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Content Article
How to cut time out of cancer pathways (HSJ, 19 January 2024)
Patient Safety Learning posted an article in Cancers
Meeting cancer performance targets is a challenge for many trusts with waiting times for diagnosis and treatment growing since the pandemic. But this is a worrying time for patients as well, and they would welcome quicker turnaround of results and diagnosis. Cutting time out of this pathway would benefit everyone but are there ways to do this which do not compromise patient safety? An HSJ webinar, in association with SS&C Blue Prism, addressed this important question and tried to find ways trusts could reduce waiting times. -
News Article
Long Covid: NHS legal action launched by family of girl
Patient Safety Learning posted a news article in News
The mother of an 11-year-old Aberdeenshire girl with Long Covid has launched a legal action against their health board, in what lawyers claim is the first case of its kind in Scotland. Helen Goss, from Westhill, is seeking damages from NHS Grampian on behalf of her daughter, Anna Hendy. The action claims the health board is responsible for "multiple failings" in Anna's treatment and care. The claim alleges failings were avoidable, that they caused Anna "injury and damage", and led to her condition worsening. Anna became unwell after contracting Covid in 2020. The action alleges a number of failings by the health board. These include claims that requests for Anna to be referred to the specialist paediatric services of immunology and neurology were refused. It also claims no further help was offered after Anna was diagnosed with Chronic Fatigue Syndrome (CFS) and Paediatric Acute-onset Neuropsychiatric Syndrome (PANS). And it says these failings "could have been avoided had NHS Grampian followed contemporary guidance on diagnosis and treatment". Read full story Source: BBC, 19 January 2024 -
Content ArticleThis study in JAMA Psychiatry aimed to assess whether multivariate machine learning approaches can identify the neural signature of major depressive disorder in individual patients. The study was conducted as a case-control neuroimaging study that included 1801 patients with depression and healthy controls. The results showed that the best machine learning algorithm only achieved a diagnostic classification accuracy of 62% across major neuroimaging modalities. The authors concluded that although multivariate neuroimaging markers increase predictive power compared with univariate analyses, no depression biomarker could be uncovered that is able to identify individual patients.
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EventuntilPPPs 2024 Cancer Care programme kicks off with this report launch webinar on AI in Imaging Diagnostics. While discussions concerning artificial intelligence (AI) have come to dominate public discourse since the launch of ChatGPT last year, in healthcare, AI has been the subject of intense debate for some time. Many of the key talking points that define the debate in healthcare echo that of its wider implications, namely the unintended consequences of unleashing unregulated algorithms across the sector and the potentially profound implications AI could have upon workforces globally. However, it is perhaps in healthcare where AI stands to make its greatest and most positive impact. Healthcare is a data-rich industry, with the treatment of patients leading to the production of vast amounts of medical records, images, lab results, and numerous other data outputs. This multimodal data can be used to train a wide range of AI systems, leading to the development of new, more targeted drug treatments and diagnostic tools, more personalised care, and a more efficient healthcare system. Join an expert panel as they help to launch PPPs newest report exploring what it takes to begin implementing AI at scale in imaging diagnostics in the NHS. Register for the webinar
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News Article
How portable X-ray machines are helping remote patients
Patient_Safety_Learning posted a news article in News
Portable X-ray machines "can literally be the difference between life and death", says radiographer Sam Pilkington. For most of us, if we need to be X-rayed the procedure is done in a hospital. But for acutely unwell patients, or for infection control, Ms Pilkington says that portable machines are very helpful. This is because "they remove the excess burden of transportation from the patients", says the final-year student at the University of the West of England in Bristol, who is also a member of the Institute of Physics. Instead the X-ray equipment goes to them. There are obvious advantages for remote locations, including battlefields, roadsides and disaster zones. Read full story Source: BBC News, 8 January 2024 -
Content ArticleRob Behrens reflects on the work the Parliamentary and Health Service Ombudsman (PHSO) has done over the last year to drive improvements in patient safety.
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Content ArticleElective recovery plans in part rely on the strengths of Surgical Hubs (SH) and Community Diagnostic Centres (CDC) to provide additional support. This report by the Medical Technology Group (MTG) considers how well these new tools are working for the NHS. It raises questions about how SHs and CDCs have been established and the decision making processes within these services.
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Content ArticleIn a study published in Rheumatology, researchers used the example of neuropsychiatric lupus, an incurable autoimmune disease that is particularly challenging to diagnose, to examine the different value given by clinicians to 13 different types of evidence used in diagnoses. This included evidence such as brain scans, patient views, and the observations of family and friends.
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News Article
Autism diagnosis wait times hit 300 days
Patient Safety Learning posted a news article in News
The average wait for an autism diagnosis in England has hit 300 days, according to new NHS data. That is up 53% from 12 months prior and exceeds the NICE target of 91 days. The National Autistic Society described such wait times as appalling, warning "autistic people shouldn't miss out on vital support because they haven't got a timely assessment." A government spokesperson said it had made £4.2m available this year to improve services for autistic children. Rose Matthews, 63, from County Durham, said receiving an autism diagnosis had been "lifesaving - and I don't say that flippantly". Before receiving their diagnosis at the age of 59, Rose, who uses "they" and "them" as personal pronouns, said: "My life was unravelling. "My career was unravelling." They said their GP had "deeply misguided ideas about what being autistic meant" and brushed them aside. Joey Nettleton-Burrows, policy and public affairs manager for the National Autistic Society (NAS), said: "We do see lot of misunderstanding from people, and it can include health and social care staff, but I wouldn't say it is common with GPs." Read full story Source: BBC News, 15 December 2023 -
News Article
New tests may finally diagnose Long Covid
Patient-Safety-Learning posted a news article in News
One of the biggest challenges facing clinicians who treat Long Covid is a lack of consensus when it comes to recognising and diagnosing the condition. But a new study suggests testing for certain biomarkers may identify Long Covid with accuracy approaching 80%. Effective diagnostic testing would be a game-changer in the Long Covid fight, for it’s not just the fatigue, brain fog, heart palpitations, and other persistent symptoms that affect patients. Two out of three people with Long Covid also suffer mental health challenges like depression and anxiety. Some patients say their symptoms are not taken seriously by their doctors. And as many as 12% of Long Covid patients are unemployed because of the severity of their illness and their employers may be sceptical of their condition. Researchers at Cardiff University School of Medicine in Cardiff, Wales, United Kingdom, tracked 166 patients, 79 of whom had been diagnosed with Long Covid and 87 who had not. All participants had recovered from a severe bout of acute Covid-19. In an analysis of the blood plasma of the study participants, researchers found elevated levels of certain components. Four proteins in particular—Ba, iC3b, C5a, and TCC—predicted the presence of Long Covid with 78.5% accuracy. "I was gobsmacked by the results. We’re seeing a massive dysregulation in those four biomarkers," says study author Wioleta Zelek, PhD, a research fellow at Cardiff University. "It’s a combination that we showed was predictive of Long Covid.." Read full story Source: Medscape, 29 November 2023 -
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.
