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Content ArticleIn this personal blog, an NHS volunteer describes her experience of supporting a patient dying in hospital of Covid-19. She highlights the role that volunteers can play in giving compassion and comfort to patients in an overwhelmed health system. She also draws attention to the lack of training she had before taking on the role, and the mental and emotional toll of volunteering in such environments.
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Content ArticleThis analysis by the Organisation for Economic Co-operation and Development provides the latest comparable data and trends on the performance of health systems in OECD countries and key emerging economies. It examines performance indicators that suggest the following trends: Overall health status in the United Kingdom is close to the OECD average Overweight/obesity and alcohol consumption are higher than the OECD average Population coverage is high, with high satisfaction and strong financial protection The United Kingdom performs well on many key indicators of care quality, though avoidable hospital admissions could be further reduced Health and long-term care spending are above average, though hospital beds and the number of doctors and nurses are slightly below the OECD average The analysis also looks at the impact of the Covid-19 pandemic on deaths, health spending, life expectancy, healthcare activity and mental health.
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Content Article500,000 immunocompromised people, who are at particularly high risk from Covid, live in the UK. Because their weakened immune systems meant they were less likely to have been protected by the first two doses of the Covid-19 vaccine than the general population, the Joint Committee on Vaccination and Immunisation recommended they have a ‘third primary dose’ eight weeks after their second dose (whereas other groups were to get a booster six months after their second dose). But the complexity of this system meant that huge numbers of immunocompromised people were left waiting for a vaccine invitation that never came. In this blog for The King's Fund, Gemma Peters, Chief Executive of Blood Cancer UK, examines the challenges people with blood cancer and others with compromised immunity faced during the Covid-19 vaccine roll-out. She argues that NHS England must fix these issues by establishing a register of immunocompromised people and a reliable way of contacting them, tackling misinformation and publicly acknowledging the issues people with compromised immune systems have faced to date.
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Content Article'Virtual wards' have existed for a number of years, but Covid-19 has led to further research and pilot schemes exploring their use. How have they been used during the pandemic and what does the future hold? This explainer by Holly Walton and Naomi Fulop provides some answers.
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Content ArticleDuring the Covid-19 pandemic, mental health services had to quickly innovate to ensure that some of the most vulnerable people in society could continue to access mental health support, while protecting service users and staff from the virus. The NHS Confederation’s Mental Health Network and the International Initiative for Mental Health Leadership (IIMHL) have worked together to produce these case studies which capture ten innovations from different countries. Key themes in the case studies include: The advantages of digital platforms in improving access The importance of supporting the wellbeing of staff Using data and evaluation to drive improvements and make the financial case for innovations The benefits of co-producing services with service users and staff Lessons about how the availability of innovations is communicated
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Content ArticleThis guide by the non-profit organisation US Pharmacopeia highlights the global challenge of substandard and falsified Covid-19 vaccines and the impact this has on individuals, the ability to control the pandemic, larger societal health, public trust and social justice. It outlines strategies to help prevent, detect and respond to substandard and falsified vaccines, in line with existing World Health Organization processes.
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Content ArticleLast month, Boris Johnson argued that the downward trends in Covid cases and hospitalisations meant that it was time to scrap restrictions. Now both are rising. But the government is ending testing and most surveillance studies. Sajid Javid, the health secretary, said that the rise was “to be expected” – though this foresight did not extend to having a plan to deal with the increase in infections. Instead, he dismissed the concern about the new Deltacron variant. The health secretary seemed nonchalant about the threat the virus now posed. Sajid Javid may be right that the country has weathered the worst of the pandemic, but Covid is not yet in retreat. It makes no sense to withdraw funding from a series of studies that allow the spread of the virus to be mapped in detail. Without the data, experts won’t be able to effectively monitor the disease. The country will be less effective in responding and adjusting to future waves of infection. Individuals will be less able to make informed choices about the risks involved. The clinically vulnerable face being cut off from everyday life. “It is like turning off the headlights at the first sign of dawn,” Stephen Reicher, a psychologist at the University of St Andrews, told the Guardian. “You can’t see what’s coming and you don’t know when it makes sense to turn them on again.”
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Content ArticleWhile inequalities in health have always been a problem, the Covid-19 pandemic has shone a spotlight on inequalities, and created an opportunity for change. In this long read by The King's Fund, the authors look at the importance of developing a long-term approach to tackling health inequalities. They examine at historical attempts to tackle health inequalities and argue that we need an enduring national mission to tackle inequality. They highlight that action is needed at national and local levels if this mission is to succeed.
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Content ArticleThis is the report and formal minutes of a House of Commons Public Accounts Committee session that examined the issues surrounding NHS backlogs and waiting times in England. The session particularly focused on accountability in how NHS England and the Department for Health and Social Care manage workforce and resources. At the end of December 2021, 6.07 million patients were waiting for elective care, the biggest waiting list since records began. Only 64% (3.87 million) of these patients had been waiting for less than 18 weeks, compared with the performance standard which requires 92% to have been waiting for less than 18 weeks. Similarly, in December 2021, only 67% of patients with an urgent referral for suspected cancer were treated within 62 days compared with a requirement for 85% to be treated within that time. The report highlights that although the Covid-19 pandemic had a significant effect on the backlog, NHS waiting time performance had declined steadily in the years before the pandemic.
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This is part of our new series of Patient Safety Spotlight interviews, where we talk to people about their role and what motivates them to make health and social care safer. Julie talks to us about how attitudes to patient safety have evolved since the 1990s, the role of the World Health Organization in improving quality and safety, and the need to learn lessons from infection prevention and control approaches that were adopted during the Covid-19 pandemic. -
Content ArticleThe Covid-19 pandemic has exacerbated existing health inequalities for refugees and migrants. These populations have shown lower rates of Covid-19 vaccination uptake, and may face a range of individual, social, practical and logistical barriers to accessing vaccines. The World Health Organization (WHO) has developed this guide to provide practical recommendations, strategies and good practice for understanding and addressing barriers to Covid-19 vaccination among refugee and migrant populations. It is intended to support all stakeholders responsible for the rollout of Covid-19 vaccines to refugee and migrant populations.
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Content ArticleThis article in the Italian Journal of Pediatrics discusses existing knowledge about paediatric Long Covid and looks at how to identify and manage Long Covid in children. The authors recommend three-month primary care follow up for all children who have had Covid-19, to determine whether each child is experiencing ongoing effects after the acute phase of the virus. They highlight the need for relevant medical investigations when symptoms remain to give the best chance of successful recovery, and recommend that psychological support be offered to children where appropriate.
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ECRI: Top 10 Patient Safety Concerns 2022
Patient Safety Learning posted an article in International patient safety
ECRI's annual Top 10 list helps organisations identify imminent patient safety challenges. The 2022 edition features many first-time topics, and emphasis is on potential risks that could have the biggest impact on patient health across all care settings. The number one topic on this year’s list has been steadily growing throughout the COVID-19 pandemic and impacts patients and staff on all levels: staffing shortages. Prior to 2021, there was a growing shortage of both clinical and non-clinical staff, but the problem has grown exponentially. In early January 2022, it was estimated that 24% of US hospitals were critically understaffed, while 100 more facilitates anticipated facing critical staff shortages within the following week. The list includes diagnostic and vaccine-related errors that can impact patient outcomes. In addition, several topics on this year's list reflect challenges that have arisen as a result of the stresses associated with delivering care during a global pandemic. -
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UK Covid-19 Public Inquiry (10 March 2022)
Patient Safety Learning posted an article in Covid-19 Inquiry
This is the independent public inquiry to examine the UK’s preparedness and response to the Covid-19 pandemic, and to learn lessons for the future. The Inquiry has been established under the Inquiries Act 2005. This means that the Chair will have the power to compel the production of documents and call witnesses to give evidence on oath. The Chair has been appointed and will set out her vision for the Inquiry’s work in the coming months. The Inquiry has received the draft Terms of Reference from the Cabinet Office, and will open a public consultation tomorrow, Friday 11 March. The consultation will remain open for four weeks, and will be available online. See the UK COVID-19 Inquiry: draft terms of reference. -
Content ArticleThe introduction of remote triage and assessment early in the pandemic raised questions about patient safety. Wieringa et al. sought to capture patients and clinicians’ experiences of the management of suspected acute COVID-19 and generate wider lessons to inform safer care. Lessons from the pandemic suggest three key strategies are needed to prevent avoidable deaths and inequalities in the next crisis: (1) strengthen system resilience (including improved resourcing and staffing; support of new tools and processes; and recognising primary care’s role as the ‘risk sink’ of the healthcare system); (2) develop evidence-based triage and scoring systems; and (3) address social vulnerability.
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Content ArticleThe Covid-19 pandemic has stretched healthcare staff like never before. Tom Moberly reports on a roundtable discussion hosted by The BMJ as part of the 2022 Nuffield Trust summit, looking at why workers leave the NHS and how staff wellbeing and retention can be improved.
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WHO - Announcing World Patient Safety Day 2022 (4 March 2022)
Patient-Safety-Learning posted an article in WHO
The theme for World Patient Safety Day 2022 is Medication Safety. It will take place on 17 September 2022. Unsafe medication practices and medication errors are a leading cause of avoidable harm in healthcare across the world. Medication errors occur when weak medication systems, and human factors such as fatigue, poor environmental conditions or staff shortages, affect prescribing, transcribing, dispensing, administration and monitoring practices. This can result in severe patient harm, disability and even death. The ongoing Covid-19 pandemic has significantly exacerbated the risk of medication errors and associated medication-related harm. The theme builds on the ongoing WHO Global Patient Safety Challenge: Medication Without Harm. It also provides much-needed impetus to take urgent action for reducing medication-related harm through strengthening systems and practices of medication use. -
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NHS My Planned Care Patient Platform
Patient Safety Learning posted an article in Other health and care software
My Planned Care gives you advice and support while you wait and helps you to prepare for your hospital consultation, treatment, or surgery. This includes giving you information about waiting times at your hospital and other supporting and local services while you wait. This site is updated weekly and can be viewed by anyone, which means you, your family or carer as well as your NHS team can all see the latest information. Your hospital team will be in touch with you as soon as they can. If you are looking for an update, please check this website before contacting your hospital or GP. -
Content ArticleThe Covid-19 pandemic has rapidly accelerated a trend of decline in access to and outcomes in healthcare. This situation means that people who have the means to do so are opting for faster, private care, creating a two-tier healthcare system. However, IPPR polling shows that near-universal public support remains for retaining a universal, free, comprehensive and tax-funded NHS. The public highly values the principles of the NHS as a system that universalises the benefits of the best healthcare and shares the cost across the population. This report by The Institute for Public Policy Research (IPPR) think tank proposes policies based on three aims: recovery, building back better and increased sustainability facing an uncertain future.
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Content ArticleThis study in PLOS Medicine looked at the uptake of the Covid-19 vaccine in different ethnic groups in Manchester between 1 December 2020 and 18 April 2021. Covid-19 vaccine uptake is lower amongst most minority ethnic groups compared to the White British group in England, despite higher Covid-19 mortality rates. This study adds to existing evidence by estimating inequalities for 16 minority ethnic groups, examining ethnic inequalities within population subgroups, and comparing the scale of ethnic inequalities in Covid-19 vaccine uptake to those for routine seasonal influenza vaccine uptake. The authors of the study found that ethnic inequalities in Covid-19 vaccine uptake exceeded those for influenza vaccine uptake. existed amongst those recently vaccinated against influenza. were widest amongst those with greatest Covid-19 risk. This suggests the Covid-19 vaccination programme has created additional, different health inequalities. They suggest that further research and policy action is needed to understand and remove barriers to vaccine uptake, and to build trust and confidence amongst minority ethnic communities.
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Content ArticleMedical research is progressing to clarify the full range of sub-acute and long-term effects of post-COVID-19 syndrome (Long Covid), but most manuscripts published to date only analyse the effects in patients discharged from hospital, which may induce significant bias. This Spanish study in the journal Scientific Reports aimed to analyse the single and multiple associations between post-COVID-19 characteristics with up to six months of follow-up in hospitalised and non-hospitalised Covid-19 patients. Key findings include: At six months follow-up, fatigue, arthralgia, fever, breathlessness, emotional disturbance, depression, cognitive deficit, haemoglobin, total bilirubin, and ferritin are correlated with the gender of the patient Patients with previous respiratory diseases and abnormal body mass index, ex-smoker, and dyspnoea had a robust statistically significant association. Non-hospitalised patients may suffer more severe thromboembolic events and fatigue than hospitalised patients. Functional lung tests are good predictors of chest CT imaging abnormalities in elderly patients with Long Covid.
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Content ArticleIt is critical the UK keeps the bones of its world leading data infrastructure so that we can protect ourselves from lingering and future threats, writes Jennifer Beam Dowd. While the UK’s perceived pandemic missteps abound, the country was truly “world beating” in at least one important arena—investment in crucial population data to help us understand the virus. Despite earlier reports that the Coronavirus Infection Survey carried out by the Office for National Statistics (ONS) was at risk of being scrapped, the government's new “Living with covid” strategy has retained the scheme, although it's not yet clear to what extent. While these efforts could rightfully be scaled back from crisis levels, we need to carefully transition surveillance from pandemic to “endemic” to protect ourselves from lingering and future threats.
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Content ArticleSince the start of the pandemic, the number of people waiting for NHS treatment in England has grown to 6.1 million - the highest level since comparable records began – and is expected to rise further as those who have missed out on care come forward. In February 2022, the government published the NHS elective recovery plan which aims to increase NHS treatment capacity to 30% above pre-pandemic levels by 2024−25. However, there are many uncertainties around the future demand for care and the number of ‘missing’ patients who will eventually return to seek NHS care. This tool developed by the Institute for Fiscal Studies (IFS) allows you to simulate how waiting lists may change over the next four years under different assumptions.
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Content Article
BMA NHS backlog data analysis
Patient-Safety-Learning posted an article in Coronavirus (COVID-19)
This webpage from the British Medical Association (BMA) contains analysis of NHS data and is updated monthly. It highlights the growing backlogs across the NHS and includes operations data and information on the cancer waiting list, GP referrals and A&E waiting times. -
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Blog - Learning from HSIB Covid-19 reports (27 January 2022)
Patient-Safety-Learning posted an article in Blogs
This blog summarises investigations about Covid-19 and its impact on the healthcare system carried out by the Healthcare Safety Investigation Branch (HSIB). It highlights learning from five HSIB reports: COVID-19 transmission in hospitals: management of the risk – a prospective safety investigation Early warning scores to detect deterioration in COVID-19 inpatients Oxygen issues during the COVID-19 pandemic Treating COVID-19 patients using continuous positive airway pressure (CPAP) Personal protective equipment (PPE): care workers delivering homecare during the COVID-19 response
