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News Article
Covid: Discharging hospital patients to care homes 'unlawful'
Patient Safety Learning posted a news article in News
Government policies on discharging untested patients from hospital to care homes in England at the start of the Covid pandemic have been ruled unlawful by the High Court. The ruling comes after two women took former Health Secretary Matt Hancock and Public Health England to court. Dr Cathy Gardner and Fay Harris said it had caused a "shocking death toll". Prime Minister Boris Johnson renewed his apologies for all those who lost loved ones during the pandemic. Dr Gardner and Ms Harris partially succeeded in claims against Mr Hancock and Public Health England. The women claimed key policies of discharging patients from hospitals into care homes were implemented with no testing and no suitable isolation arrangements in the homes. A barrister representing Dr Gardner and Ms Harris told the court at a hearing in March that more than 20,000 elderly or disabled care home residents died from Covid between March and June 2020 in England and Wales. Jason Coppel QC also said in a written case outline for the judicial review that the care home population was known to be "uniquely vulnerable" to Covid. "The government's failure to protect it, and positive steps taken by the government which introduced Covid-19 infection into care homes, represent one of the most egregious and devastating policy failures in the modern era," he added. Read full story Source: BBC News, 27 April 2022 -
Content ArticleOlder generations are becoming more diverse than ever, but also more unequal. Tackling these inequalities is important to ensure that everyone is able to live a good later life. This set of downloadable 'evidence cards' by the Centre for Ageing Better highlights the severe inequalities experienced by Black, Asian and Minority Ethnic groups approaching retirement age, and what causes these inequalities. The evidence cards are available to download as both PDF and image files.
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News Article
Woman waits six hours for ambulance after fall on her 100th birthday
Patient Safety Learning posted a news article in News
A woman has described how she spent more than six hours of her 100th birthday waiting in agony for an ambulance after slipping and fracturing her pelvis while getting ready for a family lunch. Irene Silsby was due to be picked up by her niece, Lynne Taylor, for a celebration to mark her centenary on 9 April. But she fell in the windowless bathroom of her care home in Greetham, Rutland, and staff called an ambulance at 9am after she managed to summon help. “All I remember is I was in terrible pain,” said Silsby from her hospital bed on Saturday. When asked of the ambulance delay, she said: “It’s disgusting. I don’t know how I stood it so long, the pain was so severe.” Taylor expected to meet the ambulance as she arrived 45 minutes later. But when she reached the care home, the manager said it would be a 10-hour wait, she said. What was to be her aunt’s first trip outside the care home in more than five months turned into her lying on a cold floor surrounded by pillows and blankets to keep her warm and quell some of the discomfort. Taylor, 60, recalled her aunt saying: “They’re not coming to me because they know I’m 100 and I’m not really worth it any more.” Taylor said she had never felt so scared, frustrated and worried. After calling 999 and expressing her outrage, she was told that life-threatening conditions were being prioritised. “I thought she was going to die,” she said. “I didn’t think that any frail, tiny, 100-year-old body could put up with that level of pain on the floor.” Read full story Source: The Guardian, 20 April 2022 -
EventuntilOur societies are currently at a crossroads. Demographic change, growing inequalities, the climate crisis, COVID-19, and the impacts of the war in Ukraine are all having a negative impact on the health and well-being of our societies. These challenges are straining public resources and the social fabric of our communities. How can we overcome these issues and grow stronger in times of crisis? The early years and later years of life are crucial stages in the life-course. How we approach health and wellbeing during these phases has a direct impact on the long-term resilience of our health systems and our wider societies. We must prioritise health equity and wellbeing among children, youth, families and older people to ensure they have the essential conditions and resources to thrive, setting them up for lifelong health and wellbeing. Alternative economic and care models, such as the Economy of Wellbeing – as well as socially-conscious public and private investments offer the potential to grow stronger and more sustainably out of the current crises. This in-person seminar will gather experts and policy makers to explore the necessary conditions in which all members of society, including young and older people, feel like capable and valued members of their immediate and wider communities. New and innovative approaches and investments will be presented, in the context of current European policy developments, and with a critical focus on their impacts on health equity. Discussions will be centred around the following themes: Securing conditions for health equity and wellbeing in childhood and adolescence in times of uncertainty Prioritising public investments for healthy and active ageing in the wake of multiple crises Exploring how we can turn our current uncertainties into opportunities for strength, through concepts like the Economy of Wellbeing Sign up for the seminar
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News Article
Leading clinicians ‘horrified’ as NHSE slashes community funding without warning
Patient Safety Learning posted a news article in News
Senior medics have reacted in horror to NHS England’s decision to ‘dramatically’ cut the funding of a key long-term plan commitment designed to improve older people’s community services and deliver more care at home. British Geriatrics Society president Jennifer Burns told HSJ the professional body was “horrified” that the budget for the Ageing Well programme for 2022-23 would be £70m instead of the £204m originally promised in the long-term plan for the NHS. “We are dismayed that the promised funding for the Ageing Well programme as set out in the NHS long-term plan is being so dramatically cut at this time,” Dr Burns said. NHSE said: “The NHS is also investing an additional £200m in funding for virtual wards across the country by March 2023, delivering more care to patients safely in the comfort of their own home which will directly benefit older patients.” But Dr Burns said that although virtual wards would go “some way to helping with hospital admissions”, they were “no substitute” for the original commitments. “Older people suffered a devastating toll during the pandemic. Now is the time for systems to ensure the right services are in place and there is sustainable planning for the healthcare needs of an ageing population.” Read full story (paywalled) Source: HSJ, 7 April 2022 -
Content ArticleFalls are the most commonly reported patient safety incident in healthcare, with nearly 250,000 reported from hospitals in England and Wales each year. As well as causing injury to patients, the cost of treating falls is estimated to be around £630 million each year in England. This eLearning course is designed to help healthcare workers prevent patient falls in hospital. There are two modules available: Module 1 is aimed at hospital-based nurses. Module 2 is aimed at foundation level doctors and includes interactive information about patient and environmental falls risk factors, the patient assessment and post fall management. Both modules have been designed to complement, not replace, local falls prevention policies and processes.
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Content ArticleThis guidance from the Department of Health and Social Care (DHSC) outlines infection prevention and control (IPC) principles for adult social care settings in England, to be used with guidance on managing specific infections. It applies from 4 April 2022. This should be read in conjunction with DHSC's Covid-19 supplement to the infection prevention and control resource for adult social care.
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Content ArticleThis Joint Committee on Human Rights inquiry will look at human rights concerns in care settings in England, highlighting areas in which the human rights of patients, older people and others living with long-term disabilities, including learning disabilities and autism, are currently undermined or at risk.
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Content ArticleThis report by the Healthcare Safety Investigation Branch (HSIB) has been published as part of a pilot launched to evaluate HSIB’s ability to carry out effective local investigations at specific hospitals and trusts, while still identifying and sharing relevant national learning. After an evaluation, it will be decided whether this model can be implemented more widely by HSIB. The investigation reviewed the case of a patient who had a stroke and was due to be taken to his local hospital emergency department (ED), but the ED advised paramedics this was not possible as their stroke service was closed. The alternative was to take him to a neighbouring hospital, but they also advised that they could also not take the patient. This was then referred back to the original ED, who restated their position, eventually leading to the neighbouring hospital agreeing to accept the patient. Once the patient arrived he then had to wait 40 minutes in an ambulance as the ED was very busy.
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Content ArticleAs well as having a significant negative impact on the health and wellbeing of people with dementia, falls increase service costs related to staff time, paramedic visits, and A&E admissions. This study in the Journal of Patient Safety examined whether a remote digital vision-based monitoring and management system had an impact on the prevention of falls. The authors concluded that a contact-free, remote digital vision-based monitoring and management system reduced falls, fall-related injuries, emergency services time, clinician time, and disruptive night time observations. This benefits clinicians by allowing them to undertake other clinical duties and promotes the health and safety of patients who might normally experience injury-related stress and disruption to sleep.
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News Article
NHS ‘woefully unprepared’ for care of an ageing England
Patient Safety Learning posted a news article in News
The NHS is “flying blind” and “woefully unprepared” to cope with England’s rapidly ageing population, senior doctors have warned as stark new figures reveal the country has only one full-time geriatrician to care for every 8,000 older people. The Royal College of Physicians (RCP) said the drastic shortage of specially trained physicians to look after the rising number of elderly people and a lack of NHS workforce planning meant England was “sleepwalking into an avoidable crisis of care for older people”. Its analysis of NHS and Office for National Statistics data shows there is just one full-time geriatrician for every 8,031 people over the age of 65 in England. There are also regional disparities, with one geriatrician caring for more than 12,500 over-65s in the east Midlands, while the figure in north-east and central London is one per 3,254. Estimates suggest that by 2040 there could be as many as 17 million over-65s. But the college warns that many doctors will soon be requiring geriatric care themselves as 48% of consultant geriatricians are due to retire within the next decade. The RCP said the health service was short of staff across all specialities and the shortage of geriatricians was one example of why the health service needed more workforce planning. It said there was no publicly available data on the number of staff the NHS needed to train now to meet future demand for care. Dr Jennifer Burns, the president of the British Geriatrics Society, said the crisis would only worsen with the “predictable rise” in the numbers of older people across the country. “It is absolutely vital that these fundamental issues around the recruitment, retention, development and support of the workforce are addressed, and that there is a properly resourced strategy for future needs,” she said. Read full story Source: The Guardian, 3 March 2022 -
Content Article
In this blog, Jayne Flood, Falls Prevention Practitioner at East Kent Hospitals NHS Foundation Trust, describes how her team introduced ‘yellow kits’* to assist patients at high risk of falls in A&E, and evaluated their impact. *Developed in partnership with Medline Industries Ltd.- Posted
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Content ArticleThis investigation by the Healthcare Safety Investigation Branch (HSIB) explores the prescription of oral paracetamol in adult inpatients who, on admission to hospital, have low bodyweight (less than 50kg). Paracetamol is a common painkiller often used as first-line management for mild to moderate pain. Although it is safe if taken at the right dose, paracetamol in large amounts is toxic to the liver and therefore the maximum dose must never be exceeded. As its 'reference case', the investigation used the case of Dora, an 83-year-old woman who weighed less than 50kg on admission and lost further weight in hospital. While in hospital, Dora was prescribed oral paracetamol 1g four times a day and towards the end of her admission, she developed multiorgan failure due to sepsis and was diagnosed with paracetamol-induced liver toxicity.
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Content ArticleBarbara Young fell downstairs at her home at 11.30am on 15 July 2021, sustaining multiple injuries including fractures of her ribs, spine and skull. Her family immediately called the emergency services and informed the ambulance call handlers that she had fallen downstairs, was not fully conscious and had sustained an apparently severe head injury. An ambulance subsequently arrived at 2.26pm and she was taken to hospital where, due to her reduced mobility, she developed pneumonia. Mrs Young’s conditioned worsened over the coming days and she died on 24 July 2021. In her report, the Coroner raises concerns about the ambulance waiting time in this case, and more generally about ambulance response times in cases where elderly patients experience falls.
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Content Article
Visiting restrictions and the impact on patients and their families: a relative's perspective
Anonymous posted an article in By patients and public
The pandemic has shone a stark spotlight on so many inequities and inconsistencies in access to health and social care. Unfortunately, many of these inequities were already there and so, in some respects, its nothing new. In this blog, I want to draw attention to how visiting restrictions can result in worse outcomes for patients and their families. I will focus mainly on the needs of older adults in hospital or care, and those with dementia, because that has been my own experience. But these restrictive practices have affected so many groups: among them, those with mental health conditions and those with learning and behavioural difficulties. -
News Article
Public urged to sign up for Covid drug trial
Patient Safety Learning posted a news article in News
Over-50s and younger adults with underlying health conditions are being urged to participate in a study of life-saving treatments for COVID-19. The study is open to those who test positive for Covid and had symptoms develop in the previous five days. Volunteers will be given pills to take at home. The study will help decide how antiviral drugs will be used, Prof Sir Jonathan Van-Tam, the deputy chief medical officer for England, said. Health Secretary Sajid Javid asked everyone eligible to "step forward" and "help us to learn more about medicines which could save thousands of lives". Antivirals were "part of our approach as we learn to live with Covid, by preventing the most vulnerable from being hospitalised", he said. The UK regulator has licensed both for treating Covid, with molnupiravir the first to be given the green light, in November. Both have completed clinical trials and shown promising results at reducing the risk of serious illness or death. Launched in December, it already has 4,500 people signed up but needs 6,000 more as soon as possible. You can sign up at the study website now or your GP may contact you to ask you to participate if you test positive for Covid. Read full story Source: BBC News, 25 January 2022 -
News ArticleNew data from the US Centers for Disease Control and Prevention (CDC) has revealed that unvaccinated adults infected with Covid-19 who are 65 and older are 49 times more likely to need hospitalisation compared to those who have received booster doses. The CDC also found that in December, unvaccinated adults in that same age group experienced a rate of Covid-related hospitalisation 17 times higher than those who are fully vaccinated. For unvaccinated adults between 50 and 64, they are 44 times more likely to require hospitalisation compared with those who are immunised. In that same age group, unvaccinated adults were also 17 times more likely to experience Covid-related hospitalisation. According to the CDC, adults who are 65 and older and have received both doses of either the Pfizer or Moderna vaccine showed a 94% reduced risk of Covid-related hospitalisations. “Getting very sick means that older adults with Covid-19 might need hospitalization, intensive care, or a ventilator to help them breathe, or they might even die. The risk increases for people in their 50s and increases in 60s, 70s, and 80s. People 85 and older are the most likely to get very sick,” the CDC said on its website. “Get vaccinated as soon as possible,” the agency added. Read full story Source: The Guardian, 21 January 2022
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Content ArticleThe Homecare Association calls on central government to invest properly in homecare, so we can address unmet need, reduce inequalities, extend healthy life expectancy of older and disabled people and reduce pressure on the NHS. To gain an up-to-date view of the additional funding required for homecare to ensure an adequate supply of good quality, sustainable services, the Homecare Association submitted enquiries under Freedom of Information legislation to 340 public organisations which purchase homecare across the United Kingdom. These consisted of local authorities, Health and Social Care (HSC) Trusts in Northern Ireland and NHS bodies. Each public organisation was asked to provide several pieces of information, including the prices (lowest, highest, average) it pays to independent and voluntary sector homecare providers for the provision of regulated homecare services, delivered to people aged 65 years or above in their own home, during a sample week in April 2021. The Homecare Deficit 2021 report presents the analysis of the data received, and thus exposes the continued deficit in funding for homecare services in the United Kingdom.
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News Article
Neglect was one of biggest killers in care homes during pandemic, report finds
Patient Safety Learning posted a news article in News
The pandemic has disproportionately affected people living in care homes, who accounted for an estimated 30% of all deaths from covid-19 across 25 countries despite making up only 1% of the world’s population, a report has estimated. The analysis was carried out by Collateral Global, a research group that says it is dedicated to reporting on the effects of governments’ mandatory COVID-19 mitigation measures. The report said the pandemic had exacerbated long running problems in the care sector, such as chronic underfunding, poor structural organisation, staff undertraining, underskilling, and underequipping, and a “lack of humanity in dealing with the most vulnerable members of society.” “Neglect, thirst, and hunger were—and possibly still are—the biggest killers,” the group said. They also said that care home residents faced barriers in access to emergency treatments during the pandemic. The study authors suggested that undiagnosed COVID-19, poor testing, and inadequate staffing and infection control were the likely factors contributing to the excess deaths in care homes. Martin Green, chief executive officer of Care England, said, “Adult social care and the NHS are two sides of the same coin and need to be treated as such. The government shouldn’t have placed such a myopic focus on the NHS without due consideration for social care too.” He said that he was “phenomenally” proud of the care workforce and wanted to ensure that they were recognised as professionals with proper career pathways and commensurate funding. Read full story (paywalled) Source: The BMJ, 22 December 2021 -
News Article
Safety fears found at home where gran was killed
Patient Safety Learning posted a news article in News
A watchdog found there were safety concerns at a south-east London care home weeks after a resident killed a woman in her bedroom, it has emerged. Alexander Rawson, 63, beat 93-year-old Eileen Dean to death at Fieldside Care Home in Catford on 3 January. Inspectors visited the care home on 26 January after the murder of the grandmother-of-five triggered alarm about patient safety. Inspectors concluded that the home failed to record dangers properly and residents "were not always safe". Mrs Dean suffered catastrophic injuries after she was attacked by Rawson with a walking stick, about two weeks after he had been moved into the home from a mental health unit. According to the Local Democracy Reporting Service, the report said: "People were not always safe. The provider had not ensured risks to people were always documented and mitigated. "Risk assessments and care plans contained conflicting information which could potentially lead to people being exposed to harm." Specific concerns were also raised to the watchdog about the home's "risk management processes." The 63-year-old was sentenced to indefinite detention in a secure psychiatric unit on Monday. Read full story Source: BBC News, 22 November 2021 -
Content ArticleThis report examines the impact of the Covid-19 pandemic on people living with long-term conditions and highlights that many have deteriorated faster than usual due to being unable to access rehabilitation services. It makes recommendations to the government aimed at restoring rehabilitation support services. The report was produced collaboratively by The Alzheimer's Society, The Stroke Association, Macmillan Cancer Support, The Centre for Mental Health, Age UK, The College of Podiatry, The Royal College of Speech and Language Therapists, The Royal College of Occupational Therapists, The Chartered Society of Physiotherapy and The British Dietetic Association.
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Content Article
This blog calls for action on the careful review of established pain medication when a patient is admitted to hospital. Richard describes the experience of two elderly patients who suffered pain due to their long term medication being stopped when they were admitted to hospital. Pain control needs must not be ignored or undermined, there needs to be carer and patient involvement and their consent, and alternative pain control must be considered.- Posted
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Content ArticleThis white paper sets out the UK Government's 10-year vision for adult social care, and provides information on funded proposals that they will implement over the next three years. It highlights the factors that will cause an increase in demand for social care over the next decade and identifies stakeholders who the proposed changes to social care will affect. A key proposal in this white paper is the cap on how much individuals in England will contribute to their care costs from October 2023, which aims to make care costs predictable and limited.
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Content ArticleThe Extensive Care Service is part of the Fylde coast Vanguard and is designed for frail elderly patients with two or more long-term conditions who are at high-risk of an emergency admission. Working closely with patients, the service aims to assist them to improve their health and wellbeing; support them to manage their own conditions and provide effective interventions when needed in order to better manage exacerbations of their conditions. One of the key components of the care model is patient activation. The service teams’ understanding of an individual’s ability to contribute to the management of their own health and wellbeing is key to ensuring the success of this approach. The model is new, different and includes the development of a unique role - a ‘wellbeing support worker’. These individuals are a consistent feature in a model which enables a fuller understanding of a patient’s ‘activation’ ability so that engagement and support can be tailored appropriately.
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News Article
England has highest death rates of older patients in western world, study finds
Patient Safety Learning posted a news article in News
England has the highest death rates of frail and older hospitalised patients in the western world, a landmark global study has found. Harvard University, the London School of Economics (LSE) and the thinktank Health Foundation, all part of the International Collaborative on Costs, Outcomes and Needs in Care (Icconic), a global network of healthcare researchers, used thousands of official medical records to compare the cost and quality of care in 10 OECD (Organisation for Economic Co-operation and Development) countries. Patient deaths are commonly used measures of performance in healthcare systems but until now there have been few sources of comparable death rates across countries. In order to assess outcomes in frail and older patients, researchers focused on two groups that represent priority areas for the NHS and other healthcare systems: those in hospital with a hip fracture and those admitted with heart failure who have diabetes. On both measures, England had higher mortality rates than all the other countries, which included the US, Germany, France, Sweden and Spain. Dr Jennifer Dixon, the chief executive of the Health Foundation, said: “The findings of the Icconic study warrant urgent further investigation, particularly the finding of higher mortality among patients with hip fracture in the year after their admission for emergency treatment." “That patients in England with hip fracture spend far longer in hospital after surgery than they would in other countries also highlights an opportunity to improve efficiency by reducing the avoidable use of hospital care. Less avoidably long stays would mean existing capacity could be better used to address the backlogs in hospital care as a result of the pandemic. This could contribute to both better outcomes for patients and, as hip fracture is the most common reason for emergency surgery, significantly improved productivity for hospitals across the country.” Read full story Source: The Guardian, 10 November 2021
