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News Article
Why Mondays are the deadliest day to go to A&E
Patient Safety Learning posted a news article in News
The number of people dying needlessly in A&E soars on a Monday as hospitals are stretched to the limit and failing to discharge patients at the weekend, new data shows. Figures uncovered by The Independent show an average of 126 patients died every Monday between 2020-2023 – 25% higher than any other day. On a Saturday, the average number of deaths drops as low as 90. Waiting times are also shown to spike massively at the start of the week, with an average of 9,300 patients spending more than 12 hours waiting on a Monday – up to 2,000 more than any other day. Medical experts said the rise in A&E waits can be attributed to people staying away from hospitals during weekends and patients not being discharged from medical care, causing a bottleneck in an already buckling system. The stark statistics also directly contradict repeated government efforts to make the NHS a seven-day service. Multiple coroners have warned the government and health leaders about delays to patients’ treatment and diagnosis due to variations in staffing and access to specialists – particularly over the weekend. Adrian Boyle, president of the Royal College of Emergency Medicine, said the NHS England data clearly signposted an “increased risk” at the start of the week. Another expert said the sharp rise in deaths on Mondays showed an A&E “running constantly in the red zone”. Read full story Source: The Independent, 8 April 2024 -
Content ArticleThe Information Commissioner’s Office (ICO) is supporting health and social care organisations to ensure they are being transparent with people about how their personal information is being used. The UK data protection regulator has today published new guidance to provide regulatory certainty on how these organisations should keep people properly informed. The health and social care sectors routinely handle sensitive information about the most intimate aspects of someone’s health, which is provided in confidence to trusted practitioners. Under data protection law, people have a right to know what is happening to their personal information, which is particularly important when accessing vital services. The guidance will help organisations to understand the definition of transparency and assess appropriate levels of transparency, as well as providing practical steps to developing effective transparency information.
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Content ArticleAbout 40,000 patient pathways have disappeared. But on the plus side, a new and better data series has begun. The referral-to-treatment (RTT) waiting list data has now changed in two important ways. First, about 40,000 patient pathways in community services are now excluded from the RTT data collections, and this accounted for all of the apparent reduction in list size in the latest (February) official RTT data. Second, NHS England has started regular publication of the more detailed and timely (though – for now – less complete and accurate) Waiting List Minimum Data set. This HSJ article looks at those changes in more detail.
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EventuntilBevan Brittan are delighted to announce their next Digital Health and Care Forum. This session will be hosted in partnership with the Masala Network, the health and life science network for South Asians in the UK. At this in-person event, we will be joined by a panel of experts in the field including: Dr Amrita Kumar, AI Clinical Lead and Consultant Radiologist at NHS Haris Shuaib, Founder and CEO at Newton’s Tree Helen Hughes, Chief Executive at Patient Safety Learning Hassan Chaudhury, Co-Founder at Vita Health Care Solutions Daniel Morris, Partner at Bevan Brittan AI and data-driven technology continues to revolutionise health and care at a giddying pace and offers enormous opportunity to shape and future-proof health systems that could be more affordable, sustainable and equitable. But to fully realise AI’s transformational potential there is a pressing need to ensure public and clinical buy-in. In this session we will consider how evidence and ethical based frameworks and guidelines, patient safety measures and regulation can all foster trust in AI. The Digital Health & Care Forum is intended to be an interactive session and an opportunity and safe space to exchange views, identify and explore key issues and share knowledge. Our events are attended by developers, purchasers, providers, funders, insurers and policy makers. Register
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Content Article
Throughout 2023, the Arthritis and Musculoskeletal Alliance (ARMA) carried out the first ever national inquiry into musculoskeletal (MSK) health inequalities. The inquiry found that the prevalence and impact of musculoskeletal conditions are not experienced equally across the population. Musculoskeletal conditions are linked to deprivation and age, are more prevalent in women and disproportionately affect some ethnic groups. Deprivation is a significant driver of inequalities in MSK health. People in deprived areas experience more chronic pain, are more likely to have a long term MSK condition and experience worse clinical outcomes and quality of life. These inequalities are avoidable through changes in the design and delivery of MSK services, and actions to address wider determinants of health and prevention. The report makes recommendations to reduce health inequalities in MSK care, treatment and outcomes. -
Content ArticleThis National Paediatric Diabetes Audit (NPDA) report on care and outcomes 2022/23 found that the prevalence of children and young people cared for in Paediatric Diabetes Units (PDUs) in England and Wales has increased from 33,251 in 2021/22 to 34,371 in 2022/23, despite a fall in the incidence of new cases. It also found that the percentages of children and young people with Type 1 and Type 2 diabetes receiving all six key annual healthcare checks have increased, but there remains much variability between PDUs (and completion rates for those with Type 2 remain lower than for those with Type 1). Other findings include: Percentages of young people with early signs of micro and macrovascular complications for both Type 1 and Type 2 diabetes show very little change in 2022/23 compared to the previous audit year Use of diabetes related technology has increased in 2022/23, with around half of children and young people with Type 1 diabetes using insulin pumps and half using a real time continuous glucose monitor (rtCGM) Around a quarter of all new cases of Type 1 diabetes had diabetic ketoacidosis (DKA) at diagnosis, compared to 25.6% in 2021/22. The report also states that, despite improvements in outcomes and use of technologies across different ethnicities and areas of deprivation, inequalities remain evident. In terms of rtCGM use, the inequality gap by deprivation has reduced, however the difference in use between Black and White children with Type 1 diabetes has widened from 8.6% in 2021/22 to 14% in 2022/23.
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News ArticleIn the next few days, once the data has been collected, the Government will come out and say that, thanks to its policies, the situation in A&E is improving. Despite estimates released recently by the Royal College of Emergency Medicine that soaring waits for A&E beds led to more than 250 needless deaths a week in England alone last year, the Government will point to declining numbers of patients who breached the four-hour target this March. The four-hour target means we're meant to see and either discharge or admit patients within four hours of their arriving in A&E. But it's a sham, writes Professor Rob Galloway in the Daily Mail. Because, for the past month, the four-hour data has been manipulated, the result of two policies introduced earlier in the month by the Government. Read full story Source: Daily Mail, 3 April 2024
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Content ArticleClinical guidelines can contribute to medication errors but there is no overall understanding of how and where these occur. This study aimed to identify guideline-related medication errors reported via a national incident reporting system, and describe types of error, stages of medication use, guidelines, drugs, specialties and clinical locations most commonly associated with such errors.
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News Article
Almost 10 million people in England could be on NHS waiting list
Patient Safety Learning posted a news article in News
Almost 10 million people across England could be waiting for an NHS appointment or treatment, 2 million more than previously estimated, according to a survey by the Office for National Statistics (ONS). The ONS survey of about 90,000 adults found that 21% of patients were waiting for a hospital appointment or to start receiving treatment on the NHS. When extrapolated, this equates to 9.7 million people. In January, the waiting list stood at 7.6 million, according to official NHS statistics. The survey found that the delays were most prominent among 16-24-year-olds, one in five of whom said they had experienced waiting times of more than a year. Conducted in January and February, the survey was part of the annual winter coronavirus infection study of adults aged 16 and over. The ONS said the survey was the first of its kind to assess the experiences of adults awaiting hospital appointments, tests or medical treatments. It said the data was experimental, based on self-reported data, and may differ from other statistics on waiting lists. Read full story Source: The Guardian, 3 April 2024 -
News Article
Long A&E wait times lead to more than 250 needless deaths a week
Patient Safety Learning posted a news article in News
More than 250 patients a week could be dying unnecessarily, due to long waits in A&E in England, according to analysis of NHS data. The Royal College of Emergency Medicine analysed the 1.5 million who waited 12 hours or more to be admitted in 2023. A previous data study had calculated the level of risk of people dying after long waits to start treatment and found it got worse after five hours. The government says the number seen within a four-hour target is improving. This is despite February seeing the highest number of attendances to A&E on record, it adds. The Royal College of Emergency Medicine (RCEM) carried out a similar analysis in 2022, which at that time resulted in an estimate of 300-500 excess deaths - more deaths than would be expected - each week. The analysis uses a statistical model based on a large study of more than five million NHS patients that was published in 2021. RCEM president Dr Adrian Boyle said long waits were continuing to put patients at risk of serious harm. "In 2023, more than 1.5 million patients waited 12 hours or more in major emergency departments, with 65% of those awaiting admission," he said. "Lack of hospital capacity means that patients are staying in longer than necessary and continue to be cared for by emergency department staff, often in clinically inappropriate areas such as corridors or ambulances. "The direct correlation between delays and mortality rates is clear. Patients are being subjected to avoidable harm." Read full story Source: BBC News, 1 April 2024 -
Content ArticleThe idea of Emergency care services experiencing seasonal spikes in demand – so called ‘Winter Pressures’ are fast becoming a thing of the past. Instead, long waits have become the new norm year-round, and staff are caring for patients in unsafe conditions on a daily basis. It is well established that long waits are associated with patient harm and excess deaths. Last year the UK Government published a Delivery Plan for the Recovery of Urgent and Emergency Care (UEC) services. A year on, far too many patients are still coming to avoidable harm. New analysis by the Royal College of Emergency Medicine (RCEM) reveals that there were almost 300 deaths a week associated with long A&E waits in 2023.
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Content ArticleThis Lancet article highlights three challenges to measuring and analysing social determinants of health (SDoH) for which data science—a cross-disciplinary set of skills to make judgements and decisions with data by using it responsibly and effectively—can be harnessed. The three challenges the authors examine are: Data necessary for capturing the exposure of interest at multiple levels appropriately are not always available nor easy to measure. SDoH are distal to individual health outcomes compared to biomedical determinants such as comorbidities. The distal placement of SDoH in relation to health outcomes results in requires long periods of time to observe their effect.
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News Article
Hackers obtain patient data from NHS Dumfries and Galloway
Patient Safety Learning posted a news article in News
A hacker group is in possession of at least a “small number” of patients’ data following a cyber-attack, NHS Dumfries and Galloway has said. Reports emerged on Wednesday of a post by the group Inc Ransom on its darknet blog, alleging it was in possession of three terabytes of data from NHS Scotland. The post included a “proof pack” of some of the data, which has been confirmed by the board to be genuine. The chief executive of the NHS board, Jeff Ace, said in a statement: “We absolutely deplore the release of confidential patient data as part of this criminal act. “This information has been released by hackers to evidence that this is in their possession. We are continuing to work with Police Scotland, the National Cyber Security Centre, the Scottish government and other agencies in response to this developing situation.” Patients whose data has been leaked will be contacted by the board, he said, while patient-facing services would continue as normal. Read full story Source: The Guardian, 27 March 2024 -
Content ArticleAlong with the Care Inspectorate, Healthcare Improvement Scotland have established a National hub for reviewing and learning from the deaths of children and young people (National hub). The National hub uses evidence to deliver change. It ultimately aims to help reduce preventable deaths and harm to children and young people.
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Content ArticleThis report was put together by two charities, Pathway and Crisis, and reveals how the national crisis facing both our health and housing systems leads to worsening health for people in inclusion health groups. Drawing on 85 pieces of published literature from the past two years, and a survey of frontline medical and healthcare professionals, the findings reveal how those who are most excluded in our society struggle to access health services due to inflexibility, discrimination and stigma. It calls on the Government, along with NHS England, to lead reform of mainstream health services and to increase the availability of specialist care. It further calls for a commitment to deliver the social housing needed to ensure that everyone has a safe and healthy home.
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News ArticleNHS doctor Chris Day has won the right to challenge a tribunal decision which raises questions about information governance in NHS hospital trusts and the use of digital evidence by employment tribunals. Day blew the whistle on acute understaffing at a South London intensive care unit linked to two patient deaths in 2013. His decade-long legal campaign has since exposed the lack of statutory whistleblowing protections for nearly 50,000 doctors below consultant level in England. An appeal tribunal in February refused Day the right to challenge key aspects of an earlier tribunal ruling that cleared Lewisham and Greenwich NHS Trust (LGT) of deliberately concealing evidence and perverting the course of justice when one of the trust’s directors “deliberately” deleted up to 90,000 emails midway through a tribunal hearing in July 2022. Day’s high-profile case nevertheless continues to raise questions about information governance practices in NHS hospital trusts and the degree of scrutiny applied to digital evidence retention and disclosure practices at UK employment tribunals. The 2022 tribunal heard that LGT communications director David Cocke had attempted to destroy up to 90,000 emails and other electronic archives that were potentially critical to the case as the hearing progressed. However, any remaining documents among the tens of thousands of emails and electronic archives, which NHS trust lawyers told the tribunal had been “permanently” destroyed, are likely still to exist and be recoverable, according to an expert consulted by Computer Weekly. Read full story Source: Computer Weekly, 19 March 2024
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Content ArticleOne of the major challenges of patient safety incident reporting and learning systems lies in the difficulties of extracting practical information from the vast amount of data collected. Furthermore, many countries have not started collecting incident reports in patient safety at national level which makes it difficult to identify avoidable patient safety incidents and take action on them nationally. Minimal Information Model for Patient Safety (MIM PS) has been developed to provide a simple tool to start collecting data on patient safety incidents to assist in data analysis and extract the minimal, but necessary information to learn from incidents in order to avoid recurrence of same types of incidents in the future. Also, the MIM PS can be used as mapping source from any types of existing reporting systems of patient safety incidents which means no need to develop the new reporting systems based on MIM PS. This MIM user guide aims to explain each MIM category and how to implement MIM. It went through a validation process with EU and EFTA countries in 2014-2015. The MIM PS validation was supported by European Union in which EFTA countries also participated in the pilot testing.
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Content Article
In this blog, Patient Safety Partners Anne Rouse and Chris Wardley and Patient Safety Learning’s Chief Executive, Helen Hughes, examine the results of a recent survey of Patient Safety Partners (PSPs). The results reveal significant variation in how the PSP role is being implemented in NHS organisations in England and highlight frustration, barriers and successes that people in the role are experiencing.- Posted
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News Article
NHS waiting list recovery ‘could take years’ report reveals
Patient Safety Learning posted a news article in News
NHS waiting lists will take more than three years to be reduced to pre-pandemic levels, according to a new analysis. Despite recent reductions in the waiting list in England, the Institute for Fiscal Studies (IFS) think tank said that it is “unlikely that waiting lists will reach pre-pandemic levels” by December 2027 – even under a “best-case scenario”. The latest figures show that the waiting list for routine hospital treatment in England has fallen for the third month in a row. An estimated 7.6 million treatments were waiting to be carried out at the end of December, relating to 6.37 million patients, down slightly from 7.61 million treatments and 6.39 million patients at the end of November, according to NHS England figures. Cutting NHS waiting lists is one of Prime Minister Rishi Sunak’s top priorities. However, the PM admitted earlier this month he would not meet his promise to reduce waiting lists. However, the new IFS analysis highlights how the NHS waiting list was already growing before the pandemic, but it rose “rapidly” during the crisis. The IFS report suggests a range of scenarios about how the waiting list could look in December 2024. Under a “more pessimistic scenario”, waiting lists will remain at the same elevated level while an “optimistic scenario” would see them fall to 5.2 million by December 2027. -
Content ArticleThis Institute for Fiscal Studies briefing, outlines what has happened to NHS waiting lists (in England, given that health is a devolved responsibility) over the last 17 years – the period for which consistent data are available – and present new scenarios of what could happen to waiting lists over the years to come. It focuses on the elective waiting list – the list of people waiting for pre-planned hospital treatment and outpatient appointments. This is what most people mean when they talk about NHS waiting lists, but it also considers a range of other NHS waiting lists and waiting times. Alongside this report, IFD has updated their interactive online tool that allows you to produce waiting list scenarios under your own assumptions.
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Content ArticleOver the past decade, the implementation of simulation education in health care has increased exponentially. Simulation-based education allows learners to practice patient care in a controlled, psychologically safe environment without the risk of harming a patient. Facilitators may identify medical errors during instruction, aiding in developing targeted education programs leading to improved patient safety. However, medical errors that occur during simulated health care may not be reported broadly in the simulation literature. This study in the Journal of Patient Safety aimed to identify and categorise the type and frequency of reported medical errors in healthcare simulation.
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Content ArticleThis annual report published by the National Confidential Inquiry into Suicide and Safety in Mental Health (NCISH) contains findings relating to people aged 10 and above who died by suicide between 2011 and 2021 across all of the UK. View an infographic outlining the report's key findings.
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Content ArticleA growing awareness of sex and gender bias in evidence has resulted in the development of new tools to address this concern. The Sex and Gender Equity in Research (SAGER) guidelines and the Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER) are two initiatives designed to foster more transparent research and reporting practices that bridge the gender evidence gap. These tools enable researchers to unravel the complexities that underpin health risks and outcomes and generate more accurate and relevant findings that can inform effective and equitable policies for better health outcomes. This Lancet article looks at the World Health Organization's (WHO's) adoption of GATHER and the SAGER guidelines to tackle sporadic and suboptimal reporting of sex and gender data. The authors argue that this move is pivotal within WHO's broader strategic agenda, which it outlined in the Roadmap to Advance Gender Equality, Human Rights and Health Equity 2023–2030, launched in December 2023.
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Content ArticleAlthough several studies have tried to quantify the cost of ‘adverse events’ in healthcare, the true costs remain unknown. To understand the ‘true cost’ of serious incidents, Jane Carthey argues we need to consider:The cost of additional treatment for the affected patient.The opportunity costs that accrue from reporting and managing incidents, claims and complaintsBusiness costs that accrue when, for example, healthcare staff are suspended.Costs resulting from implementing the duty of candour process, andPenalties and sanctions imposedIn other industries, the HSE’s Incident Cost Calculator is used to quantify the true costs of incidents. Inspired by this tool, Jane developed the Healthcare Serious Incident Cost Calculator. Available via the link below.
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Content ArticlePreventable conditions are costing the NHS and wider society hundreds of billions of pounds and leading to reduced quality of life for large numbers of people. This paper from the Tony Blair Institute for Global Change proposes ways in which the NHS can use existing tools for screening and preventing ill health, to make the UK healthier and more productive and reduce pressure on the health system. It suggests a prevention programme that uses AI to highlight risk factors and screen individuals most likely to develop chronic health conditions.
