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News ArticleCare home residents are on course to make up more than half the deaths caused directly or indirectly by the coronavirus crisis in England, according to a new analysis. The study warns that the death toll by the end of June from OVID-19 infections and other excess deaths is “likely to approach 59,000 across the entire English population, of which about 34,000 (57%) will have been care home residents”. The estimate, produced by the major healthcare business consultancy LaingBuisson, includes people who list a care home as their primary residence, wherever they died – including those who died in hospital. It is based on data from the Office for National Statistics, as well as the analyst’s own modelling of the number of care home resident deaths likely to have occurred in the absence of the pandemic. The new study coincides with mounting concerns over the failure to protect care homes earlier in the pandemic. Senior care industry figures point to the decision to move some hospital patients back to care homes in mid-March. There have also been complaints that non-Covid-related healthcare became less accessible to homes during the height of the pandemic, leading to extra deaths. Read full story Source: The Guardian, 7 June 2020
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Asymptomatic care workers unknowingly spread coronavirus
Patient Safety Learning posted a news article in News
Large numbers of staff could have been unknowingly spreading coronavirus through care homes, according to the UK's largest charitable care home provider. Data from MHA shows 42% of its staff members who recently tested positive were not displaying symptoms. Nearly 45% of residents who had a positive test were also asymptomatic. MHA operates in England, Scotland and Wales and has fully tested staff and residents in 86 of its 90 homes so far. A Department for Health and Social Care spokesperson said: "Our priority is to ensure care workers and those receiving care are protected, and the latest statistics show over 60% of care homes have had no outbreak at all. "We've set out a comprehensive support package for residents and staff, including a £600m infection control fund, testing regardless of whether you have symptoms, and a named clinical lead to support every care home." In total, 7% of MHA staff and 13% of residents received a positive test result. Routine testing is not yet under way. MHA CEO Sam Monaghan told BBC Newsnight: "It is not difficult to imagine that a lot of people may not have ended up dying if we'd had earlier testing and we'd been therefore better able to manage infection control in our homes." Read full story Source: BBC News, 3 June 2020 -
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Government censored BAME covid-risk review
Patient Safety Learning posted a news article in News
The government removed a key section from Public Health England’s review (published Tuesday) of the relative risk of COVID-19 to specific groups, HSJ has discovered. The review reveals the virus poses a greater risk to those who are older, male and overweight. The risk is also described as “disproportionate” for those with Asian, Caribbean and black ethnicities. It makes no attempt to explain why the risk to BAME groups should be higher. An earlier draft of the review which was circulated within government last week contained a section which included responses from the 1,000-plus organisations and individuals who supplied evidence to the review. Many of these suggested that discrimination and poorer life chances were playing a part in the increased risk of COVID-19 to those with BAME backgrounds. HSJ understands this section was an annex to the report but could also stand alone. Typical was the following recommendation from the response by the Muslim Council of Britain, which stated: “With high levels of deaths of BAME healthcare workers, and extensive research showing evidence and feelings of structural racism and discrimination in the NHS, PHE should consider exploring this in more detail, and looking into specific measures to tackle the culture of discrimination and racism. It may also be of value to issue a clear statement from the NHS that this is not acceptable, committing to introducing change.” One source with knowledge of the review said the section “did not survive contact with Matt Hancock’s office” over the weekend. Read full story Source: HSJ, 2 June 2020- Posted
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Coronavirus: Durham County Council accused of 'increasing' deaths
Patient Safety Learning posted a news article in News
At least 25 people have died at a care home amid claims from an industry body that a council's actions "caused" or "increased COVID-19 deaths". Melbury Court in Durham is thought to be the care home with the highest number of deaths in the UK. County Durham has had the highest number of care home deaths in England and Wales. Durham County Council said it "strongly refuted" the claim by the County Durham Care Home Association (CDCHA). Some patients went from the nearby University Hospital of North Durham to Melbury Court without being tested for coronavirus or after a positive test. A BBC investigation has discovered that in a conference call in late March, council officials were told plans to move hospital patients into care homes without testing would be disastrous. The CDCHA offered to find a specific home or homes where COVID-19 positive or untested people could be cared for rather than have them spread around the network, but this was never acted on and now the CDCHA has calculated there has been an outbreak of coronavirus in 81 of the county's 149 care homes. Maria Vincent, who runs Crosshill Care Home in Stanhope, told the council in March that care homes were not set up to accept COVID-19 patients, and described it as "neglect pure and simple". Read full story Source: BBC News, 2 June 2020 -
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Increase in learning disability deaths during the coronavirus outbreak
Patient Safety Learning posted a news article in News
The Care Quality Commission (CQC) have looked at how the number of people who have died during the coronavirus outbreak this year compares to the number of people who died at the same time last year. They looked at information about services that support people with a learning disability or autism in the 5 weeks between 10 April to 15 May in 2019 and 2020. These services can support around 30,000 people. They found that in that 5 weeks this year, 386 people with a learning disability, who may also be autistic, died. Data for the same 5 weeks last year found that 165 people with a learning disability, who may also be autistic, died. This information shows that well over twice as many people in these services died this year compared to last year. This is a 134% increase in the number of death notifications this year. This new data should be considered when decisions are being made about the prioritisation of testing at a national and local level. Kate Terroni, Chief Inspector of Adult Social Care at the Care Quality Commission (CQC) said: "Every death in today's figures represents an individual tragedy for those who have lost a loved one." "While we know this data has its limitations what it does show is a significant increase in deaths of people with a learning disability as a result of COVID-19. We already know that people with a learning disability are at an increased risk of respiratory illnesses, meaning that access to testing could be key to reducing infection and saving lives." "These figures also show that the impact on this group of people is being felt at a younger age range than in the wider population – something that should be considered in decisions on testing of people of working age with a learning disability." Read full story Source: Care Quality Commission, 2 June 2020 -
News ArticleCare homes are the focus of the COVID-19 outbreak in England and Wales. At least 40% of all coronavirus deaths have occurred in the very places dedicated to keeping people safe in their later years. The under-reporting of deaths, the lack of personal protective equipment (PPE) and testing available to staff, and the total focus on the NHS at the expense of the social care sector have all contributed to an estimated 22,000 deaths in care homes – places that government had originally advised were “very unlikely” to experience infection. But how could care homes have been failed so badly, and what checks and balances should have been in place to prevent this? Care homes in England are regulated by the Care Quality Commission (CQC). One of its key responsibilities is to carry out inspections and visits to ensure providers meet fundamental standards of quality and safety; however, as of 16 March, the regulator stopped all routine inspections to “focus on supporting providers to deliver safe care during the pandemic”. Had the CQC continued its inspections, it would have been in a position to challenge cases where PPE was being diverted away from care homes to the NHS, and to aid struggling homes in their battle to secure tests for staff and residents. Instead, care homes have effectively been left to fend for themselves. On top of this, the CQC joined similar bodies in Wales, Scotland and Northern Ireland in refusing to publish detailed data on care home deaths, arguing instead for a need to “avoid confusion” and to protect “the privacy and confidentiality of those who have died and their families”. Families and the wider public have a right to know when and where COVID-19 outbreaks are happening, and this lack of transparency is deeply troubling. Read full story Source: The Guardian, 1 June 2020
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News ArticleThe coronavirus pandemic is a “magnifier of inequality” that threatens the wellbeing of women, children, and adolescents worldwide, a roundtable of influential female leaders has heard. The United Nations has predicted that 47 million women could lose access to contraception resulting in 7 million additional unintended pregnancies over the next six months1 because of “deadly and disabling” COVID-19, the virtual event was told. There could also be 31 million additional cases of gender based violence in low and middle income countries. Policy makers have a clear duty to protect the most vulnerable and disadvantaged and to tackle the root causes of inequality with targeted policies and resources, the participants concluded. Henrietta Fore, executive director of Unicef, said that, in countries with already weak health systems, COVID-19 was disrupting medical supply chains and straining financial and human resources. Visits to healthcare centres are declining owing to lockdowns, curfews, and transport disruptions, and as communities remain fearful of infection. She cited recent research that indicated there could be an increase in child deaths amounting to an additional 6000 a day over the next six months, and 56 700 more maternal deaths. “This is a statistic we want to avoid. We are concerned about access to services,” she said. Read full story Source: BMJ, 29 May 2020
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News ArticleA hospital trust under the spotlight over avoidable baby deaths provided inadequate antenatal care, with inexperienced junior midwives working alone and doctors not always available to assess high risk women, the Care Quality Commission (CQC) has found. The latest CQC report on maternity services at East Kent Hospitals University Foundation Trust follows a report last month by the NHS Healthcare Services Investigation Branch on 24 maternity care investigations at the trust. Read full story (paywalled) Source: BMJ, 28 May 2020
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News ArticleDeaths resulting from COVID-19 infection account for only half of the number of excess deaths taking place in private homes, expert analysis of latest data suggests. Figures from the Office for National Statistics from the seven weeks to 15 May show that more than 40 000 COVID-19 deaths have now taken place in hospitals, care homes, and private homes in England and Wales. The figures also show 14 418 excess non-covid deaths. Although COVID-19 was mentioned on death certificates 13 500 times in care homes and private homes over the past seven weeks, some 23 500 more non-covid deaths have taken place in the community than would be expected. Discussing the data, David Spiegelhalter, chair of the Winton Centre for Risk and Evidence Communication at the University of Cambridge, said that “as soon as the pandemic started we saw a huge immediate spike in non-covid deaths in [private] homes that occurred close to the time hospitals were minimising the service they were providing." “Over the seven weeks up to 15 May, as the NHS focused on covid, around 8800 fewer non-covid deaths than normal occurred in hospitals.” He added that these had not been “exported” to care homes, since fairly few care home residents normally died in hospitals. Instead, he said, it seemed that these deaths had contributed to the huge rise in extra deaths in private homes during this period. Read full story Source: BMJ, 27 May 2020
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Agency is criticised over its investigation into baby’s death from hypoxia
Patient Safety Learning posted a news article in News
The coroner investigating the botched birth of a baby boy who died from hypoxia has strongly criticised the Healthcare Service Investigation Branch (HSIB) over its report on his death. Karen Henderson, who conducted the inquest into the death of baby Theo Young in May 2018 at East Surrey Hospital said that the HSIB had asked Surrey and Sussex Healthcare NHS Trust not to undertake its own investigation, “effectively preventing the recognition of causes of concern and therefore being unable to undertake any immediate and necessary remedial action at the earliest opportunity to prevent future deaths.” Read full story (paywalled) Source: BMJ, 19 May 2020- Posted
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News ArticleMore than 460 people with a learning disability have died from coronavirus in just eight weeks since the start of the outbreak in England. New data shows between the 16 March and 10 May 1,029 people with a learning disability died in England, with 45 per cent, 467, linked to coronavirus.Overall the number of deaths during the eight weeks is 550 more than would be expected when compared to the same period last year. The charity Mencap warned people with a learning disability were “being forgotten in this crisis” and called for action to tackle what it said could be “potentially discriminatory practice.” It highlighted the percentage of Covid-19 related deaths among learning disabled people was higher than those in care homes, where the proportion of Covid-19 deaths was 31 per cent for the same period. The data has been published after an outcry over the lack of transparency about the impact of Covid-19 on mental health patients and people with a learning disability or autism. Read full story Source: The Independent, 19 May 2020
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Coronavirus: real care home death toll double official figure, study says
Patient Safety Learning posted a news article in News
More than 22,000 care home residents in England and Wales may have died as a direct or indirect result of COVID-19, academics have calculated – more than double the number stated as passing away from the disease in official figures. Academics at the London School of Economics (LSE) found that data on deaths in care homes directly attributed to the virus published by the Office for National Statistics significantly underestimated the impact of the pandemic on care home residents and accounted for only about 4 out of 10 of the excess deaths in care settings recorded in recent weeks in England and Wales. The figures suggest the impact of the virus in care homes is finally reducing. They are based on reports filed directly from care home operators to the regulator, the Care Quality Commission. Care Inspectorate Wales has said Covid was confirmed or suspected in a further 504 cases in homes up to the 8 May in Wales. But academics at the care policy and evaluation centre at the LSE found that when excess deaths of other care residents and the deaths of care home residents from Covid-19 in hospitals are taken into account, the toll that can be directly and indirectly linked to the virus pandemic is likely to be more than double the current official count. Read full story Source: The Guardian, 13 May 2020 -
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Quarter of people who die from coronavirus in England have diabetes
Patient Safety Learning posted a news article in News
More than a quarter of all NHS patients who have died after being infected with COVID-19 had diabetes, according to new statistics from NHS England. Between 31 March and 12 May, a total of 5,873 patients with diabetes died in hospital from COVID-19, 26% of all coronavirus deaths. It is the first time data on hospital deaths and underlying health conditions has been revealed by the NHS. People with diabetes have previously been described as being at moderate risk from the virus and were not part of the groups told to shield themselves in their homes due to fears they were at extreme risk. The NHS England data does not specifically say whether type 1 or type 2 was more prevalent among deaths. It said work was underway to understand the deaths data to include examining the type of diabetes, ethnicity and weight of those who died. NHS England said it was working with Diabetes UK to provide support and advice to patients via its helpline which will include volunteer clinical advisers. Read full story Source: Independent, 15 May 2020 -
News ArticleMeasures to ease the lockdown in the UK could lead to tens of thousands of extra deaths if vulnerable people are not sufficiently protected and health care systems are put under strain, a study has suggested. Boris Johnson announced the first step towards normalcy — allowing unlimited exercise, one on one outdoor social meetings and a return to work for those who cannot do so at home — against a background of flattening infection numbers and fatalities caused by the virus. However in a study published in medical journal The Lancet, research led by University College London (UCL) has warned between 37,000 and 730,000 excess deaths could take place due to the direct and indirect effects of the virus within a year. Lead author Dr Amitava Banerjee said: “Older people, those with one or more underlying conditions and their carers are asking what easing the lockdown might mean for their health. Using data modelling on a number of different scenarios, our findings show the mortality risk for these vulnerable groups increases significantly, and could lead to thousands of avoidable deaths.” Read full story Source: The Independent, 13 May 2020
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Coronavirus: Care home deaths 'starting to decline'
Patient Safety Learning posted a news article in News
The number of deaths linked to coronavirus in care homes in England and Wales has fallen, figures show. The Office for National Statistics analysis showed there were 2,423 fatalities where the virus was mentioned on the death certificate in the week ending 1 May. That is down from nearly 2,800 the week before. More than 8,300 deaths in care homes have been linked to virus since the epidemic started. The number of hospital deaths have been falling since early April but the government and care sector had been struggling to contain outbreaks in care homes. Despite the drop, the virus is still have a major impact on the overall number of deaths in care homes. The total number seen in the week to 1 May is still nearly three times higher than you would normally expect. That means there a large number of deaths happening where the cause is unclear. One suggestion has been that the lack of testing in care homes has meant coronavirus has not always been listed on death certificates when it should. Read full story Source: BBC News, 12 May 2020 -
News ArticleThe NHS will this week begin to publish the numbers of people who are dying from coronavirus in mental health and learning disability units, the government has announced. England's national medical director Stephen Powis told the Downing Street daily press briefing that the figures would be published on an "ongoing basis" after calls to paint a clearer picture of the problem. It comes as figures from the Care Quality Commission showed a sharp increase in deaths among mental health patients compared to last year. Asked by The Independent whether the numbers could be made public, he replied: "Yes, I can commit that we will publish that data. "We've been looking at how we can do that; we publish deaths daily, we're looking at how we can report on those groups and I can commit that from next week we'll be publishing data on learning disabilities, autism, and mental health patients who have died in acute hospitals and we will do that on an ongoing basis." Read full story Source: The Independent, 9 May 2020
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More people dying at home during COVID-19 pandemic – UK analysis
Patient Safety Learning posted a news article in News
About 8,000 more people have died in their own homes since the start of the coronavirus pandemic than in normal times, a Guardian analysis has found, as concerns grow over the number avoiding going to hospital. Of that total, 80% died of conditions unrelated to COVID-19, according to their death certificates. Doctors’ leaders have warned that fears and deprioritisation of non-coronavirus patients are taking a deadly toll. Doctors’ leaders have warned that some sick people are too scared to go to hospital and are aware that much of the usual NHS care had been suspended in the pandemic. “These figures underline that the devastation wrought by Covid-19 spreads far beyond the immediate effects of the illness itself,” said Dr Chaand Nagpaul, the council chair of the British Medical Association. “While all parts of the NHS have rallied round in a bid to meet the immediate rocketing demand caused by the pandemic, more than half of doctors in a recent BMA survey have told us that this is worsening the care of non-Covid patients.” Read full story Source: The Guardian, 8 May 2020- Posted
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Deaths in mental health hospitals double as COVID-19 spreads
Patient Safety Learning posted a news article in News
Deaths in mental health hospitals have doubled compared to last year after 54 deaths linked to coronavirus in just three months, it has emerged. The care watchdog, the Care Quality Commission (CQC), has issued a warning to mental health hospitals that they must take action to protect vulnerable patients. New data published by the regulator showed there was a total of 106 deaths of people in mental health hospitals between 1 March and 1 May compared to 51 in the same period in 2019. In total 54 of these deaths are from confirmed or suspected coronavirus infections. The CQC has now written to all mental health hospital providers highlighting its fears over the spread of the virus within secure hospitals and units. Read full story Source: The Independent, 8 May 2020 -
News ArticleHospitals are continuing to discharge patients infected with Covid-19 into Britain’s struggling care homes, despite new figures showing deaths in the care sector still rising while those in hospitals are falling. Deputy chief scientific adviser Dame Angela McLean revealed the government was now seriously concerned about the scale of the outbreak in care homes. She said the number of deaths was now almost half of those in hospitals adding: “There is a real issue that we need to get to grips with.” In March care homes were told they had to accept thousands of patients discharged from hospitals to help hospitals free up 33,000 beds ahead of the coronavirus surge. But due to a lack of community testing it was not possible to test all patients, meaning the virus may have been able to spread without detection. Public Health England data last week showed the virus has now established itself in more than 4,500 care homes across the country. Sarah Scobie from the Nuffield Trust health think tank said: “The vulnerable social care sector is now becoming the epicentre of the COVID-19 pandemic in this country. Despite a very small decrease in overall deaths from the previous week, the numbers in care homes are still growing." Read full story Source: The Independent, 6 May 2020
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Matt Hancock faces judicial review threat over 'do not resuscitate' orders
Patient Safety Learning posted a news article in News
The health secretary Matt Hancock has been threatened with a judicial review amid fears patients’ human rights are at risk from the incorrect use of controversial do not resuscitate orders during the coronavirus pandemic. Ministers have been told they should use emergency powers to issue a direction to doctors and nurses in the NHS requiring them to comply with the law on do not attempt resuscitation orders (DNARS) and to ensure patients are properly consulted. In recent weeks there have been a number of reports of patients having DNARs put in place without their knowledge or in GPs imposing blanket decisions, prompting a warning letter from NHS England’s chief nurse last month. The legal action is being brought by Kate Masters, the daughter of Janet Tracey, who died at Addenbrooke's hospital in 2011 after a DNAR was put in place without her knowledge. In 2014, Tracey's husband David won a landmark victory at the Court of Appeal which gave patients a new legal right to be consulted by doctors when DNARS were being considered. Not consulting a patient was a breach of their human rights, the court ruled. Read full story Source: The Independent, 6 May 2020- Posted
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News ArticleHundreds of ventilators the UK government bought from China to relieve a major shortage are the wrong type and could kill patients, senior doctors have warned in a newly uncovered letter. The medical staff behind the letter say the devices were designed for use in ambulances rather than hospitals, had an "unreliable" oxygen supply and were of "basic" quality. Seen by Sky News' partner organisation NBC, the document also claims the ventilators cannot be cleaned properly, are an unfamiliar design and come with a confusing instruction manual. Cabinet Office minister Michael Gove triumphantly announced the arrival of "300 ventilators from China" to help treat COVID-19 patients on 4 April. But the letter of warning from doctors was issued just nine days later. "We believe that if used, significant patient harm, including death, is likely," it says. Read full story Source: Sky News, 30 April 2020
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Coronavirus death rates more than double in more deprived areas, figures show
Patient Safety Learning posted a news article in News
Death rates from coronavirus in the most deprived parts of England are more than double than in less deprived areas, according to new figures that show London is the worst-hit part of the country. The mortality rate for the most deprived areas for March and early April was 55.1 deaths per 100,000 population – compared with 25.3 deaths per 100,000 in the least deprived areas, according to the Office for National Statistics (ONS). The statistics show London has by far the highest mortality rate, with 85.7 deaths per 100,000 persons. This was found to be “statistically significantly higher” than any other region – almost double the next highest rate. Read full story Source: The Independent, 1 May 2020- Posted
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NHS staff coronavirus inquests told not to look at PPE shortages
Patient Safety Learning posted a news article in News
Inquests into coronavirus deaths among NHS workers should avoid examining systemic failures in provision of personal protective equipment (PPE), coroners have been told, in a move described by Labour as “very worrying”. The chief coroner for England and Wales, Mark Lucraft QC, has issued guidance that “an inquest would not be a satisfactory means of deciding whether adequate general policies and arrangements were in place for provision of PPE to healthcare workers”. Lucraft said that “if there were reason to suspect that some human failure contributed to the person being infected with the virus”, an inquest may be required. The coroner “may need to consider whether any failures of precautions in a particular workplace caused the deceased to contract the virus and so contributed to death”. But he added: “An inquest is not the right forum for addressing concerns about high-level government or public policy.” Labour warned the advice could limit the scope of investigations into the impact of PPE shortages on frontline staff who have died from COVID-19. “I am very worried that an impression is being given that coroners will never investigate whether a failure to provide PPE led to the death of a key worker,” said Lord Falconer, the shadow attorney general. “This guidance may have an unduly restricting effect on the width of inquests arising out of Covid-19-related deaths.” Read full story Source: The Guardian, 29 April 2020- Posted
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Coronavirus 'as deadly as Ebola in hospital'
Patient Safety Learning posted a news article in News
People needing hospital treatment for coronavirus are as likely to die as those with Ebola, claim UK researchers. The warning comes as the largest study in Europe showed at least a third of hospital patients with COVID-19 die. The disease is mild for most and can be treated at home, but scientists said people needed to realise how dangerous the infection could be. Obesity, ageing and being male greatly increase the risk of death, according to the data from 166 British hospitals. Medical details on nearly 17,000 coronavirus patients in England, Wales and Scotland have been analysed and it shows that 49% survived and were discharged, 33% have died and 17% were still being treated. "Some people persist in believing that Covid-19 is no worse than a bad dose of flu - they are gravely mistaken," said Calum Semple, the Chief Investigator on the trial, and a Professor in Child Health and Outbreak Medicine at the University of Liverpool. "The crude case fatality rate for people who are admitted to hospital with severe Covid-19 is 35% to 40%, which is similar to that for people admitted to hospital with Ebola. People need to hear this and get it into their heads... this is an incredibly dangerous disease." Read full story Source: BBC News, 29 April 2020 -
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Coronavirus: What is the hidden health cost?
Patient Safety Learning posted a news article in News
The rising death toll from coronavirus is never far from the headlines, but hidden behind the daily figures is what public health experts refer to as the "parallel epidemic". This is the wider impact on people's health that is the result of dealing with a pandemic. UK chief medical adviser Prof Chris Witty has been referring to this with increasing frequency during the daily briefings, speaking about the "indirect" costs of coronavirus. But what is it, and how significant could it be? Routine treatments, such as hip and knee replacements, were cancelled across the UK. This alone will have a significant impact on people's lives, though it is unlikely to kill anyone. However, the pandemic has also had a knock-on effect on emergency care. Data collected by Public Health England from a sample of A&E departments in England shows attendances have halved since the pandemic started. The trend has prompted NHS leaders to urge patients to come forward for treatment. Cancer screening has been suspended in Wales, Scotland and Northern Ireland and drastically cut back in England. But it is not only an issue for cancer patients, people with chronic conditions like diabetes or kidney disease may face trying to manage their conditions remotely without the regular face-to-face contact they would have with health professionals. The pandemic is also the 'perfect storm' for mental health. The full impact could take years to unravel. Read full story Source: BBC News, 29 April 2020- Posted
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