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News ArticleSome 1 in 10 people still experience persistent ill health 12 weeks after having COVID-19, termed “long COVID” or post-COVID conditions. A new policy brief from the European Observatory on Health Systems and Policies documents responses to post-COVID conditions in different countries of the WHO European Region and looks at how sufferers, including medical professionals, are driving some of those responses. Written for decision-makers, this brief summarises what is known about the conditions, who and how many people suffer from them, diagnosis and treatment, and how countries are addressing the issue. Commenting on long COVID, WHO Regional Director for Europe Dr Hans Henri P. Kluge said, “COVID-19 has caused a great deal of suffering among people across the Region, with reports of long COVID an extra cause for concern. It’s important that patients reporting with symptoms of long COVID are included as part of the COVID-19 response to mitigate some of the longer-term health impacts of the pandemic. This policy brief makes clear the need for policy-makers to take the lead on this issue.” Read full story Source: WHO, 25 February 2021
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Content ArticleThis World Health Organization (WHO) policy brief highlights areas where policy-makers can take action to meet the challenge of post-Covid conditions based on what is currently known. It addresses the need for multidisciplinary, multispecialty approaches to assessment and management; development of new care pathways and contextually appropriate guidelines for health professionals; and the creation of appropriate services, including rehabilitation and online support tools.
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News Article
Covid vaccines cut risk of serious illness by 80% in over-80s
Patient Safety Learning posted a news article in News
A single shot of either the Oxford-AstraZeneca or the Pfizer-BioNTech Covid jab reduces the chance of needing hospital treatment by more than 80%, an analysis in England shows. The Public Health England (PHE) data showed the effect kicked in three to four weeks after vaccination. It was based on people aged over 80 who were the first to receive the jab. Government scientists hailed the result, but stressed that two doses were needed for the best protection. It comes after similar findings were published by Scottish health authorities last week, which they hailed as "spectacular". The PHE data, which has not been peer reviewed, also suggested the Pfizer vaccine, which started being rolled out a month before the AstraZeneca vaccine, leads to an 83% reduction in deaths from Covid. This was based on people over the age of 80 who had died. The data also showed vaccination cuts the risk of people over 70 developing any Covid symptoms by around 60%, three weeks after an initial dose. Prof Van-Tam, England's deputy chief medical officer, said the decision to give the AstraZeneca vaccine to older people was "clearly vindicated". Read full story Source: BBC News, 1 March 2021 -
News Article
Suicide inquest sparks warning on 'nine month wait' for treatment
Patient Safety Learning posted a news article in News
The government has been called on to take action over the national “backlog” for a specialist mental health service after a woman died after a substantial wait to access treatment. Carole Mitchell, who died by suicide on 22 November 2019, waited almost seven months for a first appointment after being referred to Greater Manchester Mental Health Foundation Trust for psychology services. In a prevention of future deaths report, published earlier this month, coroner Alison Mutch said the inquest was told waits had since increased and “someone in Mrs Mitchell’s position today would be more likely to wait nine months”. The coroner added evidence heard suggested the delay experienced was “reflective of both the regional and national backlog for appointments”. The report has been sent to both the Department of Health and Social Care and Greater Manchester Health and Social Care Partnership. Read full story (paywalled) Source: HSJ, 1 March 2021 -
Content Article
UCLPartners proactive care programme
PatientSafetyLearning Team posted an article in Exit strategies
UCLPartners have developed a series of proactive care frameworks to restore routine care by prioritising patients at highest risk of deterioration, with pathways that mobilise the wider workforce and digital/tech, to optimise remote care and self-care, while reducing GP workload. The frameworks include: atrial fibrillation high blood pressure high cholesterol type 2 diabetes asthma COPD. The frameworks are being implemented by GPs across the country, helping practices to identify who needs priority care, and those whose care can safely be delayed. Find out more by following the link below. -
News Article
34,000 people with dementia thought to have died of Covid in UK
Patient Safety Learning posted a news article in News
More than 34,000 people with dementia are estimated to have died from coronavirus in the UK since the start of the pandemic, according to new figures. The condition has been identified in just over a quarter of all deaths due to COVID-19, partly due to the large number of deaths in care homes. Nearly 12,000 care home residents have died since January alone. A coalition of charities, including Alzheimer's Society, Dementia UK, John's Campaign and Together in Dementia Every Day (tide), are now calling for introduction of universal social care – free at the point of use like the NHS – as a legacy of COVID-19. It comes as new figures from the Office for National Statistics revealed that deaths of care home residents, where around 70% of people have dementia, are 30%t higher than previously thought. Nearly 12,000 have died since January alone. The charities also revealed the result of a survey of 1,001 people who care for someone close to them with dementia, demonstrating that the toll of the pandemic reaches further than simply deaths from the virus. More than nine in ten (92%) said the pandemic had accelerated their loved one's dementia symptoms, with a third (31%) reported a more rapid increase in difficulty speaking and holding a conversation, and a quarter (25%) in eating by themselves. Nearly a third (32%) of those who lost a loved one during the pandemic thought that isolation/lack of social contact was a significant factor in that loss. The Alzheimer Society and Dementia UK said their helplines had been flooded with calls from relatives reporting how quickly their loved ones were deteriorating. Read full story Source: The Independent, 1 March 2021 -
News Article
NHS may ‘never catch up’ with ophthalmology surgery backlog caused by covid
Patient Safety Learning posted a news article in News
Delays due to the COVID-19 crisis have created tens of thousands of year-long waiters for ophthalmology treatment, and a surgery backlog which experts say may never be recovered. NHS England provisional data shows the number of people waiting 52 weeks or longer for ophthalmology treatment increased to more than 23,000 in December, up 57,580% on just 40 the year before. Experts say ophthalmology procedures have been hit particularly hard by the cancellation of elective work due to COVID-19 pressures. On average, roughly 130,000 ophthalmology patients completed treatment per month in England in 2019, most of which would likely have been cataract surgeries. Royal College of Ophthalmologists professional standards chair Melanie Hingorani told HSJ that many in the discipline feared “traditional” ways of working were too “fragmented” to address the size of the challenge. She said that without a “much more innovative” approach it would be “really difficult” to deal with the surgery backlog on ophthalmology and that clearing it could take “two years, maybe longer”. There remained a danger, however, she added that: “Maybe we never catch up”. Read full story (paywalled) Source: HSJ, 1 March 2021 -
Content ArticleIn this article, published by Pfizer, Dr Berkeley Phillips, Country Medical Director, highlights the importance of actively listening to patients and patient organisations in order to understand their changing needs.
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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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Content ArticleThis study, published in Occupational Medicine, aimed to identify the rates of probable mental health disorder in staff working in intensive care units in nine English hospitals during June and July 2020. Results showed: Almost half of intensive care unit staff who participated in this study report symptoms consistent with a probable diagnosis of post-traumatic stress disorder, severe depression or anxiety or problem drinking. Around one in seven intensive care unit staff in this study report recent thoughts of self-harm or of wanting to be better off dead. Nursing staff in this study were more likely to report higher levels of distress than doctors or other clinical staff.
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News ArticleHospitals across London are racing to tackle a backlog of tens of thousands of urgent operations that need to be carried out in the coming weeks to prevent patients dying or losing limbs, The Independent has learnt. The slow decline in Covid patient numbers means many hospitals across the capital are warning they will still be relying on extra staff, and “surge” beds opened at the height of the crisis, well into March. NHS bosses have been briefed that across the city there are about 15,000 priority two (P2) patients. These are classed as needing urgent surgery, including for cancer, within 28 days, or they could die or be at risk of losing a limb. But the lack of available operating theatres, nurses and anaesthetists mean the city has a shortfall of more than 500 half-day surgical lists a week. The Independent has spoken with multiple NHS insiders and seen briefing documents detailing the challenges facing the capital’s hospitals, which are expected to last up to 21 March in some areas. One briefing warned: “Hospitals have insufficient capacity to meet urgent elective demand for P2. P2 demand is intended to be seen within 28 days, the surge has occurred for over 28 days. Patients who would normally have been seen are waiting longer than clinically advisable." Read full story Source: The Independent, 25 February 2021
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News ArticleShortages of oxygen are endangering the lives of more than half a million COVID-19 patients every day in the world’s poorest nations, new research has shown. Despite being vital for the effective treatment of people admitted to hospital with coronavirus, sustained access to oxygen has proven difficult in low- and middle-income countries (LMICs) due to cost, infrastructure and logistical barriers. According to Unitaid, a global health agency, more than half a million people in LMICs currently need 1.1 million cylinders of oxygen per day, with 25 countries currently reporting surges in demand, the majority in Africa. Supplies of oxygen were already constrained prior to COVID-19 and have been exacerbated by the pandemic, Unitaid says. Read full story Source: The Independent, 25 February 2021
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News Article
Covid: Half with cancer signs didn't contact GP in first wave
Patient Safety Learning posted a news article in News
Almost half of people with potential cancer symptoms did not contact their GP during the first wave of the pandemic, a survey suggests. Symptoms left unchecked included coughing up blood, lumps and changes to the appearance of moles. NHS figures showed a fall in referrals to cancer services last spring. However, this study, of almost 8,000 people, captures the fall in people contacting their GP in the first place. The team that carried out the study, from Cardiff University and Cancer Research UK, said this raised concerns that people could be diagnosed later - and so be less likely to be treated successfully and recover. They surveyed a representative sample of people across the UK and found that of 3,025 people who said they had experienced at least one symptom which could be a warning sign of cancer, 45% did not seek help. They also found that: 31% did not seek help after coughing up blood 41% did not seek help for an unexplained lump or swelling 59% did not seek help after noticing changes to the appearance of a mole. Some of the reasons given by people who did not contact their GP were not wanting to waste doctors' time or put extra strain on the NHS; not wanting to be seen as someone who made a fuss; and fear of catching Covid at appointments. But people who did contact their GP reported feeling "safe" and "secure" when attending face-to-face appointments. Read full story Source: BBC News, 25 February 2021 -
News Article
Reviews of hospital-acquired covid deaths as ‘basic’ breaches found
Patient Safety Learning posted a news article in News
Senior doctors are leading a programme of work to review deaths caused by hospital-acquired covid in the North West, which has had disproportionately high rates of nosocomial infections over the last three months. According to internal NHS England papers seen by HSJ, a number of common themes have been identified as driving the infections in the region, including “breaches in the basic tenets of infection prevention control”, insufficient numbers of cleaning staff at some trusts, and a lack of consistent testing. The papers say there is also evidence that covid occupancy rates above 20 per cent drives nosocomial transmission. Occupancy rates in the North West have been near or above this level since the start of December, but have still been significantly lower than other areas, such as London. Read full story (paywalled) Source: HSJ, 24 February 2021 -
Content ArticleThe Healthcare Safety Investigation Branch (HSIB) carried out a themed review of their maternal death investigations during the coronavirus (COVID-19) pandemic. The national learning reports can be used by healthcare leaders, policymakers, and the public to: Aid their knowledge of systemic patient safety risks. Understand the underlying contributing factors. Inform decision making to improve patient safety. Explore wider patient safety processes.
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Content ArticleAnti-stay-at-home protesters aren’t the only ones with an argument based on individual rights on their side, writes Graham Mooney, associate professor at the Johns Hopkins University School of Medicine.
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Content ArticleThis animation by the Rockefeller Foundation explains how the 'Swiss Cheese' model can be applied to containing the spread of COVID-19. Combining different methods of infection control such as wearing face masks, social distancing and vaccination, creates a more solid and resilient barrier to transmission.
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News ArticleAll adults with a learning disability will be offered the vaccine against coronavirus after new advice from government experts warned they were at greater risk from the virus. The decision is a major win for disability charities and campaigners. The decision will mean as many as 150,000 more people could be offered the vaccine. The government’s Joint Committee on Vaccination and Immunisation (JCVI) has issued new advice saying any adult on GP Learning Disability Register should be prioritised for vaccination along with adults with related conditions such as cerebral palsy. The JCVI had previously said only those were severe learning disabilities and those living in care homes should be prioritised for vaccinations. Disability rights campaigners and charities warned this left vulnerable people at increased risk from the virus. Read full story Source: The Independent, 24 February 2021
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News Article
NHS pulls a million face masks from use after safety warning
Patient Safety Learning posted a news article in News
The NHS has been warned not to use or distribute a batch of high-grade face masks after government officials warned they may not meet safety standards. The Department of Health and Social Care (DHSC) said it had “received urgent information” suggesting the items did not meet UK government specifications. Hospital bosses and others including GPs have been told to stop using the FT-045A FFP3 masks, quarantine any remaining supplies and then track down any they might have sent on to other health providers through mutual aid schemes. DHSC said it was pausing further distribution while a rapid review was carried out. Some 1.12 million masks are affected, the department said. DHSC’s warning document told health bosses: “Please be assured that we are working with regional teams and providers to fit-test staff to alternative models and provide of them with alternative masks in the quantities needed. We have a good supply of other FFP3 masks.” Rob Harwood, consultants committee chairman of the British Medical Association, told the BBC: “Healthcare staff working on the frontline do so facing the grave risk of contracting Covid, and deserve the best protection from this deadly virus." “Many will be incredibly concerned to learn that some masks designed to offer enhanced protection, as well as gloves, may not meet standards, potentially placing them at greater risk.” Read full story Source: The Independent, 24 February 2021 -
Event
WHO COVID-19 Vaccine research forum
Sam posted an event in Community Calendar
untilWHO will host a monthly WHO COVID-19 Vaccine research forum, starting on Tuesday 2 March 2021. This first webinar is scheduled between 14:00 – 16:00 Central European Time (CET). The agenda will be shared in advance. The goals of these ongoing meetings are: To encourage and facilitate the rapid dissemination of research protocols and emerging results. To provide regular updates against R&D Blueprint roadmap priorities with the ability to pivot given dynamic research needs. Register -
News ArticleLocal groups of GPs have decided to prioritise all patients with learning disabilities for COVID-19 vaccination, after fresh evidence showed that disabled patients were at much higher risk from the disease. Latest figures from the Office for National Statistics1 showed that 60% of people in England who died from covid-19 from January to November 2020 (30 296 of 50 888) had a disability. This week an extra 1.7 million people in England—including some with severe learning disabilities—are being added to the list of people identified as clinically extremely vulnerable to COVID-19, although this does not include people with mild or moderate learning disabilities. But some clinical commissioning groups (CCGs) have deviated from national guidance and said that they will prioritise all patients with learning disabilities for vaccination given the disproportionate impact on them. In a statement published on its website, Kent and Medway CCG said that it had decided to include all adults with learning disabilities in the current priority phase for vaccination delivery. “Given the evidence of covid-19 inequalities increasing deaths amongst people with learning disabilities, the NHS in Kent and Medway has agreed to prioritise vaccinating the 9500 people on GP learning disability registers,” it said. Oxfordshire CCG was also praised by local campaigners for adjusting its priority list so that everybody with a learning disability is included in priority group 6, regardless of its severity. Read full story Source: BMJ, 19 February 2021
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News Article
Housebound people being missed for vaccination, NHS warned
Patient Safety Learning posted a news article in News
People who need to receive their covid vaccinations at home are missing out because their eligibility is not being recognised by GPs, experts have warned. There have been numerous reports of housebound people being told they are ineligible for a home visit in recent weeks, with some home care providers saying only a minority of their elderly clients have been vaccinated so far. Chit Selvarajah, policy manager at the charity Independent Age, said: “We have heard from people who say they are housebound being told they weren’t considered as housebound and told to go to a vaccination centre as they are not eligible for a home visit." “We don’t know how many people have been vaccinated but it’s likely to be very small numbers at the moment.” Ruthe Isden, head of health and care influencing at Age UK, believes some older people have “slipped into being effectively housebound” over the last year, and are not yet registered as such on GP databases. She said: “The pandemic has hit the fast forward button on ageing for a lot of people. They’ve aged a long way in a short period and seen their health really deteriorate, and often they are not going to proactively identify themselves as needing more help." “It’s vital we are thinking systematically about reaching this group. At the moment, there seems to be considerable variation in how people are followed up.” Read full story (paywalled) Source: HSJ, 22 February 2021 -
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 -
Content ArticleLast November’s HSJ Patient Safety Virtual Congress focused on the COVID-19 virtual ward model, which enables the early identification and timely management of deteriorating patients in the community - a critical step in reducing avoidable deaths from all conditions. If you missed the vital discussion, you can check it out below.
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Content Article"To me, leadership isn’t defined by how nice or popular you are. It’s defined by outcomes. That’s how I judge my own successes and failures. In this pandemic—if death and collateral damage are the barometers, as they should be—the leadership teams have failed us all." An article published in the BMJ from Partha Kar, a consultant in diabetes and endocrinology.
