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Content ArticleOn the 23 January 2023 the Minister for Mental Health and Women’s Health Strategy, Maria Caulfield MP, announced the commencement of a rapid review into patient safety in mental health inpatient settings in England. The review Chair, Dr Geraldine Strathdee, was asked to consider how improvements could be made to the way that data and information is used in relation to patient safety in mental health inpatient care settings and pathways, including for people with a learning disability and autistic people. This report contains the findings of this review and an associated set of recommendations.
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Content Article
Adverse incidents arising from suboptimal healthcare are a major cause of worldwide morbidity and mortality. Arriving at an understanding of the conditions under which adverse incidents occur has the potential to improve the safety of healthcare provision. Staff working in the NHS have been contributing their experiences via a narrative data capture platform – SenseMaker – to help gain contextual insights on a wide range of topics under exploration by the NHS Horizons team. This blog by Rosanna Hunt (Senior Associate, NHS Horizons) in collaboration with Lizzy MacNamara (Junior Research Consultant, The Cynefin Co.) and Taj Nathan (Consultant Forensic Psychiatrist, Cheshire & the Wirral Partnership Foundation Trust) describes how the SenseMaker® platform could be used to extract staff experiences on the topic of patient safety incidents both reported and unreported by staff, and the facilitated conversations that would be needed to transform the data into actionable insights and commitment to change. -
Content ArticleThis report examines the reporting of patient deaths at the Norfolk and Suffolk Foundation NHS Trust (NSFT) between April 2019 and October 2022. It was undertaken by Grant Thornton on behalf of the NHS Suffolk and North East Essex and NHS Norfolk and Waveney integrated care boards at NSFT’s request.
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Content ArticleThis study in the Journal of Patient Safety outlines the development of the Leapfrog composite patient safety score. The researchers aimed to develop a composite patient safety score that provides patients, healthcare providers and healthcare purchasers with a standardised method to evaluate patient safety in general acute care hospitals in the United States. The study concluded that the composite score reflects the best available evidence regarding a hospital’s efforts and outcomes in patient safety.
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Content ArticleOver the two decades before the pandemic, the number of NHS patients admitted to hospital increased year-on-year, despite a reduction in the number of hospital beds. Since the Covid-19 pandemic, fewer patients have been admitted to NHS hospitals and length of stay has risen, raising questions about NHS productivity, quality of care and the prospects of meeting ambitions to recover services. This report by the Health Foundation analyses data around hospital admissions and suggests reasons for these trends.
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Content ArticleThe King's Fund compared the healthcare systems in different countries by doing three things: Reviewed the research literature and assessed previous attempts to rank and compare health care systems. Interviewed academic experts in international health care policy and experts who had extensive knowledge of the UK, German and Singaporean healthcare systems. Analysed the latest quantitative performance data for the UK health care system and the health systems of 18 higher-income peer countries. They analysed data in three main domains: the context the health system operates in (eg, the health status and behaviours of the population) the resources a health system has (eg, levels of staffing, equipment and health care spending) how well the health care systems uses its resources and what it achieves as a result (eg, measures of efficiency in delivering services, quality of care, financial protection from the costs of ill health, and health care outcomes).
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Content ArticleDevices and internet connectivity are essential for effective digital services but so are good design, co-development and trust. The use and beneficial impact of digital technologies and data is much more likely if technology is useable and trusted, while also meeting the needs and expectations of staff and patients. This King's Fund 3-minute read looks at human factors of digital healthcare.
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Content ArticleThe NHS in England’s annual budget is £161 billion. Yet across the sector there is huge cause for concern, including the still-growing backlog, workforce issues, the state of the estate and the relentless demand on primary care. In this blog, ex-NHS strategic health authority chief executive Mike Farrar and Health Policy Insight editor Andy Cowper look at how these issues can be tackled to provide an NHS that meets the needs of the population. They cover the following subjects: Politics, policy and prevention System working and pivoting to prevention - how to shift resources Building a compelling case for change Moving towards less top-down-ism Being clear about what an ICS is for Culture change and mindsets shifts Resourcing change
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Content ArticleThe government has published its mandate to NHS England. This mandate is intended to apply from 15 June 2023 until a new mandate is published. NHS England has a duty to seek to achieve the objectives in the mandate. The Secretary of State keeps progress against the mandate under review, setting out his views in an annual assessment which is laid in Parliament and published. The government will agree with NHS England how it should report on overall progress against the mandate to support the Secretary of State in keeping this under review. This will include reporting at agreed intervals on other delivery expectations listed beneath the objectives.
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Content ArticleAchieving an evidence-based practice not only depends on implementation of evidence-based interventions, but also requires de-implementing interventions that are not evidence-based, also known as low-value care (LVC). This is quite a new topic and knowledge is lacking concerning how de-implementation and implementation processes and determinants might differ. This scoping review identified 10 studies describing theoretical approaches that have been used concerning de-implementation of LVC. The findings point to the need for more research to identify the most important processes and determinants for successful de-implementation of LVC, and to explore differences between de-implementation and implementation.
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Content Article
Health Inequality Data Repository (WHO)
Patient_Safety_Learning posted an article in Health inequalities
Launched in April 2023 by WHO, the Health Inequality Data Repository contains datasets of disaggregated data covering diverse topics and dimensions of inequality, from a variety of publicly available data sources. It aims to make disaggregated data more accessible and navigable to diverse global audiences. -
Content Article
The National Institute for Health and Care Research (NIHR) Evidence Collections draw together evidence from important NIHR-funded and wider research. They aim to help people in policy and practice understand recent important research in a topic area. The most recent Collection is Maternity services: evidence for improvement. In this blog, one of the Collection's authors, Candace Imison, describes how it was framed by the findings from a recent investigation into failings in East Kent Hospitals’ maternity services. She focuses on some key messages from evidence on how to identify poor performance and provide effective board governance and oversight. -
Content ArticleIn January 2023, the Health and Social Care Select Committee opened an inquiry into Prevention. An interdisciplinary group of six academics, clinicians, and a coroner from the University of Oxford, the University of Birmingham, and London made a submission to that inquiry. They made their submission to the Prevention inquiry after reading and analysing more than 4,000 PFDs and working with coroners and bereaved families, which has highlighted that more must be done in health and social care to learn lessons from preventable deaths. Their full submission has now been published which included a table summarising 12 of their research studies relating to preventable deaths and providing recommendations. We have extracted the table which highlights several patient safety concerns and system safety recommendations.
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Content Article
Patient survey: Halfloop medical device app
Patient Safety Learning posted an article in Apps for health and care
Halfloop are a team of senior doctors and developers building a digital platform where patients can store information securely about their medical implants and share their progress and outcomes securely with their clinical team. They would like to hear your views by asking you to complete their short survey. -
Content Article
This is part of our series of Patient Safety Spotlight interviews, where we talk to people working for patient safety about their role and what motivates them. Maureen discusses the important role of professional standards in building a patient safety infrastructure, the need to reframe safety as a positive idea and her experience of implementing learning processes during her time as a GP. -
Content Article
NHS Impact resources
Patient Safety Learning posted an article in NHS England
NHS Impact ‘improving patient care together’ is the term NHS England is using for the new single, shared NHS improvement approach. This includes the five components which form the ‘DNA’ of all evidence-based improvement methods, which underpin a systematic approach to continuous improvement: Building a shared purpose and vision. Investing in people and culture. Developing leadership behaviours. Building improvement capability and capacity. Embedding improvement into management systems and processes. When these 5 components are consistently used, systems and organisations create the right conditions for continuous improvement and high performance, responding to today’s challenges, and delivering better care for patients and better outcomes for communities. -
Content ArticleIn 2002, a dedicated group from Pennsylvania passed the Medical Care Availability and Reduction of Error (MCARE) Act, the most robust state-level legislation of its kind. Its legacy remains 21 years later. In this interview with the journal Patient Safety, Pennsylvania's Patient Safety Authority chair, Dr Nirmal Joshi, discusses ways care has improved, what challenges persist, and how to achieve the unachievable—true culture change.
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Content ArticleAll countries of the WHO European Region currently face severe challenges related to the health and care workforce (HCWF). This report focuses on identifying effective policy and planning responses to these HCWF challenges across the Region. The report presents an overview of the HCWF situation in the Region (focusing on medical doctors, nurses, midwives, dentists, pharmacists and physiotherapists, for whom data are available) and identifies relevant policy options, their expected benefits and potential facilitators or barriers to successful implementation. Examples of sound evidence-informed practices in countries are also provided. The aim of the report is to describe the data, rather than to analyse. Data supplied by countries have been used, but in many cases these have been incomplete. It is expected that data will grow progressively in future. No data on informal health workers are included.
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Content ArticleIn England and Wales, coroners are required to write Prevention of Future Deaths reports when a death is deemed preventable so that action is taken to avert similar deaths. Since July 2013, Prevention of Future Deaths reports have been openly available via the Courts and Tribunals Judiciary website (https://www.judiciary.uk/prevention-of-future-death-reports/). However, their presentation to date have been insufficient to identify trends and learn lessons. The authors of this paper designed a web scraper to create the Preventable Deaths Tracker. On 22 June 2022, 4001 PFDs were scraped, analysed, and compared to the Office of National Statistics’ preventable mortality statistics. This commentary, published in Medico-Legal Journal, summarises the key findings and offers recommendations to improve the Prevention of Future Deaths system so lessons can be learnt to avert preventable deaths.
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Content ArticleThis white paper from CEMBooks aims to unpick some of the deeper issues surrounding bed block and emergency department crowding from the perspective of a frontline medic with two decades of emergency and flow management experience. It aims to provide a greater understanding of the factors influencing the current situation and the measures used to define it followed by some practical implementable solutions.
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Content ArticleFor decades the NHS has collected routine data on millions of patients. In a world where big data has increasing value, the UK has an opportunity to truly leverage its health data assets to benefit people in the UK and across the world—both through better health and through the generation of more research and development and economic growth. This report by the Institute of Global Health Innovation at Imperial College London provides a broad overview of the UK’s health data policy landscape. It identifies strategic and technical recommendations to move towards a health data policy ecosystem that allows clinical, societal or financial value to be more readily extracted from patient data.
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Content Article
In this blog, Patient Safety Learning considers key patient safety issues relating to complications from surgical mesh implants, highlighting further sources of opinion and research on the hub. -
Content ArticleTargets have been applied to a wide range of public services over the past 40 years. This report analyses whether targets improve the performance of public services and the reasons for this, making recommendations on when and how government should set targets. It focuses on national targets and examines what evidence there is for how they have affected how efficiently public money is turned into outcomes for the public.
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News Article
Soaring trolley waits spark warnings A&E pressures getting ‘worse and worse’
Patient Safety Learning posted a news article in News
The number of 12-hour waits in accident and emergency departments rose by 27% in one month to reach record levels in January amid warnings overcrowding is harming an increasing number of patients. Official monthly performance data prompted the Royal College of Emergency Medicine’s president to warn that the problems facing emergency departments were getting “worse and worse”, while pointing out the real number of 12-hour A&E breaches is likely higher than official data records. The figures also revealed the waiting list had hit a new high of 6.1 million, while the number of two-year breaches also rose a record level. Trusts recorded 16,558 patients last month waited 12 hours or more in an emergency department from decision to admit to being discharged or admitted. This was up from 12,986 in December. RCEM president Katherine Henderson warned on Twitter: “This is [decision to admit] plus 12 – a concept which must be retired as a performance metric. We should have 0-12 hour data. You cannot fix a problem if you [are] unwilling to face up to what it actually is. We estimate reality is 20 x more. This is getting worse and worse.” Read full story (paywalled) Source: HSJ, 10 February 2022 -
News Article
Virus almost 'wholly responsible' for spike in dementia deaths
Patient Safety Learning posted a news article in News
People with dementia, particularly care home residents early in the pandemic, were “disproportionately” vulnerable to fatal Covid infections, according to a new report. The analysis, commissioned by the Scottish Government, also found that excess deaths involving dementia during 2020 were “almost wholly” attributable to Covid. Of the 2,154 deaths where both dementia and Covid were listed on the death certificate, 95 per cent had Covid as the main underlying cause. This contradicts previous suggestions that a rise in dementia deaths early in the pandemic may have been linked indirectly to the virus as a result of “lockdown distress” or an increased use of potentially harmful sedation in elderly people confused by restrictions. The report also found that 73% (1,577) of those who died with both Covid and dementia mentioned on their death certificates had passed away in care homes. Henry Simmons, chief executive of Alzheimer’s Scotland, said their loved ones had been “torn apart by grief and loss” and that the report “raises many more questions as to why so many people with dementia living in care homes quickly became victims of Covid-19”. Read full story Source: The Herald, 10 February 2022
