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Content ArticleThe Nursing & Midwifery Council (NMC) is commissioning independent research into nursing and midwifery students’ practice learning to ensure members of the public can shape this work from the start and throughout. One way people can get involved is by being part of a new Public Advisory Group on practice learning.
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Content Article
The digitalising of patient records — why patients MUST be involved
Anonymous posted an article in Health records and plans
In this blog, Tina* discusses the patient safety issues that can occur with electronic patient records, highlighting how easily errors can occur in a patient's record but how difficult they are to fix, and why patients must be involved in the digitalising of their own records. Tina gives her perspective as a clinician but also her personal perspective as a patient who has had stigmatising material propagated throughout the system while important clinical information was excluded from her record. -
News Article
One in seven callers could not reach GP in worst-performing ICS
Patient Safety Learning posted a news article in News
People attempting to contact their GP practice are almost three times as likely to report failing to get through in some integrated care systems (ICS) than others, according to NHS England-commissioned data. The survey figures, collected for the first time by the Office for National Statistics (ONS), show 8.5% of people nationally who tried to call their GP between mid-January and mid-February this year said they could not reach the practice. This equates to 1.5 million people across England, according to the ONS. In Northamptonshire – the worst performing ICS – 14.7% of callers did not manage to make contact. That is the equivalent of around one in seven people. By comparison, only 3.9% of callers in Gloucestershire, the best performing ICS, could not get through. The findings are broadly similar when population and age are accounted for. Read full story (paywalled) Source: HSJ, 12 April 2024 -
Content ArticleThis cohort study in JAMA Network Open explored whether the empathy displayed by doctors has an impact on the outcomes of patients with chronic pain. 1470 adults with chronic low back pain were included in the study, in which empathy was more strongly associated with favourable outcomes than nonpharmacological treatments, opioid therapy and lumbar spine surgery. The findings suggest that empathy is an important aspect of the patient-doctor relationship and is associated with better outcomes among patients with chronic pain.
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News Article
Plans for Royal Mail delivery cuts could risk patient safety, NHS leaders warn
Patient Safety Learning posted a news article in News
NHS leaders have warned that Royal Mail’s plans to cut second-class deliveries to two days a week could risk patient safety. The changes are part of wider measures announced by Royal Mail’s parent company, International Distributions Services (IDS), including cuts of up to 9,000 routes, which could take more than two years to implement, saving £300m a year. IDS has assured the Royal Mail workforce that there will be no compulsory redundancies and they will request only 100 voluntary redundancies. In a letter sent to the Telegraph, executives from the NHS, Healthwatch England, the Patients Association and National Voices said the Royal Mail proposals would increase the cost of missed appointments, which already exceeds £1bn. The letter said: “Provisional Healthwatch data suggest that more than 2 million people may have missed medical appointments in 2022-23 due to late delivery of letters, and this will only deteriorate under the proposed new plans.” Sir Julian Hartley, the chief executive of NHS Providers, said the proposed delays were “extremely unhelpful”. “It’s really important that patients be updated at the earliest opportunity on developments in their care and treatment,” he said. “An efficient, punctual postal service remains a key part of that process. At a time when far too many patients already face long delays – the last thing any trust leader wants – anything that adds to that uncertainty, and possibly the worsening of conditions, would be extremely unhelpful.” Jacob Lant, the chief executive of health charity National Voices, said: “The proposals being consulted on risk further delaying vital communications and worsening digital exclusion, therefore unfairly widening health inequalities. NHS mail must remain a priority service.” Read full story Source: The Guardian, 6 April 2024 -
Content ArticleThere is a growing momentum around the world to foster greater opportunities for the involvement of mental health service users in their care and treatment planning. In-principle support for this aim is widespread across mental healthcare professionals. Yet, progress in mental health services towards this objective has lagged in practice. Francis et al. conducted a systematic review of quantitative, qualitative and mixed-method research on interventions to improve opportunities for the involvement of mental healthcare service users in treatment planning, to understand the current research evidence and the barriers to implementation. Overarching barriers to shared and supported decision-making in mental health treatment planning were: (1) Organisational (resource limitations, culture barriers, risk management priorities and structure); (2) Process (lack of knowledge, time constraints, health-related concerns, problems completing and using plans); and (3) Relationship barriers (fear and distrust for both service users and clinicians). On the basis of the barriers identified, recommendations are made to enable the implementation of new policies and programmes, the designing of new tools and for clinicians seeking to practice shared and supported decision-making in the healthcare they offer.
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Content ArticleBatches of some products made by Legency Remedies Pvt Ltd have been found to contain a bacteria called Ralstonia pickettii (R. pickettii). All potentially affected batches are being recalled following an MHRA investigation.
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Content Article
Press Ganey: Safety in healthcare 2024
Patient Safety Learning posted an article in International patient safety
A strong safety culture is the cornerstone of a thriving healthcare system. It underpins all experiences—for patients and employees—and drives key metrics like retention, loyalty, and “Likelihood to Recommend” (LTR) scores. Ultimately, a strong safety culture powers a virtuous cycle, leading to better outcomes for everyone. 'Safety in healthcare 2024' brings together Press Ganey's integrated dataset of patient and employee experience, clinical, and safety measures to analyse the landscape today. Representing 12 million patient encounters, the views of one million healthcare employees, and over 550,000 reported safety events, it explores emerging trends, as well as the strategies top-performing healthcare organisations leverage to improve patient and employee safety. -
Content ArticleThis article analyses the phenomenon of epistemic injustice within contemporary healthcare. It begins by detailing the persistent complaints patients make about their testimonial frustration and hermeneutical marginalisation, and the negative impact this has on their care. The authors offer an epistemic analysis of this problem using Miranda Fricker's account of epistemic injustice. They detail two types of epistemic injustice, testimonial and hermeneutical, and identify the negative stereotypes and structural features of modern healthcare practices that generate them. They claim that these stereotypes and structural features render ill persons especially vulnerable to these two types of epistemic injustice. The authors end by proposing five avenues for further work on epistemic injustice in healthcare. "Without the narrative acts of telling and being heard, the patient cannot convey to anyone else – or to self – what he or she is going through. More radically and perhaps equally true, without these narrative acts, the patient cannot himself or herself grasp what the events of illness mean."
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News Article
Hackers obtain patient data from NHS Dumfries and Galloway
Patient Safety Learning posted a news article in News
A hacker group is in possession of at least a “small number” of patients’ data following a cyber-attack, NHS Dumfries and Galloway has said. Reports emerged on Wednesday of a post by the group Inc Ransom on its darknet blog, alleging it was in possession of three terabytes of data from NHS Scotland. The post included a “proof pack” of some of the data, which has been confirmed by the board to be genuine. The chief executive of the NHS board, Jeff Ace, said in a statement: “We absolutely deplore the release of confidential patient data as part of this criminal act. “This information has been released by hackers to evidence that this is in their possession. We are continuing to work with Police Scotland, the National Cyber Security Centre, the Scottish government and other agencies in response to this developing situation.” Patients whose data has been leaked will be contacted by the board, he said, while patient-facing services would continue as normal. Read full story Source: The Guardian, 27 March 2024 -
Content ArticleMaking hospitals more conducive to high quality sleep might benefit patient experience and wellbeing, and could perhaps even lead to reduced length of stay. Sleep is known to be closely connected to physical and mental health, and yet hospital environments are far from conducive to high quality rest. Noise, light, disturbances for treatment or tests, other patients, staff noise and temperature can all reduce the odds of a good night’s sleep. Overnight observations can also be extremely disruptive. At some trusts, efforts are being made to address this situation. The ultimate aim? Not only to improve the patient experience, but to potentially the speed with which they heal–so reducing the likes of length of stay. Others, meanwhile, are exploring whether supporting better sleep could even reduce the need for hospital admission in the first place.
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Content ArticleThe aim of this study from Aiken et al. was to determine the well-being of physicians and nurses in hospital practice in Europe, and to identify interventions that hold promise for reducing adverse clinician outcomes and improving patient safety. The study found that poor work/life balance (57% physicians, 40% nurses), intent to leave (29% physicians, 33% nurses) and high burnout (25% physicians, 26% nurses) were prevalent. Rates varied by hospitals within countries and between countries. Better work environments and staffing were associated with lower percentages of clinicians reporting unfavourable health indicators, quality of care and patient safety. The effect of a 1 IQR improvement in work environments was associated with 7.2% fewer physicians and 5.3% fewer nurses reporting high burnout, and 14.2% fewer physicians and 8.6% fewer nurses giving their hospital an unfavourable rating of quality of care. Improving nurse staffing levels (79% nurses) and reducing bureaucracy and red tape (44% physicians) were interventions clinicians reported would be most effective in improving their own well-being, whereas individual mental health interventions were less frequently prioritised.
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Content ArticleCurrently, it is estimated that more than one in five people in the UK are living in poverty. This King's Fund analysis reveals that people living in poverty find it harder to live a healthy life, live with greater illness, face barriers to accessing timely treatment, and die earlier than the rest of the population. The analysis looks at the link between poverty and each of the following: prevalence of ill health difficulties accessing health care late or delayed treatment poorer health outcomes. The long read argues that while the NHS can, and should, do more to make timely care accessible to deprived communities, wider government and societal action is needed to address the root causes of poverty.
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News Article
Millions urged to get free NHS check for ‘silent killer’
Patient Safety Learning posted a news article in News
Millions of people are being urged to get checks for a condition which has been described as the “silent killer”. If left untreated, high blood pressure can lead to heart attacks, strokes, kidney disease and vascular dementia. Up to 4.2 million people in England are thought to be living with high blood pressure without knowing it – around a third of all those with the condition. Now, a new NHS Get Your Blood Pressure Checked campaign has been launched, backed by health charities, to warn people the condition often has no symptoms. England’s chief medical officer, Professor Sir Chris Whitty, said: “High blood pressure usually has no symptoms but can lead to serious health consequences. “The only way to know if you have high blood pressure is to get a simple, non-invasive blood pressure test. “Even if you are diagnosed, the good news is that it’s usually easily treatable. “Getting your blood pressure checked at a local pharmacy is free, quick and you don’t even need an appointment, so please go for a check today – it could save your life.” Read full story Source: The Independent, 11 March 2024 -
Content ArticleIn this opinion piece for inews, Dr Punam Krishan describes the increasing levels of verbal and physical abuse GPs are experiencing from patients in the NHS. She describes how a shift in the public's perception of GPs since the pandemic has contributed to this increase in aggression and highlights that although it is only a minority of patients who display abusive behaviour, it has a big impact on GPs wellbeing and ability to treat other patients. She goes on to outline stricter measures her practice has had to put in place to crack down on abuse from patients.
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News Article
Patients exposed to excess radiation by out-of-date radiology device
Patient Safety Learning posted a news article in News
Patients are being exposed to radiation doses at the “upper limit of safe” because a hospital is relying on a radiology machine three years after its “end of life” with a substandard second-hand part. The risk was revealed in board papers from Medway Foundation Trust, in Kent, among several other serious problems linked to outdated equipment. Recent board papers said the machine was necessary for maintaining the trust’s interventional radiology service which includes being on-call 24/7. It said: “Owing to the age of the machine we are experiencing a growing number of faults and breakdowns and due to its age no new parts are available. “At present a second hand tube has been installed to replace the existing faulty equipment.” But the papers went on to say the second-hand part has a defect “causing serious issues with the imaging [which] has the potential to increase imaging acquisitions required which will increase patient radiation dose and lengthen the procedure time”. A business case for a new machine described current radiation doses as “within the upper limit of safe”. The trust indicated “mitigations” are in place, including additional reviews of patients who use it. Read full story (paywalled) Source: HSJ, 11 March 2024 -
News Article
Patients facing uphill struggle to see GPs
Patient Safety Learning posted a news article in News
Patients in parts of England are facing an uphill struggle to see a GP, experts say, after an analysis showed wide regional variation in doctor numbers. The Nuffield Trust think tank found Kent and Medway had the fewest GPs per person, followed by Bedfordshire, Luton and Milton Keynes. It comes as ministers have struggled to hit the pledge to boost the GP workforce by 6,000 this Parliament. But the government said it had plans in place to tackle shortages. However, Dr Billy Palmer, of the Nuffield Trust, said: "Solely boosting the number of staff nationally in the NHS is not enough alone - the next government should set a clear aim of reducing the uneven distribution of key staffing groups and shortfalls to tackle unfairness in access for patients." The think-tank report found while the government had met its target to increase the number of nurses by 50,000 this Parliament, the rises had not been felt evenly, with some specialist nurse posts, such as health visitors and learning-disability nurses, seeing numbers shrink. Dr Palmer said minimum numbers of GPs may have to be set for local areas - and better incentives to attract them to those with the fewest. Read full story Source: BBC News, 8 March 2024 -
Content ArticleHospital staff members experience 1.17 aggressive events — verbal and/or physical — for every 40 hours worked, with more aggression events occurring when staff have significantly greater numbers of patients assigned to them this study from DeSanto Iennaco et al. found. The study, published in The Joint Commission Journal on Quality and Patient Safety, examined incidence of patient and visitor aggressive events toward staff at five inpatient medical units in community hospitals and academic hospitals in the Northeastern U.S. The data was collected using even counters, aggressive incident and management logs and demographic forms over a 14-day period in early 2017.
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Content ArticleThis report describes the findings of a study that collected stories of the working lives of Black and Brown healthcare staff during the Covid-19 pandemic. The study asked them to reflect on their experiences and highlight the changes they would like to see. It highlights a number of issues around victimisation, access to PPE, speaking up and risk assessments. The authors argue that the report confirms previous studies that identify the entrenched nature of racism in healthcare systems and highlights how systemic cultures of racism contributed to the disproportionate impact of Covid-19 on health and care workers from minority ethnic backgrounds.
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Content ArticleThe Falls and Fragility Fractures Audit Programme (FFFAP) is looking to recruit new members to their award-winning Patient and Carer Panel. FFFAP is a national clinical audit run by the Royal College of Physicians (RCP) and commissioned by the Healthcare Quality Improvement Partnership on behalf of NHS England and the Welsh Government. Their work aims to improve the care that patients with fragility fractures receive in hospital and after discharge and to reduce inpatient falls.
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Content ArticleHealthwatch and national organisations representing patients and NHS leaders express concerns over Royal Mail plans to delay bulk mail of NHS appointment letters from two days to three days.
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News Article
Hospital takes tough stance against patient violence
Patient Safety Learning posted a news article in News
Death threats, physical abuse and racist slurs aimed at NHS workers has prompted one hospital to make it easier for staff to “red card” violent and abusive patients. Aggressive patients or visitors could be banned from Barking, Havering and Redbridge University Hospitals NHS Trust for up to 12 months. The trust has also started using a series of body cameras in a bid to curb violence and aggression towards health workers after cases at the East London/Essex trust have doubled in the last three years. Trust workers have been punched, subject to racist slurs – including being told to “go back to the jungle” – and had their teeth broken by violent patients. As a result, hospital bosses have launched a new campaign – ‘No Abuse, No Excuse’ – to reduce violence and aggression towards staff, which includes: The introduction of 60 body cameras for staff in areas such as A&E and frailty units. Easier policies to ban patients or visitors, with bans which can last for up to a year. An increased visibility of security staff. A “de-escalation” training course for trust employees. Read full story Source: Medscape, 26 February 2024 -
News Article“I’ve seen patients take swings at doctors because they’re not happy with the time it’s taken or the doctor’s diagnosis. I’ve seen fire extinguishers set off and thrown at people, computers lifted and thrown across the emergency department and people run out of cubicles and punch other patients – people they don’t know – for no reason.” Roger Webb, a security supervisor at the Queen’s Medical Centre hospital in Nottingham, is recalling some of the more unsavoury incidents he has witnessed in the course of his work. “I’ve been struck in the groin, had scratches all over my arms where people have dug their nails in. I’ve been bitten and I’ve been spat at while trying to deal with situations. The spitting is the most depressing of those, though, because it’s so contemptuous and so horrible. And legally it’s assault.” Like staff across the NHS, those at the QMC have seen a rise in abusive, threatening and intimidatory behaviour by patients and their relatives in recent years. In 2021-22, Nottingham University hospitals (NUH), the NHS trust that runs the QMC and its sister City hospital, recorded 1,237 incidents of aggression, violence and harassment. But it had many more – 1,806 – during the following year, 2022-23. Last year brought another increase. In the six months between April to September alone, NUH recorded another 1,167 incidents, leaving 2023-24 likely to be the worst ever on record. Staff have been hit, spat at, threatened, verbally abused and racially abused during this roll call of unpleasant incidents. Racially aggravated harassment has increased notably. Some of the incidents have led to perpetrators being charged and convicted. Worryingly, in a growing number of cases, the patient has been responsible for several incidents while receiving one single episode of care. Care delays are the main trigger for abuse at the QMC. But such incidents also arise when staff are treating drunks, rival gangs, people who are high on drugs and those with mental health problems. Read full story Source: The Guardian, 25 February 2024
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Content ArticleContinuity of care, defined as an ongoing therapeutic relationship between a patient and a physician, is a defining characteristic of primary care. However, arranging a consultation with one’s regular doctor is increasingly difficult as practices face physician shortages. Kajaria-Montag et al. studied the effect of declining care continuity on the productivity of physicians by analysing data of over 10 million consultations in 381 English primary care practices over a period of 11 years. Specifically, they examined whether a consultation with the patient’s regular doctor is more productive than with another doctor in the practice. The authors found that the time to a patient’s next visit is on average 18.1% longer when the patient sees the doctor they have seen most frequently over the past two years, while there is no operationally meaningful difference in consultation duration. The data show that the productivity benefit of care continuity is larger for older patients, patients with multiple chronic conditions, and patients with mental health conditions. The authors estimate that the total consultation demand in their sample could have fallen by up to 5.2% had all practices offered continuity of care at the level of the top decile of practices while prioritising patients expected to yield the largest productivity benefits.
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News Article
Seeing same GP ‘improves patient health and cuts workload of doctors’
Patient Safety Learning posted a news article in News
Seeing the same GP improves patients’ health, reduces doctors’ workloads and could free up millions of appointments, according to the largest study of its kind. Research has previously suggested there may be benefits to seeing the same family doctor. But studies have mostly been small or covered a short period of time. Now University of Cambridge and Insead business school researchers have analysed data from 10m consultations over more than a decade in the most authoritative study on the issue yet. They found that if all GP practices moved to a model where patients saw the same doctor at each visit, it would significantly reduce doctors’ workloads while improving patient health. Multiple benefits emerged when patients had a long-term relationship with their doctor, researchers found. Seeing the same GP – known as continuity of care – meant people waited on average 18% longer between visits, compared with patients who saw different doctors. People did not take up more GP time in each consultation and the findings were particularly strong for older patients, those with multiple chronic illnesses, and people with mental health conditions. Although it will not always be possible for people to see their regular GP, researchers said the findings would translate to an estimated 5% reduction in consultations if all practices provided the level of continuity of care of the best 10% of practices. That suggests millions of appointments could be freed up. The researchers added: “Importantly, if patients receiving care from their regular doctors have longer intervals between consultations without requiring longer consultations, then continuity of care can potentially allow physicians to expand their patient list without increasing their time commitment.” Read full story Source: The Guardian, 23 February 2024
