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News ArticleThe government should ‘relieve’ GP practices of being the sole controller for their patients’ data, a senior NHS England director has said. Tim Ferris, NHSE director of transformation, said it was a “challenge” that GP practices acted as the sole controllers of their patients’ data. Dr Ferris, whose background is as a primary care doctor in the US, was giving evidence to a Lords committee on integration of primary and community care today. He was asked whether it was time to revisit legislation on the control of GP patient data. He said: “Thirty years ago when the law was created, it made more sense. But I think it might no longer be fit for purpose… The idea that if I were a GP in this country, if I had legal liability for the exchange of data, I would be worried about that.” Dr Ferris agreed there would be merit to the committee recommending the government “relieve” GPs of the sole responsibility for data protection, and their data controller status. Read full story (paywalled) Source: HSJ, 20 June 2023
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News Article
Two-thirds of GPs refuse to register homeless patients
Patient Safety Learning posted a news article in News
Two-thirds of GP practices from a sample of 100 in London declined to register a patient without an address, contrary to national rules which are meant to ensure homeless and excluded people can get healthcare, HSJ has found. NHS England guidance states anyone can register with a GP without proof of address, and that people without a permanent address “can still register using a temporary address or the address of the GP surgery”. Practices normally need to record an address, but the exception rule is meant to ensure people who are homeless, or living in unstable or short-term accommodation, are still able to access primary care or referrals for secondary services. Despite this, when HSJ called 100 randomly selected practices in London (about 9 per cent of the total), 64 refused to register the caller. Read full story (paywalled) Source: HSJ, 19 June 2023 -
Content Article
Language Matters pocket guides (April 2023)
Patient-Safety-Learning posted an article in Diabetes
The language used by healthcare professionals can have a profound impact on how people living with diabetes, and those who care for them, experience their condition and feel about living with it day-to-day. At its best, good use of language; verbal, written and non-verbal (body language) which is more inclusive and values based, can lower anxiety, build confidence, educate and help to improve self-care. On the other hand, poor communication can be stigmatising, hurtful and undermining of self-care and have a detrimental effect on clinical outcomes. Language Matters Diabetes is a global movement that aims to improve the way in which healthcare professionals and wider society talks about and to people with diabetes. These three pocket guides for different groups aim to address use of language about diabetes and people with diabetes in order to improve experiences of care and tackle stigma. Language Matters pocket guide: Healthcare professionals Language Matters pocket guide: Parents and families Language Matters pocket guide: Media and social media -
Content ArticleIn April 2022, an investigation commenced into the communications provided to patients and/or their carers following placement on a waiting list in Northern Ireland. The primary focus of the investigation is the adequacy of Trust communications to patients, and/or their carers, across various stages of the waiting list process, with significant consideration being given to the content of the Integrated Elected Access Protocol (Department of Health guidance), and its application by the Trusts. The objective was to determine whether or not systemic maladministration has arisen within the communication practices of the Northern Ireland Health and Social Care Trusts (the Trusts) and whether improvements are required. It also aims to publicise what patients and/or their carers should expect from waiting list communications. The Investigative Methodology drew evidence from a wide range of sources. This included extensive queries and information requests to the Trusts and the Department; a General Public survey (with 646 responses); a General Practitioner (GP) survey (with 321 responses); follow up interviews with a number of General Public and GP survey respondents; and a number of Case Study reviews.
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Content Article
Age-Friendly Health Systems (AFHS) is an initiative that aims to follow evidence-based practices while minimising harm in older patients. The evidence-based elements of high-quality care are known as the 4Ms: What Matters Medication Mentation Mobility During the early days of the Covid-19 pandemic, a team from the Oregon Health & Science University (OHSU) decided to examine the equity of their care for older adults. The resulting study published about the age-friendly work at OHSU is the first to include data about health equity as part of AFHS outcomes and illustrates the importance of creating equitable care at clinical and institutional policy levels. This blog looks at the process the team went through to assess and collect data about age-related equity. -
News Article
How chatbots are helping doctors be more human and empathetic
Patient Safety Learning posted a news article in News
Despite the drawbacks of turning to artificial intelligence in medicine, some US physicians find that ChatGPT improves their ability to communicate with patients. Last year, Microsoft and OpenAI released the first free version of ChatGPT. Within 72 hours, doctors were using the artificial intelligence-powered chatbot. Experts expected that ChatGPT and other A.I.-driven large language models could take over mundane tasks that eat up hours of doctors’ time and contribute to burnout, like writing appeals to health insurers or summarising patient notes. However, they found that doctors were asking ChatGPT to help them communicate with patients in a more compassionate way. Dr Michael Pignone, the chairman of the department of internal medicine at the University of Texas at Austin, has no qualms about the help he and other doctors on his staff got from ChatGPT to communicate regularly with patients. However, skeptics like Dr Dev Dash, who is part of the data science team at Stanford Health Care, are so far underwhelmed about the prospect of large language models like ChatGPT helping doctors. In tests performed by Dr Dash and his colleagues, they received replies that occasionally were wrong but, he said, more often were not useful or were inconsistent. If a doctor is using a chatbot to help communicate with a patient, errors could make a difficult situation worse. Read full story (paywalled) Source: New York Times, 12 June 2023 -
News ArticlePatients may be found guilty of discrimination if they refuse the care of a transgender medic, according to new NHS guidance. Health bosses have been warned that patients have no right to be told a healthcare worker’s assigned sex at birth. However, transgender health workers can choose not to treat patients if they feel uncomfortable doing so, the report by NHS Confederation says. The report, published earlier this month in partnership with the LGBT Foundation, says patients can only request care from a same-sex staff member in limited circumstances, such as if they are having an intimate examination. It states that when a patient requests an employee administering care to be a woman or a man, “the comfort of the staff member should be prioritised”. Read full story Source: Telegraph, 9 June 2023
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News Article
Plan for GPs to offer NHS patients weight-loss jab
Patient Safety Learning posted a news article in News
GPs in England may start offering weight-loss jabs to some patients to reduce obesity-related illnesses and resultant pressure on hospitals. Wegovy was approved for NHS use after research suggested users could shed over 10% of their body weight. The drug blunts appetite, so users feel full and eat less. Rishi Sunak said it could be a "game-changer" as he announced a £40 million pilot scheme to increase access to specialist weight management services. But experts warn "skinny jabs" - widely used in the US and endorsed by many celebrities - are not a quick fix or a substitute for a healthy diet and exercise. NHS drugs watchdog, the National Institute for Health and Care Excellence (NICE), says patients can access Wegovy for a maximum of two years via specialist weight-management services. The new scheme will test how GPs could safely prescribe such drugs and the NHS provide support in the community or digitally, contributing to the government's wider ambition to reduce pressure on hospitals and give patients access to the care they need where it is most convenient for them. Read full story Source: BBC News, 7 June 2023 -
Content ArticleAnalysis, commentary and insight on patient flow from leaders across the healthcare sector. Please note you will need to submit your details to be able to download the report.
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News ArticleParamedics are being told to take a police escort to more than 1,200 addresses for fear of attack, The Times has revealed. The College of Paramedics said the figure was outrageous and called on courts to implement tougher sentences for assaults on paramedics. Ambulance services have marked hundreds of addresses after violence towards crew. Notes on addresses include “patient keeps axe under pillow — serrated knife hidden round the house and is known to be a risk”, “shoots/throws acid”, and “patient is anti-ambulance”. Read full story (paywalled) Source: The Times, 4 June 2023
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Content ArticleProbiotics are used for both generally healthy consumers and in clinical settings, but there have been adverse events as a result of their consumption. Concise and actionable recommendations on how to use probiotics safely and effectively are therefore needed, especially as increasing numbers of new strains and products come to market, and probiotic use increases in vulnerable populations. The International Scientific Association for Probiotics and Prebiotics convened a meeting to discuss and produce evidence-based recommendations on potential acute and long-term risks, risks to vulnerable populations, the importance for probiotic product quality to match the needs of vulnerable populations and the need for adverse event reporting related to probiotic use. This paper presents these recommendations to guide the scientific and medical community on judging probiotic safety.
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News ArticleAn integrated care board (ICB) has advised its GP practices not to give patients automatic access to their records, contradicting NHS England national requirements. Instead, North East London ICB has suggested practices only allow access where patients request it, and subject to conditions. The national go-live date for patients to be allowed automatic access to future entries in their records has been repeatedly delayed since initially being set at December 2021. GPs have argued they needed more time to redact sensitive information, ensure records are not inappropriately shared, and train staff. They have cited workload and safeguarding concerns. The ICB’s chief clinical information officer Osman Bhatti, who is a GP, told HSJ the ICB instead “wanted a process where patients could access both prospective and retrospective records safely, with less workload for GPs and so patients who actually want access can have it”. Read full story (paywalled) Source: HSJ. 1 June 2023
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Content ArticleIn Australia, as in many other countries, the harms caused by transvaginal mesh surgery have prompted individual and collective attempts to achieve redress. Media outlets covered aspects of the rise of mesh surgery as a procedure, the experience of mesh-affected women and the formal inquiries and legal actions that followed, The authors of this article in the journal Health Expectations conducted a media analysis of the ten most read Australian newspapers and online news media platforms, focusing on how mesh and the interaction of stakeholders in mesh stories were presented to the Australian public. They found that mass media reporting, combined with medicolegal action and an Australian Senate Inquiry, appears to have provided women with greater epistemic justice, with powerful actors considering their stories. They argue that although medical reporting is not recognised in the hierarchy of evidence embedded in the medical knowledge system, in this case, media reporting has contributed to shaping medical knowledge in significant ways.
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News ArticleThe decision last week by the Metropolitan police commissioner, Sir Mark Rowley, that in future his officers will attend emergency calls related to mental health only where a threat to life is feared, was both a wake-up call and a threat. His letter, and deadline of 31 August, have raised the stakes in negotiations with health bosses. The danger is that his combative approach will undermine attempts to find a solution to a problem that no one denies. In Humberside, a scheme called Right Care, Right Person resulted in 1,100 police officer hours a month being clawed back as health practitioners took over tasks that were previously done by them. The scheme attracted plaudits from the police inspectorate. This is the example that Sir Mark aims to follow as part of his plan to put his discredited force back on its feet. This is a sound idea. Humberside police has been judged the best force in the country, and successful innovations in public service should be copied. But the Met is a special case. At almost 20 times the size of Humberside’s service, with 43,000 officers, it is a huge organisation with responsibility for policing a growing city of almost 9 million people. Its relationships with local health and care services are far more complicated than in a smaller area. In London, there are five integrated care systems (partnership organisations that plan and deliver care). Given how overstretched these services already are, it is alarming to learn of the capital’s police chief announcing a unilateral withdrawal. Read full story Source: The Guardian, 29 May 2023
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Content ArticleThis WHO report includes six case studies from 12 individuals with lived experience of diverse health conditions. These case studies explore the topics of power dynamics and power reorientation towards individuals with lived experience; informed decision-making and health literacy; community engagement across broader health networks and health systems; lived experience as evidence and expertise; exclusion and the importance of involving groups that are marginalized; and advocacy and human rights. It is the first publication in the WHO Intention to action series, which aims to enhance the limited evidence base on the impact of meaningful engagement and address the lack of standardized approaches on how to operationalise meaningful engagement. The Intention to action series aims to do this by providing a platform from which individuals with lived experience, and organisational and institutional champions, can share solutions, challenges and promising practices related to this cross-cutting agenda.
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News Article
GPs urged to trial experimental drugs on patients
Patient Safety Learning posted a news article in News
Lord O’Shaughnessy has carried out a widespread review of clinical trials in Britain and found it is falling behind in medical research. He has suggested a raft of reforms, which include financial incentives for GPs who carry out community drugs and treatments trials on their patients at local surgeries or in their own homes. Patients who receive genomic testing on the NHS should also be automatically asked to consent to their genetic data being used for research, the report recommends. The Medicines and Healthcare products Regulatory Agency (MHRA) has been told to cut red tape and speed up approvals for medicines. It has also been asked to approve clinical trials within 60 days of submission. Writing in The Telegraph, Will Quince, Minister of State for Health and Secondary Care, said: “Cutting the time it takes for new medicines to reach patients is vital and has a direct impact on how patients recover faster or better manage conditions. “We want to make it easier for more people to be a part of life-changing research and giving the option to take part in trials virtually will improve the scope of who wants to, or can take part. “From cancer to obesity, these research studies can lead to billions of pounds in savings for the NHS and cut waiting lists through faster diagnosis and enhanced treatment.” Read full story (paywalled_ Source: The Telegraph, 26 May 2023 -
News ArticlePatients are being urged to shop around on the NHS app and website to cut their waiting time for treatment in England. IT systems have been updated to allow patients to more easily exercise their right to choose where they go for planned care, such as knee operations. They will now be able to view up to five providers - filtered by distance, waiting times and quality of care. But hospitals warned staffing shortages still needed to be tackled to make the biggest impact on waits. The idea of choosing where to go for treatment has been in place since the early 2000s, but few use it. Currently only1 in 10 exercises their right to choose, with patients reporting they are not always offered a choice of where to go or that it is hard to select different venues. Ministers believe that by searching the list of different hospitals, patients will be able to reduce their waits - potentially by up to three months, research suggests. Read full story Source: BBC News, 25 May 2023
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Content Article
The Community Health and Wellbeing Worker (CHWW) model was devised in Brazil in the 1990s, where it is called the Family Health Strategy. There are over 250,000 CHWWs in Brazil, described as ‘the ears and eyes of the GP in the community’. They are full time members of the local primary care team and focus on a defined location, usually 200 households, keeping in regular contact with the residents. By visiting households at least once a month, the delivery of primary care becomes truly local and embedded into everyday life. This article describes a pilot of a CHWW model by the NIHR Applied Research Collaboration Northwest London. It discusses how the project was established and includes case studies from the pilot. -
Content Article
NICE decision aid: Should I take a statin?
Patient Safety Learning posted an article in Heart conditions
This decision aid from the National Institute for Health and Care Excellence (NICE) can help you if you are thinking about taking a statin. It is for people who do not already have heart disease and have not had a stroke. You can use it to help you to talk about your options with your healthcare professional (such as your doctor, pharmacist or nurse). -
News Article
Northern Ireland: No shows to health appointments costing thousands
Patient Safety Learning posted a news article in News
Patients who fail to turn up for surgical day case procedures are costing the health service thousands of pounds. It is a problem across Northern Ireland's five health trusts. Over a 10-month period in the South Eastern area 14,000 patients did not attend or cancelled review appointments on the day they were due to turn up. Assistant Director of Elective Surgery at the South Eastern Trust Christine Allam said it was "frustrating". The South Eastern trust review showed between April 2022 and January 2023, 7,755 people did not attend or cancelled new outpatient appointments on the day. During the same period, 14,003 or 10% of patients didn't show for review appointments. Ms Allam said the situation was "frustrating for those patients who are waiting to be seen". "Those slots where people don't turn up are lost capacity because we haven't been given notice - and this only lengthens the waiting lists," she added. It is a problem that all health trusts are experiencing. Read full story Source: BBC News, 24 May 2023 -
Content ArticleThis podcast series from Julie Taylor aims to raise awareness of Long Covid, provide a platform of support, education and the lived experience. Julie is a registered nurse in the UK and became unwell with Covid in May 2020 while working on the frontline, during the first wave of the pandemic. She now lives with Long Covid and POTS (postural orthostatic tachycardia syndrome). In this podcast series, Julie shares her journey and lived experience, the symptoms and how each impacts daily life, not only the physical issues but also the impact this has had mentally and emotionally.
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News ArticleSome mental health patients in England are still having to travel more than 300 miles for hospital treatment two years after the government pledged to end the “completely unacceptable” practice. The number of patients in crisis forced to move potentially hundreds of miles for NHS help is rising again after falling during the pandemic, separating them from family and support networks and potentially delaying their recuperation. According to official data seen by the Observer, 420 so-called “out of area” treatments started in February because no local beds were available – up from 240 in February last year. The most recent NHS England records show there are 720 out of area placements deemed “inappropriate”, risking the patient’s recovery. Dr Mayura Deshpande, an associate registrar for policy at the Royal College of Psychiatrists, said targets for eliminating the practice had been “widely missed” and called for an urgent plan for the proper funding of mental health services. “It’s completely unacceptable that some mental health patients are having to travel hundreds of miles for care at a time when they are at their most vulnerable,” she said. Read full story Source: The Guardian, 20 May 2023
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Content ArticleThis KevinMD podcast discusses with family physician Lisa Baron the pervasive issue of medical gaslighting, particularly in women seeking care for chronic illnesses. We’ll delve into the consequences of dismissing symptoms and the importance of validating patient concerns. We’ll also explore the role of social media in connecting patients with support and treatment options, as well as steps doctors can take to improve their bedside manner and rebuild trust with patients who have been gaslit in the past.
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Content ArticleWith the Supreme Court having recently heard the Worcestershire appeal on local authority responsibility for section 117 aftercare, Bevan Brittan consider the current legal framework for health responsibility.
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Content ArticleHospitals can significantly elevate patient satisfaction and enhance the delivery of healthcare services by incorporating best practices from adjacent and non-adjacent sectors. Chetan Trivedi explores several solutions, from multiple sectors, that can serve as a blueprint for hospitals across every key step of the patient journey, spanning from admission to discharge.
