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Showing results for tags 'High risk groups'.
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Content Article
In this blog, Jo Jerrome, CEO of Thrombosis UK, explains the dangers of deep vein thrombosis (DVT) and why it is important for patients and staff to be aware of the risk factors. Jo offers advice on how we can all manage our risk of DVT, and introduces their award-winning, free patient app – “Let’s talk clots”. -
EventuntilAre all of your severely immunocompromised patients aged 50 and over vaccinated against shingles? These patients are eligible for vaccination through the National programme Discuss identifying and vaccinating your most vulnerable patients, and how GSK can support you. This event is organised and funded by GSK. Further information and registration
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Content ArticleThis population-based cohort study from Sweden and Norway aimed to explore whether exposure to mRNA Covid-19 vaccination during pregnancy increases the risk of adverse events in newborn infants. The cohort included 94,303 infants exposed to Covid-19 vaccination during pregnancy and 102,167 control infants born between June 2021 and January 2023. The authors found that vaccination during pregnancy was associated with lower odds of neonatal intracranial haemorrhage, cerebral ischemia and hypoxic-ischemic encephalopathy, and neonatal mortality.
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Content ArticleUndervaccination—receiving fewer than the recommended number of Covid-19 vaccine doses—could be associated with increased risk of severe Covid-19 outcomes including hospitalisation or death compared with full vaccination. This study aimed to determine the factors associated with undervaccination and to investigate the risk of severe Covid-19 outcomes in people who were undervaccinated in each UK nation, and across the UK. The authors found that rates of undervaccination against Covid-19 ranged from 32·8% to 49·8% across the four UK nations in summer 2022. They also concluded that undervaccination was associated with an elevated risk of severe Covid-19 outcomes.
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Content ArticleThe only masking that’s going on is that of the government’s continued failure to get to grips with the virus, writes George Monbiot in this Guardian opinion piece. For some people, going to hospital may now be more dangerous than staying at home untreated. Many clinically vulnerable people fear, sometimes with good reason, that a visit to hospital or the doctors’ surgery could be the end of them. Of course, there have always been dangers where sick people gather. But, until now, health services have sought to minimise them. Astonishingly, this is often no longer the case. Across the UK, over the past two years, the NHS has been standing down even the most basic precautions against Covid-19. For example, staff in many surgeries and hospitals are no longer required to wear face masks in most clinical settings. Reassuring posters have appeared even in cancer wards, where patients might be severely immunocompromised. A notice, photographed and posted on social media last week, tells people that while they are “no longer required to wear a mask in this area”, they should use hand sanitiser “to protect our vulnerable patients, visitors and our staff”. Sanitising is good practice. But Covid-19 is an airborne virus, which spreads further and faster by exhalation than by touch.
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Content ArticleIn April 2023, National Voices held a workshop with members, supported by The Disrupt Foundation, on the unequal impact of the Covid-19 pandemic. It explored how communities and groups were affected differently by both the virus itself and the measures brought in to control it. It painted a grim picture of the ways in which the pandemic response exacerbated existing, deep-rooted inequalities across the UK and compounded the disadvantages experienced by people from minoritised communities, by disabled people and by people living with long term conditions. Just some examples include people who are immunocompromised, who were asked to go into isolation for huge periods of time and still feel completely overlooked as control measures have been lifted. Or the use of DNRs (Do Not Resuscitate orders) which were disproportionately applied to people with learning disabilities. With the Covid-19 Inquiry underway, it is imperative that we capture the lessons learnt from the pandemic, and use them to suggest action for the future.
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News Article
Covid vaccines should be available to buy privately in UK, scientists say
Patient Safety Learning posted a news article in News
Covid vaccines should be made available for people to buy privately in Britain, leading scientists have urged, amid concerns over a new wave of the virus which could worsen in autumn and winter. Unlike flu jabs, which individuals or employers can buy for about £15 from high street pharmacies, Covid jabs are only available on the NHS in the UK. This month the UK government announced that the Covid autumn booster programme would cover a smaller pool of the population than earlier vaccination drives. The age limit has been raised from 50 to 65 and above, with some younger vulnerable groups also eligible. Covid is on the rise, according to the UK Health Security Agency (UKHSA). Experts raised concerns the wave could continue to grow and add to winter pressures on the NHS. Prof Adam Finn, of the University of Bristol, a member of the UK’s Joint Committee on Vaccination and Immunisation (JCVI), said Covid jabs should be available commercially. Some employers might want to offer the vaccines to their staff, he added. Speaking in a personal capacity, Finn said: “I think it will be a good idea for vaccines to be made available to those that want them on the private market. I don’t really see any reason why that shouldn’t be happening.” Read full story Source: The Guardian, 17 August 2023 -
News Article
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 -
News ArticleMany vulnerable patients are struggling to access covid treatments after commissioning responsibility switched to integrated care boards this week, charities have warned. Approximately two million vulnerable patients must now contact local services themselves to access treatments designed to combat covid infections, such as the antivirals Paxlovid and Sotrovimab. Integrated care boards are expected to coordinate and fund “equitable” access. Prior to 27 June, identification of patients and the delivery of treatment was coordinated nationally under pandemic arrangements. However, a group of 20 patient charities have written to Steve Barclay warning that most ICBs have not drawn up plans to deliver this new responsibility, leaving patients and primary care clinicians unclear on how to access the treatments. “Despite continually raising our concerns with those carrying out the planning, implementation, and communication of this [policy], we now find that we are in exactly the position we warned against,” they said. Read full story (paywalled) Source: HSJ, 3 July 2023
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Content Article
UK Covid-19 Inquiry website
Patient Safety Learning posted an article in Covid-19 Inquiry
The UK Covid-19 Inquiry has been set up to examine the UK’s response to and impact of the Covid-19 pandemic, and learn lessons for the future. The Inquiry’s work is guided by its Terms of Reference. -
News Article
Fears for vulnerable patients as NHSE changes covid treatment rules
Patient-Safety-Learning posted a news article in News
Some of the most vulnerable patients could risk missing out on covid treatment because new rules will place the onus on them to access antiviral medication themselves instead of the NHS contacting them directly, senior figures have warned. The warnings follow NHS England’s national medical director Sir Stephen Powis writing to local leaders last week advising them the national commissioner will no longer identify patients who are eligible for covid treatment. This means eligible patients will need to contact local services themselves, rather than being approached proactively by a covid medicines delivery unit. Patients Association chief executive Rachel Power said: “Expecting patients ill with covid to know they’re eligible for these treatments and ask for them is unreasonable. How will they know they’re eligible or who to contact?” Read full story (paywalled) Source: HSJ, 6 April 2023 -
Content ArticleIn this study, Tsampasian et al. looked at what the risk factors were for developing post−COVID-19 condition (also known as Long Covid). The systematic review and meta-analysis of 41 studies, including 860 783 patients, found that female sex, older age, higher body mass index, smoking, preexisting comorbidities, and previous hospitalisation or ICU admission were risk factors significantly associated with developing Long Covid, and that SARS-CoV-2 vaccination with two doses was associated with lower risk of Long Covid. The findings of this systematic review and meta-analysis provide a profile of the characteristics associated with increased risk of developing Long Covid and suggest that vaccination may be protective against Long Covid.
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News Article
Specialist NHS centres aim to halve maternity deaths in England
Patient Safety Learning posted a news article in News
Women at risk of dying in pregnancy or childbirth will be treated at a network of specialist NHS centres under a national drive to halve maternal deaths. For the first time, women in England with conditions such as heart disease, epilepsy or cancer will have access to specialist care from doctors trained to treat medical problems in pregnancy. Two thirds of maternal deaths in the UK are due to medical conditions that pre-date or develop during pregnancy, rather than direct complications of birth. Previously there was no dedicated national service for these women. The 17 NHS centres, covering every region of the country, aim to prevent these deaths by bringing together specialist doctors, obstetricians, midwives and nurses under one roof. GPs and A&E staff will also be trained to identify “red flag” symptoms of illnesses in pregnant women and refer patients directly to the centres, where they can be assessed and receive medication or procedures. Read full story (paywalled) Source: The Times, 20 March 2023 -
News Article
Rheumatic patients 'left behind' after lockdown
Patient Safety Learning posted a news article in News
Patients with rheumatic conditions who shielded during the pandemic feel "left behind", according to new research. The University of the West of England (UWE) in Bristol conducted a study with patients about their experiences of shielding during the pandemic and how it continued to affect them. Researchers interviewed 15 rheumatology patients from the Bristol area. Pamela Richards, who suffers with arthritis, said the pandemic has been "a massive blow" to the way she lives. "I have never experienced anything like shielding, it heightened a sense of anxiety in me," said Ms Richards. "How do I get food? I cannot leave the house. How can I see friends? I was not allowed to." Ms Richards, who shielded for nearly two years during the pandemic, said that life has not returned to normal, despite no longer being advised to shield. "It is a new normal, which is about being on high alert and managing risk every day," she said. Researcher Christine Silverthorne said: "Many are still dealing with lasting physical and mental effects both from the experience of shielding and as a consequence of delays to their healthcare and treatment". Read full story Source: BBC News, 6 March 2023 -
Content ArticleRisk assessment during the maternity pathway relies on healthcare professionals recognising a change in a pregnant woman/person’s circumstances that may increase the level of risk. Risk assessments are undertaken during the numerous contacts pregnant women/people have with a team of healthcare professionals throughout the maternity pathway. This thematic review draws on findings from the Healthcare Safety Investigation Branch's (HSIB's) maternity investigation programme to identify key issues associated with assessing risk during pregnancy, labour and birth (known as the ‘maternity pathway’). It examined all reports undertaken by the HSIB maternity investigation programme from April 2019 to January 2022, with the aim of identifying key learnings about risk assessment. A total of 208 reports that had made findings and recommendations to NHS trusts about risk assessment during the maternity pathway were included. The review identified an overarching theme around the need to facilitate and support individualised risk assessments for pregnant women/people to improve maternity safety. Within this, seven specific ‘risk assessment themes’ within the maternity care pathway were identified as commonly appearing in HSIB reports. These seven themes require a focus from the healthcare system to help mitigate risks and enable NHS trusts and clinicians to deliver safe and effective maternity care to pregnant women/people.
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News ArticleThe National Institute for Health and Care Excellence (NICE) has decided not to recommend Evusheld for adults who are unlikely to have an adequate immune response or cannot have the vaccine against Covid-19, citing a lack of evidence that it is effective against circulating variants. However, it is still reviewing whether the antibody drug could be used to prevent covid-19 infection in adults at the highest risk of severe illness, including people with immunodeficiency, people who have had a solid organ transplant, and people with cancer. NICE’s director of medicines evaluation, Helen Knight, acknowledged that the decision would be “disappointing for the many thousands” of vulnerable people who “continue to significantly modify their behaviour to avoid infection. Commenting on NICE’s decision, Lennard Lee, senior clinical research fellow at the University of Birmingham, said, “While it’s right for NICE to ensure that treatment options are based on the best possible evidence for their safety, efficacy, and cost effectiveness, it must be recognised that those who remain extremely vulnerable to covid need to be prioritised in trials akin to those early days of the pandemic to find treatments fit for them. “Otherwise, we run the risk of consigning half a million people to continue to live in 2020, stuck in their homes, not able to see their families and friends for fear of infection with no protection.” Read full story Source: The BMJ, 16 February 2023
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News ArticleEmergency patients are being left open to abuse when they are at their most vulnerable because of a lack of vetting of ambulance workers, watchdog officials have warned. One watchdog official warned that abusers would even seek out work as a paramedic because it provided an “attractive environment” for exploitation. Figures show that dozens of ambulance workers have faced action over sexual assault in the past two years, while paramedics account for one in three cases of tribunal action against care professionals. But one survivors’ group warned the figures were just the “tip of the iceberg”. Paramedics who have been struck off in the past two years include one who performed a sex act in front of a patient, while another was handed a suspended prison sentence for possessing thousands of images of child pornography. Helen Vine, special adviser to the Care Quality Commission, told a recent webinar: “There is a small proportion of the population who are seeking to abuse our patients and the ambulance can be an attractive environment for that type of individual. One of the reasons for this is the ambulance sector is predominantly lone working … and ambulance services offer privileged often unsupervised access to patients who can be very vulnerable". She said the lack of checks meant offenders were able to move between providers, adding: “They test the waters and their behaviours ... if they are challenged, they will move on, however, if they are not challenged then they can hide in plain sight, and they are wearing a trusted uniform and given responsible access to that patient group. Read full story Source: The Independent, 12 February 2023
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News Article
USA: Patients needing home IV nutrition fear dangerous shortages
Patient Safety Learning posted a news article in News
CVS Health confirmed last year it was closing half its Coram home infusion branches and firing about 2,000 nurses, dietitians and pharmacists. Their patients with life-threatening digestive disorders depend on parenteral nutrition, or PN — in which amino acids, sugars, fats, vitamins and electrolytes typically are pumped through a catheter into a large vein near the heart. A day later Optum Rx, another big supplier, announced its own consolidation. Suddenly, thousands were scrambling for their complex essential drugs and nutrients. “With this kind of disruption, patients can’t get through on the phones. They panic,” said Cynthia Reddick, a senior nutritionist laid off last summer in the CVS restructuring. “It was very difficult. Many emails, many phone calls, acting as a liaison between my doctor and the company,” said Elizabeth Fisher Smith, a 32-year-old public health instructor in New York, whose Coram branch closed. A rare medical disorder has forced her to rely on PN for survival since 2017. “It added to my mental burden,” she said Home and outpatient infusions in the USA are a growing business, as new drugs for chronic illness expand treatment options and enable patients, providers and insurers to avoid hospitalisation. But while reimbursement for expensive new drugs has attracted corporations and private equity, the industry is constrained by a lack of nurses and pharmacists. The less profitable parts of the business — and the vulnerable patients they serve — are at risk. This includes the 30,000-plus Americans who rely on parenteral nutrition — including premature infants, post-surgery patients and those with damaged bowels because of genetic defects. Read full story (paywalled) Source: The Washington Post, 6 February 2023 -
News ArticleVulnerable female patients have been sexually “exposed” on a mixed gender ward deemed not “fit for purpose”, the NHS watchdog has warned. The Care Quality Commission found that sexual incidents had occured at Hill Crest, a 25-bed mixed gender mental health unit in Redditch, as male and female were being put at risk. It found male patients are able to walk into female bathrooms and bedrooms, leading to risks of sexual assault and relationships. It found that sexual incidents had taken on the unit because of the risks. The rate of assaults on mixed sex wards is significantly higher than on single-sex wards, data has shown. According to the CQC, the trust graded sexual incidents between patients as “low harm” but did not fully consider them or follow up actions to keep patients safe. Read full story Source: The Independent, 8 February 2023
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Content ArticleCardiovascular disease (CVD) causes 1 in 4 deaths in England, and is a leading cause of morbidity, disability and health inequalities. The Covid-19 pandemic has added to the urgency of tackling CVD because CVD significantly increases the risk of severe disease and death from Covid-19. This report by The King's Fund looks at published data, literature, policy and evidence on CVD. The writers also carried out interviews and a workshop with key stakeholders working in health and care to inform their research.
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News Article
Manchester to open two homes for vulnerable children stuck in hospital
Patient Safety Learning posted a news article in News
Manchester city council is setting up two special children’s homes to house the increasing number of vulnerable young people who end up stuck in hospital because no residential providers will take them. The homes, believed to be the first of their kind, aim to undercut private operators which sometimes demand tens of thousands of pounds each week to look after children with the most complex needs. Five Manchester children with complex emotional needs spent many weeks in hospital in 2022 because no children’s homes would take them because of their challenging behaviour, according to the city council’s director of children’s services. Manchester council has developed what it calls the Take a Breath model. Two houses are being renovated to house up to four children in total, with the first hopefully moving in by March. The idea is that when children first turn up at hospital – often at accident and emergency after a suicide attempt or self-harming incidents – once their injuries have been treated they can be discharged straight into the new homes rather than occupying a paediatric bed they do not need. Jointly commissioned by the council and the NHS, the two homes will cost £1.4m a year. Of that, MCC expects to spend £5,500 a week for each child. It represents a huge cost saving compared with some external placements. Last year the council was charged £16,550 a week by one private provider to look after a young profoundly autistic person with learning difficulties deemed a danger to themselves and to others. Read full story Source: The Guardian, 22 January 2023 -
News ArticleAn NHS trust declined to provide care for a vulnerable Black man days before he died in police custody while having a psychotic episode, The Independent has learnt. Godrick Osei, 35, died after being restrained by up to seven Devon and Cornwall Police officers in the early hours of 3 July 2022, after fleeing his flat and hiding in the cupboard of a care home in Truro. His family said he had been expressing “paranoid thoughts” and had called the police himself for help. He was arrested and died within an hour. Mr Osei had been diagnosed with anxiety and depression, had suspected post-traumatic stress disorder (PTSD) and was prescribed various medications to treat these conditions. He also intermittently used illicit drugs and had suffered alleged sexual assault in prison around 2013, according to a medical report from North East London NHS Foundation Trust (NELFT). In the days before his death, Mr Osei was in the care of NELFT’s community mental health team, whose caseworkers were concerned that he was exhibiting signs of a further severe illness – emotionally unstable personality disorder (EUPD) – and was a high risk to himself. However, Mr Osei was based outside the team’s catchment area, and NELFT asked the neighbouring Cornwall Partnership NHS Foundation Trust (CPT) to assess him instead. CPT refused without explaining why, according to a medical report seen by The Independent. Following Mr Osei’s death, an investigating officer from NELFT made multiple attempts to contact CPT to explore the possibility of a joint investigation into the matter, but didn’t receive a response. Read full story Source: The Independent, 16 January 2023
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News Article
Discharge guidance could see patients die
Patient Safety Learning posted a news article in News
Patients discharged from hospital without social care packages could die at home, doctors have warned. They said Welsh government advice to do this showed a system at breaking point. The British Medical Association (BMA) said it rejects the guidance to "change the risk threshold" for releasing people from hospital. The Welsh government said discharging patients could help them get better "by reducing the risk of infection and muscle wastage". Royal College of General Practitioners Wales chairwoman, Rowena Christmas, said the NHS was "unbelievably stretched". "A frail, elderly person coming home, who can't really safely get from their bed or their chair to the bathroom without risk of falling over, they're not going to be able to survive at home," Dr Christmas said. "I completely understand we need more beds, but that feels like a bad move." Read full story Source: BBC News, 6 January 2023 -
News Article
Antiviral does not cut Covid hospital admissions or deaths in vaccinated
Patient Safety Learning posted a news article in News
The antiviral, molnupiravir, does not reduce coronavirus hospital admissions or deaths in vaccinated people at high risk, new research suggests. But the treatment was associated with a shorter recovery time, by four days, and reduced viral load. People who received molnupiravir reported feeling better compared to those who received usual care, the study found. Researchers suggest that while the drug could have some benefits in terms of symptom reduction, the cost of the drug may mean it is not the best choice for the general population, given the study findings. But it may be useful in reducing the pressure on UK health systems, they added. Chris Butler, professor of primary care in the Nuffield Department of Primary Care Health Sciences and co-chief investigator of Panoramic, said: “Finding effective, safe and scalable early treatments for Covid-19 in the community is the next major frontier in our research response to the ongoing worldwide pandemic. “It is in the community where treatments could have a massive reach and impact. “But decisions about who to treat should always be based on evidence from rigorous clinical trials that involve people who would most likely be prescribed the drugs.” Read full story Source: The Independent, 23 December 2022 -
Content Article
Molnupiravir plus usual care versus usual care alone as early treatment for adults with COVID-19 at increased risk of adverse outcomes (PANORAMIC): an open-label, platform-adaptive randomised controlled trial (22 December 2022)
Patient Safety Learning posted an article in Data, research and statistics
The safety, effectiveness, and cost-effectiveness of molnupiravir, an oral antiviral medication for SARS-CoV-2, has not been established in vaccinated patients in the community at increased risk of morbidity and mortality from COVID-19. In this study, Butler et al. aimed to establish whether the addition of molnupiravir to usual care reduced hospital admissions and deaths associated with COVID-19 in this population. The authors conclude that molnupiravir did not reduce the frequency of COVID-19-associated hospitalisations or death among high-risk vaccinated adults in the community.
