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Found 469 results
  1. News Article
    Difficulties seeing GPs during the pandemic have hampered efforts to tackle dementia, with thousands missing out on a diagnosis, Sajid Javid has said. Announcing a ten-year strategy aimed at preventing four in ten cases of the disease, the health secretary said that delays had “stemmed the tide of progress”. GPs must play a “crucial role” in referring patients, he said. NHS leaders went further, saying a drop in face-to-face GP appointments had meant “opportunities have been lost” to spot signs of dementia. Only 62% of consultations in March were face to face, compared with 80% before the pandemic. Javid said: “By 2025, one million people in the UK are expected to have dementia, and this is expected to rise to 1.6 million by 2040. I know the Alzheimer’s Society has estimated over 30,000 people didn’t receive a diagnosis because of the pandemic. Tens of thousands are still missing out on a dementia diagnosis each year because they confuse key symptoms with getting old.” About 325,000 in England have dementia but are undiagnosed, meaning they cannot get treatment or social care support. Speaking at the Alzheimer’s Society conference, Javid said the government would publish a strategy this year, which would be “as bold as we’ve been with our ten-year plan for cancer”, focusing on prevention and research. Read full story (paywalled) Source: The Times, 18 May 2022 This week is Dementia Action Week - see our Top picks: 5 key resources about patient safety for people with dementia
  2. Content Article
    Next Steps is a tool created by the Dementia Change Action Network to help patients find the right support, at the right time, while waiting for their memory assessment appointment. Some patients are facing longer waits as a result of the Covid-19 pandemic, and it can be an uncertain time. Next Steps provides information about what to expect from the memory assessment process and about organisations who can help.
  3. News Article
    Parents whose children have mysteriously fallen ill with hepatitis and received a delayed diagnosis could be entitled to negligence claims, lawyers believe. Officials are no closer to explaining a recent and unusual outbreak in cases of liver inflammation recorded among young children across the UK. To date, a total of 163 children have been diagnosed. Eleven of these have received liver transplants, while 13 are currently in hospital. Globally in recent months, 300 children have been struck down by the illness, which has no clear cause. Because the UK cases have been identified retrospectively, there is potential that doctors and medics may have “missed signs” which would have led to earlier hepatitis diagnoses and treatment, lawyers say. “There are a significant number of these diagnoses which are actually retrospective,” said Jonathan Peacock, a partner at VWV specialising in clinical negligence. “The obvious issue there from a negligence point of view is if you have missed signs, which ought to have led you to a diagnosis of hepatitis earlier, as a result of which it’s gone untreated and the outcome is worse, then potentially you’re negligent. “There’s two stages: was the care diagnosis, treatment, intervention, was that of a reasonable standard? If the answer is no – there was clearly a negligent delay, or a breach of duty of care, then the second question that then arises is has the individual been harmed by that delay?” Read full story Source: The Independent, 10 May 2022
  4. News Article
    New calculations from Cancer Research UK estimate that, on average, over 65,000 people in England are left waiting longer than 28 days to find out whether they have cancer each month. These estimates are based on the latest data from the Faster Diagnosis Standard (FDS). The FDS is a performance standard introduced by Government in 2021. It’s used to better capture how long people on certain cancer-related referrals wait for a diagnosis. This applies to people referred by their GP urgently with suspected cancer, following breast symptoms, or have been picked up through cancer screening. The current FDS target is set at 75%, meaning three quarters of people being urgently referred should be told they have cancer or given the all-clear within that timeframe. However, this target has yet to be met. In addition, the data has revealed major variation across the country – with only 78 of 143 trusts meeting the 75% target. This means that despite the tireless efforts of NHS staff, chronic capacity issues mean that people continue to be failed by the system. Michelle Mitchell, our chief executive, said: “As a country we should not be willing to accept that over 1 in 4 people on an urgent referral are left waiting over a month to find out whether they have cancer. Nor should we stand for the variation that exists across the country.” The charity is calling on Government to include a more ambitious target within its upcoming 10-year cancer plan, to help ensure around 54,300 more people each month receive a diagnosis or have cancer ruled out within a month. With a robust plan and sustained investment to build a cancer workforce fit for the future, patients will be diagnosed quicker and earlier, which will save more lives. Read full story Source: Cancer Research UK, 9 May 2022
  5. Content Article
    Accurate and timely diagnosis is a key aspect of healthcare, and misdiagnosis and delayed diagnosis can have serious consequences for patients. This eBook published by the National Academies for Science, Engineering and Medicine highlights that tackling diagnostic error in healthcare is a moral, professional, and public health duty. It makes recommendations to improve the safety of diagnostic processes, outlining the need for collaboration and a widespread commitment to change among healthcare professionals, healthcare organisations, patients and their families, researchers and policy makers.
  6. Content Article
    Positive defensive medicine describes an approach to healthcare that involves excessive testing, over-diagnosing and overtreatment. Negative defensive medicine, on the contrary, describes an approach where doctors avoid, refer or transfer high risk patients. This article in Patient Safety in Surgery examines how both defensive medicine approaches can contribute to medical errors.
  7. News Article
    NHS leaders are urging people to attend vital lung cancer check-ups as figures reveal almost two-thirds of those invited are not coming forward. The NHS targeted lung health check service offered in some parts of England aims to help diagnose cancer at an earlier stage when treatment may be more successful. Current and former smokers aged between 55 and 74 are invited to speak to a healthcare professional and, if they have a higher chance of developing lung cancer, are offered a scan of their lungs. Doctors are keen to reach those who may not have sought help for symptoms during the pandemic and could be living with undiagnosed lung cancer. People diagnosed at the earliest stage are nearly 20 times more likely to survive for five years than those whose cancer is caught late, according to the NHS. The NHS has already diagnosed 600 people with the disease in travelling trucks, which visit convenient community sites across the UK, such as supermarkets and sports centres, aiming to make it easier for people to access check-ups. But figures show only a third (35%) of patients go to their lung health check when invited by the NHS. “These lung checks can save lives,” said Dame Cally Palmer, the NHS cancer director. “By going out into communities we find more people who may not have otherwise realised they have lung cancer, with hundreds already diagnosed and hundreds of thousands due to be invited." Read full story Source: The Guardian, 19 April 2022
  8. Content Article
    This study in JAMA Network Open aimed to investigate whether attention-deficit/hyperactivity disorder (ADHD) is over diagnosed in children and adolescents. The authors reviewed 334 published studies and found convincing evidence that ADHD is over diagnosed. They highlight that the harms associated with ADHD diagnosis may outweigh the benefits, particularly in children and young people with milder symptoms.
  9. Content Article
    Laura Cockram, Head of Policy and Campaigning at Parkinson's UK, and regular blogger for the hub, shares with us what Parkinson's UK will be doing to support World Parkinson's Day.
  10. News Article
    More than a quarter of cancers in Northern Ireland are being diagnosed in hospital emergency departments, according to Cancer Research UK. The study, published in The Lancet Oncology, was supported by NI Cancer Registry at Queen's University Belfast. It looked at 857,068 cases diagnosed between 2012 and 2017 in six countries including Australia, Denmark and the UK. Clare Crossey, 35, from Lurgan was diagnosed with acute myeloid leukaemia in February 2018 after being admitted to hospital as an emergency. The 35-year-old mother-of-two, who is a domiciliary care assistant, suddenly became very unwell with symptoms including tiredness and bruising. She told BBC News NI she had contacted her local health centre, where a GP told her she was being overly anxious. Ms Crossey said she had panicked, fearing she may have leukaemia after looking up her symptoms on the internet. "I had a feeling that things weren't right," she said. "The doctor did not agree with my suspicions as they passed me the number of the Samaritans helpline, a prescription for beta blockers and told me to wait a week for blood tests." She said: "I went to Craigavon's A&E, they did blood tests and within hours a consultant broke the news to me that I might have leukaemia." The medical team told her that had she waited any longer to come to the emergency department, she could have died, said Ms Crossley. Barbara Roulston, from Cancer Research UK, said the study confirmed too many people were only being diagnosed with cancer once their health had deteriorated to a point when they needed to go to their emergency department. "We need to reduce the number of cancer diagnoses that are happening in this way," she said. "That means renewed focus on early diagnosis and prevention through things like better awareness of symptoms, better uptake of screening programs and the way to do that is to get funding for the cancer strategy which was published recently. "If we don't, the risk is that we will start to see cancer survival going backwards." Read full story Source: BBC News, 7 April 222
  11. Content Article
    This report by the Health and Social Care Commons Select Committee examines why cancer outcomes in England remain behind other comparable countries. For example, 58.9% of people in England diagnosed with colon cancer will live for five years or more, compared to 66.8% in Canada and 70.8% in Australia. The report identifies key issues in early diagnosis, access to treatment, variation in services and research and innovation, and makes recommendations aimed at improving cancer survival rates in England.
  12. Content Article
    This article in the British Journal of General Practice aimed to develop a safety-netting intervention to reduce delays in cancer diagnosis in primary care. To develop the tool, patient representatives, GPs and nurse practitioners were invited to a series of co-design workshops. These workshops suggested the intervention format and content should incorporate visual and written communication specifying clear timelines for monitoring symptoms and when to present back. Participants also agreed that they needed to be available in paper and electronic forms, be linked to existing computer systems and be able to be delivered within a 10-minute consultation. The output of this process was the Shared Safety Net Action Plan (SSNAP), a safety-netting intervention to assist the timely diagnosis of cancer in primary care.
  13. News Article
    The NHS in England is struggling to make progress on its flagship target to diagnose three-quarters of cancer cases at an early stage, MPs are warning. The Health and Social Care Committee said staffing shortages and disruption from the pandemic were causing delays. Some 54% of cases are diagnosed at stages one and two, considered vital for increasing the chances of survival. By 2028, the aim is to diagnose 75% of cases in the early stages, but there has been no improvement in six years. It means England - as well as other UK nations - lag behind comparable countries such as Australia and Canada when it comes to cancer survival. If the lack of progress continues, the committee warned that it could lead to more than 340,000 people missing out on an early cancer diagnosis. The Department of Health said it recognised "business as usual is not enough" and said it was developing a new 10-year cancer plan. But a spokesman said progress was already being made, with a network of 160 new diagnostic centres being opened.R Read full story Source: BBC News, 5 April 2022
  14. Content Article
    This study in the Journal of Patient Safety aimed to describe the contributing factors in diagnosis-related and failure-to-monitor malpractice claims in which nurses are named the primary responsible party. It also aimed to identify actions healthcare leaders can take to enhance the role of nurses in diagnosis. The authors found that as nurses are held legally accountable for their role in diagnosis, leaders need to raise awareness across the system of the roles and responsibilities of nurses in this area. They also need to focus on enhancing nurses' diagnostic skills and knowledge.
  15. News Article
    The UK's top public health doctor says anyone with a persistent cough and fever should not dismiss it as Covid - and should consider other infectious illnesses like tuberculosis (TB). Dr Jenny Harries' warning comes as provisional data shows there were 4,430 cases recorded in England in 2021, despite sharp declines in recent years. Charities are calling for more funding to tackle the disease around the world. They say the pandemic and conflicts have set back progress worldwide. In 2020, global deaths because of tuberculosis ranked second to Covid for any infectious disease. The charity Stop TB Partnership warns the war in Ukraine could have "devastating impacts on health services", including the country's strong national TB treatment programme. The charity is urging all countries to put facilities in place urgently so refugees can be given the care they need. In the UK a requirement for Ukrainians to take a TB test before arrival has been waived for those who are coming to the country on the family scheme visa. Refugees arriving on the scheme will get medical care and testing via GPs. Meanwhile Dr Jenny Harries, chief executive of the UK Health Security Agency, said delayed diagnosis and treatment, particularly during the pandemic, will have increased the number of undetected cases in England. Read full story Source: BBC News, 24 March 2022
  16. News Article
    An NHS trust has apologised over the death of a 27-year-old events manager after a locum gynaecologist mistook aggressive cervical cancer for a hormonal or bowel problem. The family of Porsche McGregor-Sims, who died a day after being admitted to Queen Alexandra hospital in Portsmouth, told her inquest that she had felt she was not listened to and that the misdiagnosis had robbed them of a chance to say goodbye. The area coroner Rosamund Rhodes-Kemp said the case was one of the most “shocking and traumatic” she had dealt with and she would write to Portsmouth hospitals university NHS trust expressing her concern. In December 2019, McGregor-Sims’ GP referred her to a consultant after she complained of abdominal pain and vaginal bleeding. She saw Dr Peter Schlesinger, an agency locum at the Queen Alexandra hospital, at the end of January 2020. He did not physically examine her and believed her symptoms were linked to changing hormones or irritable bowel syndrome (IBS). After the UK went into lockdown two months later, McGregor-Sims continued to report symptoms but was prescribed antibiotics over the phone and was seen in person only after a GP thought she might have Covid because she had shortness of breath. McGregor-Sims was finally diagnosed with an aggressive form of cervical cancer and on 13 April was taken to hospital, where she died a day later. During the inquest, her family accused Schlesinger of having denied them their chance to say goodbye. Her mother, Fiona Hawke, told him: “You robbed us of the opportunity to prepare for her death and say goodbye to her.” Schlesinger insisted McGregor-Sims’ symptoms – including bleeding after sex – did not lead him to think she had a serious illness. Dr Claire Burton, a consultant gynaecologist, said Schlesinger should have physically examined McGregor-Sims, and apologised for the care she received at the trust. Read full story Source: The Guardian, 24 March 2022
  17. Content Article
    This investigation by the Healthcare Safety Investigation Branch (HSIB) explores the timely recognition and treatment of suspected pulmonary embolism in emergency departments. Pulmonary embolisms can form when clots from the deep veins of the body, usually originating in the legs, travel through the venous system and become lodged in the lungs. A person suffering from a pulmonary embolism requires urgent treatment to reduce the chance of significant harm or death.
  18. News Article
    Tens of thousands more women tested themselves for autism last year with numbers seeking tests now far outstripping men, new data shows. Statistics seen by The Independent show around 150,000 women took an online test verified by health professionals to see if they have autism last year, up from about 49,000 in 2020. Health professionals said the increase was a consequence of women not being diagnosed with the neurodevelopmental disorder as children and teens due to autism wrongly being viewed as a male disorder. Experts told The Independent autistic women and girls are routinely overlooked and neglected by health services due to them being more likely to conceal or internalise symptoms. Data from Clinical Partners, one of the UK’s leading mental health care providers which works closely with the NHS, shows women made up 56 per cent of those using their autism tests last year. This is substantially higher than the 46 per cent of women testing themselves for autism in 2020. Hannah Hayward, neurodevelopmental specialist at Clinical Partners, who provided the exclusive data, explained: “Diagnosis is crucial – without which, women and men can be susceptible to symptoms of mental health conditions including anxiety and depression and it is common for them to be misdiagnosed with or develop other conditions such as anxiety, anorexia, depression or Borderline Personality Disorder,” Read full story Source: The Independent, 23 March 2022
  19. Content Article
    Chloe Lumb was known to have a genetic risk of aortic dissection that was being monitored. When she presented to James Cook University Hospital in Middlesbrough on 4 January 2021 a diagnosis of aortic dissection was not made, despite the prior knowledge about her risk and her clinical symptoms. The next day she contacted the hospital following discharge because of ongoing symptoms but was not asked to return to hospital. In her report, the Coroner states that a diagnosis of aortic dissection and appropriate surgical treatment would have prevented Ms Lumb’s death.
  20. Content Article
    The gender health gap is a long-standing, deeply entrenched problem that stretches back centuries - yet it is only finally starting to get the attention it deserves. In this discussion hosted by The Independent's Women's Correspondent Maya Oppenheim, Dr Jess Taylor, Le’Nise Brothers, Sandra Igwe and Dr Geeta Nargund explore the steps that must be taken to solve the gender health gap, including proper education of health professionals and engaging in open honest conversations.
  21. News Article
    The only NHS gender identity service for children in England and Wales is under unsustainable pressure as the demand for the service outstrips capacity, a review has found. The interim report of the Cass Review, commissioned by NHS England in 2020, recommends that a network of regional hubs be created to provide care and support to young people with gender incongruence or dysphoria, arguing their care is “everyone’s business”. Led by the paediatrician Hilary Cass, the interim report explains that the significant rise in referrals to the Gender Identity Development Service (GIDS) at the Tavistock and Portman NHS foundation trust in London has resulted in overwhelmed staff and waiting lists of up to two years that leave young people “at considerable risk” of distress and deteriorating mental health. Last spring, the Care Quality Commission demanded monthly updates on numbers on waiting lists and actions to reduce them in a highly critical report on GIDS. Differing views and lack of open discussion about the nature of gender incongruence in childhood and adolescence – and whether transition is always the best option – means that patients can experience a “clinician lottery”, says the new review, which carried out extensive interviews with professionals and those with lived experience. It notes that the clinical approach used by GIDS “has not been subjected to some of the usual control measures” typically applied with new treatments. Another significant issue raised with the review team was that of “diagnostic overshadowing”, whereby once a young person is identified as having gender-related distress, other complex needs – such as neurodiversity or a mental health problem that would normally be managed by local services – can be overlooked. Read full story Source: The Guardian, 10 March 2022
  22. Content Article
    At present there is a single specialist service providing gender identity services for children and young people – the Gender Identity Development Service (GIDS) at the Tavistock and Portman NHS Foundation Trust. In recent years GIDS has experienced a significant increase in referrals which has contributed to long waiting lists and growing concern about how the NHS should most appropriately assess, diagnose and care for this population of children and young people. The Cass Review has submitted an interim report to NHS England, which sets out their work to date, what has been learnt so far and the approach going forward. The report does not set out final recommendations at this stage.
  23. News Article
    The two-week wait cancer target should be scrapped and replaced with a different measure, as part of an overhaul of cancer standards, NHS England has said. After piloting a new measure which aims to see 75% of patients given the all-clear or a diagnosis within 28 days of referral, NHS England has recommended .The new “faster diagnosis target” would replace the current ‘two-week wait’ target, which is for 93% to have seen a specialist within two weeks, but not necessarily had a diagnosis. This proposal, and other changes to the way cancer waiting time targets are organised, will be consulted on until 6 April. The nine current cancer targets were created in 2000. The current headline measure along with the two-week wait — a two-month wait from urgent GP referral to first treatment — has not been hit since December 2015. The document containing the proposals said the current two-week standard saw some patients given an appointment at which no test was taken, purely to hit the target. For some suspected cancers, “many trusts… offer outpatient appointments to ensure they hit the target”, without improving diagnosis. The move to scrap the two-week wait was welcomed – with significant caveats — by Cancer Research UK Cancer Research UK chief executive Michelle Mitchell said: “The new Faster Diagnosis Standard is a more meaningful target than the current two-week wait that will hopefully improve early diagnosis. If all trusts met the 75 per cent target, it would be an improvement to where we are now. However, in the long-term to improve cancer survival, we’d like to see a 95 per cent target originally proposed in the 2015 cancer strategy in Sajid Javid’s upcoming 10-year plan for cancer. “We recognise the target was set lower because of a shortage of cancer specialists, critical to diagnosing cancer across the NHS. The government must provide the extra investment they have promised to grow the NHS workforce. Every moment of delay risks more people waiting for diagnosis and treatment.” Read full story (paywalled) Source: HSJ, 10 March 2022
  24. Content Article
    In this episode of The King's Fund podcast, host Helen McKenna speaks with Professor Dame Lesley Regan and Dr Janine Austin Clayton about women’s health journeys from start to finish. They explore why women can struggle to get medical professionals to listen to them and the impact this has on diagnosis and treatment, as well as the mental and physical effects on women themselves.
  25. Content Article
    Language barriers, reduced self-advocacy, lower health literacy and biased care may hinder the diagnostic process. This US study in BMJ Quality & Safety looks at patient-reported diagnostic errors, what contributes to them and the impact they have, and examines the differences between respondents with limited English-language health literacy or disadvantaged socioeconomic position, and their counterparts. The authors conclude that: interpreter access should be viewed as a diagnostic safety imperative. social determinants affecting care access and affordability should be routinely addressed as part of the diagnostic process. patients and their families should be encouraged to access and update their medical records.
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