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News ArticleThree in four NHS staff have struggled with a mental health condition in the last year, according to a new poll. A survey of workers carried out by NHS Charities Together over medics’ mental health comes as healthcare leaders were forced to reverse cuts to NHS Practitioner Health, a service for medics. A backlash from NHS staff over the proposed cuts forced health secretary Victoria Atkins to intervene. In the new poll of more than 1,000 NHS staff, 76% said they have experienced a health condition in the last year with 52% reporting anxiety, 51% reporting low mood, while 42% of respondents also said they’d experienced exhaustion. Meanwhile, the most recent NHS data shows the most common reasons for staff sickness are anxiety, stress, depression or other psychiatric conditions, with more than 586,600 working days lost over this in November 2023. NHS Practitioner Health began as a mental health service for GPs but has since expanded to other specialities following funding from NHS England. However, last week the provider announced this national funding was due to end, so its service would be reduced. NHS England said the decision was so it could review the services available for all NHS staff. However, it was forced to u-turn on the decision and agreed to provide funding for an additional year. Read full story Source: The Independent, 17 April 2024
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News ArticleA regulator overseeing 340,000 professionals breached a psychologist’s human rights by letting their fitness-to-practise case go on for a decade, amid widespread very long delays, it has emerged. A judgment from the Health and Care Professions Tribunal said the “lamentable” situation for the registrant was down to the “disgraceful… manner in which the Healthcare Professions Council dealt with their case”. The HCPC oversees professional standards for several groups including radiographers, paramedics, physiotherapists, occupational therapists, and operating department practitioners. If a complaint is made about a registrant, it can investigate and refer them to the tribunal, which can strike them off. The Society of Radiographers said the current speed of cases was “simply unacceptable” and its director of industrial strategy Dean Rogers added: “Our members spend too long working — and living — under the intense scrutiny of their regulator, often under the control of an interim order restricting or even preventing their practise while investigations drag on.” Read full story (paywalled) Source: HSJ, 17 April 2024
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News Article
Staff mental health support axed by NHSE
Patient Safety Learning posted a news article in News
A dedicated mental health and addiction support service for secondary care staff is shutting to new patients, as NHS England is set to cut its funding. The NHS Practitioner Health programme, which was rolled out nationally in October 2019, is halting new registrations for secondary care staff from 15 April. NHS England has informed the provider its funding will be cut for secondary care staff, subject to a review it is carrying out of wider services. The Practitioner Health programme for GPs and dentists is expected to continue for another year, although its future beyond that is also unclear, HSJ was told. An announcement published on X, formerly known as Twitter, said: “New secondary care patients will be signposted to alternative sources of support, including your GP, occupational health departments and organisational employee assistance programmes.” Its axing comes amid severe pressure on NHS budgets nationally and locally, with overall funding barely keeping up with anticipated inflation in 2024-25, and many integrated care systems forecasting large deficits. Medical unions and senior doctors have criticised the axing of the service. Read full story (paywalled) Source: HSJ, 12 April 2024 -
Content Article
Lampard Inquiry: terms of reference (10 April 2024)
Mark Hughes posted an article in Other reports and inquiries
The Lampard Inquiry will seek to understand the events that led to the tragic deaths of mental health inpatients under the care of NHS trusts in Essex between 2000 and 2023. This document outlines the terms of reference set following consultation with the chair of the inquiry, Baroness Lampard. -
News Article
Man suffered psychosis after Trust failed to inform him of steroids side-effects
Patient Safety Learning posted a news article in News
A man who suffered a psychotic episode which lasted for weeks was not fully informed about potential extreme side-effects of taking steroids medication, England’s health service Ombudsman has found. Andrew Holland was prescribed steroids in early January 2022 by Manchester Royal Eye Hospital after losing vision in his left eye and suffering a severe infection in his right eye. The 61-year-old from Manchester was given the medication as treatment for eye inflammation, but soon began suffering from disrupted sleep and severe headaches. These side-effects developed into more serious ones, including becoming aggressive, psychotic, and inexplicably wandering the street at different times of the day and night. After several hospital visits due to his symptoms, Andrew attended Manchester University NHS Foundation Trust’s emergency department in mid-January with a severe headache and later became an inpatient. He was diagnosed with steroid induced psychosis, with symptoms including hallucinations, insomnia and behaviour changes. Though no failings were found with Manchester University NHS Foundation Trust in prescribing Andrew with steroids for the eye condition, the Ombudsman discovered a missed opportunity to fully inform him of potential extreme side-effects. He was therefore unable to make a fully informed decision about whether to take them or not. The Trust apologised for an ‘unsatisfactory experience’. However, the Ombudsman found relevant guidelines were not followed. Moreover, there had been no acknowledgement of mistakes in communication about the side-effects. Nor was any attempt made to correct them. Read full story Source: PSHO, 10 April 2024 -
Content ArticleDr Hilary Cass has submitted her final report and recommendations to NHS England in her role as Chair of the Independent Review of gender identity services for children and young people. The Review was commissioned by NHS England to make recommendations on how to improve NHS gender identity services, and ensure that children and young people who are questioning their gender identity or experiencing gender dysphoria receive a high standard of care, that meets their needs, is safe, holistic and effective. The report describes what is known about the young people who are seeking NHS support around their gender identity and sets out the recommended clinical approach to care and support they should expect, the interventions that should be available, and how services should be organised across the country. It also makes recommendations on the quality improvement and research infrastructure required to ensure that the evidence base underpinning care is strengthened.
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News Article
One in three health workers suffering ‘burnout’ amid NHS staffing crisis
Patient Safety Learning posted a news article in News
Almost one in three NHS employees have had to take time off work suffering poor mental health in the past year, new research suggests. The Unison union said its survey of 12,000 health workers shows the impact of a staffing crisis, with many suffering “burnout”. Panic attacks, high blood pressure, chest pains and headaches are among the physical signs of stress reported by nurses, porters, 999 call handlers and other NHS staff who completed the survey. The news comes as more than half of the mental health hubs launched for NHS workers after the pandemic have closed since last year, according to the British Psychological Society. Unison said workforce pressures are taking a huge toll as staff tackle a waiting list backlog, with many struggling to look after their wellbeing. Of those who were off with mental health problems, one in five said they did not tell their employer the real cause of their absence, mainly because they did not feel their manager or employer would be supportive. The union said staff feel undervalued and frustrated, with many quitting for less stressful jobs that pay more. Read full story Source: The Independent, 8 April 2024 -
Content ArticleThere is a growing momentum around the world to foster greater opportunities for the involvement of mental health service users in their care and treatment planning. In-principle support for this aim is widespread across mental healthcare professionals. Yet, progress in mental health services towards this objective has lagged in practice. Francis et al. conducted a systematic review of quantitative, qualitative and mixed-method research on interventions to improve opportunities for the involvement of mental healthcare service users in treatment planning, to understand the current research evidence and the barriers to implementation. Overarching barriers to shared and supported decision-making in mental health treatment planning were: (1) Organisational (resource limitations, culture barriers, risk management priorities and structure); (2) Process (lack of knowledge, time constraints, health-related concerns, problems completing and using plans); and (3) Relationship barriers (fear and distrust for both service users and clinicians). On the basis of the barriers identified, recommendations are made to enable the implementation of new policies and programmes, the designing of new tools and for clinicians seeking to practice shared and supported decision-making in the healthcare they offer.
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Content ArticleThis report sets out Care Quality Commission's activity and findings during 2022/23 from our engagement with people who are subject to the Mental Health Act 1983 (MHA) as well as a review of services registered to assess, treat and care for people detained using the MHA.
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Content Article
Amplifying maternal voices toolkit (MMHA, 18 March 2024)
Patient-Safety-Learning posted an article in Maternity
Drawing on insights from Maternal Mental Health Alliance (MMHA) Lived Experience Champions, member organisations and local contacts, this toolkit offers creative ideas and practical tools to empower individuals in shaping perinatal mental health care at a local level. The toolkit explores innovative examples of ongoing efforts to bring about this much-needed change. It contains resources relating to: Breaking barriers Demonstrating impact Making connections Sharing stories -
News ArticlePatients at the hospital that treated killer Valdo Calocane were discharged too soon and released in a worse state into the community, the NHS safety watchdog has found. Serious failings by Nottinghamshire Hospital Foundation Trust in keeping patients and the public safe have been identified in a review from the Care Quality Commission (CQC). More than 1,200 patients are waiting to be seen by community services, the report found. Meanwhile, several hundred who are receiving treatment did not have a clinician overseeing their care,the CQC found. The review was launched by the government following the conviction of killer Valdo Calocane, who was under the care of the NHS trust’s community services. The CQC review said patients reported that crisis services are either “useless” or detrimental to their health. The three broad areas of concern, highlighted in the CQC’s report, were: High demand for services was leading to long waiting times for care and a lack of oversight of those waiting. The trust does not have enough staff to keep patients safe in the community and within some hospital services. Senior leaders at the trust do not have clear oversight of the risks and issues within the service. Read full story Source: The Independent, 27 March 2024
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Content ArticleFollowing the conviction of Valdo Calocane in January 2024 for the killings of Ian Coates, Grace O’Malley-Kumar and Barnaby Webber, the Secretary of State for Health and Social Care commissioned the Care Quality Commission (CQC) to carry out a rapid review of Nottinghamshire Healthcare NHS Foundation Trust (NHFT) under section 48 of the Health and Social Care Act 2008. As part of the review, CQC were asked to look at 3 specific areas: A rapid review of the available evidence related to the care of Valdo Calocane An assessment of patient safety and quality of care provided by NHFT An assessment of progress made at Rampton Hospital since the most recent CQC inspection activity In this report, CQC detail the findings of parts 2 and 3. They will publish a separate report on part 1 in relation to the care of VC in summer 2024.
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News ArticleA senior mental health nurse suffered “degrading and humiliating” treatment while she languished for 10 days on an unsuitable NHS ward during a mental health crisis, The Independent has been told. Rachel Luby, 36, was admitted to Basildon Hospital A&E in Essex on 5 January this year after attempting to take an overdose of over-the-counter medicine following a traumatic assault. This, she claimed, was the start of weeks of horrific care she endured while waiting for a mental health bed. It culminated in her being restrained and forced into a caged van “like an animal”. She revealed her story after The Independent reported on a warning from top emergency doctors that self-harming and suicidal patients who go to A&E are not being treated with compassion because staff are overwhelmed. Ms Luby, an award-winning nurse, said she waited more than a week and a half in a general hospital before she was moved to a bed on a mental health ward. Ms Luby was able to leave the ward and find medication to overdose again, despite staff allegedly assessing her as a risk. In a second incident, she went to the bathroom and attempted to take her own life. She told The Independent: “I feel that this is something I will not recover from. I will not ever reach out for help in the future. “If this is the treatment that I’m getting as a nurse, then what the heck is happening to those that don’t have the voice or education that I have? It horrifies me to think what is happening to people that are far more vulnerable than me.” Read full story Source: The Independent, 27 March 2024
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Content ArticleSharon shares her experience of using an external female catheter. This is an example of where person centred care has a positive impact on the physical and mental wellbeing of a patient.
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Content ArticleIn this 6 minute video, Laurence describes his experiences of post-ICU delirium.
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News ArticleA&E staff are unable to properly look after the most vulnerable mental health patients or treat them with compassion because emergency departments are so overwhelmed, top medics have warned. An exclusive report shared with The Independent shows more than 40% of patients who needed emergency care due to self-harm or suicide attempts received no compassionate care while in A&E, according to their medical records. The data, collated by the Royal College of Emergency Medicine (RCEM), prompted a warning from top doctor Dr Adrian Boyle that mental health patients are spending far too long in A&E – where they are cared for by staff who are not specifically trained for their needs – before being moved to an appropriate ward. Dr Boyle, who is president of the RCEM, said there had been some progress in improving care for a “historically disadvantaged” group, but added: “Patients with mental health problems are still spending too long in our emergency departments, with an average length of stay of nearly 10 hours and this has not really improved. “An emergency department is frequently noisy and agitating, the lights never go off and cannot be described as an environment that promotes recovery.” When a patient goes to A&E after a self-harm attempt, they should receive an assessment by a clinician into the type of self-harm, reasons for it, future plans or further suicidal thoughts. The college said it indicates a “significant gap” in the NHS’ ability to provide holistic care for mental health patients with complex needs and warned “urgent” improvements are needed. Read full story Source: The Independent, 25 March 2024
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News Article
More than half of England’s army veterans have health problems
Patient Safety Learning posted a news article in News
More than half of England’s army veterans have experienced mental or physical health issues since returning to civilian life, and some are reluctant to share their experiences, a survey has revealed. The survey of 4,910 veterans, commissioned jointly by the Royal College of GPs (RCGP) and the Office for Veterans’ Affairs (OVA), found that 55% have experienced a health issue potentially related to their service since leaving the armed forces. Over 80% of respondents said their condition had got worse since returning to civilian life. One in seven of those surveyed said they had not sought help from a healthcare professional. A preference for managing issues alone and the belief that their experience would not be understood by a civilian health professional were the most common reasons given. This fear of being misunderstood is demonstrated by the finding that 63% of veterans said they would be more likely to seek help if they knew their GP practice was signed up to the Veteran Friendly Accreditation scheme. More than 3,000 of England’s 6,313 GP practices are accredited, but the survey’s findings have prompted the RCGP – with NHS England and the OVA – to launch an initiative to get more GP practices on to the scheme. Practices that sign up will be provided with a “simple process” for identifying, understanding and supporting veterans and, where appropriate, referring them to dedicated veterans’ physical and mental health and wellbeing services. Read full story Source: The Guardian, 25 March 2024 -
News Article
Campaigner: Mental health 'deaths crisis' getting worse
Patient Safety Learning posted a news article in News
A campaigner in Norfolk says the "deaths crisis" at the county's mental health trust is getting worse. Bereaved relatives met the mental health minister, Maria Caulfield, to discuss failings at the Norfolk and Suffolk NHS Foundation Trust (NSFT). The trust says it is on a "rapid, and much-needed journey of improvement". Mark Harrison, from the Campaign to Save Mental Health Services in Norfolk and Suffolk, said: "We judge people by what they do, not what they say." Members of the campaign group met Ms Caulfield and other MPs in Westminster on 12 March and demanded an independent public inquiry into the trust. It came after a report last summer which found that more than 8,000 mental health patients had died unexpectedly in Norfolk and Suffolk between 2019 and 2022. At the meeting, it was agreed Ms Caulfield would meet bosses at the NSFT. The health select committee will also be asked to conduct an inquiry into the trust as part of a broader public inquiry. But Mr Harrison said he had little confidence anything would change. "The deaths crisis is just out of control and it's accelerating," he said. "We have been doing this for 10 years. Every time somebody promises to do something, it doesn't come to anything." Read full story Source: BBC News, 20 March 2024 -
News Article
Chair hits out at government delay to mental health deaths inquiry
Patient Safety Learning posted a news article in News
The chair of an inquiry into the deaths of mental health patients in Essex has said she is “disappointed” at a delay in having its scope confirmed by the health secretary. Baroness Kate Lampard said she has been unable to begin substantive work on the probe while still waiting for sign-off from government. An inquiry was launched in 2021 to review the deaths of at least 2,000 people in contact with Essex mental health services across a 20-year period. Baroness Lampard took over as chair last year after it gained new powers to compel people to give evidence, following concerns not enough staff were coming forward. She has proposed expanding its scope by a further two years until 2022 due to ongoing concerns and to cover NHS patients treated in the private sector. The final terms of reference will be set by the health secretary Victoria Atkins. Baroness Lampard said she has not heard back from the Department of Health and Social Care on her proposals since submitting them three months ago. Read full story (paywalled) Source: HSJ, 19 March 2024 -
News ArticleA controversial unproven medical condition which is rooted in pseudoscience and disputed by doctors is routinely being used in Britain to explain deaths after police restraint, the Observer has found. “Acute behavioural disturbance” (ABD) and “excited delirium” are used to describe people who are agitated or acting bizarrely, usually due to mental illness, drug use or both. Symptoms are said to include insensitivity to pain, aggression, “superhuman” strength and elevated heart rate. Police and other emergency services say the labels, often used interchangeably, are a helpful shorthand used to identify when a person who might need medical help and restraint may be dangerous. But the terms are not recognised by the World Health Organization and have been condemned as “spurious” by campaigners who say they are used to “explain away” the police role in deaths. The American Medical Association rejected “excited delirium” after it was used by police lawyers in the case of George Floyd. California lawmakers banned it as a diagnosis or cause of death in October, saying it had been “used for decades to explain away mysterious deaths of mostly black and brown people in police custody”. The Royal College of Psychiatrists has also warned that the current definition of ABD, as it is now more commonly known in the UK, could be leading to people “being subjected to avoidable and potentially harmful interventions”. In 2017, a Home Office-commissioned review into deaths in police custody said the terms were “strongly disputed amongst medical professionals”. The Royal College of Psychiatrists has also warned that the current definition of ABD, as it is now more commonly known in the UK, could be leading to people “being subjected to avoidable and potentially harmful interventions”. In 2017, a Home Office-commissioned review into deaths in police custody said the terms were “strongly disputed amongst medical professionals”. Read full story Source: The Guardian, 17 March 2024
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News Article
Calls for public inquiry into 20,000 sexual abuse allegations on NHS wards
Patient Safety Learning posted a news article in News
The government is facing calls for a public inquiry into the scandal of sexual abuse in mental health hospitals, following an investigation by The Independent. Rape Crisis England and Wales has warned that the “alarming” scale of abuse within the UK’s psychiatric system requires “major intervention” from ministers. It comes after an expose by the Independent and Sky News revealed that almost 20,000 reports of sexual incidents – involving both patients and staff – had been made in more than half of NHS mental health trusts in the past five years. As well as a public inquiry, which would give survivors the chance to give evidence, Rape Crisis England and Wales wants the government to appoint a named minister with responsibility for addressing the problem. Chief executive Ciara Bergman said: “That anyone in the already vulnerable position of needing or being detained for in-patient care because of their mental health needs should experience sexual violence and abuse whilst in the care of the state, is deeply concerning. “We are concerned that without major intervention and leadership at the highest levels, this could lead to more incidents of sexual violence and abuse happening, and this behaviour being accepted as inevitable, when it is not, and is indeed absolutely preventable.” Read full story Source: The Independent, 15 March 2024 -
Content ArticleOlder people’s mental health has long been overlooked and poor mental health is often dismissed by health professionals as an ‘inevitable’ part of getting older. And despite NHS Talking Therapies having higher than average recovery rates among the over-65s, this service is less likely to be offered to older people. Commissioned by Age UK, this briefing from the Centre for Mental Health summarises evidence about the mental health of older people in England. It finds that ageist attitudes underpin a system that discriminates against older people, while fatalistic assumptions about what people can expect for their mental health in later life undermine the provision of effective support to promote wellbeing, prevent mental ill health and treat mental health difficulties. The briefing finds that while older people may possess many protective factors for good mental health, they face numerous risk factors, including poorer physical health, reduced mobility and, for some, poverty and racism. Tackling the risk factors and boosting protective factors can increase wellbeing in later life and either prevent or stop the escalation of mental health problems.
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Content ArticleMore than 3 years after the onset of the Covid-19 global pandemic, a wave of evidence suggests that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can lead to postacute sequelae in pulmonary and broad array of extrapulmonary organ systems—including increased risks and burdens of cardiovascular disorders, neurologic and mental health disorders, metabolic disorders (diabetes and dyslipidemia), kidney disorders and gastrointestinal disorders. However, up until now, evidence is mostly limited to the first year postinfection. Bowe et al. built a cohort of 138,818 individuals with SARS-CoV-2 infection and 5,985,227 noninfected control group from the US Department of Veterans Affairs and followed them for 2 years to estimate the risks of death and 80 prespecified postacute sequelae of Covid-19 (PASC) according to care setting during the acute phase of infection. They found that the increased risk of death was not significant beyond 6 months after infection among nonhospitalised but remained significantly elevated through the 2 years in hospitalised individuals. Within the 80 prespecified sequelae, 69% and 35% of them became not significant at 2 years after infection among nonhospitalised and hospitalised individuals, respectively. In summary, while risks of many sequelae declined 2 years after infection, the substantial cumulative burden of health loss due to PASC calls for attention to the care needs of people with long-term health effects due to SARS-CoV-2 infection.
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News Article
Mental health trust failed to heed safety warnings, campaigners say
Patient Safety Learning posted a news article in News
A mental health trust linked to thousands of unexpected patient deaths repeatedly failed to act on coroners' safety warnings, campaigners say. BBC News has been given exclusive access to new evidence from coroners' reports gathered by a campaign group. It wants a criminal investigation into why so many patients died at Norfolk and Suffolk NHS Foundation Trust - and has sent police the evidence. Campaigners, including patients and bereaved families, claim it is failing to make vital safety improvements despite promising to do so. Last summer, a report found more than 8,000 mental-health patients had died unexpectedly in Norfolk and Suffolk between 2019 and 2022. This is defined as the death of a patient who has not been identified as critically ill or whose death is not expected by the clinical team. The new evidence, based on 38 coroners' prevention of future death (PFD) reports since 2013, suggests there were repeated warnings more patients could die unless safety issues were addressed, including: dangerously poor record-keeping and communication family concerns being ignored unsafe levels of staffing at the trust. And campaigners say the trust's failure to improve safety has led to more deaths. Read full story Source: BBC News, 12 March 2024 -
Content Article
This is part of our series of Patient Safety Spotlight interviews, where we talk to people working for patient safety about their role and what motivates them. Joy talks to us about why we need to reduce the use of restrictive practices in healthcare, the role of research in identifying unsafe practices and how the Restraint Reduction Network shares and helps organisations implement safer approaches to care.
