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Found 499 results
  1. Content Article
    The COVID-19 pandemic has led to a widespread response across the NHS in terms of how staff and the departments and organisations in which they work can help to manage the challenges being faced now and in the coming weeks and months. This includes the need to learn new skills and procedures at short notice, to rehearse the management of complex and potentially hazardous clinical cases in unfamiliar environments, and to be assured that any systems, policies and protocols that are put into action are designed to promote safe, effective care and support staff well-being. There is an important role for simulation as a technique or intervention in this set of unique circumstances, which will be implemented more effectively if integrated and aligned with the many other initiatives aimed at supporting staff and the NHS as a whole.
  2. Content Article
    The Talking about dying report seeks to offer advice and support for any doctor on holding conversations with patients much earlier after the diagnosis of a progressive or terminal condition, including frailty. The report identified that the timely, honest conversations about their future that patients want are not happening. Yet, these proactive discussions are fundamental to effective clinical management plans, part of being a medical professional and align with the aspirations of the Royal College of Physicians's Future Hospital Commission report. The Talking about dying report begins to highlight and challenge professional reluctance to engage in conversations with patients about uncertainty, treatment ceilings, resuscitation status and death. It offers some ‘mythbusters’ to get physicians thinking and we offer signposts to tools and educational resources to support physicians and other healthcare professionals.
  3. Content Article
    This video has been produced by the staff at Guy's and St Thomas' Hospital NHS Foundation Trust. It demonstrates how to prone an intensive care patient. If proning a patient with COVID-19, full personal protective equipment (PPE) will be required by all staff.
  4. Content Article
    In this blog published in the Guardian, a doctor on the frontline of the UK coronavirus outbreak talks about how he and others are ‘terrified’ about the lack of protection – and a plan. Working on the infectious diseases ward of a major UK hospital, which has now become the coronavirus ward, or 'red zone', the doctor explains why he is terrified. "I’m seriously considering whether I can keep working as a doctor. I may be OK – I’m young and healthy – but I can’t bear the thought of infecting other patients with a disease that could kill them. And that is the risk, without proper PPE. It’s terrifying; it’s indescribable. This is not seasonal flu. This is a new virus with greater mortality and we know much less about it."
  5. News Article
    NHS national leaders are set to reassure doctors they should not fear regulatory reprisals, within reason, if they end up working outside their areas of expertise during the coronavirus outbreak. HSJ understands the UK’s four chief medical officers and the General Medical Council are drafting a letter to be sent to all UK doctors, which will contain the reassurances, as the system braces for a sharp rise in covid-19 cases. The letter will also urge doctors to be flexible and not to resist new ways of working, with senior figures expecting many clinicians working in other specialities or locations during the outbreak. The letter will say doctors, while still expected to follow good medical practice, should not fear reprimand from their employers or national bodies such as the GMC, NHS England or other regulators. Read full story (paywalled) Source: HSJ, 11 March 2020
  6. News Article
    The British Medical Association (BMA) should not allow itself to become a campaign tool for vested interest groups seeking a dangerous change in the law, writes Dr Matthew Davis in the Guardian. "Doctors have a responsibility to first do no harm... Even when it may feel uncomfortable, doctors must continue to exercise their Hippocratic duty", says Dr Davies. "The BMA must remain opposed to assisted suicide if the medical profession it claims to represent is to have any credibility in safe, caring and trustworthy expertise. It must not allow itself to become a campaign tool for vested interest groups seeking an extreme and dangerous change in the law that has, even very recently, been rejected by parliament." Read full story Source: The Guardian, 25 February 2020
  7. News Article
    Doctors need to stop moaning and take responsibility for improving the NHS, the leader of Britain’s medics has said. Ministers have given the NHS a “substantial sum” of money and doctors must now stop blaming the government for all its problems, Carrie MacEwen, Chairwoman of the Academy of Medical Royal Colleges, told The Times. Britain’s 220,000 doctors have a professional duty to make the health service’s ten-year plan work and can no longer “sit on their hands”, Professor MacEwen said. After years in which the loudest medical voices have tended to complain about government funding and staffing levels, she said that doctors should take advantage of a “golden opportunity”. Read full story (paywalled) Source: The Times, 25 February 2020
  8. News Article
    Lives may be at risk unless the NHS reviews how stand-in doctors are recruited, a coroner has warned. Harry Richford's death after a series of failings at a hospital in Margate, Kent, was ruled "wholly avoidable". An inquest heard he was delivered by an "inexperienced" locum doctor who was new to the hospital. A national review into the recruitment, assessment and supervision of locums should be carried out, Christopher Sutton-Mattocks said in a report. The coroner wrote that particular emphasis should be considered upon the scope of locums' activities before they are left responsible for out-of-hours labour care. He issued 19 recommendations to prevent future deaths, including a request that NHS England and the Royal College of Obstetricians and Gynaecologists consider such a review, warning "there may be a risk to other lives both at this trust and at other trusts in the future". Read full story Source: BBC News, 19 February 2020
  9. News Article
    London doctors are using artificial intelligence to predict which patients with chest pains are at greatest risk of death. A trial at Barts Heart Centre, in Smithfield, and the Royal Free Hospital, in Hampstead, found that poor blood flow was a “strong predictor” of heart attack, stroke and heart failure. Doctors used computer programmes to analyse images of the heart from more than 1,000 patients and cross-referenced the scans with their health over the next two years. The computers were “taught” to search for indicators of future “adverse cardiovascular outcomes” and are now used in a real-time basis to help doctors identify who is most at risk. Read full story Source: Evening Standard, 15 February 2020
  10. News Article
    The Doctors’ Association UK has compiled stories from 602 frontline doctors which expose a startling culture of bullying and overwork in the NHS. The stories include: a pregnant doctor who fainted after being forced to stand up for 15 hours straight and being denied water. The junior doctor was subsequently shouted at in front of colleagues and patients on regaining consciousness and told it was her choice to be pregnant and that ‘no allowances would be made’. a doctor who told us that a junior doctor hung themselves in a cupboard whilst on shift and was not found for 3 days as no-one had looked for them. His junior doctor colleagues were not allowed to talk about his suicide and it was all ‘hushed up’. a doctor who was denied a change of clothes into scrubs after having a miscarriage at work despite her trousers being soaked in blood. Full press release
  11. News Article
    Leaving the EU means the UK has greater control over the training of healthcare professionals. The Department of Health and Social Care (DHSC) has announced that nurses and other allied healthcare professionals will be able to retrain as doctors ‘more quickly’ now the UK has left the EU. Under training standards set by the EU, existing healthcare professionals wishing to move into another area would have to complete a set standard of training, regardless of any existing health background or qualifications. Under the potential new system, a nurse who has been in the job for 10 years could benefit from training standards based upon experience and qualifications, rather than strict time-frames. Health Secretary Matt Hancock said: “Our incredible NHS is full of highly-qualified and dedicated professionals – and I want to do everything I can to help them fulfil their ambitions and provide the best possible care for patients. Without being bound by EU regulations, we can focus on ensuring our workforce has the necessary training which is best suited to them and their experience, without ever compromising on our high standards of care or on patient safety. The plans we are setting out today mean that we can retrain healthcare workers and get them back to the frontline faster. This is good for patients, and good for our NHS." Nursing leaders warn that the move needs to come without compromising patient care. Andrea Sutcliffe CBE, Chief Executive and Registrar at the Nursing and Midwifery Council (NMC) said: “Having enough health and care professionals with the right knowledge, skills and values is vital to meet the individual needs of people across all four countries of the UK now and in the future." “The NMC supports the wish to explore how education and training for registered nurses and midwives may be achieved in more flexible ways while ensuring our high standards are maintained and not compromised. Every nursing and midwifery professional must be safe and competent to provide the best care and support possible." Read full story Source: Nursing Notes, 9 February 2020
  12. Content Article
    First, do no harm. Doctors, nurses, and clinicians swear by this code of conduct. Yet, medical errors are made every single day - avoidable mistakes that often cost lives. Inspired by two such mistakes, Dr. Peter Pronovost made it his personal mission to improve patient safety and make preventable deaths a thing of the past, one hospital at a time. Safe Patients, Smart Hospitals shows how Dr. Pronovost started a revolution by creating a simple checklist that standardised a common ICU procedure. His reforms are being implemented in all fifty states of the US and have saved hundreds of lives by cutting hospital-acquired infection rates by 70%. Atul Gawande profiled Dr. Pronovost's reforms in a New Yorker article and his bestselling book The Checklist Manifesto is based upon Dr. Pronovost's success in patient safety. But Safe Patients, Smart Hospitals is the real story: an inspiring, thought-provoking, accessible insider's narrative about how doctors and nurses are improving patient care.
  13. Content Article
    “It’s not something we talk about or that everybody experiences to the same degree but I think most of us are affected, be it subconsciously or consciously by antiquated, competitive, hierarchical values. Revered doctors are those that work above and beyond the hours they are paid for, that come in even when they are sick, that prioritise work over their families, over sleep and their own health. Doctors that are kind and compassionate but that don’t allow themselves to be affected by their experiences. Doctors that would go from one cardiac arrest to the next without letting their judgement cloud or their actions falter.”  This blog by Dr Natalie Ashburner who is the Doctors Association UK (DAUK) Editor emphasises the importance of doctors speaking up about their mental health.
  14. Content Article
    I'm Martin. In this blog I want to talk about my role as a Macmillan acute oncology clinical nurse specialist (CNS) and what our team has done to improve patient safety within the acute ward of our hospitals. Coming from a non-oncology background there was a lot to learn when I moved into acute oncology. My background was mainly acute cardiac and respiratory, but this allowed me to notice how powerful and time effective the presence of an acute oncology CNS could be in improving cancer patient safety within the emergency department.
  15. Content Article
    Anaesthetists are thought to be at increased risk of suicide amongst the medical profession. The aims of the following guidelines written by the Association of Anaesthetists are: increase awareness of suicide and associated vulnerabilities, risk factors and precipitants; to emphasise safe ways to respond to individuals in distress, both for them and for colleagues working alongside them; and to support individuals, departments and organisations in coping with a suicide.
  16. Content Article
    In this video, Prof Kevin Fong, Consultant Anaesthetist at UCL (University College London) is joined in a panel discussion by three other experts in Human Factors and Ergonomics (HFE): Dr Fiona Kelly, Consultant Anaesthetist and Intensivist at Royal United Hospitals Bath and lead of the Difficult Airway Society (DAS) group on HFE Prof Chris Frerk, Consultant Anaesthetist at Northampton General Hospital and CHFG (Clinical Human Factors Group)Trustee Mr Clinton John, Operating Department Practitioner and Head for Clinical Education at UCLH. They will discuss and share their top tips about HFE in the context of airway management. This forms part of a free course from Future Learn Airway Matters course to  help others explore key concepts underlying safe, multidisciplinary airway management.
  17. Content Article
    The government response to the care failures at the Mid Staffordshire NHS Foundation Trust led to the policy imperative of ‘regular interaction and engagement between nurses and patients’ in the NHS. The pressure on nursing to act resulted in the introduction of the US model, known as ‘intentional rounding’, into nursing practice. This is a timed, planned intervention that sets out to address fundamental elements of nursing care by means of a regular bedside ward round. This study, published by Health Services and Delivery Research, aimed to examine what it is about intentional rounding in hospital wards that works, for whom and in what circumstances.
  18. Content Article
    Elisabeth Poorman argues that becoming a doctor means learning that mistakes are not acceptable. From study through to practice, doctors are told in ways big and small, the only way to be a good doctor is to be a perfect doctor. The pressure only intensifies when real harm is on the line. The encouraged response is to study harder, sleep less, and never admit fear. 
  19. Content Article
    Never events (NEs) are serious preventable patient safety incidents and are a component of formal quality and safety improvement (Q&SI) policies in the UK and elsewhere. A preliminary list of NEs for UK general practice has been developed, but the frequency of these events, or their acceptability to GPs as a Q&SI approach, is currently unknown. This study from Stocks et al., published in the Journal of Patient Safety, aimed to estimate the frequency of 10 NEs occurring within GPs' own practices and the extent to which the NE approach is perceived as acceptable for use.
  20. Content Article
    Samantha Batt-Rawden, Co-founder of the The Doctors' Association UK, discusses the struggles of a junior doctor and how changes in the NHS over the last 14 years has made it so much harder to do an already hard job. In this article published in the Metro, she says "that the combination of spiralling workloads and a decimation of morale and camaraderie has been toxic for the profession." Last year, 55% of UK doctors met the criteria for burnout and ‘emotional exhaustion’, with one in five resorting to the use of drugs or alcohol as a ‘coping strategy’. It’s hardly surprising that we are haemorrhaging doctors out of the profession, and it’s only getting worse. So, how do we fix this? Sally suggests that we need to treat staff like human beings if we are going to have any hope of stemming the exodus of clinicians. It’s as simple as restoring some on-call rooms so we can get our heads down, and stop crashing our cars on the way home. Or it’s as basic as ensuring that junior doctors have leave for our own weddings. Honestly, at this stage, just letting us have access to now-outlawed NHS coffee overnight would be a significant morale boost.
  21. News Article
    A coroner has today slammed a hospital for a series of serious failings after a mother bled to death when a medic refused to allow her vital clotting products. Gabriela Pintilie, 36, from Grays, Essex, gave birth to her healthy baby girl, Stefania, in February last year following a C-section after a long labour. But she suffered a major haemorrhage and died from a cardiac arrest hours later. Basildon University Hospital, in Essex, came under fire after it emerged a locum haematologist refused to give Mrs Pintilie the blood after he followed the wrong set of guidelines. The fresh frozen plasma, which could have saved her life, remained outside the theatre after senior staff were not told it was available. Essex Coroner Caroline Beasley-Murray today slammed the hospital for a lack of clear leadership and teamwork during the crucial minutes and hours when Mrs Pintilie suffered a massive haemorrhage. The court heard how the on-call haematologist Dr Asad Omran, who was at home, was called but refused to give permission for vital blood-clotting drugs to be issued until further tests were run. An expert witness said she believed the use of clotting drugs in the 'extreme situation' would have 'significantly increased' the chances of a different outcome. Dr Omran did not initially issue blood-clotting drugs because he followed the wrong protocol. He was following protocol for a normal adult, instead of a woman in labour, which was 'completely at odds with clinical guidelines'. Read full story Source: Mail Online, 20 January 2020
  22. Content Article

    Walk on by...

    Anonymous

    Anonymous posted an article in Florence in the Machine

    This anonymous blog is about a patient with learning disabilities, his treatment and outcome while coming in for a 'routine' procedure. This blog highlights the need for adequate training for all staff around caring for patients with learning disabilities to prevent harm and protracted length of stay.
  23. News Article
    Family doctors are under intense pressure and general practice is running on empty, warns the Royal College of GPs (RCGP). It says severe staff shortages are causing "unacceptable" delays for patients in England. In a letter to Health Secretary Matt Hancock, its chairman says ministers must take urgent action to deal with the lack of GPs. The government said it had recruited a "record number" of GP trainees. Ministers are committed to recruiting 6,000 more GPs in England by 2025. Prof Martin Marshall, who took over as RCGP chairman in November, says GPs are struggling with an escalating workload, which is causing many to burn out and leave the profession. Dr Andrew Dharman, who works at the The Avenue surgery in Ealing, said the stress has got worse because of the enormous workload placed on GPs. He said: "Sometimes it feels like you're drowning. You know you're trying to stay afloat and on top of all the workload. And you're trying to make sure you're providing the kind of care that you envisage when you go to medical school." "You feel frustrated sometimes that you can't necessarily do that because of the amount of work and patients." Read full story Source: BBC News, 9 January 2020
  24. News Article
    New research from the UK’s Drug Safety Research Unit (DSRU) has found that hospital pharmacists, doctors and nurses only recorded batch numbers for biologic medicines between 38% and 58% of the time during routine hospital practice. Further, an analysis of spontaneous adverse drug reaction (ADR) reports showed that brand names were only included 38% of the time, while batch number traceability was only 15%. Because of the study results, the DSRU is encouraging health professionals to improve the recording in order to aid patient safety, suggesting that it has “some way to go to encourage health professionals to record this information.” Read full story Source: PharmaTimes Online, 7 January 2020
  25. Content Article
    Amandip Sidhu is a Learn Not Blame member and pharmacist. Tragically, Amandip lost his brother, a respected Consultant Cardiologist, to suicide. In this heartbreaking and powerful guest blog for Doctors Association UK (DAUK) and the Compassionate Culture campaign, Amandip reflects on the “just get on with it” attitude of the NHS, and how we must move to kinder NHS that treats it’s staff with much needed compassion.
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