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Content ArticleTo support patients to understand the risks of taking sodium valproate during pregnancy, NHS England has launched two new shared decision-making tools. This is part of an NHS-wide effort to reduce the use of valproate in people who can get pregnant, and to help those that do continue with valproate to prevent pregnancies.
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Content ArticleA new report presents the preliminary findings of the Care Post-Roe Study, and shows how US healthcare providers have been unable to provide the standard of care in states with abortion bans since the Supreme Court struck down Roe v. Wade ten months ago, leading to harm and negative health outcomes for patients. The report shows that healthcare providers have seen increased morbidity, exacerbated pregnancy complications, an inability to provide time-sensitive care, and increased delays in obtaining care for patients in states with abortion bans. This has impacted both patients and providers and has deepened the existing inequities in the health care system for people of colour.
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Content ArticleApproximately 8% of US doctors experience a malpractice claim annually. Most malpractice claims are a result of adverse events, which may or may not be a result of medical errors. However, not all medicolegal cases are the result of medical errors or negligence, but rather, may be associated with the individual nature of the patient-doctor relationship. The strength of this relationship may be partially determined by a physician’s emotional intelligence (EI), or his or her ability to monitor and regulate his or her emotions as well as the emotions of others. This review evaluates the role of EI in developing the patient-physician relationship and how EI may influence patient decisions to pursue medicolegal action.
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Content ArticleThe results from the 2022 British Social Attitudes survey made for very difficult reading for those of us working in the NHS right now. Overall satisfaction with the NHS is at the lowest level ever recorded and similarly satisfaction with individual services is at record lows across the board, but it was satisfaction with A&E services that saw the sharpest fall in 2022. Kelly Ameneshoa, an Emergency Medicine Doctor working across South London and Surrey, reflects on the findings.
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News ArticleNearly 150 doctors have been disciplined for sexual misconduct in the last five years, as surgeons call for action on the “systemic” and “cultural” problem of sexual assault within healthcare, The Independent can reveal. Doctors campaigning for the UK’s healthcare services to address widespread problems with sexual harassment and assault in medicine have warned that people do not feel safe to come forward with allegations amid deep-seated “hierarchies” within healthcare. The Royal College of Surgeons’ Women in Surgery chair has said the issues are “widespread” across the health services and improvements to protecting whistleblowers needed to be made nationally. Last year, surgeons Becky Fisher and Simon Fleming wrote an academic paper exposing the problem of sexual assault, harassment and rape in surgery and surgical training. In interviews with The Independent, both have warned the “institutional” problem goes beyond surgery and across all of the healthcare services. Mr Fleming said the figures from the GMC were the “the very tip of the iceberg” in terms of actual levels of sexual assault within healthcare. Talking about the role of the GMC, Mr Fleming said he’d been told “by more than one person” that when they’ve reached out to the GMC over sexual assault or misconduct they were “failed” by the regulator and were “either not helped, abandoned or told to deal with it locally”. Read full story Source: The Independent, 15 February 2022
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News ArticleHealth officials have “paid lip service” to racism in the NHS for years, leading black, Asian and minority ethnic doctors have warned as they called for “concrete” action to tackle inequalities exposed by a landmark review. The damning study – the largest of its kind – had found “vast” and “widespread” inequity in every aspect of healthcare it reviewed, and warned that this was harming the health of minority ethnic patients in England. In response, an NHS spokesperson said the health service was “already taking action” to improve the experiences of patients and access to services and was working “to drive forward” the recommendations made in the report. However, Dr JS Bamrah, a consultant psychiatrist in Greater Manchester and national chairman of the British Association of Physicians of Indian Origin, said he was unsatisfied with the response. “This 166-page review … is a terrible indictment of the current state of the NHS,” he told the Guardian. “As many of us have often said and reported, we don’t need any further reports. It’s action we need, as there are scores of patients who are not getting optimal treatment, and many are being neglected. “It really isn’t good enough for NHS bosses to say that action is being taken and it’s even more disappointing to then not see any concrete proposals on dealing with glaring disparities despite all that we have learnt during the pandemic.” Dr Rajesh Mohan, presidential lead for race and equality at the Royal College of Psychiatrists, said it was “time for warm words to end” as he urged NHS leaders to “do everything they can to ensure patients from ethnic minority backgrounds get the care they need”. Read full story Source: The Guardian, 15 February 2022
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News Article
NHS hospital doctor arrested on suspicion of sexual assault
Patient Safety Learning posted a news article in News
Two NHS hospital trusts are working with police after a doctor was arrested on suspicion of sexual assault. Staffordshire Police has launched a major incident review of the doctor's work at hospitals in Dudley, West Midlands, and Stoke-on-Trent, The Sunday Times reported. The force said the 34-year-old man from the West Midlands was arrested in December and released on bail. It is reviewing an investigation into the same suspect it undertook in 2018. The doctor was suspended from seeing patients at the Royal Stoke University Hospital in Staffordshire when the parents of a vulnerable female raised concerns about his examination of her, the Sunday Times reported. The case was referred to police in 2018 who said there was "insufficient evidence to take further action" at the time. The Staffordshire force has now reported itself to the Independent Office for Police Conduct. University Hospitals of North Midlands NHS Trust, which runs the Royal Stoke, said it was working with police and had set up a helpline for any patient and guardian who may have concerns. Read full story Source: BBC News, 13 February 2022 -
News ArticleOne in four doctors in the NHS are so tired that their ability to treat patients has become impaired, according to the first survey to reveal the impact of sleep deprivation on medics during the coronavirus pandemic. Growing workloads, longer hours and widespread staff shortages are causing extreme tiredness among medics, leading to memory problems and difficulty concentrating, according to the report by the Medical Defence Union (MDU), which provides legal support to about 200,000 doctors, nurses, dentists and other healthcare workers. The survey of more than 500 doctors across the UK, carried out within the past month and seen by the Guardian, uncovered almost 40 near misses as a direct result of exhaustion. In at least seven cases, patients actually sustained harm. Despite encouraging signs the Omicron wave may be fading, doctors admitted the constant pressure of the past 22 months spent fighting coronavirus on the frontline was taking a toll on their technical skills and even their ability to make what should be straightforward medical decisions. Medics admitted for the first time sleep deprivation was causing real harm to patients in the NHS. Almost six in 10 doctors (59%) reported their sleep patterns had worsened during the pandemic. More than a quarter (26%) of medics admitted being so tired that their ability to treat patients was “impaired”. Of these, one in six (18%) said a patient was harmed or a near miss occurred as a result. Read full story Source: The Guardian, 17 January 2022 Read MDU press release
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News Article
Omicron blocks thousands of overseas doctors joining NHS
Patient Safety Learning posted a news article in News
Thousands of overseas-qualified doctors wanting to work in the UK will be delayed after the General Medical Council cancelled exams due to the surge in Covid cases. The regulator said its decision to pause professional and linguistic assessment board tests, scheduled for January and February, was made “in direct response” to the current omicron wave. Up to 54 doctors would have been needed each per day as examiners, it said, alongside a “large number of role players and staff”. It comes as overseas recruitment is seen by government and national officials as a crucial way to boost NHS staffing, including GPs. Director of registration Una Lane said: “We are deeply disappointed to have to cancel exams at this time, but given the pressures on the NHS and the impact on examiner availability, it was the only viable option.” Read full story (paywalled) Source: HSJ, 6 January 2022 -
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Doctors and nurses vent anger as unvaccinated Covid cases delay vital operations
Patient Safety Learning posted a news article in News
The NHS has a backlog of 5.8 million waiting for surgery and specialists are increasingly frustrated at how the unvaccinated have left them unable to tackle it. Doctors and nurses have told of their anger and frustration at not being able to treat seriously ill patients as new figures show that more than 90% of Covid sufferers requiring the most specialist care are unvaccinated. While the success of the vaccination rollout has reduced the overall impact of COVID-19 on hospitals, intensive care clinicians from across England have spoken out over the continuing pressure they are under. Between 20% and 30% of critical care beds in England are occupied by Covid patients and three-quarters of those have not been vaccinated, according to the latest data up to July this year. Read full story (paywalled) Source: The Times, 4 December 2021 -
News Article
Covid: Doctors' leaders back postponed health checks
Patient Safety Learning posted a news article in News
Doctors' leaders have welcomed plans to allow GPs in England to defer some services to deliver Covid booster jabs instead. Practices can postpone minor surgery and routine health checks for over-75s and new patients until 31 March. All adults in England are expected to be offered boosters by the end of January in response to the emergence of the Omicron variant. A further 75 Omicron cases were confirmed in England on Friday. On Saturday the UK reported a further 42,848 cases of coronavirus and 127 deaths within 28 days of a positive Covid test while 372,557 booster jabs were administered on Friday. Dr Farah Jameel, the GP committee chair of the British Medical Association, said the new measures would release GPs from "filling out paperwork" and chasing unnecessary and often undeliverable targets. She told BBC Radio 4's Today programme: "We have been struggling with significant prevailing workforce pressures - backlog pressures, winter pressures, pandemic pressures. "Whilst these changes make a difference and start to create some time, I think every single practice will have to look at just how much time it does release." Read full story Source: BBC News, 5 December 2021- Posted
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Unsupportive Government ‘indirectly puts GP patient lives at risk’
Patient Safety Learning posted a news article in News
A lack of support for general practice is indirectly putting patient lives at risk, amid escalating abuse in GP practices, the England LMCs conference has heard. A debate around abuse saw 99% of conference delegates agree that ‘the abuse of primary care staff directly affects patient care and puts patient safety at risk’. And 98% agreed that ‘when Government and [NHS England] choose not to support NHS staff, they directly affect patient safety and knowingly put lives at risk’. The conference also voted to ‘demand that healthcare policy is decided based on high-quality evidence on population health, and not the whims of a handful of vitriolic media’, with the vote unanimous on the topic. Speaking in the debate, which focussed on GP abuse and wellbeing, Dr Abel Adegoke of Wirral LMC told delegates that the NHS "runs on the blood of GPs" He said: "About four weeks ago, my younger sister was being buried and I had to watch via Zoom because that was taking place in Nigeria – yet I was still seeing patients. That was the day I felt so sad about being a GP because despite that sacrifice, I was still abused by a patient who wanted to be seen urgently for an absolutely non-urgent condition." "We are being taken for granted." Read full story Source: Pulse, 30 November 2021- Posted
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News ArticlePoliticians and doctors in Germany have called for urgent action to control the spread of COVID-19 after a record number of cases were reported on 11 November. Germany had 50 196 new confirmed Covid cases on 11 November, up from 39 676 cases on 10 November and 9658 on 1 November, showed figures from the Robert Koch Institute. A total of 235 Covid related deaths were reported on 11 November, up from 23 on 1 November. Speaking in the Bundestag, Germany’s lower house of parliament, the federal vice chancellor, Olaf Scholz, said that immediate steps must be taken to “winterproof” Germany against what is being described as the nation’s fourth wave of Covid-19. Scholz will meet next week with the prime ministers of Germany’s 16 states to discuss new measures to fight the pandemic. “The virus is still with us and threatens the health of citizens,” Scholz said, adding that efforts must be intensified to convince unvaccinated Germans to become fully vaccinated and encourage those already vaccinated to have the booster shot." Everything must be done, he said, to ensure “that millions of citizens get a booster—that is the task of the next weeks and months.” Read full story Source: BMJ, 12 November 2021
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Research confirms impact of COVID-19 on doctors’ mental health
Patient Safety Learning posted a news article in News
The COVID-19 crisis triggered high levels of anxiety and depression among doctors in the UK, Italy and Spain, a new study has found The research of 5,000 survey responses, across the three countries, found Italian doctors were most likely to have suffered during the crisis last year. The study, published in PLOS ONE, measured the mental wellbeing of doctors in Catalonia (Spain), Italy and the UK during June, November and December 2020. It found that around one in four medical doctors in Italy had experienced symptoms of anxiety in June and December 2020, with around one in five reporting symptoms of depression over the same period. In Catalonia around 16% of doctors reported anxiety and around 17% experienced depression. In the UK around 12% of doctors reported anxiety and around 14% had symptoms of depression. The study is among the first cross-country analysis of mental wellbeing among healthcare workers during the COVID-19 pandemic and the first to focus on medical doctors. Across all countries, female doctors and doctors under 60 were more likely to have anxiety or depression. Professor Quintana-Domeque, professor of economics at the University of Exeter Business School, who carried out the study said: “The COVID-19 pandemic has been classified as a traumatic event, with healthcare workers arguably having the most direct and longest exposure to this disease." “The results of this study suggest that institutional support for healthcare workers, and in particular doctors, is important in protecting and promoting their mental health in the current and in future pandemics.” Read full story Source: The Independent, 3 November 2021 -
News Article
Trainee doctors 'scared to come to work'
Patient Safety Learning posted a news article in News
Some trainee doctors and consultants at one Welsh health board are "scared to come to work", a report has found. A report by the Royal College of Physicians (RCP) described "frightening experiences" staff faced at Aneurin Bevan University Health Board. Chronic understaffing and excessive workloads at the Grange hospital in Cwmbran were causing "very serious patient safety concerns", it added. The Health Board said it had taken the findings of the report very seriously. The report, obtained by BBC Wales, said that some trainee doctors and consultants were worried about working in case they lost their licence to practise. It also said the problems had caused some consultants to feel demoralised and on the brink of leaving. One trainee told the authors of the report: "On one overnight shift, I treated a four-year-old with seizures. The ambulance took six hours. Colleagues treated an 18-month-old with burns. Lots of kids come in with respiratory distress. Paediatric cases are not uncommon. We've treated stabbing victims. Colleagues delivered a baby earlier in the minor injuries unit. These things shouldn't happen at all." Another trainee said: "There's so much patient movement with [this] model. I recently sent someone from Nevill Hall to the Grange to get a scan, then to the [Royal] Gwent to get a follow-up procedure, then back to Nevill Hall. "That's three bed moves, three ambulance crews and three medical people dealing with the same patient. It's extremely inefficient." And another added: "I worry about the safety of the patients coming into this hospital." Read full story Source: BBC News, -
News ArticleWhite doctors applying for medical posts in London are six times more likely to be offered a job than black applicants, figures released under the Freedom of Information Act show. The new data also show that white doctors are four times more likely to be successful than Asian candidates or candidates from a mixed ethnic background. The figures were uncovered by Sheila Cunliffe, a senior human resources professional who works in workforce transformation across the NHS and the wider public sector. Cunliffe sent freedom of information requests to all 18 NHS acute trusts in London asking for a breakdown by ethnicity for 2020-21 of the numbers of applicants for medical jobs, shortlisted candidates, and candidates offered positions. Twelve of the 18 trusts shared their full unredacted data with The BMJ on all grades of job applications. Across these 12 trusts, 29% (4675 of 15 853) of white applicants were shortlisted in 2020-21, compared with 13% (2041 of 15 515) of black applicants, 14% (8406 of 59 211) of Asian applicants, and 15% (1620 of 10 860) of applicants of mixed ethnicity. Overall, 7% (1148) of white applicants were offered jobs, compared with 1% (188) of black applicants, 2% (1050) of Asian applicants, and 2% (188) of applicants of mixed ethnicity. Cunliffe said that the findings were just one indicator of the barriers that applicants from ethnic minorities faced. “The racism some of these results point to will be replicated in the day-to-day lived experience of staff working within the trust,” she said. “NHSEI [NHS England and NHS Improvement] need to look at data in a more detailed way and, where needed, set out to trusts their clear expectations and targets for improvement.” Read full story Source: BMJ, 13 October 2021
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HEE tells trusts to prioritise training, or services will suffer
Patient Safety Learning posted a news article in News
The quality and performance of services will suffer if medical training is not ‘prioritised and funded’ by trusts, Health Education England (HEE) has warned. HEE has set out actions in its “Covid training recovery interim report” that must be done alongside NHS England, the Department of Health and Social Care and others to protect post-covid workforce recovery. At the beginning of the pandemic, junior doctors’ training was severely disrupted because thousands of staff were redeployed to covid wards, while most routine elective operations and diagnostic procedures were stopped. HEE says training has still not returned to pre-covid levels, and fears there could be further disruptions over winter if significant volumes of elective care are cancelled. According to its report, if medical training is not “prioritised and funded”, the “long-term costs to service are significantly greater”. “If delivery recovery is prioritised over training recovery there will be an initial increase in service delivery time and value, but this will be followed swiftly by a reduction in service delivery time and value,” it warned. Read full story Source: HSJ, 13 October 2021 -
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Doctors and nurses at London’s frontline hospital denied coronavirus vaccine
Patient Safety Learning posted a news article in News
Doctors and nurses on the front line of the fight against coronavirus at the Royal London Hospital – which has the largest number of Covid patients in the capital – have been denied the Pfizer vaccine, The Independent has learnt. Hospital bosses at Barts Health Trust have written to staff today expressing their frustration over the decisions by NHS England, which meant the northeast of London – where the rate of infections and hospitalisations are worst – has not been given access to any vaccines. The Independent has learned that staff from the Royal London booked appointments to be vaccinated at University College London, but they were turned away because the vaccinations had been earmarked for NHS staff from University College London Hospital Trust. The trust’s chief medical officer wrote to senior doctors on Monday warning them the crisis facing the hospital would get worse before it gets better. Professor Alistair Chesser told staff: “It has been frustrating to see the vaccine delivered to other trusts and to GP surgeries but not to us in the last few days given the pressure we are under. Please be assured we are lobbying for our staff and our patients at the very highest levels and will not let this rest.” Read full story Source: The Independent, 22 December 2020 -
News ArticleResearch by a group of doctors has found ‘major deficiencies’ around infection control within hospitals in the North West region. The study looked at trusts’ adherence to Public Health England guidance around limiting the spread of COVID-19 within orthopaedic services. The study found patients were routinely being allocated to hospital beds before they had been confirmed as covid-negative, “thus allowing spread of COVID-19 not only between patients but also between nursing and medical staff”. Fewer than half of patients were nursed with the appropriate screens in place, while it was uncommon for doctors to be tested regularly. Separate statistics published by NHS England suggest almost 20 per cent of new covid cases in North West hospitals from August to December were likely to be nosocomial, meaning they were acquired on the wards. This was a higher proportion than any other region. Read full story Source: HSJ (paywalled), 16 December 2020
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News ArticleA trust is investigating after two junior doctors developed covid following an offsite event attended by 22 juniors where social distancing rules were allegedly ignored. The cases, involving doctors from the Royal Surrey Foundation Trust in Guildford, have been declared an outbreak by Public Health England and police have investigated the incident. But HSJ understands that contact tracing has concluded no patients needed to be tested because staff had worn appropriate PPE at all times and those involved had swiftly self-isolated once they realised they might have covid or had been at risk of exposure to it. It is not known whether any of the doctors had returned to work after the event before realising they might have been exposed to covid. Dr Mark Evans, deputy medical director, said: “Protecting our patients is our priority and we are committed to ensuring that all of our staff follow government guidance. This incident took place outside of work and has been reported appropriately, and there was no disruption to our services for patients.” Read full story Source: HSJ, 22 October 2020
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Racial discrimination widespread in NHS job offers, says report
Patient Safety Learning posted a news article in News
Doctors from black, Asian and minority ethnic backgrounds have been hindered in their search for senior roles because of widespread “racial discrimination” in the NHS, according to a report from the Royal College of Physicians. The RCP, which represents 30,000 of the UK’s hospital doctors, found that ingrained “bias” in the NHS made it much harder for BAME doctors to become a consultant compared with their white counterparts. “It is clear from the results of this survey that racial discrimination is still a major issue within the NHS,” said Dr Andrew Goddard, the RCP’s president. “It’s a travesty that any healthcare appointment would be based on anything other than ability.” Read full story Source: The Guardian, 21 October 2020 -
News ArticleA key player in the junior doctor disputes with Jeremy Hunt has now joined the former health secretary’s patient safety charity. Jeeves Wijesuriya, former chair of the British Medical Association’s junior doctors committee, is among the nine people who will serve on the advisory board of the Patient Safety Watch charity. Mr Hunt has also announced that Sir Robert Francis, who led the Mid Staffs inquiry; England’s former chief medical officer Dame Sally Davies; former medical director of the NHS, Sir Bruce Keogh; and Dame Marianne Griffiths, chief executive of Western Sussex Hospitals Foundation Trust, will also serve on the advisory board. Mr Hunt announced Patient Safety Watch last year to establish data to report on levels of patient safety and avoidable harm in healthcare, and commission research from leading universities. He has previously said he will invest hundreds of thousands of pounds in the charity over several years. He told HSJ: “Patient safety has moved massively up the agenda because of the issue of nosocomial infections that have affected both staff and patients during covid." “This high powered advisory board will help Patient Safety Watch make measured but decisive interventions so that we get better at learning from what inevitably goes wrong - not just in a pandemic but in normal times as well.” Read full story Source: HSJ, 8 October 2020
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News ArticleSenior doctors specialising in infectious diseases have written an open letter expressing "concern" about the rapid increase in COVID-19 cases in Northern Ireland. The letter is signed by 13 medics from hospitals across Northern Ireland. It calls for the public to stick to government guidance on reducing social interactions and also warns against "stigmatising people and areas with high levels of infection." The letter reads: "We need to support people who test positive. This pandemic requires us to work together to bring it under control urgently. We need to reduce the potential for transmission to protect our health service, and we need to fix our test and trace system to try and gain better control of this virus in our community." On Monday, 616 new cases of COVID-19 were identified in Northern Ireland, bringing the total during the pandemic to 14,690. The number of deaths recorded by the Department of Health remains at 584. Among those who have signed the letter are Dr Claire Donnelly, a consultant physician who specialises in infectious diseases; consultant virologist Dr Conall McCaughey and consultant paediatrician Dr Sharon Christie. Entitled an "appeal to people to adhere to Covid public health guidance", the letter lays bare the stark reality of the infections rates. The letter adds: "Worryingly the number of cases is increasing rapidly in many areas over the last week, indicating that we have widespread community transmission in many parts of Northern Ireland." Read full story Source: BBC News, 6 October 2020
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News ArticleA decision not to "urgently" refer an anorexic woman whose condition had significantly deteriorated contributed to her death, a coroner said. Amanda Bowles, 45, was found at her Cambridge home in September 2017. An eating disorder psychiatrist who assessed her on 24 August apologised to Ms Bowles' family for not organising an admission under the Mental Health Act. Assistant coroner Sean Horstead said the decision not to arrange an assessment "contributed to her death". Mr Horstead told an inquest at Huntingdon Racecourse that also on the balance of probabilities the "decision not to significantly increase the level of in-person monitoring" following 24 August "contributed to the death". In his narrative conclusion, Mr Horstead said it was "possible... that had a robust system for monitoring Ms Bowles in the months preceding her death been in place, then the deterioration in her physical and mental health may have been detected earlier" and led to an earlier referral to the Adult Eating Disorder Service. He said this absence "was the direct consequence of the lack of formally commissioned monitoring in either primary or secondary care for eating disorder patients". Read full story Source: BBC News, 17 September 2020
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News ArticleA damning report into Devon’s NHS 111 and out of hours GP service has revealed shocking stories of patients who have either had their health put at risk or tragically died due to the service being in need of urgent improvement. Devon Doctors Limited, which provides an Urgent Integrated Care Service (UICS) across Devon and Somerset, was inspected by independent health and social care regulator the Care Quality Commission (CQC) in July, after concerns were raised about the service. They included the care and treatment of patients, deaths and serious incidents, call waits, staff shortages, and low morale. Inspectors found 'deep rooted issues'. The CQC concluded it was not assured that patients were being treated promptly enough and, in some cases, they had not received safe care or treatment. It is calling for the service to make urgent improvements which will be closely monitored. Since August 2019, the report stated Devon Doctors had received 179 complaints. Nine had been identified by the service as incidents of high risk of harm and six had been identified by the service as incidents of moderate risk of harm. These had been recorded on the service’s significant event log. However, on review, the CQC identified an additional 30 events from the complaints log which could also have been classed as either moderate or high risk of harm. Read full story Source: Devon Live, 15 September 2020