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Content ArticleFrom infection control to maintaining safe staffing levels, the COVID-19 pandemic has helped to highlight the intrinsic link between patient safety and staff safety. At the recent Future of Hospitals event from Health Plus Care Online, Helen Hughes, Patient Safety Learning's CEO, Timothy Clark, Founder & CEO of Leader Factor, and Claire Cox, Guys and St Thomas' Hospital, explore this further, considering how ensuring staff safety supports making improvements to patient safety. They consider the essential role that creating a psychologically safe workplace plays in enabling staff to speak up and effectively tackle incidents of unsafe care.
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News ArticlePregnant women and new mothers are three times as likely to suffer from poor mental health in the wake of the coronavirus pandemic, according to a new study. The report, carried out by a coalition of leading maternal mental health organisations, suggested before that the public health crisis up to 20% of women developed a mental illness during pregnancy or within the first year after having a baby. But in lockdown, 6 in 10 mothers had substantial concerns around their mental health, according to researchers who polled more than 5,000 pregnant women and parents. The study warned women were more likely to suffer from anxiety, depression, loneliness and suicidal thoughts during the COVID-19 crisis. The Maternal Mental Health Alliance is one of the organisations behind the research. Luciana Berger, a former Labour MP who is now chair of the group, said: “Today’s report should serve as an ear-splitting warning siren about the dangers to women’s maternal mental health and potential risks to the wellbeing of their babies." Read full story Source: The Independent, 16 March 2021
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News Article
Charities warn cancer death rate could rise
Patient Safety Learning posted a news article in News
A group of 47 cancer charities says that without urgent action, the UK's cancer death rate will rise for the first time in decades. NHS figures suggest tens of thousands fewer people started cancer treatment since the first lockdown compared to normal times. One Cancer Voice says that the NHS needs more resources. The government says cancer treatment remains a top priority and urges people to see their GP if they have symptoms. Radio 1 Newsbeat has spoken exclusively to One Cancer Voice about the impact of coronavirus on cancer care. The group of charities wants to see more staff available to diagnose and treat cancer, with greater NHS access to private facilities in order to "clear the backlog". "We are calling on the government to invest more money in ensuring the backlog of cancer cases is reduced and eliminated," says Michelle Mitchell, the boss of Cancer Research UK, which heads up One Cancer Voice. "We could face, in this country today, the prospect of cancer survival reducing for the first time in decades. That's why urgent action is required by the government." Read full story Source: BBC News, 16 March 2021 -
Content ArticleAn organisational culture that seeks to assign blame when things go wrong makes patient harm more likely to happen again. At the recent Future of Hospitals event from Health Plus Care Online, Helen Hughes, Patient Safety Learning's CEO, speaks with Dr Duncan Bootland, Medical Director at Air Ambulance Kent Surrey Sussex (AAKSS), who was recently rated as outstanding by the Care Quality Commission across all five of its inspection key lines of enquiry. In this recording of the session, Helen and Duncan talk about the safety culture synergy of healthcare and aviation and how behaviour impacts on safety, considering the values-based approach being championed by AAKSS.
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Event
COVERSCAN Q&A
Sam posted an event in Community Calendar
untilPerspectum has launched the first study to map how COVID-19 impacts the health of multiple organs and identify at-risk features for the virus, with detailed cross-sectional imaging and genetic studies. This study is on the National Institute for Health Research (NIHR) Portfolio. Join COVERSCAN for the next live Q&A webinar. Any questions you'd like answered, send to: Perspectum.Communications@perspectum.com Register for study participant Q&A -
News ArticleStories about people getting blood clots soon after taking the Oxford/AstraZeneca vaccine have become a source of anxiety among European leaders. After a report on a death and three hospitalisations in Norway, which found serious blood clotting in adults who had received the vaccine, Ireland has temporarily suspended the jab. Some anxiety about a new vaccine is understandable, and any suspected reactions should be investigated. But in the current circumstances we need to think slow as well as fast, and resist drawing causal links between events where none may exist. As Ireland’s deputy chief medical officer, Ronan Glynn, has stressed, there is no proof that this vaccine causes blood clots. It’s a common human tendency to attribute a causal effect between different events, even when there isn’t one present: we wash the car and the next day a bird relieves itself all over the bonnet. Typical. Or, more seriously, someone is diagnosed with autism after receiving the MMR vaccine, so people assume a causal connection – even when there isn’t one. And now, people get blood clots after having a vaccine, leading to concern over whether the vaccine is what caused the blood clots. Read full story Source: The Guardian, 15 March 2021
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News Article
Has Covid changed hospitals for the better?
Patient Safety Learning posted a news article in News
The pandemic has been a catalyst for innovation in the NHS and some changes will have a lasting effect, says Dr John Wright of Bradford Royal Infirmary. The Covid pandemic has transformed our hospitals. Car parks are empty, once-bustling corridors are quiet, and these days you won't see any staff making fashion statements - we're all in scrubs and masks. Dr Wright says changes made to reduce spread of infection are here to stay and will help us live with future outbreaks of Covid and other infectious diseases. But there is also much to learn from how we have adapted to non-Covid care - with drive-through PCR swabs and blood tests, for example, or the use of oximeters to monitor oxygen levels in the blood of Covid patients in their homes, providing warning if they need to be admitted to hospital. But the biggest change has been in the way hospital consultations are carried out. Before the pandemic nearly all appointments took place face-to-face. Last year probably 90% occurred via telephone or video call, and most of my colleagues at Bradford Royal Infirmary are still running remote clinics today. This is much more convenient for patients. In the past a typical consultation might have involved a half-day of travel, the search for a parking place, and then sitting in a waiting room. However, remote consultations do have their drawbacks. Patients tend to underplay their symptoms on the phone and it is easier to avoid discussing challenging issues. Life-changing diagnoses require sensitive, face-to-face communication. Another problem is that some patients struggle with technology. The main drawback, though, is that clinicians are unable to undertake physical examination remotely. Clinical histories are the yin of the consultation but physical examinations are the yang, and video consultations only provide half the picture. Read full story Source: BBC News, 15 March 2021 -
News Article
NHSE director: It could take a year for cancer services to return to normal
Patient Safety Learning posted a news article in News
NHS England’s cancer director has said it could take another year for the level of cancer treatments and diagnosis carried out to return to normal, after being impeded by COVID-19. National cancer director Dame Cally Palmer told HSJ’s national cancer forum event last week that activity over the past 12 months had been 89% of the previous year, but the service was committed to getting “fully reset” to 2019 levels by March 2022. She shared information showing that, by December 2020, the amount of treatment being carried out following an urgent referral, for most cancers, exceeded December 2019 levels, but that there are still significant treatment backlogs. And, for lung cancer patients, the number of treatments carried out in December 2020 was only 73% of that a year earlier — a decrease from September and October 2020 levels — as covid pressures rose during the third wave. Lung cancer is one of the most amenable to treatment if picked up early. Other areas of diagnostics and treatment have also been severely impeded because of requirements to change practice to reduce the risk of spreading covid, particularly to vulnerable patients. Dame Cally, also chief executive of the Royal Marsden Foundation Trust, said the service was committed to returning to at least normal levels of activity across the board by March next year. Read full story (paywalled) Source: HSJ, 12 March 2021 -
News ArticleProfessor Sir Ian Diamond, head of the Office for National Statistics (ONS), has said there will “no doubt” be another wave of coronavirus infections in the autumn. Speaking on Sunday, Sir Ian acknowledged the impact of the “wonderful” vaccine rollout though cautioned “we need to recognise that this is a virus that isn’t going to go away.” "And I have no doubt that in the autumn there will be a further wave of infections," he told The Andrew Marr Show on BBC One. The UK’s national statistician pointed toward regional variations in terms of how many people have antibodies. “There is a lot of regional variation, so we find 30 per cent of London have antibodies whereas only 16 per cent in the South West, so we need to recognise that as well,” he told the programme. This comes after Professor Chris Whitty, England’s chief medical officer, said he would “strongly advise” against any rapid easing of coronavirus restrictions. Read full story Source: The Independent, 14 March 2021
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Content Article
Human factors for emergency response and critical care
Patient Safety Learning posted an article in Techniques
In this blog post, Liv System’s Nigel Scard talks with Courtney Grant, a Senior Human Factors engineer with Transport for London (TfL). Nigel and Courtney worked together for a number of years at TfL on a number of station and line upgrade projects. A few years ago, Courtney applied his Human Factors and research skills with great tenacity, to a serious healthcare related incident which impacted him personally. This resulted in an important, lifesaving change to ambulance service procedures. In this interview, Courtney describes this in detail and also describes his recent work in supporting the Chartered Institute of Ergonomics and Human Factors (CIEHF) in supporting the response to the COVID-19 pandemic. -
News Article
COVID-19: NHS waits at record high as second wave hits care
Patient Safety Learning posted a news article in News
The Covid surge in January hit key services including cancer and routine surgery, NHS England figures show. Less than half the expected number of operations were done, pushing the waiting list to a record-high of 4.6m. More than 300,000 of those have been waiting more than a year for treatment - compared to 1,600 before the pandemic began. Surgeons described it as a dire situation which would take a long time to turnaround. Tim Mitchell, of the Royal College of Surgeons of England, said: "Behind today's statistics are people waiting in limbo. Many will be in considerable pain, others will have restricted mobility and be at risk of isolation and loneliness." "Dealing with this daunting backlog will take time, and also sustained investment in the NHS," he said. Similar problems are also being seen in Scotland where 39,000 people have been waiting over a year for treatment. The NHS Confederation has warned the true picture could be much worse with nearly 6 million fewer referrals made by GPs in England for routine treatments, which includes operations such as knee and hip replacements, last year, suggested there was an additional hidden backlog. The organisation, which represents hospitals, said it was likely people have not sought help or found it difficult to access services during the pandemic. Read full story Source: BBC News, 11 March 2021 -
News Article
Homeless prioritised for Covid vaccine alongside at-risk adults, Hancock says
Patient Safety Learning posted a news article in News
Homeless people will be prioritised for coronavirus vaccinations alongside adults in at-risk groups, the government has said. Matt Hancock, the health secretary, said the decision would “save more lives among those most at risk in society”. It comes after the Joint Committee on Vaccination and Immunisation, which said those experiencing rough-sleeping or homelessness were likely to have underlying health conditions and should be offered vaccinations alongside those in priority group six. "People experiencing homelessness are likely to have health conditions that put them at higher risk of death from COVID-19. He added: "This advice will help us to protect more people who are at greater risk, ensuring that fewer people become seriously ill or die from the virus." Read full story Source: The Independent, 11 March 2021 -
Content ArticleThis report from the Tony Blair Institute looks at progress made in they released a report in October 2020 which set out a series of recommendations on how the government should respond to Long COVID. These recommendations covered: addressing the need for further research on Long COVID launching an awareness campaign improving diagnosis of Long COVID putting in place specialist support for sufferers using the COVID Symptom Study data to screen for those likely to develop Long COVID. This latest report, A long-term plan for Long Covid, includes: more detail on the recommendations made an update on what has happened in each area where appropriate, what more could be done.
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News Article
Cancer patients 'lack same protection' after first jab
Patient Safety Learning posted a news article in News
Cancer patients are much less protected against COVID-19 than other people after one dose of the Pfizer vaccine, the first real-world study in this area suggests. With a 12-week wait for the second dose this could leave them vulnerable, says the King's College London and Francis Crick Institute research team. An early second dose appeared to boost cancer patients' protection. Cancer charities are calling for the vaccine strategy to be reviewed. But Cancer Research UK said the small study had not yet been reviewed by other scientists and people undergoing cancer treatment should continue to follow the advice of their doctors. The government said it was focused on "saving lives" and the antibody response "was only part of the protection provided by the vaccine". About 1.2 million people at very high risk of being seriously ill with COVID-19 were prioritised for a first vaccine dose in the first phase of the UK rollout, which includes people with specific cancers. The UK government decided to extend the gap between first and second jabs from three to 12 weeks in late December to give more people some protection as soon as possible. Dr Sheeba Irshad, oncologist and senior study author from King's College London, said the findings were "really worrying" and recommended an urgent review of the timing of doses for people in clinically extremely vulnerable groups. "Until then, it is important that cancer patients continue to observe all public health measures in place such as social distancing and shielding when attending hospitals, even after vaccination," she said. The study, which recruited 205 people, included 151 with solid cancers, such as lung, breast and bowel, or blood cancers. The researchers tested volunteers for antibodies and T-cells in their blood, which signals that the immune system can protect against illness from the virus in the future. Three weeks after one dose, an antibody response was found in 39% of people with solid cancers, 13% of people with blood cancer and 97% of people with no cancer. Following a second dose three weeks after the first, which some cancer patients received, there was a sharp rise in their antibody response against the coronavirus, to 95%. However, among those who had to wait longer for their second dose, there was no real improvement in protection. Read full story Source: BBC News, 11 March 2021 -
News Article
Scientists question NHS algorithm as young people called in for jab
Patient Safety Learning posted a news article in News
Scientists are questioning the reliability of algorithms used to trawl through patients’ health records and flag those who should be asked to shield and prioritised for vaccination. GPs have reported being contacted by young, healthy patients confused as to why they have been told they are at high risk, or have been invited for a COVID-19 jab. The Joint Committee on Vaccination and Immunisation (JCVI) has defined nine priority groups for vaccination, including everyone aged over 50, plus frontline health and social care workers and people aged 16–64 with serious health conditions. The QCovid risk prediction algorithm, introduced last month, combines various characteristics, including age, sex, ethnicity and body mass index (BMI), to estimate the risk of catching, being admitted to hospital, or dying from Covid-19. However, the algorithm appears to throw up certain inconsistencies. For example, if a patient’s weight or ethnicity are not recorded on their health records, QCovid automatically ascribes them a BMI of 31 (obese) and the highest risk ethnicity (black African), meaning they are more likely to be invited for a vaccine. One York-based GP, Dr Abbie Brooks, has identified 110 seemingly healthy individuals who were added to the shielding list and invited to book a vaccine last month. Although it will not harm younger, healthier individuals to receive a jab before their peers, it may mean more vulnerable people have to wait longer for their doses. “I can see that they don’t want to miss out people, which may be why they’re taking this conservative approach, but the problem is that when you make that prioritisation, you are pushing others further down the line,” Irene Petersen, professor of epidemiology and health informatics at University College London, said. Read full story Source: The Guardian, 9 March 2021 -
Content ArticleThe pandemic has impacted on all aspects of NHS care, with elective and diagnostic activities among those services that have been disrupted. This has led to a considerable backlog of people waiting for NHS treatment. This briefing, from the NHS Confederation, explores what lies ahead for the health service and patients, based on their modelling of referral-to-treatment waiting trajectories in 2021. It offers an outline policy framework, drawn up by their members, for starting to reduce waiting lists in an effective, equitable and efficient way.
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News Article
Hundreds of patients with chronic pain waiting a year for first NHS appointment
Patient Safety Learning posted a news article in News
NHS clinics were still seeing just two-thirds of the number of chronic pain patients they normally would by the end of last year, with some patients having waited a year or more. In Ayrshire and Arran, 94 of the 112 chronic pain patients seen between October and December – equivalent to nearly 84% – had been on the waiting list for their first appointment for 52 weeks or longer. Only nine were seen within the 18-week target. This was by far the worst performance for any health board in Scotland. Pain relief clinics across NHS Scotland were paused for four months at the beginning of the pandemic, leading to reports that some patients with problems such as nerve damage and arthritis were paying thousands of pounds to travel to private facilities in England for medical infusions or injections to ease their symptoms. In a statement at the end of last year, Joanne Edwards, the director of acute service at NHS Ayrshire and Arran, apologised for the delays, saying the coronavirus pandemic "has had a significant impact on the capacity of the chronic pain service". Ms Edwards said the health board was increasing the number of face to face and telephone clinics that the chronic pain team can undertake, adding that an "enhanced clinical review" of the waiting list was also being carried out to prioritise patients for appointment based on clinical need. Read full story Source: The Herald, 10 March 2021 -
News Article
Covid online symptom checker 'may delay treatment'
Patient Safety Learning posted a news article in News
The NHS Covid symptom checker has been criticised by a study which found it may not pick up some people who are seriously ill. By being told to stay at home rather than consult a doctor, they may not receive treatment quickly enough. NHS Digital says the 111 online service, used more than 3.9 million times in the past year, is not a diagnostic tool. The symptom checker has been constantly revised and updated, it adds. The NHS 111 online Covid symptom checker asks a series of set questions about symptoms in order to offer people advice on their condition and what to do next. The study, in BMJ Health and Care Informatics, used 50 simulated cases to compare online checkers used during the pandemic from four countries - UK, US, Japan and Singapore. It found the symptom checkers used by the UK and US were half as likely to advise people to consult a doctor as the systems used in Japan and Singapore. Japan and Singapore also had the lowest case fatality rates of the four nations. Despite improvements in the safety of the NHS 111 symptom checker since the research was carried out in April, the researchers said they still have "ongoing concerns". Read full story Source: BBC News, 9 March 2021 -
News Article
Covid: Shropshire hospitals 'discharging patients who then infect their families'
Patient Safety Learning posted a news article in News
Patients with coronavirus have been discharged from a hospital and infected family members, a councillor claimed. Heather Kidd, a Liberal Democrat member of Shropshire Council, said a woman in south Shropshire told her that her husband had been "sent home with Covid". She initially found evidence of four cases but said those were the "tip of the iceberg" with more coming to light. The medical director of Shrewsbury and Telford Hospital NHS Trust (SaTH) said they were following guidelines, but would look into the "concerning" cases. Ms Kidd said since she first spoke out, she had been contacted by a number of people who have had Covid-positive family members discharged from the Royal Shrewsbury Hospital and the Princess Royal in Telford back into their homes. Arne Rose, the medical director at SaTH, said there was now a "special swab squad" testing patients every 24 hours as opposed to every 48 hours. He said some patients, who after 28 days of their first positive Covid test were no longer considered infectious, would be the subject of a "careful risk assessment". They could then be discharged with advice on self-isolating at home. "The cases... sound concerning," Mr Rose said, adding he would investigate to "learn if anything went wrong." Read full story Source: BBC News, 7 March 2021 -
News ArticleYounger adults and those living in poorer neighbourhoods and black people have the highest levels of vaccine hesitancy, new survey data from the Office for National Statistics has shown. The vast majority of Britons back the COVID-19 vaccines and are keen to be inoculated, with more than 9 out 10 people being positive about the jab. But the ONS said data from a survey between 13 January and 7 February revealed reluctance among less than 10% of the population. It found more than 4 in 10 of black or black British adults reported vaccine hesitancy, the highest of all ethnic groups, while adults aged 16-29 were most likely to report hesitancy, at around 1 in 6 or 17%. Adults living in the most deprived areas of England were more likely to report vaccine hesitancy at 16%, compared with 7% of adults in the least deprived areas of England. This has been evident in the take up of the vaccine among some deprived areas of the country which have struggled to vaccinate everyone in priority groups. Even among NHS and social care staff there has been reported hesitancy over vaccines, particularly among BAME staff. Read full story Source: The Independent, 9 March 2021
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News Article
Type 1 diabetes and COVID-19 link being investigated
Patient Safety Learning posted a news article in News
A study is under way in the Southern Health Trust area to investigate possible links between Type 1 diabetes and COVID-19. A consultant paediatrician said there has been an increase in the number of young people being diagnosed since the beginning of the pandemic. Last year, the trust said there were 41 new cases, its highest yearly total on record. Dr Sarinda Millar specialises in Type 1 diabetes in children and young people. "We are having more diagnoses, specially since the start of 2021 but more last year, as well," she said. "...in January we had nine new cases of Type 1 diabetes in children and young people in one week alone in our trust area," she said. "In other years, we wouldn't even have had one every week. And regionally, we have all seen an increase in Type 1 diabetes which leads us to question is COVID-19 in some way related?" Because of the increase in Type 1 diabetes over the past year, the Southern Trust is commissioning fresh research on the matter. "It is quite a wide piece of research we are hoping to do," Dr Millar said. "As well as looking to see if these children have been exposed to Covid, looking at their antibody status, we also want to know what other implications COVID-19 has had. For example, have families delayed bringing their child to hospital? We have seen that children are presenting sicker." Read full story Source: BBC News, 8 March 2021 -
EventuntilThis Westminister Health Forum conference is focussing on the future of vaccination programmes in the UK. Stakeholders and policymakers will review progress and discuss what can be learned for the future development and uptake of vaccinations - as well as the priorities for improving routine immunisation coverage in the UK. The conference takes place with the UK COVID-19 vaccination programme overwhelmingly regarded as progressing well, but with: challenges - around take-up and reluctance from some sections of society to engage tensions - internationally and within the UK over supply and distribution questions - over how to achieve sufficient global levels of immunisation. Areas for discussion include: progress, early lessons and the role of the vaccine in the wider national response to the pandemic development of the COVID-19 vaccine and what can be learned from the innovative methods and processes that have been used to implement rollout at pace and scale implications for the future of vaccines in the UK and improving routine immunisation coverage in the UK the future role of the UK in global development, rollout and administration of vaccinations. Register
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News Article
'There’s a lot of nasty stuff': the people living with long Covid
Patient Safety Learning posted a news article in News
Sufferers say they have had little specialist help despite NHS England setting up dedicated clinics. “It’s not that I feel I have been abandoned, I think that is perfectly obvious,” says Rachel Pope. “If you speak to any long Covid patient, they have been abandoned.” Until exactly a year ago – 5 March 2020 – Pope was “an incredibly fit woman”. A senior lecturer in European prehistory at the University of Liverpool, her work and lifestyle were very active. But after falling ill to Covid, she spent four months unable to walk, then three more when she could manage little more than “a sort of shuffle”. She still has a host of symptoms, “but the most debilitating is the fact that I still can’t do more than 2,000 steps in a day. Until a few weeks ago, I was still choking every day. There’s a lot of nasty stuff that [long Covid sufferers] are living with, without treatment. “It’s not a great situation to be in. I mean, we didn’t die. But this isn’t exactly living either.” A year into the pandemic, accounts such as Pope’s have become dispiritingly familiar, as the experiences of the many thousands who have struggled for months with long Covid, often alone and unsupported, are emerging. Read full story Source: The Guardian, 5 March 2021 -
News Article
Six million ‘hidden’ patients could flood NHS waiting lists this year
Patient Safety Learning posted a news article in News
As many as 6 million “hidden” patients could join the queue for NHS treatment in the coming months, swelling official waiting lists to records not seen for more than a decade, health chiefs have warned. In the wake of a Budget that offered no new investment for the health service ministers must level with the public that previous guarantees on waiting times are now impossible to meet, the head of the NHS Confederation has said. In an interview with The Independent, Danny Mortimer said some patients should expect to wait many months, or possibly even beyond a year, for their treatment. He said: “It's going to take many years to recover the waiting list position to where we want it to be. “We have to be realistic about the time that it will take us to address these issues, and the government have to be realistic about what it will take particularly if this week’s Budget is an indication that actually there won’t be money made available to the NHS to truly address these issues. “The government has to take responsibility for explaining to the public what the consequences of that are.” Read full story Source: The Independent, 7 March 2021, -
News Article
NHS may have to care for ‘a million long Covid patients after pandemic’
Patient Safety Learning posted a news article in News
A leading doctor has said the NHS should expect to treat up to a million people for long Covid in the aftermath of the pandemic. Long Covid affects about 1 in 10 people of any age infected with coronavirus, and sufferers can experience symptoms including breathlessness, chronic fatigue, brain fog, anxiety and stress for several months after contracting COVID-19. The likelihood of experiencing long-term symptoms does not appear to be linked to the severity of the initial virus and people with mild symptoms at first can still have debilitating long Covid. The absence of long Covid registers makes it difficult to measure the scale of the problem, and major studies into the condition are ongoing in an attempt to identify causes and potential treatments. But one of Britain’s leading doctors, who spoke on condition of anonymity, estimates that about a million people will need care for long Covid as the NHS recovers from the effects of the pandemic. “Although officially about 4 million people have had Covid, in reality, it’s about 8 million or 9 million,” the anonymous doctor told The Guardian. “If 10% of those people have got something, then it could be almost a million people, and that’s enormous.” Read full story Source: The Independent, 7 March 2021
