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Content ArticleThe COVID-19 Evidence Network to support Decision-making (COVID-END) helps: those supporting decision-making about COVID-19 to find and use the best available evidence (i.e. to support the evidence-demand side of the pandemic response) researchers to avoid waste by reducing duplication in and better coordinating the COVID-19 evidence syntheses, technology assessments and guidelines being produced (i.e., to support the evidence-supply side of the pandemic response). COVID-END is a time-limited network that brings together more than 50 of the world’s leading evidence-synthesis, technology-assessment and guideline-development groups around the world. It covers the full spectrum of the pandemic response, from public-health measures and clinical management to health-system arrangements and economic and social responses. It also covers the full spectrum of contexts where the pandemic response is playing out, including low-, middle- and high-income countries.
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Content ArticleDr John Campbell, a retired A&E nurse, discusses the current news, research and evidence on COVID-19 in the US and UK, the new coronavirus cases linked to mink farms, and free supplies of vitamin D to care home residents and clinically extremely vulnerable people in England.
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Content ArticleOn the same day that the nation went into a second lockdown, the Government published revised guidance on Visiting Arrangements for Care Homes. Whereas previous versions of this guidance had adopted a more neutral approach, the steer from the Government is now clear; the expectation is for care homes to be facilitating visits wherever possible. This Bevan Brittan article looks at what the law says, what the new guidance says and what care homes should be doing.
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Content ArticleCovid has been a traumatic experience for many who work in the NHS. Battlefield scenes, redeployment and it can seem there is little end in sight. However, there have been positives. Improved team work, new ways of delivering care and better use of technology. How can we use this learning? How can we ensure that we capture the good stuff, and make sure that we don’t go back to old habits? Improvement Cymru, the all-Wales Improvement service for NHS Wales, has developed a ‘Learning from COVID’ toolkit’. It is based on the idea that bringing teams together to consider these questions in a facilitated discussion is not only practically helpful in supporting the service to develop – it is important in helping those individuals involved reflect on and come to terms with what they have experiences.
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Content ArticleAs we seek to develop a national healthcare system that delivers true 21st century care, we are confronted by a COVID-19 pandemic that has identified numerous challenges. Among the most important: the need to provide correct diagnoses. Definitive answers about diagnosis are critical not only for patients, but also for their families and others around them. Consequential questions gnaw at us: Are we diagnosing COVID-19 correctly? Are we missing cases? How do we know? How can we improve? Gopal Khanna and Jeff Brady are hopeful that some of the changes that have resulted from the US's battle against the pandemic will spark the long-term improvements in diagnostic safety that will strengthen the system’s ability to address COVID-19 and other challenges we face.
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Content ArticleHealthcare providers around the world are engaged in actions intended to enhance health, yet they regularly put themselves at risk in order to care for their patients. Working in stressful health care environments can make this burden worse. The COVID-19 pandemic brought these dangers to an entirely new level, revealing how risks to health workers risk patient health and safety in turn. Creating a safe space for health-care workers has never been more important. Today, health workers worry about being infected with the novel coronavirus themselves and contributing to the spread of the virus at work, at home, or in their communities.Health workers have also had to work with limited access or adherence to personal protective equipment (PPE) and other infection prevention and control measures. They’ve had to be flexible and resilient in the face of ever-changing and evolving work policies and practices. Such stressors take a toll on the well-being and safety of our health providers. And that’s not good for patients, as Ivy Bourgeault and Chris Power explores in this article.
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Content ArticleMaintaining safe elective surgical activity during the global coronavirus disease 2019 (COVID‐19) pandemic is challenging and it is not clear how COVID‐19 may impact peri‐operative morbidity and mortality in this population. Therefore, adaptations to normal care pathways are required. Here, Kane et al. establish if implementation of a bespoke peri‐operative care bundle for urgent elective surgery during a pandemic surge period can deliver a low COVID‐19‐associated complication profile. Kane et al. present a single‐centre retrospective cohort study from a tertiary care hospital of patients planned for urgent elective surgery during the initial COVID‐19 surge in the UK between 29 March and 12 June 2020.
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Content ArticleIn this Anaesthesia editorial, Simoes and Bhangu, on behalf of the CovidSurg Collaborative, outline why and how elective surgery must restart. "COVID‐19‐free pathways will be crucial for patient safety during the COVID‐19 pandemic, as they seem to lead to low rates of SARS‐CoV‐2 infection rates and complications. Further preventive measures and patient level risk assessment will allow surgery to safely restart and continue during this, and future, crises." This editorial accompanies an article by Kane et al. Anaesthesia 2020; 75: 1596–1604.
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Content ArticleThis interactive webinar was part of the world tour series designed by the World Health Organization's Patients for Patient Safety (PFPS) Global Network and hosted by Patients for Patient Safety Canada, the patient-led program of the Canadian Patient Safety Institute, a WHO Collaborating Centre on Patient Safety and Patient Engagement. Watch on demand and download slides from the webinar.
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Content ArticleThis guidance from the Department of Health and Social Care (DHSC) sets out: key messages to assist with planning and preparation in the context of the COVID-19 pandemic so that local procedures can be put in place to minimise risk and provide the best possible support to people in supported living settings. safe systems of working including, social distancing, respiratory and hand hygiene and enhanced cleaning. how infection prevention and control (IPC) and personal protective equipment (PPE) applies to supported living settings.
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Content ArticleThe onset of COVID-19 caused some patients throughout the United States to delay their surgeries as many hospital systems postponed nonemergent procedures. This led to a potentially large backlog of case volume. In a recent McKinsey survey of health system leaders, hospital executives said they may struggle to address this backlog given workforce availability, enhanced sanitation protocols, and reserved inpatient capacity. Without healthcare systems recalibrating demand and capacity, patients could face long backlogs for procedures, and potentially experience higher morbidity and mortality rates. Solutions may include 1) reducing the unnecessary deferral of care, 2) effectively addressing new throughput challenges, 3) using advanced analytics to better forecast demand and manage capacity in real time, and 4) reimagining operating room operations to increase long-term capacity. Berlin et al. explore these solutions further in this article.
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Content ArticleLast week a letter signed by 435 GP practice staff on access to GP practices was published in The Times. The letter was drafted by a group of grass root GPs, in response to the recent misleading allegations that GPs have been “closed” during the pandemic. These headlines damage the reputation and morale of the workforce. Responsible media reporting is a patient safety issue, as those patients who believe this false rhetoric may not seek help for worrying symptoms. We have already seen reduced rates of cancer diagnosis during the pandemic by around 40%, along with reduced presentations of other major non-covid illnesses. Irresponsible media may also cause inappropriate use of emergency departments and the NHS 111 helpline, which adds further pressure on our secondary care colleagues at a critical time for the NHS. GPs Simon Hodes and Neena Jha discuss this further in this BMJ Opinion article.
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Content ArticleCOVID-19 survivors Fiona Lowenstein and Nikki Brueggeman share their experiences with the disease and how they navigated the healthcare system during the pandemic, and how they were inspired to become advocates for others.
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Content ArticleInformation to help people make the right decisions about their general health and treatment against perceived risk of COVID-19 infection has been a key concern of Patient Information Forum (PIF) members throughout the pandemic. The Covid Choices survey was developed with a collaborative group of expert patients and other partners. More than 800 people responded to the survey and made more than 1000 detailed free text comments expressing their concerns. The vast majority of people had a health condition or cared for someone who did. Around 60% said their long-term condition put them at risk of infection and just under half were shielding. Responses represented people with a wide range of health conditions.
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Content ArticleThe COVID-19 pandemic clearly illustrates the intersection of structural racism, social risk factors, and health. Data from the Centers for Disease Control and Prevention on COVID-19 infection and mortality rates show high incidences in specific geographic regions. Further investigation within Louisiana revealed that rates of hospitalisation and death in Black patients were twice as high as would be expected on the basis of demographic representation. It has been hypothesised that increased exposure to COVID-19 among Black Americans is attributable to greater representation in service occupations and a greater likelihood of living in inner cities with high population density.
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Content Article
Stolen breaths (16 July 2020)
Patient Safety Learning posted an article in Improving patient safety
In this perspective for the New England Journal of Medicine, Harderman et al. recommend that healthcare systems engage, at the very least, in five practices to dismantle structural racism and improve the health and well-being of the black community and the country. -
Content ArticleBlack, Latinx, and Native Americans are experiencing disproportionate burdens of infections, hospitalisations, and deaths from COVID-19. Similar disparities are observed in other countries where minority groups face hurdles in accessing health, education, and social services as well as affordable, healthy food. These stark manifestations of health inequities have emerged in the wake of a body of evidence linking obesity and obesity-related chronic diseases, such as hypertension, diabetes, and cardiovascular disease — conditions that disproportionately affect disadvantaged populations — with severe outcomes from COVID-19. Though the factors underlying racial and ethnic disparities in COVID-19 in the United States are multifaceted and complex, long-standing disparities in nutrition and obesity play a crucial role in the health inequities unfolding during the pandemic.
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Content ArticleAs the race to develop a vaccine for COVID-19 has reached phase 3 clinical trials, concerns are increasing about the low rates of trial participation in important subgroups, including Black communities. Recent data show that although Black people make up 13% of the US population, they account for 21% of deaths from COVID-19 but only 3% of enrollees in vaccine trials. This problem threatens both the validity and the generalisability of the trial results and is of particular concern in vaccine trials, in which differences in lifetime environmental exposures can result in differences in immunologic responses that could affect both safety and efficacy. Despite long-standing calls from the Food and Drug Administration (FDA) and the National Institutes of Health (NIH) to improve the participation of underrepresented subgroups in drug trials, the problem persists. Warren et al., in an article in the New England Journal of Medicine, explore what the barriers are to greater participation of Black people in COVID-19 trials.
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Content ArticleHealthcare workers and their families account for 17% of hospital admissions for COVID-19 in the working age population (18-65 years), finds new research published in the BMJ. Shah et al. assessed the risk of hospital admission for COVID-19 among patient facing and non-patient facing healthcare workers and their household members. The study revealed that healthcare workers in patient-facing roles were around three times more likely to be hospitalised with the virus than the general population. The authors call for an urgent focus on how COVID-19 spreads around hospitals to prevent a similar toll in future waves of the pandemic. They also call for hospitals to consider re-deploying staff with vulnerable family members away from high-risk zones.
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Content ArticleThis report is the product of a review by Baroness Doreen Lawrence, commissioned by the Labour Party, into the disproportionate impact of Covid-19 on Black, Asian and minority ethnic communities. In her introduction to the report, Baroness Lawrence says: "Black, Asian and minority ethnic people have been overexposed, under protected, stigmatised and overlooked during this pandemic – and this has been generations in the making. The impact of Covid is not random, but foreseeable and inevitable – the consequence of decades of structural injustice, inequality and discrimination that blights our society. We are in the middle of an avoidable crisis. And this report is a rallying cry to break that clear and tragic pattern."
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Content ArticleThis Healthcare Safety Investigation Branch (HSIB) report charts a four-month patient safety investigation that was launched following concern that patients were contracting COVID-19 after being admitted to hospital. The report references data presented to SAGE in mid-May that suggested around 20% of patients were reporting symptoms seven days after admission. The aim of the investigation was to understand the factors that could contribute to the risk of transmission, how the NHS operates to reduce that risk and where there may be opportunities to reduce that risk even further. The investigation represented the voices of those working across the health service, from strategic national planners to hospital porters. It also captured experiences of patients and families, providing further insight into the challenges of managing the transmission of COVID-19.
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Content ArticleThis report seeks to inform the six-month review of the Coronavirus legislation required by the Coronavirus Act 2020 along with any future response to a “second wave” of the virus later this year. The report begins by setting out the legislative framework in play, then focuses on the following themes and rights: Human rights impact of the lockdown (Articles 8, 9, 10 and 11 ECHR) The right to life, including both the substantive and procedural duties on government (Articles 2 and 3 ECHR) and the right to health which has been (partially) incorporated within the positive obligation to secure the right to life. Issues in relation to detention settings (Articles 5, 8, 3 and 2 ECHR) Contact tracing and privacy rights (Articles 8 and 14 ECHR) Access to justice (Articles 6 and 2 ECHR) Children’s rights —the right to education (Article 2 of Protocol 1 ECHR) and the right to family life (Article 8 ECHR) The report also reflects on the challenge of ensuring the emergency legislation required in response to the outbreak was subject to appropriate parliamentary scrutiny and review. Follow the link below to read the full report including conclusions and recommendations.
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Content ArticleA new report from Healthwatch and the British Red Cross looks at how well the new hospital discharge policy is working for patients, carers and healthcare professionals. In March 2020, the Government introduced a new hospital discharge policy to help the NHS free up beds by getting people out of hospital quickly. This meant anyone who may need out-of-hospital support to help them recover would now have their needs assessed after being discharged, rather than in hospital. How has the new policy affected people's experience of leaving hospital? Healthwatch and the British Red Cross spoke to over 500 patients and carers and conducted 47 in-depth interviews with health and care professionals involved in the hospital discharge process. The research shows significant numbers of people are not receiving follow-up support after being discharged from hospital under new policy, leading to unmet needs.
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Content ArticleWith the possibility of a spike in COVID-19 cases this winter, doctors, nurses and medical staff may be coming in feeling already depleted from an uncontrolled pandemic. Guest host Dan Gorenstein of the Tradeoffs podcast talks with Dr Albert Wu, co-director of RISE (Resilience in Stressful Events) which provides emotional support to health system staff. Gorenstein and Wu talk about why health care workers may have low reserves right now, how COVID may be changing perceived stigma around mental health support for frontline workers and what institutions can do to ensure the well-being and resilience of all staff."Asking people to be heroic over and over again, to run back into the fire multiple times, gets harder each time" (Dr Wu).This is a podcast called Public Health on Call, produced by John Hopkins Bloomberg School of Public Health.
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Content ArticleAs a second wave of COVID-19 infections is underway in the UK, Sarah Scobie answers some key questions on how mortality figures are collected and measured during the pandemic. How do the numbers relate to the daily figures reported, and are all the extra deaths due to the coronavirus?
