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News Article
HIV blood tests to be rolled out to more hospitals
Patient Safety Learning posted a news article in News
Opt-out blood tests for HIV, Hepatitis B and Hepatitis C will be rolled out to a further 46 hospitals across England, the government has announced. Health Secretary Victoria Atkins said the new £20m programme would lead to earlier diagnoses and treatment. Under the scheme, anyone having a blood test in selected hospital A&E units has also been tested for HIV, Hepatitis B and Hepatitis C, unless they opted out. The trials have been taking place for the last 18 months in 33 hospitals in London, Greater Manchester, Sussex and Blackpool, where prevalence is classed by the NHS as "very high". Figures released by the NHS earlier show those pilots have identified more than 3,500 cases of the three bloodborne infections since April 2022, including more than 580 HIV cases. Ms Atkins said: "The more people we can diagnose, the more chance we have of ending new transmissions of the virus and the stigma wrongly attached to it." She added that rolling out the tests to more hospitals would help ensure early diagnoses so people "can be given the support and the medical treatment they need to live not just longer lives but also higher quality lives". Read full story Source: BBC News, 29 November 2023 -
News ArticlePatients are at risk of having serious health conditions missed because of the lack of continuity of care provided by GPs, the NHS safety watchdog says. Investigators highlighted the case of Brian who was seen by eight different GPs before his cancer was spotted as an example of what can go wrong. Brian had a history of breast cancer and had been discharged from the breast cancer service. Two years later he began to have back pain. Over the following eight months, he saw two out-of-hours GPs and six GPs based at his local practices as well as a physio and GP nurse, before he was sent for a hospital check-up in late 2020. A secondary cancer had developed on Brian's spine, but it was too late to offer him curative treatment and he was given end-of-life care. He has since died. The watchdog said the lack of continuity of care resulted in the diagnosis of Brian's cancer being missed. One of the key problems was that the different GPs he saw missed the fact he was attending repeatedly for the same issue. Senior investigator Neil Alexander said Brian's case was a "stark example" of what can happen when there is a breakdown in continuity of care. "He told our team 'when I am gone, no-one else should have to go through what I did'." Read full story Source: BBC News, 30 November 2023
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Content ArticlePatients who visit their GP practice with an ongoing health problem may see several different GPs about the same symptoms. To make sure they receive safe and efficient care, there needs to be a system in place to ensure continuity of care. In the context of this report, continuity of care is where a patient has an ongoing relationship with a specific doctor, or when information is managed in a way that allows any doctor to care for a patient. While some GP practices in England operate a formalised system of continuity of care, many do not. This investigation explored the safety risk associated with the lack of a system of continuity of care within GP practices. The investigation focused on: How GP practices manage continuity of care. This includes how electronic record systems alert GPs to repeat attendances for symptoms that are not resolving and how information is shared across the healthcare system. Workload pressures that affect the ability of GP practices to deliver continuity of care. This investigation’s findings, safety recommendations and safety observations aim to prevent the delayed diagnosis of serious health conditions caused by a lack of continuity of care and to improve care for patients across the NHS.
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News Article
At least 20,000 annual UK cancer deaths avoidable, says charity
Patient Safety Learning posted a news article in News
At least 20,000 cancer deaths a year could be avoided in the UK with a national commitment to invest in research and innovation, and fix the NHS, says Cancer Research UK. Progress is being made in finding new treatments for the condition that affects 50% of people at some point. But the charity says the UK lags behind comparable countries for survival. It has launched a manifesto of priorities for this government and the next, ahead of a general election. The document sets out what the charity says needs to change - and fast. Whoever is running the country must commit to developing a 10-year cancer plan, spearheaded by a National Cancer Council accountable to the prime minister to bring government, charities, industry and scientific experts together, it says. Key areas to focus on include: More investment in research to close an estimated £1bn funding gap. Greater disease prevention - banishing smoking to the history books, for example. Earlier diagnosis, through screening. Better tests and treatments, as well as cutting NHS waiting lists and investing in more staff. Read full story Source: BBC News, 28 November 2023 -
Content ArticleCancer Research UK has set out how the next UK Government could dramatically improve cancer outcomes and prevent 20,000 cancer deaths a year by 2040. 'Longer better lives: A manifesto for cancer research and care' has been developed with the insights of cancer patients and experts from across health, life sciences, government and academic sectors. The charity said that huge strides have been made in beating cancer – with survival in the UK doubling over the last 50 years. But it warned that with NHS cancer services in crisis and around half a million new cancer cases each year expected by 2040 – this hard-won progress is at risk of stalling. With the UK lagging behind comparable countries when it comes to cancer survival, the charity is calling on all political parties to make cancer a top priority in their party manifestos.
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Content ArticleAn estimated 90,000 people are living with dementia in Scotland, with that number expected to increase to 164,000 by 2036. These national clinical guidelines from Health Improvement Scotland, the first to be published in nearly 20 years, provide recommendations on the assessment, treatment and support of adults living with dementia. It calls for greater awareness of pre-death grief for people with dementia, their carers and their loved ones, as they fear the loss of the person they know. To accompany the guidelines, a podcast has been produced by Health Improvement Scotland speaking to professionals, including Dr Adam Daly, Chair of Healthcare Improvement Scotland’s Guideline Development Group and a Consultant in old age psychiatry, and Jacqueline Thompson, a nurse consultant and the lead on pre-grief death for the guideline. We also hear from Marion Ritchie, a carer who experienced pre-death grief while caring for her husband.
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Content Article
Watch this short film about what to do if you experience pain in your testicle/s, by Cardiff Fertility Studies and the British Fertility Society, made in partnership with Orchid. -
Content ArticleThe Care Quality Commission's (CQC) annual report on their work to enforce the Ionising Radiation (Medical Exposure) Regulations in England has been published. The regulations protect people from the dangers of being accidentally or unintentionally exposed to ionising radiation in a healthcare setting. Errors can happen when healthcare providers use ionising radiation to diagnose or treat people. Healthcare providers must notify CQC about these. The report gives a breakdown of the number and type errors that CQC was notified about between 1 April 2022 and 31 March 2023. The report also presents the key findings from our inspection and enforcement activity in that time.
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Content ArticleOn Nov 7 2023, NHS Resolution’s Safety and Learning team, hosted a virtual forum on learning from venous thromboembolism (VTE) claims in primary care. The purpose was to raise awareness of the cost and scale of harm, discuss the challenges and recommendations around recognition and treatment of VTE in general practice. We heard from a range of experts in the field with experience in developing and spreading best practice.
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News Article
Collective intelligence can help reduce medical misdiagnoses
Patient Safety Learning posted a news article in News
An estimated 250,000 people die from preventable medical errors in the U.S. each year. Many of these errors originate during the diagnostic process. A powerful way to increase diagnostic accuracy is to combine the diagnoses of multiple diagnosticians into a collective solution. However, there has been a dearth of methods for aggregating independent diagnoses in general medical diagnostics. Researchers from the Max Planck Institute for Human Development, the Institute for Cognitive Sciences and Technologies (ISTC), and the Norwegian University of Science and Technology have therefore introduced a fully automated solution using knowledge engineering methods. The researchers tested their solution on 1,333 medical cases provided by The Human Diagnosis Project (Human Dx), each of which was independently diagnosed by 10 diagnosticians. The collective solution substantially increased diagnostic accuracy: Single diagnosticians achieved 46% accuracy, whereas pooling the decisions of 10 diagnosticians increased accuracy to 76%. Improvements occurred across medical specialties, chief complaints, and diagnosticians’ tenure levels. "Our results show the life-saving potential of tapping into the collective intelligence," says first author Ralf Kurvers. He is a senior research scientist at the Center for Adaptive Rationality of the Max Planck Institute for Human Development and his research focuses on social and collective decision making in humans and animals. Read full story Source: Digital Health News, 2 November 2023 -
Content ArticleA pulmonary embolism happens when a blood clot breaks off and travels to the lungs where it blocks the flow of blood. Although life-threatening, when diagnosed promptly survival rates are good. This report from the Parliamentary and Health Service Ombudsman (PHSO) looks at the case of a man who died of a pulmonary embolism after doctors failed to test for deep vein thrombosis.
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Content ArticleIn October 2021 the government announced plans for new community diagnostic centres (CDCs) across England. The ambition was that these centres would provide people with increased and more convenient access to diagnostics tests, and would lead to earlier diagnosis and reduce pressure on hospitals. Two years on, with 127 centres open and 1,563,400 patients waiting for a diagnostic test as of the end of August 2023, how are community diagnostic centres getting on and what challenges are they facing?
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Content ArticleInternationally, there is a growing awareness on diagnostic errors as a major – and too often overlooked – patient safety problem. According to analyses conducted by the Danish Society for Patient Safety, diagnostic errors are not only common, but they also have major consequences for patients and the healthcare system’s finances. In this article, Charlotte Frendved and Siri Tribler hope that by raising awareness of the diagnostic process and possible vulnerabilities can help improve patient safety.
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Content ArticleThis guide is a self assessment tool to enable Primary Care to become dementia friendly. It includes a checklist for GP practices to help people with dementia and their carers access high quality care and support. People with dementia, carers and staff in GP practices have worked together to co-design and develop this guide. It outlines the benefits for general practice in becoming dementia friendly and includes checklists covering: General practice systems General practice culture Patient diagnosis, care and support Physical environment This guide is adapted from the Alzheimer’s Society’s Guide to Making General Practice Dementia Friendly.
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Content ArticleA dementia diagnosis is a fundamental first stage of the dementia pathway. Missing out on an early and accurate diagnosis can have a significant negative impact, for example limiting access to symptom management interventions, ultimately leading to poorer outcomes and increased health and social care costs. This inquiry focuses on understanding the scale of impact of regional health inequalities on access to a dementia diagnosis and developing solutions to reduce their influence.
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News Article
ADHD ‘not over-diagnosed’ despite surge in Ritalin prescriptions
Patient Safety Learning posted a news article in News
Children are not being over-diagnosed with ADHD despite concerns about a spike in prescriptions of powerful stimulant drugs, a leading psychiatrist has said. NHS statistics show 125,000 children and teenagers in England are taking drugs such as Ritalin for symptoms such as poor concentration, up by a quarter since before the Covid pandemic. Isobel Heyman, a consultant child and adolescent psychiatrist at Great Ormond Street Hospital and lead for child mental health at Cambridge Children’s Hospital, said that on the whole ADHD remained “under-treated” and that this was driving high levels of mental illness in young people. Speaking to the Times Health Commission, Heyman said: “My understanding is that the increase in prescribing is largely related to increased diagnosis and increased recognition … We are still overall slightly under-treating [rather] than over-treating. “There is a problem about over-medicalisation of ordinary distress, ordinary ebullience and over-enthusiasm in young people.” She said the public should be reassured that ADHD diagnoses follow a “very stringent” process. However, she said private adult ADHD clinics may be less “rigorous” in providing a diagnosis. Read full story (paywalled) Source: The Times, 18 October 2023 Further reading: Long waits for ADHD diagnosis and treatment are a patient safety issue -
News Article
Women at greater risk of heart attack death due to medical sexism
Patient Safety Learning posted a news article in News
Women are a third less likely to receive lifesaving treatment for heart attacks due to sexism in medicine, research shows. Research led by the University of Leeds and the British Heart Foundation (BHF) pooled NHS data from previous studies looking at common heart conditions over the past two decades. It investigated how care varied according to age and sex, finding that women were significantly less likely to receive treatment for heart attacks and heart failure. Following the most severe type of heart attack — a Stemi — women were one third less likely to receive a potentially lifesaving diagnostic procedure called a coronary angiogram. Women were significantly more likely to die after being admitted to hospital with a severe heart attack. They were also less likely to be prescribed preventative drugs that can help to protect against future heart attacks, such as statins or beta-blockers. Dr Sonya Babu-Narayan, associate medical director at the BHF and a consultant cardiologist said: “This review adds to existing evidence showing that the odds are stacked against women when it comes to their heart care. Deep-rooted inequalities mean women are underdiagnosed, undertreated, and underserved by today’s healthcare system." “The underrepresentation of women in research could jeopardise the effectiveness of new tests and treatment, posing a threat to women’s health in the long-term,” she added. Read full story (paywalled) Source: The Times, 5 October 2023 -
News Article
Thousands unaware they have diabetes could be diagnosed at A&E, says study
Patient Safety Learning posted a news article in News
Thousands of people unaware they have type 2 diabetes could be diagnosed and avoid serious complications if screening was introduced in emergency departments, a study suggests. The prevalence of the disease has risen dramatically in countries of all income levels in the last three decades, according to the World Health Organization. More than 400 million people have been diagnosed, but millions more are estimated to be in the dark about the fact they have the condition. A study that took place in an NHS trust in England suggests 10% more cases could be picked up with the use of a simple blood test. Screening could also pick up 30% more cases of pre-diabetes – a serious condition where blood sugar levels are higher than normal. The findings are being presented at the annual meeting of the European Association for the Study of Diabetes (EASD) in Hamburg, Germany. “Early diagnosis is the best way to avoid the devastating complications of type 2 diabetes, and offers the best chance of living a long and healthy life,” said Prof Edward Jude, of Tameside and Glossop integrated care NHS foundation trust. Read full story Source: The Guardian, 3 October 2023 -
News Article
Doctors used to diagnosing men may not spot 35,000 women with diabetes
Patient Safety Learning posted a news article in News
Thousands of women may be missing out on a diagnosis of type 2 diabetes because the thresholds are geared towards men, research suggests. Scientists assessed test results from more than one million patients across the country and concluded that the bar for diagnosis might be set too high for women. They calculated that, if thresholds were lowered slightly, an extra 35,000 women under the age of 50 in England would be diagnosed with type 2 diabetes — increasing the number in this age group with the condition by 17%. Under the present guidelines, those 35,000 women would be given the all-clear and would miss out on the chance of earlier treatment and lifestyle advice, increasing their risk of complications in later life. The team, led by doctors at the University of Manchester and including researchers from hospitals nationwide, stressed that their findings were preliminary, and needed further assessment before their hypothesis was confirmed. But, if proved correct, they believe that about 65 young women may be dying of diabetes each year without a diagnosis. Read full story (paywalled) Source: The Times, 1 October 2023 -
Content ArticleThe National Early Warning Score (NEWS2) is calculated using routine vital sign measures of temperature, pulse and so on. It is used by ambulance staff and emergency departments to identify sick adults whose condition is likely to deteriorate. NEWS2 has been shown to work among the general population. However, it has been unclear if it could monitor the condition of care home residents because of their age, frailty, and multiple long-term conditions. New research from the National Institute for Health and Care Research (NIHR) shows that, among care home residents admitted to hospital as an emergency, NEWS2 can effectively identify people whose condition is likely to get worse.
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Content Article
This report from Asthma + Lung UK highlights that lung diseases such as COPD, asthma and pneumonia are the third leading cause of death in England, whilst the UK as a whole has the worst death rate from lung disease in Europe. Hospital admissions for lung diseases have doubled in the last 20 years and lack of proper testing for lung diseases is having an impact on patient safety, as GPs have to "guess" diagnoses. The report highlights three areas where policy changes should be implemented in order to improve care for people affected, reduce pressure on services and deliver massive savings for the NHS: Diagnosing lung disease early and accurately Keeping people healthy and out of hospital Providing treatments that work -
Content ArticleDementia remains the biggest killer in the UK and is on track to be the nation’s most expensive health condition by 2030. This report by the charity Alzheimer's Research UK sets out a series of calls for party leaders ahead of the next general election, all of which are underpinned by an urgent recommendation for greater investment in dementia research.
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News Article
Sepsis often missed as 50% of screening tools don’t work, study finds
Patient Safety Learning posted a news article in News
Paramedics and A&E doctors often miss signs of sepsis and two of the four ways health professionals screen for the killer condition do not work, a new study claims. Doctors, NHS bosses and health charities have been concerned for years that too many cases of sepsis go undiagnosed, leaving people badly damaged or dead, because sepsis is so hard to detect. Unless a patient is diagnosed quickly, their body’s immune system goes into overdrive in response to an infection and then attacks vital tissues and organs. If left untreated, sepsis can cause shock, organ failure and death. Research from Germany, presented at this week’s European Emergency Medicine Congress in Barcelona, claims to have uncovered significant flaws in two of the four screening tools that health workers use worldwide to identify cases of the life-threatening illness. The four systems are NEWS2 (National Early Warning Score), qSOFA (quick Sequential Organ Failure Assessment), MEWS (Modified Early Warning Score) and SIRS (Systemic Inflammatory Response Syndrome). The researchers analysed records of the care given to 221,429 patients in Germany who were treated by emergency health workers outside hospital settings in 2016. “Only one of four screening tools had a reasonably accurate prediction rate for sepsis – NEWS2. It was able to correctly predict 72.2% of all sepsis cases and correctly identified 81.4% of negative, non-septic cases,” they concluded. NHS England stressed that it already deploys NEWS2, which emerged as the best system. An NHS spokesperson said: “This study shows the NHS actually is using the best screening tool available for detecting sepsis – NEWS2 – and as professional guidance for doctors in England sets out, it is essential that any patient’s wishes to seek a second opinion are respected.” Read full story Source: Guardian, 20 September 2023 -
Content Article
Top picks: Six resources about sepsis
Patient Safety Learning posted an article in Deterioration and sepsis
According to the UK Sepsis Trust, sepsis affects 245,000 people every year in the UK alone, and 48,000 people die of sepsis-related illnesses. Sepsis arises when the body’s response to an infection injures its own tissues and organs. It may lead to shock, multi-organ failure, and death – especially if not recognised early and treated promptly. At Patient Safety Learning we believe that sharing insights and learning is vital to improving outcomes and reducing harm. That's why we created the hub; to provide a space for people to come together and share their experiences, resources and good practice examples. We have pulled together six useful resources about sepsis that have been shared on the hub. They include advice on recognising and managing sepsis along with educational materials. -
Content Article
Health Education England: THINK SEPSIS
Patient Safety Learning posted an article in Deterioration and sepsis
“THINK SEPSIS” is a Health Education England programme aimed at improving the diagnosis and management of those with sepsis. A number of sepsis cases result in death every year. Some of the deaths are preventable. Prompt recognition of sepsis and rapid intervention will help reduce the number of deaths occurring annually. The learning materials that are available on this website support the early identification and management of sepsis. It includes a film and a wide range of learning materials for primary care, secondary care and paediatrics.
