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Showing results for tags 'Health inequalities'.
Found 1,216 results
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Content ArticleA core responsibility of the NHS is to maintain the highest standards of safety and effectiveness of medical devices available for all patients in its care. Evidence has emerged, however, about the potential for racial and ethnic bias in the design and use of some medical devices commonly used in the NHS, and that some ethnic groups may receive sub-optimal treatment as a result. In response to these concerns, the UK Government commissioned this independent review on equity in medical devices. In its final report, the Review sets out the need for immediate action to tackle the impact of ethnic biases in the use of medical devices. Its findings and recommendations have also been published in a short animation. The Government’s response to the Review's 18 recommendations has also been published alongside its final report.
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Content ArticleThis annual report from ECRI and the Institute for Safe Medication Practices (ISMP) presents the top 10 patient safety concerns currently confronting the healthcare industry. It is a guide for a systems approach to adopting proactive strategies and solutions to mitigate risks, improve healthcare outcomes and enhance the well-being of patients and the healthcare workforce. Drawing on ECRI and ISMP’s evidence-based research, data and insights, this report sheds light on issues that leaders should evaluate within their own institutions as potential opportunities to reduce preventable harm. Some of the concerns represent emerging risks, some are well known but still unresolved, but all of them pertain to areas where organisations can make meaningful change.
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Content ArticleThousands of people with sight loss remain 'Out of Sight' in the hidden scandal of vision rehabilitation. Life changes after sight loss, sometimes overnight, often in dramatic ways. Done well, vision rehabilitation equips people with new ways to stay independent: to get out and about, adapt their work, shop and enjoy hobbies. However, the reality is stark. 86% of local authorities in England miss the 28-day recommended deadline to explore a person’s needs. Threadbare services mean people wait without the support they’re entitled to, at risk of physical accidents and injuries as well as mental health crises. The RNIB are calling on all UK political parties to commit to ensuring blind and partially sighted people get the support they need, when they need it.
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News Article
Health services for eating disorders overrun
Patient Safety Learning posted a news article in News
Health services for Londoners with eating disorders are struggling to cope with demand, a new report warns. Data from London's mental health trusts shows adult referrals have increased by 56% - from 3,000 to nearly 8,000 - in the last six years Child and adolescent referrals increased by 158%, from 1,400 to 4,000, in the same time period. The report has been compiled by the London Assembly's health committee. It has made 12 recommendations to London Mayor Sadiq Khan and City Hall officers, which include assessing other physical and mental health indicators as well as just patients' bodyweight as per their BMI. One consultant clinical psychologist told the committee that "almost all of the eating disorder services in London do not have the staffing levels available to safely provide the care required". Read full story Source: BBC News, 7 March 2024 -
Content ArticleIn June 2023, the London Assembly Health Committee launched an investigation into eating disorders in London, following reports that referrals for eating disorder services have increased in recent years and performance against waiting time standards dropped during the COVID-19 pandemic. The aim of this investigation was to understand what is driving the increase in referrals, how services are responding to this additional demand and to explore people’s access to, experiences of, and outcomes from treatment services. The Committee held two formal meetings with expert guests, including clinicians, people with experience of living with an eating disorder, and representatives from the Greater London Authority and NHS England. It also held a private session with people with lived experience of being affected by an eating disorder and received 112 responses to its survey from those with experience of an eating disorder, supporting a family member or friend with an eating disorder or those working with those experiencing an eating disorder.
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Content ArticleThis cohort study examined whether sociodemographic characteristics affected patient access to and use of patient health care portals during the Covid-19 pandemic. The authors found significant disparities in portal use by sex, age, multimorbidity and health literacy were found. While disparities by sex and age decreased and were no longer statistically significant by 2021, disparities by multimorbidity remained consistent throughout the pandemic and disparities by health literacy were exacerbated.
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Content ArticleAs the USA's largest health insurer, the Centers for Medicare & Medicaid Services (CMS) has established quality standards, metrics, and programmes to improve healthcare not just for the 170 million individuals supported by its programmes, but for all Americans. The 2024 National Impact Assessment of CMS Quality Measures Report (Impact Assessment Report) assesses the quality and efficiency impact of measures endorsed by the consensus-based entity and used by CMS.
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News Article
USA: Care quality, safety 'worse than expected' during Covid-19 pandemic
Patient Safety Learning posted a news article in News
A new CMS report reveals disparities in care quality and patient safety within US hospitals before and during the pandemic, finding "a large proportion of measures had worse than expected performance." CMS released its 2024 National Impact Assessment Feb. 28, which is released every three years and evaluates the measures used in 26 CMS quality and value-based incentive payment programs. This edition of the report compares quality measure scores pre-COVID-19 with hospitals' results in 2020 and 2021, the initial years of the COVID-19 public health emergency. Here are eight findings from the 72-page assessment: 1. During 2020 and 2021, a large proportion of measures had worse than expected performance, including significant worsening of key patient safety metrics. 2. Half or more of the performance measures in five priorities had worse results in 2021 than expected from the 2016–2019 baseline. Priorities with the highest proportions of worse-than-expected results in 2021 were wellness and prevention (69%), behavioural health (55%), safety (54%), chronic conditions (52%), and seamless care coordination (50%). 3. Specific to safety, standardised infection ratios worsened significantly in hospitals for central line–associated bloodstream infections (94% worse), MRSA (55% worse) and CAUTI (34% worse). Before the Covid-19 PHE (2015–2019), 34,455 fewer healthcare-associated infections (HAIs) were reported in acute care settings. 4. More than 35% of measures in two priorities had better results in 2021 than expected from 2016–2019 baseline trends. Those priorities are seamless care coordination (50%) and affordability and efficiency (38%). 5. Specific to affordability and efficiency, emergency department visits for home health patients fared 1.4 percentage points better, and acute care hospitalization in the first 60 days of home health in 2021 was 1.5 percentage points better. 6. Accountable entities with the highest proportions of worse than expected results in 2021 were clinicians (64%), accountable care organizations (54%), and acute care facilities (54%). 7. Wellness and prevention had the highest percentage of measures showing health equity disparities; notable examples include pneumococcal and influenza vaccinations among racial and ethnic groups. 8. Comparison racial and ethnic groups fared worse than the White reference group on 40 of 45 (88.9%) affordability and efficiency measures and 32 of 41 (78%) chronic conditions measures. For example, disparities were recorded for Black or African American patients in 32, or 71%, of the affordability and efficiency measures, mostly related to readmissions. Read full story Source: Becker Hospital Review, 29 February 2024 -
News Article
Worst-off find it harder than well-off to access NHS care, survey finds
Patient Safety Learning posted a news article in News
Poorer people find it much harder to access NHS care than the well-off and have a worse experience when they do get it, research by the health service’s consumer watchdog has found. Those on the lowest incomes have much more difficulty getting a GP appointment, dental care or help with mental health problems, according to a survey by Healthwatch England. They are also more likely to feel they are not listened to by a health professional and not involved in key decisions about their care compared with those who are financially comfortable. The links between poverty and ill-health are well known, but the Healthwatch findings show that the worse-off also face the disadvantage what the watchdog called barriers to obtaining healthcare when they need it. The findings have prompted fears that the NHS is too often a “two-tier service” with access closely related to wealth, and calls for it to do more to make services more accessible to everyone. Healthwatch’s survey of 2,018 people aged 16 and over in England, which was a representative sample of the population, found that: 42% of those who described their financial situation as “really struggling” said they had trouble getting to see a GP, double the 21% of those who were “very comfortable”. 38% of the worst-off found it hard to get NHS dental care, compared with 20% of the better-off. 28% of the very poor had difficulty accessing mental health treatment, whereas only 9% of the very comfortable did so. Read full story Source: The Guardian, 4 March 2024 -
Content ArticleUsing experiences of care from over 10 million people collected over the past ten years, Healthwatch England presents a bold vision for the NHS in 2030. In a new report, Healthwatch outlines what they think the NHS should be in six years and how it can get there. The vision calls for a focus on three key themes: Making the NHS easier to access and navigate. Tackling health inequalities. Building a patient-centred culture.
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Content ArticleWomen of colour frequently report that their race has impacted the quality of care they receive. In this study, women of colour who experienced a traumatic birth described the racist and gendered stereotypes ascribed to them (uneducated, negligent, (in)tolerant to pain, and dramatic) and how those stereotypes impacted the obstetrical care they received. Ultimately these experiences caused long-term harm to their mental health, decreased trust in healthcare, and reduced the desire to have children in the future.
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Content ArticleThe authors of this JAMA article describe the experience of a family member who was in critical care, and who is deaf. They outline a lack of awareness amongst healthcare professionals about their relative's deafness and highlight the lack of understanding in how to communicate with her. They go on to outline a number of approaches to communicating with patients who are deaf or hard of hearing.
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Content ArticleThis US study looked at how critical care doctors approach shared decision-making with Black compared with White caregivers of critically ill patients. The authors found that racial disparities exist in critical care clinicians' approaches to shared decision-making and suggest potential areas for future interventions aimed at promoting equity.
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Content ArticleHealth inequalities are avoidable, unfair and systematic differences in health between different groups of people. Here we examine the key data on this complex and wide-ranging issue.
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Content ArticleThis US study in the journal Pediatrics analysed a national sample of paediatric hospitalisations to identify disparities in safety events. The authors used data from the 2019 Kids’ Inpatient Database and looked at the independent variables of race, ethnicity and the organisation paying for care (for example, private insurance company or Medicaid). The results showed disparities in safety events for Black and Hispanic children, indicating a need for targeted interventions to improve patient safety in hospitals.
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Content ArticleSpina bifida is a developmental condition affecting the brain and spine, often leading to physical and cognitive impairments, and bladder and bowel issues. Widely regarded as one of the most severe conditions compatible with life, open spina bifida can result in significant morbidity, with numerous body systems and tissues affected.
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Content ArticleEarly-onset colon cancer (EOCC) is increasing in the US and disproportionately affects African-Americans. This analysis in the American Journal of Surgery aimed to compare EOCC survival among Black and White patients after matching relevant socio-demographic factors and stage. The authors found that Black patients with stage 3 EOCC are less likely to receive chemotherapy and have worse survival than White patients. They call for further research to identify potential factors driving this inequality.
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Content ArticleAiring Pain is a podcast from Pain Concern. Each edition brings together people in pain and top specialists to talk about resources that can help. This edition investigates the significant inequalities and disparities in treatment among primary care pain management services. It features the following participants: Professor Jonathan Hill, Director of Research for the School of Allied Health Professionals and Professor of Physiotherapy at the Keele School of Medicine; Dr Ama Kissie, post-doctoral fellow at the University of Ghent and a Clinical Psychologist; Dr Whitney Scott, clinical psychologist who lectures at Kings College London and is the research lead at the INPUT Pain Management Unit at Guy’s & St Thomas’ Hospital.
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Content ArticleThis report by the Patients Association analyses the opinions and experiences of diagnostic testing services of more than 1,000 NHS patients. It highlights that patients view diagnostics as a fundamental part of the NHS—and one that should be prioritised. Most respondents (93%) want testing capacity to be invested in over the coming years so that patients can receive tests and diagnosis more quickly. Patients place such importance on diagnostics that 60% would consider paying for the tests they need if they faced a long wait on the NHS.
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Content Article
Can I be seen? Birthing while Black (17 February 2024)
Patient-Safety-Learning posted an article in Maternity
In this Lancet article, Lioba Hirsch shares her experience of labour and birth as a Black woman. She describes dismissive behaviours and blaming comments from several healthcare professionals that left her feeling unable to ask questions and advocate for herself and her baby. She suggests that the lack of compassion and dignity she was shown are a risk to patient safety: "I am so glad that my child was safe that day, but many children and their birthing parents are not and the slope from disrespect and disregard to dismissal and its consequences is a slippery one." -
News Article
Black children suffer ‘more complications’ after appendicitis surgery
Patient Safety Learning posted a news article in News
Black children in the UK are four times more likely to experience complications after appendicitis surgery than their white counterparts, a study has found. The study, funded by the Association of Paediatric Anaesthetists of Great Britain and Ireland, looked at 2,799 children from 80 hospitals across the UK aged under 16 who had surgery for suspected appendicitis between November 2019 and January 2022. Of these, 185 children (7%) developed postoperative complications within 30 days of the surgery. Three-quarters of these complications were related to the wound, while a quarter were respiratory, urinary or catheter-related or of unknown origin. The study found that black children had a four times greater risk of experiencing complications after the operation, and that this risk was independent of the child’s socioeconomic status and health history. Appendicitis is one of the most common paediatric surgical emergency with 10,000 performed every year. The authors said that this was the first study to look at the demographic differences of postoperative complication rates in regards to appendicitis. The researchers said they could not draw firm conclusions regarding why black children had worse outcomes after this type of emergency surgery, and that this apparent health inequality “requires urgent further investigation and development of interventions aimed at resolution”. Read full story Source: The Guardian, 22 February 2024 -
Content ArticleA growing awareness of sex and gender bias in evidence has resulted in the development of new tools to address this concern. The Sex and Gender Equity in Research (SAGER) guidelines and the Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER) are two initiatives designed to foster more transparent research and reporting practices that bridge the gender evidence gap. These tools enable researchers to unravel the complexities that underpin health risks and outcomes and generate more accurate and relevant findings that can inform effective and equitable policies for better health outcomes. This Lancet article looks at the World Health Organization's (WHO's) adoption of GATHER and the SAGER guidelines to tackle sporadic and suboptimal reporting of sex and gender data. The authors argue that this move is pivotal within WHO's broader strategic agenda, which it outlined in the Roadmap to Advance Gender Equality, Human Rights and Health Equity 2023–2030, launched in December 2023.
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Content ArticleThis animation aims to help staff and employers across health and social care understand Oliver's Training and why it is so vitally important. It was co-designed and co-produced with autistic people and people with a learning disability. Oliver McGowan died aged 18 in 2017 after being given antipsychotic medication to which he had a fatal reaction. He was given the medication despite his own and his family's assertions that he could not be given antipsychotics, and the fact that this was recorded in his medical records. The animation tells his story and highlights the increased risks facing people with learning disabilities and autism when accessing healthcare.
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Content Article
The King's Fund: Mental health 360 (21 February 2024)
Patient Safety Learning posted an article in Mental health
The King's Fund 'Mental health 360' aims to provide a ‘360-degree’ review of mental health care in England. It focuses on nine core areas, bringing together data available at the time of publication with expert insights to help you understand what is happening in relation to mental health and the wider context. The nine core areas covered are: Prevalence Access Workforce Funding and costs Quality and patient experience Acute mental health care for adults Services for children and young people Inequalities Data. -
Content ArticleWhen public areas such as train stations breach their capacity, emergency protocols are rolled out and stations are closed. Yet when hospitals become overcrowded, there isn’t the option to stop urgent and emergency care. Instead, staff have to develop workarounds, delivering care in areas not designed – nor safe or effective – for clinical use, a phenomenon commonly known as ‘corridor care’. The increasing frequency of corridor care is alarming – both for patient safety and staff morale, and because it risks normalising substandard care delivery. Corridor care largely occurs when emergency departments are inundated with patients. 45,000 people visit major hospital A&E departments in England each day, 16% more than 10 years ago. Many of these patients require hospital admission or further care. Limited beds within hospitals, stretched community services and chronically low social care capacity mean that A&E often becomes a bottleneck, with patients unable to ‘flow’ out of the department because there are no free beds elsewhere in the hospital. In this blog, Heather Wilson a Programme and Policy Officer in the Healthy Lives team at the Health Foundation, as well as a registered nurse who continues to work in a central London emergency department discusses the impact of corridor care on staff, patients and families. Further reading on the hub: A silent safety scandal: A nurse’s first-hand account of a corridor nursing shift
