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News Article
Stevens hits out at raft of ‘pound foolish’ government decisions
Patient Safety Learning posted a news article in News
‘Chronic short-termism’ by government is undermining the nation’s ability to respond to another pandemic, a previous NHS England chief executive has said. In his first written statement to the covid public inquiry, Lord Stevens said ministers had failed to upgrade NHS infrastructure and modernise social care, delayed public health improvements, and cut testing and research programmes. This is despite the 2023 national risk register identifying a further pandemic as the highest risk, with “5-25%pa Lord Stevens – NHSE CEO from 2014 to summer 2021 – said it was “encouraging the government has now permitted NHS England to publish a funded long-term workforce plan”, but added: “There is also a strong case for revisiting several other national decisions. “These include the dismantling of some community infection surveillance infrastructure; cancelling some scientific and clinical research programmes developed during the pandemic; postponing various preventative health measures; deferring reform of social care; and further delaying upgrades of health buildings, equipment and technology.” Read full story (paywalled) Source: HSJ, 3 November 2023 -
News Article
Martha’s rule must be available 24/7, England’s patient safety commissioner says
Patient Safety Learning posted a news article in News
Patients and their relatives will be able to request a second opinion from senior medics around the clock when the “Martha’s rule” system starts in hospitals in England. The government’s patient safety commissioner, asked by the health secretary, Steve Barclay, to advise on how to implement the change, has said access to a medic’s opinion must operate 24/7. Dr Henrietta Hughes made clear to Barclay in a letter that inpatients and families worried that their loved one’s health is deteriorating should be able to seek a second opinion at any time of day or night. In her letter, which she published on Wednesday, Hughes also said the availability of that service must be widely advertised in hospitals, so patients know they can use it. She told Barclay that all staff in acute and specialist medical NHS trusts in England “must have 24/7 access to a rapid review from a critical care outreach team who they can contact should they have concerns about a patient”. Hughes added: “All patients, their families, carers and advocates must also have access to the same 24/7 rapid review from a critical care outreach team which they can contact via mechanisms advertised around the hospital and more widely if they are worried about the patient’s condition. This is Martha’s rule.” Read full story Source: The Guardian, 3 November 2023 -
News Article
Pritchard warns strikes threaten elective targets and safety
Patient Safety Learning posted a news article in News
NHS England boss Amanda Pritchard has warned that meeting key elective recovery targets to eliminate 65-week waiters by March and ensure the waiting list is falling by next year is becoming “increasingly challenging”. Ms Pritchard also re-emphasised concerns already expressed by NHS England that “if strikes continue into winter, it will be extremely difficult for us to provide safe care to our patients, particularly with a twindemic of covid and flu”. The NHSE boss was asked by HSJ at the King’s Fund’s annual conference on Thursday how confident she was about the NHS achieving its next elective recovery target on 65-week waiters and the prime minister’s pledge in January to reduce overall waiting lists. Ms Pritchard said: “We are really encouraged that there are talks under way between the government and the British Medical Association but clearly having had the level of disruption over the last 10 months of industrial action, we have seen really significant challenge on maintaining focus on reducing both long waits and on tackling overall waiting list size.” She said that on weeks when there were no strikes, waiting lists reduced, and there had been sustained progress on cutting long waiters “despite the pressures of industrial action”. She praised the “extraordinary amount of focus and creativity from NHS staff” to achieve this. But she added: “[There has to be] a real recognition that with ongoing industrial action [reducing long waiters and the overall list] is going to be an increasingly challenging target.” Read full story Source: HSJ, 3 November 2023 -
News Article
Children's health warning system rolled out by NHS
Patient Safety Learning posted a news article in News
NHS England is rolling out a national early-warning system to help medics spot and treat a deteriorating child patient quickly - and act on parents' concerns. Parents and carers are "at the heart of the new system", NHS chiefs say. Scores for signs such as blood pressure, heart rate and oxygen levels will be tracked on a chart. But if a parent is worried their child is sicker than the chart suggests, care will be rapidly escalated. While similar systems already exist in many hospitals, NHS national medical director, Prof Sir Stephen Powis, said staff and patients alike would welcome the introduction of a standardised system across hospitals. "We know that nobody can spot the signs of a child getting sicker better than their parents, which is why we have ensured that the concerns of families and carers are right at the heart of this new system, with immediate escalation in a child's care if they raise concerns and plans to incorporate the right to a second opinion as the system develops further," he said. The rollout follows the patient safety commissioner, Dr Henrietta Hughes, recommending that Martha's rule is delivered across England's hospitals, giving patients and families the right to an urgent second opinion and rapid review from a critical care team if they are worried about a patient's condition. Read full story Source: BBC News, 3 November 2023 -
Content Article
Roger Kline's writings
Patient Safety Learning posted an article in Suggest a useful website
Roger Kline is a research fellow at Middlesex University Business School prior to which he held senior positions in eight UK trade unions. Roger has an extensive knowledge and experience of workplace culture, primarily in the public sector. On his web page you can find a selection of his published papers, books and blogs. -
News ArticleChildren feel they have to attempt suicide multiple times before they get treatment from NHS mental health services, the former children’s commissioner has warned. Anne Longfield said that schoolchildren were aware that NHS mental health infrastructure was “buckling and far from being able to cope with the demand”. She told the Times Health Commission: “When I first became children’s commissioner in 2015, the thing that children talked about most often was mental health. They said they knew they couldn’t get help and treatment easily, because there just wasn’t enough help to go around. “Some said, we know that we’ve almost got to try and take our own life before we can get help. And I thought that was pretty shocking at the time. Now, young people are saying not only do they have to try to take their own life, they have to try and take their own life several times, and they say there will be an assessment of levels of intent within that.” Read full story Source: The Times, 1 November 2023
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News Article
‘Short termism’ is undermining NHS savings and safety, warns CEO
Patient Safety Learning posted a news article in News
The government must allow health systems to plan their finances over a longer period to help deliver ‘real’ savings by rationalising services, says a leading chief executive. Kevin McGee, who recently stepped down from Lancashire Teaching Hospitals, said the “short-termism” baked into the annual NHS budget cycle is a major source of frustration for local leaders. Many trusts and systems have struggled to deliver their financial plans this year due to the savings required, and Mr McGee warned that continuing to “salami slice” the budgets will exacerbate patient safety risks. He said Lancashire and many other systems urgently need to rationalise and consolidate acute services on fewer sites, which would bring significant cost savings. However, changes such as these can often take years to plan and implement. Read full story (paywalled) Source: HSJ, 1 November 2023 -
News Article
Black and Asian people find it harder to access NHS mental health services
Patient Safety Learning posted a news article in News
Black, Asian and minority ethnic people experience longer waiting times, and are less likely to be in recovery after treatment, when accessing NHS mental health services compared with their white counterparts, a report has found. The research looked at 10 years’ worth of anonymised patient data from NHS Talking Therapies, formerly known as Improving Access to Psychological Therapies – an NHS programme that launched in 2008 to improve patient access to NHS mental health services. A total of 1.2 million people accessed NHS Talking Therapies services in 2021-22, and by 2024 the programme aims to help 1.9 million people in England with anxiety or depression to access treatment. The report, Ethnic Inequalities in Improving Access to Psychological Therapies, commissioned by the NHS Race and Health Observatory and undertaken by the National Collaborating Centre for Mental Health, found that people from black and minority ethnic backgrounds were less likely to go on to have at least one treatment session, despite having been referred by their GP, than their white counterparts. Dr Lade Smith, the president of the Royal College of Psychiatrists, said: “For far too long we have known that people from minoritised ethnic groups don’t get the mental healthcare they need. This review confirms, despite some improvements, it remains that access, experience and outcomes of talking therapies absolutely must get better, especially for Bangladeshi people. “There is progress, particularly for people from black African backgrounds, if they can get into therapy, but getting therapy in the first place continues to be difficult. This review provides clear recommendations about how to build on the improvements seen. I hope that decision-makers, system leaders and practitioners will act on these findings.” Read full story Source: The Guardian, 1 November 2023 -
Content ArticleAn independent review from the NHS Race & Health Observatory of services provided by NHS Talking Therapies has identified that psychotherapy services need better tailoring to meet the needs of Black and minoritised ethnic groups.
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News Article
Patients waiting months could travel for treatment
Patient Safety Learning posted a news article in News
Patients who have been waiting more than 40 weeks for treatment in England will be offered the option of getting seen in another part of the country. About 400,000 will be contacted in the coming weeks and asked whether they would be willing to travel and how far. Patients already have a right to ask for treatment elsewhere. But NHS England believes that by proactively contacting the longest waiters they will help unlock some of the worst bottlenecks in the system. Only those who do not have an appointment already scheduled within the next eight weeks will receive the offer via text, email or letter. The 400,000 figure represents about 5% of the total number waiting for treatment. If a patient is happy to travel, the treatment could either be in an NHS or private sector hospital. Those on low incomes will be entitled to some financial support to enable them to travel for treatment. Patients will retain their place on the waiting list at their local hospital while other options are explored. Read full story Source: BBC News, 31 October 2023 -
News Article
Parents of babies who died or were harmed in NHS care demand inquiry
Patient Safety Learning posted a news article in News
Parents of babies who have died or been harmed as a result of poor care are demanding that ministers order a public inquiry into repeated failings in NHS maternity units. They want Steve Barclay, the health secretary, to set up a judge-led statutory inquiry to investigate recurring problems in maternity services, which cost the NHS in England £2.6bn a year in damages. Babies are still being damaged and dying, despite previous inquiries into maternity scandals at the Morecambe Bay, Shrewsbury and Telford, and East Kent NHS trusts recommending changes. The NHS’s failure to improve maternity safety is so alarming that a public inquiry is needed to finally ensure that women and babies no longer come to harm, the families say. The Maternity Safety Alliance, a group of relatives of newborns who have died due to lapses in NHS childbirth, warned that scandals will continue unless such an inquiry is held. “Our babies are too precious to keep on ignoring the reality that despite a raft of national initiatives and policies implemented in the wake of investigations and reports, systemic issues continue to adversely impact on the care of women and babies. “Far too much avoidable harm continues to devastate lives in circumstances that could and should be avoided. Fundamental reform is needed,” they said in a letter urging Barclay to intervene. Read full story Source: The Guardian, 31 October 2023 -
News ArticleFormer BBC Technology correspondent Rory Cellan-Jones, now a writer and podcaster, has Parkinson's disease. Two weeks ago, after fracturing his elbow in a nasty fall, he found out just how difficult it can be to get answers from the NHS. "Getting information about one's treatment seems like an obstacle race where the system is always one step ahead. But communication between medical staff within and between hospitals also appears hopelessly inadequate, with the gulf between doctors and nurses particularly acute. "I also sense that, in some cases, new computer systems are slowing not speeding information through the system. On Saturday morning, as we waited in the surgical assessment unit, four nurses gathered around a computer screen while a fifth explained to them all the steps needed to check-in a patient and get them into a bed. It took about 20 minutes and appeared to be akin to mastering some complex video game beset with bear traps." Rory's latest experience as a customer of the health service has left him convinced that more money and more staff won't solve its problems without some fundamental changes in the way it communicates. Read full story Source: BBC News, 29 October 2023
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Content ArticleNew analysis by the Health Foundation shows that, if current trends continue, the waiting list for routine hospital treatment (‘elective care’) in England could rise to over 8 million by next summer, regardless of whether NHS industrial action continues. The analysis models four different future scenarios to look at the prospects for reducing the waiting list by the end of 2024. It shows that, on current trends, the waiting list could peak at 8 million by August 2024 if there is no further strike action, before starting to fall. If strike action were to continue the waiting list could be 180,000 higher. The analysis finds that industrial action by consultants and junior doctors has so far lengthened the waiting list by around 210,000, just 3% of the overall size of the list, which totalled 7.75 million at the end of August 2023. The analysis also points out that strikes are also likely to have indirect impacts, by squeezing NHS finances and diverting management attention away from productivity improvement. The analysis, which features an interactive ‘waiting list calculator’, also includes illustrative better and worse case scenarios.
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News Article
Performance of vital demand management service collapses
Patient Safety Learning posted a news article in News
The performance of one of the NHS’s flagship strategies to reduce demand on over-stretched hospitals has collapsed, HSJ can reveal. Internal NHS figures show the number of processed advice and guidance requests (A&G) from GPs to hospital consultants fell by 28% between June and August, alongside a 32% fall in the number of processed cases where patients were diverted away from secondary care. This comes despite the overall number of A&G requests from GPs only falling by 5% in the same period. A&G services allow GPs to contact hospital consultants before making a referral in order to ensure only clinically appropriate patients are referred to secondary care. The model is described by NHS England as a ”a key part of the National Elective Care Recovery and Transformation Programme’s work.” The data showing the fall in processed requests and diversions from secondary care came from NHSE’s specialist advice activity dashboard, which HSJ has seen. Read full story (paywalled) Source: HSJ, 26 October 2023 -
News ArticleRishi Sunak is “highly unlikely” to meet his promise to cut NHS waiting lists, health leaders have warned, as a “sobering” analysis suggests the backlog will rise to 8 million and won’t begin to fall until next summer. The prime minister vowed in January that “NHS waiting lists will fall” as he outlined five pledges upon which he staked his premiership. The backlog was 7.2 million at the time. It is now 7.75 million, the highest since records began in 2007. But a grim report published today by the Health Foundation, an independent thinktank, will pile further pressure on Sunak over the NHS. The 15-page analysis predicts that the waiting list for hospital treatment in England will continue to rise for at least 10 months and ultimately top 8 million, regardless of whether or not strikes continue. The thinktank modelled four different scenarios and concluded that, based on current trends, NHS waiting list figures could peak by August 2024 if there was no more strike action by healthcare workers, before starting to come down. If strikes were to continue, the list could increase a further 180,000, it said. Matthew Taylor, the chief executive of the NHS Confederation, said: “This analysis all but confirms that the prime minister’s pledge to reduce the size of the waiting list is increasingly unlikely to be met.” He added: “As the Health Foundation report rightly says, the root cause of the delays to treatment that patients are now experiencing is a decade of underinvestment in the NHS.” Read full story Source: The Guardian, 27 October 2023
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News ArticleNo senior NHS England director is prepared to take responsibility for ADHD services — which are facing waits of up to a decade and severe medication shortages — HSJ has discovered. Despite soaring demand for assessments and widespread drug shortages recently triggering a national patient safety alert, responsibility for attention-deficit/hyperactivity disorder services does not sit within any NHS England directorate. HSJ understands that none of NHSE’s mental health, learning disability, or autism programmes have been given any resources for ADHD. It is also claimed that the medical and long-term conditions teams “are not very interested” in taking responsibility, and “assumed someone else was doing it”. A senior source, very close to the issue, told HSJ that no NHS senior director had taken “ownership” of the issue, and there was a widespread misapprehension that responsibility for ADHD services was part of the autism remit given to the mental health directorate. “We haven’t got the attention we need around ADHD,” said the source, “we need a [dedicated] neurodiversity programme.” Read full story (paywalled) Source: HSJ, 26 October 2023
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News Article
Four trusts report quarter of all ‘critical incidents’
Patient Safety Learning posted a news article in News
More than a quarter of ‘critical incidents’ have been declared by just four trusts since the start of the crisis in urgent and emergency care. Data obtained by HSJ shows 241 critical incidents have been declared by organisations due to “operational” or “system pressures” between April 2021, when long waits for urgent care began to surge upwards, and last month. Four trusts account for 68 of these (28%). Critical incidents are declared when the level of disruption “results in an organisation temporarily or permanently losing its ability to deliver critical services, or where patients and staff may be at risk of harm”. These incidents may require “special measures and support from other agencies, to restore normal operating functions,” according to the NHS England definition. Most critical incidents were only in place for a few days before being stood down by the trust or system, but some were in place for much longer – sometimes for several months at a time, the data suggests. Read full story (paywalled) Source: HSJ, 25 October 2023 -
News Article
Jasper Brooks inquest: Baby died due to 'neglect' at hospital
Patient Safety Learning posted a news article in News
A coroner has found neglect contributed to a baby's death at the hospital where he was born. Jasper Brooks died at the Darent Valley Hospital in Kent on 15 April 2021. The coroner found gross failures by midwives and consultants at the hospital and says Jasper's death was "wholly avoidable". Jasper was a second child for Jim and Phoebe Brooks. Due to a complication during pregnancy of her first child, Phoebe was booked in to have an elective Caesarean section to deliver Jasper. But in April 2021 those plans changed overnight. A check-up found Phoebe had raised blood pressure. She was told to remain in hospital and that the C-section would happen the following morning - nine days earlier than planned - when there were more staff on duty. Jasper's parents say the midwives caring for Phoebe repeatedly failed to listen to her and Jim's concerns - that she was shaking violently, feeling sick, and thought she was bleeding internally. "We felt like an inconvenience - no-one wanted to deal with me that night," Phoebe says. "The doctor didn't want to do my C-section, the midwife that's meant to be looking after me, she just doesn't really care. "I remember saying clearly to her, 'my whole body is shaking - something's happening, and no-one's taking the time to listen to what I'm saying or listen in on my baby'." At the inquest hearing, midwife Jennifer Davis was accused by the family's barrister, Richard Baker KC, of "failing to act on signs of blood loss, failing to determine if Phoebe was in active labour, and failing to call a senior doctor when necessary". Jasper was born without a heartbeat, so a resuscitation team was called. But during the inquest, the family learned that further errors were made because the correct people failed to attend the resuscitation. There was no consultant neonatologist on site - a doctor with expertise in looking after newborn infants or those born prematurely. Intubation, the process of placing a breathing tube into the windpipe - which should only take a few minutes - did not occur for 18 minutes. There was also a delay in administering adrenaline to try to stimulate Jasper's heart. Read full story Source BBC News, 24 October 2023 -
News Article
East Kent NHS Trust: Lessons not learned at maternity trust, mum says
Patient Safety Learning posted a news article in News
Lessons still have not been learned at a Kent hospital trust which was criticised in a damning report, a mother has said. Dr Bill Kirkup's review found at least 45 babies might have survived with better care at East Kent NHS hospitals. Victoria, whose six-year-old daughter needs 24-hour support, said: "I've had no contact from anyone from the trust." Her case was one of 202 that were examined by Dr Kirkup in his report, which was published exactly a year ago. Victoria, whose daughter is living with the consequences of failings in her care during her birth, said: "Our children have become unwell because of what has happened to them. "I don't feel lessons have been learned whatsoever. "Treatment hadn't been made available as easily as it should have done for children that are still living this experience every day." Read full story Source: BBC News, 19 October 2023 -
Content ArticleNHS colleagues are working hard to restore elective care, but data shows that activity for children and young people (CYP) is still below pre-pandemic levels and recovery remains behind rates seen in adult services. The specialties of ENT, dental services, ophthalmology, urology, and trauma and orthopaedics (including spinal surgery) are especially challenged, with the longest waiting lists for surgery for young patients. Getting It Right First Time (GIRFT) has supported NHS England’s drive for CYP elective recovery by developing concise guidance –Closing the gap: Actions to reduce waiting times for children and young people – offering ten actions which can help reduce waiting times for children, as well as quick links to data, resources and best practice case studies. The ten actions address how to improve theatre capacity, increase theatre utilisation and streamline pathways of care, and include practical measure such as adding extra sessions or ‘super events’ for children’s surgery, avoiding procedures of limited medical benefit by using clinical decision tools, and staggering children’s admission times. The guidance links to a series of case studies demonstrating how teams across England have taken innovative measures to address their waiting times.
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News Article
Two-thirds of England’s maternity units dangerously substandard, says CQC
Patient Safety Learning posted a news article in News
Almost two-thirds of maternity units provide dangerously substandard care that puts women and babies at risk, the NHS watchdog has said in a damning report. The Care Quality Commission (CQC) has rated 65% of maternity services in England as either “inadequate” or “requires improvement” for the safety of care – up from 54% last year. Services are beset by a host of problems, including serious staff shortages and internal tensions, which mean that too many mothers and their babies receive care that is not good enough, it said. Women too often face delays in accessing care, do not receive the one-to-one care from a midwife to which they are entitled or experience communication problems with staff looking after them, including being shouted at by midwives. The CQC judged overall quality of care to be inadequate or require improvement at 85 maternity units, almost as many at which it rated it to be either good or outstanding – 87. The number of units offering substandard care has soared by 30 in the last year, from 55 to 85. It said that, having inspected 73% of all maternity units, “the overarching picture is one of a service and staff under huge pressure. People have described staff going above and beyond for women and other people using maternity services and their families in the face of this pressure. “However, many are still not receiving the safe, high-quality care that they deserve.” Read full story Source: The Guardian, 20 October 2023 -
Content Article
CQC: State of Care 2022/23
Patient Safety Learning posted an article in Care Quality Commission (CQC)
The Care Quality Commission (CQC) State of Care is an annual assessment of health care and social care in England. The report looks at the trends, shares examples of good and outstanding care, and highlights where care needs to improve. -
News ArticleFinancial directors need to take responsibility for safety, which should be at the core of how the NHS runs services, the leadership of the Health Services Safety Investigations Body (HSSIB) said at its launch Wednesday. The Healthcare Safety Investigation Branch is now an independent body – and has been renamed HSSIB – although maternity investigations are hosted by the Care Quality Commission. Questioning how many finance directors across the NHS take responsibility for safety, HSSIB’s interim chief investigator Rosie Benneyworth said: “We need a position where finance directors in every organisation are as responsible for safety as the person leading the safety agenda and vice versa, the safety person works with the finance agenda to support them. “Often you see the finance director and safety lead don’t work effectively together and we need to change that.” Dr Benneyworth said progress will not be made unless operational delivery, financial delivery and safety are tackled “in the same breath”. HSSIB’s new chair Ted Baker also called for safety to become a core part of running services “in the way running the accounts is”, as it is currently still seen “as an add-on”. He stressed that safety “drives efficiencies, enables innovation and saves costs”. Read full story (paywalled) Source: HSJ, 19 October 2023
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News Article
Two trusts to miss deadline for eliminating ‘distressing’ wards
Patient Safety Learning posted a news article in News
At least two trusts are set to fall short on a high-profile pledge to eradicate ‘dormitory’ style wards in mental health facilities, with delays caused by cost pressures and shortage of materials and labour. In 2020, ministers said more than 1,200 beds in mental health dormitories across more than 50 sites would be replaced with single, en-suite accommodation by March 2025. Around £400m was allocated to achieve this. However, information gathered by HSJ via freedom of information requests suggests there will be at least 37 dormitory beds still in use beyond that date. In 2018, the Care Quality Commission said: “In the 21st century, patients, many of whom have not agreed to admission, should not be expected to share sleeping accommodation with strangers, some of whom may be agitated”. Patients have told HSJ they felt “distressed”, “unsafe” and “intimidated” on dormitory style wards. Leaders of trusts impacted by delays told HSJ of rising cost pressures, shortages of construction materials and availability of labour. Read full story (paywalled) Source: HSJ, 17 October 2023 -
News Article
Patient declared dead woke up in hospital
Patient Safety Learning posted a news article in News
An ambulance trust has apologised after a patient who was declared "dead" later woke up in hospital. As first reported by The Northern Echo, the individual was taken by paramedics to Darlington Memorial Hospital on Friday. The newspaper reported they had been declared dead following an incident earlier that day. The North East Ambulance Service (NEAS) apologised to the patient's family and said an inquiry had begun. The patient has not been identified or their current condition revealed. NEAS director of paramedicine Andrew Hodge said: "As soon as we were made aware of this incident, we opened an investigation and contacted the patient's family. "We are deeply sorry for the distress that this has caused them. "A full review of this incident is being undertaken and we are unable to comment any further at this stage. "The colleagues involved are being supported appropriately and we will not be commenting further about any individuals at this point." Read full story Source: BBC News, 17 October 2023
