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Found 1,285 results
  1. Content Article
    Great Ormond Street Hospital NHS Foundation Trust is one of the world’s leading children’s hospitals, receiving 242,694 outpatient visits and 42,112 inpatient visits every year (figures from 2021/22). This paper seeks to provide an overview of the safety systems and processes Great Ormond Street Hospital has in place to keep patients, staff, and healthcare environments safe.
  2. Content Article
    Doctors At Work is a series of video podcasts hosted by Dr Mat Daniel. In this episode, Dr Gordon Caldwell shares his experiences of managing and preventing adverse events. He stresses the importance of creating a culture that encourages everyone to speak up. His top tips for preventing errors is to create systems, checklists and routines that ensure a focus on all aspects of care not just the obvious and urgent.
  3. Content Article
    Antibiotic resistance is an increasing problem in healthcare, especially in nursing homes where up to 75% of antibiotics are prescribed inappropriately. This series of webinars from the Pennsylvania Patient Safety Authority covers various aspects of antibiotic stewardship including: Types of antimicrobials Why antibiotic stewardship and who should be at the table Antimicrobial usage Mechanisms of antimicrobial resistance Antibiograms Antimicrobial baseline data Developing an antimicrobial stewardship plan Antimicrobial usage data
  4. News Article
    NHS England’s drive to encourage patient-initiated appointments is only having a marginal impact on reducing overall outpatient follow-ups, a major study suggests. NHS England currently has a target to have 5% of outpatients on patient-initiated follow-up pathways, and hopes this can be increased substantially in future years. The headline finding in a study by the Nuffield Trust think tank, which analysed almost 60 million cases, was that for every 5% on PIFU pathways, this roughly corresponded to 2% fewer outpatient follow-up attendances overall. It suggests PIFU implementation would need to be dramatically expanded to get anywhere close to a 25% reduction in total follow-up activity, which NHSE had previously targeted by March 2023. As previously reported, there has been little to no reduction so far. Chris Sherlaw-Johnson, senior fellow at the Nuffield Trust, said: “As few patients are currently on PIFU pathways at present, it’s not going to have that noticeable impact on the overall number of follow ups.” He also stressed it was not clear whether the reduction was caused by the genuine elimination of unnecessary follow-ups or if patients were not returning for care despite needing it. Read full story (paywalled) Source: HSJ, 25 January 2024
  5. Content Article
    Millions of people use hospital services as an outpatient, with numbers of appointments rising rapidly over recent years. Patient-initiated follow-up (PIFU) is a relatively new initiative in the English NHS, and the NIHR RSET team has conducted a mixed-methods evaluation as the process develops to understand how it's working and what impact it's having on health care systems and the staff and patients involved.
  6. News Article
    One in 20 patients has to wait at least four weeks to see a GP at a time when funding for family doctor services is falling, NHS figures show. In November 2023, 1.5m appointments in England at a GP surgery took place four weeks or more after they were booked, 4.8% of the 31.9m held that month. In one in six appointments, 5.4m (17.3%), the patient was forced to wait at least two weeks after booking it to see a GP, practice nurse or other health professional. “Millions of people are being left anxious or waiting in pain because they can’t get an appointment with their GP,” said Ed Davey, the leader of the Liberal Democrats, who highlighted the latest evidence underlining the long delays that many patients face to see a GP. “Staggering” numbers of patients now have to wait a long time, he said. GP leaders blamed the situation on the widespread shortage of family doctors, which they said was making it impossible to keep up with the rising demand for appointments. Burnout due to intense workloads is prompting more GPs to work part time. Read full story Source: The Guardian, 22 January 2024
  7. Content Article
    Laura Cockram, Head of Policy and Campaigning at Parkinson's UK, and regular blogger for the hub, shares with us what Parkinson's UK will be doing to support World Parkinson's Day.
  8. Content Article
    Medication shortages can occur for many reasons, including manufacturing and quality problems, delays and discontinuations. This Food and Drug Administration (FDA) database provides information on drugs with a supply issue. Information is provided to the FDA by manufacturers.
  9. News Article
    More than 8,500 patients in England were being treated on virtual wards in the run-up to Christmas, figures have revealed, as the NHS moves to ease pressures on hospital capacity. However, experts said the so-called hospitals at home are not a “silver bullet to solve the crisis in health and social care”. Figures published by NHS Digital revealed some 8,586 patients were treated virtually in December 2023, up from 7,886 in November. The snapshot was taken on 21 December 2023, meaning it is likely those patients spent Christmas on a virtual ward rather than an actual hospital. Virtual wards allow patients to receive care in their own homes, with clinical staff using apps or wearable technology to monitor them remotely. Professor Sir Stephen Powis, NHS national medical director, said the “rapid expansion” of virtual wards beds and patients “is a real NHS success story”. He added: “This not only frees up vital hospital beds for those who need them most but ensures patients can recover in the place they are most comfortable with support from families, carers and friends, and while occupancy has been growing rapidly as NHS teams make the most of all bed capacity available, we want to see continued growth right across the country so as many patients as possible can benefit." However, Wendy Preston, the head of nursing practice at the Royal College of Nursing (RCN), said “virtual wards aren’t a silver bullet to solve the crisis in health and social care”. “Whether they’re in a physical bed or on a virtual ward, patients still need to be able to see a nurse,” she added. “But there are over 40,000 nursing vacancies across the NHS, and social care is chronically understaffed. Run effectively, virtual wards can relieve pressure, but on every single shift nursing staff are fighting an uphill battle to care for too many patients. “If the UK government wants to turn around the state of the NHS and deliver the ‘hospital level’ care at home that patients expect, nursing staff need to see game-changing investment in the workforce.” Read full story Source: The Independent, 15 January 2024
  10. Content Article
    People with diabetes often encounter stigma in the form of negative social judgments, stereotypes and prejudice, which can adversely affect emotional, mental and physical health, self-care, access to healthcare and social and professional opportunities. On average, four in five adults with diabetes experience diabetes stigma and one in five experience discrimination due to diabetes in healthcare, education, and employment. Diabetes stigma and discrimination are harmful, unacceptable, unethical, and counterproductive. Collective leadership is needed to proactively challenge, and bring an end to, diabetes stigma and discrimination. To help achieve this, an international multidisciplinary expert panel conducted rapid reviews and participated in a three-round Delphi survey process. The group achieved consensus on 25 statements of evidence and 24 statements of recommendations. The consensus is that diabetes stigma is driven primarily by blame, perceptions of burden or sickness, invisibility and fear or disgust.
  11. Content Article
    There are around 1.3 billion people in the world with a disability, but in many settings, the understanding of reasonable adjustments among healthcare workers is inadequate to provide the same quality of care for people with disabilities as individuals without disabilities. Inclusive healthcare requires improvements in accessibility and training for healthcare professionals. Some progress is being made and medical education in some countries now includes disability, human rights and reasonable adjustments in education and training. This Lancet article outlines global examples of attempts to improve healthcare workers' understanding of disabilities and inclusion.
  12. Content Article
    Ileostomy is a common treatment option for various gastrointestinal conditions. This study in Surgery aimed to examine how receiving care at different facilities might increase the risk of post-discharge complications and readmission following ileostomy. The authors used a national cohort to explore the associations of care fragmentation among ileostomy patients experiencing adverse outcomes and increased hospitalisation.
  13. Content Article
    In this article for the Journal of Eating Disorders, Alykhan Asaria considers the criteria used in a paper by Guadiani et al. (J Eat Disord 10:23, 2022) to define ‘terminal anorexia nervosa’ and outlines concerns about this new term from a lived experience perspective. The author highlights issues about the ambiguities around how the criteria can be applied safely and the impact of labelling anorexia nervosa sufferers with terms. Further articles on the hub from Alykhan Asaria: ‘Terminal anorexia’: a lived experience perspective
  14. News Article
    Almost one in four people have bought medicine online or at a pharmacy to treat their illness after failing to see a GP face to face, according to a UK survey underlining the rise of do-it-yourself treatment. Nearly one in five (19%) have gone to A&E seeking urgent medical treatment for the same reason, the research commissioned by the Liberal Democrats shows. One in six (16%) people agreed when asked by the pollsters Savanta ComRes if the difficulty of getting an in-person family doctor appointment meant they had “carried out medical treatment on yourself or asked somebody else who is not a medical professional to do so”. Ed Davey, the leader of the Liberal Democrats, said delays and difficulty in accessing GP appointments constituted a national scandal, and face-to-face GP appointments had become “almost extinct” in some areas of the country. He said: “We now have the devastating situation where people are left treating themselves or even self-prescribing medication because they can’t see their local GP.” Dr Richard Van Mellaerts, the deputy chair of the British Medical Association’s GP committee in England, said: “While self-care and consulting other services such as pharmacies and NHS 111 will often be the right thing to do for many minor health conditions, it is worrying if patients feel forced into inappropriate courses of action because they are struggling to book an appointment for an issue that requires the attention of a GP or a member of practice staff.” Read full story Source: The Guardian, 2 January 2024
  15. Content Article
    The Belmont Report was written by the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. The Commission, created as a result of the National Research Act of 1974, was charged with identifying the basic ethical principles that should underlie the conduct of biomedical and behavioral research involving human subjects and developing guidelines to assure that such research is conducted in accordance with those principles. Informed by monthly discussions that spanned nearly four years and an intensive four days of deliberation in 1976, the Commission published the Belmont Report, which identifies basic ethical principles and guidelines that address ethical issues arising from the conduct of research with human subjects.
  16. Content Article
    The ethnicity data gap pertains to three major challenges to address ethnic health inequality: Under-representation of ethnic minorities in research Poor data quality on ethnicity Ethnicity data not being meaningfully analysed. These challenges are especially relevant for research involving under-served migrant populations in the UK. This study in BMC Public Health aimed to review how ethnicity is captured, reported, analysed and theorised within policy-relevant research on ethnic health inequities. The authors concluded that the multi-dimensional nature of ethnicity is not currently reflected in UK health research studies, where ethnicity is often aggregated and analysed without justification. Researchers should communicate clearly how ethnicity is operationalised for their study, with appropriate justification for clustering and analysis that is meaningfully theorised.
  17. Content Article
    An estimated 2.1 million people are living with Long Covid in the UK alone. The Conversation recently asked 888 people in the UK with Long Covid about their experiences of stigma, and 95% of them said they had experienced stigma related to their condition. On top of the physical symptoms, people living with Long Covid may have to contend with discrimination and prejudice within their communities, workplaces and even health services. Long Covid is a relatively new medical condition, and has been subject to lots of misinformation and minimisation of its legitimacy as a physical illness. To date, there have been no estimates as to how common stigma around long COVID is, which has limited our ability to tackle the problem. Being aware of numerous anecdotes of the discrimination Long Covid patients face, The Conversation decided to look into the extent of this problem and designed a questionnaire together with people who had lived experience of the illness. The questions aimed to estimate how commonly people with Long Covid experience stigma across three domains. “Enacted stigma” means being treated unfairly due to their long COVID, “internalised stigma” is where people feel embarrassed or ashamed of their illness, and “anticipated stigma” is a person’s expectation that they will be treated poorly because of their condition.
  18. Content Article
    Data federation is a process that uses software to connect many existing systems so that they can function as one. It was recently announced that the contract to develop the NHS Federated Data Platform (FDP).has been awarded to US analytics and AI firm Palantir. This blog explains what the FDP is and what it will do, as well as outlining issues surrounding data privacy that have been raised with the Department of Health and Social Care and NHS England by National Voices and other organisations.
  19. News Article
    A London acute trust is planning to provide staff working in frailty units with body cameras and those in antenatal clinics with additional security, as violence and aggression against them goes ‘through the roof’. Matthew Trainer, chief executive of Barking, Havering and Redbridge University Hospitals Trust in north east London, described the measures the trust is planning to take in response to growing staff concerns about their safety. Speaking at a King’s Fund event about making NHS careers more attractive, Mr Trainer said: “We need to understand the impact of violence and aggression against the workforce and that’s going through the roof just now. “Our ultrasound technicians have now asked for help as their antenatal scans are becoming so fraught. We are about to introduce body cameras in our frailty wards to help with the increase in violence and aggression against staff there.” Mr Trainer – who joined BHRUT in 2021 from Oxleas Foundation Trust – said a long-running problem with violence and aggression in emergency departments was spreading to other departments. Mr Trainer stressed the main problem, particularly in frailty units, was not patients’ own behaviour, but that of family and friends visiting them. Read full story (paywalled) Source: HSJ, 13 December 2023
  20. Content Article
    With around half a million people receiving homecare medicines services at a cost that is likely to be between £3billion and £4billion each year, there are questions over what the NHS is getting for its money and how governance and accountability within the system could be improved. This article outlines an investigation by The Pharmaceutical Journal that has revealed hundreds of patient safety incidents caused by problematic homecare medicines services.
  21. News Article
    GPs have warned that the extent of verbal abuse directed at them and their practice staff ‘is increasing’, with the majority reporting that things are worse now than during the height of the Covid pandemic. A UK-wide survey of more than 2,000 doctors – of which 617 were GPs – found that 85% of GPs have reported receiving verbal abuse from patients within the last 12 months. The research conducted by Medical and Dental Defence Union of Scotland (MDDUS) also found that 15% of GPs reporting verbal abuse said they ‘had to resort to involving the police’ to deal with abusive patient situations over the past year. In the survey, GPs identified key triggers such as ‘lack of access to a face-to-face consultation’ and ‘complaints about their quality of care’ as the factors that could escalate to verbal abuse. One GP who responded to the survey said: "During a consultation with a young adult, they got very irate and demanded I just give them what they came for. "I explained they had to calm down and we would only proceed then at which they called me an ugly, fat, c**t and threatened to smash my face in. That consultation stayed with me for quite a while after that." Another said: ‘A patient smashed the surgery front door (it needed replacing) because he didn’t get what he wanted when he wanted it. "This was very scary for staff and other patients and the police didn’t even come until the next day. I felt alone, defensive and wondered why we bother to try to provide a service when some patients have already decided it isn’t good enough for them." Read full story Source: Pulse, 7 December 2023
  22. Content Article
    In this episode of the Medicine and the Machine podcast, Scottish GP Gavin Francis talks about the need to reconsider the importance of convalescence. He discusses the role of GPs in supporting patients through recovery after a hospital admission or period of illness and talks about a lack of awareness of the principles of convalescence amongst patients.
  23. News Article
    The NHS has been accused of “breaking the law” by creating a massive data platform that will share information about patients. Four organisations are bringing a lawsuit against NHS England claiming that there is no legal basis for its setting up of the Federated Data Platform (FDP). They plan to seek a judicial review of its decision. NHS England sparked controversy last week when it handed the £330m contract to establish and operate the FDP for seven years from next spring to Palantir, the US spytech company. The platform involves software that will allow health service trusts and also integrated care systems, or regional groupings of trusts, to share information much more easily in order to improve care. Rosa Curling, director of Foxglove, a campaign group that monitors big tech and which is co-ordinating the lawsuit, said: “The government has gambled £330m on overhauling how NHS data is handled but bizarrely seems to have left off the bit where they make sure their system is lawful. NHS England says the platform will help hospitals tackle the 7.8m-strong backlog of care they are facing and enable them to discharge sooner patients who are medically fit to leave. But this may be the first in a series of legal actions prompted by fears that the FDP could lead to breaches of sensitive patient health information, and to data ultimately being sold. “You can’t just massively expand access to confidential patient data without making sure you also follow the law.” Read full story Source: The Guardian, 30 November 2023
  24. News Article
    Health Education England (HEE) and NHS England have warned BMA that its stance on medical associate professionals (MAPs) is impacting NHS relationships and patient confidence. HEE published an open letter to the BMA in response to the union’s call to halt recruitment of MAPs – which includes physician associates (PAs) working in general practice – until regulation is in place. The BMA Council passed a motion calling for a halt to recruitment of MAPs two weeks ago, on the grounds of patient safety. This followed a previous motion to that effect from its GP committee for England earlier this month. Proposing to bring forward a planned meeting with the BMA to discuss the matter, HEE’s letter said: "This continuing public discourse around MAPs is impacting relations between your members and their MAP colleagues, the health and wellbeing of MAPs already working in the NHS, and potentially the confidence of patients." HEE chief workforce, training and education officer Dr Navina Evans and NHS England medical director Sir Stephen Powis argued in the letter that evidence shows "MAPs are safe", and that they "increase the breadth of skill, capacity and flexibility of teams" and reduce workload pressure on other clinicians. ‘Any issues of patient safety identified resulting from MAPs ‘must be addressed in the same way we would any other profession’, the letter added. Read full story Source: Pulse, 27 November 2023
  25. Content Article
    The BMJ’s new “practical prescribing” series aims to improve decision making Prescribing is one of the most fundamental parts of medicine and one of the most common interventions in health care. In the UK, the British National Formulary lists more than 1600 drugs. The number of prescriptions dispensed in the community in England grew by 66% from 686 million prescriptions in 2004 to 1.14 billion prescriptions in 2021-22.34 Polypharmacy has also increased, with around 15% of people in England taking five or more medicines a day and 7% taking eight or more medicines a day. The BMJ in conjunction with the Drug and Therapeutics Bulletin has commissioned a series of articles on practical prescribing. These articles will highlight important issues for prescribers to consider and prompts for shared decision making between prescribers, patients, and their carers. The series—targeted at all medical and non-medical prescribers, particularly doctors in training—will cover medicines commonly prescribed in primary and secondary care. The format is designed to help readers recall their understanding of a medication through a series of questions, exploring up-to-date evidence, and reviewing accessible information not readily found in prescribing texts.
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