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Content ArticleVisits from loved ones are vital to the health and wellbeing of people receiving care in care homes, hospitals and hospices. There have been concerns about visiting restrictions in health and care settings for several years, and the restrictions introduced in response to the COVID-19 pandemic exacerbated these concerns. While those restrictions were in place at the time to control the risk of transmission and keep people safe, it was detrimental for loved ones to have been kept apart or not to have had someone supporting them in hospital. Guidance is now clear that visiting should be encouraged and facilitated in all circumstances. This consultation seeks views on introducing secondary legislation to protect visiting as a fundamental standard across CQC-registered settings so that no one is denied reasonable access to visitors while they are resident in a care home, or a patient in hospital or a hospice. This includes accompanying people to hospital appointments (outpatients or diagnostic visits). Related reading on the hub: 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
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News Article“Stop killing us,” protesters across Poland chanted this evening, demanding the legalisation of abortion, after reports reached the media of a pregnant woman’s death in a hospital in May. On Monday, Poland’s patients’ rights ombudsman, Bartłomiej Chmielowiec, said that the John Paul II hospital should have told 33-year-old Dorota Lalik that her life could be saved through an abortion. The hospital violated her rights by withholding the information, the ombudsman ruled. The woman died in the hospital in Nowy Targ, in the south of the country, on 24 May, three days after her admission. “No one told us that we had practically no chance for a healthy baby … The entire time they were giving us false hope that everything will be OK … that [in the worst case] the child will be premature,” Lalik’s husband told Polish media. “No one gave us the choice or the chance to save Dorota, because no one told us her life was at risk.” Read full story Source: The Guardian, 14 June 2023
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Content ArticleRace and ethnicity have been associated with poor pregnancy outcomes in many countries. In the UK, the rates of baby death and stillbirth among Black and Asian mothers are double those for White women. Most studies examine trends for individual countries. This large database study explored how race and ethnicity is linked to pregnancy outcomes in wealthy countries. Key findings Black women consistently had worse outcomes than White women across the globe. Hispanic women were three times more likely to experience baby death compared with White women. South Asian women had an increased risk of early birth and having a baby with an unexpectedly low weight (small for the length of pregnancy) compared with White women. Racial disparities in some outcomes were found in all regions. The researchers call for a global, joined-up approach to tackling disparities. Breaking down barriers to care for ethnic minorities, particularly Black women, could help. More research is needed to understand why outcomes are for worse for ethnic minorities. The researchers recommend routine collection of data on race and ethnicity. The link below takes you to the Plain English summary of the research, you can also view the full research study.
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News ArticleWomen are waiting too long for abortions, according to a major review into a leading UK provider. The Care Quality Commission (CQC) review of the leadership at the abortion provider the British Pregnancy Advisory Service found there were “delays” in “investigating incidents”. The remains of some pregnancies were sometimes not stored properly and there were issues were record keeping, patient monitoring and safe care, the review found. The watchdog also noted “women did not always receive care in a timely way to meet their needs”. The health watchdog said: “In August 2021 we found significant concerns in we found that safe care was not being provided; ineffective safeguarding processes; incomplete risk assessments were not fully completed; observations were not monitored or recorded; records were not fully completed, clear or up to date.” Read full story Source: The Independent, 2 June 2023
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Content ArticleIn March 2019, NHS England published Saving Babies Lives version 2, which included information for providers and commissioners of maternity care on how to reduce perinatal mortality across England. One element of this recommends the appointment of a fetal monitoring lead with the responsibility of improving the standard of fetal monitoring. The aim of the fetal monitoring lead is to support staff working on the labour ward to provide high quality intrapartum risk assessments and accurate CTG interpretation and should contribute to building and sustaining a safety culture on the labour ward with all staff committed to continuous improvement. The importance of fetal monitoring was highlighted again in the Ockenden Report, published December 2020. The report recommended, as an essential action, that all maternity services must appoint a dedicated lead midwife and lead obstetrician, both with demonstrated expertise, to focus on and champion best practice in fetal monitoring. Monitoring May is a month long learning event based around fetal monitoring, human factors, maternity safety and shared learning. The East Midlands Academic Health Sciences Network has shared the recording of Monitoring May’s discussions and presentations.
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News Article
Primodos: Pregnancy test damages claims thrown out by judge
Patient Safety Learning posted a news article in News
Claims for damages by more than 170 people who say they were affected by hormone-based pregnancy test drugs have been thrown out by a High Court judge. The drugs, including Primodos, were given to women to test if they were pregnant from the 1950s to 1970s and alleged to have caused birth defects. But the judge ruled there was no new evidence linking the tests with foetal harm and "no real prospect of success". Campaigners say they are "profoundly disappointed" with the judgement. Legal action had been brought against three drug companies - Bayer Pharma, Schering Health Care, Aventis Pharma - as well as the government in a bid for compensation. However, they argued there was no evidence of a "causal association" between the hormone pregnancy tests and the harm suffered by the claimants. Marie Lyon, chair of the Association for Children Damaged by Hormone Pregnancy Tests, said she was "profoundly disappointed" with the judgement. "We do not accept the defendants' claim that our evidence did not provide sufficient scientific evidence and look forward to the additional scientific evidence, to support our original argument, which is due to be published shortly," she added. Read full story Source: BBC News, 28 May 2023 Further reading on the hub: Patient Safety Spotlight interview with Marie Lyon, chair of the Association for Children Damaged by Hormone Pregnancy Tests -
Content ArticleTo support patients to understand the risks of taking sodium valproate during pregnancy, NHS England has launched two new shared decision-making tools. This is part of an NHS-wide effort to reduce the use of valproate in people who can get pregnant, and to help those that do continue with valproate to prevent pregnancies.
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News Article
Male GPs in England less likely to refer patients for IVF, report finds
Patient Safety Learning posted a news article in News
Male GPs are less likely to refer eligible patients for IVF, research by a fertility charity suggests, raising concerns about access to NHS-funded treatment. The Progress Educational Trust’s (PET) report highlights “utter confusion” and a lack of knowledge among GPs about eligibility criteria for NHS-funded treatment, which it says is exacerbating the so-called IVF postcode lottery. GPs typically make the initial referral to fertility clinics, meaning that they play a crucial role in access. “For NHS treatment, GPs are the main initial gatekeeper. If you’re not getting pregnant, that’s who you go to for advice and support,” said Sarah Norcross, the director of PET. “It struck me that, when people have a known cause of infertility, male GPs still weren’t passing them on.” The report is based on a survey of 200 GPs and commissioners across England, carried out by an independent research company, which investigated knowledge of national fertility guidelines and criteria they use for referral decisions. Read full story Source: The Guardian, 19 May 2023 -
News Article
Call for national guidelines on discussing past trauma in maternity appointments
Patient Safety Learning posted a news article in News
National guidelines are needed to help maternity care professionals navigate discussions with pregnant women about past traumas, experts have said. Their study, published in the journal Plos One, also found that while talking about previously experienced traumas can be valuable, they can also trigger painful memories if not approached sensitively. The authors also raised concerns about the support available for professionals who may not feel equipped to explore challenging topics such as domestic or sexual abuse, childhood trauma and birth trauma without adequate guidelines or referral pathways. Joanne Cull, a midwife and PhD student at the University of Central Lancashire’s School of Community Health and Midwifery, who is corresponding author on the study, said: “As awareness of the long-term effects of trauma on health and wellbeing has grown, there has been a move toward asking pregnant women about previous trauma, usually at the first appointment. “No national guidance on this has been published in the UK so NHS Trusts have implemented this on a piecemeal approach.” Read full story Source: The Independent, 17 May 2023 -
News ArticleHealthcare providers caring for pregnant patients in the months after the US Supreme Court’s decision to strike down Roe v Wade have been unable to provide standard medical care in states where abortion is effectively outlawed, leading to delays and worsening and dangerous health outcomes for patients, according to an expansive new report. In the wake of the Supreme Court’s ruling last year, individual reports from patients and providers have shed some light on the wide range of harm facing pregnant women in states where access to abortion care is restricted or outright banned. But a first-of-its-kind report from the University of California San Francisco captures examples from across the country, documenting 50 cases in more than a dozen states that enacted abortion bans within the last 10 months, painting a “stark picture of how the fall of Roe is impacting healthcare in states that restrict abortion,” according to the report’s author Dr Daniel Grossman. “Banning abortion and tying providers’ hands impacts every aspect of care and will do so for years to come,” he said in a statement accompanying the report. “Pregnant people deserve better than regressive policies that put their health and lives at risk.” Read full story Source: The Independent, 16 May 2023
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Content ArticleA new report presents the preliminary findings of the Care Post-Roe Study, and shows how US healthcare providers have been unable to provide the standard of care in states with abortion bans since the Supreme Court struck down Roe v. Wade ten months ago, leading to harm and negative health outcomes for patients. The report shows that healthcare providers have seen increased morbidity, exacerbated pregnancy complications, an inability to provide time-sensitive care, and increased delays in obtaining care for patients in states with abortion bans. This has impacted both patients and providers and has deepened the existing inequities in the health care system for people of colour.
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Content ArticleHealthcare systems rely on self-advocacy from service users to maintain the safety and quality of care. Systemic bias, service pressures and workforce issues often deny agency to patients at times when they need to have most control over representation of their story. This drives diagnostic error, treatment delay or failure to treat important conditions. In maternal care, perinatal mental health and thrombosis are significant challenges. With funding from SBRI Health care, Ulster University and Southern Health and Social Care Trust are developing an NLP powered platform that will empower mothers to be more active agents in their perinatal care. Download the poster below.
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Content Article
Planning pregnancy with aortic disease (leaflet)
Patient_Safety_Learning posted an article in Maternity
Pregnancy in women with aortic disease can be high risk. However, the risk can be reduced with the right care and planning. This leaflet developed by Aortic Dissection Awareness UK & Ireland, provides advice and guidance for women with aortic disease who are planning on having a baby. -
News Article
Babies are dying because of NHS failings, poverty and inequality, charities warn
Patient Safety Learning posted a news article in News
Hundreds of babies are dying unnecessarily because overstretched maternity services are delivering substandard care and struggling to overcome entrenched poverty and racial inequalities, a report has warned. The report by baby loss charities Sands and Tommy’s says the government’s aim to halve the number of stillbirths and neonatal deaths in England by 2025 is stalling, while there is no target in Scotland, Wales or Northern Ireland. Stillbirths are creeping up in England after falling in the past decade. Babies dying before and during delivery rose to just over four in every 1,000 births in 2021. Similarly, long-falling rates of neonatal deaths, where newborns die within the first four weeks of birth, are also rising. There were 1.4 deaths of newborn babies for every 1,000 births in 2021, compared with 1.3 in 2020. Robert Wilson, head of the charities’ joint policy unit, said the government and NHS need to make fundamental changes. “The UK is not making enough progress to reduce rates of pregnancy loss and baby death, and there are worrying signs that these rates are now heading in the wrong direction,” he said. Read full story Source: The Guardian, 14 May 2023 -
Content ArticleIn 2022 the charities Sands and Tommy’s came together to form a Joint Policy Unit. Together they are focussed on achieving policy change that will save more babies’ lives during pregnancy and the neonatal period and on tackling inequalities in loss, so that everyone can benefit from the best possible outcomes. This first report from the Unit brings together a range of evidence to identify the key changes needed to save more babies’ lives and reduce inequalities in pregnancy and baby loss. None of the individual data it contains is new, but it gives decision makers a clear view of where we are now, and where action is required to make progress.
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Event
Everywoman festival
Patient Safety Learning posted an event in Community Calendar
untilThe Everywoman festival is a one day event aimed at all women over the age of 16 and aims to empower women to understand what is normal and when to seek help for issues that can affect 90% of women at some point in their life. The festival combines more than 40 workshops and 6 themed seminar sessions with a fun, relaxed environment with art workshops, food and drink, music and charity stands. Themes are wide ranging and include periods and endometriosis, pelvis pain and bladder, childbirth injury, menopause and sexual wellbeing. Additional drop in sessions to meet the consultant experts as well as book readings and signings will be available on the day. The Everywoman Festival will be held in the heart of Cardiff in the beautiful venue of Insole Court. It will feature a range of interactive workshops and talks from leading health experts. Attendees will have the opportunity to learn about everything from nutrition and fitness to mindfulness through art. For those who are looking for something a little more active, there will be a variety of fitness classes and workshops taking place throughout the day. From seated yoga, Pilates to Belly dancing and dancing lessons from Heels empowerment, there's something for everyone, regardless of their fitness level. Charities attending with stalls and information include Coppa feel, Endometriosis UK, Womens Aid, the Menstrual project and Fair Treatment for Women of Wales. Health stalls from Muslim Doctors Cymru, Medtronic, Mcgregor, THD will be on hand to provide information and signpost for everything from your bladder and bowels, childbirth to high blood pressure. Some of the highlights of the festival are the wellness market, where attendees can shop for a wide variety of health and wellness products and in the creative market products from artists such as Black and Beech, Melin Trygwynt and Eliza Eliza. Further tickets and information Follow on instagram @Theeverywomanfestival A5leaflet Everywoman (2).pdf -
News Article
FDA panel backs first over-the-counter birth control pill in US
Patient Safety Learning posted a news article in News
The first non-prescription birth control pill in the US is on the way to approval, after a thumbs-up from an advisory committee of drug regulators. The Food and Drug Administration (FDA) panel's unanimous vote is not binding, but means the agency is likely to formally approve the drug this summer. Opill has been available, but only by prescription, for the past 50 years. The push for over-the-counter access in the US comes amid Republican-led efforts to restrict access to abortion and contraception at the national and state level. Advisors on the panel said they were mostly confident women of all ages would use the drug as appropriate without first consulting a healthcare provider. "In the balance between benefit and risk, we'd have a hard time justifying not taking this action," said chairwoman Maria Coyle, an Ohio State University pharmacist. "The drug is incredibly effective, and I think it will be effective in the over-the-counter realm just as it is in the prescription realm." Read full story Source: BBC News, 10 May 2023 -
News ArticleThe NHS must start sharing figures on mental health checks for pregnant women and new mothers amid gaps in hospital data, top doctors warn. One in six NHS trusts is not able to say whether they screen pregnant women for mental health issues at all, despite national guidelines recommending these checks be done at 10 weeks. Suicide has been recorded has one of the leading drivers in post-natal deaths. The findings come as the latest NHS figures show 51,000 women accessed specialist perinatal mental health services in the 12 months prior this fell short of a target for the NHS to see 66,000 mothers in 2022-23. Access levels have. however, improved from 31,000 a year in March 2022. The Royal College of Psychiatrists has called for NHS England to “urgently” publish data on every hospital in the country showing whether they are carrying out this vital screening. Last November the latest national report into maternal deaths, from researchers led by Oxford University, found suicide was again the leading cause of direct deaths in women a year after the end of their pregnancy. Read full story Source: The Independent, 4 May 2023
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News Article
Poor mental health support during pregnancy risks UK women’s lives
Patient Safety Learning posted a news article in News
Women’s lives are being put at risk by substandard mental health care during their pregnancy and in the first year after childbirth in most parts of the UK, a report has found. About one in every five women develops a mental illness at some point during the perinatal period, the stage from pregnancy up to a year after giving birth. However, none of the health and social care boards in Northern Ireland or Wales met the national quality standards created by the Royal College of Psychiatrists’ Perinatal Quality Network (PQN). Maternal deaths due to mental health problems are also increasing, with maternal suicide being the lead cause of deaths in the first year after childbirth. Despite this, the report by the Maternal Mental Health Alliance (MMHA) found that many specialist perinatal mental health services do not receive adequate attention or investment, or meet the quality standard of care. The minimum standard of care that women, babies and families should receive is defined as PQN standards type 1. In England, only 16% of the specialist perinatal mental health community teams met these standards. Read full story Source: The Guardian, 2 May 2023 -
News Article
USA: Two hospitals broke law by denying abortion
Patient Safety Learning posted a news article in News
US federal health officials say two hospitals broke the law by denying an abortion to a woman experiencing a life-threatening emergency. The hospitals, in Kansas and Missouri, are now being probed by the Department of Health and Human Services (HHS). The investigation is the first of its kind to be launched since the Supreme Court invalidated the national right to an abortion last year. After the Supreme Court ruling, the White House warned hospitals that doctors must provide abortions if the health of the patient is at risk - even in states that have banned abortion. "Fortunately, this patient survived. But she never should have gone through the terrifying ordeal she experienced in the first place," HHS Secretary Xavier Becerra said in a statement seen by BBC News. "We want her, and every patient out there like her, to know that we will do everything we can to protect their lives and health, and to investigate and enforce the law to the fullest extent of our legal authority, in accordance with orders from the courts." Read full story Source: BBC News, 1 May 2023 -
News Article
Failure to recognise ectopic pregnancy causing women’s deaths, says expert
Patient Safety Learning posted a news article in News
Women are dying or suffering avoidable harm because of a failure to recognise ectopic pregnancy, one of the country’s leading experts on maternal health has said. Speaking to the Guardian, Prof Marian Knight of the University of Oxford, who leads a national research programme on maternal deaths, called for action to improve diagnosis of the acute, life-threatening condition, in which a fertilised egg implants itself outside the womb, normally in the fallopian tube. Ectopic pregnancies are never viable and if left untreated can result in the tube rupturing, causing potentially fatal internal bleeding. “We could prevent more women from dying from ectopic pregnancy because of lacking of basic recognition and management of the condition,” said Knight. The warning comes as new data obtained by freedom of information request suggests that dozens of women have experienced “severe harm” after being admitted to hospital with ectopic pregnancies in the past five years. The Mbrrace report, published last year, said eight women died from ectopic pregnancies between 2018 and 2020, all but one of whom had received suboptimal treatment. In three instances, better care might have saved their lives, the report concluded. “There’s no doubt that in the [maternal deaths] inquiry we are still seeing the same messages of ectopic pregnancy not being recognised,” said Knight. “That people either don’t pick up on the fact that they’re pregnant or get single-minded about one diagnosis.” Read full story Source: The Guardian, 1 May 2023 -
News Article
Alternative to epidural recommended for women in labour
Patient Safety Learning posted a news article in News
Women in labour should be offered an alternative to an epidural spinal block injection, say new draft guidelines for the NHS. The National Institute for Health and Care Excellence (NICE) is recommending remifentanil, which is a fast-acting morphine-like drug given into a vein. Women control the medication themselves, by pressing a button to get more of the drug for pain relief. A timer ensures the user cannot administer too much of it. Women who decide to try remifentanil and do not like it could still decide to have an epidural instead if there is no medical reason why they should not. They can use gas and air, also called Entonox, which is a mix of oxygen and nitrous oxide, at the same time. NICE says having remifentanil as a treatment option has advantages - it might enable women to be more mobile than with an epidural, which makes the legs numb and weak, for example. Evidence suggests fewer epidurals might mean fewer births using instruments like forceps and ventouse vacuum suction, says NICE. Read full story Source: BBC News, 25 April 2023 -
Content ArticleOn the 20 January 2023 the Health and Social Care Select Committee published a reported with reviewed the progress that the UK Government has made in implementing the recommendations of the Independent Medicines and Medical Devices Safety Review, sometimes referred to as the Cumberlege Review. This paper sets out the UK Government’s response to the recommendations set out in this report. Related reading: Health and Social Care Select Committee: Follow-up on the IMMDS report and the Government’s response (20 January 2023) Patient Safety Learning: Response to the Select Committee report on the Independent Medicines and Medical Devices Safety Review (20 January 2023)
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News Article
Herpes deaths: NHS trust lied about virus links, inquest hears
Patient Safety Learning posted a news article in News
The mother of a young woman who died with herpes said she was "disgusted" with an NHS trust which "lied" about the potential cause of the virus. Kim Sampson and Samantha Mulcahy died with herpes after the same obstetrician at the East Kent Hospitals University NHS Trust carried out their caesareans. Yvette Sampson's daughter had been "fit and healthy" until she gave birth on 3 May 2018, an inquest has heard. She said the trust had lied about links between the two mothers' deaths. They were treated by the same surgeon and midwife six weeks apart, neither of whom were tested for herpes, the inquest in Maidstone was told. Ms Sampson said her daughter had been "in agony" from 3 May when she gave birth to her second child, until she died on 22 May. She told the inquest she had received "poor treatment" by midwives at the Queen Elizabeth the Queen Mother Hospital (QEQM) in Margate, which she felt also "contributed" to her daughter's death. Ms Sampson was initially denied a Caesarean and instead told to push for almost three hours, despite repeatedly telling midwives that "something wasn't right" and "clinging to the bed in agony", her mother said. Read full story Source: BBC News, 20 April 2023 -
News Article
Mifepristone: US Supreme Court delays abortion pill access decision
Patient Safety Learning posted a news article in News
The US Supreme Court has extended until Friday a temporary block on limits to access of a popular abortion pill. A Texas judge suspended approval of abortion drug mifepristone on 7 April, questioning its safety. Parts of that decision were upheld on appeal, prompting the Biden administration to make an emergency request to the Supreme Court. It's the most significant such case since the Supreme Court last year ended the nationwide right to abortion. The pill - used in more than half of abortions in the US - was first approved by the Food and Drug Administration (FDA) more than two decades ago. Critics say that by overriding the FDA's approval, the court in Texas has usurped the federal health agency's remit to regulate food, medicine, and medical devices. Legal experts warn the ruling opens the door for challenges to other approved medicines in the US and could also stifle development of future drugs. Read full story Source: BBC News, 20 April 2023
