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Content ArticleThis article in The Guardian aims to explain the major pressures the NHS will face in Autumn 2022. It identifies and explores the following threats: Covid Influenza Cost of living crisis Workforce shortages Pay
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Covid-19 has posed a huge challenge to the delivery of safe care, both when infection rates were at their highest levels and in terms of its long-term impact on health and social care systems.[1] The pandemic has magnified existing patient safety issues, created new ones, and exposed safety gaps which require systemic responses. This month the World Health Organization (WHO) has published a new report, Implications of the Covid-19 pandemic for patient safety: A rapid review.[2] The review aims to create a greater understanding of the impact of the pandemic on patient safety, particularly in relation to diagnostic services, treatment and care management. In this blog, Patient Safety Learning, one of the international organisations who contributed to this review, provides an overview and reflections on some the key themes and issues raised in this review. -
Content ArticleCOVID-19 is associated with increased risks of neurological and psychiatric sequelae in the weeks and months thereafter. How long these risks remain, whether they affect children and adults similarly, and whether SARS-CoV-2 variants differ in their risk profiles remains unclear. This study from Taquet et al. looked at the risks of 14 different disorders in 1.25 million patients two years on from Covid, mostly in the US. It then compared them with a closely-matched group of 1.25 million people who had a different respiratory infection. In the group who had Covid, after two years, there were more new cases of dementia, stroke and brain fog in adults aged over 65; brain fog in adults aged 18-64; and epilepsy and psychotic disorders in children, although the overall risks were small. Some disorders became less common two years after Covid, including anxiety and depression in children and adults and psychotic disorders in adults. The increased risk of depression and anxiety in adults lasts less than two months before returning to normal levels, the research found.
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Content ArticleGovernments in England, Scotland and Wales recently withdrew covid sick leave for NHS staff. These changes to sick pay provision for staff on Covid-related sick pay is hard to understand at a time when Covid-19 infections are going up exponentially and many NHS organisations are reporting increasing numbers of staff off sick. Evidence is emerging that your chances of on-going issues (Long Covid) following a covid infection increase with each re-infection. Given this you might expect that NHS organisations were ensuring their infection control guidelines guaranteed staff were fully protected against Covid-19. However, in many Trusts this does not appear to be the case. Throughout the pandemic many NHS organisations seem to have focused on following Government guidelines about PPE requirements and ignored their obligations under Health and Safety Legislation. This has resulted in on-going shortcomings in protecting staff at work. This is discussed by Professor Raymond Agius and colleagues in a BMJ blog.
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An assurance case for COVID-19 (28 October 2021)
Patient Safety Learning posted an article in Blogs
The iterative processes that engineers and technicians use to address problems could have been applied by decision-makers throughout the COVID-19 pandemic writes Rick Schrenker. -
Content ArticleThe pandemic has emphasised the high risk of avoidable harm to patients, health workers, and the general public, and has identified a range of safety gaps across all core components of health systems at all levels. The World Health Organization (WHO)'s rapid review ‘Implications of the COVID-19 pandemic for patient safety’ explores impacts that the COVID-19 pandemic did have on patient safety in terms of risks and avoidable harm, specifically in terms of diagnostic, treatment and care management related issues as well as highlights the main patterns of these implications within the broader health system context.
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Content ArticleThis article published by The Conversation looks at the pressures faced by ambulance services and emergency departments across Australia as a result of Covid-19. There has been an increase in 'ramping', where ambulances queue up outside hospitals. Ramping is a sign that the whole health system is under immense pressure. The article looks at the large amounts of funding Australian local governments are putting into ambulance services and emergency departments (EDs), but highlight that this will not solve the issues face by the health system if issues discharging patients into community and social care remain. It highlights a model developed in Leeds, UK, that has been adopted by the health service in Victoria, Australia, focused on solving more systemic issues. The Leeds model aims to improve patient flow in and out of the hospital and ensure that patients are quickly transferred from ambulances into EDs. Discharge coordinators organise the care patients need in the community after an ED or hospital stay. The authors also look at the role of community paramedics in keeping patients out of hospital and their potential to reduce financial and capacity pressure on health systems worldwide.
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Content ArticleThis article in The BMJ examines the case for vaccinating children under five against Covid, following the US recently recommending that children aged six months to five years should receive Covid-19 vaccines. It looks at the risks and benefits of vaccination for young children, citing recent Moderna and Pfizer trials. It highlights that children are more likely than adults to experience asymptomatic Covid-19 or very mild illness, and are much less likely to have severe disease requiring hospital admission. But for children with underlying health conditions, such as long term neurological disease, vaccination may be beneficial in preventing severe disease.
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Content ArticleDuring the Covid-19 pandemic, intensive Care Units (ICUs) all came under severe pressure, resulting in higher than usual mortality and complications rates, and longer stays. However, there was variation in outcomes among ICUs and this editorial in the journal Annals of Intensive Care discusses the concept of a resilient ICU. It looks at which metrics can be used to address the capacity to respond, sustain results and incorporate new practices that lead to improvement.
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Content ArticleThis report examines the approaches and key decisions taken by UK governments during the pandemic and the public health measures they introduced. It assesses whether these choices were timely, appropriate, and proportionate to deal with the threat and impact of COVID-19.
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Content ArticleThis research explores how the COVID-19 pandemic has changed the ways doctors make end-of-life decisions, particularly around Do Not Attempt Cardio-Pulmonary Resuscitation (DNACPR), treatment escalation and doctors’ views on the legalisation of euthanasia and physician-assisted suicide.
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Infographic: Long Covid explained
Patient Safety Learning posted an article in Good practice and useful resources
The science behind the symptoms of Long Covid are explained in this infographic from docdroid. -
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UK Covid-19 Inquiry: Opening statement (21 July 2022)
Patient Safety Learning posted an article in Covid-19 Inquiry
In her opening statement, Baroness Heather Hallett, Chair of the UK Covid-19 Inquiry, has set out her approach to running it. The Inquiry will consider and report on the preparations and the response to the pandemic in England, Wales, Scotland and Northern Ireland. The Terms of Reference provide the broad outline of the issues the Inquiry will investigate. -
Content ArticleCOVID-19 has been associated with new-onset cardiovascular disease (CVD) and diabetes mellitus (DM), but it is not known whether COVID-19 has long-term impacts on cardiometabolic outcomes. This study from Rezell-Potts et al. aimed to determine whether the incidence of new DM and CVDs are increased over 12 months after COVID-19 compared with matched controls. The study found that CVD was increased early after COVID-19 mainly from pulmonary embolism, atrial arrhythmias, and venous thromboses. DM incidence remained elevated for at least 12 weeks following COVID-19 before declining. People without preexisting CVD or DM who suffer from COVID-19 do not appear to have a long-term increase in incidence of these conditions.
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Marie Curie - Better end of life report (April 2021)
Patient-Safety-Learning posted an article in End of life care
The Better End of Life programme is a collaboration between Marie Curie, King's College London Cicely Saunders Institute, Hull York Medical School, the University of Hull and the University of Cambridge. It's first research report outlines key findings of the programme relating to the experience of death and dying during 2020, at the height of the Covid-19 pandemic. This interactive webpage presents graphics which highlight the key findings of the research. -
Content ArticleDavid Oliver is a consultant in geriatrics and acute general medicine who has worked in the NHS for 33 years. In this blog, he talks about his personal experience of running covid 'hot' wards during the different waves of the pandemic, describing the toll working in these conditions has taken on the health of him and many of his colleagues. He highlights the impact of looking after dying patients without adequate PPE, informing family members of patients' death over the phone, being responsible for many more patients than usual and witnessing colleagues die from Covid-19. The result has been burnout, mental health issues and low morale for a workforce that was already stretched before the pandemic hit the UK. David finally caught Covid-19 himself in March 2022 and he talks about how the virus—plus the cumulative effect of working under such strain for over two years—has meant he is not able to work and has been signed-off sick since mid-May.
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Content ArticleThe Covid-19 pandemic presented the need for fast decision-making in a rapidly shifting global context. This article in BMJ Evidence Based Medicine looks at the limitations of traditional evidence-based medicine (EBM) approaches when investigating questions in the context of complex, shifting environments. The authors argue that it is time to take a more varied approach to defining what counts as ‘high-quality’ evidence. They introduce some conceptual tools and quality frameworks from various fields involving what is known as mechanistic research, including complexity science, engineering and the social sciences. The article proposes that the tools and frameworks of mechanistic evidence, sometimes known as ‘EBM+’ when combined with traditional EBM, may help develop the interdisciplinary evidence base needed to take us out of this protracted pandemic.
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Content ArticleThe Government’s aim throughout the COVID-19 pandemic has been to protect the lives and livelihoods of citizens across the UK. This document sets out how the Government has and will continue to protect and support citizens by: enabling society and the economy to open up more quickly than many comparable countries; using vaccines; and supporting the NHS and social care sector. It also sets out how England will move into a new phase of managing COVID-19. The Devolved Administrations will each set out how they will manage this transition in Scotland, Wales and Northern Ireland. The global pandemic is not yet over and the Government’s Scientific Advisory Group for Emergencies (SAGE) is clear there is considerable uncertainty about the path that the pandemic will now take in the UK. This document therefore also sets out how the Government will ensure resilience, maintaining contingency capabilities to deal with a range of possible scenarios.
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Content ArticleThe Industrial Injuries Advisory Council (IIAC) is an independent scientific advisory body that looks at industrial injuries benefit and how it is administered. Since the start of the Covid-19 pandemic in 2020, the IIAC has been reviewing and assessing the increasing scientific evidence on the occupational risks of Covid-19. This report builds on an IIAC interim Position Paper published in February 2021 and considers more recent data on the occupational impacts of Covid-19, particularly around the longer term health problems and disability caused by the virus. IIAC found the most convincing and consistent evidence was for health and social care workers in certain occupational settings, who present with five serious pathological complications following Covid-19 that have been shown to cause persistent impairment and loss of function in some workers.
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Content ArticleMoral injury is a specific kind of trauma that can happen when when people face situations that deeply violate their conscience or threaten their core values. This blog for Scientific American looks at the experience of ER doctor Torree McGowan when the Delta wave of Covid-19 hit the central Oregon region where she works. It examines the impact that moral injury has had on her mental health and her relationship with patients. The author looks at how Covid-19 hugely increased the incidence of moral injury as people in frontline roles faced ethically wrenching dilemmas every day. The growing realisation that moral injury is a separate diagnosis to other conditions such as PTSD and depression is resulting in a wider range of treatments and trauma therapies. Many of these treatments encourage people to face moral conflicts head-on rather than blotting them out or explaining them away, and they emphasize the importance of community support in long-term recovery.
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Content ArticleThe Health Survey (Northern Ireland) has run annually, on a continuous basis, since 2010/11. The 2021/22 survey included questions relating to general health, mental health and wellbeing, smoking and drinking alcohol. The sample size for the survey was 3,154 individuals aged 16 and over. This article presents the key findings of the Health Survey (Northern Ireland): First Results 2021/22 report. One important finding was that of respondents who had been in contact with the health and social care system in the last year, 73% were either very satisfied or satisfied with their experience (down from 85% in 2020/21), while almost a fifth (18%) were either dissatisfied or very dissatisfied (double that in 2020/21 – 9%).
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Content ArticleIn this episode of 'Better Never Stops', Virginia Mason Institute Senior Partner Melissa Lin interviews Dana Nelson-Peterson, Vice President of Nursing Operations at Virginia Mason Franciscan Health, who shares what happens when you trust a management system and improvement process to solve your toughest challenges. Dana shares her story of leading a critical part of Virginia Mason’s Covid response.
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Covid Airborne Protection Alliance Latest News
Patient Safety Learning posted an article in Coronavirus (COVID-19)
The Covid Airborne Protection Alliance – formerly the AGP Alliance – (Chaired by BAPEN's Dr Barry Jones) is calling on Governments and health services in all four nations of the UK to review and update its guidance regarding personal protective equipment (PPE) for all health and social care staff as a matter of urgency. Stay up to date with their latest news. -
Content ArticleSouth Wales pharmacist, Geraint Jones, contracted COVID-19 in April 2020. He shares an insight to his experiences over the last year after he was later diagnosed with Long Covid.
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Long Covid by Geraint Jones
Patient Safety Learning posted an article in Patient recovery
Geraint Jones, a healthcare worker at a hospital in Wales, shares his experiences of Long Covid. Geraint tested positive for COVID-19 in April 2020, whilst working on the COVID-positive wards in a district general hospital. This long-lasting illness is still little understood, but new research is uncovering some of the recurring symptoms that many patients experience and suggesting better options for treatment for adults and children.
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