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News Article
Over 1000 'adverse events' in women and infants' care in Scotland
Patient Safety Learning posted a news article in News
More than 1000 investigations have been launched in Scotland over the past decade into adverse events affecting women and infants' healthcare. Figures obtained by the Herald show that at least 1,032 Significant Adverse Event Reviews (Saers) have been initiated by health boards since 2012 following "near misses" or instances of unexpected harm or death in relation to obstetrics, maternity, gynaecology or neonatal services. The true figure will be higher as two health boards - Grampian and Orkney - have yet to respond to the freedom of information request, and a number of health boards reported the totals per year as "less than five" to protect patient confidentiality. Saers are internal health board investigations which are carried out following events that could have, or did, result in major harm or death for a patient. Major harm is generally classified as long-term disability or where medical intervention was required to save the patient's life. They are intended as learning exercises to establish what went wrong and whether it could have been avoided. Not all Saers find fault with the patient's care, but the objective is to improve safety. NHS Lanarkshire was only able to provide data from April 2015 onwards, but this revealed a total of 194 Saers - of which 102 related to neonatal or maternity services, and 80 for obstetrics. A Fatal Accident Inquiry involving NHS Lanarkshire has already been ordered into the deaths of three infants - Leo Lamont and Ellie McCormick in 2019, and Mirabelle Bosch in 2021 - because they had died in "circumstances giving rise to serious public concern". Read full story (paywalled) Source: The Herald, 10 December 2022 -
News Article
As a black man I wasn't included in cancer stats
Patient Safety Learning posted a news article in News
What started as a shoulder ache led to a whirlwind diagnosis of stage four cancer and a rare genetic mutation for Spike Elliott. But his journey also highlighted a worrying ethnicity data gap in our health system. It comes as research by one charity shows just how few patient records include ethnicity information in Wales. The Welsh government said it was working to improve the diversity of data collection and health research. One oncologist said it meant assumptions were made about how patients will respond, despite there being "clear differences" in how certain cancers affect different racial groups. "I was given a life expectancy of 6 to 12 months. That was statistically supported. "But I was alarmed when I was made aware that the statistics don't include the BAME (Black, Asian and Minority Ethnic) community. "Because what was my outcome then?" Read full story Source: BBC News, 21 June 2023 -
News ArticleThe government should ‘relieve’ GP practices of being the sole controller for their patients’ data, a senior NHS England director has said. Tim Ferris, NHSE director of transformation, said it was a “challenge” that GP practices acted as the sole controllers of their patients’ data. Dr Ferris, whose background is as a primary care doctor in the US, was giving evidence to a Lords committee on integration of primary and community care today. He was asked whether it was time to revisit legislation on the control of GP patient data. He said: “Thirty years ago when the law was created, it made more sense. But I think it might no longer be fit for purpose… The idea that if I were a GP in this country, if I had legal liability for the exchange of data, I would be worried about that.” Dr Ferris agreed there would be merit to the committee recommending the government “relieve” GPs of the sole responsibility for data protection, and their data controller status. Read full story (paywalled) Source: HSJ, 20 June 2023
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News Article
Trust insists ‘our data is correct’ despite waiting list ‘grip’ concerns
Patient Safety Learning posted a news article in News
An external review of waiting list management at a large acute trust has found several serious problems – including ‘pop-up’ patients and thousands of cancelled appointments each week – but concluded they were no worse than would be found at ‘most NHS trusts’. The review appears to have been triggered after University Hospitals of the North Midlands declared unexpected increases in the number of 78-week and 104-week waiters earlier this year, while the government and NHS England have been intensively performance managing these measures. The independent report by independent consultant Wendy Baines states: “The review found no evidence of deliberate irregularities in the management of waiting times. “Although as the case for most NHS trusts, the capacity to misrepresent the ‘true’ volume of waiters at a certain point in time is significant. “Managing this risk by minimising the capacity for errors through training, the right pathway administration systems and tools, and the ability to monitor data quality through a defined set of process assurance measures is key. Whilst UHNM possesses these components, they are not necessarily working in cohesion to provide the assurance and oversight needed to manage patient waiting times.” Read full story (paywalled) Source: HSJ, 13 June 2023 -
News Article
'Hidden' rise in blood clot deaths 'breaking families' warns charity
Patient Safety Learning posted a news article in News
Thrombosis UK has warned that deaths involving blood clots are higher than expected as it called for more transparency over the work hospitals are doing to reduce the risk for patients. Before the pandemic hit, hospitals were regularly publishing data on the number of patients who had been risk assessed for blood clots. In March 2020, the NHS in England took the decision to suspend the data collection on venous thromboembolism (also known as VTE) risk assessments to “release capacity in providers and commissioners to manage the Covid-19 pandemic”. But the data collection and publication is yet to resume. The charity said the data shows how many VTE cases are missed in hospitals. One bereaved man described how his mother died last year after the condition was missed. Tim Edwards, 42, said healthcare workers missed signs of the condition while Jennifer Edwards, 74, was in hospital on the south coast. Despite having many symptoms of a pulmonary embolism she was discharged home and died three days later. Mr Edwards said: ““My mother’s symptoms were missed from her admission to hospital right up to her time in the cardiology department. “She was discharged and passed away three days after phoning the NHS with shortness of breath. She should not have died. I took it upon myself to enquire about the circumstances surrounding her death and was overwhelmed by the lack of care taken. “Sadly, I know this is not an isolated case.” Read full story Source: Wales Online, 12 May 2023 Further reading on the hub: Pulmonary embolism misdiagnosis – a systemic problem (a blog from Tim Edwards) Independent review of pulmonary embolism fatalities in England & Wales – recent trends, excess deaths, their causes and risk management concerns (Tim Edwards) Jenny, and why we must learn from her misdiagnosis of pulmonary embolism National Voices: Pulmonary embolism misdiagnosis - a blog by Helen Hughes. -
News Article
Figures show maternal death rate race disparity
Patient Safety Learning posted a news article in News
Figures showing the risk of maternal death being almost four times higher among women from black ethnic minority backgrounds compared with white women in the UK have been published. The figures, which relate to 2019 - 2021, have been released by MBRRACE-UK, a collaboration involving the University of Leicester. The MBRRACE-UK collaboration (Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries), led from Oxford Population Health's National Perinatal Epidemiology Unit, looked at data on women who died during, or up to six weeks after, pregnancy between 2019 and 2021 in the UK. The report showed the risk of maternal death in 2019 - 2021 was almost four times higher among women from black ethnic minority backgrounds compared with white women. Marian Knight, professor of Maternal and Child Population Health at Oxford Population Health and maternal reporting lead, said: "Persistent disparities in maternal health remain. "It is critical that we are working towards more inclusive care where women are listened to, their voices are heard, and we are acting upon what they are telling us." Read full story Source: BBC News, 11 May 2023 -
News ArticleThe NHS must start sharing figures on mental health checks for pregnant women and new mothers amid gaps in hospital data, top doctors warn. One in six NHS trusts is not able to say whether they screen pregnant women for mental health issues at all, despite national guidelines recommending these checks be done at 10 weeks. Suicide has been recorded has one of the leading drivers in post-natal deaths. The findings come as the latest NHS figures show 51,000 women accessed specialist perinatal mental health services in the 12 months prior this fell short of a target for the NHS to see 66,000 mothers in 2022-23. Access levels have. however, improved from 31,000 a year in March 2022. The Royal College of Psychiatrists has called for NHS England to “urgently” publish data on every hospital in the country showing whether they are carrying out this vital screening. Last November the latest national report into maternal deaths, from researchers led by Oxford University, found suicide was again the leading cause of direct deaths in women a year after the end of their pregnancy. Read full story Source: The Independent, 4 May 2023
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News Article
Covid no longer the leading cause of death in England and Wales
Patient Safety Learning posted a news article in News
Covid-19 has dropped out of the top five leading causes of death in England and Wales for the first time since the start of the pandemic, figures show. Coronavirus was recorded as the main cause of death for 22,454 people in 2022, or 3.9% of all deaths registered, making it the sixth leading cause overall. In both 2020 and 2021 Covid-19 was the leading cause of death, with 73,766 deaths (12.1% of the total) and 67,350 (11.5%) respectively. By contrast, dementia and Alzheimer’s disease was the leading cause in England and Wales in 2022, with 65,967 deaths registered (11.4% of the total), up from 61,250 (10.4%) in 2021. The other causes in the top five were ischaemic heart diseases (59,356 deaths and 10.3% of the total); chronic lower respiratory diseases (29,815 deaths, 5.2%); cerebrovascular diseases such as strokes and aneurysms (29,274 deaths, 5.1%); and trachea, bronchus and lung cancer (28,571 deaths, 5.0%). Read full story Source: The Independent, 11 April 2023 -
News Article
Why US mothers are more likely to die in childbirth
Patient Safety Learning posted a news article in News
The United States remains one of the most dangerous wealthy nations for a woman to give birth. Maternal mortality rose by 40% at the height of the pandemic, according to new data released by the US Centers for Disease Control and Prevention. In 2021, 33 women died out of every 100,000 live births in the US, up from 23.8 in 2020. That rate was more than double for black women, who were nearly three times more likely to die than white women, according to the CDC. Compared to other countries, the maternal mortality rate was twice as high in the US than in the UK, Germany and France; and three times higher than in Spain, Italy, Japan and several other countries, according to the most recent global comparison data kept by the World Bank. "Clearly the US is an outlier," said Joan Costa-i-Font, a professor of health economics at the London School of Economics. "Covid has made [maternal mortality] worse, but it was already a major issue in the US." Read full story Source: BBC News, 18 March 2023 -
News ArticleFollowing the Advanced cyber attack in August 2022, Phil Huggins has revealed to a Digital Health Rewired audience that the NHS has “seen no clinical impact or significant clinical harm”, after a review to be released in the near future. The national chief information security officer for health and care at NHS England was speaking alongside a panel on the Cyber Security Stage on day two of Digital Health Rewired 2023 in London. Huggins explained that although the impact of the Advanced attack was big on the system, in a clinical sense it was not particularly damaging, despite the fact that client data was confirmed to have been exfiltrated. However, Ayesha Rahim, clinical lead for digital mental health at NHS England and chief medical information officer at Surrey and Borders Partnership Foundation Trust, was also on the panel, and spoke of the huge impact the attack had on staff. “The date 4th August is imprinted in my brain”, Rahim said, which is when the attack first happened and was first reported. She explained that it is “quite difficult to fully convey the chaos this caused”, giving examples of staff having no idea what a patient’s background was and therefore having to do everything “blindfolded”. Rahim said staff could not tell if it was safe to go out on visits to mental health patients due to the lack of data and information on them, and every time a person saw a staff member they were retraumatised having to explain their past over and over, including experiences of sexual abuse. Read full story Source: Digital Health, 15 March 2023
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News Article
Gonorrhoea cases rising quickly in England
Patient Safety Learning posted a news article in News
Gonorrhoea cases in England have resurged since the easing of Covid restrictions, health officials are warning people who are sexually active. The disease is caused by the bacterium Neisseria gonorrhoeae. The infection is spread by unprotected vaginal, oral and anal sex. Symptoms can include a thick green or yellow discharge from sexual organs, pain when urinating and bleeding between periods, but some people will have no symptoms. Condoms can stop the spread of this and other sexually transmitted infections. Experts say people should practise safe sex and get tested regularly if they are having sex with new or casual partners. Testing is simple, free and discreet, they advise. Provisional data shows diagnoses in the first half of 2022 hit 56,327 - 21% higher than for the same period in 2019. An untreated infection can lead to infertility, pelvic inflammatory disease and can be passed on to a child during pregnancy. Read full story Source: BBC News, 16 March 2023 -
News Article
UK life expectancy growing at slower rate than rest of G7, research shows
Patient Safety Learning posted a news article in News
Life expectancy in the UK has grown at a slower rate than comparable countries over the past seven decades, according to researchers, who say this is the result of widening inequality. The UK lags behind all other countries in the group of G7 advanced economies except the US, according to a new analysis of global life expectancy rankings published in the Journal of the Royal Society of Medicine. While life expectancy has increased in absolute terms, similar countries have experienced larger increases, they wrote. In the 1950s, the UK had one of the longest life expectancies in the world, ranking seventh globally behind countries such as Denmark, Norway and Sweden, but in 2021 the UK was ranked 29th. The researchers said this was partly due to income inequality, which rose considerably in the UK during and after the 1980s. Prof Martin McKee, of the London School of Hygiene & Tropical Medicine, said: “That rise also saw an increase in the variation in life expectancy between different social groups. One reason why the overall increase in life expectancy has been so sluggish in the UK is that in recent years it has fallen for poorer groups". Read full story Source: The Guardian, 16 March 2023 -
News Article
Steve Barclay accused of breaking pledge over NHS staff abuse data
Patient Safety Learning posted a news article in News
NHS staff have accused Steve Barclay of breaking a pledge to publish details of how many of them are abused and assaulted in the course of their work. In 2018, when Barclay was a junior minister in the Department of Health and Social Care (DHSC), he promised he would resume publication of those statistics in the following year. However, five years later, Barclay has not fulfilled his pledge, despite being in his second stint as health secretary. Health unions and NHS leaders have warned that frontline staff have been on the receiving end of increased abuse, threats, aggression and assaults since the first outbreak of Covid. Long waiting times for care appear to be a particular source of frustration for some patients or their relatives. Growing numbers of ambulance crew personnel have begun using body-worn cameras in recent years to deter assaults and record any that do occur. In 2022, the London ambulance service recorded 877 reports of verbal abuse or threats of violence, 516 physical assaults – including kicking, punching, head-butting and use of a weapon – and 49 sexual assaults on staff. Read full story Source: The Guardian, 16 March 2023 -
Content ArticleSystem working (which includes health and care) is the only way the NHS can address the interlinked problems of struggling primary care, elective backlog, ambulance and emergency department overload, and delayed discharge. In this HSJ article, Len Richards explains how system working grows from the right culture, clinical leadership and systemwide joined up, real-time data.
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Content ArticleThis report includes findings from a two-month-long study of data brokers and data on U.S. individuals’ mental health conditions. The report aims to make more transparent the data broker industry and its processes for selling and exchanging mental health data about depressed and anxious individuals. The research is critical as more depressed and anxious individuals utilise personal devices and software-based health-tracking applications (many of which are not protected by the Health Insurance Portability and Accountability Act), often unknowingly putting their sensitive mental health data at risk.
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Content ArticleIncomplete or inaccurate recording of ethnicity will undermine attempts to address health inequalities and improve access, experience and outcomes for Black, Asian and minority ethnic communities. This report by the Race Equality Foundation and the Office for National Statistics (ONS) looks at different aspects of the recording of ethnicity in healthcare. The authors interviewed people from a range of communities across England, as well as healthcare workers from different areas and settings to understand both sides of the process of collecting ethnicity data.
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Content ArticleIn this analysis, the Health Foundation looks at the outlook for health funding following the 2022 Autumn Statement, draws out some implications for clearing the NHS estate maintenance backlog and looks at the potential impact of pay and other cost pressures on NHS spending power.
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Content ArticleAhead of World Cancer Day 2023, Cancer Research UK have published a new report that shows that the impact of cancer for people in the UK will only grow, and sets out the challenges that cancer services are already facing today. New modelling published in the report, Cancer in the UK: Overview 2023 shows that if current trends continue, cancer cases will rise from the 384,000 diagnosed each year now, to over half a million by 2040. To put that into context, that means around a third more people will be diagnosed with the condition every year in comparison to current levels. And we could see around a quarter more annual cancer deaths – 208,000 by 2040, With services barely treading water now, Governments across the UK must act if they are to effectively meet the increase in demand that this analysis anticipates, but efforts have been piecemeal so far.
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Content ArticleThe General Practice Data Trust (GPDT) Pilot Study: Report on Patient Focus Groups reports on patients’ attitudes about sharing their health data for research and planning purposes. It is the result of research by academics at the Centre for Social Ethics and Policy (CSEP) at the University of Manchester, supported by the Patients Association, and is part of the GP Data Trusts pilot project. Funded by the Data Trusts Initiative, the project wanted to understand why so many people opted out from NHS Digital’s GP Data for Research and Planning (GPDPR) programme when it was launched in 2021. The research found that patients mostly supported the use of patient data in health research, but they often didn’t like the idea that companies might make money from the use of their health data. Many felt they had not been given enough information about the GPDPR programme; some would have been happy to share their data if they had known more about the programme. The researchers also asked focus group participants if holding patient data in a trust would reassure them about how their data are used. This was welcomed and the report goes into more detail about what patients thought of this idea.
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Content Article
This is a brief summary of a Westminster Hall debate in the House of Commons on the 31 January 2023 on NHS hysteroscopy treatment, tabled by Lyn Brown MP. -
Content Article
NHS England - Making data count (18 January 2021)
Patient-Safety-Learning posted an article in Data and insight
These practical guides from NHS England are suitable for those working at all levels in the health service, from ward to board. They provide information on how to make better use of data. Guides include: Making data count - getting started Making data count - strengthening your decisions -
Content ArticleThe Royal College of Emergency Medicine (RCEM) ‘Wales' Emergency Medicine Workforce Census 2023’ is an in-depth analysis of the state of the Emergency Medicine workforce, providing an insight into the working patterns of clinicians and allowing a forecast to be made around the future workforce needs of Emergency Departments in Wales.
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Content ArticleIn this blog, Paul E Sax, Contributing Editor at NEJM Journal Watch looks at a recent study into the effectiveness of medical masks compared to N95 respirators for preventing Covid-19 infection among healthcare workers. The author aims to help readers understand how to appraise research studies and decide how and whether to apply their findings. He defines some of the complex terminology used in the study and looks at its methods and findings from both a critical and supportive viewpoint.
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Content ArticleThis article presents data on how deprivation affects life expectancy and health life expectancy at birth. It highlights a difference in life expectancy of around 9 years for males and 8 years for females between the most and least deprived deciles of society.
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Content ArticleThis study examined the risks and patterns of childhood deaths before and during the COVID-19 pandemic. In this cohort study, there were 3409 childhood deaths from April 2019 to March 2020, 3035 deaths from April 2020 to March 2021, and 3428 deaths from April 2021 to March 2022. Overall risk of death was significantly lower from 2020 to 2021, but not from 2021 to 2022 when compared with the reference year of 2019 to 2020. These findings suggest that there was a significant reduction in all-cause child mortality during the first year of the COVID-19 pandemic (2020-2021), which returned to near prepandemic levels the following year (2021-2022).
