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Content ArticleThe All Party Parliamentary Group on Menopause (the APPG), chaired by leading parliamentary campaigner Carolyn Harris MP, has published its final report following a year-long inquiry into the subject. The MPs findings demonstrate that widespread action is needed across all spheres to improve the situation for those going through the menopause, and the families, friends and colleagues affected by it. Menopause symptoms can have a debilitating impact on the day-to-day lives of women. Whether from the inability to get the right diagnosis at the right time, difficulties in accessing HRT, a lack of support from their employer while struggling at work, or simply not being able to recognise what is happening to them and their bodies and seek help. Despite the fact that 51% of the population will experience the menopause, the entrenched taboo around women’s health issues has meant that the support for the 13 million women currently going through peri-menopause or menopause is completely inadequate. The APPG is particularly concerned about the socio-economic divide emerging between women who are able to access the right treatment, and those who lose out in the postcode lottery and do not have the financial means to seek treatment elsewhere.
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Content ArticleThis report from Skills for Care provides a comprehensive analysis of the adult social care workforce in England and the characteristics of the 1.50 million people working in it. Topics covered include recent trends in workforce supply and demand, employment information, recruitment and retention, demographics, pay, qualification rates and future workforce forecasts.
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News Article
More than 400 pregnant women prescribed topiramate in the past year
Patient Safety Learning posted a news article in News
Between April 2021 and March 2022, more than 400 pregnant women were prescribed the anti-epileptic medicine topiramate, which has been found to cause congenital malformations, figures published by NHS Digital have revealed. The data, published on 29 September 2022, covers prescribing of anti-epileptic drugs in females aged 0–54 years in England from 1 April 2018 through to 31 March 2022. Overall, it shows a reduction in the number of females prescribed sodium valproate; from 27,441 in April 2018 to 19,766 in March 2022. However, the numbers also show that sodium valproate, which can cause birth defects, is still being prescribed during pregnancy, with 42 women being prescribed the drug at some point during their pregnancy between April 2021 and March 2022, compared with 43 in the previous year. In addition, the data show that, during that same time period, 430 females were prescribed topiramate, which is used for treatment of migraines as well as epilepsy, during their pregnancy. In 2021, a safety review, carried out by the Medicines and Healthcare products Regulatory Agency (MHRA) found that carbamazepine, phenobarbital, phenytoin and topiramate were associated with an increased risk of major congenital malformations. In July 2022, the MHRA launched a further review looking specifically at the safety of topiramate, after study results showed an increased risk of autism, developmental disorders and learning difficulties among babies exposed to the medicine during their mother’s pregnancy. Daniel Jennings, senior policy and campaigns officer at Epilepsy Action, said it was “concerning” to see that prescribing figures for valproate had not decreased, compared with the previous year, and that despite the MHRA identifying other epilepsy medicines that could pose a risk if taken in pregnancy, there had been “little or no communication” about these risks. “There is also still a large group of epilepsy medicines where we don’t have an adequate bank of evidence about their safe use during pregnancy,” he added. “The MHRA and NHS England need to work together to communicate the risks and carry out research to protect women with epilepsy.” Read full story Source: The Pharmaceutical Journal. 7 October 2022 -
Content ArticleOn 23 April 2020 Jaqueline Lake commenced an investigation into the death of Eliot Harris aged 48. Eliot had schizophrenia and diabetes. Eliot had not been taking medication for several days and his condition deteriorated. He was admitted to Northgate under the Mental Health Act after assessment on 5 April. He was initially in seclusion then on the ward from 6 April, he spent a lot of time in his room and only ate cheese sandwiches. He only accepted medication in intramuscular form and on 9 April by depot injection. His physical observations were recorded as being normal, and a blood test on 7 April showed he did not have diabetes. His intake of food and fluid remained minimal but he was not put on a chart to monitor this. Staff last entered his room at 17:46 on 9 April. He was last seen conscious at 18:10 on 9 April. He was found unresponsive at 01:33 and declared dead at 02:00. The investigation concluded at the end of the inquest on 8 August 2022. Medical cause of death: 1a) Unascertained Conclusion: Open – the evidence does not reveal the means by which Eliot Harris came by his death.
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Content ArticleHealthcare Inspectorate Wales (HIW) is the independent inspectorate of the NHS and regulator of independent healthcare in Wales. This annual report highlights key findings from HIW's regulation, inspection and review of healthcare services in Wales. It demonstrates how HIW carried out its functions and outlines the number of inspections and quality checks it undertook during 2021-22.
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Content ArticleThe rapid uptake of digital healthcare channels offers huge benefits, but evidence also suggests a close correlation between digital exclusion and social disadvantage. People with protected characteristics under the Equality Act are among those least likely to have access to the internet and the skills needed to use it. Experts from across health and care came together to contribute to "Access Denied", a new whitepaper on digital health inequalities. This whitepaper sets out recommendations to ensure that those innovating in digital healthcare can do so in a way which addresses healthcare inequalities.
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Content ArticleSpecialised services typically care for small numbers of patients with rare or complex conditions. They are commonly overlooked in debates around the future of the NHS. This is despite costs growing by over 50% in eight years, and now exceeding £20bn per year. The spotlight is returning, with proposals from NHS England to change how these services are planned, with power and responsibility being devolved down to new Integrated Care Boards – sub-regional structures across England. This report sets out a series of recommendations which Policy Exchange believe should underpin these reforms, including refinement of the services into more logical groupings, an expanded role for patient and carer input into service design, and stronger ministerial and financial oversight to ensure the sustainability of service delivery for the longer term.
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Content ArticleThis instalment of Royal College of Emergency Medicine (RCEM)’s Acute Insight Series summarises key issues in mental health emergency care and provides recommendations for policymakers, NHS England, Integrated Care Systems, and Trusts to enable patients to access emergency mental healthcare in a safe, efficient, and timely manner.
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News Article
‘Gross’ care delays could become ‘new normal’, says CQC report
Patient Safety Learning posted a news article in News
The Care Quality Commission (CQC) has urged system leaders to move away from “quick fixes” to the “enormous gap in resources and capacity” in urgent and emergency care. A report by the CQC and a large group of emergency clinicians and other health and care leaders calls for a ”move away from reactive ‘quick fixes’ such as tents in the car park or corridor care to proactive long-term solutions and to address the enormous gap in resources and capacity”. The use of tents and treating more patients in corridors have been increasingly adopted by hospitals in recent months, sometimes encouraged by NHS England, particularly when they are under pressure to reduce handover delays from ambulances. The report, 'People First: a response from health and care leaders to the urgent and emergency care system crisis', suggests: expanding use of urgent community response teams to attend minor injuries 999/111 calls, giving acute and social care providers direct access to GP and community service booking systems, and providing “rapid access” to support packages to help people avoid hospital admission. Read full story (paywalled) Source: HSJ, 22 September 2022 -
Content ArticleIn this blog, Ian Lavery, Senior Investigation Science Educator at the Healthcare Safety Investigation Branch (HSIB) summarises a presentation given to HSIB staff by healthcare improvement expert Professor Mary Dixon-Woods. The presentation highlighted that a recommendation alone could fall short of the intended impact on the healthcare system. It looked at creating recommendations to respond to real world working, the importance of involving people most affected by patient safety incidents and why it's vital to look at when things go right.
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News Article
Patient safety: Each UK nation needs overarching lead, report urges
Patient Safety Learning posted a news article in News
A new patient safety chief should be appointed in each of the four UK nations to oversee health and social care and tackle the currently “fragmented and complex” system, experts have urged. The Professional Standards Authority for Health and Social Care (the body that oversees the 10 statutory bodies that regulate health and social care professionals in the UK, including the General Medical Council) has called for what it described as a radical rethink to improve safety in care. In a report published last week, it recommended the appointment of an independent health and social care safety commissioner (or equivalent) for each UK country. These commissioners would identify current and potential risks across the whole health and social care system, it said, and instigate necessary action across organisations. Read full story (paywalled) Source: BMJ, 6 September 2022 Related reading Working together to achieve safer care for all: a blog by Alan Clamp (chief executive of the Professional Standards Authority) Joining up a fragmented landscape: Reflections on the PSA report ‘Safer care for all’ (a blog from Patient Safety Learning -
Content Article
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Last week the Professional Standards Authority for Health and Social Care (PSA) published a new report, Safer care for all – solutions from professional regulation and beyond, which examines the current state of professional health and care regulation in the UK. In this blog, Patient Safety Learning considers this report from a patient safety perspective. PSA's chief executive, Alan Clamp, has also written a blog for the hub on the report, which can be read here. -
Content Article
In a recent report, the Professional Standards Authority (PSA) for Health and Social Care sets out its view on the biggest challenges affecting the quality and safety of health and social care. In this blog, Alan Clamp, PSA's chief executive, summarises these challenges and the possible solutions. You can also read Patient Safety Learning's reflections on the PSA report here.- Posted
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News Article
Doctors warn Truss over NHS ‘fantasy’
Patient Safety Learning posted a news article in News
Liz Truss has been warned against “fantasy predictions” that the NHS can return to normal without radical change and was told that “unacceptable standards” are being normalised. In a rare political intervention, the professional standards body for the UK’s 220,000 doctors agreed that the NHS was routinely letting down patients. The Academy of Medical Royal Colleges said politicians must be prepared for radical changes to save the health service. Closing smaller hospitals, accepting that routine dentistry cannot be free for everyone and a return of Covid volunteers to allow doctors to treat more patients were all suggested by the head of the academy. The academy released a report that declared the NHS was in crisis, writing: “The system is providing increasing proportions of care or services which are sub-standard, threaten patient safety, and should not be acceptable in a country with the resources that we have in the United Kingdom. If we do not act with urgency, we risk permanently normalising the unacceptable standards we now witness daily.” The report sets out a series of recommendations for reform, including boosting staff numbers, reforming social care and spending more on technology. Helen Stokes-Lampard, the academy’s chairwoman, said patients were facing a “dismal winter” and that politicians must take difficult decisions. “If we don’t make changes it will inevitably deteriorate further,” she said. “The demand isn’t going away, the pressure isn’t going away, which is why the challenge for our government and for our whole society is to confront these issues and have a difficult conversation.” Read full story (paywalled) Source: The Times, 9 September 2022 -
Content ArticleThis is an Early Day Motion tabled in the House of Commons on 5 September 2022, which calls on the Government to implement the recommendations of the Independent Medicines and Medical Devices Safety Review in full, in particular recommendation 4 of the report calling for the establishment of separate schemes to meet the costs of additional care and support to those who have suffered avoidable harm.
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Content ArticleThis guideline from the National Institute for Health and Care Excellence (NICE) covers assessment, management and preventing recurrence for children, young people and adults who have self-harmed. It includes those with a mental health problem, neurodevelopmental disorder or learning disability and applies to all sectors that work with people who have self-harmed.
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Content ArticleFormal evaluations of programmes are an important source of learning about the challenges faced in improving quality in healthcare and how they can be addressed. The authors of this narrative review in BMJ Quality & Safety aimed to integrate lessons from evaluations of the Health Foundation's improvement programmes with relevant literature. They argue that securing improvement may be hard and slow and faces many challenges, but formal evaluations assist in recognising the nature of these challenges and help in addressing them.
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Content ArticleThe European Network for Safer Healthcare (ENSH) joined forces with the European Association of Urology Nurses (EAUN) to work on a policy campaign to prevent catheter-associated urinary tract infections (CAUTI) in Europe as a path to improving patient safety and preventing anti-microbial resistance (AMR) through: Improvement of adherence to existing European guidelines to prevent CAUTI. Development of European indicators to support the European Centre for Disease Prevention and Control (ECDC) and/or national surveillance systems.
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Content ArticleThis Healthcare Safety Investigation Branch (HSIB) investigation aims to help improve patient safety in relation to the use of a flush fluid and blood sampling from an arterial line in people who are critically ill in hospital. As its ‘reference case’, the investigation uses the experience of Keith, a 66 year old man who during a stay in a clinical care unit had blood samples taken from an arterial line which were contaminated with the flush fluid containing glucose. As a result he received incorrect treatment which led to his blood glucose levels being reduced to below the recommended limit.
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Content ArticleHealth inequalities are not inevitable and are unfair. Many people from different backgrounds across our society suffer health inequalities which can negatively impact the whole community, not just those directly affected. Birmingham and Lewisham African Caribbean Health Inequalities Review (BLACHIR) set out to urgently reveal and explore the background to health inequalities experienced by the Black African and Black Caribbean communities. Birmingham is home to 8% of the Black African and Black Caribbean populations in England and 23% of Lewisham’s population is Black African or Black Caribbean (ONS 2011). The main aim of the Review is to improve the health of Black African and Black Caribbean people in the communities by listening to them, recognising their priorities, discussing, and reflecting on the findings and coproducing recommended solutions for the Health and Wellbeing Board and NHS Integrated Care Systems to consider and respond to.
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Content ArticleThis report provides a review of the Healthcare Safety Investigation Branch (HSIB) maternity investigation programme during 2021/22, including an overview of activity during this period, themes arising from investigations and plans for the future. It is intended for healthcare organisations, policymakers and the public to understand the work HSIB have undertaken.
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Content ArticleThis is the first in a new series of ‘In Conversation with’ podcasts from the All Party Parliamentary Group (APPG) on First Do No Harm. In this episode Lord Philip Hunt discusses the key achievements of the Health and Care Act 2022 of relevance to the APPG’s work, and the areas still left to address. The APPG on First Do No Harm is a group of parliamentarians who are committed to raising awareness of and building support for the recommendations in First Do No Harm, the report of the Independent Medicines and Medical Devices Safety Review, and to ensure the implementation of the recommendations by the UK Government and others.
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Content ArticleThis landmark report from the Leapfrog Group, an independent national healthcare safety watchdog in the US, is the result of an intensive year-long effort bringing together the nation’s leading experts on diagnostic excellence, including physicians, nurses, patients, health plans, and employers. Together, the multi-stakeholder group reviewed the evidence and identified 29 evidence-based actions hospitals can implement now to protect patients from harm or death due to diagnostic errors. Diagnostic errors contribute to 40,000-80,000 deaths a year, with over 250,000 Americans experiencing a diagnostic error in hospitals. This includes delayed, wrong, and missed diagnoses, and those that are not effectively communicated to the patient.
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Content ArticleThe Ockenden review into the failings in maternity care at Shrewsbury and Telford Hospital NHS Trust in the UK makes for sobering reading. The review focuses predominantly on the period from 2000 to 2019 and estimates that there were significant or major concerns in the care of nine women and more than 200 babies who died while receiving care at the Trust. Many more women and babies suffered serious injuries. It was clear that the Shrewsbury and Telford Hospital NHS Trust did not investigate, learn, change, or listen to families when adverse events occurred. The conclusions of the Ockenden review make it clear that safe staffing levels, a well trained workforce, an ability to learn from incidents, and a willingness and ability to listen to families are all crucial for safe maternity care.
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Content ArticleThe Regulation and Quality Improvement Authority (RQIA) is the independent body responsible for regulating and inspecting the quality and availability of Health and Social Care services in Northern Ireland. The (RQIA) was commissioned to examine the application and effectiveness of the Procedure for the Reporting and Follow-up of Serious Adverse Incidents in Northern Ireland. The review was conducted by an Expert Review Team established by the RQIA and made five recommendations for implementation.
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