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Content ArticleAfter a decade of austerity, The NHS Long Term Plan was meant to be a turning point for healthcare. However, those plans have been severely disrupted by the coronavirus pandemic. New analysis from the Institute for Public Policy Research shows the scale of the damage done by the pandemic across several major health conditions. It recommends a package of six ambitious changes to ‘build back better’. These policies are designed to do three things. First, they intend to ensure the pandemic does not cause lasting damage to healthcare services for future generations. Second, they look to bring in areas – like social care and public health – that are not covered in The NHS Long Term Plan, but which COVID-19 has harshly reminded us are integral to healthcare. Third, they look to capture the innovations that occurred during the pandemic.
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News ArticleThe NHS is to spend almost £100m to make maternity units across the NHS safer for mothers and babies in a major victory for families and The Independent – which has been campaigning for better training for midwives and doctors. NHS England announced the investment on Thursday in response to the care scandal at the Shrewsbury and Telford Hospital Trust. As well as boosting the numbers of midwives and doctors on wards, NHS England said the money would include an extra £26.5m for safety training for midwives and doctors across England. The £96m represents one of the biggest investments in maternity services for decades. A total of £46m will be to used to recruit 1,000 extra midwives along with £10m for the equivalent of 80 extra doctors. As well as training cash will also be used to create new roles to oversee trusts safety and help recruit staff from overseas. The investment is a direct response to the poor care at the Shrewsbury and Telford Hospital Trust where The Independent revealed in 2019 that dozens of babies and mothers had died or been left brain damaged as a result of persistent poor care over decades. An inquiry is examining more than 1,860 cases, making it the largest maternity scandal in NHS history. Read full story Source: The Independent, 25 March 2021
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Content ArticleGP practices are usually run separately from hospitals. In some places in England and Wales, the NHS organisations responsible for managing hospitals are now also running local GP practices. It is difficult in some areas for practices, which are small organisations, to recruit GPs and keep going. It is also desirable to coordinate GP services with hospital care. For these reasons, it may help if the organisations managing hospitals also run GP practices.
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Content ArticleIn 2020, the Scottish Government announced a National Review of Eating Disorder Services. This report has now been published and highlights inconsistent access to eating disorder services in Scotland and the need for greater support. All 15 detailed recommendations laid out in the review will be taken forward by an implementation group of relevant stakeholders, guided by a lived experience panel, including patients, their families and loved ones, and third sector representatives. Recommendations are categorised as follows: Recommendation 1: Covid-19 response Recommendation 2: Implementation planning Recommendation 3: Coordination of national activity and data collection Recommendation 4: Lived Experienced Panel Recommendation 5: Public health Recommendation 6: Self-help resources available to all Recommendation 7: Early Intervention Recommendation 8: Primary care Recommendation 9: Safe medical care Recommendation 10: Investment in specialist eating disorder services Recommendation 11: Workforce Recommendation 12: Education and Training Recommendation 13: Families and carers Recommendation 14: Inpatient eating disorder services Recommendation 15: Eating disorders research in Scotland. To read the full review, follow the link below.
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Content ArticleOn Thursday 18 March, the G20 Health and Development Partnership in collaboration with RLDatix held an Online Panel Discussion for the launch of the International Patient Safety Report: ‘The Overlooked Pandemic – How to Transform Patient Safety and Save Healthcare Systems’.
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Content ArticleAs part of the NHS family, NHS Supply Chain is prioritising patient and user safety as a core part of their approach to supplying clinical products to the NHS by raising standards and effective partnership working. Jonathan Devereux, Head of Safety and Innovation, heads up a small team focused on driving proactive action on safety complaints, building an innovation pathway and ensuring they drive safety into the agenda for future procurement. In this article for the National Health Executive he explains the work the clinical and product assurance team are doing.
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Content ArticleAt the recent Future of Hospitals event from Health Plus Care Online, Helen Hughes (CEO, Patient Safety Learning) Jenny Davidson (Director of Governance, King Edward VII’s Hospital) and Natasha Swinscoe (CEO, West of England AHSN) discuss some of the key current patient safety issues, challenges, and opportunities in the context the pandemic and beyond. They explore how the healthcare system has responded to COVID-19, reflecting on emerging innovations and new patient safety challenges. They consider the long-term impact of the pandemic on patient safety and on non-COVID-19 care and support.
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Content ArticleIn my tweets and posts I have suggested that patients themselves need to take more responsibility for the medicines they are prescribed. But what about vulnerable groups who may depend on decisions being made for them, and in their best interests? Whilst there are circumstances where antipsychotic (psychotropic) medicines are an appropriate option for people with autism and learning disabilities, these occasions are limited. In all cases the patient matters most, and any decision to prescribe must be part of a team based, patient-led decision, which is regularly reviewed.
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Content ArticleWe need a twin track approach in workforce planning – one for the medium-term and other for the long-term – writes Rob Smith, Director of Workforce Planning and Intelligence, Health Education England, in this HSJ article.
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Content ArticleThe Health Systems in Transition (HiT) profiles are country-based reports that provide a detailed description of a health system, and of reform and policy initiatives in progress or under development in a specific country. Here is the HiT profile for Japan.
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News Article
NHS reforms risk sowing confusion and undermining safety, MPs warned
Patient Safety Learning posted a news article in News
A bid for more control over the NHS by ministers risks undermining patient safety and sowing confusion over who is ultimately responsible for services, MPs have been warned. The Commons Health Select Committee was told the proposals, set out in a new white paper published last month, lacked detail on the involvement of patients in local services and needed urgent clarification of the new powers the health secretary will have. The plans will give ministers new powers over the independent Healthcare Safety Investigation Branch (HSIB), including being able to tell it what to investigate and the power to remove protections for NHS staff who give evidence in secret. Last week experts warned the plans for HSIB could undermine its role and have lasting consequences on efforts to encourage NHS staff to be honest about errors. Under the proposals the health secretary would be able to remove so-called “safe space” protections for evidence given by NHS workers. Chris Hopson, chief executive of NHS Providers, told the committee hospitals were worried about the plans. He said: “We are very nervous about this relationship between the secretary of state and HSIB. In order for it to be an effective independent organisation, it does need to be free from the appearance of any kind of political control. There's a very high degree of nervousness about the ability to somehow switch safe space on and off. People need to know where they stand.” Read full story Source: The Independent, 2 March 2021 -
Content ArticleThis article from the King's Fund examines the differences in health outcomes for ethnic minority groups, highlighting the variation across groups and conditions, and considers what’s needed to reduce health inequalities.
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Event
The Future of Hospitals Event 2021
Patient Safety Learning posted an event in Community Calendar
untilThe Prime Minister recently announced a funding package worth £3.7 billion to build 40 hospitals by 2030 in the biggest hospital building programme in a generation. The Health Infrastructure Plan will also provide capital to modernise diagnostics and technology and help eradicate critical safety issues in the NHS. The scale of the impact of the COVID-19 pandemic has caused big shifts in the way hospitals deliver services. The NHS has had to mobilise to respond to the acute needs of people infected with the virus whilst at the same time scaling back non-COVID-19 healthcare. Services have had to be rapidly re-designed on a large scale to release capacity for treating patients with COVID-19. With the development of a Health and Care Bill that looks to build on the innovation and integration seen during COVID-19, healthcare professionals will have to balance providing care during a pandemic with systemic and transformational change across the system. This unique event from the Institute of Government & Public Policy examines the current and future state of NHS hospitals and the impact of COVD-19. It takes a close look at all the vital components that make up NHS acute care including patient safety, workforce, infection control, standards, funding, estates, and emergency care. Hear a combination of policy updates and best practice case studies from a wide variety of organisations within acute healthcare. Patient Safety Learning's Helen Hughes will be one of the presenters at the event. Register -
Content ArticleThe Natasha Allergy Research Foundation (NARF) has added its voice to a chorus of growing safety concerns about the rise in businesses operating out of people’s homes. NARF said urgent government intervention on food safety standards is required to deal with the subject that has gained increased attention during the coronavirus pandemic. Tanya Ednan-Laperouse, founder of Natasha’s Foundation, said the emergence of tens of thousands of at-home and dark kitchens during the COVID-19 pandemic raises fears about food safety, particularly for the two million plus people in the UK who have food allergies. “...we need ministerial intervention, laws to ensure businesses are regulated, inspected and rated, and an urgent commitment to boost resources targeted at food safety. The cost of failure for many families will be too high.” The Foundation was set up by the parents of Natasha Ednan-Laperouse who died in 2016 after an allergic reaction to sesame in a baguette. It has been instrumental in new labeling legislation, called Natasha’s Law, that will come into force in the UK beginning in October.
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Event
Reducing variation in healthcare services
Sam posted an event in Community Calendar
untilThere are many sources of variation in healthcare that can affect the flow of patients through care systems. Reducing and managing variation enables systems to become more predictable and easier to manage so allowing improvement of quality and safety. To effect successful service improvements, you need to understand the source of variation and use a range of tools to reduce and manage it. This pandemic has provoked the best of human compassion and solidarity, but those who manage our health systems still face extraordinary challenges responding to COVID-19. Looking beyond the crisis, our collective learning about the effects of the large falls in healthcare use can help inform and intensify efforts to reduce unnecessary care. The aim of this webinar is to build a culture of collaborative working across the healthcare workforce and reduce variation to prevent avoidable harm to patients, enhance healthcare equity, and improve the sustainability of health systems everywhere. Register -
News Article
Key NHS long-term plan target to be missed ‘due to covid’
Patient Safety Learning posted a news article in News
The NHS is set to miss a major national target to eliminate inappropriate out of area placements within mental health by the end of March, HSJ can reveal. At least eight of the 52 English NHS mental health trusts surveyed by HSJ are predicting they will miss the national deadline of getting rid of their inappropriate OAPs by the end of next month. The national target was one of the headline mental health pledges set out in 2014’s Five Year Forward View. The pledge was also in 2019’s long-term plan. Inappropriate OAPs refer to people being sent out of their region to an inpatient mental health bed if no beds are available within their area. Patients are regularly sent hundreds of miles away from their homes. Read full story (paywalled) Source: HSJ, 23 February 2021 -
Content ArticleIn the latest Patient Safety Watch newsletter, Jeremy Hunt interviews Aidan Fowler on his role as National Director for Patient Safety, the impact the new health and care bill will have on patient safety, and his personal wish list for the next couple of years. (Interview appears at the end of the newsletter.)
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News Article
Sharp drop in patient goodwill towards NHS since autumn
Patient Safety Learning posted a news article in News
Patient positivity about NHS hospital services suffered a sharp drop during the autumn, and satisfaction with access is now well below pre-pandemic levels, according to analysis exclusively shared with HSJ. The analysis of social media and online sentiment by PEP Health appears to show that a surge of goodwill towards the health service during the first covid peak last spring dissipated last autumn. At that time, the first-wave peak had passed, but hospitals were getting a lot busier — with more emergency attendances, and efforts to get planned appointments and procedures back close to normal levels. Emergency departments were coming under strain, coping with infection control measures, and large numbers of very long waits for elective care had built up. The drop in positive feeling towards NHS hospitals was particularly felt between October and January, especially with concerns over the speed of access to health services. The work only covers acute hospital services. One hospital chief executive told HSJ the change in patient sentiment was palpable at the frontline. “There is quite a lot of chippiness from patients and relatives. The ‘we love the NHS’ feels a very long lost memory. “We see a lot of chippiness to staff, and aggression and irritability — which is understandable because everyone’s been waiting a long time — but is really unhelpful because everyone [staff are] knackered and trying to do their best.” Read full story (paywalled) Source: HSJ, 22 February 2021 -
News Article
The NHS rose to the challenge of Covid, but its next test may be even harder
Patient Safety Learning posted a news article in News
Over the past year, our NHS has risen to the challenges of the pandemic. But it’s been a very close-run thing. There have been well-publicised difficulties such as the shortage of ventilators, ICU beds and PPE, and the physical and staffing capacity of the health service has been strained to breaking point. GPs have managed the risks to patients who have been unable to receive specialist care. We now face a growing backlog of postponed treatments and emerging mental health issues. So if we were to imagine a post-Covid NHS, toughened by the challenges of the pandemic but better prepared for the future, what would it look like? To ensure the health service is capable of meeting the challenges it will face in the next decade and beyond, it will require both structural and local reforms. The word “reform” triggers unease among many NHS professionals, who have been subject to numerous reorganisations over the years and have witnessed efforts being diverted into reforms at the expense of improving patient care. While some of the changes in the recent NHS white paper seem sensible, their effectiveness will depend on the final detail. To ensure the focus remains on patients, all policy reforms and local changes should convincingly pass at least one of these six tests: Will they reduce demand on the NHS by preventing disease or improving wellbeing? Will they speed up the time between a patient seeking help and receiving treatment? Will they enhance patient safety before, during or after treatment? Will they enable better clinical outcomes? Will they provide better taxpayer value? And will they reduce the inequality of access that has resulted in some groups receiving less care than others? Read full story Source: The Guardian, 18 February 2021 -
Content ArticlePrevention of Future Deaths Reports (PFDs) made by coroners to address concerns arising from inquests can provide powerful leverage for change, although the reality is that health and social care organisations would generally rather avoid a PFD if possible because they also highlight - in a very public way - concerns about how their services operate which can, in turn, lead to further regulatory scrutiny, principally from the CQC. The need for more consistency in terms of thresholds for making PFDs and the form these take, plus the Chief Coroner’s strong commitment to ensuring that PFDs do what they are designed to do - i.e. harness learning from deaths - have been key drivers behind a recent re-vamping of the existing Chief Coroner’s guidance note on this. What do health and social care organisations need to know about the revised PFD guidance? This briefing looks in more detail about what’s changed (and what hasn’t).
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EventuntilThere are many sources of variation in healthcare that can affect the flow of patients through care systems. Reducing and managing variation enables systems to become more predictable and easier to manage so allowing improvement of quality and safety. To effect successful service improvements, you need to understand the source of variation and use a range of tools to reduce and manage it. This pandemic has provoked the best of human compassion and solidarity, but those who manage our health systems still face extraordinary challenges responding to COVID-19. Looking beyond the crisis, our collective learning about the effects of the large falls in healthcare use can help inform and intensify efforts to reduce unnecessary care. The aim of this webinar from GovConnect is to build a culture of collaborative working across the healthcare workforce and reduce variation to prevent avoidable harm to patients, enhance healthcare equity, and improve the sustainability of health systems everywhere. Register
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Content ArticleUrgent action is needed in the NHS to meet a ballooning backlog of procedures put on hold during the pandemic and build a more resilient health care system. This report from Reform, produced jointly with Edge Health, shows the scale of the challenges the NHS faces: 6 million fewer patients were referred to treatment in 2020 than in 2019 • 10 million patients could be on a waitlist by April By April, 52-week waits for care are projected to have risen 12,008% since March 2020 (by December they had already risen by 7139%) Cancellations of diagnostic testing and delayed treatment may lead to 1,660 extra deaths from lung cancer alone.
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Content ArticleThe scale of the emergency response to the COVID-19 pandemic has been extraordinary, but what comes next? The King's Fund spoke with people involved in response efforts for disasters from around the world, from the Christchurch earthquakes in New Zealand to the Grenfell Tower fire in London, to understand what the health and care system can learn from the experience of recovery from other disasters as it responds to the pandemic.
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News ArticleMaking maternity wards safer for mothers and babies will need £400m of extra spending every year, hospital leaders have told The Independent. They warn that without increased funding, the NHS will not be able to fully implement recommendations made by an inquiry into poor maternity care at the Shrewsbury and Telford Hospitals Trust – where dozens of babies died or were left brain damaged in the largest maternity scandal in NHS history. Multiple maternity care failings at hospitals across the country in the past 12 months have sparked concerns over the safety of mothers and their babies with MPs on the Commons Health Select Committee launching an investigation into the issue last year. Hospital leaders say even just covering existing shortfalls of 3,000 midwives and recruiting 20 per cent more obstetricians, will cost at least £250m a year. To pay for extra anaesthetists, neonatal nurses and other support staff could push the cost to more than £400m. Chris Hopson, chief executive of NHS Providers, which represents hospital trusts, told The Independent that ministers faced a choice of either making the extra cash available or forcing the NHS to cut money elsewhere. In a letter to MPs on the committee, Mr Hopson urged them to demand extra funding in its forthcoming report on maternity safety in an effort to force ministers to confront the issue. Read full story Source: The Independent,9 February 2021,
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News Article
Hancock will face difficult questions over his power grab to stop ‘NHSE games’
Patient Safety Learning posted a news article in News
The NHS bill due to land in Parliament before the summer break will be the first for nearly 10 years, so will address various overdue changes and is certain to be significant. The bill’s thrust has become clear from the draft of the government’s white paper leaked on Friday, though some important details might change before a final version is published in the next few weeks. Many of the white paper proposals are what NHS England has been asking for in formal proposals over the last 18 months, and reflect the direction the NHS has been moving slowly but inexorably towards for several years. NHSE’s central aim of clearing up the NHS landscape by turning integrated care systems into statutory agencies, but without overdoing the central specification of how they will work, is largely intact. Clinical commissioning groups are reconstituted as ICSs, a move unpopular with some but accepted by most. There is a formal role for local authorities planned in the shape of “partnership councils”. This creates a little extra bureaucracy but does not give them real power in the NHS. NHSE and ICSs are given a bit more sway over foundation trusts, but probably not enough to set off a huge row with NHS Providers. The leaked version of the white paper also includes proposals which NHSE will not be happy about, including giving the health secretary a sweeping “general power to direct NHS England on its functions”, another to transfer functions between all arm’s length bodies and even abolish them, and ability to intervene at any stage in NHS service reconfigurations. If pursued, these risk bringing even more toxic politics back into the NHS, both in the process of putting through the legislation itself, and beyond that, in the day to day running of the service. Read full story (paywalled) Source: HSJ, 6 February 2021
