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News ArticleA trust has been accused of presiding over the deterioration of a key service amid communication problems between senior leaders and a ‘worrying series of resignations’ which has left the department with ‘no doctors’. The British Association of Dermatologists wrote to Worcestershire Acute Hospitals Trust on 13 July to request an urgent meeting with the provider’s management to discuss the matter. The letter, seen by HSJ, outlines fundamental patient safety and staffing concerns about the trust’s dermatology service and accuses the trust of putting “continued communication barriers” between clinicians and management. The letter, signed by BAD president Mabs Chowdhury, says there are now “no doctors in the department” after two consultants and a locum consultant resigned “due to apparent unhappiness with the running of services [and in] a continuation of a worrying series of resignations”. Read full story (paywalled) Source: HSJ, 19 July 2023
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Doctors call for return of face mask guidance
Patient Safety Learning posted a news article in News
Doctors have warned the decision to remove face mask guidance in healthcare settings is "playing Russian roulette" with staff and patients' welfare. It was withdrawn in May in hospitals, dentists and GP surgeries having been in place since June 2020. Doctors from the British Medical Association (BMA) Scotland condemned the decision at the time. Now, the Scottish Healthcare Workers Coalition has written to ministers to highlight the "very serious flaws" in changing the guidance. The group is made up of Scottish healthcare workers who worked throughout the pandemic and are now living with long Covid or another chronic post-viral illness or disability. In the letter, the coalition states the updated guidance is not based on the science of coronavirus transmission and "represents a flawed and dangerous decision which will result in more infection in health and social care settings". Dr Shaun Peter Qureshi, of the Scottish Healthcare Workers Coalition, said: "At-risk patients have entirely legitimate concerns that they may endanger their health by visiting their GP or hospital. "With at least 4% of NHS staff now living with chronic post-Covid complications, the Scottish government must follow the evidence and improve protections from the airborne spread (of the virus) in healthcare settings, not reduce them." Read full story Source: BBC News, 17 July 2023 -
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‘Helpless’ CEO’s report expresses ‘extreme concern’ over doctors strikes
Patient Safety Learning posted a news article in News
Acute trust leaders have expressed ‘extreme concern’ over their ability to maintain safe services in the upcoming junior doctor and consultant strikes. Leaders at Worcestershire Acute Hospitals Trust are “extremely concerned about the impact on patients… as well as on the health and wellbeing of staff”, according to its latest CEO report to the board, Junior doctors are striking between 7am on Thursday 13 July and 7am on Tuesday 18 July. The report warned this would result in “complete withdrawal of labour, with no exemptions to cover emergency and critical services”. The report said: “Junior doctors may only be recalled to work in the event of a mass casualty incident… Although other staff can cover for junior doctors they are becoming exhausted and increasingly reluctant to do so. “We are therefore extremely concerned about our ability to maintain safe services.” Read full story (paywalled) Source: HSJ, 12 July 2023- Posted
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News Article
NHSE cuts elective targets and admits PM’s waiting list pledge under threat
Patient Safety Learning posted a news article in News
NHS England has reduced its elective activity target for the service because of the impact of junior doctors’ strike, and acknowledged the service may not hit the prime minister’s pledge to reduce waiting lists before the next general election if the industrial action continues. NHSE has agreed a deal with ministers which will see the “value based” elective activity target set for the service reduced for 2023-24 from 107 per cent of pre-pandemic levels to 105 per cent (See explainer box on value-based targets below). Trust finance bosses were briefed by NHSE chief finance officer Julian Kelly this morning (Wednesday 12 July) on the eve of junior doctors’ longest strike action to date. Read full story (paywalled) Source: HSJ, 12 July 2023- Posted
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Parents fear spread of ‘associate’ doctors at NHS will end in more tragedies
Patient Safety Learning posted a news article in News
A 30-year-old actress whose symptoms were dismissed as anxiety died of a blood clot. Emily Chesterton believed she had seen a GP, but had in fact been seen twice by a physician associate (PA), a newer type of medical role that involves significantly less training. Her parents, Brendan and Marion Chesterton, both 64 and retired teachers, said they have serious concerns about plans for thousands more PAs to be employed to combat staff shortages as part of the NHS Long Term Workforce Plan. Chesterton’s calf pain and shortness of breath should have suggested a pulmonary embolism and meant she was sent to A&E. A coroner concluded this would probably have saved her life. Instead she was told to take anxiety pills. She collapsed that evening. She was taken to hospital but her heart stopped and she could not be revived. Read full story (paywalled) Source: The Times, 10 July 2023- Posted
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News ArticleA struggling trust has been warned by regulators that it could see its junior doctors removed, after concerns about clinical supervision and safety at a hospital whose A&E closes at night. NHS England inspectors who visited Cheltenham General Hospital found emergency patients – including potential surgical patients – became the responsibility of the overnight medical team when its accident and emergency closed in the evening. One night, 26 patients had been handed across, the inspectors were told, and some patients were felt to be inappropriate for medical referral. A surgical registrar could be telephoned at Gloucester Royal Hospital about surgical patients. They were told that although there were no incidents of serious harm, there had been many “near misses” and juniors felt “unsafe and unsupported in terms of consultant clinical supervision, overall clinical/nursing staffing support or logistically in managing patients in this setting or arranging transfers”. Read full story (paywalled) Source: HSJ, 7 July 2023
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Content ArticleA significant number of doctors and other healthcare workers have developed post-acute COVID, including a large number who developed it as a result of workplace exposure to Covid-19. This paper examines the impact post-acute Covid symptoms have had on the medical workforce, personally and professionally. It provides a unique and valuable insight into the experience of UK doctors suffering from post-acute Covid. It has been informed by a UK survey of over 600 doctors suffering from the continuing effects of an infection with Covid-19, as well as wider research of the issues. The survey was undertaken by the British Medical Association (BMA) in partnership with Long COVID Doctors for Action. This is the first comprehensive survey of doctors with post-acute Covid health complications. This paper should inform the support needed by current sufferers of post-acute COVID in the NHS workforce, and help protect services and patients now and in the future.
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Most doctors think ministers want to destroy NHS, BMA boss says
Patient Safety Learning posted a news article in News
Most frontline medics believe ministers are seeking to “destroy the NHS” because they have starved it of cash and mistreated its staff, the leader of Britain’s doctors has said. Prof Philip Banfield also warned that the health service, which on Wednesday will mark the 75th anniversary of its creation, is so fragile that it may not survive until its 80th. Banfield, the British Medical Association’s chair of council, mounted an unusually strong attack on the government’s handling of the NHS in an interview with the Guardian. “This government has to demonstrate that it is not setting out to destroy the NHS, which it is failing to do at this point in time,” he said. “It is a very common comment that I hear, from both doctors and patients, that this government is consciously running the NHS down. [And] if you run it down far enough, it’s going to lead to destruction. “You’ll struggle to find someone [among doctors] on the frontline who thinks otherwise, because that’s what it feels like.” Read full story Source: The Guardian, 4 July 2023- Posted
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Content ArticleAs a doctor, receiving a letter from the GMC confirming that a complaint has been raised against you by a patient, and the GMC are now investigating that complaint, can be a frightening experience. This blog by solicitor Nicola Wheater, looks at how communication failings can lead to GMC complaints and describes what to expect from the process. She also highlights support available for doctors facing a GMC complaint.
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News ArticleThe head of NHS England has warned that July's planned strikes in the health service could be the worst yet for patients. Amanda Pritchard said industrial action across the NHS had already caused "significant" disruption - and that patients were paying the price. This month's consultant strike will bring a "different level of challenge" than previous strikes, she said. Junior doctors and consultants will strike for a combined seven days. Ms Pritchard told the BBC's Sunday with Laura Kuenssberg programme that the work of consultants - who are striking for the first time in a decade - cannot be covered "in the same way" as junior doctors. "The hard truth is that it is patients that are paying the price for the fact that all sides have not yet managed to reach a resolution," she said. Read full story Source: BBC News, 2 July 2023
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Government aims to boost NHS with thousands more doctors and nurses
Patient Safety Learning posted a news article in News
Thousands more doctors and nurses will be trained in England every year as part of a government push to plug the huge workforce gaps that plague almost all NHS services. The number of places in medical schools will rise from 7,500 to 10,000 by 2028 and could reach 15,000 by 2031 as a result of the NHS’s first long-term workforce plan. There will also be a big expansion in training places for those who want to become nurses, with the number rising by a third to 40,000 by 2028 – matching the number of nurses the health service currently lacks. Amanda Pritchard, the chief executive of NHS England, hailed the long-awaited plan as “a once in a generation opportunity to put staffing on a sustainable footing for years to come”. Medical groups, health experts and organisations representing NHS staff welcomed the plan as ambitious but overdue. Richard Murray, chief executive of the King’s Fund thinktank, said it could be a “landmark moment” for the health service by providing it with the staff it needs to provide proper care. Read full story Source: The Guardian, 29 June 2023- Posted
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Content ArticleThe state of medical education and practice in the UK 2023 is published at a time when the UK health systems face extensive challenges. This report from the General Medical Council (GMC) shares concerning data about the experiences of doctors and the challenges to providing adequate care to patients. In this context, careful and constructive exploration of the practical, evidence-based steps that can be taken to improve the situation is critical – to protect both patients and the doctors who care for them.
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News Article
Nurses strikes to end but now senior doctors vote to walk out
Patient Safety Learning posted a news article in News
Nurses strikes are set to end but the disruption for NHS patients will continue as senior doctors are the latest to vote to walk out. The Royal College of Nursing failed to reach the threshold needed to hold further action, with just 43% of the required 50% of members returning a ballot to hold fresh walkouts. But more than 24,000 members of the British Medical Association (BMA) backed industrial action by 86% on a turnout of 71%, well above the legal threshold of 50%, with senior doctors set to strike on 20 and 21 July. It comes after the union last week announced a five-day strike by junior doctors will be held from 13 July. NHS leaders have said consecutive walkouts from junior doctors and now consultants presents a “huge risk” for the health service. Read full story Source: The Independent, 27 June 2023 -
Content ArticleThis is part of our series of Patient Safety Spotlight interviews, where we talk to people working for patient safety about their role and what motivates them. Dan talks to us about how his experiences as a paediatrician and military doctor have influenced his view of patient safety. He also describes the increasing complexity in healthcare systems and highlights the need for the Government to commit policy and resources to building and sustaining the NHS workforce.
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News Article
NHS plans: Sunak says expansion means 'more doctors, nurses, and GPs'
Patient Safety Learning posted a news article in News
The NHS is set to undergo the "largest expansion in training and workforce" in its history, Rishi Sunak has said. Speaking to the BBC, the prime minister said the plans would reduce "reliance on foreign-trained healthcare professionals". It comes at a time of record-high waiting lists in the NHS and junior doctors set to stage a five-day strike next month. The full plans are expected to be published next week. Pressed about the length of time it would take to see the results of the changes, Mr Sunak accepted it could take "five, ten, fifteen years for these things to come through", but that did not mean it was not the right thing to do. Read full story Source: BBC News, 25 June 2023- Posted
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News ArticleJunior doctors will take part in what is “thought to be the longest single period of industrial action in the history of the health service” for five days next month. The British Medical Association junior doctor committee announced this morning there would be a walkout from 7am on Thursday 13 July and 7am on Tuesday 18 July in its ongoing pay dispute with government. It comes amid growing expectation that a Royal College of Nursing ballot on further strike action over the Agenda for Change pay award, which ends this week, is likely to fail to secure a mandate. But junior doctors’ strikes are continuing to hit elective recovery, and strain relationships, with workload on other groups increased as they are asked to provide cover. Junior doctors have allowed no “derogations” (exemptions) from the action, as they say other staff groups can cover emergency care, and one move to call them in to a busy hospital in the south west, in an earlier round, was abandoned. Read full story (paywalled) Source: HSJ, 23 June 2023
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News ArticleA warning has been made over the possible side effects of a common NHS antibiotic by a coroner after a newly retired senior doctor died by suicide. "Respected and experienced" consultant cardiologist Robert Stevenson had no history of depression or mental health problems before he started a course of ciprofloxacin. But just over a week later, the 63-year-old went for a walk and messaged his wife to tell her he had left a note under his pillow. He was later found dead in a nearby wood. The note he had left was said to be "uncharacteristically confused and illogical" with "baseless concerns" that he might have AIDS after taking an online HIV tester kit, an inquest heard. The hearing was told Dr Stevenson hadn't been told about a "potential rare link" to suicidal behaviour in patients who took the drug, as this wasn't in line with medical guidance. Now, coroner Martin Fleming issued a warning to highlight the risk of taking the antibiotic, which is prescribed by the health service for serious conditions. Read full story Source: The Mirror, 20 June 2023
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Fresh review into ‘doctors being bullied with regulatory referrals’
Patient Safety Learning posted a news article in News
Investigators have begun a further review of how a major trust handles disciplinary and professional standards cases, including allegations leaders had targeted some doctors with referrals to the medical regulator, HSJ has learned. The claims were part of a raft of concerns raised about University Hospitals Birmingham Foundation Trust over recent months, including BBC Newsnight reporting that a large number of General Medical Council referrals had led to no action; and claims of whistleblowing doctors “being bullied… by the threat of referrals to the GMC”. One external review of UHB, whose report was published in March, already examined the issue, and said it had identified 17 cases which contradicted Newsnight’s claim, with two referrals resulting in criminal conviction and removal from the medical register. It said there was “nothing exceptional” about the referral numbers or types at UHB, or their outcomes, but also noted that medical staff told the review about “dysfunctional processes for maintaining higher professional standards”, and “expressed a perception that there was a rather rapid process to escalate to a GMC referral”. Read full story (paywalled) Source: HSJ, 21 June 2023- Posted
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News ArticleJunior doctors could indefinitely withdraw labor, and strike for three days a month until next year, the medics’ union leaders have warned. Hundreds of junior doctors gathered outside the largest NHS conference of the year, NHS Confedexpo, on Thursday chanting “pay us fair, pay right, we don’t want to have to strike”. The British Medical Association’s junior doctor committee co-chair Dr Rob Laurenson warned junior doctors may next escalate strike action in an “indefinite withdrawal of labour”. NHS England boss Amanda Pritchard said the strike is a “serious risk to patient safety” and industrial action “creates risk and upheaval”. She said tens of thousands of appointments will be affected. Read full story Source: The Independent, 15 June 2023
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Retired specialists set to help with tackling Covid backlog
Patient Safety Learning posted a news article in News
Retired doctors will have an option to “keep caring” and re-join the NHS to carry out outpatient appointments in a new initiative to help reduce waiting lists. From autumn, newly-retired doctors will be able to sign up to a new digital platform where they will be able to offer their availability to trusts across England to perform outpatient appointments, either virtually or in person. NHS hospitals will choose the consultant whose skillset and availability best matches the appointments they need covered, which are scheduled and arranged with patients in the normal way. More than four-fifths of people on the waiting list require an outpatient appointment such as a follow-up for cardiology or rheumatology – rather than a surgical procedure. Consultants carrying out remote appointments could be based anywhere in England, which can help those hospitals in areas with higher demand. Those requiring a face-to-face appointment or follow-up will be seen in the usual way. Speaking at NHS Confed Expo, Amanda Pritchard, NHS Chief Executive, said: “Ahead of the NHS 75th birthday in July, this new platform is an innovative example of how we are constantly adapting the way we work to benefit patients by helping to reduce waiting times as well as supporting staff. “Using this digital tool will help us to match patients with retired doctors who we know are keen to stay working in a flexible way so they can keep caring for patients, as well as allowing us to expand capacity to see even more patients – and faster. “NHS staff have already made excellent progress against our Elective Recovery Plan – and this platform will not only help us continue to reduce the longest waits but it will also help us slash agency spend, using the existing capacity of experienced doctors who still have so much to offer the NHS”. Read full story Source: NHS England, 14 June 2023- Posted
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News ArticleSome doctors in Australia are using the title “specialist general physician” despite not having completed the training required by law, potentially misleading patients with complex and chronic health conditions that require specialised care, physicians say. After completing a medical degree and postgraduate work experience, graduates can apply to the Royal Australasian College of Physicians (RACP) fellowship training program. All RACP trainees complete similar foundational training before choosing areas of advanced training to specialise in such as geriatrics, cardiology, general medicine or other areas. General physicians are different from general practitioners (also known as GPs). General physicians care for patients with unusual or complex conditions and see patients either in hospital or those who are referred to them, usually by the patient’s GP. Medical practitioners can only use titles such as “specialist general physician”, “specialist geriatrician” or “specialist cardiologist” if they have completed the advanced specialist RACP training in the corresponding field of practice and have registered with the Australian Health Practitioner Regulation Agency (Ahpra). But Dr Jenna Paterson, a specialist general physician working in Victoria and South Australia, said there are “many, many” doctors who advertise their services to patients as a “general physician” without the qualifications to do so. Read full story Source: The Guardian, 13 June 2023
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How chatbots are helping doctors be more human and empathetic
Patient Safety Learning posted a news article in News
Despite the drawbacks of turning to artificial intelligence in medicine, some US physicians find that ChatGPT improves their ability to communicate with patients. Last year, Microsoft and OpenAI released the first free version of ChatGPT. Within 72 hours, doctors were using the artificial intelligence-powered chatbot. Experts expected that ChatGPT and other A.I.-driven large language models could take over mundane tasks that eat up hours of doctors’ time and contribute to burnout, like writing appeals to health insurers or summarising patient notes. However, they found that doctors were asking ChatGPT to help them communicate with patients in a more compassionate way. Dr Michael Pignone, the chairman of the department of internal medicine at the University of Texas at Austin, has no qualms about the help he and other doctors on his staff got from ChatGPT to communicate regularly with patients. However, skeptics like Dr Dev Dash, who is part of the data science team at Stanford Health Care, are so far underwhelmed about the prospect of large language models like ChatGPT helping doctors. In tests performed by Dr Dash and his colleagues, they received replies that occasionally were wrong but, he said, more often were not useful or were inconsistent. If a doctor is using a chatbot to help communicate with a patient, errors could make a difficult situation worse. Read full story (paywalled) Source: New York Times, 12 June 2023 -
Content ArticleThere has been growing concern about doctors’ conflicts of interests (COIs) but it is unclear what processes and tools exist to enable the consistent declaration and management of such interests. This study in the Journal of the Royal Society of Medicine mapped existing policies across a variety of organisations and settings to better understand the degree of variation and identify opportunities for improvement. The analysis of organisational policies revealed wide variation in what interests should be declared, when and how. This variation suggests that the current system may not be adequate to maintain a high level of professional integrity in all settings and that there is a need for better standardisation that reduces the risk of errors while addressing the needs of doctors, organisations and the public.
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Three-day strike by doctors in England expected to have ‘enormous impact’
Patient Safety Learning posted a news article in News
Almost all routine NHS care in England will be disrupted for three days this week when junior doctors strike in their latest attempt to force ministers to increase their pay. Prof Stephen Powis, NHS England’s national medical director, said the stoppage would have an enormous impact and lead to huge numbers of patients missing out on planned care. Many thousands of junior doctors are due to stage a 72-hour walkout starting at 7am on Wednesday and continuing until 7am on Saturday. “The NHS has been preparing extensively for this next set of strikes,” said Powis. “But we know that – with the sheer number of appointments that need to be rescheduled – it will have an enormous impact on routine care for patients and on the waiting list, as procedures can take time to rearrange with multiple teams involved.” Read full story Source: The Guardian, 13 June 2023- Posted
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Twenty-four UK doctors in five years censured over medical record breaches
Patient Safety Learning posted a news article in News
Twenty-four doctors have been disciplined by the UK medical regulator in the last five years after accessing and using information from patients’ treatment records without good reason. The General Medical Council (GMC) said it had struck off two of the 24 doctors it had sanctioned after finding that they had undertaken “inappropriate use” of medical records. Another 10 were suspended, 10 were warned about their future conduct, one had a condition imposed on their licence to practise medicine and the other had to undertake not to repeat their behaviour. The 24 cases were among 194 incidents of doctors allegedly accessing medical records without a clinical justification that prompted a complaint to the regulator between 2017 and 2022. Privacy campaigners said it was shocking that almost 200 people had made complaints to the GMC accusing doctors of violating patients’ confidentiality in that way. Read full story Source: The Guardian, 13 June 2023- Posted
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