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Content ArticleThis article looks at why health journalists should be more thorough in their approach to covering news relating to diagnostic errors. Leading researchers suggest that health care providers have done little to address the problem of diagnostic errors since a seminal report was released by the Institute of Medicine in 2015 describing the widespread harms from missed and delayed diagnoses. The article looks at the issues relating to diagnosis and highlights the importance of journalists reporting on solutions as well as stories of harm. It also focuses on how health journalism can play a key role in holding healthcare organisations to account.
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Content ArticleThe New Zealand Ministry of Health has released its first Women’s Health Strategy, which sets the direction for improving the health and wellbeing of women over the next 10 years. It outlines long-term priorities which will guide health system progress towards equity and healthy futures for women. The vision of the strategy is pae ora (healthy futures) for women. All women will: live longer in good health have improved wellbeing and quality of life be part of healthy, and resilient whānau and communities, within healthy environments that sustain their health and wellbeing. A key priority is equitable health outcomes for wāhine Māori, a commitment under Te Tiriti o Waitangi (The Treaty of Waitangi). The strategy also aims to help achieve equity of health outcomes between men and women, and between all groups of women.
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Content ArticleThis article from Sarcoma UK was written by Dermot’s family to develop their reflections and recommendations on the recent publication of the Healthcare Safety Investigation (HSIB) report, Variations in the delivery of palliative care services to adults.
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Content ArticleSafety netting is a consultation technique to communicate uncertainty, provide patient information on red-flag symptoms, and plan for future appointments to ensure timely re-assessment of a patient’s condition. It is a way of managing clinical risk and helping patients identify the need to seek further medical help if their condition fails to improve, changes, or if they have concerns about their health. Former GP Professor Paul Silverston discusses the purpose of safety-netting and offers advice on a structured approach to implementing it in practice. Further reading on safety netting: Safety-netting in general practice: how to manage uncertain diagnoses Optimising GPs’ communication of advice to facilitate patients’ self-care and prompt follow-up when the diagnosis is uncertain: a realist review of ‘safety-netting’ in primary care
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Content ArticleA series of videos on managing deterioration, including: Introduction to sepsis and serious illness Preventing the spread of infection Soft signs of deterioration NEWS What is it Measuring the respiratory rate Measuring oxygen saturation Measuring blood pressure Measuring the heart rate Measuring the level of alertness How to measure temperature Calculating and recording a NEWS score Structured communications and escalation Treatment escalation plans and resuscitation Recognising deterioration in people with a learning disabilities How to use your pulse oximeter and Covid-19 diary.
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Content ArticleThis opinion piece in the Journal of Eating Disorders looks at the use of the diagnosis 'terminal anorexia' and its impact on people with anorexia nervosa, their families and the healthcare professionals working with them. Alykhan Asaria offers a lived-experience perspective on how the term may cause distress and harm to patients, feeding the narrative power of an individual's eating disorder. The article also talks about how the term can remove hope from patients, families and clinicians, and how it might set a dangerous precedent in paving the way for people with other mental health conditions to be labelled 'terminal'.
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Content ArticleWhat health condition affects some 200 million people around the world, yet remains woefully misunderstood, underfunded, and barely addressed in medical-school curricula? Endometriosis is a disease that the World Health Organization estimates affects 1 in 10 women and girls globally. And yet the National Institute of Health allocates a whopping 0.038% of its research resources to the disorder. Endometriosis, which involves tissue similar to uterine tissue growing elsewhere in the body, has myriad symptoms, including GI distress, migraines, discomfort during sex and abdominal pain that can range from debilitating to excruciating. Countless women miss days of school and work, lose their jobs, and suffer depression as a result of the illness. Experts say endometriosis could be the underlying cause of 50% of infertility cases. L Despite efforts to raise awareness, it persists as an underground topic, and many doctors are ill equipped to help those afflicted or don’t even believe their patients. “It’s a perfect storm of undervaluing women and women’s health, inequities in health care, menstrual taboo, gender bias, racial bias, and financial barriers to healthcare,” said Shannon Cohn, the director of Below the Belt: The Last Health Taboo, a searing one-hour documentary set to premiere on PBS.
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Content Article
In 2022, an illustration of a Black foetus in the womb by Nigerian medical illustrator and medical student Chidiebere Ibe, went viral. The image sparked an important conversation around representation in medical imagery and the impact this has on health outcomes for patients who are Black, Indigenous and people of colour (BIPOC). Research showed that only 5% of medical images show dark skin and only 8% of medical illustrators identified as BIPOC. A collaboration between Chidiebere Ibe, Deloitte and Johnson & Johnson, Illustrate Change aims to build the world's largest library of BIPOC medical illustrations for use in medical education and training. So far, the library contains images relevant to the following specialties: Dermatology Eye disease General health Haematology Maternal health Oncology Orthopaedics -
Content ArticleIn this article, published by British Vogue, Alexa Chung shares her experiences of endometriosis and the barriers and attitudes she faced in seeking a diagnosis and treatment.
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Content ArticleIn this presentation from the AD Awareness Day UK 2018, Dr Emma Redfern and Prof Mark Callaway provide a Masterclass in diagnosing aortic dissection in the emergency setting.
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Content Article
Attention deficit hyperactivity disorder (ADHD) is a condition that affects people's behaviour. It has a wide range of symptoms and can affect both children and adults—people with ADHD may find it hard to focus on or complete tasks, feel restless or impatient, experience impulsiveness and find it hard to organise their time and their things.[1] ADHD can have devastating mental health implications and research studies have linked ADHD to increased suicide and mortality rates. This means that being unable to access effective treatment can be a patient safety risk for people with ADHD. In this blog, Lotty Tizzard, Patient Safety Learning’s Content and Engagement Manager, explores the state of ADHD diagnosis and treatment in the UK. She looks at why many are concerned about the waiting times for adults and children seeking an ADHD assessment and speaks to Elsa*, who was diagnosed with ADHD in her 30s, about her experiences. *Name changed -
Content ArticleA formal diagnosis of dementia can help people living with the condition and their families gain a better understanding of what to expect and help to inform important decisions about treatment, support and care. Alzheimer’s Society estimate that in England, Wales and Northern Ireland there are over 300,000 people living with dementia who do not have a diagnosis. In this report they highlight barriers to accessing a timely and accurate dementia diagnosis and advocate for practical changes and tangible solutions to overcome them.
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News Article
Waits for diagnosis and decision rise to over 38 weeks
Patient Safety Learning posted a news article in News
Waiting times to diagnosis and decision rose by more than a week in December, reaching 38.6 weeks at month end. This matters because many urgent conditions are only detected when the patient reaches diagnosis, including nearly a quarter of all cancers, and such very long waits put those patients at risk. Looking at the whole referral-to-treatment waiting list, which includes patients who have a diagnosis and decision, waiting times remained roughly steady at 43.4 weeks, compared with the standard of 18 weeks that is still required by legislation. Waiting times are a function of both the size and shape of the waiting list, and in December the former got worse and the latter improved. There were 6,067,326 patients on the waiting list as December ended, which is the first time the official figures have topped six million. As many as 310,813 of them had waited over a year (strictly, 52 weeks), and 20,065 over two years (104 weeks). The NHS’s backlog recovery plan has committed that “By July 2022, no one will wait longer than two years for an elective treatment”. Read full story (paywalled) Source: HSJ, 10 February 2022 -
News ArticleTwo years of the pandemic have meant drops in essential screening and detection in Australia, while cancer patients undergo treatments alone and isolate to avoid Covid risks. When Claire Simpson turned 50 in early 2020, she received a letter telling her to get a mammogram. Then the pandemic hit, and Victoria went into lockdown. “Like many people, I put it off until we were coming out of that lockdown, but by then it was September and I couldn’t get an appointment until December,” she says. In February 2021 she was diagnosed with breast cancer and had a mastectomy. Tests showed she was positive for the aggressive HER2 receptor, so she began 12 weeks of chemotherapy as well as a treatment called Herceptin, which she received an IV infusion of every three weeks. Simpson says the delay in screening “really, really delayed diagnosis for me, by a good six months”. “I can’t help but feel that [an earlier screening] could have probably saved me from having to have chemotherapy and this Herceptin infusion therapy that I’m having,” she says. Her last Herceptin treatment was last Wednesday. She has been living in self-imposed lockdown, terrified as the Omicron wave built that she would have to isolate due to Covid and disrupt her treatment. That self-imposed isolation will continue until her final surgery, an elective operation scheduled for mid-year. Cancer screening dropped by 10% in Victoria alone in the first year of the pandemic. In 2021, referrals to the Peter MacCallum Cancer Centre, a leading treatment and research facility in Melbourne, were down 40%. “That is certainly going to bounce back at some point,” says Prof Sherene Loi, an oncologist and researcher at Peter MacCallum. “It is potentially going to be a real problem in a few years’ time. At the moment we have a lot of very young cancer diagnoses, a lot of breast cancer … we are just flat chat.” Read full Source: The Guardian, 13 February 2022
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News Article
People in England surviving cancer for longer, NHS reports
Patient Safety Learning posted a news article in News
Growing numbers of adults and children in England are surviving for longer after being diagnosed with cancer, with increases in lifespan seen in almost all types of the disease. Survival for one year and five years rose among adults diagnosed between 2015 and 2019 compared with those whose illness was identified between 2006 and 2010, NHS Digital reported. Survival is highest in adults who have melanoma of the skin, one of the main forms of skin cancer. Nine out of 10 men now survive for five years, as do almost 95% of women. However, survival remains stubbornly low for other forms of the disease, including pancreatic cancer and mesothelioma, which is mainly caused by prolonged exposure to asbestos. Just 6.3% of men and 7.8% of women who develop mesothelioma are still alive five years later. NHS Digital found that “in England one-year non-standardised net survival has improved, with patients diagnosed between 2015 and 2019 having a higher one-year survival than patients diagnosed between 2006 and 2010. “This trend was seen for all cancers and both genders except for bladder cancer. The largest improvement was 1.6 percentage points on average per year for lung cancer in females.” Greater survival after five years “was seen for all cancers and both genders except for bladder cancer and colon cancer,” the NHS’s statistical arm added. “The largest improvement was myeloma in females, [which was up] 1.4 percentage points on average per year.” However, Anna Jewell, the chair of the Less Survivable Cancers Taskforce, warned that the chances of survival remained low for people with a number of some forms of the disease. “Although overall cancer survival rates have generally increased in the past decades, we are not seeing the same improvements in prognosis for patients diagnosed with less survivable cancers, including those of the lung, liver, brain, oesophagus, pancreas and stomach.” Read full story Source: The Guardian, 4 February 2022 -
News Article
Improving cancer care a huge challenge post-pandemic
Patient Safety Learning posted a news article in News
Improving cancer care will be a huge challenge, ministers are being warned as they promise a new 10-year strategy for England. Figures suggest there have been 34,000 fewer diagnoses since Covid hit - 50,000 if you include the whole UK. It risks an increasing number of late diagnoses which reduces the chances of survival, cancer charities said. It comes as the government is promising to invest in new technologies and equipment to spot cancer quicker. Health Secretary Sajid Javid said the new "war on cancer" strategy will be published later this year. "It will take a far-reaching look at how we want cancer care to be in 2032. Looking at all stages from prevention, to diagnosis, treatment and vaccines," he said. Mr Javid pointed out the NHS was already taking steps, including evaluating new blood tests to spot cancers early and opening a network of testing centres. Lynda Thomas, of Macmillan Cancer Support, said given the impact of the pandemic people with cancer needed "support more than ever". "We have been sounding the alarm for a long time," she added. But she said while improving diagnosis and treatment was crucial, it was like "building sandcastles while the tide comes" without extra staff to tackle the backlogs and demand for care. Read full story Source: BBC News, 4 February 2022 -
News Article
Family of Cornwall girl, 6, misled over cause of death, coroner finds
Patient Safety Learning posted a news article in News
A six-year-old girl thought to have died from sepsis was in fact suffering from a blood condition triggered by E coli infection, an inquest has found. Coco Rose Bradford was taken to the Royal Cornwall hospital in the summer of 2017 suffering from stomach problems and later transferred to the Bristol Royal hospital for children, where she died. The following year an independent review flagged up failings in her care in Cornwall and the Royal Cornwall hospitals trust apologised for how it had treated her. Her family were left with the belief she had died of sepsis and could have been saved if she had been given antibiotics. But on Friday, coroner Andrew Cox, sitting in Truro, found that Coco died from multiple organ failure caused by haemolytic uraemic syndrome (HUS). The inquest heard there is no proven treatment for HUS. Cox said Coco’s family had been misled over the sepsis diagnosis, which he said was deeply regrettable, adding: “As a matter of fact, I find Coco had overwhelming HUS, not overwhelming sepsis.” During the inquest, the court heard Coco’s family felt staff at the Cornish hospital were “dismissive, rude and arrogant” and did not take her condition seriously. Cox found that although staff had recognised the risk of HUS from the moment Coco was admitted, this was not clearly set out in a robust management plan. The coroner also said a lack of communication had made Coco “something of a hostage to fortune”. Read full story Source: The Guardian, 14 January 2022 -
News Article
Scotland: Cancers with low survival rate 'being detected too late'
Patient Safety Learning posted a news article in News
People with some of the deadliest forms of cancer are being diagnosed later than ever as a result of disruption to healthcare caused by the Covid pandemic, campaigners have warned. Stomach, lung, pancreatic, brain, stomach and oesophageal cancers have some of the poorest long-term survival rates and have always been disproportionately diagnosed late following an emergency hospital admission. However, campaigners are concerned that the poor prognoses for these patients have been exacerbated by factors such as a reluctance to attend A&E or bother GPs during the pandemic, and by bottlenecks in the numbers of patients waiting for tests such as CT scans or endoscopy. A drive to raise awareness of the symptoms for these cancers – which are not subject to any routine screening programmes – along with a push for more investment into research for treatments has been launched today to mark the first Less Survivable Cancers Awareness Day. Dawn Crosby, head of Scotland and Northern Ireland for Pancreatic Cancer UK and a member of the Less Survivable Cancers Taskforce, said: “We know that delays in diagnosis lead to much poorer outcomes for patients with these rapidly-advancing cancers. We also know the trauma associated with receiving a diagnosis in an emergency setting for both patients and families." “These cancers are currently difficult or impossible to treat at later stages and the time from diagnosis to death is often brutally short compared to more survivable cancers. “The situation is critical and has been exacerbated by the Covid-19 pandemic. The Taskforce is calling for a significant increase in research funding, as well as a commitment to increasing resources for early diagnosis for less survivable cancers so we can close the deadly cancer gap.” Read full story Source: The Herald, 11 January 2022 -
News Article
Swift action needed to prevent 'cancer catastrophe' as NHS fails to meet target
Patient Safety Learning posted a news article in News
Swift action is needed from the Scottish Government to prevent a “cancer catastrophe”, campaigners have claimed, as new figures showed the NHS has again failed to meet a key waiting times standard. Ministers have set the target of having 95% of patients begin treatment within 62 days of being referred for help because cancer is suspected. But the latest data showed another decline in performance against this in the period July to September, with only 83.1% beginning treatment in this timeframe – down from 84.1% in the previous quarter and below the 87.3% that was achieved in July to September last year. None of Scotland’s health boards met the goal of starting to treat patients within two months of referral – and nor was this target achieved for any cancer types. The latest figures from Public Health Scotland showed that in NHS Orkney, only two out of five (40%) of patients referred with an urgent suspicion of cancer began treatment within two months, the lowest rate in Scotland. And less than three quarters (71.8%) of those suspected of having bowel cancer began treatment within two days, compared to 76 per cent of those with cervical cancer, 91.5% of those with lung cancer and 92.7% of those with breast cancer. It comes as the number of people being referred to help increased by almost a third from the same time last year. Read full story Source: The Scotsman, 14 December 2021 -
News ArticleThe NHS may be missing more than 9 million referrals, while patients face a “postcode lottery” for cancer treatment and routine operations, a parliament watchdog has warned. Millions of patients have either avoided or been unable to obtain healthcare during the pandemic leaving the NHS with a potential unknown backlog of operations, which could push the national waiting list to 12 million by 2025. A report from the government’s National Audit Office today also warned patients across England are facing a postcode lottery in terms of waits with some hospital waiting lists far larger than others following the pandemic. Eve Byrne, head of campaigns and public affairs, at Macmillan Cancer Support, said: “This report confirms what we hear day in, day out from people living with cancer. Chronic staffing shortages are already having a devastating impact on cancer patients, and we have major concerns that is only set to worsen without urgent action. She said the government’s plan to tackle operations backlog must be backed up by steps to ensure enough nurses staff. “Without these critical pieces of the puzzle, we risk increasing numbers of people facing later diagnoses, poorer care and potentially worse chances of survival. This has to change,” she added. Read full story Source: The Independent, 1 December 2021
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News Article
Late diagnosis of breast cancer rises as NHS struggles in Covid crisis
Patient Safety Learning posted a news article in News
Soaring numbers of women are being diagnosed with advanced breast cancer, undermining their chances of survival, because of Covid’s disruption of NHS care, a charity has warned. The number of women being diagnosed with the disease at stage 4 is as much as 48% higher in some months than expected, with the pandemic to blame, says Macmillan Cancer Support. At the same time, fewer women are being confirmed as having breast cancer at stage 1, when their chances of responding well to treatment and living longer are much higher. Macmillan estimates that there is now a backlog of 47,300 people across the UK who have not yet been diagnosed with some form of cancer, as a direct result of Covid. They include people who could not access care in the usual way because many NHS services were scaled back, and also those who were too scared to seek help or did not want to add to the pressure the health service was already under. None have had a confirmed diagnosis of cancer, though some may be undergoing tests or screening. Steven McIntosh, Executive Director of Advocacy and Communications at Macmillan Cancer Support, says: “Nearly two years into the pandemic, there is still a mountain of almost 50,000 people who are missing a cancer diagnosis. Thousands more are already facing delays and disruption as they go through treatment. While hard-working healthcare professionals continue to do all they can to diagnose and treat patients on time, they are fighting an uphill battle. Cancer patients are stuck, waiting in a system that doesn’t have the capacity to treat them fast enough, let alone deal with the backlog of thousands who have yet to come forward.” “The Government has promised an NHS Elective Recovery Plan. This must show how it will tackle spiralling pressures on cancer services. It has never been more crucial to boost NHS capacity to treat and support everybody with cancer, so people receive the critical care they need now and in the years to come.” Read full story Source: The Guardian, 26 November 2021 -
News Article
Alarm over ‘serious’ delays in diagnosing childhood cancer in England
Patient Safety Learning posted a news article in News
Health experts have raised the alarm over “serious” delays in diagnosing children and young people with cancer, as a study reveals the number found to have the disease during the pandemic fell by almost a fifth. The University of Oxford found a “substantial reduction in childhood, teenage and young adult cancer detection” in England last year. The research, being presented on Friday at the National Cancer Research Institute (NCRI) festival, showed a 17% drop in cases diagnosed in the under-25s last year compared with previous years. The impact of Covid on adults with cancer is well known. However, previously little has been known about the toll on younger patients. As well as the fall in the overall numbers of children diagnosed with cancer, researchers found that even those whose cancer was spotted last year were more likely to have been diagnosed only after being admitted to intensive care. That suggests long delays in accessing care may have made them much sicker, experts say. Read full story Source: The Guardian, 12 November 2021 -
News Article
Cancer detection fell in Scotland during pandemic
Patient Safety Learning posted a news article in News
About 1,600 fewer people than expected were diagnosed with the three most common cancers during the first nine months of the Covid pandemic. Public Health Scotland (PHS) has attempted to work out how restrictions put in place at the start of coronavirus affected diagnosis of the disease. The statistics show that breast cancer diagnosis was down by 19%, bowel cancer by 25% and lung cancer by 9%. The data also showed cancer was not being diagnosed at the earliest stages. This is when treatment is most successful. Cancer Research UK called for urgent action to prevent progress on cancer survival going backwards. David Ferguson, from Cancer Research UK in Scotland, said the PHS report reinforced fears that opportunities to diagnose cancer at an early stage were missed during the pandemic. He said: "Urgent action is needed. Cancer survival wasn't good enough before the pandemic. Too many people are waiting far too long for diagnosis and treatment so this must be addressed." He called for a "road map" to tackle staff shortages and backlogs. "If swift action isn't taken, our fear is that cancer survival in Scotland could go backwards," he said. Read full story Source: BBC News, 3 November 2021 -
News Article
NHS England hospitals having to rely on ‘obsolete’ imaging equipment
Patient Safety Learning posted a news article in News
About a third of NHS trusts in England are using “technically obsolete” imaging equipment that could be putting patients’ health at risk, while existing shortages of doctors who are qualified to diagnose and treat disease and injuries using medical imaging techniques could triple by 2030. According to data obtained through freedom of information requests by Channel 4’s Dispatches programme, 27.1% of trusts in NHS England have at least one computerised tomography (CT) scanner that is 10 years old or more, while 34.5% have at least one magnetic resonance imaging (MRI) scanner in the same category. These are used to diagnose various conditions including cancer, stroke and heart disease, detect damage to bones and internal organs, or guide further treatment. An NHS England report published last year recommended that all imaging equipment aged 10 years or older be replaced. Software upgrades may not be possible on older equipment, limiting its use, while older CT scanners may require higher radiation doses to deliver the same image, it said. Dr Julian Elford, a consultant radiologist and medical director at the Royal College of Radiologists (RCR), said: “CT and MRI machines start to become technically obsolete at 10 years. Older kit breaks down frequently, is slower, and produces poorer quality images, so upgrading is critical." “We don’t just need upgraded scanners, though; we need significantly more scanners in the first place. The [NHS England report] called for doubling the number of scanners – we firmly support that call, and recommend a government-funded programme for equipment replacement on an appropriate cycle so that radiologists can diagnose and treat their patients safely." Read full story Source: The Guardian, 18 October 2021 -
News ArticleThe Becker's Clinical Leadership & Infection Control editorial team chose the top 10 patient safety issues for healthcare leaders to prioritise in 2021, presented below in no particular order, based on news, study findings and trends reported in the past year. COVID-19 Healthcare staffing shortages Missed and delayed diagnoses Drug and medicine supply shortages Low vaccination coverage and disease resurgance Clinical burnout Health equity Healthcare-associated infections Surgical mistakes Standardising safety efforts. Read full story Source: Becker's Healthcare, 30 December 2020
