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Content ArticleThere is evidence of disproportionate mortality and morbidity amongst black, Asian and minority ethnic (BAME) people, including NHS staff, who have contracted COVID-19. The authors of this blog argue that this is not just an equality, diversity and inclusion issue but an urgent medical emergency and we need to act now.They look at how the NHS can support BAME staff through the COVID-19 pandemic and beyond, focusing on: protection of staff engagement with staff representation in decision making rehabilitation and recovery communications and media.
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Content ArticleHealthcare Improvement Scotland is currently working with the Scottish Government to develop COVID-19 specific Anticipatory Care Planning (ACP) templates and guidance. ACP is a person-centred approach to help people to plan for their future. The essence of ACP is to encourage individuals to think ahead to help ensure that in the event of a change in their health or care needs, including loss of capacity, the right thing is done at the right time by the right person with the right outcome. ACP can benefit many individuals, from those with early onset of long-term conditions to people with chronic and complex illnesses, to plan ahead for care needs. ACP can be beneficial to individuals towards the end of their life, however the process can be more effective if started earlier in their journey. The link below takes you to an online resource that is designed to be used in conjunction with practitioner judgement, and is not for sole use by individuals and their families without guidance.
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Content Article
COVID-19 tests: The safety implications of false negatives
PatientSafetyLearning Team posted an article in Blogs
The number of people accessing COVID-19 testing in the UK continues to increase. Health Secretary, Matt Hancock recently announced, that anyone over the age of five years old who is showing symptoms is eligible for a test [1]. However, there are concerns that the rate of ‘false negative’ test results could be as high as 30% and a significant number of people are wrongly being told they do not have the virus [2]. This could be due to the particularly difficult nature of obtaining the swab, which requires someone to take a sample from the very back of the mouth or deep from inside the nose. “Swabbing patients using the correct technique is paramount in ensuring an accurate result. Nasal swabs need to be taken from far back in the nasal pharynx and is often uncomfortable for the patient. By simply swabbing the inside of the nasal passage is not deep enough to verify that the virus is present. I am unsure that all clinical staff have been taught the correct way to swab patients.” Claire Cox, Intensive Care Outreach Nurse. Members of the public are now able to request self-testing kits to do at home if they are experiencing symptoms. If clinicians like Claire are finding the test challenging to perform on others, it is likely that patients could struggle to swab deep enough into their own nasal pharynx (7-8cm). There is a risk that as the number of people testing themselves increases, so too will the rate of false negative results. Testing is a key element of the UK’s COVID-19 infection control strategy [3]. A high, and potentially rising, rate of false negative results means that a significant number of people could be carrying the virus, wrongly reassured they are not infectious. In this blog, we look at some of the associated safety risks. -
Content ArticleOur NHS staff are doing fantastic work to tackle the COVID-19 pandemic and keep essential services going – their hard work and dedication during this difficult time is remarkable. As the NHS Chief Executive Sir Simon Stevens made clear in his letter of 29 April 2020 to NHS chief executives, it is important to remind everyone of the duty – and right – of those who work in the NHS to speak up about anything which gets in the way of patient care and worker wellbeing. Hear what Prerana Issar, the first NHS Chief People Officer, has to say in her blog. See also our hub resources on Whistleblowing and Speak Up Guardians.
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Content ArticleHow will the coronavirus pandemic affect the nation’s mental health? Covid-19 and the nation’s mental health: Forecasting needs and risks in the UK is the first assessment from the Centre for Mental Health of the likely impacts of COVID-19 on mental health in Britain. It uses evidence from previous epidemics internationally and from the aftermath of the 2008 banking crisis to estimate what effect COVID-19 will have on mental health at population level in the UK.
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Content ArticleDraft resolution proposed by Albania, Australia, Bangladesh, Belarus, Bhutan, Botswana, Brazil, Canada, Chile, Colombia, El Salvador, Guatemala, Iceland, India, Indonesia, Japan, Mexico, Monaco, Montenegro, Mozambique, New Zealand, North Macedonia, Norway, Paraguay, Peru, Republic of Korea, Republic of Moldova, Russian Federation, San Marino, Sierra Leone, South Africa, the European Union and its Member States, Turkey, Ukraine, United Kingdom of Great Britain and Northern Ireland and Zambia following the 73rd World Health Assembly.
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Content Article
Coronavirus: 'I didn't want her dying on her own'
Patient Safety Learning posted an article in Blogs
Siobhan Brammeld is a care worker at Massereene Manor care home in County Antrim and leads the social care team. She has sat with several residents as they passed away having contracted COVID-19. In this interview with BBC News NI she says she was convinced some residents had "died before their time". "I feel as though I am on autopilot - it never leaves my head. Sometimes I worry that I could have done more," she said. "These are sad times, scary times too," she added. Siobhan told BBC News that staff felt not enough was done to prepare them for the pandemic and that workers like her were left to the side. "I feel we were left on our own. We as workers were forgotten about as well as the wee residents," she said. "At the start of all this I just wanted to scream at somebody - could someone please come and help these wee residents? I just didn't want them to die before their time." "I watched what was happening in other countries and you knew it was coming, but there didn't seem to be an awful lot happening to prepare us." -
Content ArticleThe Care Quality Commission (CQC) has published the first of what will be a regular series of insight documents intended to highlight COVID-19 related pressures on the sectors that CQC regulates. This document draws on information gathered through direct feedback from staff and people receiving care, regular data collection from services who provide care for people in their own homes, and insight from providers and partners. The information collected from these sources is being used to understand the wider impact of COVID-19, to share regular updates with local, regional, and national system partners and the Department of Health and Social Care, and to highlight any emerging trends and issues.
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Content Article
Rethink Mental Illness: COVID-19 and mental illness
Patient Safety Learning posted an article in Mental health
The charity Rethink Mental Illness have set up an online hub to provide practical support and information that is useful for people living with, or supporting people with mental illness during the coronavirus pandemic. -
Content ArticleDesperate times offer opportunities for the light to come streaming in. Currently, we are seeing that light in the outpouring of support and love for health and care staff across the world during this pandemic. In the UK, a large proportion of those staff come from ethnic minorities and some are dying at a much higher rate than white staff. The same is true in the general population. The authors of this article, published by the Kings Fund, take a look at the statistics and ask 'what are we to do now?'
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Content ArticleAround 6.5 million carers in the UK are propping up the NHS by keeping loved ones safe at home. Where is their recognition? For the past eight years, Sheena and her brother have been caring for their mother, who has early onset dementia, diabetes and other health issues. In her blog to the Guardian, Sheena discusses why she wants to see affirmative action for carers, why government needs to take responsibility and why the carers themselves need to be involved in these discussions.
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Content ArticleTips, advice and guidance on where you can get support for your mental health during the coronavirus (COVID-19) pandemic. If you’re worried about the impact of coronavirus on your mental health, you are not alone. The COVID-19 pandemic is a new and uncertain time for all of us and will affect our mental health in different ways. However you are feeling right now is valid. With the right help and support, we can get through this. Here is you will find advice from Young Minds on things you can do to keep mentally healthy during this time.
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Content ArticleThis statement outlines the UK's four nations’ collective strategic priorities and approach to Allied Health Professional (AHP) rehabilitation leadership during and after COVID-19. Rehabilitation is critical to ensuring our population’s recovery from the impacts of the pandemic and the long-term sustainability of the health and social care system. AHPs are at the centre in shaping the rehabilitation agenda while working as part of the wider multidisciplinary and multiagency teams across all sectors.
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Content ArticleMental Health UK has provided information and tips for managing your mental health during the coronavirus pandemic. Whether you're social distancing or self-isolating you may be feeling anxious or stressed during this time, and that's completely normal. There are simple steps you can take to look after your mental health and wellbeing.
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Content ArticleFrom the early stages of the COVID-19 pandemic in the UK, Patient Safety Learning has been working with others in healthcare – from patients and staff to healthcare leaders and politicians – to identify the impact the pandemic is having on non COVID-19 treatment and care, and on patient safety. Recently, Patient Safety Learning hosted a webinar, in partnership with HealthPlusCare, titled ‘Patient safety: Time for questions? Non Covid-19 care and treatment’. The webinar took place on Wednesday 6 May, with a panel consisting of: Professor Maureen Baker CBE, Chair of the Professional Records Standards Body and past Chair of the Royal College of GPs Professor Mike Bewick, Chair of CECOPS and past Deputy Medical Director to Sir Bruce Keogh at NHS England Dr Jane Carthey, Human Factors and Patient Safety Specialist Mike Fairbourn, Chair of ABHI Patient Safety Working Group and BD Country General Manager Dean Russell MP, MP for Watford and member of the Health and Social Care Select Committee Claire Cox, Patient Safety Learning’s Associate Director of Patient Safety and Critical Care Outreach Nurse Helen Hughes, Patient Safety Learning’s Chief Executive We are delighted with the success of the webinar, with 542 participants. Those who attended represented stakeholders from across the health and care system, and were well-engaged, making good use of the chat, Q&A and polls.
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Content ArticleToo little, too late, says Scally, Jacobson and Abbasi in this BMJ Editorial on the government's response to COVID-19. The UK government and its advisers were confident that they were “well prepared” when COVID-19 swept East Asia. The four-pronged plan of 3 March to contain, delay, research, and mitigate was supported by all UK countries and backed, they claimed, by science. With over 30 000 hospital and community deaths by 12 May, where did the plan go wrong? What was the role of public health in the biggest public health crisis since the Spanish flu of 1918? And what now needs to be done?
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Content ArticleIf a nasogastric tube (NGT) has been misplaced into the respiratory tract and this is not detected before fluids, feed or medication are given, death or severe harm can be caused. The consequences are even more likely to be fatal for patients who are already critically ill. Most nasogastric ‘Never Events’ of feeding into the respiratory tract through a misplaced tube continue to arise from misinterpretation of x-rays by staff who had not been given training in the ‘four criteria’ technique and were unaware that relying on the position of the tube tip alone on a radiograph can be a fatal error. BAPEN has produced this easy reference guide.
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Content ArticleThis document “Resumption of hospital services after lockdown” provides a comprehensive set of action plans and key guidelines to be followed in the context of continuous hospital preparedness. It specifically addresses the action plan in India for resuming of services, in the safest and most effective manner to safeguard both patients and healthcare worker.
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Content ArticleEuropean governments hope that contact tracing apps can allow them to ease lockdowns. But much work must be done at both national and EU level before restrictions can be eased. There are growing calls for lifting lockdowns across European countries. Austria and Denmark have already announced plans to open schools. But ending lockdowns without mass testing and contact tracing firmly in place will be very dangerous, as COVID-19 is far more infectious than its predecessors, like SARS. Even with rigorous testing and contact tracing, some curbs on social contact will be needed, and lockdown measures will need to be eased step by step. Once it has been shown that restrictions can be eased while containing the spread of the disease, there will still need to be co-ordination at the EU level to allow travel between member-states. Without trust in each other’s exit strategies, countries will be wary of opening up. In this article, John Springford, Deputy Director of the Centre for European Reform, stresses that mass testing and contact tracing apps must be in place before lockdowns can be eased in Europe - and that the EU has an important role to play.
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Content ArticleThe British public have been offered alternating periods of lockdown and relaxation of restrictions as part of the COVID-19 lockdown exit strategy. Extended periods of lockdown will increase economic and social damage, and each relaxation will almost certainly trigger a further epidemic wave of deaths. These cycles will kill tens of thousands, perhaps hundreds of thousands, of people before a vaccine becomes available, with the most disadvantaged groups experiencing the greatest suffering. There is an alternative strategy: universal repeated testing. The authors of this article published in The Lancet recommend evaluation of weekly severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antigen testing of the whole population in an entire city as a demonstration site (preferably several towns and cities, if possible), with strict household quarantine after a positive test. Quarantine would end when all residents of the household test negative at the same time; everyone else in the city can resume normal life, if they choose to.
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Content ArticleOn 4 May 2020, a 13-strong committee convened by former UK government Chief Scientific Adviser Sir David King discussed some aspects of the science behind the UK strategy in a two and a half hour meeting. Leading experts in public health, epidemiology, primary care, virology, mathematical modelling, and social and health policy, raised ideas and issues for consideration which are shared in this report. The report does not aim to critique such work. Rather, it recognises that such solutions will take time and will still require an appropriate public health infrastructure to maximise their benefit. This is the focus of this first report and the meeting aimed to offer some constructive ideas to the governments of the UK and the devolved nations about how best to tackle this crisis, to save lives, suppress the coronavirus and get the economy moving again.
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Content Article
NHS trade unions’ blueprint for return (May 2020)
PatientSafetyLearning Team posted an article in Exit strategies
As we enter what could be the start of a gradual easing of lockdown restrictions, discussion has turned to how the NHS restarts those services that were stepped down during the peak of the COVID-19 pandemic. In this document, 16 NHS trade unions That is why 16 NHS trade unions are asking UK governments and employers to work with them to deliver their Blueprint for Return, in which they set out 9 key recommendations. -
Content ArticleThe Children’s Commissioner’s Office is concerned about the limitations in support offered to new families under lockdown, the reductions in contact with health visitors, and the inability to maintain birth registers. In this briefing paper, they highlight the need for policymakers to put families with young children, and especially those with newborns, at the heart of coronavirus planning. It shows that the risks to babies and young children can be reduced if the government and services think creatively to find ways to bring vital support to new parents, and takes proactive steps to ensure that different agencies routinely share data on these children – now more important than ever.
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Content ArticleContrary to popular belief, people rarely panic in dangerous situations. Withholding information is patronising and counter-productive says Stephen Reicher, a member of the Sage subcommittee advising the government on behavioural science. He suggests in his blog in the the Guardian that there needs to be a broader shift in the relationship between the state and its citizens. The government must abandon a psychology that infantilises people. It must recognise and respect the ability of the public to acknowledge and deal with harsh realities. It must engage us as full partners in every stage of the strategy against Covid-19: from formulating a response, to implementing and evaluating policy. And, as in any constructive relationship, none of this can happen without putting openness at the very heart of what government does.
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Content ArticleThis is a joint letter from The Health Foundation, The King's Fund and the Nuffield Trust to the Health and Social Care Select Committee for the evidence session on delivering core NHS and care services during the pandemic and beyond.
