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Showing results for tags 'Information sharing'.
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Content ArticleIn the first in a series of blogs looking at the range of investigation methods used by HSIB, Nichola Crust reflects on how Appreciative Inquiry can be used to examine patient safety and identify opportunities for learning.
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Content ArticleThis letter is a resource for patients to help GPs identify the complications of pelvic mesh. It explains signs and symptoms of women presenting with pelvic mesh-related conditions and if required, where to signpost them for further help. It has been issued by the Patient Safety Commissioner for England, developed in partnership with the patient campaign groups Sling the Mesh and the Rectopexy mesh victims and support.
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Content Article
Patient survey: Halfloop medical device app
Patient Safety Learning posted an article in Apps for health and care
Halfloop are a team of senior doctors and developers building a digital platform where patients can store information securely about their medical implants and share their progress and outcomes securely with their clinical team. They would like to hear your views by asking you to complete their short survey. -
Content ArticleRecently, there has been a concerning increase in the number of deaths of pregnant women, especially from Black, Asian and deprived backgrounds. In addition, there have been several investigations into safety issues in maternity services, such as the Ockenden, East Kent, and Shrewsbury and Telford report. This National Institute for Health and Care Research (NIHR) Collection highlights evidence in priority areas, identified in the East Kent report, to support high-quality care and avoid safety issues in maternity services.
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Content ArticleTo support patients to understand the risks of taking sodium valproate during pregnancy, NHS England has launched two new shared decision-making tools. This is part of an NHS-wide effort to reduce the use of valproate in people who can get pregnant, and to help those that do continue with valproate to prevent pregnancies.
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Content ArticleHealthcare systems rely on self-advocacy from service users to maintain the safety and quality of care. Systemic bias, service pressures and workforce issues often deny agency to patients at times when they need to have most control over representation of their story. This drives diagnostic error, treatment delay or failure to treat important conditions. In maternal care, perinatal mental health and thrombosis are significant challenges. With funding from SBRI Health care, Ulster University and Southern Health and Social Care Trust are developing an NLP powered platform that will empower mothers to be more active agents in their perinatal care. Download the poster below.
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Content ArticleThis webinar shares the findings of a co-production project in Nottingham and Nottinghamshire Integrated Care Board (ICB) to remove barriers to shared decision making. The partners in the project were the ICB’s Personalised Care Team, the My Life Choices lived experience panel, the Patient Information Forum (PIF) and the Patients Association. Over the course of six co-production meetings, they developed simple resources to support patients and professionals to have better shared decision making conversations. Speakers discuss practical solutions to help patients and professionals get the most from limited appointment times which can be applied nationally.
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Content ArticleThis case study published by The Beryl Institute looks at an initiative to collect real-time feedback on patient experiences at the Stanford Health Care emergency department in California. Previously, the department had sent a survey to patients well after their visit, but the team realised that capturing this information sooner was critical. Matthew Lim, Patient Experience Manager at Stanford Health Care describes the practical and replicable steps the organisation took in implementing a QR code-based feedback system. He describes the results, lessons learned and potential future developments.
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Content Article
Infopool prostate cancer patient resource
Patient-Safety-Learning posted an article in Cancers
This patient resource created by Prostate Cancer Research aims to equip patients and the public with information about prostate cancer. It contains information on: testing and diagnosis treatment choices living with side effects clinical trials. -
News Article
NHS trust failings may have contributed to Bristol student’s death, inquest finds
Patient Safety Learning posted a news article in News
A string of failings may have contributed to the death of a “deeply vulnerable” law student who killed herself while being treated in a psychiatric hospital in Bristol, an inquest jury has said. Zoë Wilson, 22, had informed staff she was hearing voices in her head telling her to kill herself and 30 minutes before she died was seen by a nurse through an observation hatch looking frightened and behaving oddly but nobody went into her room to check her. Speaking after the jury’s conclusions, Wilson’s family said that Avon and Wiltshire mental health partnership NHS trust (AWP) should face criminal charges over the case. AWP said it accepted it had fallen short in its care of Wilson. Zoë on the 17 June 2019 she told staff she was hearing voices telling her to kill herself and handed over an item that she could have used to harm herself with. She was not moved to an acute ward and other items that she could have used were not removed. At 1am on 19 June she was observed standing beside her bathroom door looking frightened but staff did not go to her. Thirty minutes later she was checked again and had harmed herself. Emergency services were called but she was pronounced dead. Giving evidence to Avon coroner’s court, the nurse who saw Wilson at 1am said he had only worked in the unit a handful of times and had not met Wilson before that night. The jury concluded that steps taken to keep her safe that night had been inadequate and also criticised communication and information sharing. In a statement, her family, said: “Zoë was a wonderful, bright, and deeply vulnerable young woman. She was on a low-risk ward even when she told staff that voices in her head were telling her to kill herself.” They called for AWP to face a criminal prosecution by the Care Quality Commission (CQC). “We will continue to fight for justice in her name,” they said. “She will never be forgotten.” Read full story Source: The Guardian, 27 January 2022 -
News Article
Did bad vaccine advice cost Samantha Willis her life?
Patient Safety Learning posted a news article in News
When the UK’s jab programme began, expectant mothers were told to steer clear – so Samantha decided to wait until she had had her baby. Two weeks after giving birth, she died in hospital from Covid. Samantha was unvaccinated – she had received advice against getting jabbed at an antenatal appointment. When the Covid vaccine programme began in the UK on 8 December 2020, pregnant women were told not to get vaccinated. But in October 2020, the Royal College of Obstetricians and Gynaecologists (RCOG) published guidance warning that “intensive care admission may be more common in pregnant women with Covid-19 than in non-pregnant women of the same age” and that pregnant women with Covid were three times more likely to have a preterm birth. Further evidence emerged in 2021 indicating that pregnant women were particularly vulnerable to Covid, especially in their final trimester. Research from the University of Washington, published in January, found that pregnant women were 13 times more likely to die from Covid than people of a similar age who were not pregnant. But throughout February and March, the JCVI’s scientists did not appear especially concerned about examining the case for vaccinating pregnant women. Priority in the early stages of the vaccine programme was being given to older people, so many pregnant women remained towards the back of the queue. The maternity campaign group Pregnant Then Screwed said: “If you look at who was on the Covid war cabinet and leading the daily briefing, it was nearly all men,” says Joeli Brearley, its founder. “Pregnant women were treated as if they were very similar to the general population, rather than being seen as a special cohort that needs special consideration. They were just not a priority.” Read full story Source: The Guardian, 23 November 2021 -
News Article
Patient Safety Learning joins the National Voices coalition
Patient Safety Learning posted a news article in News
Press release: 23 November 2021 We are pleased to announce that Patient Safety Learning is now a member of National Voices, the leading coalition of health and social care charities in England. Members of National Voices work together to strengthen the voice of patients, service users, carers, their families and the voluntary organisations that work for them. Commenting on today’s announcement, Patient Safety Learning’s Chief Executive Helen Hughes said: “We are delighted to have joined National Voices. To reduce avoidable harm in health and social care we all need to work in partnership to identify patient safety concerns, highlight where changes are needed and share good practice, to help deliver the systemic change required to create a patient-safe future. We look forward to working closely with partners in National Voices going forward to help improve patient safety.” Notes to editors: Patient Safety Learning is a charity and independent voice for improving patient safety. We harness the knowledge, insights, enthusiasm and commitment of health and social care organisations, professionals and patients for system-wide change and the reduction of avoidable harm. National Voices is the leading coalition of health and social care charities in England. We have more than 180 members covering a diverse range of health conditions and communities, connecting us with the experiences of millions of people. We work together to strengthen the voice of patients, service users, carers, their families and the voluntary organisations that work for them. -
News Article
Pregnant women at risk from NHS workers’ mixed messages over safety of jab
Patient Safety Learning posted a news article in News
Pregnant women are being advised by some health professionals not to have the Covid vaccine despite an edict from the NHS that they should encourage them to get the jab. One in six of the most critically ill Covid patients requiring life-saving care are unvaccinated pregnant women, figures released last week show. Yet messages sent to the Vaccines and Pregnancy helpline, launched on 20 August to help pregnant women navigate information about the vaccine, suggest that some midwives are advising against the jab. One said: “I was initially keen to have the vaccine and then advised by a midwife not to have it.” Another wrote: “I had my first dose before I knew I was pregnant. Now I’m pregnant I’ve been told I’m not allowed my second.” Another reported: “I’ve been advised by midwives not to get the vaccine due to the impact on ovulation and menstruation.” The helpline was set up by the organisation Full Fact in partnership with the campaign group Pregnant Then Screwed. Many of those contacting it complained of conflicting advice while others were pushed from pillar to post. One said: “I’m pregnant and really confused about getting the vaccine. I’ve spoken to my health visitor, who said speak to your GP, the GP said speak to your midwife, and the midwife said they can’t advise me.” Full Fact’s deputy editor, Claire Milne, said the helpline was established to counter misinformation about the vaccine. She explained: “It’s not right so many pregnant women have been left scared for their safety and that of their unborn children. “Messaging around the safety of the vaccines in pregnancy has been, at times, confused. It’s vital that up-to-date information is available – especially when speaking with health professionals.” Read full story Source: The Guardian, 17 October 2021 -
News ArticleIn a bid to fight against misinformation about the coronavirus vaccines, a group of scientists from all over the world have created an online guide to building a ‘truth sandwich’. The guide serves to arm people with practical tips, up-to-date information and evidence to talk reliably about the vaccines, and enable them to constructively challenge associated myths. The scientists, led by the University of Bristol, are appealing to everyone to understand the facts set out in the 'COVID-19 Vaccine Communication Handbook', follow the guidance and spread the word. Professor Stephan Lewandowsky, the lead author of the guide, said: “Vaccines are our ticket to freedom and communication about them should be our passport to getting everyone on board." “The way all of us refer to and discuss the COVID-19 vaccines can literally help win the battle against this devastating virus by tackling misinformation and improving uptake, which is crucial." Read full story Source: The Independent, 7 January 2021
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News Article
‘Do not resuscitate’ orders caused potentially avoidable deaths, regulator finds
Patient Safety Learning posted a news article in News
Do-not-resuscitate orders were wrongly allocated to some care home residents during the COVID-19 pandemic, causing potentially avoidable deaths, the first phase of a review by England’s Care Quality Commission (CQC) has found. The regulator warned that some of the “inappropriate” do not attempt cardiopulmonary resuscitation (DNACPR) notices applied in the spring may still be in place and called on all care providers to check with the person concerned that they consent. The review was prompted by concerns about the blanket application of the orders in care homes in the early part of the pandemic, amid then prevalent fears that NHS hospitals would be overwhelmed. The CQC received 40 submissions from the public, mostly about DNACPR orders that had been put in place without consulting with the person or their family. These included reports of all the residents of one care home being given a DNACPR notice, and of the notices routinely being applied to anyone infected with Covid. Some people reported that they did not even know a DNACPR order had been placed on their relative until they were quite unwell. “There is evidence of unacceptable and inappropriate DNACPRs being made at the start of the pandemic,” the interim report found, adding that the practice may have caused “potentially avoidable death”. Read full story Source: The Guardian, 3 December 2020 -
News Article
NHS needs to ‘radically simplify’ data sharing rules, says tech chief
Patient Safety Learning posted a news article in News
A national tech chief has called for a ‘radical simplification’ of the way in which NHS patients can opt out of having their data shared. NHSX chief executive Matthew Gould today said the current system was “overly complicated” with “too many different opt out mechanisms” and it needs to be made “super simple” for the public. His comments come as NHSX, NHS Digital and the Department of Health and Social Care are working on the much-delayed and controversial GP data-sharing programme. The scheme was paused indefinitely this summer after backlash from GPs and campaigners. Speaking at the Healthcare Excellence Through Technology conference, Mr Gould said the NHS had a “rich history of misfiring” on getting the public’s trust for data-sharing projects, which included the recent furore around the paused General Practice Data for Planning and Research. He said: “Where we are at the moment is an overcomplicated overlap of too many different opt out mechanisms and we’re trying to work out how to radically simplify this." Read full story (paywalled) Source: HSJ, 28 September 2021 -
News Article
TikTok video of IUD removal at home prompts warning from health authorities
Patient Safety Learning posted a news article in News
A TikTok user who went viral with a video of herself removing her implanted birth control device has prompted calls among sexual health experts for better monitoring of social media platforms. In a video which has gained over 178,000 likes, TikTok user Mikkie Gallagher is filmed performing a ‘DIY IUD removal’ wearing medical gloves, writing on top of the post: “A lot easier than I thought TBH,” and “Catch of the day: Mirena IUD, 2 inches”. An intrauterine device (IUD) is inserted into the uterus to prevent pregnancy and sometimes assist in relieving period pain. They usually need to be taken out every five to 10 years depending on the type. Women can choose when to have them removed. Family Planning Victoria CEO, Claire Vissenga, said she found it very concerning that “DIY could pass as healthcare or professional assistance”. “... it’s just a ridiculous thing to do. Removing an IUD potentially does physical damage, and could complicate contraception,” says Vissenga Family Planning medical director, Kathleen McNamee, said 80% of DIY IUD removals failed, leading to GP or emergency visits. “If the person dislodges the IUD in a failed attempt, it could no longer be effective as a contraceptive method and result in an unwanted pregnancy,” she said. Read full story Source: The Guardian, 24 September 2021 -
News Article
Ministers to legislate for more power over patient data
Patient-Safety-Learning posted a news article in News
Ministers are to legislate more powers over how data on patients is collected and are imposing a 'duty' on the NHS to share patient information when doing so would benefit the system. The Health and Social Care Act 2021 already allows for sharing of data on an individual basis but staff have reported finding it hard to share it when it comes to primary and secondary care and administrative purposes. The new draft strategy produced by NHSX, has suggested it may want to use cloud storage to create a set of “structured data records” with the idea that it would make it easier for patients to access their own data. Read full story. (paywalled) Source: HSJ, 22 June 2021 -
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EventuntilThis online event is an important update for prescribers, and for those who take prescribed medicines, on the RPS Prescribing Competency Framework. This framework was originally produced in by the National Prescribing Centre as a competency framework for all prescribers, and updated by the Royal Pharmaceutical Society (RPS) in 2016. Join this event to: Hear about the changes to the RPS competency framework for all prescribers. Hear how others in pharmacy and other healthcare professions are using the framework. Ask questions to colleagues who were involved in updating the framework. Register
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Event“Improving patient experience is not simple. As well as effective leadership and a receptive culture, trusts need a whole systems approach to collecting, analysing, using and learning from patient feedback for quality improvement. Without such an approach it is almost impossible to track, measure and drive quality improvement.” NHS England and Improvement 2019 Convenzis are excited to share details of our 1st Virtual NHS Patient Experience Conference to date, this live and interactive session will focus on key findings from the 2019 British Social Attitudes survey and discuss how the 2020 COVID-19 outbreak affected patient satisfaction and assurance. Register
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EventOn November 29, 1999, the Institute of Medicine released a report called To Err is Human: Building a Safer Health System, the report reviewed the status of patient safety in the US and UK, 20 years on and the NHS have released The NHS Patient Safety Strategy. Within the newly developed strategy, the NHS has three strategic aims that will support the development of patient safety culture & a patient safety system. This virtual conference will discuss the 2020, COVID-19 response best practice, along with some national policy insights and international trends. Register
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EventuntilMore than 1,900 delegates have attended Health and care explained, ranging from chief executives of charities to NHS leaders, students and representatives from government bodies. Returning for its ninth run, The King Fund's conference gives you the opportunity to interact with our policy experts, who will guide you through the latest health and social care data and explain how the system in England really works. You will hear balanced and honest views about the pressures and opportunities facing the system in 2021. Register
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Content Article
PRSB Diabetes standards (July 2022)
Patient-Safety-Learning posted an article in Diabetes
People with diabetes are increasingly using medical devices to help manage their condition, including devices for monitoring glucose and delivering insulin. However, healthcare professionals are finding that they cannot always access up to date information about a person with diabetes and the data from their medical devices. This makes it harder to provide the best advice and support. The Professional Record Standards Body (PRSB) was commissioned by NHS England and NHS Improvement to produce two standards for sharing diabetes information between people and professionals across all care settings, including self management data from digital apps and medical devices (for example, continuous glucose monitors). The Diabetes Information Record Standard which defines the information needed to support a person’s diabetes management. It includes information that could be recorded by health and care professionals or the person themselves that is relevant to the diabetes care of the person and should be shared between different care providers. The Diabetes Self-Management Standard which defines information that could be recorded by the person (or their carer) at home (either using digital apps or medical devices) and shared with health and care professionals. -
Content ArticleThis blog considers the similarities and differences between the Healthcare Safety Investigation Branch in England and Ukom, the Norwegian Healthcare Investigation Board. Both are independent national organisations, which take a no blame approach to patient safety investigations, however they also have a number of distinct differences in their approach.
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