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Found 1,334 results
  1. Content Article
    Since retiring from his role in public health, Dr Bill Kirkup has focused on independent investigations into public service failures, including maternity services at Morecambe Bay and East Kent. In this podcast, Bill talks to Parliamentary and Health Service Ombudsman Rob Behrens about his career, what he's learnt during his investigations and how we can make more progress in improving patient safety.
  2. Content Article
    In a new report analysing healthcare complaint investigations, the Parliamentary and Health Service Ombudsman (PHSO) have set out the need for the NHS to do more to accept accountability and learn from mistakes in cases of avoidable harm. This blog sets out Patient Safety Learning’s reflections on this report.
  3. Content Article
    In this blog, Dr Ahmed Khalafalla looks at the war in Sudan and its disastrous consequences for the health system. He outlines his observations about the impacts of war and conflict on patient safety, from shortages of medical equipment to disruptions to vital primary care services.
  4. Content Article
    Pennsylvania is the only state that requires acute care facilities to report all events of harm or potential for harm. The Pennsylvania Patient Safety Reporting System (PA-PSRS) is the largest repository of patient safety data in the United States and one of the largest in the world, with over 4.5 million acute care event reports dating back to 2004. Herein, we examine patient safety event reports submitted to the PA-PSRS acute care database in 2022 and compare them to prior years. The authors extracted data from PA-PSRS and obtained data from the Pennsylvania Health Care Cost Containment Council (PHC4). Counts of reports were calculated based on report submission date, and rates were calculated based on event occurrence date and calculated per 1,000 patient days for hospitals or 1,000 surgical encounters for ambulatory surgical facilities (ASFs). The study found there was a decrease in the number of incident reports submitted to PA-PSRS in 2022 and an increase in serious and high harm event reports.
  5. Content Article
    On the 18 April 2023 the Women and Equalities Select Committee published a report on Black maternal health. This analysed Government and NHS activities to date in this area and made a number of recommendations for further action needed to end disparities in maternal deaths. This paper sets out the UK Government’s response to the recommendations in this report.
  6. Content Article
    The extent to which postintensive care unit (ICU) clinics may improve patient safety for those discharged after receiving intensive care remains unclear. This observational cohort study from Karlick et al., conducted at an academic, tertiary care medical centre, used qualitative survey data analysed via conventional content analysis to describe patient safety threats encountered in the post-ICU clinic. For 83 included patients, safety threats were identified for 60 patients resulting in 96 separate safety threats. These were categorised into 7 themes: medication errors (27%); inadequate medical follow-up (25%); inadequate patient support (16%); high-risk behaviours (5%); medical complications (5%); equipment/supplies failures (4%); and other (18%). Of the 96 safety threats, 41% were preventable, 27% ameliorable, and 32% were neither preventable nor ameliorable. Nearly 3 out of 4 patients within a post-ICU clinic had an identifiable safety threat. Medication errors and delayed medical follow-up were the most common safety threats identified; most were either preventable or ameliorable.
  7. News Article
    30,000 people believe they are victims of negligence each week in the UK, new research carried out by YouGov for Injury Awareness Week (26-30 June) has found. Participants were asked if they have suffered an injury or illness in the last year which was caused because of negligence, for example by another road user, an employer, a colleague, or a medic. “We need to shine a light on the impact these injuries can have on people who were doing nothing more than living their lives before they fell victim to the recklessness or carelessness of others,” said Mike Benner, chief executive of the Association of Personal Injury Lawyers (APIL) which commissioned the Injury Awareness Week study. “Often these injures are severe, some are life-changing, and some are life-ending,” he said. “The fact that the harm has been caused by negligence is significant, because negligence could and should be avoided,” said Mr Benner. “An accident is simply an incident which no-one could have reasonably foreseen. Negligence is doing something, or failing to do something, that could cause injury to others. Employers have a duty to make sure we return home from a day’s work unscathed, for example, and drivers need to take care to not harm fellow road users. “If someone were to take one thing away from this Injury Awareness Week, it’s the knowledge that any one of us could be among the 30,000 injured needlessly in a week. Avoidable injuries are an issue we should all be concerned about,” he said. Read full story Source: APIL, 22 June 2023
  8. Content Article
    There have been significant developments in patient safety over the last decade. But there is a concerning disconnect between increasing activity and progress made to embed a just and learning culture across the NHS. Recognising the challenging operational context for the NHS, this report from the Parliamentary and Health Service Ombudsman (PHSO) draws on findings from their investigations. It asks what more must be done to close the gap between ambitious patient safety objectives and the reality of frontline practice. PHSO identified 22 NHS complaint investigations closed over the past three years where they found a death was – more likely that not – avoidable. It analysed these cases for common themes and conducted in-depth interviews with the families involved.
  9. News Article
    More than half of all serious incidents where patients came to harm involving West Midlands Ambulance Service were due to clinical errors. A trust audit found choking management, cardiac arrests and inappropriate patient discharges as themes. It also noted a decision to close all community ambulance stations was taken without first doing a full risk assessment of the impact on safety. After the number of serious incidents increased from 138 in 2021-22 to 327 in 2022-23, an audit by WMAS found 53% were due to mistakes with their treatment. A situation where a person comes to significant harm in care is identified as a serious clinical incident. Sources say the trust also delayed looking into 5,000 serious patient incidents. Read full story Source: BBC News, 29 June 2023
  10. Content Article
    The Armstrong Institute for Patient Safety and Quality provides an infrastructure that oversees, coordinates and supports patient safety and quality efforts across Johns Hopkins' integrated healthcare system. Their mission is to eliminate patient harm, achieve best patient outcomes at the lowest possible cost and share that knowledge through research and training The Armstrong Institute for Patient Safety and Quality leads regional, national and international projects that reduce preventable harm, improve patient and clinical outcomes, and decrease health care costs. They apply a scientific approach to improvement, employing robust measures and rigorous data-collection methods that can be broadly disseminated and sustained.
  11. News Article
    Litigation costs for specialties including intensive care, oncology and emergency medicine have rocketed by up to five times as much as they were before the pandemic, internal data obtained by HSJ reveals. HSJ's data reveal costs for claims relating to intensive care, oncology, neurology, ambulances, ophthalmology and emergency care have increased – both for damages and legal costs – by significantly more than average. The steepest cost rise was in intensive care, which saw the bill increase fivefold from £4.3m in 2019-20 to £23.7m in 2021-22. Other specialisms which reported higher than average percentage increases were oncology, a 159% increase from £15m to £38.9m, and neurology, a 95% uplift from £18.4m to £36m. Key findings from these reports included missed or delayed diagnosis, missing signs of deterioration, failure to recognise the significance of patients re-attending accident and emergency multiple times with the same problem, and communication issues. Adrian Boyle, president of the Royal College of Emergency Medicine, said: “I’m extremely worried about the amount of money we’re spending on litigation… There’s a good reason we must not normalise an abnormal situation and we need to invest in an emergency care system which avoids these huge costs.” Read full story (paywalled) Source: HSJ, 23 June 2023
  12. Content Article
    Sickle cell disease is the name for a group of inherited red blood cell disorders that affect haemoglobin, which is a protein in red blood cells that carries oxygen through a person’s body. It mainly affects people from African or Caribbean backgrounds, though it can affect anyone. It affects approximately 15,000 people in the UK. In November 2021, the All-Party Parliamentary Group for Sickle Cell and Thalassaemia published a report detailing the issues that people with sickle cell disease experience in relation to their care. The report made 31 recommendations to organisations across the healthcare system to help address these issues. HSIB launched two investigations (see also: Management of sickle cell crisis) to find out what additional learning or knowledge could be added in this area and to provide further insights into the practical challenges that patients with sickle cell disease may face when receiving NHS care. This investigation set out to review the care of patients with sickle cell disease who need to have an invasive procedure. Invasive procedures involve accessing the inside of a patient’s body, either through an incision (cut) or one of the body’s orifices. Specifically, the investigation focused on: how haematology teams – the specialists who treat people with blood disorders – are involved and informed when a patient with sickle cell disease is treated in another area of healthcare how patients with sickle cell disease are prepared for invasive procedures how and where clinical information relevant to the patient is shared.
  13. Content Article
    The final report on the Transvaginal Mesh Case Record Review.
  14. News Article
    At least 100,000 people across the UK have had their lives put at risk over the last decade because of delays to them getting tested or treated for cancer, a new report claims. In some cases, patients’ treatment options narrowed or their cancer spread or became incurable as a direct result of their long waits for NHS care, according to Macmillan Cancer Support. The “inhumane” impact of delays on patients is “shameful”, it said, blaming ministers across the four home nations for underfunding and not tackling staff shortages in cancer services. “I’ve had patients arrive for their radical chemotherapy appointment, who wait three hours only to be told that because of staff shortages we can’t deliver their treatment today. It’s inhumane”, said Naman Julka-Anderson, an advanced practice therapeutic radiographer who is also an allied health professional clinical adviser for Macmillan. Many waited longer than 62 days to start treatment – surgery, chemotherapy or radiotherapy – after a GP referred them as an urgent case, the charity’s analysis of official NHS data found. At least 100,000 of those 180,000 people have seen their symptoms worsen, or their cancer progress or their chances reduce of successfully being treated because they have had to wait. Read full story Source: The Guardian, 20 June 2023
  15. Content Article
    Tony Clarke suffered from a chronic inflammatory skin disease, hidradenitis suppurativa. In September 2020, Tony underwent surgery to remove infected tissue on one side of his body. When he entered the operating theatre, Tony’s surgical team first covered part of his body with an alcohol-based solution, to keep the area clean. Then, when the operation began, the surgeons began cutting off the infected tissue using a diathermy pen, a device that targets electrically-induced heat to stop wounds from bleeding. However, shortly into the surgery, disaster struck: heat from the surgical pen had ignited the alcohol on Tony’s body. “But because alcohol burns so hot, no fire was seen,” says Tony, recalling an explanation he later received from the hospital.  “The surgeons were concentrating on the right side of my body. The left side was left burning for about 20 minutes.” For the next four months, Tony travelled back to the hospital every three days, to get his injuries checked and bandages changed. During that time, Tony describes himself as ‘totally disabled.’ In September this year, Tony, as a patient ambassador for prevention of surgical fires, spoke at a conference held in York by the Association for Perioperative Practice (AFPP). There, perioperative practitioners from across the country gathered to listen to Tony’s experience. “I was speaking to lots and lots of different professionals in the medical service and they'd never heard of it [being set on fire during surgery]. It was a rarity for them,” Tony says. Tony’s now working with different health agencies, with the aim of stopping preventable surgical burns entirely.
  16. News Article
    The government is being urged to launch a public inquiry into "systemic failings" at mental health hospitals across England. Leading mental health charity Mind says "immediate political action" is needed as NHS mental health facilities are "at breaking point". Mind claims "patients' human rights are being violated" and "wrongly restrained" across "run-down, understaffed" mental health wards. Its Raise the Standard campaign argues that a "full statutory inquiry" is the "first step" into resolving widespread issues. Dr Sarah Hughes, chief executive of Mind, said: "One case of abuse, neglect or unsafe care is too many, people are suffering because of the shocking state of care in mental health hospitals. "People should go to hospital to get well, not to endure harm. This is wholly unacceptable and must be addressed urgently." Read full story Source: Sky News, 20 June 2023
  17. Content Article
    The UK Covid-19 Inquiry has been set up to examine the UK’s response to and impact of the Covid-19 pandemic, and learn lessons for the future. The Inquiry’s work is guided by its Terms of Reference.
  18. Content Article
    MP Emma Hardy and Sling The Mesh drafted a letter to MP Maria Caulfield for an update on mesh centres, waiting times and outcome measures. The letter was sent in January 2023 and the reply has been received this week and shared by Sling the Mesh.
  19. News Article
    Dozens of former patients are launching legal action against a group of scandal-hit children’s mental health hospitals after The Independent exposed a culture of “systemic abuse”. More than 30 people, some of who are still children, are taking action after claiming they were mistreated at children’s hospitals run by The Huntercombe Group between 2003 and 2023. Allegations include children being injured during restraint, inappropriate force-feeding and patients being over-medicated. Among the claimants are: A boy who has been left “traumatised” after being “drugged out of his mind” while staying at one of the hospitals. A girl who alleges she was groped by a member of staff and now needs more intensive inpatient care. A woman who says she was “forced to wee in bins” as there were not enough staff to take patients to the toilet. A mother of one claimant told The Independent: “It is diabolical, I hope [the claims] can stop them from doing any more damage because it is just awful. Our beautiful girl has just been so ruined by them.” Read full story Source: The Independent, 18 June 2023
  20. News Article
    AN Ayrshire MSP has called for an end to surgical mesh being implanted in hernia patients in Scotland. A Freedom of Information request by Labour's Katy Clark has revealed that one in 12 of all hernia patients in NHS Ayrshire and Arran who have been implanted with surgical mesh since 2015 have been readmitted to hospital due to complications. And the West of Scotland MSP has backed a petition by constituents calling for the suspension of the use of surgical mesh until an independent review has been carried out. It follows the recent public health scandal over the pain and suffering endured by many women across Scotland implanted with transvaginal mesh. It took years of tireless campaigning by affected women before the Scottish Government took action, last year creating a mesh removal reimbursement scheme. Read full story Source: Irvine Times, 9 June 2023
  21. Content Article
    Failure to be aware of and to follow clinical guidelines and protocols could constitute clinical negligence, but not in all cases, and much will depend on the facts of each case. John Tingle, Lecturer in Law, Birmingham Law School, University of Birmingham, discusses aspects of the law on clinical guidelines and other care management tools.
  22. News Article
    Leann Sutherland was 21 and suffering from chronic migraines when one of Scotland's top surgeons offered to operate. She was told she would be in hospital for a few days and had a 60% chance of improvement. Instead she was in for months while Sam Eljamel operated on her seven times. "He had free rein on my body. He was playing god with my body and the NHS handed him the scalpel, seven times," says Leann. When Leann tried to raise concerns with staff she was told that Mr Eljamel had saved her life. She was not told that he was under investigation, nor that he had been later forced to step down. It was only after seeing recent BBC coverage she realised she was not alone. The BBC can reveal her surgeon - the former head of neurosurgery at NHS Tayside - was harming patients and putting them at risk for years but the health board let him carry on regardless. BBC Scotland has spoken to three surgeons who worked under Mr Eljamel at Tayside. All three said he was a bully who was allowed to get away with harming patients. All three said there was a lack of accountability in the department and that Mr Eljamel was allowed to behave as if he were a "god" - partly because of the research funding he brought to the department. Read full story Source: BBC News, 16 June 2023
  23. Content Article
    David Gilbert is a writer and health activist. He was the first patient director in the healthcare system. He is a mental health service user with 40 years of experience in healthcare, specialising in patient and public engagement and coproduction. He helped pioneer the concept of patient leadership and authored ‘The Patient Revolution - how we can heal the health care system’. He is the founder and director of InHealth Associates, a network of specialists that supports experiential practice and patient leadership. His monthly newsletter, Impatient, is now published on the HSJ website.
  24. News Article
    More than three quarters of all multimillion-pound NHS medical negligence payouts are the consequences of failures in maternity care, new figures show. In total, 364 patients or families received the highest-value compensation payments of at least £3.5 million after suing the NHS last year. Of those, 279 (77%) were maternity-related damages, according to figures from NHS Resolution. The large payouts have been offered to parents whose babies were stillborn or suffered avoidable life-changing disabilities or brain injuries. Maternity makes up the bulk of NHS compensation payments. There were more than 10,000 clinical negligence claims brought against the NHS in 2021-22, with a total value of more than £6 billion. Maternity accounted for 62% of payments, or £3.74 billion. When taking into account all cost of harm, including future periodic payments and legal costs, the cost of compensating mothers and their families rises to £8.2 billion a year. Analysis by The Times Health Commission found that this is more than twice the £3 billion spent by the NHS annually on maternity and neonatal services. Maternity claims have increased during the past decade amid a string of high-profile scandals and a shortage of midwives. Read full story (paywalled) Source: The Times, 12 June 2023
  25. Content Article
    This is part of our series of Patient Safety Spotlight interviews, where we talk to people working for patient safety about their role and what motivates them.  Paul talks to us about how AvMA helps people who have suffered direct or indirect medical harm and to help them to seek justice, why upcoming changes to the legal system could restrict access to clinical negligence claims and the importance of compassionate engagement in improving harmed patients’ experiences of the healthcare system.
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