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News Article
Largest ever daily fall in covid hospital patients
Patient Safety Learning posted a news article in News
The number of covid positive patients in English hospitals fell by 1,491 yesterday, by far the biggest decline recorded since the start of the pandemic. The previous record was set during the decline of the first wave, when numbers fell 1,055 on 17 April. The largest drop in the third wave before yesterday’s record was the 798 seen last Saturday. The national total of covid positive hospital patients now stands at 30,846, a drop of 9 per cent on the peak set on 18 January, but still 163 per cent of the mid-April peak. All seven English regions are now seeing a week-on-week decline in the number of their covid hospital patients for the first time. All have well established trends in falling admissions, with London and the south east seeing the running seven-day total fall by almost a third since a peak on 9 January. The east and south west have seen their admissions total decline by a fifth, while the midlands total has dropped 16 per cent in just five days and north east and Yorkshire nine in only four. Read full story (paywalled) Source: HSJ, 28 January 2021 -
News Article
Black over-80s 'half as likely' to have been vaccinated
Patient Safety Learning posted a news article in News
Black people over the age of 80 were half as likely as their white peers to have been vaccinated against Covid by 13 January, a large study suggests. This is despite the fact black people are four times more likely to die with COVID-19 than their white counterparts. People living in deprived areas or who have severe mental-health conditions or learning disabilities were also less likely to have received a vaccination. The study was based on more than 20 million patient records in England. The OpenSafely study, by the University of Oxford and the London School of Hygiene and Tropical Medicine, found of the million of those over 80 but not living in a care home: 43% of the white people had been given their first dose of the vaccine 30% of the Bangladeshi and Pakistani people had 21% of the black people had. Bangladeshi and Pakistani people are twice as likely to die with COVID-19 as white peple. Birmingham-based business owner Tru Powell told BBC Radio 5 Live of a "lack of trust between the government and people of colour". "People of colour have been subject to institutionalised racism within the healthcare system," she said. "We are five times more likely to be detained under the Mental Health Act and four times more likely to die in childbirth." Read full story Source: BBC News, 28 January 2021 -
Content Article
National Voices: What We Need Now
PatientSafetyLearning Team posted an article in Data, research and statistics
This report summarises how National Voices engaged with people who have ongoing health and care needs during the first phase of the pandemic and how this engagement led to a set of statements that describe what people who use health and care services now expect these services to look and feel like.These statements express people’s reasonable expectations of healthcare. Most would see the demand to be listened to and have one’s decisions respected as basic tenets of normal healthcare. The power of these statements lies in the fact that they are truly reflective of what people with significant health and care needs said they needed and wanted. National Voices believe that their simplicity, their self-evident realism and the pragmatism they therefore inspire demand an equally practical and grounded response from system leaders, and everyone tasked with designing and delivering health and care. -
News ArticleOnly a third of local authorities that are rolling out lateral flow testing have made the test’s limitations clear to the public—including that it does not pick up all cases and that people testing negative could still be infected, an investigation by The BMJ has found. A search of the websites of the 114 local authorities rolling out lateral flow testing found that 81 provided information for the public on rapid COVID-19 testing. Of these, nearly half (47%; 38) did not explain the limitations of the tests or make it clear that people needed to continue following the restrictions or safety measures even if they tested negative, as they could still be infected. Although 53% (43) did advise people to continue to follow the current measures after a negative result, only 32% (26) were clear about the test’s limitations or its potential for false negatives. The advice the websites gave to the public about a negative test result ranged from “A single negative test is not a passport to carrying on your daily life ‘virus-free’... don’t let a negative COVID-19 test give you a false sense of security” to “It is good news that you don’t have the coronavirus.” On 10 January England’s health secretary, Matt Hancock, launched the drive for local authorities to test asymptomatic people who cannot work from home, to try to halt the spread of the virus. But many public health experts are concerned about false reassurance from mass testing. Read full story Source: BMJ, 26 January 2021
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News ArticleNew advice on how to treat coronavirus has been issued by the World Health Organisation (WHO) as it also begins a wide-reaching study into the effects of so-called "long COVID". For COVID-19 patients at home, WHO is now suggesting the use of a pulse oximetry machine to measure oxygen levels in the blood - but warns that this should only be done after full patient education and with medical follow-up support if necessary. For hospitalised patients, WHO is recommending the use of low-dose anticoagulants to prevent clots forming in blood vessels, known as thrombosis. And for sufferers who are already using supplemental oxygen, the organisation is officially endorsing the positioning of patients on their stomachs to increase oxygen flow. This is known as "awake prone positioning". The new guidelines also include a recommendation that healthcare professionals favour "clinical judgement over models" in making decisions for individual patients. Read full story Source: Sky News, 26 January 2021
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News ArticleA trust has warned it may reach a ‘tipping point’ where it is ‘impossible’ to separate covid positive and negative patients. Surrey and Sussex Healthcare Trust also revealed in papers published ahead of its Thursday board meeting that it planned to distribute a “duty of candour” leaflet for patients, warning them of the risk of contracting covid in hospital. The papers noted covid patients at the trust increased from 80 pre-Christmas to 230 by January, filling half its beds. HSJ’s figures suggest covid patients at the trust continued to rise until around 14 January before dropping back slightly. The report from the trust’s safety and quality committee — which met on 7 January — said: “It is becoming more difficult to separate the covid+ and covid- patients. In an increasing number of instances, patients are admitted to cold areas for non-covid treatment and without symptoms but then test positive. These patients then need to be admitted to hot areas and any contacts (including patients from the same bay) isolated. “At some point a tipping point could be reached where it may be impossible to retain hot and cold areas.” Read full story (paywalled) Source: HSJ, 27 January 2021
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Content ArticleThe Faculty of Occupational Medicine (FOM) has published guidance for healthcare professionals to assist them in facilitating the return to work of people who are unable to work due to Long-COVID. Follow the link below or download the guidance as a pdf.
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News ArticleRotating clinicians and keeping ventilation running are among Public Health England’s (PHE) recommendations for how to avoid spreading covid while looking after patients in the back of ambulances outside emergency departments. The suggestions are made in unprecedented new guidance issued by PHE amid sky-high rates of very long ambulance handovers outside hospitals. This is because emergency departments (EDs) are struggling with attempts to maintain distancing for infection control, along with high occupancy and severe operational pressures elsewhere in hospitals. It has led over the past two months to large numbers of patients being looked after in ambulances for extended times while they wait for space in ED. The PHE guidance, added last week to existing covid guidance for ambulance services, says it should only happen in “exceptional circumstances”. But it says staff in this situation should adopt infection prevention and control procedures including: if more than one clinician is available, rotating them regularly, so allowing them time to change PPE and have a drink; keeping ventilation systems running which may require the engine to be kept running; ensuring patients and any essential escorts wear surgical masks, as long as patient care is not compromised; minimising the number of people within the patient compartment and avoiding sitting face-to-face with patients; and decontaminating contact surfaces more frequently and during the delay if possible. Read full story (paywalled) Source: HSJ, 25 January 2021
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News ArticleLondon’s largest acute trust has been accused of ‘emotional blackmail’ by suggesting junior doctors could do voluntary shifts in its ‘really short staffed’ critical care unit. In an email cascaded to all junior doctors at Whipps Cross Hospital, run by Barts Health Trust, hospital medical director Heather Noble said day and night shifts at another trust site, the Royal London Hospital, “really need cover”. She said doctors could work overtime through a “voluntary or paid shift”, and that if they made contact, should “state whether or not they want to be paid”. Doctors working at the trust who received the email, who wished to remain anonymous, described the email as “tone deaf” and “not the right way to incentivise anyone to do what they want”. One medic said: “There has been a lot of anger generated by this correspondence amongst junior doctors. People already working antisocial and demanding rotas are very unhappy about being asked to work more hours for free.” Read full story (paywalled) Source: HSJ, 26 January 2021
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News ArticleMen working in low-skilled jobs or care, leisure and service roles are more than three times as likely to die from Covid as professionals, according to new data. Office for National Statistics (ONS) figures show there were 7,961 coronavirus-related deaths registered among the working-age population (those aged 20 to 64 years) in England and Wales between 9 March and 28 December last year. Nearly two-thirds of those deaths were among men (5,128 fatalities). Analysis by the ONS shows men who worked in low-skilled occupations (699 deaths) or care, leisure and other service occupations (258 deaths) had the highest rates of death involving Covid-19, with 66.3 and 64.1 deaths per 100,000 males, respectively. Men working in process plants, as security guards or as chefs, had some of the highest COVID-19 death rates. Plant workers recorded a rate of 143.2 deaths per 100,000 males, while for security guards and related occupations, the figure stood at 100.7 deaths per 100,000 males. Ben Humberstone, ONS head of health analysis and life events, said: “Jobs with regular exposure to Covid-19 and those working in close proximity to others continue to have higher COVID-19 death rates when compared with the rest of the working-age population.” However, the figures do not prove that rates of death are caused directly by differences in employment. “There are a complex combination of factors that influence the risk of death, from your age and your ethnicity, where you live and who you live with, to pre-existing health conditions,” Mr Humberstone said. Read full story Source: The Independent, 25 January 2021
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Content ArticleThe Health Foundation policy tracker provides a description and timeline of national policy and health system responses to COVID-19 in England in 2020. The full tracker includes data on what changes have been introduced, when, why, and by whom – as well as how these changes have been communicated by policymakers. We track policy changes in five areas – from health and care system changes to wider social and economic policy.
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Content ArticleThis report to Congress details a strategy to achieve the principal purpose and objective of Operation Warp Speed (OWS): ensuring that every American who wants to receive a COVID-19 vaccine can receive one, by delivering safe and effective vaccine doses to the American people beginning January 2021.
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Content ArticleSue Hignett and Paul Bowie propose taking a much-needed professional approach to patient safety through an accredited learning pathway to integrate safety into clinical systems and develop healthcare safety specialists and experts
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Content ArticleThis report summarises the impacts on babies of COVID-19 and the spring 2020 national lockdown. The report also explores how local systems responded to the challenges presented by COVID-19. It seeks to understand the factors that have shaped the response by services that support babies and their families. Most importantly, the report seeks to ensure that lessons are learnt for the future of service provision for this age group.
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News Article
Cancer operations down 800 in first two weeks of January
Patient Safety Learning posted a news article in News
There were 800 fewer cancer surgeries in the first two weeks of January than usually take place during the period, according to provisional data seen by HSJ. The bulk of this reduction came in London and the surrounding counties such as Essex, Bedfordshire, and Surrey. London and the south east have been severely hit by coronavirus pressures, causing widely reported mass cancellations of non-urgent elective surgery. However, the impact on cancer cases has, so far, been less clear. NHS England has insisted in the last week that urgent cancer cases should be given the same priority as coronavirus patients. Read full story (paywalled) Source: HSJ, 25 January 2021 -
News Article
Record ethnicity of those getting covid vaccine to fight stigma, NHSE told
Patient Safety Learning posted a news article in News
NHS England has been urged to introduce routine recording of race and ethnicity data when people are given their covid vaccination. Documents seen by HSJ show Pinnacle, the IT system being used by GPs and mass vaccination centres to record jabs, does not directly require ethnicity to be recorded. Jabeer Butt, chief executive of the Race Equality Foundation, which promotes race equality in public services, told HSJ that making it a requirement would help establish the facts on uptake among different groups, more quickly. It is understood the NHS is able to ascertain data on vaccine uptake by ethnicity by connecting it with GP records, through the national immunisation management service, and potentially with other healthcare data. However, Mr Butt said this would provide only limited insight and take more time. He believes the absence of data may allow ”misconceptions” to take hold about lower uptake among some minorities, which can lead to stigma, when in fact, he said, the trend may so far simply be due to there being fewer black and Asian people in the oldest age groups, who are the first eligible for vaccination. Read full story (paywalled) Source: HSJ, 24 January 2021 -
Content Article
Hidden wounds
Stephanie O'Donohue posted an article in Staff safety
In this short blog, Stephanie O'Donohue, Content and Engagement Manager for the hub, reflects on the inner turmoil many NHS staff are experiencing as they are having to spread themselves, and their care, thin. -
News Article
My ‘Long Covid’ nightmare: Still sick after 6 months
Patient Safety Learning posted a news article in News
A Times reporter caught the coronavirus during the New York City outbreak last April. But the acute phase of the illness was just the beginning. Laura recounts her experience of Covid nearly 3 months after first being diagnosed. "I remember the second time I thought I would die." Read full story Source: The New York Times, 21 January 2021 -
Content ArticleFrontline clinicians working with the National CLEAR Programme for ICU have published ten recommendations that can be adopted in ICU in 48 hours, to help manage the COVID surge. Click on the image or download the attachment as a PDF.
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Content ArticleRegina Hoffman, Executive director of Pennsylvania’s Patient Safety Authority and editor-in-chief of Patient Safety, discusses why we need to shift the focus from "whomever-care" to a "people's care" approach. She hopes after the pandemic that the next chapter brings radical change to how we approach patient safety and says we must start by making patient safety a national priority. This is part of a series of blogs from Regina 'The bigger picture'.
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Content Article'Covid Oximetry @home' describes an enhanced package of care for individuals with confirmed (or suspected) COVID-19 who are at risk for future deterioration. NHS England and Improvement wrote to all CCGs and trusts to encourage the development of local CO@H projects. The 'CO@h' package of care involves the remote monitoring of the patient's condition through providing regular contact with a local health care team who will reassess the individuals symptoms (including oxygen saturation levels). This close monitoring enables the individual to remain at their usual place of residence whilst allowing early signs of deterioration to be identified and escalated quickly and appropriately. This material has been designed primarily for use across the South East AHSN network by colleagues within the Wessex AHSN, Kent Surrey Sussex AHSN and Oxford AHSN regions. Colleagues from regions beyond the South East are also very welcome to make use of this toolkit in setting up their own local approaches to remote monitoring.
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News ArticleOne of the mysteries of COVID-19 is why oxygen levels in the blood can drop to dangerously low levels without the patient noticing. It is known as "silent hypoxia" and as a result, patients have been arriving in hospital in far worse health than they realised and, in some cases, too late to treat effectively. But a potentially life-saving solution, in the form of a pulse oximeter, allows patients to monitor their oxygen levels at home, and costs about £20. They are being rolled out for high-risk Covid patients in the UK, and the doctor leading the scheme thinks everyone should consider buying one. A normal oxygen level in the blood is between 95% and 100%. "With Covid, we were admitting patients with oxygen levels in the 70s or low-or-middle 80s," said Dr Matt Inada-Kim, a consultant in acute medicine at Hampshire Hospitals. He told BBC Radio 4's Inside Health: "It was a really curious and scary presentation and really made us rethink what we were doing." Read full story Source: BBC News, 21 January 2021 See hub resource on the 'Covid Oximetry @home' project
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News ArticleThe second wave of COVID-19 has put doctors under huge pressure, the Royal College of Physicians has warned, as two thirds of physicians report feeling tired or exhausted. A survey of 25 500 members of the college from across the UK, conducted on 2 November, received 1890 responses. It found that two thirds (64%, 931) felt tired or exhausted, 48% (687) felt worried, and just under a third (29%, 424) felt demoralised. Almost a fifth (19%, 280) said they have sought informal mental health support, such as speaking to colleagues or friends, during the pandemic. Just 10% (155) said they had sought formal mental health support from either their employer, GP, or external services. College president Andrew Goddard said he was concerned about the mental health of doctors, “There is no way to dress it up—it is pretty awful at the moment in the world of medicine. Hospital admissions are at the highest ever level, staff are exhausted, and although there is light at the end of the tunnel, it seems a long way away.” He said that before the pandemic, few physicians would have expected to need formal mental health support during their career. After the pandemic, staff will be in desperate need of a break, Goddard said, and will need specific time away if they’re to be at their best. “Doctors have demonstrated remarkable resilience throughout the pandemic, working under the most challenging conditions the NHS has ever faced, but they can’t continue working this way forever,” he said. Read full story Source: The BMJ, 21 January 2021
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News ArticleJust a third of people aged 80 and over have received the covid vaccine in one part of England, compared to four out of five in the area with the highest rate, new NHS England figures have revealed. Gloucestershire delivered at least one dose of the vaccine to 85% of its over 80s population between 8 December and 17 January. Three other STPs — Northamptonshire, Herefordshire and Worcestershire, and Lancashire and South Cumbria — have all delivered at least one dose to at least three-quarters of over 80s in the area. By contrast, Suffolk and North East Essex has vaccinated just 36% of its over 80s population. A further seven of England’s 42 STP/Integrated Care Systems had vaccinated under half of their over 80s population. The mixture of reasons for the differences are not known — it may be due to supply, delivery issues, the nature of the area, or the size of the over-80s population. NHS England has maintained that the vaccine is being used nearly as quickly as it is available each week, with supply the main constraint. NHSE decides when sites are able to open and when they have supply. Read full story (paywalled) Source: HSJ, 21 January 2021
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News Article
Ambulance service facing 'terrifying' levels of risk, says trust chief
Patient Safety Learning posted a news article in News
The chief executive of a small acute trust has described the “terrifying situation” faced by ambulance crews and hospital staff in trying to provide adequate emergency care as coronavirus threatens to overwhelm the local NHS services. Susan Gilby, of Countess of Chester Hospital Foundation Trust, told HSJ staff are seeing “tragic and potentially avoidable” instances where patients with COVID-19 have reached the emergency department too late. She suggested this is due to a combination of patients waiting too long to call 999, and then having to wait long periods for an ambulance to arrive. Cheshire has been among the hardest hit areas in England during this third wave of coronavirus, with all four of its acute hospitals having very high covid occupancy rates. Dr Gilby, a former critical care consultant, said her trust has been at around 60 per cent covid occupancy for the last fortnight, which has made her increasingly fearful of the difficulties in admitting patients through the emergency department due to a lack of beds. This can then cause knock-on delays for patients arriving in ambulances, and ties those ambulance crews up for long periods, preventing them from responding to further 999 calls. She said ambulance turnaround times had been relatively good at the Countess of Chester, but she had spoken to paramedics handing over patients who were “really struggling” to get to people quickly enough. Read full story (paywalled) Source: HSJ, 22 January 2021
