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News ArticleThe risk of dying from coronavirus is more than twice as great in the most deprived areas of England – with the disparity largest for women, analysis shows. A study by the Health Foundation of deaths from COVID-19 showed women in the most deprived parts of the country had a risk of dying that was 133% higher than those in the least deprived neighbourhoods. Between men the difference in risk was 114% higher in worse-off areas, suggesting that while deprivation is a key factor in risk of death from coronavirus for both sexes, its effect is worse for women. Experts say the evidence shows the impact of COVID-19 is falling disproportionately on the poorest in society. Mai Stafford, principal data analyst at the Health Foundation, told The Independent: “This pandemic could and should be a watershed moment in creating the social and political will to build a society that values everyone’s health now and in the long term. Without significant action, there is a real risk that those facing the most disadvantage will eventually pay the highest price.” Read full story Source: The Independent, 21 May 2020
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Choices for the “New Normal” (4 May 2020)
Patient Safety Learning posted an article in Blogs
No one can say with certainty what the consequences of this pandemic will be in 6 months, let alone 6 years or 60. Some “new normal” may emerge, in which novel systems and assumptions will replace many others long taken for granted. But at this early stage, it is more honest to frame the new, post–COVID-19 normal not as predictions, but as a series of choices. In this article in JAMA, Donald Berwick proposes six properties of care for durable change: tempo, standards, working conditions, proximity, preparedness, and equity. -
Content ArticleThe impact of COVID-19 on communities of colour in the US is dramatically and disproportionately affecting African-Americans most of all. The reasons are complex, with underlying health conditions (e.g., hypertension, diabetes) acting as one contributing factor. Yet, these health problems, public health experts say, largely reflect the history and ongoing realities of racism in the US that have created barriers to accessing quality health care and the conditions that can lead to better health.
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Content ArticleThe impact of the virus that causes COVID-19 could hardly be more disparate. While billions are stuck at home and restricted by social-distancing guidelines, millions of people must still put themselves and their families at risk by continuing to go to work. Millions are coping with the requirement of effectively working from home, but millions more have lost their jobs and don’t know how they will pay for housing or food. And for those who contract the virus, its effects span from nothing at all to death. Derek Feeley discusses these inequities in an article for the Institute of Healthcare Improvement.
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Content ArticleThe COVID-19 pandemic has affected some sections of the population more than others, and there are growing concerns that the UK’s minority ethnic groups are being disproportionately affected. Following evidence that minority groups are over-represented in hospitalisations and deaths from the virus, Public Health England has launched an inquiry into the issue. In the short term, ethnic inequalities are likely to manifest from the COVID-19 crisis in two main ways: through exposure to infection and health risks, including mortality; through exposure to loss of income. This report brings together evidence on the unequal health and economic impacts of COVID-19 on people in minority ethnic groups in the UK, presenting information on risk factors for each of the largest minority ethnic groups in England and Wales: white other, Indian, Pakistani, Bangladeshi, black African and black Caribbean. The analysis focuses on a limited but crucial set of risk factors in terms of both infection risk and economic vulnerability in the short term.
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News ArticleThe Office for National Statistics (ONS) has published its first figures analysis Covid-19 related deaths by ethnic group in England and Wales between March 2 and April 10. The results showed that the risk of death involving the coronavirus among Black, Asian, and minority ethnic (BAME) groups is “significantly higher” than that of those of white ethnicity. Researchers found that when taking age into account, in comparison to white men and women, black men are 4.2 times more likely to die from a Covid-19-related death and black women are 4.3 times more likely. People with Bangladeshi, Pakistani, Indian and mixed ethnicities have a raised risk of death, too. Read full story (paywalled) Source: The Telegraph, 7 May 2020
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Revealed: the NHS’s plan to protect BAME staff from COVID-19
Patient Safety Learning posted a news article in News
The NHS faces a new set of wide-ranging requirements as part of a comprehensive plan to mitigate the impact of COVID-19 on black, Asian and minority ethnic staff, HSJ has discovered. A draft NHS England/NHS Improvement document, seen by HSJ, proposes trusts ensure every staff member has “a risk assessment to keep them safe”. It says the centre will provide: “Guidance and support to employers on creating proactive approaches to risk assessment for BAME staff, including physical and mental health.” The document, Addressing Impact of Covid-19 on BAME Staff in the NHS, will call for five actions: 1. Every member of staff, current and returning, will have a risk assessment to keep them safe. 2. Every organisation with a CEO, and for primary care CCGs and ICSs, needs a BAME co-leader. 3. Diversity at every level of the health and care system starts with the podium, through our senior decision-making forums and across all organisations and at all levels of the workforce. 4. A bespoke health and wellbeing (including rehab and recovery) offer for BAME staff will be developed and rolled out for the system. 5. Every part of the system will use guidance on increasing diversity and inclusion in communications will be produced, led by the system. Read full story Source: HSJ, 6 April 2020- Posted
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Content ArticleCould prisons be an opportunity to address serious health inequalities? Or do they lead to worse health for people living in prison? In this podcast from the Kings Fund, Anna Charles explores the health and wellbeing of people living in prison, their access to health and care services, and what happens on release. She’s joined by: Dr Jake Hard, Chair of the Royal College of General Practitioners Secure Environments Group Christina Marriott, Chief Executive Officer of Revolving Doors Chantal Edge, Public Health registrar and NIHR research fellow Kate Morrissey, National Implementation Lead for RECONNECT at NHS England and NHS Improvement.
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COVID-19 'sheds light on health inequalities in North East'
Patient Safety Learning posted a news article in News
A leading doctor has called on the government to address regional health inequalities surrounding coronavirus. Dr George Rae, the British Medical Association's regional chairman for the North East, has written an open letter saying the area is "suffering disproportionately". He said it was "time to ask why" and wanted action to "close the gap". A government spokesman said it was working "incredibly hard" to protect the nation's public health. "This is gravely disconcerting," Dr Rae wrote. "Not only does this mean that we're suffering from a disproportionate amount of serious cases and deaths but also that, as a consequence, gradual lockdown measures may be affected - prolonging the hurt caused to our local economy. Covid-19 has shone a light on the health inequalities in the North East". "What we need now is action from the government to close this gap and reduce the vulnerability of people in the North East to many medical conditions and, indeed, any future viruses." Read full story Source: BBC News, 5 May 2020 -
Content ArticleRadio 4's Women's Hour programme discusses coronavirus and the impact the current pandemic is having on access to cervical screening services. Later in the programme, the discussion turns to the topic of dealing with addiction during the lockdown. Cervical screening (listen from the start of the recording) Speakers, Kate Sanger, Head of Public Affairs at Jo's Cervical Cancer Trust, and consultant gynaecologist Dr Christine Ekechi stress that patients should not hesitate to contact their GP if they have any concerns or symptoms. Symptoms might include: abnormal bleeding, bleeding after sex, bleeding after the menopause, bleeding in between periods, unexplained pelvic pain and in some cases increased vaginal discharge. Addiction (21:45) According to the charity Action on Addiction, one in three people are addicted to something. How difficult can it be to remain sober or clean in lockdown, and what support can you still access? Speakers include Holly Sexton, Substance Misuse Practitioner at We Are With You, and Caroline Turriff, a freelance journalist who is 15 years in recovery. They discuss whether opiate painkillers and methadone being more easily available through pharmacies creates safety issues. Caroline argues that it will reduce the risk of people obtaining opiates online or heroin via street dealers which she says could enable them to obtain life-threatening amounts.
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Content ArticlePatient experience data has long been used as a measure of quality of healthcare, but there remains a gap between measurement and improvement. The focus of the study discussed in this blog, was on understanding how staff approached patient experience projects, why some struggled, and how they made sense of the tasks.
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Primary Care Women's Health Forum: Resources
PatientSafetyLearning Team posted an article in Women's health
This webpage from the Primary Care Women's Health Forum (PCWHF), contains the latest guidelines, patient materials and articles from the board alongside recommended external resources. Resources include: Intrauterine methods for all indications. How to manage contraceptive provision without face to face consultations. Having a pessary fitted for a vaginal prolapse. Advice following insertion or removal of your contraceptive implant.- Posted
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Bulletin of the World Health Organization
Patient Safety Learning posted an article in WHO
The Bulletin of the World Health Organization is a fully open-access monthly journal of public health with a special focus on low and middle-income countries.- Posted
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News ArticleNeglect and serious failures by the Home Office and multiple other agencies contributed to the death of a vulnerable man who died from hypothermia, dehydration and malnutrition in an immigration removal centre, an inquest has found. Prince Fosu, a 31-year-old Ghanaian national, died in October 2012 when his naked body was found on the concrete floor of his cell in Harmondsworth, a detention centre near Heathrow. He had been experiencing a psychotic episode but he was not referred for a mental health assessment due to “gross failures” by all agencies to recognise the need to provide appropriate care to a person unable to look after himself. Four GPs, two nurses, two Home Office contract monitors, three members of the Independent Monitoring Board (IMB) and countless detention custody officers and managers who visited him failed to take any meaningful steps, the inquest found. Three doctors have since been referred to the UK’s medical watchdog for their alleged failures relating to the death of Mr Fosu on recommendation of the Prison and Probation Ombudsman (PPO), who said the care he received fell “considerably below acceptable standards”. Read full story Source: The Independent, 3 March 2020
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Prisoners suffer cancelled appointments and poorer healthcare
Patient Safety Learning posted a news article in News
Prisoners in Britain frequently have hospital appointments cancelled and receive less healthcare than the general public, a new study has found. As many as 4 in 10 hospital appointments made for a prisoner were cancelled or missed in 2017–18, with missed appointments costing the NHS £2 million. The in-depth analysis of prison healthcare by the Nuffield Trust think tank examined 110,000 hospital records from 112 prisons in England. It revealed 56 prisoners gave birth during their prison stay, with six prisoners giving birth either in prison or on their way to hospital. The Nuffield Trust said its findings raised concerns about how prisoners are able to access hospital care after a cut in the number of frontline prison staff and a rising prison population. Lead author Dr Miranda Davies, a senior fellow at the Nuffield Trust, said: “The punishment of being in prison should not extend to curbing people’s rights to healthcare. Yet our analysis suggests that prisoners are missing out on potentially vital treatment and are experiencing many more cancelled appointments than non-prisoners.” Read full story Source: The Independent, 26 February 2020- Posted
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Content ArticleIt is widely known that prisons in England and Wales are crowded and facing severe difficulties, but the health and health care use of the prisoners within has received little attention. Drawing on over 110,000 patient hospital records for prisoners at 112 prisons, this study from the Nuffield Trust provides the most in-depth look to date at how prisoners’ health needs are being met in hospital.
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Content ArticleAn interview with Jennifer Block, author of Everything Below The Waist: Why Health Care Needs A Feminist Revolution. This interview was published on the Hysterical Women website.
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Content ArticleThe Marmot Review into health inequalities in England was published on 11 February 2010. It proposes an evidence based strategy to address the social determinants of health, the conditions in which people are born, grow, live, work and age and which can lead to health inequalities.
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Content ArticleThe Health Foundation commissioned the Institute of Health Equity to examine progress in addressing health inequalities in England, 10 years on from the landmark study Fair Society, Healthy Lives (The Marmot Review). Led by Professor Sir Michael Marmot, the review explores changes since 2010 in five policy objectives: giving every child the best start in life enabling all people to maximise their capabilities and have control over their lives ensuring a healthy standard of living for all creating fair employment and good work for all creating and developing healthy and sustainable places and communities. For each objective the report outlines areas of progress and decline since 2010 and proposes recommendations for future action, setting out a clear agenda at a national, regional and local level.
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Content ArticleThe author of this article, published in The Guardian, argues that centuries of female exclusion has meant women’s diseases are often missed, misdiagnosed or remain a total mystery.
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Content ArticleThis report by the World Health Organization, draws attention to gender as a powerful determinant of health care access and outcomes. By analysing universal health coverage (UHC) indicators from a gender perspective, including indicators dis-aggregated by sex, the report exposes how people’s gender intersects with their socioeconomic backgrounds and other aspects of their identities and circumstances to produce health inequities. It applies gender and equity perspectives to service coverage and financial protection, two key dimensions of UHC. It concentrates on the policies and services of health systems, while acknowledging that breaking gender- and equity-related barriers requires a multisectoral approach. It shows how health systems and UHC policies, by increasing gender responsiveness, can improve equity. And it recommends ways to incorporate gender in the UHC framework for monitoring country progress.
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Content ArticleAmerican women visit more doctors, have more surgery, and fill more prescriptions than men. In Everything Below the Waist, Jennifer Block asks: why is the life expectancy of women today declining relative to women in other high-income countries and even relative to the generation before them? Block examines several staples of modern women's health care, from fertility technology to contraception to pelvic surgery to miscarriage treatment and finds that while over-diagnosis and over-treatment persist in medicine generally, they are particularly acute for women. Further reading: Interview with the author
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Content ArticleFourteen years after being diagnosed with endometriosis, Gabrielle Jackson couldn't believe how little had changed in the treatment and knowledge of the disease. In 2015, her personal story kick-started a worldwide investigation into the disease by the Guardian; thousands of women got in touch to tell their own stories and many more read and shared the material. What began as one issue led Jackson to explore how women, historically and through to the present day, are under-served by the systems that should keep them happy, healthy and informed about their bodies. Further reading: Interview with the author
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Content ArticleThe term “racism” is rarely used in the medical literature. Most physicians are not explicitly racist and are committed to treating all patients equally. However, they operate in an inherently racist system. Structural racism is insidious, and a large and growing body of literature documents disparate outcomes for different races despite the best efforts of individual healthcare professionals. If we aim to curtail systematic violence and premature death, clinicians and researchers will have to take an active role in addressing the root cause. Structural racism, the systems-level factors related to, yet distinct from, interpersonal racism, leads to increased rates of premature death and reduced levels of overall health and well-being. Like other epidemics, structural racism is causing widespread suffering, not only for black people and other communities of colour but for our society as a whole. It is a threat to the physical, emotional, and social well-being of every person in a society that allocates privilege on the basis of race. Hardeman et al. believe that as clinicians and researchers, we wield power, privilege, and responsibility for dismantling structural racism — and in this New England Journal of Medicine article the authors highlight recommendations for clinicians and researchers who wish to do so.
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Content ArticleThis is an interview with Gabrielle Jackson, author of Pain and Prejudice: A call to arms for women and their bodies, published by the Hysterical Women website. Jackson talks about her diagnosis of endometriosis, the lack of advanced medical knowledge around women's medical issues and a need for access to better treatments.
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