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Content ArticleLucy is a world-leading authority on recovering from disaster. She has been at the centre of the most seismic events of the last few decades, advising on everything from the 2004 Boxing Day tsunami to the 7/7 bombings, the Christchurch earthquake in New Zealand, the Grenfell fire and the Covid-19 pandemic. In every catastrophe, Lucy is there to pick up the pieces and prepare for the next one. She holds governments to account, helps communities rally together, returns personal possessions to families, and holds the hands of the survivors. In her moving memoir she reveals what happens in the aftermath and explores how we pick up and rebuild with strength and perseverance. She takes us behind the police tape to scenes of destruction and chaos, introducing us to victims and their families, but also to the government briefing rooms and bunkers, where confusion and stale biscuits can reign supreme. Telling her own personal story, Lucy looks back at a life spent on the edges of disaster, from a Liverpudlian childhood steeped in the Hillsborough tragedy to the many losses and loves of her career.
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News Article
Trusts need hundreds of millions to stop hospitals’ roofs collapsing
Patient Safety Learning posted a news article in News
Trusts need hundreds of millions of pounds to remediate dangerous roofs. A series of freedom of information requests submitted by New Civil Engineer has revealed five of the worst affected trusts have applied for £331.9m of additional funding to be spent on fixing reinforced autoclaved aerated concrete planks during the next three years. In response to NCE’s freedom of information investigation, Liberal Democrat deputy leader and health spokesperson Daisy Cooper said “patients are paying the price for years of neglect” by successive governments. “It is truly shocking that patients are being treated in crumbling buildings that could be at risk of collapse. The NHS is crying out for the funds to fix creaking roofs so that patients can be treated safely. The public needs to know that the funds to fix this are on the way as soon as possible.” Read full story Source: HSJ, 17 October 2022 -
Content ArticleCommunity Diagnostic Centres (CDCs) can relieve pressure on NHS acute services and bring diagnostic services closer to patients. This resource by the Chartered Institute of Ergonomics & Human Factors (CIEHF) explores ten principles for including systems thinking in the design of the diagnostic workforce and CDC services.
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Content ArticleIdentifying a route to net zero emissions for a complex system as large as the NHS is particularly challenging. To understand how and when the NHS can reach net zero we established an NHS Net Zero Expert Panel, reviewed nearly 600 pieces of evidence submitted to us and conducted extensive analysis and modelling. The targets set are as ambitious as possible, while remaining realistic; and are supported by immediate action and a commitment to continuous monitoring, evaluation and innovation. The aim is to be the world’s first net zero national health service.
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Content ArticleA new AHRQ resource, “Reducing Healthcare Carbon Emissions: A Primer on Measures and Actions for Healthcare Organizations to Mitigate Climate Change,” is now available to help healthcare organisations reduce their carbon footprint and protect communities from climate threats. AHRQ contracted with the Institute for Healthcare Improvement to develop the primer. It describes six domains contributing to greenhouse gas emissions in healthcare: building energy; transportation; anaesthetic gas; pharmaceuticals and chemicals; medical devices and supplies; and food. The primer identifies measures to track progress toward reducing greenhouse gas emissions in each domain. It also features vignettes of what health systems have done to reduce emissions and includes resources and tools to support implementation.
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News ArticleEvery year, air pollution causes up to 36,000 deaths in the UK. The World Health Organization and the UK Government recognise that air pollution is the largest environmental health risk we face today. Millions of people around the world breathe polluted air that puts their respiratory and cardiovascular health, and in some cases even their lives, at risk. Phasing out fossil fuels would be a major step in protecting health for current and future generations. More than a thousand health professionals have already endorsed the call for a treaty. Add your name to endorse the call for a treaty. Next week, the Global Climate and Health Alliance are planning a major press launch of the health community's letter calling for a Fossil Fuel Non-Proliferation Treaty and want to secure as many signatures as possible. They are encouraging healthcare professionals to help to build momentum by inviting two—or more—of your health colleagues to sign the health letter before the launch on 14 September. Invite your colleagues to sign the health letter By clicking the link above, you'll be taken to a form where you can send a short note of invitation to a colleague to sign the letter. They will be sent your note, as well as a link to some additional information about the Fossil Fuel Non-Proliferation Treaty. The form can only send one email at a time, but you use the form as many times as you wish.
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News ArticleA senior NHS leader has warned of a “life-threatening” situation in which clinically vulnerable people are being admitted to hospital after having their energy supplies disconnected. Sam Allen, chief executive of North East and North Cumbria Integrated Care Board (ICB), has written to Ofgem today to raise “serious concerns” that vulnerable people have seen their electricity or gas services disconnected as a result of non-payment. In the letter, which the ICB has published on its website, Ms Allen said the impact of energy supplies being cut off “will be life threatening for some people” and place additional demand on already stretched health and social care services. She wrote: “It has come to light that we are starting to see examples where clinically vulnerable people have been disconnected from their home energy supply which has then led to a hospital admission. “This is impacting on people who live independently at home, with the support from our community health services team and are reliant on using electric devices for survival. “An example of this is oxygen; and there will be many other examples. There is also a similar concern for clinically vulnerable people with mental health needs who may find themselves without energy supply. “Put simply, the impact of having their energy supply terminated will be life threatening for some people as well as placing additional demands on already stretched health and social care services.” Read full story (paywalled) Source: HSJ, 5 September 2022
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News Article
Half of healthcare facilities globally lack basic hygiene services
Patient Safety Learning posted a news article in News
Half of healthcare facilities worldwide lack basic hygiene services with water and soap or alcohol-based hand rub where patients receive care and at toilets in these facilities, according to a new report by WHO and UNICEF. Around 3.85 billion people use these facilities, putting them at greater risk of infection, including 688 million people who receive care at facilities with no hygiene services at all. “Hygiene facilities and practices in health care settings are non-negotiable. Their improvement is essential to pandemic recovery, prevention and preparedness. Hygiene in health care facilities cannot be secured without increasing investments in basic measures, which include safe water, clean toilets, and safely managed health care waste,” said Dr Maria Neira, WHO Director, Department of Environment, Climate Change and Health. “I encourage Member States to step up their efforts to implement their 2019 World Health Assembly commitment to strengthen water, sanitation and hygiene (WASH) services in health care facilities, and to monitor these efforts.” The latest report, “Progress on WASH in health care facilities 2000–2021: special focus on WASH and infection prevention and control”, has for the first time established this global baseline on hygiene services – which assessed access at points of care as well as toilets – as more countries than ever report on critical elements of WASH services in their hospitals and other health centres. For hygiene, data are now available for 40 countries, representing 35% of the world’s population, up from 21 countries in 2020 and 14 in 2019. The newly established global estimate reveals a clearer and more alarming picture of the state of hygiene in health care facilities. Though 68% of health care facilities had hygiene facilities at points of care, and 65% had handwashing facilities with water and soap at toilets, only 51% had both and therefore met the criteria for basic hygiene services. Furthermore, 1 in 11 (9%) of health care facilities globally have neither. “If health care providers don’t have access to a hygiene service, patients don’t have a health care facility,” said Kelly Ann Naylor, UNICEF Director of WASH and Climate, Environment, Energy, and Disaster Risk Reduction (CEED). “Hospitals and clinics without safe water and basic hygiene and sanitation services are a potential death trap for pregnant mothers, newborns, and children. Every year, around 670,000 newborns lose their lives to sepsis. This is a travesty – even more so as their deaths are preventable.” Read full story Source: WHO, 30 August 2022 -
Content ArticleIn March 2018, the Secretary-General of the United Nations launched a global call to action for WASH in all healthcare facilities, noting that healthcare facilities are essential tools in reducing disease, and that without basic WASH services, healthcare facilities can instead contribute to more infections, prolonged hospital stays and preventable deaths, including of mothers and babies. This call was answered in a May 2019 World Health Assembly resolution calling on countries to conduct comprehensive assessments of WASH and IPC in health care facilities, and to take steps to improve WASH and IPC conditions where necessary. In May 2022, the World Health Assembly passed a resolution calling for WHO to draft a global strategy on infection prevention and control. The World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF), through the WHO/ UNICEF Joint Monitoring Programme for Water Supply, Sanitation and Hygiene (JMP) release progress updates on WASH in households, WASH in schools and WASH in health care facilities every two years. This 2022 update presents national, regional and global estimates for WASH in healthcare facilities up to the year 2021, with a special focus on the linkages between WASH and infection prevention and control (IPC). Achieving universal access to WASH in health care facilities requires political will and strong leadership at both national and facility levels, but is highly cost-effective, and would yield substantial health benefits.
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News Article
No new London hospitals until at least 2027
Patient-Safety-Learning posted a news article in News
Two new London hospitals will not open until 2027 at the earliest, the BBC has been told. In 2019, the government pledged to build a new hospital in Sutton and another at Whipps Cross in east London. The St Helier complex in Sutton in south London dates back to the 1930s and much of the Epsom site is about 40 years old. But Dr Ruth Charlton, chief medical officer at Epsom and St Helier Hospital, said: "Our working conditions... are not fit for 21st century healthcare. We really feel that our patients and or staff deserve facilities that would allow them to deliver the quality of healthcare that we all wish to receive." A Department of Health and Social Care spokesperson said: "We have committed to deliver 40 new hospitals by 2030, backed by an initial £3.7bn. We are working closely with all the schemes in the programme and providing funding to develop their plans - final funding allocations are only confirmed once business cases have been fully reviewed and agreed. By taking a more centralised approach, we will reduce the overall time taken to build the hospitals and provide better value for money for the taxpayer." Read full story Source: BBC News (25 August 2022) -
Content ArticleSuccessful adoption of novel noncontact physiological measurement and physical monitoring requires analysis of how they support patient care. Lloyd-Jukes et al. review available technologies and present their vision-based patient monitoring and management system, supported by a framework enabling its integration within clinical workflows. The framework links tasks such as assessing patients to elements of the patient journey (eg, risk factors and early warning signs). The system enabled insights from patient activity reports and noncontact vital sign measurements. It supports staff in ensuring patients' health follows desired trajectories, avoiding adverse events, making observations without disrupting patients' rest, intervening proactively, and learning from incidents.
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Content ArticlePerioperative practitioners in the UK are universally concerned about the risk surgical smoke plume poses to their health. Yet less than a fifth are aware of any policy being in place to manage this risk within their organisation. The majority of hospitals have plume evacuation equipment in place, but it is only used in the minority of surgical procedures. Almost three-quarters of theatre staff have experienced symptoms associated with exposure to surgical smoke plume. But these symptoms are rarely reported and, when they are, no action is generally taken. These are the findings of a new report published by the Surgical Plume Alliance (SPA), a joint advocacy initiative between the Association for Perioperative Practice (AfPP) and the International Council on Surgical Plume (ICSP). They aimed to gain a greater understanding of the awareness levels, training, management and policy surrounding surgical smoke plume in the UK.
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Content Article
The NHS has declared climate change a health emergency, but are trust leaders and healthcare staff talking and acting on this? Angela Hayes, Clinical Lead Sustainability at the Christie Foundation Trust, discusses climate change and the impact it has on all of our lives and health. She believes healthcare professionals have a moral duty to act, to protect and improve public health, and should demand stronger action in tackling climate change.- Posted
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Content ArticleThe Quality Network for Inpatient Working Age Mental Health Services (QNWA) based within the Royal College of Psychiatrists' Centre for Quality Improvement are pleased to announce the publication of their 8th edition standards. Since the publication of the first edition standards in 2006, the Network has grown to include over 140 members from the NHS and private sector. This new edition of standards aims to reflect the changes in working practices and legislation over the last two years in addition to placing greater emphasis on equality, diversity and inclusion as well as sustainability in inpatient mental health services. The eighth edition standards have been drawn from key documents and expert consensus and have been subject to extensive consultation with professional groups involved in the provision of inpatient mental health services, and with people and carers who have used services in the past.
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Content ArticleAngela Hayes discusses the global impact healthcare has on climate change and the effect it has on our health.
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Content ArticleThis report published by the National Confidential Enquiry into Patient Outcome and Death (NCEPOD) looked to identify and explore remediable factors in the clinical and organisation of the physical healthcare provided to adult patients admitted to a mental health inpatient setting. The report suggests that a physical healthcare plan should be developed when patients are admitted to a mental health inpatient setting. Other key messages aimed at improving care include calls to: formalise clinical networks/pathways between mental health and physical health care; involve patients and their carers in their physical health care, and use admission as an opportunity to assess and involve patients in their general health, and include mental health and physical health conditions on electronic patient records.
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Content ArticleAn investigation started on 9 October 2020 into the death of Matthew Alexander Caseby. Following his admission and subsequent absconsion from the Priory Hospital in Edgbaston, Matthew stepped in front of a train on the 8 September 2020 and was fatally injured. At the time, Matthew was suffering from disorder thinking and did not have the capacity to form any intention to end his life. Matthew absconded from Beech ward over a fence in the courtyard area and at the time of his absconsion Matthew was unattended. It was inappropriate for Matthew to be left unattended in the courtyard. There were concerns regarding Matthew absconding but the recording processes on Beech ward were inadequate which resulted in the communication to staff involved in Matthew's care being lacking. As a result of risks not being fully recorded, Matthew's risk assessment was not adequate as it was not based on all of the available information. Overall, the inadequate risk assessment for Matthew, the inadequate documentation records, the lack of a risk assessment for the courtyard area and the absence of a policy regarding observations levels in the courtyard means that the courtyard was not safe for Matthew to use unattended. His death was contributed to by neglect on the part of the treating hospital.
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Content ArticleThe article in the Journal of Global Health examines the unique patient safety risks that can arise in fragile, conflict-affected and vulnerable settings (FCV), including humanitarian crises, conflict, extreme adversity, services disruption and immediate or protracted emergencies. Recent estimates suggest a large proportion of the total number of preventable deaths take place in FCV settings, including 60% of preventable maternal deaths, 53% of deaths in children under five years, and 45% of neonatal deaths. The authors highlight a gap in knowledge and research about healthcare in FCV settings, which prevents researchers from being able to effectively assess interventions for quality, safety and sustainability. They suggest that more academic research is urgently needed in order to make policy and practice more effective in improving patient safety in these settings.
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News ArticleA patient was left traumatised when his body caught on fire halfway through surgery - leaving his insides scorched. Mark, 52, went to hospital for a routine abscess removal - but woke up to the news that a freak accident in theatre had sparked an horrific blaze. A diathermy machine, used to stop bleeding, caused a swab to catch fire - before flames burnt their way through his exposed flesh, Mark explained. It took over a year for Mark - not his real name - to recover from his dreadful injuries - and the emotional scarring it caused. Between 2008 and 2018, 37 cases were acknowledged by NHS trusts across Britain. But from 2009 to 2019, it has paid out nearly £14 million in compensation settlements and legal fees. Fires such as these are often fuelled by leaking oxygen - and are caused by faulty machinery or sparking equipment. Campaigners are concerned that UK hospitals are lagging behind other countries in recording surgical fires and introducing protocols to reduce both their frequency and severity. Theatre scrub nurse Kathy Nabbie has spent the past five years trying to make colleagues more aware of the threat of surgical fires. In 2017 - after hearing how a woman in Oregon, USA, had suffered severe burns when her face was set alight in surgery - she made a simple safety checklist. Her Fire Risk Assessment tool allowed colleagues to check for the presence of elements that together might cause a fire to break out. But senior staff failed to implement the initiative and - when a surgical fire actually took place three months later - Kathy learned that her laminated checklist had simply been put in a drawer. “I couldn’t believe it,” she said. “After that they did start using it, but why on earth should it have taken an actual fire to persuade them?” Read full story Source: The Sun, 7 April 2022 Further reading What can we do to improve safety in the theatre? Reflections from theatre nurse Kathy Nabbie How I raised awareness of fires in the operating theatre - Kathy Nabbie
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News Article
Lincolnshire Trust fined after patient suffered serious avoidable harm
Patient Safety Learning posted a news article in News
United Lincolnshire Hospitals NHS Trust has been ordered to pay a total of £111,204 in fines and legal costs after pleading guilty to failing to provide safe care and treatment to an elderly patient, causing them avoidable harm, following a sentencing hearing on Friday, 25 March at Boston Magistrates’ Court. The case was taken by the Care Quality Commission (CQC) under regulations 12 and 22 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The case against United Lincolnshire Hospitals NHS Trust involved the care of an elderly patient, Iris Longmate, who was admitted to the Greetwell Ward at Lincoln County Hospital on 20 February 2019. On March 3, 2019 Iris fainted and fell unsupervised from a commode, and was found face down on the floor in her room. Iris sustained spinal injuries and a cut to the head as a result of the fall, but then also suffered significant burns to her thigh and left arm as a result of being pressed against a radiator whilst being assessed by staff following the fall. Iris was subsequently transferred to Queens Medical Centre for assessment and treatment. She sadly contracted pneumonia in hospital and died on March 14, 2019. United Lincolnshire Hospitals NHS Trust pleaded guilty to a single offence of failure to provide safe care and treatment causing avoidable harm to Iris, for which the trust was fined £100,000. The court also ordered the trust to pay £170 victim surcharge and £11,034 costs to the CQC. The trust was found to not have taken all reasonable steps to ensure that safe care and treatment was provided, resulting in avoidable harm to Iris. In pleading guilty to the offence of causing avoidable harm to Iris, the trust also acknowledged that other patients on the Greetwell Ward had also been exposed to a significant risk of avoidable harm. Fiona Allinson, CQC’s deputy chief inspector of hospitals, said: "This death is a tragedy. My thoughts are with the family and others grieving for their loss." "People have the right to safe care and treatment, so it’s unacceptable that patient safety was not well managed by United Lincolnshire Hospitals NHS Trust," she said. "Had the trust addressed the issues with the exposed heating pipes before Iris fell, she wouldn’t have suffered such awful burns injuries." Read full story Source: Medscape, 2 April 2022 -
News Article
Patient care and safety put at risk in A&E at brand new £350m hospital
Patient Safety Learning posted a news article in News
Patients visiting Wales' newest emergency department were likely to have been put at risk of harm due to the lack of processes and systems in place, inspectors found. Healthcare Inspectorate Wales (HIW) carried out an unannounced inspection of The Grange University Hospital in Cwmbran between 1 and 3 November last year and published its findings on 29 March. On the day of their arrival inspectors said The Grange was at full capacity with no empty beds in A&E or in the hospital in general. Despite the best efforts of staff who were "working hard under pressure" the report stated the emergency department had several issues which could have compromised the privacy and dignity of patients. This included problems with the physical environment of the waiting room, which was described as a "major cause of anxiety" for visitors, as well as with the flow of patients through the hospital in general. It found that patients were not triaged and medically managed in A&E in a timely fashion with many being placed on uncomfortable chairs or in corridors for hours on end. Between 1 April 2021 and 1 November 2021, the average waiting time in the department was six hours and seven minutes. The report said some issues required immediate action including the fact patients in the waiting area were often left to "deteriorate without being overseen". There were also infection control failures which could have led to the cross-contamination of Covid-19. "We were not assured that all the processes and systems in place were sufficient to ensure that patients consistently received an acceptable standard of safe and effective care," the report stated. Read full story Source: Wales Online, 1 April 2022 -
Content ArticlePeople in England’s most deprived neighbourhoods work longer hours than those in the rest of the country but live shorter lives with more years in ill health costing an estimated £29.8bn a year to the economy in lost productivity. People living in these communities were also 46% more likely to die from COVID-19 than those in the rest of England. The findings, revealed in a joint report released today by the All-Parliamentary Party Group for ‘left behind’ neighbourhoods and Northern Health Science Alliance, shows the devastating impact of poor health for those living in deprived areas and left behind neighbourhoods (LBNs) and makes a number of recommendations to overcome the health inequalities faced by people living in these places. Those living in local authorities that contain ‘left behind’ neighbourhoods have a further £2bn gap in lost productivity compared to those areas with a similar rate of deprivation but with more civic assets, connectedness and an active and engaged community. Across most measures people in these areas fair even worse than those in deprived neighbourhoods.
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Content Article
Responding to patient alarms in single patient rooms
katepym posted an article in Equipment and facilities
This survey for health and care staff looks at how quickly staff are aware of alarms emitted by bedside monitoring equipment in single patient rooms, and their ability to respond. Doors to single patient rooms are often kept shut for long periods of time for reasons of privacy, dignity and (at the moment especially) infection control. With the UK Government targeting a growth in the proportion of NHS hospital rooms which have a single bed, is this a risk to the health and wellbeing of patients? This is not a specific issue where data is collected, so an online survey has been created to gather feedback and opinions. -
Content Article
Staff safety and wellbeing
Becky T posted an article in Staff safety
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An original article that explores the significance of both staff physical safety in the workplace as well as their psychological safety and wellbeing. In particular, I highlight the impact the COVID-19 pandemic has had on both these areas, and discuss the importance of ensuring all aspects of staff safety. -
News Article
Overcrowded A&Es ‘much more dangerous now because of covid’
Patient Safety Learning posted a news article in News
Emergency departments across England are reporting ‘dangerous’ overcrowding similar to levels seen pre-covid, and struggling to maintain social distancing, A&E leaders have warned. The Royal College of Emergency Medicine said it was concerned about covid spreading among the most vulnerable patients, as overall transmission rates continue to rise sharply across the UK. It was always anticipated that A&E activity would return to pre-covid levels this winter, following a significant drop-off in A&E activity during the spring and early summer, and that service transformation would be needed to help maintain social distancing. But the emergence of widespread overcrowding so far ahead of winter is of serious concern to system leaders. A&E staff were already being forced to make difficult trade-offs over which patients to isolate, the college’s vice president told HSJ. He also urged NHS leaders not to place unrealistic expectations on the impact a new model involving walk-in patients booking slots by phone could make on addressing overcrowding in emergency departments. RCEM vice president Adrian Boyle said the NHS was “largely back to the pre-covid levels of crowding” but it was “much more dangerous now because of covid”. He said: “We are hearing that most emergency departments can’t maintain social distancing safely and staff are having to make fairly difficult trade-offs about which people need to be isolated. No one can be safely social distanced in a corridor.” Read full story (paywalled) Source: HSJ, 21 September 2020
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