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Content ArticleThe purpose of the Learn from patient safety events (LFPSE) service (previously known during development as the Patient Safety Incident Management System - PSIMS) is to enable learning from patient safety events – incidents, risks, outcomes of concern and also things that went well. Our ability to protect future patients from harm depends on promoting a culture that welcomes and encourages the recording of events. It is essential to abide by these principles to ensure that we continue to successfully learn from patient safety events and reduce harm. This document sets out the circumstances in which LFPSE data are the appropriate data source to be used and describes their appropriate use. These principles emphasise the purpose and characteristics of LFPSE data, and promote consistency across data users. It is essential that users of LFPSE data understand and represent it appropriately, as inappropriate presentations of LFPSE data could discourage recording.
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Content ArticleIn March 2017 the National Quality Board issued the guidance on the actions all NHS Trusts should undertake to learn from a review of the care provided to patients who die stating it should be integral to a provider’s clinical governance and quality improvement work. Hertfordshire Partnership University Foundation Trust have developed a policy on Learning from Deaths setting out the work to be undertaken to review care provided to service users who die in the Trust's care.
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News ArticleThe United States is now in its fourth-biggest Covid surge, according to official case counts – but experts believe the actual current rate is much higher. America is averaging about 94,000 new cases every day, and hospitalizations have been ticking upward since April, though they remain much lower than previous peaks. But Covid cases could be undercounted by a factor of 30, an early survey of the surge in New York City indicates. “It would appear official case counts are under-estimating the true burden of infection by about 30-fold, which is a huge surprise,” said Denis Nash, an author of the study and a distinguished professor of epidemiology at the City University of New York School of Public Health. While the study focused on New York, these findings may be true throughout the rest of the country, Nash said. In fact, New Yorkers likely have better access to testing than most of the country, which means undercounting could be even worse elsewhere. “It’s very worrisome. To me, it means that our ability to really understand and get ahead of the virus is undermined,” Nash said. Read full story Source: The Guardian, 2 June 2022
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News Article
UK Long Covid cases hit record high of 2 million
Patient Safety Learning posted a news article in News
The number of people suspected to be living with Long Covid has risen to a record high of two million, new figures show. Estimates from the Office for National Statistics (ONS) suggest that, as of 1 May, around 3.1% of the population were suffering from persistent symptoms after becoming infected with coronavirus. This includes 826,000 who have had Long Covid for at least one year – up from 791,000 in April. Some 376,000 people have meanwhile lived with the condition for at least two years, the figures show. The prevalence of Long Covid in the UK has jumped sharply since the end of the Omicron wave, which infected millions of people over winter. Since the beginning of the year, 700,000 people have developed the condition – more than one-third of the overall total. Lingering symptoms adversely affected the day-to-day activities of 1.4 million people, the ONS said, with 398,000 reporting that their ability undertake day-to-day activities had been “limited a lot”. Long Covid was found to be most prevalent in people aged 35 to 69 years, women, people living in more deprived areas, those working in healthcare, social care, or teaching and education, and those with another activity-limiting health condition or disability, the ONS said. Read full story Source: The Independent, 1 June 2022 -
News Article
NHS will not hit virtual wards target, internal data suggests
Patient Safety Learning posted a news article in News
The NHS is on trajectory to fall short of a flagship pledge to have around 24,000 “virtual ward beds” in place by December 2023, internal data has revealed. NHS England’s figures from March, seen by HSJ, suggest the system is instead more likely to have created around 18,500 virtual beds by the 2023 deadline. Senior clinicians, including the Royal College of Physicians and the Society of Acute Medicine, have recently raised concerns about the speed and timing of the roll-out and staffing implications. And now fresh concerns are also being raised about the programme following publication of a new academic study which suggests virtual wards set up by the NHS during Covid made little impact on length of stay or readmissions rates. Alison Leary, professor of healthcare and workforce modelling, London South Bank University, was one of the first senior leaders to publicly voice concerns about the NHS’s virtual wards programme. Professor Leary told HSJ: “I am not surprised [systems are falling] short. Since Elaine [Elaine Maxwell, visiting professor, London South Bank University] and I published our piece in HSJ, I have been contacted by several clinicians who have serious concerns over virtual wards and staffing them.” Read full story (paywalled) Source: HSJ, 31 March 2022 -
Content ArticleAccording to new data released by the NHS, a total of 379 medical malpractices called ‘Never Events’ were recorded between 1 April 2021 and 28 February 2022. The term is defined by the service as “serious, largely preventable patient safety incidents that should not occur if healthcare providers have implemented existing national guidance or safety recommendations.” See below Statista's chart representing the data.
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Content ArticleThis study in Clinical Epidemiology aimed to investigate the long-term complications associated with surgical mesh devices used to treat stress urinary incontinence (SUI) and pelvic organ prolapse (POP). The authors looked at rates of diagnoses of depression, anxiety or self-harm (composite measure) and sexual dysfunction, and rates of prescriptions for antibiotics and opioids in women with and without mesh surgery, with a diagnostic SUI/POP code, registered in the Clinical Practice Research Datalink (CPRD) gold database. The study found that mesh surgery was associated with poor mental and sexual health outcomes, alongside increased opioid and antibiotic use, in women with no history of these outcomes and improved mental health, and lower opioid use, in women with a previous history of these outcomes. The authors highlight the need to carefully consider the risks and benefits of mesh surgery on an individual basis.
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Content ArticleIn this three-year strategy, NHS Resolution outlines its strategic priorities to 2025. The four priority areas in the new strategy are: Deliver fair resolution – focussing our resources to avoid patients and healthcare staff having to go through formal processes that can be distressing and costly Share data and insights to improve services – sharing our unique data and insights to reduce risk and help improve the healthcare system Collaborate to improve maternity outcomes – working with others in the maternity care system to reduce neonatal harm Invest in our people and systems – building up our corporate capacity and capabilities internally to support the health and legal systems. These priorities aim to help the organisation contribute to: a reduction in harm to patients. a reduction in the distress caused to patients and healthcare staff involved when a claim or concern arises. a reduction in the cost required to deliver fair resolution. This will release public funds for other priorities, including healthcare. ensuring indemnity arrangements are a driver for positive change across the healthcare system. NHS Resolution has also produced a video summary of the strategy.
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News Article
Wrong surgery and jabs among hundreds of NHS ‘never events’
Patient Safety Learning posted a news article in News
A woman who had her ovaries removed by mistake was one victim of the hundreds of “never events” that occurred in the NHS over the past year. Between April 2021 and March 2022 more than 400 patients in England’s hospitals suffered errors so serious that they should never have happened according to data released by NHS England. They include the wrong hips, legs, eyes and knees being operated on, and diabetic patients being given too much insulin. Foreign objects were left inside 98 patients after operations, including gauzes, swabs, drill guides, scalpel blades and needles. Vaginal swabs were left in patients 32 times and surgical swabs were left 21 times. Other objects left inside patients included part of a pair of wire cutters, part of a scalpel blade, and the bolt from surgical forceps. On three separate occasions part of a drill bit was left in a patient. “Wrong-site surgery” was carried out on 171 patients and six patients had injections to the wrong eye. The wrong hip implant was put in 12 times, a wrong knee implant was performed 11 times, and patients were connected to air instead of oxygen 13 times. Seven patients were given the wrong type of blood during a transfusion. Some patients were given doses of drugs that were far too high, including the immunosuppressant methotrexate, which is used for severe arthritis, psoriasis and leukaemia. There were 11 overdoses of insulin. Read full story (paywalled) Source: The Times, 19 May 2022 -
News ArticleObese adults in Britain are on course to outnumber those who are a healthy weight within five years, a stark report has revealed. Experts have warned there will be a “tipping point” in 2027 when one third of adults will be obese if current trends continue. By 2040, they predict there will 21 million people classed as obese in the UK, and 19 million deemed to be overweight. The analysis by Cancer Research UK shows seven in 10 (71%) people will be overweight or obese by 2040. Of this, almost four in 10 (36%) adults will be obese. At present, 64% of adults are overweight or obese, with figures rising every year. Being overweight or obese increases the risk of at least 13 different types of cancer and also causes other conditions such as high blood pressure and Type 2 diabetes. The new data comes after former Conservative leader William Hague attacked the government for postponing a ban on “buy one get one free” deals for foods high in fat, salt and sugar for a year because of the cost-of-living crisis. Read full story Source: The Independent, 19 May 2022
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Content ArticleIn this guest blog for the Professional Records Standards Body (PRSB), Taffy Gatawa, Chief Information and Compliance Officer at everyLIFE Technologies, talks about the importance of ensuring that healthcare technologies comply with recognised standards. She discusses everyLIFE's experience on PRSB’s Standards Partnership Scheme, and their journey to implementing standards in their digital products. Taffy describes a process of learning and feedback, achieved through desktop research, clinical reviews and critical engagement with PRSB and customers.
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Content Article‘Digital clinical safety’ refers to avoiding harm to patients and staff that could be caused by technologies manufactured, implemented and used in the health service. In this blog, Dr Kelsey Flott, Deputy Director of Patient Safety at the NHS Transformation Directorate, looks at the importance of digital clinical safety in driving quality improvement. She talks about how the Digital Clinical Strategy is being implemented and the drive to collect better evidence about the effectiveness of improvement technologies.
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News ArticleNew figures leaked to HSJ show the true volume of 12-hour waiters in emergency departments is more than four times higher than official statistics suggest. Internal NHS England figures for February and March show around one in five admissions through ED waited more than 12 hours from arriving until being admitted to a ward – equating to around 158,000 cases. The official stats published by NHSE record a slightly different, and shorter, time period, from ‘decision to admit’ to admission. There were around 39,000 of these cases in the same two months, which equates to 4 per cent of admissions through ED, and 5.4 per cent of total emergency admissions. The Royal College of Emergency Medicine has long called for the official stats to reflect the total time spent from arrival in ED (as per the internal data), and for trusts to be measured and regulated on this. Senior medics have for some time been warning about the patient safety risks of long waiting in EDs and have appealed to NHS England and the government for plans to tackle the crisis. Adrian Boyle, vice president of RCEM, said: “This data show the scale of long waiting times in emergency departments and the scale of the patient safety crisis. Performance continues to deteriorate across multiple metrics meaning we are documenting a failing urgent and emergency care system without any system transformation or improvement." Read full story (paywalled) Source: HSJ, 13 May 2022
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Content ArticleThe recent NHS staff survey showed worrying results across all staff groups, but it was midwives who reported the sharpest decline in how satisfied they are in their work. Lucina Rolewicz takes a closer look at their responses to the survey, and emphasises the importance of improving the situation.
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Content ArticleIn 2010, the US Department of Health and Human Services Office of Inspector General (OIG) reported the first national incidence rate of patient harm events in hospitals—27% of hospitalised Medicare patients experienced harm in October 2008. During that month, hospital care associated with these events cost Medicare and patients an estimated $324 million in reimbursement, coinsurance, and deductible payments. Nearly half of these events were preventable. OIG conducted a new study to update the national incidence rate of patient harm events among hospitalised Medicare patients in October 2018. This work included calculating a new rate of preventable events and updating the cost of patient harm to the Medicare programme.
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News Article
Hundreds of organisations breached patient data rules, reveals BMJ
Patient Safety Learning posted a news article in News
Hundreds of organisations, including drug companies, private healthcare providers and universities, have breached patient data sharing agreements but not had their access to patient data withdrawn, a report reveals. “High risk” breaches were revealed to have occurred at healthcare groups, pharmaceutical giants and educational institutions including Virgin Care, GlaxoSmithKline (GSK) and Imperial College London, during audits by NHS Digital, according to an investigation by the BMJ. This means these organisations were handling information outside the remit agreed in data contracts and may be failing to protect confidentiality, the journal said. In one instance, local NHS commissioners allowed sensitive, identifiable patient data to be released to Virgin Care without permission from NHS Digital. When auditors tried to get access to Virgin Care to check their compliance, they were denied access for several weeks and the company refused to delete the patient data, the BMJ reported. Records about mental health, including children and young people, those with learning disabilities, diagnostic imaging and other confidential patient data was being processed outside the scope of objectives agreed with NHS Digital, at an address that had not been agreed, and without a data sharing contract. A spokesperson for Virgin Care said it had “robust data protection in place”. “It is outrageous that private companies and university research teams are failing to comply,” said Kingsley Manning, the former chair of NHS Digital. “How is it that these organisations can be so lax with data?” Read full story Source: The Guardian, 11 May 2022 -
Content ArticleHealth policy-making and reform require, first and foremost, a sound understanding of how a health system is performing. To assist countries in this process, the Health Systems Performance Assessment Framework for Universal Health Coverage offers a comprehensive attempt at guiding the collection and analysis of health system data in relation to policy goals and 21st century challenges. This book is grounded in the premise that any whole-of-sector assessment exercise should collect information on and examine the performance of both the functions of the health system as well as its performance goals. Thus, it follows through each of the health system functions (i.e., health system governance, financing, resource generation and service delivery), outlining their purpose, the sub-functions needed to fulfil that purpose, and assessment areas to evaluate how well a function performs. This innovative framework conceptually links health system functions to intermediate and final health system goals. As a result, policy-makers will be better able to determine and analyse possible origins or impact of poor performance on a particular health system outcome.
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Content Article
Menopause and the workplace: Fawcett Society 2022
Patient Safety Learning posted an article in Women's health
Workplaces are failing menopausal women and change is urgently needed. A report from the Fawcett Society 'Menopause and the Workplace'' delves into women’s experiences at work and is the largest representative survey of menopausal women conducted in the UK. -
Content ArticleMaternity services shouldn’t be waiting for whistle-blowers or inquiries to alert them to problems, says Dr Mark Ratnarajah, a practising paediatrician and managing director of C2-Ai. Instead systematic transdisciplinary reviews and real-time data should support a culture of shared learning, that helps ensure patient safety is everybody’s responsibility.
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Content Article
Patient Safety Authority Annual Report 2021
Sam posted an article in International patient safety
The Patient Safety Authority (PSA) share its 2021 annual report, highlighting the agency’s expansion of education and reporting efforts to improve patient safety throughout the commonwealth. PSA is an independent state agency that collects reports of patient safety events from Pennsylvania healthcare facilities. Pennsylvania is the only state that requires acute care facilities to report all incidents of harm (serious events) or potential for harm (incidents). -
News Article
Trusts failing on waiting list ask told to ‘get act together’
Patient Safety Learning posted a news article in News
Trusts have been told to ‘get their act together’ on health inequalities, after HSJ research suggested only a small minority have so far published data on disparities in waiting times between different patient groups. Planning guidance issued by NHS England in September 2021 said trusts’ board performance reports should include a disaggregation of waiting lists by ethnicity and deprivation group. Through freedom of information and media requests, HSJ attempted to obtain such data from the 20 trusts with the largest waiting lists, but only three currently appear to have met the requirement in full. The remainder either said they were still undertaking the work, were thinking about how to publish it, or failed to respond. Roger Kline, an academic researcher and former director of NHSE’s workforce race equality standard, said trusts should have been collecting and publishing the data for years. He said: “We know there are issues around health and healthcare of some groups of people, most notably in poor working class communities and black and minority ethnic communities. It shouldn’t be seen as an optional extra, this should be part of good public health work and good equitable healthcare provision." “This data should be on the trust website. It should be an active part of the conversations with local communities. Well done to the trusts that are pushing this forward. The ones that are not need to get their act together.” Read full story (paywalled) Source: HSJ, 3 May 2022 -
News ArticleThe number of notified “extreme” and “major” incidents involving serious harm to patients and others in hospital has risen significantly in the Republic of Ireland in recent years, new figures reveal. Reported “extreme” incidents, which can involve death or permanent incapacity, rose from 373 in 2017 to 579 last year. The number of cases classified as “major”, where there is long-term disability or incapacity, climbed from 46 to 82 in the same period. “Moderate” incidents, when there is a patient injury involving medical treatment, also increased from 9,219 in 2017 to 13,563 last year. Minor incidents, involving injury or illness needing first aid, also increased over the same time from 9,210 to 15,483. The figures, involving patients, staff, visitors, contractors and the public, were released by the HSE in response to a parliamentary question from Aontú leader Peadar Tóibín. A spokewoman for the HSE said: “It is HSE policy that all incidents are identified, reported and reviewed so that learning from events can be shared to improve the quality and safety of services.” “The number of reported incidents has increased year on year since 2004 with a significant increase noted since 2015, with the introduction of the National Incident Management System.” Read full story Source: Independent.ie, 3 May 2022
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News Article
Lack of Covid testing leaves researchers blind to evolution patterns, WHO warns
Patient Safety Learning posted a news article in News
A dramatic drop in testing for Covid-19 has left the world blind to the virus’s continuing rampage and its potentially dangerous mutations, the head of the World Health Organization has warned. The UN health agency said that reported Covid cases and deaths had been dropping dramatically. “Last week, just over 15,000 deaths were reported to WHO – the lowest weekly total since March 2020,” WHO chief Tedros Adhanom Ghebreyesus told reporters. While saying this was “a very welcome trend”, he warned that the declining numbers could also be a result of significant cuts in testing for the virus. “As many countries reduce testing, WHO is receiving less and less information about transmission and sequencing,” he said. “This makes us increasingly blind to patterns of transmission and evolution." “When it comes to a deadly virus, ignorance is not bliss.” William Rodriguez, who heads the global diagnostics alliance FIND, also decried that many governments in recent months simply stopped looking for Covid cases. Speaking at the press conference hosted by WHO, he pointed out that in the past four months, amid surging Covid cases from the Omicron variant, “testing rates have plummeted by 70% to 90% worldwide”. The plunging testing rates came despite the fact that there is now more access to accurate testing than ever before. “We have an unprecedented ability to know what is happening,” Rodriguez said. “And yet today, because testing has been the first casualty of a global decision to let down our guard, we’re becoming blind to what is happening with this virus.” Read full story Source: The Guardian, 26 April 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.
