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Found 323 results
  1. Content Article
    This article in BBC Science Focus looks at the factors driving an increase in testosterone prescribing for women in the UK. The author, Dr Michelle Griffin, highlights the need to ensure that there is a strong evidence base for prescribing testosterone to women. While there have been some clinical trials and studies around testosterone as a treatment for low libido, there is concern that patients, doctors and pharma companies are relying on anecdotal accounts of its effectiveness to treat symptoms such as low mood, poor concentration and tiredness. She also highlights that testosterone prescribing is just one example of the lack of research going into women's health issues and treatments, and argues that this is contributing to health inequity.
  2. Content Article
    Peter Seaby had Down's Syndrome and autism and was cared for at home by members of his family for 62 years. However, in 2017, Peter was removed from the home he shared with his sister Karen, who was his full time carer, and placed in a care home. Karen and Peter's brother Mick were not told by social services why Peter was moved. Within six months of being in the home, Peter choked on a carrot and died. Karen and Mick found the subsequent inquest into Peter's death in July 2021 to be inadequate and launched a Judicial Review challenge which was successful in quashing the findings of the initial inquest. A new inquest was held in February 2023 Journalist George Julian has been following and reporting on Peter's second inquest and has written several blog posts about the case, highlighting serious failings in his care that led to his death: Peter Seaby’s 2nd inquest – how he came to be in the care of the Priory Group Peter Seaby’s 2nd inquest “I have stood on my own in this” Peter Seaby’s 2nd inquest – the SALT plan Peter Seaby’s 2nd inquest – record keeping and decision making Peter Seaby’s 2nd inquest – April 2018 Peter Seaby’s 2nd inquest – May 2018 Peter Seaby’s 2nd Inquest – Conclusion
  3. Content Article
    Risk assessment during the maternity pathway relies on healthcare professionals recognising a change in a pregnant woman/person’s circumstances that may increase the level of risk. Risk assessments are undertaken during the numerous contacts pregnant women/people have with a team of healthcare professionals throughout the maternity pathway. This thematic review draws on findings from the Healthcare Safety Investigation Branch's (HSIB's) maternity investigation programme to identify key issues associated with assessing risk during pregnancy, labour and birth (known as the ‘maternity pathway’). It examined all reports undertaken by the HSIB maternity investigation programme from April 2019 to January 2022, with the aim of identifying key learnings about risk assessment. A total of 208 reports that had made findings and recommendations to NHS trusts about risk assessment during the maternity pathway were included. The review identified an overarching theme around the need to facilitate and support individualised risk assessments for pregnant women/people to improve maternity safety. Within this, seven specific ‘risk assessment themes’ within the maternity care pathway were identified as commonly appearing in HSIB reports. These seven themes require a focus from the healthcare system to help mitigate risks and enable NHS trusts and clinicians to deliver safe and effective maternity care to pregnant women/people.
  4. Content Article
    Slides from the recent Patient Safety Incident Response Framework (PSIRF) governance workshop giving an update and overview from the national team. Presentations were given from the early adopters: Jacquetta Hardacre, Assistant Director Safety and Risk, East Lancashire Hospitals NHS Trust and Kerry Crowther, Patient Safety Specialist, Cornwall Partnership NHS Foundation Trust. The workshop concluded with a Q&A panel with the presenters and Gillian Lewis Head of Patient Safety Strategy Delivery, NHS England.
  5. Content Article
    This ethnographic qualitative study in the BMJ aimed to describe how patients are engaged with cancer decisions in the context of multidisciplinary teams (MDT) and how MDT recommendations are carried out in the context of a shared decision. The study was carried out at four head and neck cancer centres in the north of England. The authors found that the current model of MDT decision-making does not support shared decision-making, and may actively undermine it. They recommend the development of a model that allows the individual patient more input into MDT discussions, and where decisions are made on potential treatment options rather than providing a single recommendation for discussion with the patient. Deeper consideration should be given to how the MDT incorporates the patient perspective and/or delivers its discussion of options to the patient.
  6. Content Article
    The OptiBreech project is a research study exploring the feasibility of evaluating a new care pathway for women with a breech pregnancy. About 1 in 25 babies are born bottom-down (breech) after 37 weeks of pregnancy. Women who wish to plan a vaginal breech birth have asked for more reliable support from an experienced professional. This aligns with national policy to enable maternal choice. In this video, Dr Shawn Walker explains why the combination of meconium and tachycardia, particularly in the first stage of labour, indicates increased risk in breech births.
  7. Content Article
    The word 'controversy' almost always accompanies any reference to electroconvulsive therapy (ECT). It has a dark history and remains a deeply contentious practice. For many, ECT is seen as outdated, forever linked with frightening images of medical abuse, cruelty and even punishment. In this programme for BBC Radio 4, Professor Sally Marlow met her friend Dr Tania Gergel at King’s College London, which forced her to reassess everything she thought she knew about ECT. Tania told Sally that ECT had saved her life on numerous occasions and that ECT is the only treatment that can bring her back to health after episodes of severe depression, psychosis and mania. Tania is Director of Research at Bipolar UK. She’s a philosopher and an internationally respected medical ethicist. She also lives with a serious mental illness; an unusual mixed type of bipolar disorder. During her last period of illness a year ago, Tania kept an audio diary., which she shares extracts from throughout the programme in order to break down stigma around both mental illness and ECT.
  8. Content Article
    Self-binding directives instruct clinicians to overrule treatment refusal during future severe episodes of illness. These directives are promoted as having the potential to increase autonomy for individuals with severe episodic mental illness. Although lived experience is central to their creation, the views of service users on self-binding directives have not been seriously investigated. This study in The Lancet Psychiatry aimed to explore whether reasons for endorsement, ambivalence or rejection given by service users with bipolar disorder can address concerns regarding self-binding directives, decision-making capacity and human rights.
  9. News Article
    More than a third of delayed discharges for long-stay patients are being caused by factors generally associated with the NHS, according to new data obtained by HSJ. Delayed discharges from hospital are often blamed on issues around social care, but figures for the nine months to January, for patients who have been in hospital for at least 21 days, suggest a significant proportion are due to NHS-related delays. The most common reason is waiting for rehabilitation beds in a community hospital or similar facility, which accounts for 23% of total delayed discharges, based on daily averages. Other reasons generally associated with NHS-related issues included delays around medical decisions (4%), therapist decisions (4 per cent), transfers to another acute site (2%), and diagnostic tests (1%). On top of this, a further 12% of the causes were at least partly associated with the NHS, such as delays relating to transfer of care hubs, which are generally jointly run with councils. Read full story (paywalled) Source: HSJ, 9 February 2023
  10. News Article
    Some ambulance trusts are not sending paramedics to up to around a quarter of their most serious calls, according to figures obtained by HSJ. HSJ submitted data requests to all 10 English ambulance trusts after the Care Quality Commission raised concerns about the proportion of category one calls not being attended by a paramedic at South Central Ambulance Service Foundation Trust. The regulator said in a report published in August last year that between November 2021 and April 2022 around 9% of the trust’s category one calls were not attended by a paramedic. Inspectors said this meant some patients “did not receive care or treatment that met their needs because there were not appropriately qualified staff making the decisions and providing treatment.” But data obtained via freedom of information requests reveals other ambulance trusts had far lower proportions of category one calls attended by paramedics than the South Central service last year. Read full story Source: HSJ, 2 February 2023
  11. Content Article
    This video and written summary from the Institute of Health and Social Care Management (IHSCM) look at the principles of running virtual wards, where patients are monitored and cared for in their own homes with the help of remote treatment options and supported by technology. Hosted by health policy analyst Roy Lilley, speakers include: Professor Alison Leary Elaine Strachan-Hall Steph Lawrence Alexandra Evans Dr Elaine Maxwell
  12. Content Article
    In this interview with the publisher Bloomsbury, freelance health journalist and founder of the Hysterical Women blog Sarah Graham talks about her book, Rebel Bodies: A guide to the gender health gap revolution. She discusses the recurrent themes she came across in her work as a health journalist which inspired her to set up her blog: women's experiences of gaslighting, dismissal and disbelief by the medical system. Sarah talks about how her book aims to bring together all the stories and ideas she has worked on for the last five or so years and highlight how closely they’re linked. The book also celebrates the resilience, determination, sisterhood and solidarity Sarah has witnessed from patient advocates and campaigners across the sphere of women’s health and trans health. Read Sarah's 2020 blog, Gender bias: A threat to women’s health, on the hub.
  13. Content Article
    In this article for The Guardian, psychiatrist Rebecca Thomas talks about the benefits and problems related to electroconvulsive therapy (ECT) treatments, which are used in cases of severe depression. Having had 70 individual ECT treatments for depression herself, Rebecca highlights that although the therapy can be very effective, doctors need to acknowledge the issues it can cause for patients. She talks about the memory issues ECT can cause, and highlights that as a therapy it has been stigmatised, which spreads fear about a treatment that can be necessary and life-saving. Concluding that decisions around ECT therapy should be clinical and not moral, she urges doctors not to be complacent about the risks, and patients to be careful about stigmatising an effective treatment.
  14. Content Article
    Cynefin, pronounced kuh-nev-in, is a Welsh word that signifies the multiple, intertwined factors in our environment and our experience that influence us (how we think, interpret and act) in ways we can never fully understand.  The Cynefin Framework was developed to help leaders understand their challenges and to make decisions in context. It has been applied to many different environments including healthcare and safety. To read more about the framework and to watch a 12-minute introductory film, follow the link below to the Cynefin Co website.
  15. Content Article
    This report from Simon Milburn, Area Coroner for the area of Cambridgeshire and Peterborough, looks at the death of Jonathan Kingsman, who died of pulmonary thromboembolism and deep vein thrombosis on 1 February 2021. Mr Kingsman had been admitted to Fulbourn Hospital, Cambridge under section 2 of the Mental Health Act 1983 on 26 January. It was noted that on admission, Mr Kingsman had not consumed any fluids for several hours. The doctor on call carried out an initial risk assessment for venous thromboembolism (VTE), but as Mr Kingsman's mobility was deemed to 'not have significantly reduced ability', the assessor was directed by the guidance to stop the assessment. It was agreed at the Inquest that Mr Kingsman fell into this category and likewise agreed that throughout his time in hospital that there were no changes to his mobility which would have prompted a renewed risk assessment. However, Mr Kingsman did have other risk factors for VTE, and the coroner raised matters of concern about the risk assessment process as follows: That the risk assessment requires no consideration of risk factors other than mobility unless ‘Step 1’ is passed regardless of the number of other risk factors which may be present and their severity – Mr Kingsman was not obviously at risk of ‘significantly increased immobility compared to his normal state’ but died as a result of a DVT/VTE nonetheless. It is reasonable to expect that others may be in the same position in the future. The risk assessment form contains no guidance on its completion and no definition of certain terms. A copy of the report was sent to The Secretary of State for the Department of Health.
  16. Content Article
    The Patients Association's Patient Partnership Week brought together patients, carers and healthcare professionals to talk about patient partnership.
  17. News Article
    With the distressing spate of news reports about mums and ­babies who weren’t kept safe in hospital, an initiative in the Midlands to improve patient safety in maternal and acute care settings comes as a relief. The newly announced Midlands Patient Safety Research Collaboration will bring together NHS trusts, ­universities and private business to evaluate how digital tools can help clinical decision making and reduce danger for patients. Problems can arise if communication is poor between medics when patients move between departments. Professor Alice Turner of Birmingham University said: “The power of new technology available to us means that we can address one of the ongoing areas of risk for patients, which is effective communication and clinical decision making. “The new collaboration will be looking at how digital tools can make a real difference to reduce risks and support patient safety in the areas of acute medicine and maternal health.” Digital decision-making tools could improve prescribing and personalised management for patients needing emergency care. Importantly, these tools should provide a smoother flow of information between healthcare professionals in acute care between hospitals, doctors and the West Midlands Ambulance Service, and hopefully reduce risks of patient harm at key points during acute care. Read full story Source: The Mirror, 18 December 2022
  18. Content Article
    This guide by the Patient Information Forum (PIF) provides practical support for translating health information. It offers tips on overcoming key challenges and links to useful resources. It is mainly focused on foreign language translation, but the principles can also be applied to British Sign Language and Braille. Research shows that in the UK, up to a million people cannot speak English well or at all, and these people have a lower proportion of good health than English speakers. Providing culturally appropriate, translated health information can help people manage their own health and take part in shared decision making. Translation is consistently raised as a key challenge by health information producers. Please note, you will need to join PIF to view this content.
  19. Content Article
    This US study in the journal Medical Care aimed to investigate the extent of physician practice adoption of patient engagement strategies nationally. The authors analysed data collected from the National Survey of Healthcare Organizations and Systems (NSHOS) on adoption of patient engagement strategies. They found that there was modest adoption of shared decision-making and motivational interviewing, and low adoption of shared medical appointments.
  20. Content Article
    In this episode of the NICE talks podcast, Consultant Respiratory Physician Dr Hitasha Rupani, Medicines Consultant Clinical Adviser at the National Institute for Health and Care Excellence (NICE) Jonathan Underhill and asthma patient Sheba Joseph discuss NICE’s recently published patient decision aid on asthma inhalers and climate change. The tool supports people with asthma to consider whether they might be able to use inhalers which have a smaller carbon footprint as part of their treatment plan. View the NICE patient decision aid on asthma inhalers and climate change
  21. Content Article
    An expert review of the clinical records of 44 deceased patients who had been under the care of neurologist Dr Michael Watt has found there were “significant failures” in their treatment and care. Dr Watt, a former Belfast Health and Social Care Trust consultant neurologist, was at the centre of Northern Ireland’s largest ever recall of patients, which began in 2018, after concerns were raised about his clinical work. More than 4,000 of his former patients attended recall appointments. At the direction of the Department of Health, in August 2021, the Regulation and Quality Improvement Authority (RQIA) commissioned the Royal College of Physicians to undertake an expert review of the clinical records of certain deceased patients who had been under the care of Dr Watt, with the intention to understand his clinical practice, to ensure learning for others and to help make care better and safer in the future.
  22. Content Article
    In this blog for The Patients Association, Patient Safety Commissioner Henrietta Hughes looks at the importance of patient involvement in improving patient safety. She argues that patient voices should be embedded in the design and delivery of healthcare, and highlights that services and organisations need to seek feedback from patients from a wide variety of backgrounds. She also outlines why shared decision making and consent are vital to ensure patients are safe and have more control over their care and treatment.
  23. News Article
    A review of the clinical records of 44 patients who died under the care of former neurologist Michael Watt has found "significant failures in their treatment" and "poor communication with families". While this review looked at a sample of cases in which people died, potentially thousands more could be affected. The review arises from a 2018 recall of 2,500 outpatients who were in Dr Watt's care at the Belfast Health Trust. About one in five patients had to have their diagnoses changed. This separate review into 44 deaths was conducted by the Royal College of Physicians at the request of the regulator, the Regulation and Quality Improvement Authority (RQIA). It highlighted concerns over clinical decision-making, prescribing and diagnostics. It reveals a misdiagnosis rate of 45% among this group of patients, twice that for living patients. Speaking to BBC News NI, the RQIA's chair, Christine Collins, said the outcome of the review was "shocking and gut-wrenching as so many had experienced unpleasant deaths which they ought not to have done". Read full story Source: BBC News, 29 November 2022
  24. Content Article
    The Patients Association has been working with NHS England to look at how to improve GP referrals of patients to hospital. The goal was to look at ways specialists could support GPs so they could reduce the number of outpatient appointments patients have to attend, without compromising care. This report includes an overview of the patient panel workshops, key themes and findings from the workshops, and a set of recommendations.
  25. News Article
    Attending physicians and advanced practice clinicians in US emergency departments are more concerned about medical errors resulting in patient harm than in malpractice litigation, according to a study published JAMA Network Open. The findings are based on an online survey of 1,222 ED clinicians across acute care hospitals in Massachusetts from January to September 2020. Respondents used a Likert scale of 1 (strongly disagree) to 6 (strongly agree) to indicate their degree of agreement with statements on how fearful they are of making a mistake that leads to a patient harm in their day-to-day practice, and how fearful they are of an error that results in being sued. The mean score was greater for fear of harm (4.40) than fear of being sued (3.40), the findings showed. Researchers said the mean scores for both fear of harm and fear of suit were similar regardless of whether the survey was completed before or after onset of the COVID-19 pandemic. Although previous studies have associated clinicians' fear of legal concerns with "excessive healthcare use through defensive medicine," the role fear of patient harm may play in clinical decision-making is less documented, researchers said. "Although the study did not delineate the association between this concern and potential overuse of testing, it suggested that fear of harm should be considered with, and may be more consequential, than fear of suit in medical decision-making," researchers said. Read full story Source: Becker's Hospital Review, 21 November 2022
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