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News Article
NHS told long-term sick can ‘get on with life’ if treated at home
Patient Safety Learning posted a news article in News
Millions of people with long-term illnesses should get medical treatment at home rather than in hospital to help them carry on working, according to a report. The NHS is being urged to deliver more medicines directly to patients’ doors, so they can self-administer drugs at home, and “get on with life” rather than having to travel back and forth to hospitals. New research shows this model of care, called clinical homecare, helps those needing regular treatment for chronic conditions, including cancer and arthritis, to stay in employment and retain independence. Experts said providing more patients with specialist medicines at home can play a vital role in tackling the UK’s growing rates of economic inactivity, with 2.7 million long-term sick now signed off work. The report, commissioned by the National Clinical Homecare Association, said expanding the schemes means millions of patients “could be supported to continue working and living their lives without being defined by their health status”, adding that up to three million cancer patients could benefit. Read full story (paywalled) Source: The Times, 19 March 2024 -
News Article
Oxford palliative care 'virtual ward' launched
Patient Safety Learning posted a news article in News
A "virtual ward" enabling patients who want to die at home get the palliative care they need has launched. Hospice Outreach provides a "specialised pathway" for patients identified by existing services who would benefit from support. It is part of a project that supports people at the very end of their life. Dr Victoria Bradley, of Oxford University Hospitals NHS Foundation Trust (OUH), said it was about giving people "control and agency". OUH claims Hospice Outreach's virtual ward will mean more people will receive personalised care, including in their own homes if that is their choice. It said specialist palliative care would be "provided virtually or in person, depending on what is best for the patient". Amelia Foster, chief executive at Sobell House, said: "Being able to offer a virtual ward to those in a palliative crisis or at the end of their lives helping them to remain at home means more people can access our care in the way that they wish." Dr Bradley, who is the clinical lead for palliative medicine at OUH, said: "We can support with discharge from hospital to people's homes if that is their wish, and by reducing people's time in hospital and caring for them at home, we can offer the right support in their chosen surroundings." Read full story Source: BBC News, 14 March 2024 -
News Article
Families of disabled people tell BBC of battle for NHS care support
Patient Safety Learning posted a news article in News
More than 100 families looking after severely disabled adults and children outside hospital, have told the BBC that the NHS is failing to provide enough vital support. The NHS says help is based on individual needs and guidelines ensure consistency across England and Wales. However, some families describe the system as adversarial. Only those living outside hospital with life-limiting conditions, or at risk of severe harm if they don't have significant support, get this help from the NHS. It is provided through a scheme called Continuing Healthcare (CHC) for adults, and its equivalent for under-18s, Children and Young People's Continuing Care. Cases in England are decided by NHS Integrated Care Boards (ICBs) - panels responsible for planning local health and care services. In Wales, they are overseen by local health boards. The BBC has heard from 105 families who described serious concerns with how the two schemes are working - with most calling for reform. One young man with 24-hour needs hasn't received any CHC help despite being eligible since February 2023 - his parents, who first applied for support on his behalf nearly two years ago, currently provide round-the-clock care Another family were told overnight care for their teenage child - who is non-verbal, has severe mobility issues and requires 24/7 support - would be reduced from seven down to three nights a week, without a reason being given. Read full story Source: BBC News, 14 February 2024 -
Content ArticleThe aim of this study, published in the BMJ, was to evaluate whether a structured online supervised group physical and mental health rehabilitation programme can improve health related quality of life compared with usual care in adults with Long Covid. Best practice usual care was a single online session of advice and support with a trained practitioner. The REGAIN intervention was delivered online over eight weeks and consisted of weekly home based, live, supervised, group exercise and psychological support sessions. The authors concluded that in adults with Long Covid, an online, home based, supervised, group physical and mental health rehabilitation programme was clinically effective at improving health related quality of life at 3 and 12 months compared with usual care.
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News Article
Cluster of baby death inquiries as bereaved parents demand answers
Patient Safety Learning posted a news article in News
Lawyers and charities tell of mothers told to ‘labour at home as long as they can’, dangerously few midwives and ‘lies’ during natal care. As Rozelle Bosch approached her due date she had every reason to expect a healthy baby. Neither she, her husband nor the midwives knew that the child was in the breech position at 30 weeks. When her waters broke a fortnight early, Bosch and her husband, Eckhardt, both first-time parents, had been reassured by NHS Lanarkshire that all was well and that the mother was “low risk”. They were sent home from Wishaw hospital and told to monitor conditions until the pregnancy became “active”. Shortly before 11pm on 1 July 2021, her husband called an ambulance saying that Bosch was in labour and was giving birth. Bosch was in an upstairs bedroom on her knees and paramedics noted that “the baby was pink”. They soon asked the control room for a doctor or midwife to attend but none were available. By the time the ambulance took the family to hospital, the baby had turned blue. Within two days, baby Mirabelle had died. She had become trapped with only her feet and calves delivered while the couple were still at home. A post-mortem has found that Mirabelle suffered oxygen deprivation to the brain from “head entrapment” during delivery. Last month, her father explained to a fatal accident inquiry (FAI) at Glasgow sheriff court: “We were told Rozelle was healthy and Mirabelle was healthy. I think this was a lie and the consequences have me standing here today.” The way that the tragedy unfolded is striking, not just because of the devastating consequences, but because it is not an entirely isolated case. The same FAI is examining the deaths of two other newborns, Ellie McCormick and Leo Lamont, who also died in NHS Lanarkshire less than a month apart in 2019. Experts say it is rare for the Crown and Procurator Fiscal Service to group investigations in this way. Darren Deery, the McCormicks’ lawyer and a medical negligence specialist with Drummond Miller, said he had noticed a “considerable increase” in parents contacting the law firm in the past three years. Read full story (paywalled) Source: The Times, 11 February 2024 -
News Article
Doctors issue warning after spike in ‘freebirthing’
Patient Safety Learning posted a news article in News
Doctors have warned of the risks of “freebirthing” – where a woman gives birth without the help of a medic or midwife. Unassisted births, or “freebirths”, are thought to have been on the increase since the start of the Covid pandemic, when people may have been worried about attending hospitals and home births were suspended in many areas. The practice is not illegal and women have the right to decline any care during their pregnancy and delivery. Some women hire a doula to support them during birth. The Royal College of Obstetricians and Gynaecologists (RCOG) said women should be supported to have the birth they choose, but “safety is paramount” and families need to be aware of the risks of going it alone. The Nursing and Midwifery Council (NMC) said it is in the early stages of collaboration with the Chief Midwifery Officer’s teams, the Royal College of Midwives (RCM) and the Department of Health to better understand professional concerns about freebirthing and what organisations may need to do. Its statement on unassisted births supports women’s choice, but notes that “midwives are understandably concerned about women giving birth at home without assistance, as it brings with it increased risks to both the mother and baby”. It also states that women need to be informed that a midwife may not be available to be sent out to their home during labour if they change their mind and wish to have help. Read full story Source: The Independent, 8 February 2024 -
News Article
‘One part of the solution’: how virtual NHS wards are now a reality
Patient Safety Learning posted a news article in News
Harold Chugg spent much of early 2023 in a hospital bed because of worsening heart failure. During his most recent admission in June, the 75-year-old received several blood transfusions, which led to fluid accumulating in his lungs and tissues. Ordinarily, he would have remained in hospital for further days or weeks while the medical team got his fluid retention under control. But Harold was offered an alternative: admission to a virtual ward where he would be closely monitored in the comfort of his own home. Armed with a computer tablet, a Bluetooth-enabled blood pressure cuff and weighing scales, Harold returned to his farm near Chulmleigh in north Devon and logged his own symptoms and measurements daily, which were reviewed by a specialist nurse in another part of the county. Virtual wards provide hospital-level care in people’s homes through the use of apps, wearables and daily “virtual ward rounds” by medical staff, who review patient data and follow up with telephone calls or home visits where necessary. More than 10,000 such beds are already available across England and at least a further 15,000 are planned. Scotland, Wales and Northern Ireland are also funding their expansion. But while proponents claim patients in virtual wards recover at the same rate or faster than those treated in hospital, and that the wards’ provision can help cut waiting lists and costs, some worry that their rapid expansion could place additional strain on patients and caregivers while distracting from the need to invest in emergency care. “Virtual wards, if they deliver hospital-level processes of care, are just one part of the solution, not a panacea,” said Dr Tim Cooksley, a recent ex-president of the Society for Acute Medicine. Read full story Source: The Guardian, 7 February 2024 -
Content ArticleThis article in the Nursing Times explores reflective practice in community nursing, focusing on a stressful incident in which a patient who had not been contactable during a home visit was later found to have died. The article emphasises the necessity of structured reflection, utilising Rolfe’s reflective model, to explore nurses’ feelings. It delves into the model’s stages, its impact on critical thinking and guiding reflection through questions, and highlights the importance of reflective practice, emphasising its role in learning, professional development and improving patient outcomes. The article concludes by showcasing the successful implementation of a new model and its positive impact on patient safety in home visits, providing a structured approach for nurses and health professionals.
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Content ArticleChildren are more than twice as likely as adults to experience a medication error at home. In this interview for the journal Patient Safety, Dr Kathleen Walsh, paediatrician at Boston Children’s Hospital, discusses why that is the case and provides some tips to keep children—and adults—safe.
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Content ArticleWith around half a million people receiving homecare medicines services at a cost that is likely to be between £3billion and £4billion each year, there are questions over what the NHS is getting for its money and how governance and accountability within the system could be improved. This article outlines an investigation by The Pharmaceutical Journal that has revealed hundreds of patient safety incidents caused by problematic homecare medicines services.
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Content Article
Listening to the system - implementing virtual wards
Patient_Safety_Learning posted an article in NICE
In this blog, Angela Osei, associate director, NICE implementation support, sets out to understand some of the challenges, benefits and considerations of setting up and running a virtual ward, from the perspective of teams on the front lines. -
News ArticlePrivate healthcare companies are harming NHS patients in their own homes by failing to deliver vital medicines, and then escaping censure amid an alarming lack of oversight by ministers and regulators, members of the House of Lords have warned. More than 500,000 patients and their families rely on private companies paid by the NHS to deliver essential medical supplies, drugs and healthcare to their homes. The homecare medicines services sector is estimated to be worth billions of pounds. A report by the Lords public services committee says patients are being harmed due to “real and serious problems” with the services provided by for-profit companies. The absence of a single person or organisation with overall control or oversight of the sector means poor performance is going unchecked, it says. “There are serious problems with the way services are provided,” the Lords report says. “Some patients are experiencing delays, receiving the wrong medicine or not being taught how to administer their medicine. [This] can have serious impacts on patients’ health, sometimes requiring hospital care. This leaves NHS staff either firefighting the problems caused by problems in homecare medicines services, or working on the assumption that those services will fail.” Read full story Source: The Guardian, 16 November 2023
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Content ArticleHomecare medicines services deliver medicines and provide medicine-related care to patients in their homes, for example, teaching them to self-inject, and delivering medicine that might need special transport. In this report, the House of Lords Public Services Committee highlights concerns about multiple reports of delays and errors by homecare providers, resulting in patients receiving care later than scheduled. The report states that this key service is not working the way it should and, in some cases, is causing patients serious harm.
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News Article
Two-thirds of homecare patient safety incidents linked to major provider
Patient Safety Learning posted a news article in News
Two-thirds of patient safety incidents recorded during hospital trusts’ monthly reporting period for homecare medicine provision were for services provided by the company Sciensus, an investigation by The Pharmaceutical Journal has revealed. In response to a freedom of information request sent to 131 hospital trusts in England in August 2023, 32 trusts recorded 417 patient safety incidents during their most recent monthly reporting period, which ranged from May to July 2023. Some 66% of these incidents (277) related to services delivered by homecare provider Sciensus, despite providing medicines to fewer than half (44%) of the 96,849 patients covered in the data. The findings come after the House of Lords Public Services Committee opened an inquiry into homecare medicines services in May 2023 following press reports of complaints from patient organisations and others about the service provided. The inquiry heard evidence from patient groups, regulators, homecare companies and the government during the summer and the committee will publish its report on 16 November 2023. Sciensus was previously known as Healthcare at Home and is one of the UK’s largest homecare companies. The data also uncovered that Sciensus was a poor performer on “failed” deliveries, defined as those that did not arrive on the scheduled day. Read full story Source: The Pharmaceutical Journal, 9 November 2023 -
Content ArticleThis report provides a comprehensive analysis of the adult social care workforce in England and the characteristics of the 1.52 million people working in it. Topics covered include: recent trends in workforce supply and demand, employment overview, recruitment and retention, demographics, pay, qualification rates, and future workforce projections.
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Content ArticleThe National Wound Care Strategy Programme, the AHSN Network’s Transforming Wound Care programme, and the Patient Experience Network have created a new resource to teach patients how to take a photograph of their wound to empower them to take an active role in their healthcare. Developed for patients by patients, based on experience and medical information, the resource provides hints and tips on best practice with taking wound photographs, including the mechanics of getting the best possible photograph and what photographs should and should not include to assist healthcare providers in providing the best possible care.
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Content Article
The Family Oops and Burns First Aid eBook
Kristina Stiles posted an article in Recommended books and literature
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'The Family Oops and Burns First Aid' is a free children's book written by Kristina Stiles, beautifully illustrated by Jill Latter, created to support children and their families learning about burns prevention and first aid principles together. The book describes an accident prone family who are not burns aware, who have to go to school to learn about burn safety and first aid principles within the home. The book is aimed at KS1 children and their families, and is available as hard copy book by request from Children's Burns Trust and also as an audio/video book via YouTube. -
News Article
Up to 900,000 older people taken to A&E each year due to lack of NHS care at home
Patient Safety Learning posted a news article in News
Almost 900,000 older people are admitted to hospital every year as an emergency because the NHS is failing to keep them healthy at home, Age UK has warned. A major lack of services outside hospitals means elderly people are also suffering avoidable harm, such as falls and urinary tract infections, the charity said. In a new report it urges NHS bosses to push through huge changes to how the “hospital-oriented” service operates and establish “home first” as the principle of where care is provided. Doing so would reduce the strain on overcrowded hospitals and leave the NHS better set up to respond to the increase in the number of over-65s and especially over-85s, Age UK said. Its report, on the state of health and care of older people in England, concluded that “our health and care system is struggling, and too often failing, to meet the needs of our growing older population.” Read full story Source: The Guardian, 11 July 2023 -
News ArticleGPs should offer all patients presenting with signs of colorectal cancer a faecal immunochemical test (FIT) to reduce the waiting times for a colonoscopy, the National Institute for Health and Care Excellence (NICE) has recommended in draft guidance. The current NICE recommendation is to offer FIT to people presenting to primary care with low risk symptoms suggestive of colorectal cancer, while people with high risk symptoms should be immediately referred to the suspected cancer pathway. However, patients often have lengthy waiting times for colonoscopy because of limited capacity. NICE estimates that the recommendation should lead to 50% fewer referrals for urgent colonoscopies being made by GPs each year. Read full story (paywalled) Source: BMJ, 5 July 2023
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News Article
Tens of thousands of children to be treated in ‘virtual wards’ at home
Patient Safety Learning posted a news article in News
Tens of thousands of children will be treated in “virtual wards” to free hospital beds for more critically ill patients under new NHS plans. The Hospital at Home service will be expanded to include paediatric care in every region of England this month, the health service announced. As part of the service, clinical teams review patients daily and can provide treatments including blood tests, prescribe medicines or administer fluids through a drip. Ward rounds can include home visits or a video call, and many services use technology such as apps and wearable devices to monitor recovery. Professor Simon Kenny, the NHS’s national clinical director for children and young people, said: “The introduction of paediatric virtual wards means children can receive clinical care from home, surrounded by family and an environment they and their parents would rather they be — with nurses and doctors just a call away.” Read full story (paywalled) Source: The Times. 5 July 2023 -
Content ArticlePostpartum hypertensive disorders pose a serious health risk to new mothers; nearly 75 percent of maternal deaths associated with hypertensive disorders occur in the postpartum period. For the past decade, the obstetrics department at the Hospital of the University of Pennsylvania (HUP) has tried to lower these risks by checking patients’ blood pressure after they are released from the hospital. Their initial efforts to have patients return to the office for an in-person blood pressure check shortly after discharge yielded disappointing results, so the team revamped their approach and ultimately developed an extremely successful program called Heart Safe Motherhood. The programme started when the team at HUP gave a small group of women a blood pressure cuff each. They told them they would receive text messages after discharge instructing them to take their blood pressure at 8am, and that they would need to send in the reading. At 1pm, they would get another text requesting that they send their blood pressure again. This article describes how Heart Safe Motherhood evolved to improve the likelihood of mothers submitting their readings, and how the programme was scaled up to five hospitals in the group. It looks at how the approach has helped tackled health inequalities and improved the safety of postpartum mothers.
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News Article
Digital NHS health check to be launched across England in spring
Patient Safety Learning posted a news article in News
A digital NHS Health Check is to be rolled out across England from next spring, the government has announced, in an attempt to alleviate the pressure on GP surgeries. The initiative will deliver 1m checks in the first four years, according to the Department for Health and Social Care (DHSC). Tens of thousands of cases of hypertension are expected to be identified and hundreds of strokes and heart attacks prevented. Patients will be able to access the check via a mobile phone, tablet or computer, the DHSC said. Participants will complete an online questionnaire, enter height, weight, and the results of a cholesterol test which they can carry out at home. They will also be asked to have their blood pressure checked at a pharmacy. The results, which will be available online, will direct people to personalised advice. Referrals to GPs will only be made if further tests and treatment are needed. Professor Sir Nilesh Samani, medical director at the British Heart Foundation, said: “This initiative will help to reach more people and encourage them to get their blood pressure and cholesterol levels checked so that, where necessary, healthcare professionals can work with them to manage their condition. “This could play an important role in helping people live healthier for longer and saving lives in the coming years, while reducing pressure on the NHS.” Read full story Source: The Guardian, 28 June 2023 -
News Article
Two-thirds of GPs refuse to register homeless patients
Patient Safety Learning posted a news article in News
Two-thirds of GP practices from a sample of 100 in London declined to register a patient without an address, contrary to national rules which are meant to ensure homeless and excluded people can get healthcare, HSJ has found. NHS England guidance states anyone can register with a GP without proof of address, and that people without a permanent address “can still register using a temporary address or the address of the GP surgery”. Practices normally need to record an address, but the exception rule is meant to ensure people who are homeless, or living in unstable or short-term accommodation, are still able to access primary care or referrals for secondary services. Despite this, when HSJ called 100 randomly selected practices in London (about 9 per cent of the total), 64 refused to register the caller. Read full story (paywalled) Source: HSJ, 19 June 2023 -
News ArticleParamedics are being told to take a police escort to more than 1,200 addresses for fear of attack, The Times has revealed. The College of Paramedics said the figure was outrageous and called on courts to implement tougher sentences for assaults on paramedics. Ambulance services have marked hundreds of addresses after violence towards crew. Notes on addresses include “patient keeps axe under pillow — serrated knife hidden round the house and is known to be a risk”, “shoots/throws acid”, and “patient is anti-ambulance”. Read full story (paywalled) Source: The Times, 4 June 2023
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News Article
Hepatitis C home test kits available to most-at-risk in England
Patient Safety Learning posted a news article in News
Home test kits for a virus which attacks the liver are now available to order online in England, as the NHS tries to reach those needing treatment. Hepatitis C tends to affect current or past drug users and people who have had contact with infected blood through a tattoo or medical procedure abroad. It can lead to liver disease and cancer, but symptoms often go unnoticed for many years. The NHS website says it can usually be cured by taking a course of tablets. More than 70,000 people are thought to be living with the virus in England. Some may not know they have it, so would be unlikely to go to their GP for a test. Read full story Source: BBC News, 13 May 2023
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