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Content ArticleThis document summarises the current landscape of virtual wards from the perspective of healthcare for older people, and provides advice to those looking to set up such services for older people living with frailty.
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Content ArticleWe know that NHS organisations may sometimes need to reorganise their services to consider how they can best deliver care to patients. This can mean there is a need to repurpose existing environments, for example hospital wards or clinical areas. Staff may also be redeployed to deal with surges in demand when the pressure on the system is at its greatest. We commonly see this during winter, with ‘winter pressures’ wards, but we have also seen this become more common during other times of the year as the NHS deals with the lasting impact of coronavirus (COVID-19) and staff shortages in some key areas. It’s important that the NHS has this ability to adapt to try and make sure it can deliver the best and safest care to as many patients as possible. The ability to flex in this way helps to keep the NHS operating when it is at its busiest and makes sure that patients can still access appropriate care. Scott Hislop, the Healthcare Safety Investigation Branch (HSIB) Principal National Investigator, looks at the challenges faced by the NHS when flexing to meet demands and how to mitigate potential risks to patient safety.
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Content ArticleThis briefing from the Centre of Mental Health summarises evidence from six studies on the use of digital and telephone technology to deliver mental health services. It finds that using remote technology can improve access to mental health support for rural communities, disabled people or people needing a specialist service far from home. It has the potential to increase access and choice in mental health care. But it also risks exacerbating inequalities for people who are digitally excluded.
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Content ArticleIn this blog for Medpage Today, US doctor Diane Solomon talks about the power of apologising to patients. Outlining the tendency of healthcare professionals to defend their practice, she describes how being honest and open with patients about errors demonstrates humanity and compassion. She talks about the importance of being sincere when apologising and outlines how taking responsibility builds trust and can positively change future outcomes.
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Content ArticleRoughly 16 million Americans are living with Long Covid, but many are not getting the right medical care. In this article in Popular Science, Miles Griffis argues that one way to improve the system is by letting patients lead. He describes his own disabling case of Long Covid, the issues he has faced in gaining access to Long Covid clinics and the lack of treatment options available to him. He argues that at some point, the demand from patients for treatment will force progress in Long Covid research.
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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. Ian talks to us about rebuilding patient trust in the healthcare system, how the Private Healthcare Information Network (PHIN) is helping to improve decision making for patients in the private sector, and why recognising the link between physical and mental health is vital to patient safety. -
Content ArticleThis case study published by the Healthcare Quality Improvement Partnership (HQIP) highlights the Epilepsy12 Audit’s approach to working with children and young people to improve paediatric epilepsy care. Epilepsy12 Youth Advocates are epilepsy experienced or interested children, young people, families and an epilepsy specialist nurse. They volunteer together to shape Epilepsy12 and to lead improvement activities with families and epilepsy services. The audit won the Richard Driscoll Memorial Award (RDMA) 2022. The RDMA asks HQIP commissioned programmes to describe how patients and carers influence the production of the patient-focused outputs of the programme.
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Content ArticleThis report from the Institute for Fiscal Studies examines how NHS funding, resources and treatment volumes compare with pre-pandemic levels. The study examines how the funding, staffing and hospital beds available to the NHS have changed since 2019, comparing the number of patients treated by the NHS in eight different areas compares with 2019 levels. For most areas of care, the NHS is still struggling to treat more people than it was pre-pandemic, despite having – on the face of it – additional staff and funding. The report considers a range of different factors that could explain this seeming fall in performance and output.
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Content Article
Patient Innovation website
Patient Safety Learning posted an article in Patient-centred care
Patient Innovation is an online platform where patients and caregivers around the world connect to share the solutions they developed themselves or had the help from collaborators to cope with a health-related problem. -
Content ArticlePatients are facing increased delays at almost every stage of their NHS treatment, as the health system struggles to find the resources to deal with demand. The latest data shows waiting lists across England have surpassed record highs every month for two years running, one of many major challenges currently facing the NHS. But what impact does this have on ordinary people trying to access the NHS in 2022? Through a combination of interviews with health professionals and analysis of official data, the Guardian has plotted the journeys of four fictional patients through their NHS journey and how waiting times have changed at each stage of their treatment and recovery.
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Content ArticleThis report published by the National Confidential Enquiry into Patient Outcome and Death (NCEPOD) assesses the quality of care provided to adult patients with a pre-existing epilepsy disorder, or who were subsequently diagnosed with epilepsy and presented to hospital following a seizure, between 1 January and 31 December 2020.
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Content ArticleRoyal Cornwall QI conference online book supporting the conference. The online brochure highlights all the quality improvement projects at Royal Cornwall Hospitals.
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Content Article
University Hospital Southampton: Use of NEWS2 and SBAR poster
Patient Safety Learning posted an article in Handover
The University Hospital Southampton share their poster on using NEWS2 and SBAR. -
Content ArticleThis report by The Patient Experience Library looks at patient experience in urgent and emergency care (UEC), reviewing four years' worth of studies from sources including government bodies, policy think tanks, academic institutions and the local Healthwatch network.
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Content ArticleThis systematic review in the International Journal of Health Planning and Management aimed to examine and analyse the existing literature that examines the impact of strike action on patient morbidity—all patient outcomes apart from death. 15 studies were included in the review. and articles included a variety of outcomes from hypertension control to rates of chlamydia. Strikes ranged from 13 to 118 days, with a mean strike length of 56 days. The authors found that the majority of studies reported that strike action had a neutral or mixed impact on patient morbidity. One study reported positive outcomes and three studies reported negative outcomes, however in both cases, the impact that the strike had was marginal.
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Content Article
NSW Government: Between the Flags
Patient Safety Learning posted an article in International patient safety
The Between the Flags (BTF) system is a 'deteriorating patient safety net system' for patients who are cared for in New South Wales (NSW) public health facilities in Australia. It is designed to assist clinicians to recognise when patients are deteriorating and to respond appropriately when they do. -
Content ArticleThis report by the Beryl Institute and Ipsos explores the core trends impacting healthcare and patient experience overall in the United States. It highlights key issues expressed by consumers in an online survey relating to quality of care and experience of care, taking into account the impact of the Covid-19 pandemic and how it has altered the delivery of healthcare.
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Content ArticleVision-based patient monitoring systems (VBPMS) are assistive tools that enable staff to enhance and support patient safety in inpatient services by delivering non-contact measurement of physiological parameters such as pulse and breathing rate, some estimate of patient location, activity or behaviour data and some form of contextual video information (which may be blurred) either in real-time or through subsequent reviews. In some cases, a VBPMS can be classified as a medical device regulated by the Medicines and Healthcare products Regulatory Agency and have specific indications for use. Providers adopting the technology need to ensure users are appropriately trained.
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Content ArticlePatient safety is vital to well-functioning health systems. A key component is safe prescribing, particularly in primary care where most medications are prescribed. Previous research has demonstrated that the number of patients exposed to potentially hazardous prescribing can be reduced by interrogating the electronic health record (EHR) database of general practices and providing feedback to general practitioners (GPs) in a pharmacist-led intervention. This study aimed to develop and roll out an online dashboard application that delivers this audit and feedback intervention in a continuous fashion.
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News Article
‘Contentious’ US tech firm to harvest patient data in NHSE waiting list push
Patient Safety Learning posted a news article in News
NHS England has ordered the collection of identifiable patient data from hospitals by US data firm Palantir, for a pilot scheme aimed at accelerating recovery of elective waiting lists. The regulator has instructed NHS Digital, with which it will merge in January, to use Palantir’s Foundry platform to collect data about patients’ admission, inpatient, discharge and outpatient activity at acute hospitals. Identifiable data such as patients’ NHS numbers, date of birth, and postcode will be collected through Palantir’s software. Patients cannot opt out of having their data collected. But NHS Digital’s Caldicott Guardian – who is meant to safeguard use of data – has identified “risks” in the pilot and said it needs additional work before it can meet confidentiality requirements. The data collected will be “anonymised in accordance with the ICO’s (Information Commissioner’s) Anonymisation Code of Practice”. However, privacy campaigners Medconfidential claimed this code is not fit for purpose and warned that NHS chiefs were making the same mistakes as previous failed efforts to use patient data appropriately. Read full story (paywalled) Source: HSJ, 1 November 2022 -
News ArticleA consultant oncologist who ignored a hospital instruction and attended patients’ cancer surgery on two days when he knew he was still testing positive for Covid-19 has been suspended from the UK medical register for three months. Andrew Gaya admitted knowingly breaking the rules but told the medical practitioners tribunal he had feared that the patients’ treatments would be postponed if he could not attend the private London Gamma Knife Centre, part of HCA Healthcare UK. The two incidents occurred in the early weeks of the pandemic, at a time of high covid death rates. “I did not take the decision to attend the centre on 3 April 2020 lightly and was aware it was not in accordance with the instructions I had been given,” Gaya told the tribunal. “At the time I thought that I wasn’t going to do any harm and that I was acting in the best interests of the patient as the case was urgent. “I know I should have telephoned [the relevant manager] and asked if she would allow me to undertake the treatment, but I was afraid her answer would be ‘no’ and that the patient’s treatment would be cancelled,” he told the tribunal in a witness statement. Both patients have since died, but after the tribunal concluded Gaya told the Daily Telegraph, “One lived for 6 months with good quality of life.” Gaya, who was present as part of a multidisciplinary team, wore protective gear and observed social distancing. There is no evidence that he had infected anyone. Read full story Source: BMJ, 1 November 2022
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News ArticleNHS England “forgot the people” when it published controversial guidelines last month which said patients faced being removed from the waiting list if they declined two appointment dates, a senior director has admitted. NHSE elective recovery chief Sir Jim Mackey said the guidance was drafted to address legitimate concerns from trusts, but that the process had been “rushed”. Following Sir Jim’s comments, NHSE told HSJ the guidance, which had sparked widespead criticism including from patient groups, would not be changing. But Sir Jim said NHSE would “spend time” better understanding patients after “reflecting” on the process which had created the controversial guidelines. Speaking at the King’s Fund annual conference, Sir Jim said: “[The guidance] was largely a response to trusts saying to us: ‘We keep offering these patients options and they won’t take them, so what do we do?’ “We rushed through a policy to try and deal with that, and in the process, I think forgot the people…We’ve reflected on that.” Read full story (paywalled) Source: HSJ, 1 November 2022
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News ArticleThe Care Quality Commission (CQC) has issued two fixed penalty notices to University Hospitals Birmingham NHS Foundation Trust totalling £8,000 for failing to seek consent to care and treatment of someone in their care. A 55-year-old gentleman who had diagnoses of epilepsy and autism was admitted to Good Hope Hospital in Birmingham on six occasions between 12 May 2019 and 6 October 2019. He had also been deaf since birth and communicated via British Sign Language (BSL) and lip reading. These fixed penalty notices relate to the trust’s care and treatment of the patient at Good Hope Hospital in relation to three medical procedures, which occurred in September, October and November 2019. CQC found that on these three occasions, the trust did not comply with Regulation 11 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, requiring registered persons to obtain the consent of the relevant person when providing care and treatment to them. Regulation 11 also states if someone is 16 or over and is unable to give consent because they lack capacity, the registered person must act in accordance with the Mental Capacity Act 2005. The three procedures where CQC found consent failures, were feeding tubes, aimed at providing nutritional support to the patient, who was struggling with food. Read full story Source: CQC, 7 October 2022
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News Article
More than a million Americans ration insulin due to the high cost of the drug
Patient Safety Learning posted a news article in News
Insulin rights activists and those who live with diabetes are calling for meaningful action to address the high costs of insulin in the United States as a new study shows the widespread habit of rationing the life-saving medicine. A study published on 18 October in the Annals of Internal Medicine by researchers at Harvard Medical School, the City University of New York’s Hunter College and Public Citizen, found that 1.3 million Americans rationed insulin due to the high costs of insulin in 2021. The staggering number represents an estimated 16.5% of the US population with diabetes. The study found insulin rationing was most commonly reported by those without health insurance coverage and individuals under the age of 65 not eligible for Medicare. Black insulin users were more likely to report rationing insulin, at 23.2%. The impact of the practice can be terrible. Janelle Lutgen of Dubuque county, Iowa, lost her 32-year-old son Jesse, a type 1 diabetic, after he started rationing his insulin because he lost his job and with it his health insurance and died in early 2018 from diabetic ketoacidosis. Without health insurance, Lutgen said over-the-counter insulin costs more than $1,000 (£865) a month, and that her son couldn’t afford the high cost of healthcare coverage in the marketplace without a job and wasn’t eligible for Medicaid coverage because his income from when he was working was too high. “It would probably be impossible to really know exactly all the harm that’s been done with high insulin prices,” said Lutgen, who explained that individuals who ration insulin because of the cost, if they do survive, can still experience other health impacts such as neuropathy, or losing toes or feet. “It seems like we can’t get it through legislators’ heads that we have to make sure everyone who needs insulin can get it, not just people who have insurance or people on Medicare – everybody. The only way to do that is to go to the root of the problem, big pharma.” Read full story Source: The Guardian, 1 November 2022 -
News ArticleA surge in Covid cases over winter could lead to harsh visiting restrictions being reimposed in care homes and hospitals, MPs and campaigners have warned. Families are still facing a “postcode lottery” of Covid restrictions in care homes, with visiting times restricted and personal protective equipment (PPE) obligatory. However MPs are worried that some will reimpose even harsher measures if Covid cases rise this winter. Daily global Covid infections are projected to rise slowly to around 18.7 million by February, up from the current 16.7 million average daily cases this October. MPs are calling for the government to enact legislation that would enshrine the right for an essential care giver to be present with their loved ones in care settings. Liberal Democrat MP Daisy Cooper said that one of her constituents, Lynn, was not allowed into a hospital A&E ward to see her husband Andy when his dementia deteriorated over Christmas last year. The hospital refused to let Andy have any visitors for two weeks until Ms Cooper intervened. When she was allowed in, Lynn was distraught to find that Andy had lost a significant amount of weight in the weeks he was isolated. Ms Cooper continued: “We have come a long way since last Christmas, and since the start of the pandemic, but as winter approaches the NHS and care settings are once again expected to struggle with a surge in Covid cases. “It is not inconceivable that what happened to Lynn and Andy could happen again to them and to many others.” Read full story Source: Independent, 30 October 2022 Further hub reading Visiting restrictions and the impact on patients and their families: a relative's perspective It’s time to rename the ‘visitor’: reflections from a relative Mother knows best – a blog by Dr Abha Agrawal
