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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 -
Content ArticleIn 2021, cybersecurity attacks on healthcare providers in the US reached an all-time high, with one study indicating that more than 45 million people were affected by these attacks in 2021 – a 32% increase on 2020. This report published by the Office of Senator Mark R Warner outlines the risk to patient safety posed by cyberattacks and proposes ways to improve federal leadership, enhance healthcare providers' preparedness for cyber emergencies and establish minimum cyber hygiene practices for healthcare organisations.
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Content ArticleCancer research is a crucial pillar for countries to deliver more affordable, higher quality, and more equitable cancer care. Patients treated in research-active hospitals have better outcomes than patients who are not treated in these settings. However, cancer in Europe is at a crossroads. Cancer was already a leading cause of premature death before the COVID-19 pandemic, and the disastrous effects of the pandemic on early diagnosis and treatment will probably set back cancer outcomes in Europe by almost a decade. Recognising the pivotal importance of research not just to mitigate the pandemic today, but to build better European cancer services and systems for patients tomorrow, the Lancet Oncology European Groundshot Commission on cancer research brings together a wide range of experts, together with detailed new data on cancer research activity across Europe during the past 12 years.
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Content ArticleHow ambulance staff feel about their work has long been a concern, but the results of the latest staff survey show that their job satisfaction has deteriorated further. This blog from the Nuffield Trust takes a closer look at the findings and describes the importance of improving the situation.
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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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Content ArticleThe National Vascular Registry, which measures the quality and outcomes of care for adult patients who undergo major vascular procedures in the NHS, has published its latest annual report. This report provides comparative information on five major emergency and elective vascular interventions between 2019 and 2021: Repair of aortic aneurysms, including elective infra-renal, ruptured infra-renal, and more complex aneurysms Lower limb bypass Lower limb angioplasty/stenting Major lower limb amputation Carotid endarterectomy The report also includes the results from an organisational audit of NHS vascular services in 2022.
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Content ArticleThis interactive tool developed by the Office for National Statistics (ONS) can be used to explore how health changed in each local authority area across England between 2015 and 2020, according to the Health Index.
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Content ArticleEstablished in 2006, the National Neonatal Audit Programme (NNAP) is commissioned by the Healthcare Quality Improvement Partnership (HQIP) and delivered by the Royal College of Paediatrics and Child Health (RCPCH). It assesses whether babies admitted to neonatal units receive consistent high-quality care in relation to the NNAP audit measures that are aligned to a set of professionally agreed guidelines and standards. The NNAP also identifies variation in the provision of neonatal care at local unit, regional network and national levels and supports stakeholders to use audit data to stimulate improvement in care delivery and outcomes. This report summarises the key messages and national recommendations developed by the NNAP Project Board and Methodology and Dataset Group, based on NNAP data relating to babies discharged from neonatal care in England and Wales between January and December 2021.
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Content ArticleThis document describes the development of the The Northumbria Local Health Index, a collaborative project between Northumbria Healthcare Trust and the Office for National Statistics (ONS). The Health Index aims to produce a more holistic measure of health, recognising health as an asset to the nation and communities. It is a composite measure of 56 indicators across three over-arching domains—healthy people which covers health outcomes, healthy lives which includes behavioural risk factors and healthy places which captures social and wider determinants of health. The Northumbria Local Health Index has created a deeper understanding of how health and the drivers of health differ between areas within the local authorities of Northumberland and North Tyneside and provides a data driven framework that could enable effective and collaborative work to tackle health inequalities. It demonstrates the potential for the Health Index to become a ‘small area’ health tool for planning health and healthcare provision.
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Content ArticleAhead of the government's medium-term fiscal plan, the annual Institute for Government/Chartered Institute of Public Finance and Accountancy (CIPFA) public services stocktake reveals that public services won’t have returned to pre-pandemic performance by the next election, which in most cases was already worse than when the Conservatives came to power in 2010. Performance Tracker reviews the state of nine public services – general practice, hospitals, adult social care, children’s social care, neighbourhood services, schools, police, criminal courts and prisons – and their comparative and inter-connected problems.
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Content ArticleThe MBRRACE-UK collaboration, led from Oxford Population Health's National Perinatal Epidemiology Unit (NPEU), has published the results of their latest UK Confidential Enquiry into Maternal Deaths and Morbidity. These annual rigorous reports are recognised as a gold standard in identifying key improvements needed for maternity services. The latest Saving Lives, Improving Mothers' Care analysis examines in detail the care of all women who died during, or up to one year after, pregnancy between 2018 and 2020 in the UK. This is the first report to include data that demonstrates the impact of the COVID-19 pandemic on maternal deaths.
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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 -
Content ArticleEarlier this year, information technology (IT) systems at one of the largest hospital trusts in the NHS stopped working for 10 days. This was the latest in a long history of NHS IT system failures across primary and secondary care. As “paperless” is now the default operating mode for many healthcare systems globally, IT failures block access to records, prevent clinicians from ordering investigations, restrict service provision, and bring to a halt the everyday business of healthcare. 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. There is a growing disconnect between government messaging promoting a digital future for healthcare (including artificial intelligence) and the lived experience of clinical staff coping daily with ongoing IT problems., writes Joe Zhang and Hutan Ashrafia in a BMJ Editorial. Digital capabilities exist in a strict hierarchy, with IT infrastructure as the foundational layer. This digital future will not materialise without closer attention to crumbling IT infrastructure and poor user experiences.
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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 -
Content ArticleCornerstone is a free publication for anyone passionate about evidence-based healthcare, including Quality Improvement (QI), audit and clinical effectiveness professionals, and those who plan, deliver and receive healthcare. It is produced by the Healthcare Quality Improvement Partnership (HQIP), which was established in 2008 to increase the impact of clinical audit on healthcare quality improvement and support improved outcomes for patients.
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Content ArticleAmbulance services in England are under immense pressure. In July 2022, all ambulance services in England declared REAP (Resource Escalation Action Plan) level four, reflecting potential service failure. Volumes of calls to 999 are increasing, patients in distress and pain are waiting longer for help to reach them, and ambulance teams feel unable to do their job well. The new Secretary of State for Health and Social Care has previously named cutting ambulance waits as his number one priority. As he takes up the role for the second time, he will again need to include ambulances in his list of priorities for the health and care system. Steps taken to date to help address the underlying issues have not yet had an impact on the pressures facing ambulance services. This analysis from The Health Foundation looks at ambulance service performance and explores the contributing factors and priorities for improvement.
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Content ArticleMaternal Mortality Review Committees (MMRCs) in the US are multidisciplinary committees that convene at the state or local level to comprehensively review deaths during or within a year of pregnancy. MMRCs have access to clinical and non-clinical information to more fully understand the circumstances surrounding each death, determine whether the death was pregnancy-related, and develop recommendations for action to prevent similar deaths in the future. This article summarises the data from MMRCs in 36 US states between 2017 and 2019, demonstrating variations in prevalence and cause of death according to race, ethnicity and geographical area. The data suggests that over 80% of pregnancy-related deaths examined were determined to be preventable.
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Content ArticleMike Fell, executive director of national cybersecurity operations at NHS Digital,, discusses the WannaCry cyberattack, teaching GP surgeries to up their game and how data can save lives.
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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 -
News Article
‘Contentious’ US tech firm to harvest patient data in NHSE waiting list push
Patient Safety Learning posted a news article in News
NHS England has ordered the collection of identifiable patient data from hospitals by US data firm Palantir, for a pilot scheme aimed at accelerating recovery of elective waiting lists. The regulator has instructed NHS Digital, with which it will merge in January, to use Palantir’s Foundry platform to collect data about patients’ admission, inpatient, discharge and outpatient activity at acute hospitals. Identifiable data such as patients’ NHS numbers, date of birth, and postcode will be collected through Palantir’s software. Patients cannot opt out of having their data collected. But NHS Digital’s Caldicott Guardian – who is meant to safeguard use of data – has identified “risks” in the pilot and said it needs additional work before it can meet confidentiality requirements. The data collected will be “anonymised in accordance with the ICO’s (Information Commissioner’s) Anonymisation Code of Practice”. However, privacy campaigners Medconfidential claimed this code is not fit for purpose and warned that NHS chiefs were making the same mistakes as previous failed efforts to use patient data appropriately. Read full story (paywalled) Source: HSJ, 1 November 2022 -
Content ArticleThis tool developed by the Office for Health Improvement and Disparities aims to provide intelligence about the wider determinants of health to help improve population health and reduce health inequalities. Wider determinants, also known as social determinants, are a diverse range of social, economic and environmental factors which impact on people’s health. They are influenced by the local, national and international distribution of power and resources which shape the conditions of daily life, and they determine the extent to which different individuals have the physical, social and personal resources to identify and achieve goals, meet their needs and deal with changes to their circumstances. The tool is updated on an ongoing basis and provides data on the wider determinants, as well as resources to help organisations take further action to tackle health inequalities.
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Content ArticleThis article by the consultancy firm Carnall Farrar looks at the opportunity the newly established Integrated Care Systems (ICSs) have to improve health outcomes, tackle inequalities, enhance productivity and support broader social and economic development. The relationship between deprivation and health outcomes is well known and evidenced, and by working collaboratively, the NHS, local authorities and Voluntary, Community and Social Enterprise (VCSE) organisations can address the wider determinants of health outcomes, starting with the impact of deprivation.
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Content ArticleThis series of short articles by the Nuffield Trust looks at common criticisms of the NHS, and provides evidence as to why they are untrue. The articles look at the following four interrelated arguments: We already spend too much on our health and despite this our outcomes are poor The NHS is a ‘sacred cow’ and has not been reformed We should copy other countries and adopt a social insurance model There is not enough use of competition and choice
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Content ArticleIn this opinion piece for The BMJ, David Oliver, consultant in geriatrics and acute general medicine, highlights the findings of three recent reports into the growing crisis in social care: Falling short: How far have we come in improving support for unpaid carers in England? (The Nuffield Trust) The state of the adult social care workforce in England 2022 (Skills for Care) The Cost of Caring: Deprivation and Poverty among Residential Care Workers in the UK (The Health Foundation) The reports evidence a lack of support for unpaid carers, growing vacancies in the sector and a high proportion of the residential care workforce living in poverty and food insecurity. David Oliver highlights that in spite of Government promises, there is still no feasible, future-proof plan to protect social care and its staff.
