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Content Article
World Patient Safety Day 2024
Patient Safety Learning posted an article in WHO
This year’s World Patient Safety Day on 17 September 2024 is focused on the theme “Improving diagnosis for patient safety”. This article explains the aims of the event and the areas it will cover. -
Content Article
Endometriosis: A patient's journey (10 April 2024)
Patient-Safety-Learning posted an article in Women's health
This Medscape article tells the story of Josephine Vest, who was diagnosed with endometriosis aged 19. Now 30, she describes how her symptoms were dismissed and belittled by GPs and gynaecologists before she received a diagnosis a year after her symptoms began. With an average diagnostic delay approaching nine years across the UK, Josephine counts herself fortunate to have been diagnosed in this time frame. She goes on to describe the obstacles she faced in getting effective treatment and the suspicious attitudes healthcare staff displayed towards her. -
News Article
Black people who spot cancer symptoms are taking twice as long to be diagnosed
Patient Safety Learning posted a news article in News
Black and Asian people who spot cancer symptoms are taking twice as long to be diagnosed as white people, a shocking new study shows. Research by Bristol Myers Squibb (BMS) and Shine Cancer Support shows that people from minority ethnic backgrounds face an average of a year’s delay between first noticing symptoms and receiving a diagnosis of cancer. These groups report more negative experiences of cancer care than white people, limited knowledge about the diseases and lack of awareness of support services, which all contribute to later diagnostic rates. “In a year that’s revealed that the UK’s cancer survival lags behind comparable countries, I am saddened but unsurprised that people from minority ethnic groups face additional hurdles that delay their diagnosis.” said Ceinwen Giles, co-ceo of Shine Cancer Support. “We know that catching cancer earlier saves lives, yet with year long waits for some people, collaborative efforts between health leadership, advocacy groups and the pharmaceutical industry are required.” Read full story Source: The Independent, 9 April 2024 -
Content ArticleCancer Equals is a campaign launched by Bristol Myers Squibb, to understand and help address the many factors that lead to delays in cancer diagnosis and variations in cancer experiences between people from different backgrounds. Cancer Equals research shows that people from minority ethnic groups experience seven months longer delays between noticing cancer symptoms and diagnosis compared to white individuals. Many factors lead to these delays in diagnosis and differences in people’s experience of cancer – no one’s story is the same. Delays to diagnosis will and do impact prognosis, changing the course of peoples’ lives. Health disparities and inequalities are an ongoing and pressing issue, with the UK government, NHS and patient groups committed to increasing earlier diagnosis and improving outcomes for people living with cancer.
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News Article
NHS faces ‘avalanche’ of demand for autism and ADHD services, thinktank warns
Patient Safety Learning posted a news article in News
The NHS is experiencing an “avalanche of need” over autism and attention deficit hyperactivity disorder (ADHD), but the system in place to cope with surging demand for assessments and treatments is “obsolete”, a health thinktank has warned. There must be a “radical rethink” of how people with the conditions are cared for in England if the health service is to meet the rapidly expanding need for services, according to the Nuffield Trust. The thinktank is calling for a “whole-system approach” across education, society and the NHS, amid changing social attitudes and better awareness of the conditions. It comes days after the NHS announced a major review of ADHD services. Thea Stein, the chief executive of the Nuffield Trust, said: “The extraordinary, unpredicted and unprecedented rise in demand for autism assessments and ADHD treatments have completely overtaken the NHS’s capacity to meet them. It is frankly impossible to imagine how the system can grow fast enough to fulfil this demand. “We shouldn’t underestimate what this means for children in particular: many schools expect an assessment and formal diagnosis to access support – and children and their families suffer while they wait.” Read full story Source: The Guardian, 4 April 2024 -
Content ArticleLong waiting times for autism and attention deficit hyperactivity disorder (ADHD) assessments can prevent people from getting the vital care and medication they need. Health and education support often relies on a formal diagnosis, without which there can be severe negative consequences. Estimates show that there might be as many as 1.2 million autistic people and 2.2 million people with ADHD in England, and providing them with the right support is no small task. Recent news reports have highlighted a huge rise in demand for autism and ADHD diagnoses amid increased awareness and understanding of neurodiversity. Exploring referrals and waits for autism and ADHD assessments is a key first step to understanding the scale of the issue, which can then be used to drive improvements and change. This blog from the Nuffield Trust looks at what the data is telling us.
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Content ArticleThis qualitative study in the Journal of Patient Safety aimed to understand the perception of dental patients who have experienced a dental diagnostic error and to identify patient-centred strategies to help reduce future occurrences. Recruiting patients via social media, the researchers conducted a screening survey, initial assessment and 67 individual patient interviews to capture the effects of misdiagnosis, missed diagnosis or delayed diagnosis on patient lives. They found that dental patients endured prolonged suffering, disease progression, unnecessary treatments and the development of new symptoms as a result of diagnostic errors. Patients believed that the following factors contributed to diagnostic errors: Poor provider communication Inadequate time with provider Lack of patient self-advocacy and health literacy. Patients suggested that future diagnostic errors could be mitigated through: improvements in provider chairside manners more detailed patient diagnostic workups improving personal self-advocacy enhanced reporting systems.
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Content ArticleThis cohort study in JAMA Network explored the incidence of and factors associated with inappropriate diagnosis of pneumonia in hospitalised patients. The results showed that older patients, those with dementia and those presenting with altered mental status had the highest risk of being inappropriately diagnosed. For those who were inappropriately diagnosed, full antibiotic duration was associated with antibiotic-associated adverse events.
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News Article
Startup developing AI-powered sepsis & infection tests in trials at 9 NHS Trusts
Clive Flashman posted a news article in News
Presymptom Health’s technology provides early and reliable information about infection status and severity in patients with non-specific symptoms, helping doctors make better treatment decisions. The company’s tests can be run on NHS PCR platforms, which were widely deployed during the COVID pandemic and are now often under-utilised. By detecting true infection and sepsis earlier, it’s possible to save lives and significantly reduce the incorrect use of antibiotics. When it comes to sepsis, Presymptom’s technology could revolutionise treatment. According to The UK Sepsis Trust, every 3 seconds, someone in the world dies of sepsis. In the UK alone, 245,000 people are affected by sepsis with at least 48,000 people losing their lives in sepsis-related illnesses every year. This is more than breast, bowel and prostate cancer combined. When diagnosed at a late stage, the likelihood of death increases by 10% for every hour left untreated. Yet, for many patients, with early diagnosis it is easily treatable. “We’re confident that our first product can play a big part in tackling Anti-Microbial Resistance (AMR), which has been identified by the World Health Organisation as one of the top 10 global public health threats,” said Dr Iain Miller, CEO of Presymptom Health. “By understanding the presence, or absence, of infection as early as possible, doctors can be more confident in their diagnosis and avoid unnecessarily prescribing antibiotics – something that is a growing concern in the NHS and globally. “If we take Sepsis as an example. Sepsis diagnostics hasn’t moved on in more than a century, and currently doctors can only diagnose it when advanced symptoms and organ failure are present – which is often too late. Our technology enables doctors to diagnose both infection and sepsis up to three days before formal clinical diagnosis, radically transforming the process and preventing unnecessary deaths. The science behind Presymptom’s technology is based upon 10 years of work conducted at Defence Science and Technology Laboratory (Dstl) and originated from £16m of sustained Ministry of Defence investment in a programme of research designed to help service personnel survive infection from combat injuries. The technology is currently undergoing clinical trials at nine NHS hospitals in the UK, with results anticipated later in 2024. In addition, Presymptom is working on additional UK and EU trials. -
News ArticleMinisters are being urged to roll out a better testing regime for one of the country’s biggest killers, with the most recent figures showing death rates for chronic obstructive pulmonary disease more than three times higher in some of the most deprived areas of the country. More than 20,000 people a year in England die from chronic obstructive pulmonary disease. The most significant cause of COPD is smoking, but a significant proportion of cases are work-related, triggered by exposure to fumes, chemicals and dust at work. Figures from the Office for National Statistics reveal that death rates from the disease are significantly higher in more deprived areas of the country. The NHS is rolling out targeted lung screening across England for people aged between 55 and 74 who are current or former smokers. The charity Asthma + Lung UK says the checks will identify many people who may have COPD, but there is no established protocol for them to be diagnosed and given appropriate treatment and support. Dr Samantha Walker, interim chief executive at Asthma + Lung UK, said: “Once targeted lung health checks are fully rolled out, millions of people could be told they have an incurable lung disease like chronic obstructive pulmonary disease, but they won’t be given a firm diagnosis or signposted to the right support, which is simply unacceptable. “What we need to see is a national referral pathway in place for those people who show signs of having other lung conditions as part of this screening process to ensure that people with all suspected lung conditions get the diagnosis and treatments that they deserve. We know that people with lung disease will live better, fuller lives with an earlier diagnosis.” Read full story Source: The Guardian, 24 March 2024
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Content ArticleThe role of artificial intelligence (AI) in healthcare is expanding quickly with clinical, administrative, and patient facing uses emerging in many specialties. Research on the effectiveness of AI in healthcare is generally weak, but evidence of AI improving doctor’s diagnostic decisions is emerging for some focused clinical applications, including interpreting lung pathology and retinal images. However, we must work with patients to understand how AI impacts on their care, says Rebecca Rosen in this BMJ opinion piece.
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Content ArticleAmbulatory safety nets not only safeguard against diagnostic errors, they also encourage collaboration, support health care providers, and break down competitive barriers for the greater good of patient safety.
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Content ArticleSevere myalgic encephalomyelitis or chronic fatigue syndrome (ME/CFS) in children and young people is a little-understood condition which significantly impacts education, development and quality of life. This study in BMJ Paediatrics Open used data from a population-wide surveillance study to explore the screening investigation, referral and management of suspected cases of paediatric severe ME/CFS. The authors found that full investigation is frequently incomplete in children and young people with suspected severe ME/CFS. Recommendations for referral and management are poorly implemented—in particular the needs of children and young people who are unable to leave their home might be poorly met.
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Content ArticleDiagnostic errors cause significant patient harm. The clinician’s ultimate goal is to achieve diagnostic excellence in order to serve patients safely. This can be accomplished by learning from both errors and successes in patient care. However, the extent to which clinicians grow and navigate diagnostic errors and successes in patient care is poorly understood. Clinically experienced hospitalists, who have cared for numerous acutely ill patients, should have great insights from their successes and mistakes to inform others striving for excellence in patient care.
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Content ArticleDiagnostic delays in the emergency department (ED) are a serious patient safety concern. This retrospective cohort study included children treated at 954 EDs across 8 states, and examined the association between ED volume and delayed diagnosis of first-time diagnosis of an acute, serious conditions (e.g., bacterial meningitis, compartment syndrome, stroke). The researchers found that EDs with lower pediatric volume had higher rates of delayed diagnosis across 23 serious conditions.
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Content ArticleGetting a diagnosis for endometriosis now takes almost a year longer than before the pandemic, according to new research published by Endometriosis UK during Endometriosis Action Month 2024. The new study shows that diagnosis times in the UK have significantly worsened over the last 3 years, increasing to an average of 8 years and 10 months, an increase of 10 months since 2020. This lengthy wait means a delay in accessing treatment, during which the disease may progress, leading to worsening physical symptoms and a risk of permanent organ damage. Endometriosis impacts the physical and mental health of 1 in 10 women and those assigned female at birth in the UK from puberty to menopause, although the impact may be felt for life.
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News Article
Endometriosis: Women in Wales waiting 10 years for diagnosis
Patient Safety Learning posted a news article in News
The wait to be diagnosed with endometriosis has increased to almost ten years, a "devastating" milestone say women with the condition. It now takes almost a year more than before 2020 to be diagnosed, according to research published by Endometriosis UK, which is setting up new volunteer-led support groups in Wales. The wait in Wales is also the longest in the UK, the research found. The Welsh government said it knew there was "room for improvement". "Nobody listened to me, and to feel like women are still going through that 20 years after my diagnosis is horrific," said Michelle Bates. The 48-year old from Cardiff was diagnosed aged 25 after suffering with "harrowing" pain from age 13 onwards - a 12-year wait. "I went back and forth to the GP with my mum, who was the only one who believed in my pain," she said. The study by Endometriosis UK, which is based on a survey of 4,371 people who received a diagnosis of endometriosis, showed almost half of all respondents (47%) had visited their GP 10 or more times with symptoms prior to receiving a diagnosis, and 70% had visited five times or more. It also found 78% of people who later went on to receive a diagnosis of endometriosis - up from 69% in 2020 - were told by doctors they were making a "fuss about nothing", or comments to that effect. Read full story Source: BBC News, 18 March 2024 -
Content Article
Top picks: 12 research papers on Long Covid
Patient Safety Learning posted an article in Blogs
We are seeing more and more people who have been devastated by the long-lasting impact of Covid-19. Long Covid is a relatively new condition which is still being studied and the need for more awareness and advocacy has never been greater. Scientists are carrying out large-scale clinical trials and researchers are on the hunt for new therapies in the hope that patients with Long Covid will finally see improvements in treatment and support for their symptoms. In this Top picks blog, shared on International Long Covid Awareness Day, we highlight 12 recent research papers on Long Covid. -
Content Article
Unpacking cancer disparities in England (7 March 2024)
Patient-Safety-Learning posted an article in Cancers
Despite major gains in diagnosis and treatment, England continues to experience high disparities in cancer outcomes, with social and financial deprivation major drivers. This article from the thinktank Public Policy Projects looks at the underlying issues that lead to variation in both the likelihood of developing cancer, such as dietary differences, and in diagnosis, such as inaccessible screening programmes -
News ArticleAt least 50,000 people will die from pancreatic cancer over the next five years unless the government gives more funding to improve how quickly the condition is diagnosed and treated, a major charity has warned. Pancreatic Cancer UK hit out at 50 years of “unacceptably slow progress” compared to other types of cancer as it warned that thousands of lives will be lost unless £35m of “urgent” investment is put towards improving survival rates of the disease. The charity predicted that pancreatic cancer – described by experts as the “quickest-killing cancer” – is expected to kill more people each year than breast cancer by 2027, which would make it the fourth-biggest cause of cancer deaths in the UK. The charity has also called for a commitment to treat everyone diagnosed with the cancer within 21 days, which it says would double the number of people getting treatment in time. Figures show that, compared to the 52.5% survival rate across the 20 most common cancers in the UK, those with pancreatic cancer have just a 7% survival rate. Around 10,500 people are diagnosed with the disease each year, with 9,558 deaths a year, according to Cancer Research UK, with more than half of people dying within three months of diagnosis. Read full story Source: The Independent, 12 March 2024
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News Article
Ombudsman warns over-stretched doctors could put cancer patients at risk
Patient Safety Learning posted a news article in News
England’s NHS Ombudsman has warned that cancer patients could be put at risk because of over-stretched and exhausted health staff working in a system at breaking point and delays in diagnosis and treatment. The Parliamentary and Health Service Ombudsman (PHSO) revealed that between April 2020 and December 2023, his Office carried out 1,019 investigations related to cancer. Of those 185 were upheld or partly upheld. Issues with diagnosis and treatment were the most common cancer-related issues investigated by PHSO. These issues included treatment delays, misdiagnosis, failure to identify cancer, the mismanagement of conditions, and pain management. Complaints about cancer care also included concerns about poor communication, complaint handling, referrals, and end-of-life care. Most investigations were about lung cancer, followed by breast cancer and colorectal cancer. The Ombudsman recently closed an investigation around the death of Sandra Eastwood whose cancer was not diagnosed for almost a year after scans were not read correctly. The delay meant she missed out on the chance of treatment which has a 95% survival rate. In 2021, PHSO published a report about recurrent failings in the way X-rays and scans are reported on and followed up across the NHS service. Mr Behrens said, “What happened to Mrs Eastwood was unacceptable and her family’s grief will no doubt have been compounded by knowing that mistakes were made in her care. “Her case also shows, in the most tragic of ways, that while some progress has been made on my recommendations to improve imaging services, it is not enough and more must be done. “Government must act now to prioritise this issue and protect more patients from harm.” Read full story Source: Parliamentary Health and Health Service Ombudsman, 9 March 2024 -
Content ArticleThis study compared the blood of patients with confirmed Covid-19 infection with that of uninfected controls. The authors found that there were changes to serum proteins in the blood of patients experiencing Long Covid. This indicates activation of the immune system’s complement cascade, altered coagulation and tissue injury. At the cellular level, Long Covid was linked to aggregates comprising monocytes and platelets. These findings provide knowledge of potential biomarkers for diagnosis and may inform directions for treatments.
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Content ArticleSepsis is an emergency medical condition where the immune system overreacts to an infection. It affects people of all ages and, without urgent treatment, can lead to organ failure and death. This leaflet by the Sepsis Trust outlines the symptoms of sepsis in children and aims to help parents and carers identify when to seek medical help.
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News Article
Women in UK waiting almost nine years for endometriosis diagnosis, study finds
Patient Safety Learning posted a news article in News
Women are waiting nearly nine years for an endometriosis diagnosis in the UK, according to research that found health professionals often minimise or dismiss symptoms. The study by the charity Endometriosis UK suggests waiting times for a diagnosis have significantly deteriorated in the past three years, increasing to an average of eight years and 10 months, up 10 months since 2020. In Scotland, the average diagnosis time has increased by four months. The report, based on a survey of 4,371 people who have received a diagnosis, shows that 47% of respondents had visited their GP 10 or more times with symptoms before being diagnosed, and 70% had visited five times or more. The chief executive of Endometriosis UK, Emma Cox, said: “Taking almost nine years to get a diagnosis of endometriosis is unacceptable. Our finding that it now takes even longer to get a diagnosis of endometriosis must be a wake-up call to decision-makers to stop minimising or ignoring the significant impact endometriosis can have on both physical and mental health.” The report includes examples of patients’ experiences, with many being told that their pain was “normal”. One said: “I was constantly dismissed, ignored and belittled by medical professionals telling me that my symptoms were simply due to stress and tiredness. I persevered for over 10 years desperate for help.” Another said she had been told she was “being dramatic” after going to her GP as a teenager with painful periods. Another said: “A&E nurses told me that everyone has period pain so take paracetamol and go home.” Read full story Source: The Guardian, 4 March 2024 -
Content ArticleSpina bifida develops early in the embryonic stage of pregnancy but is not usually detected until the midterm (20 week) ultrasound scan. Shine conducted a survey to assess the antenatal care experiences of parents to children with spina bifida. Volunteers were recruited via social media and 71 eligible (UK-based) responses were received, revealing numerous elements of antenatal care in need of significant improvement. Shine have published the findings and recommendations for improving antenatal diagnosis and care for spina bifida.
