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Content ArticlePharmacovigilance is the observation and monitoring of possible harms from exposure to a variety of pharmaceuticals, biologics and devices. In this blog, Professor of Evidence-based Medicine Carl Heneghan and Clinical Epidemiologist Tom Jefferson talk about a recent attempt to obtain data on the incidence of deaths following Covid-19 vaccination from the Medicines & Healthcare Products Regulatory Agency (MHRA) through a Freedom of Information request. They describe how the MHRA initially said they were unable to provide the information as it would cost too much to extract, and after sending a follow up request to the MHRA's Chief Safety Officer, they have not heard anything further after an initial promise to investigate. They argue that the MHRA is failing the public by failing to investigate the side effects of Covid vaccines using information from Yellow Card reports. This blog is paywalled once you have read a certain number of articles each month.
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Content Article
In this blog, hub topic lead Julie Storr talks about her new book Infection prevention and control: A social science perspective, which explores new perspectives on and approaches to infection prevention and control (IPC). The book examines how people and their behaviour affect IPC, and how they are in turn affected by IPC measures. Julie highlights the importance of compassion in IPC policy and implementation and outlines the unintended negative consequences that IPC measures can have. Among other contributors, Patient Safety Learning's Chief Executive Helen Hughes has written a chapter for the book highlighting the need for patient safety to be treated as a core purpose of health and social care.- Posted
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Content ArticleThis report set out an infectious disease strategy for England, including new arrangements to counter old and new threats, such as radiological and chemical hazards through bioterrorism, by describing the scope of the threat posed as well as establishing the priorities for action to combat this threat. It aimed to overhaul previously fragmented systems and to place a new emphasis on communicable diseases through direct action plans, programmes to inform understanding and legislative reform.
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News ArticlePatients diagnosed with cancer in 2020 had “significantly lower” survival rates in Scotland a year after having their cases confirmed compared with the previous year, a report has found. The increase in deaths was an indirect result of the pandemic as coronavirus dissuaded people from getting check-ups or visiting physicians. Many cancer screening programmes were also paused and infection control measures in healthcare settings caused delays in both diagnosis and treatment. Andrew Elder, president of the Royal College of Physicians, said the government’s decision to pause screening programmes was “understandable in the extreme circumstances”, but added that the figures were “concerning”. He said: “Fewer and later presentations by patients who may have had more advanced disease clearly have had sometimes tragic consequences that are now being identified in the data.” Read full story (paywalled) Source: The Times, 31 May 2023
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News Article
CQC case reveals ‘degrading’ conditions in England care home as Covid hit
Patient Safety Learning posted a news article in News
The depth of suffering in care homes in England as Covid hit has been laid bare in a court case exposing “degrading” treatment with residents being “catastrophically let down”. Care levels at the Temple Court care home in Kettering collapsed so badly in April 2020, when ministers rushed to free up NHS capacity by discharging thousands of people, that residents were left lying in their own faeces, dehydrated, malnourished and suffering necrotic, infected wounds, the Care Quality Commission found. Fifteen of its residents died with Covid in the first weeks of the pandemic. The case foreshadows the UK Covid-19 public inquiry module on the care sector, which next year will test Matt Hancock’s claim to have thrown “a protective ring around social care”. The prosecution resulted in a £120,000 fine handed down at Northampton magistrates court last week. The operator, Amicura, apologised but said it had been “acting in the national interest and supporting the NHS by accepting patients discharged from hospitals into care homes under government policy”. Read full story Source: The Guardian, 29 May 2023 -
Content ArticleIn England, the NHS National Breast Screening Programme (NHSBSP) offers routine breast screening to all women, some trans men and non-binary people, between the ages of 50 years and up to their 71st birthday, every 3 years. The unfolding Covid-19 pandemic in early 2020 was understandably a time of great anxiety and concern. Culturally we were seeing strong behavioural shifts such as social distancing and a general change in all our daily life patterns. Conceptually, and as leaders, we understood the vulnerability we observed, but felt that we did not have the 'right language' and in fact lacked the relevant experience of how to address and communicate with staff and clients during this crisis. A semiotic, observational research project was utilised that aimed at providing insight how cultural behaviour was being shaped and expressed during the early onset of the Covid-19 pandemic in England. The recommendations of the project were then integrated and implemented into an action plan and subsequent practice. Semiotic analysis revealed that several factors (positive and negative) impacted on peoples' confidence and had practical and emotional implications. Eleven main codes which are belief systems about oneself and others were identified and expressed in a multitude of different ways revealing three main themes or needs i.e. Reassurance, Trust and Clarity. An action plan was developed in response to the project findings and recommendation were implemented. Effective leadership relies on situational awareness. This semiotic project enabled the authors to find the 'right' language and communication style so that they could connect with staff at the time of crisis.
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Content ArticleIn February 2023, the government commissioned an independent review to offer recommendations on how to resolve key challenges in conducting commercial clinical trials in the UK and transform the UK commercial clinical trial environment. The review sets out 27 recommendations, including both priority actions to progress in 2023 and longer-term ambitions for UK commercial clinical trials. The review was conducted by Lord James O’Shaughnessy, Senior Partner at consultancy firm Newmarket Strategy, Board Member of Health Data Research UK (HDR UK) and former Health Minister, who was appointed as review Chair. During the review, Lord O’Shaughnessy consulted closely with industry and a wide range of stakeholders across the UK clinical trials sector. The government response welcomes all recommendations from the review, in principle, and makes 5 headline commitments backed by £121 million. An implementation update, setting out progress made against these commitments and a comprehensive response to the remaining recommendations, will be published in the autumn.
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News Article
World must prepare for disease more deadlier than Covid, WHO chief warns
Patient Safety Learning posted a news article in News
The head of the World Health Organisation warned on Tuesday that governments need to prepare for a disease even deadlier than Covid-19. Dr Tedros Adhanom Ghebreyesus, director general of WHO, told its annual health assembly in Geneva that it was time to advance negotiations on preventing the next pandemic. He warned that nation states cannot “kick this can down the road” and that the next global disease was bound to “come knocking”. Dr Tedros said: “If we do not make the changes that must be made, then who will? And if we do not make them now, then when?” He added: “The threat of another variant emerging that causes new surges of disease and death remains. And the threat of another pathogen emerging with even deadlier potential remains.” Read full story Source: The Independent, 24 May 2023 -
Content ArticleThis podcast series from Julie Taylor aims to raise awareness of Long Covid, provide a platform of support, education and the lived experience. Julie is a registered nurse in the UK and became unwell with Covid in May 2020 while working on the frontline, during the first wave of the pandemic. She now lives with Long Covid and POTS (postural orthostatic tachycardia syndrome). In this podcast series, Julie shares her journey and lived experience, the symptoms and how each impacts daily life, not only the physical issues but also the impact this has had mentally and emotionally.
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Content ArticleIn this letter to The Lancet, Thomas Cueni, Director General of the International Federation of Pharmaceutical Manufacturers and Associations argues that the need to focus on equitable rollout of vaccines in the event of a future pandemic is a key global health priority. He proposes that Governments, pharma companies and other stakeholders should focus on the challenges that led to the inequitable rollout of vaccines, which he identifies as vaccine nationalism and need for more diverse manufacturing. He highlights an industry proposal for equitable response to future pandemics supported by vaccine manufacturers and biotechnologies. the proposal involves manufacturers setting aside a percentage of pandemic tools for allocation to susceptible populations in low-income countries.
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News Article
Poor diabetes care may be behind 7,000 excess deaths
Patient Safety Learning posted a news article in News
Delayed health checks among people with diabetes may have contributed to 7,000 more deaths than usual in England last year, a charity report suggests. The routine checks help cut the risk of serious complications like amputations and heart attacks. Diabetes UK says too many people are still being "left to go it alone" when managing their challenging condition. There are more than five million people in the UK living with diabetes, but around 1.9 million missed out on routine vital checks in 2021-22, Diabetes UK says. Disruption to care during the pandemic is likely to be a factor in the current backlog, which may be leading to higher numbers of deaths than usual in people with diabetes, it says. Between January and March 2023, for example, there were 1,461 excess deaths involving diabetes - three times higher than during the same period last year. "Urgent action is needed to reverse this trend and support everyone living with diabetes to live well with the condition," the report says. Read full story Source: BBC News, 10 May 2023 -
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Diabetes care: Is it fair enough? (Diabetes UK, 10 May 2023)
Patient Safety Learning posted an article in Diabetes
Missed checks, disrupted care and health inequalities have been revealed in a new report from Diabetes UK looking at the state of diabetes care in England. The report reveals that less than half (47%) of people living with diabetes in England received all eight of their required checks in 2021-22, meaning 1.9 million people did not receive the care they need. It is calling for urgent action to address the routine diabetes care backlog and prevent avoidable deaths of people living with diabetes. -
Content ArticleA group of patients and families with experience of end-of-life care worked with researchers from the Nuffield Trust to review findings from its research investigating the effect of the pandemic on people who were receiving end-of-life care at home. This web page summarises the research findings from the perspective of patients and family.
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News Article
Covid global health emergency is over, WHO says
Patient Safety Learning posted a news article in News
The World Health Organization (WHO) has declared that Covid-19 no longer represents a "global health emergency". The statement represents a major step towards ending the pandemic and comes three years after it first declared its highest level of alert over the virus. Officials said the virus' death rate had dropped from a peak of more than 100,000 people per week in January 2021 to just over 3,500 on 24 April. The head of the WHO said at least seven million people died in the pandemic. But Dr Tedros Adhanom Ghebreyesus said that the true figure was "likely" closer to 20 million deaths - nearly three times the official estimate - and he warned that the virus remained a significant threat. "Yesterday, the Emergency Committee met for the 15th time and recommended to me that I declare an end to the public health emergency of international concern. I've accepted that advice. It is therefore with great hope that I declare Covid-19 over as a global health emergency," Dr Tedros said. Read full story Source: BBC News, 6 May 2023 -
News Article
Whistleblower says career shattered by treatment
Patient Safety Learning posted a news article in News
A former top medic on the Isle of Man who was unfairly dismissed has said her career has been "shattered" by her treatment. Rosalind Ranson was the Department of Health and Social Care's (DHSC) medical director from January 2020. She was awarded a record £3.19m in compensation after a lengthy tribunal which ruled she had been unfairly dismissed for whistleblowing. Dr Ranson raised a number of serious concerns about the coronavirus advice on the island that was not being passed on to ministers. She was later marginalised before being dismissed as the island's top medic when the operational services of DHSC transitioned into Manx Care. Dr Ranson said: "For me it is a tragedy that my 35-year career in medicine has come to an end through these circumstances. "I was proud of my professional integrity, my resilience, and my strength to stand up for those that I protected through my work as a doctor." Read full story Source: BBC News, 4 May 2023 -
Content ArticleSocial care in England entered the pandemic in a fragile state. With much already written about the government’s response to the Covid-19 pandemic in the social care sector, this new report from the Nuffield Trust in collaboration with the Care Policy and Evaluation Centre analyses the structural and systemic factors that influenced that initial national response. Covid had far-reaching impacts on social care and exacerbated many longstanding issues. This work seeks to highlight progress and identify where action is needed to create a more resilient system.
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News Article
Sick and tired: Australia's Long Covid inquiry report released
Patient Safety Learning posted a news article in News
A national Long Covid and Covid-19 database is among the key recommendations of a unanimous report released by an Australian parliamentary Committee for its inquiry into Long Covid and repeated Covid infections. The House of Representative’s Standing Committee on Health, Aged Care and Sport’s report aims to improve Australia’s response to Long Covid, an often-debilitating condition possibly affecting hundreds of thousands of Australians. The Chair of the Committee, Dr Mike Freelander MP said: ‘It is clear that the emergence of Long Covid has created challenges for patients and health care professionals alike. People with Long Covid suffer from a lack of information and treatment options. Health care professionals, who worked tirelessly over the acute phase of the pandemic, are now in a difficult situation trying to support patients with this new and poorly understood condition.’ The Committee made nine unanimous recommendations aimed at strengthening the Australian Government’s management of Long Covid, including regarding: A definition of long COVID for use in Australia Evidence-based living guidelines for long COVID, co-designed with patients with lived experience A nationally coordinated research program for long COVID and COVID-19 The COVID-19 vaccination communication strategy Access to antiviral treatments for COVID-19 Support for primary healthcare providers Indoor air quality and ventilation. Read full story Source: Parliament of Australia, 24 April 2023 -
Content ArticleThis article in USA Today looks at how the Covid-19 pandemic has caused setbacks in hospitals' patient safety progress. It looks at data from a report by the US non-profit health care watchdog organisation, Leapfrog, which show increases in hospital-acquired infections, including urinary tract and drug-resistant staph infections, as well as infections in central lines. These infections spiked during the pandemic and remain at a five-year high. The article also looks at the case study of St Bernard Hospital in Chicago, which was rated poorly by Leapfrog on handwashing, medication safety, falls prevention and infection prevention, but then made huge progress in improving safety. It describes the different approaches and interventions taken by St Bernard.
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News Article
Senedd could investigate Wales' Covid response in Labour-Tory deal
Patient Safety Learning posted a news article in News
Wales' response to the pandemic could be investigated by a new Senedd committee under a deal between Welsh Labour and the Welsh Conservatives. A special committee will see if there are any gaps in what the UK Covid-19 inquiry says about Wales. It follows a long-running row over whether Wales needs its own probe into the pandemic. The Welsh Conservatives welcomed the "halfway-house" compromise. The Welsh government has continued to resist calls for a Wales-specific public inquiry into Covid, supporting instead the UK-wide effort chaired by Baroness Hallett. The inquiry has a sub-module specific to Wales and will hold public hearings in the country this autumn. Campaigners fear the UK inquiry will not be comprehensive enough. Read full story Source: BBC News, 4 May 2023 -
Content ArticleDuring the first waves of the Covid-19 pandemic, the UK shielding policy was introduced with the intention to protect people at the highest risk of harm from Covid-19 infection. This study in the journal Public Health aimed to describe intervention effects in Wales at one year. The authors retrospectively compared linked demographic and clinical data for cohorts of people identified for shielding from 23 March to 21 May 2020 with the rest of the population. The largest clinical categories in the shielded cohort were severe respiratory condition (35.5%), immunosuppressive therapy (25.9%) and cancer (18.6%). The study found that: Deaths and healthcare utilisation were higher amongst shielded people than the general population, as would be expected in the sicker population. Differences in testing rates, deprivation and pre-existing health are potential confounders, but lack of clear impact on infection rates raises questions about the success of shielding and indicates that further research is required to fully evaluate this national policy intervention.
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Content ArticleThe Relatives and Residents Association (R&RA) is conducting a survey which aims to gather evidence on the impact of the Covid-19 pandemic on access to healthcare services for those living in care homes. R&RA is seeking responses from people who were living in care homes at any point during the pandemic, or from their relatives and friends. Our analysis of the responses will be shared with the UK Covid-19 Inquiry, including anonymised examples. The survey should take around 10-15 mins to complete.
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I guess that a common feature linking most visitors to Patient Safety Learning is that they have a profound interest in two things. First, recognising and applauding innovations and ‘best practice’ in healthcare. Second, recognising, exposing and denouncing bad practice. The thing they have in common is the desire to learn from the mistakes in the past to do better in the future. When it comes to ‘bad practice’ in healthcare it is usually in connection with some adverse and damaging impact on patients. Our thoughts turn perhaps to certain medical failures, such as the ‘Mid‑Staffs scandal’. Seldom do we find the need to consider the adverse and damaging impacts on the doctors, nurses and all the other staff who work in the health and social care sector. However, those of you who watched the recent BBC Panorama programme, 'Forgotten heroes of the Covid frontline' will have been appalled at the scandal that now confronts so many frontline staff for whom we stood outside our front doors and clapped for so enthusiastically back in those dark days at the height of the pandemic. This blog is dedicated to those 'forgotten heroes'. I hope that it demonstrates that they are not, in fact, forgotten I hope that the resources linked to this blog may be of help to them. -
Content ArticleA gap analysis identified the need for process improvement surrounding the identification and reporting of adverse drug reactions related to moderate sedation. A change to documentation was selected to address this gap. The challenge was disseminating the change in a meaningful way during a time of high census and limited staffing due to the COVID-19 pandemic. Complex adaptive systems theory was used to plan interventions in these conditions.
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Content ArticleThe CVDPREVENT Audit has published its third annual audit report covering the audit period up to March 2022. The report provides insight into the impact of the Covid-19 pandemic on primary care services, when diagnosis and management of hypertension were significantly disrupted. It also compares the national position against key ambitions identified as milestones for the prevention of cardiovascular disease (CVD) and the detection and management of atrial fibrillation, blood pressure and cholesterol. It also includes findings relating to diagnoses of chronic kidney disease and diabetes, lifestyle and health inequalities, as well as a number of recommendations to support the prevention of cardiovascular disease.
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Content ArticleThere has been a steady increase in the numbers of people dying at home in recent years. These trends became entrenched during the pandemic, which could reflect people fearful of Covid-19 in hospitals and care homes just as much as broader patient preferences for dying at home. So did those dying at home receive the care they needed, at a good standard? This new research from the Nuffield Trust sheds light on the services used by people who died at home in England, before and during the first year of the pandemic.
