemic. The authors compared general mental health, anxiety symptoms, and depression symptoms in the general population and other groups during covid-19 with outcomes from the same cohorts before Covid-19. The study found high risk of bias in many studies and substantial heterogeneity suggest caution in interpreting results. Nonetheless, most symptom change estimates for general mental health, anxiety symptoms, and depression symptoms were close to zero and not statistically significant, and significant changes were of minimal to small magnitudes. Small negative changes occurred for women or female participants in all domains. The authors will update the results of this systematic review as more evidence accrues.
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Content ArticleEmergency care services in the UK face an unparalleled crisis, with more patients than ever before experiencing extremely long waiting times in Emergency Departments (EDs), associated with patient harm and excess deaths. This explainer from the Royal College of Emergency Medicine (RCEM) outlines the latest data on ED waiting times and the impact this is having on patient safety.
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Content Article
Top picks: Women's health inequity
Patient_Safety_Learning posted an article in Patient Safety Learning's Top Picks
Today (8 March 2023) is International Women’s Day and this year’s theme is #embraceequity. Sex and gender-based inequities in health are widely recognised, with much work needed to improve care, treatment and outcomes for women. In this blog, we’ve selected seven resources to highlight and evidence some of the key patient safety issues and the need for greater investment in this area. -
Content Article
In this opinion piece, Kath Sansom, founder of Sling the Mesh, looks at why an audit of pelvic mesh outcomes due to be published in April 2023 has again failed to capture the true extent of the harm caused by the procedure. She outlines why the approach taken by the Government and NHS Digital was flawed and why it is so important to understand both the proportion of women who have experienced harm as a result of the procedure, and the nature of their injuries and side effects.- Posted
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Content ArticleThe new NHS recovery plan accepts that data on long delays in emergency departments must be published monthly to help improve patient care and hold systems to account, writes Katherine Henderson in this BMJ opinion piece.
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Content Article
Every day in 2020, approximately 800 women died from preventable causes related to pregnancy and childbirth - meaning that a woman dies around every two minutes. Sustainable Development Goal (SDG) target 3.1 is to reduce maternal mortality to less than 70 maternal deaths per 100 000 live births by 2030. This report presents internationally comparable global, regional and country-level estimates and trends for maternal mortality between 2000 and 2020. -
Content Article
WHO: Introducing the Patient Safety Friendly Hospital Initiative
Patient Safety Learning posted an article in WHO
The Patient Safety Friendly Hospital Initiative (PSFHI) aims to address the burden of unsafe care in the Eastern Mediterranean Region. It helps institutions in countries of the Region to launch comprehensive patient safety programmes, with assistance from the World Health Organization (WHO). -
Content ArticleThis report was produced by NHS Digital to investigate activity in the NHS in England surrounding patients who have had a procedure for the treatment of urogynaecological prolapse or stress urinary incontinence, including those where mesh, tape or their equivalents have been used. The report uses Hospital Episode Statistics (HES) data and was undertaken to help the NHS and others establish a clearer national picture of patients who have had these procedures. NHS Digital notes that these statistics are classified as experimental and should be used with caution. Experimental statistics are new official statistics undergoing evaluation.
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Content ArticleThe Association of Anaesthetists established a working group to help anaesthetics trainees with safe sleeping patterns. In this blog, Dr Emma Plunkett, consultant anaesthetist and chair of the working group, talks more about new initiatives to fight fatigue and why it’s important to monitor the impact of tiredness in the national training surveys.
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News Article
Former NHSE chief: ‘Most hospital discharge data is useless’
Patient Safety Learning posted a news article in News
A former chief executive of the NHS has said most data collected about hospital discharges by NHS England is ‘useless’ and biased against social care. Sir David Nicholson, who was chief executive of the NHS from 2006 to 2013, and of NHS England until 2014, has said “almost all” of the data around delayed discharges “is designed to show how bad social care is”. Sir David, who is now chair of Worcestershire Acute Hospitals Trust and Sandwell and West Birmingham Trust, added that data on the number of patients with the “right to reside” in hospital is “wholly useless” when trying to improve discharge rates. NHSE publishes figures on the numbers of patients who “no longer meet the criteria to reside” in hospital – and during the winter months will publish this every week. NHSE has said the data collected on discharges helps to improve patient care and flow. In an interview with HSJ editor, Sir David said: “The problem we have with a lot of the data we collect [is that] it is designed for accountability reasons, not operational reasons. “And if you want a good example of that, have a look at the debate around discharge at the moment. There is a myriad of data, almost all of it is useless […] and almost all of it is designed to show how bad social care is. It’s extraordinary". Read full story (paywalled) Source: HSJ, 30 November 2022 -
News Article
‘Patient safety progress stopped in its tracks by covid’ says Hunt report
Patient Safety Learning posted a news article in News
A report commissioned by Jeremy Hunt before he became Chancellor has highlighted how the pandemic ’stopped progress on patient safety in its tracks’ and called for more accurate data to be published on a range of measures. The National State of Patient Safety was funded by Mr Hunt’s Patient Safety Watch charity and produced by Imperial College London’s Institute of Global Health Innovation. It highlights a rise in rates of MRSA and C. difficile since the onset of the pandemic in 2020, as well as an increase in deaths due to venous thromboembolism and hip fractures. The report said the pandemic had also exacerbated issues associated with staff wellbeing, claiming there had been “notable rises” in staff burnout and ill-health. The researchers described problems with the breadth and accuracy of available patient safety data and highlighted that only 44% of trusts currently fulfilled the obligation to report their own estimated number of avoidable deaths. Although the report added that “data on rates of avoidable deaths are not a panacea”, it described them as a “snapshot of safety and harm and are most usefully used to initiate further work to understand the causes of unwarranted variation”. Read full story (paywalled) Source: HSJ, 27 November 2022 -
News ArticleGreg Price died of complications after testicular cancer surgery, but a review of his case found missed faxes, follow-ups and botched data-sharing ultimately cost the vibrant 31-year-old Alberta man his life. All the missteps in his case meant it took 407 days from his first complaint for Price — an engineer, pilot, and athlete — to be diagnosed with cancer. He died three months after his doctor said he should see a specialist, and while he was being passed between multiple doctors, his health data often was not. Now, his sister, Teri Price, says too little has changed in medical information-sharing in the decade since her brother's death. This, despite a review of his case — the 2013 Alberta Continuity of Patient Care Study — that recommended life-saving changes to the healthcare system to avoid more experiences like his. So, she's fighting to improve the system that she says not only failed her brother, but keeps failing to change. Price says that Canadians assume that their health information is shared between doctors to keep them safe and studied to improve the system, but often, it's not. And medical front-line staff in Canada say problems persist when it comes to sharing everything from patient information to aggregate medical and staffing data. "Information tends to be broken up between the services that patients attend," said Ewan Affleck, a doctor in the Northwest Territories who has spent his career fighting for better data access, and a member of the expert advisory arm of the Pan-Canadian Health Data Strategy Group. "The cohesion and use of health data in Canada is legislated to fail." Read full story Source: CBC News, 17 November 2022
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News Article
Ambulance waits quadruple in handover hotspots
Patient Safety Learning posted a news article in News
Ambulance waiting times for stroke and suspected heart attacks have quadrupled in four parts of England since before Covid-19 – whereas others have only grown by half – underlining the severe impact of long accident and emergency handovers. Response times have leapt across England over the past two years, particularly for category 2 and 3 incidents, but the data makes clear that the steepest increases are in areas where hospitals have the biggest handover delay problems. Of the 10 patches with the largest increases in average category 2 performance between 2018-19 and 2021-22, four are served by major hospitals which make up NHS England’s “cohort one” of trusts selected for the worst handover problems; and four more are on government’s list of 15 which accounted for the most long handover delays last winter. The increase in handover delays – in turn linked to delayed discharge, staffing, lack of community services and social care’s collapse – are the stand-out reason for areas with a steep rise in response times. Read full story (paywalled) Source: HSJ, 18 November 2022 -
News Article
ICSs may be breaching patient confidentiality, watchdog warns
Patient Safety Learning posted a news article in News
The health service’s independent data watchdog has issued a warning to local NHS bodies over concerns confidential patient information is being shared unlawfully with third parties, including for ‘population health’ analysis. In a letter to integrated care systems (ICSs), National Data Guardian Nicola Byrne and UK Caldicott Guardian Council chair Arjun Dhillon said they had both “been made aware that within some local record sharing programmes, organisations could be processing confidential patient information without ensuring that the processing does not breach confidentiality”. They added among the four areas of concern health and care staff had raised with them was that confidential patient information may be being transferred from local record sharing programmes to third party hosted secure data environments. Secure Data Environments are data storage and access platforms where organisations can apply to access data for planning and research purposes. It is not clear what kind of patient data may have been unlawfully shared. Read full story (paywalled) Source: HSJ, 17 November 2022 -
News ArticleVoices offer lots of information. Turns out, they can even help diagnose an illness — and researchers in the USA are working on an app for that. The National Institutes of Health is funding a massive research project to collect voice data and develop an AI that could diagnose people based on their speech. Everything from your vocal cord vibrations to breathing patterns when you speak offers potential information about your health, says laryngologist Dr. Yael Bensoussan, the director of the University of South Florida's Health Voice Center and a leader on the study. "We asked experts: Well, if you close your eyes when a patient comes in, just by listening to their voice, can you have an idea of the diagnosis they have?" Bensoussan says. "And that's where we got all our information." Someone who speaks low and slowly might have Parkinson's disease. Slurring is a sign of a stroke. Scientists could even diagnose depression or cancer. The team will start by collecting the voices of people with conditions in five areas: neurological disorders, voice disorders, mood disorders, respiratory disorders and pediatric disorders like autism and speech delays. This isn't the first time researchers have used AI to study human voices, but it's the first time data will be collected on this level — the project is a collaboration between USF, Cornell and 10 other institutions. The ultimate goal is an app that could help bridge access to rural or underserved communities, by helping general practitioners refer patients to specialists. Long term, iPhones or Alexa could detect changes in your voice, such as a cough, and advise you to seek medical attention. Read full story Source: NPR, 10 October 2022
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News Article
Doctors warn failing NHS IT systems ‘undermining’ patient safety
Patient Safety Learning posted a news article in News
“Failing” IT systems in the NHS are a threat to patient safety. medics have warned. Doctors and nurses should not “tolerate problems with IT infrastructure as the norm”, according to a new editorial, published in The BMJ. Experts from Imperial College London and University College London point to an incident in which IT systems at Guy’s and St Thomas’ NHS Foundation Trust – one of the largest hospital trusts in the country – went down for 10 days. The outage, caused by the July heatwave, led to procedures and appointments being postponed for a number of patients. The new editorial highlights how IT failures can restrict services as doctors are unable to access records and are prevented from ordering diagnostic tests. This can “bring a halt to the everyday business of healthcare”, they said. The authors suggest that the NHS IT infrastructure is “crumbling” and leads to “poor user experiences” as well as patient safety incidents. “Increasing digital transformation means such failures are no longer mere inconvenience but fundamentally affect our ability to deliver safe and effective care – they result in patient harm and increased costs,” they wrote. Read full story Source: 10 November 2022 -
News Article
NHS waiting times for routine hospital treatment hits another new record high
Patient Safety Learning posted a news article in News
The number of people in England waiting to start routine hospital treatment has risen to a record high. 7.1 million people were waiting to start treatment at the end of September, according to new figures from NHS England. This is up from 7 million in August, and is the highest number since records begain in August 2007. A staggering 401,537 people have been waiting for more than 52 weeks to start their treatment, according to England’s September figures. NHS medical director Sir Stephen Powis said: “There is no doubt October has been a challenging month for staff who are now facing a tripledemic of Covid, flu and record pressure on emergency services with more people attending A&E or requiring the most urgent ambulance callout than any other October. “Pressure on emergency services remains high as a result of more than 13,000 beds taken up each day by people who no longer need to be in hospital. “But staff have kept their foot on the accelerator to get the backlog down with 18-month waiters down by three-fifths on last year.” Read full story Source: The Independent, 10 November 2022 -
News Article
1.5m fewer people on waiting list than thought
Patient Safety Learning posted a news article in News
NHS England has revealed it estimates there are 5.5 million people on elective referral to treatment waiting lists, rather than the 7 million which is often reported. No figures have previously been given for the number of separate individuals, but many in politics, policy and the media have often indicated it is the same as the total number of entries on the RTT list – which hit 7 million in August. NHSE elective recovery chief Sir Jim Mackey, speaking at the King’s Fund annual conference in London yesterday, revealed an estimate for the first time of the number of individuals. Sir Jim said: “It’s actually 5.5 million people, but seven million entries on the waiting list. There are around a million and a half people, we think, who are on multiple times. So, it’s a lot more complicated than we all think.” He said it was not clear how many were patients waiting for genuinely separate issues or procedures, and how many were duplicates for the same pathway – essentially errors. Sir Jim said he hoped a new NHSE project would clarify the picture. He said: “Sometimes there are people on twice, where they need one thing then another thing. Other times it’s a bit more complicated… We’re just about to start a process with a handful of organisations to try and work out what that means.” Read full story (paywalled) Source: HSJ, 2 November 2022 -
Content ArticleMuch research has been done into the causes, extent and impact of health inequalities that affect rural and coastal populations. Health services in these areas currently face serious challenges due to a combination of factors, including social deprivation, ageing populations and workforce staffing issues. In this blog, Patrick Mitchell, Director of Innovation, Digital and Transformation at Health Education England (HEE), describes a new HEE programme that aims to help tackle health inequalities in rural and coastal areas.
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Content ArticleThis paper ranks the performance of the UK health care system with that of 18 similar, wealthy countries since 2000 or the earliest year for which data is available. It covers the level of health spending, overall life expectancy, the health care outcomes of the major diseases and the outcomes for treatable mortality and childbirth.
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Content ArticleNew data from the Office for National Statistics demonstrates that people with severe and potentially terminal health conditions are more than twice as likely to take their own lives than the general population. This press release by the Campaign for Dignity in Dying highlights the patient safety issues caused by current laws around assisted dying in the UK, including patients dying alone by suicide, without loved ones to support them.
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Content ArticleThis study in the British Journal of General Practice aimed to examine trends in prescribing for anxiety in UK primary care between 2003 and 2018. Anxiolytic drugs are a group of medications used to relieve anxiety. The authors analysed data from 2.5 million adults to determine prevalence, incidence rates and treatment duration for prescriptions of any anxiolytic, and also for each drug class. The authors found that, between 2003 and 2018: prevalence of any anxiolytic prescription increased, driven by increases in those starting treatment, rather than more long-term use. incident beta-blocker prescribing increased over the 16 years, whereas incident benzodiazepine prescriptions decreased. long-term prescribing of benzodiazepines declined, yet 44% of prescriptions in 2017 were longer than the recommended four weeks. incident prescriptions in each drug class have risen substantially in young adults in recent years. They conclude that increases in incident prescribing may reflect better detection of anxiety or increasing acceptability of medication. However, they also caution that prescribing approaches may cause unintended harm, as some prescribing is not based on robust evidence of effectiveness and may contradict guidelines. They highlight that there is limited evidence on the overall impact of taking antidepressants long term.
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Content ArticleThis is the report of Professor Ben Goldacre’s review into how the efficient and safe use of health data for research and analysis can benefit patients and the healthcare sector. It sets out a practical vision of how the Department of Health and the NHS can curate, manage and analyse the huge volume of health data available in the UK, and then communicate and use that data to improve the quality, safety and efficiency of health services.
