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Content ArticleSurgeons' News is a magazine for surgical, dental and allied healthcare professionals. Published quarterly by the Royal College of Surgeons of Edinburgh, it features comment and opinion from leading professionals, plus reviews and reports on subjects relevant to all career levels. In an article in the June issue (page 16), Patient Safety Learning's Helen Hughes describes the steps being taken to address the widescale issue of avoidable harm.
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Content Article
Draft Code of governance for NHS provider trusts (May 2022)
Patient Safety Learning posted an article in Boards
This code sets out a common overarching framework for the corporate governance of trusts, reflecting developments in UK corporate governance and the development of integrated care systems. -
Content ArticleiSupport are an international group of health professionals, academics, young people, parents, child rights specialists, psychologists and youth workers who are all passionate about the health and wellbeing of children, especially when they interact with healthcare services. The group is made up of over 50 members from around the world. iSupport have been working together throughout 2021 to develop standards for children and young people (aged 0-18 years) undergoing clinical procedures, based on internationally agreed children’s rights set out by the UNCRC (1989). The standards aim to ensure that the short and long-term physical, emotional and psychological well-being of children and young people are of central importance in any decision-making for procedures or procedural practice. The standards have been developed through ongoing and extensive consultation within the collaborative group and with established youth and parent forums. iSupport have also sought wider feedback, input and consensus through an international online survey.
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Content ArticleHow can healthcare organisations work towards becoming true learning organisations in a reliable safety system? At the Health Plus Care conference on the 18 May 2022, Patient Safety Learning's Chief Executive Helen Hughes and Dr Sanjiv Sharma, Medical Director at Great Ormond Street Hospital for Children (GOSH), discussed the activity being undertaken at Great Ormond Street, one the world’s leading children’s hospitals, to transform their approach to patient safety, in collaboration with Patient Safety Learning. See attached their presentation slides.
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Content ArticleThis opinion piece in The BMJ looks at the importance of doctors being honest in all settings. Daniel Sokol, medical ethicist and barrister, uses the behaviour of the character Adam in the BBC series 'This is Going to Hurt' to look at why it is so important that doctors are honest. In one episode, Adam pretends not to be a doctor in order to avoid intervening when someone needs medical attention in the community. Daniel discusses the ethical and legal issues associated with this kind of behaviour, highlighting that it could lead to suspension or removal from the GMC register. He discusses how dishonesty undermines public trust, and the fact that dishonesty in any area of life can have professional consequences for doctors.
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News Article
Intensive care units for children not meeting standards, says NHSE report
Patient Safety Learning posted a news article in News
Three intensive care units for children are not meeting standards for co-located services, a national report has found. Royal Stoke University Hospital, Royal Brompton Hospital in London and Freeman Hospital in Newcastle, which all have “level three” paediatric intensive care beds for the most seriously ill patients, do not offer specialised paediatric surgery, according to a report from NHS England’s Getting it Right First Time (GIRFT) programme. The report, released in April, said specialised paediatric surgery “should be co-located on the same site” as a paediatric intensive care unit with level three beds and be “immediately available” to meet quality standards set by the Paediatric Intensive Care Society. The report also found the units do not offer services such as trauma, neurosurgery and bone marrow transplantation, which it says is a reflection of the variability and “the poor alignment” of specialised paediatric services at PICUs. Read full story (paywalled) Source: HSJ, 23 May 2022 -
Content ArticleIn this guest blog for the Professional Records Standards Body (PRSB), Taffy Gatawa, Chief Information and Compliance Officer at everyLIFE Technologies, talks about the importance of ensuring that healthcare technologies comply with recognised standards. She discusses everyLIFE's experience on PRSB’s Standards Partnership Scheme, and their journey to implementing standards in their digital products. Taffy describes a process of learning and feedback, achieved through desktop research, clinical reviews and critical engagement with PRSB and customers.
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EventWebinar to report on progress with updating the ISO 23908 standard on safety mechanisms in the design and manufacture of devices and the prevention of sharps injuries. See the agenda below. Agenda for webinar on 22.06.22 at 09.00 updating the ISO 23908 standard on safety mechanisms and the prevention of sharps injuries.docx Click here to join the meeting
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Content ArticleHealth policy-making and reform require, first and foremost, a sound understanding of how a health system is performing. To assist countries in this process, the Health Systems Performance Assessment Framework for Universal Health Coverage offers a comprehensive attempt at guiding the collection and analysis of health system data in relation to policy goals and 21st century challenges. This book is grounded in the premise that any whole-of-sector assessment exercise should collect information on and examine the performance of both the functions of the health system as well as its performance goals. Thus, it follows through each of the health system functions (i.e., health system governance, financing, resource generation and service delivery), outlining their purpose, the sub-functions needed to fulfil that purpose, and assessment areas to evaluate how well a function performs. This innovative framework conceptually links health system functions to intermediate and final health system goals. As a result, policy-makers will be better able to determine and analyse possible origins or impact of poor performance on a particular health system outcome.
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Content ArticleThe International Confederation of Midwives (ICM) aims to strengthen Midwives Associations and advance the profession of midwifery globally. These resources from the ICM provide guidance for midwives on: Policy and practice Advocacy Education Regulation Association Covid-19 Respectful maternity care Mentoring
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Content ArticleInfection prevention and control (IPC) programmes and practices play a vital role to ensure outbreak preparedness and control, including patient safety and quality of care, which remain essential components of universal health coverage across health systems worldwide. However, detailed IPC evaluations using standardised validated tools, such as the WHO IPC self-assessment framework (IPCAF), are limited. Tomczyk et al. have conducted the first WHO global survey to assess implementation of these programmes in healthcare facilities. IPC professionals were invited through global outreach and national coordinated efforts to complete the online WHO IPC assessment framework (IPCAF). The study found that despite an overall high IPCAF score globally, important gaps in IPC facility implementation and core components across income levels hinder IPC progress. Increased support for more effective and sustainable IPC programmes is crucial to reduce risks posed by outbreaks to global health security and to ensure patient and health worker safety.
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Content ArticleThe Safety Culture Programme for Maternity & Neonatal Board Safety Champions was commissioned by NHSE/I Women’s Health Policy team. The programme was co-designed with stakeholders including Board Safety Champions, Leaders from the Maternity and Neonatal system and Maternity Voices Partnership through March 2021. The programme is underpinned by the NHSE/I framework developed by the Maternity Transformation Programme Board. The aim of the framework and the programme (concluded on 25 March 2022) is to create the conditions for a culture of safety and continuous improvement across perinatal services to improve the quality, safety and experience of care. View the presentation slides from the recent Aqua event and an overview of the HSIB Investigation Programmes highlighting the differences between the National Investigations Programme and the Maternity Investigations Programme.
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Content ArticleHealth systems in low and middle income countries (LMIC) are increasingly pluralistic, involving a wide mix of public, not-for-profit and for-profit providers. Regulation should be a key foundation of the Government's stewardship role of these heterogeneous facilities, but performance of this function is generally weak, with serious consequence for patient safety and quality of care. There has been little evaluation of strategies to strengthen regulation in LMIC, a notable exception being the Kenya Patient Safety Impact Evaluation (KePSIE), a collaboration between the Kenyan Ministry of Health and the World Bank. This randomised controlled trial is assessing the impact of a set of innovative regulatory interventions in public and private facilities in three Kenyan counties. These comprise the use of the Joint Health Inspections Checklist (JHIC), which synthesises the areas covered by all the regulatory Boards and Councils; increased inspection frequency; risk-based inspections where warnings, sanctions and time to re-inspection depend on inspection scores; and display of regulatory results outside facilities. The KePSIE trial will provide a rigorous quantitative assessment of these regulatory strategies. The results are expected to make an important contribution to the limited evidence base on regulation and regulatory reform. The findings will be of substantial benefit to those concerned with regulatory reform and the improvement of quality and safety more generally in Kenya and other LMIC settings.
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Content ArticleMedication safety events with the potential for patient harm do occur in healthcare settings. Pharmacists are regularly tasked with utilizing their medication knowledge to optimize the medication-use process and reduce the likelihood of error. To prepare for these responsibilities in professional practice, it is important to introduce patient safety principles during educational experiences. The Accreditation Council for Pharmacy Education (ACPE) and the American Society of Health-System Pharmacists (ASHP) have set forth accreditation standards focused on the management of medication-use processes to ensure these competencies during pharmacy didactic learning and postgraduate training. The experience described here provides perspective on educational and experiential opportunities across the continuum of pharmacy education, with a focus on a relationship between a college of pharmacy and healthcare system. Various activities, including discussions, medication event reviews, audits, and continuous quality improvement efforts, have provided the experiences to achieve standards for these pharmacy learners. These activities support a culture of safety from early training.
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Content Article
PRSB: Social Prescribing Standard V0.2
Patient Safety Learning posted an article in Social prescribing
For many people, improving their health and wellbeing requires a holistic approach and support by professionals who can help them focus on what matters to them to live well. Social prescribing supports people to understand their needs and connects them to local community (non-clinical) often voluntary services which can provide the help they need. -
Content ArticleThis report by Save the Children's Global Medical Team (GMT) shares the results of independent audits conducted in 2021. The audits aimed to assess the safety and quality of clinical and pharmacy services delivered by the organisation across seven countries. The team strategically focused on higher-risk programmes where Save the Children staff deliver services directly, with an aim to ensure that services remain safe and fully assured.
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Content ArticleThere has been little evaluation of strategies to strengthen regulation in LMIC, a notable exception being the Kenya Patient Safety Impact Evaluation (KePSIE), a collaboration between the Kenyan Ministry of Health and the World Bank. KePSIE is one of the worlds largest trials on improving patient safety, testing at scale complementary approaches to protect patients and prevent disease outbreaks. KePSIE provides validated tools to measure patient safety and assess facility performance in resource-poor primary care settings across multiple domains; development of an inspection checklist in collaboration with the country and large-scale pilot of inspections using a professional cadre and globally relevant empirical evidence on the effectiveness of government inspections and consumer empowerment to ensure patient safety.
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News Article
UK to bring in licensing scheme for Botox and filler procedures
Patient Safety Learning posted a news article in News
People administering Botox or fillers will be required to have a licence under new laws after an “unacceptable” rise in reports of botched cosmetic procedures in the UK. The legislation to protect against rogue practitioners will make it an offence to perform such non-surgical work without a licence after Sajid Javid said “far too many people have been left emotionally and physically scarred” when things have gone wrong. The health secretary recognised that most of those in the aesthetics industry “follow good practice” when it comes to patient safety but said it was time to think about the harm botched cosmetic procedures can have. “We’re doing all we can to protect patients from potential harm, but I urge anyone considering a cosmetic procedure to take the time to think about the impact on both their physical and mental health and ensure they are using a reputable, safe and qualified practitioner,” he said. Maria Caulfield, the minister for patient safety, said the spread of images online via social media has led to a rise in demand for Botox and fillers and there had been a subsequent increase in people suffering the consequences of badly performed procedures. She said: “While these can be administered safely, we are seeing an unacceptable rise in people being left physically and mentally scarred from poorly performed procedures.” Read full story Source: The Guardian, 28 February 2022 -
Event
PRSB: Overprescribing standard
Patient Safety Learning posted an event in Community Calendar
untilAround 1 in 5 hospital admissions in over-65s and around 6.5% of total hospital admissions are caused by the adverse effects of medicines. Prescribing people medicines that they neither need nor want can lead to serious harm, as identified in the Government’s 2021 National overprescribing review report. This is why the PRSB has been tasked with reviewing and revising our eDischarge summary standard and supporting documentation to ensure it addresses the issue of #oveprescribing and provide useful guidance to help users address issues. To do this, we are holding an online consultation with organisations who endorsed the 2017 eDischarge standard, the individuals and representatives who participated in the standard’s development consultations, those who have since implemented the 2017 standard and frontline health and care professionals – particularly prescribers – and people. Data standards ensure that people’s medicines information is recorded in a single, digital space that is at less risk of human error than if recorded on paper. Standards also allow for this information to be recorded in a common way that is shareable and readable across different computer systems in different care settings, for care at the point of need. Read more about how standards can support medicines reconciliation and reduce overprescribing: https://theprsb.org/prsb-response-to-national-over-prescribing-review-report/ Register -
Content ArticleThe National Comparative Audit of Blood Transfusion (NCABT) is a programme of clinical audits which looks at the use and administration of blood and blood components in NHS and independent hospitals in England. Blood services in Northern Ireland, Scotland and Wales are also invited to take part. The audit aims to provide evidence that blood is being ordered and used appropriately and administered safely, and to highlight where practice is deviating from guidelines and may cause patients harm. The latest audit took place in 2021, and previous audits are also available to download on this page.
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Content ArticleSedation for therapeutic and investigative procedures in healthcare is extensively and increasingly used. In 2013 the Academy of Medical Royal Colleges (the Academy) published Safe sedation practice for healthcare procedures: Standards and guidance (this updated and replaced earlier guidance). The guidance recommended core knowledge, skills and competencies required for the safe delivery of effective sedation. It also highlighted that safety will be enhanced by the provision of achievable standards, along with the availability of appropriate facilities and monitoring used under good organisational governance of staffing, equipment, education and practice. However, despite this, avoidable morbidity and mortality continue to occur. Service reviews by the Royal College of Anaesthetists’ (RCoA’s) Anaesthesia Clinical Services Accreditation (ACSA) programme suggest that the recommendations in the 2013 guidance have not been fully acted upon by many hospitals. Therefore, this update summarises the recommendations to provide regulators with a set of standards against which to inspect facilities providing sedation and to ensure that safety standards are being met.
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Content ArticleThe District Nursing service typically serves a defined geographical population or neighbourhood. The service is provided in every village, town and city in the UK. It is a nurse-led service, with a team leader who normally holds an NMC recordable specialist practitioner qualification. These new workforce standards for District Nursing were developed by the Queen's Nursing Institute's International Community Nursing Observatory (ICNO) over the past eighteen months, led by its Director, Professor Alison Leary. They safety standards for the District Nursing workforce in the UK, setting out areas of risk and giving examples of major ‘red flags’ that require escalation.
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Content ArticleShared decision making is a collaborative process in which clinicians and patients consider treatment options based on evidence about their potential benefits and harms, to enable the patient to decide the best course for themselves. The person’s priorities and concerns, wishes, preferences and goals should inform the conversation and the decision made. The Professional Records Standards Body (PRSB) produced this draft standard on shared decision making following widespread consultation and a series of role plays which tested the standard’s usability in practice. It was was developed to align with the GMC guidance on shared decision-making and consent, as well as the NICE guidelines on shared decision-making. The final version of the PRSB standard is due to be released in Summer 2022.
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Content ArticleQuality is complex and difficult to define, and institutions and organisations often have their own definitions, measurements and assurance processes. The Care Excellence Framework (CEF), developed and used at University Hospitals of North Midlands NHS Trust, is a unique, integrated framework of measurement, clinical observation, patient and staff interviews and benchmarking. It also has an internal accreditation system that provides assurance from ward to board based on the five Care Quality Commission (CQC) domains and reflects CQC standards. The CEF has been established in its existing form since autumn 2016 and has been used in all areas of the organisation. This article provides an overview of the development and use of the CEF in an acute care setting, demonstrates how the framework acts as an internal accreditation system, and shows how it can encourage staff to undertake effective change and transform care from ordinary to excellent.
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Content Article
Falsified Medicine Directive explained
Patient Safety Learning posted an article in Medication
As global trade and the Internet keep on growing it has become much easier for people to pass goods off as genuine. Counterfeiting in medicine products is becoming more prevalent and countries are now adopting systems to protect the legitimate supply of products to protect the industry and importantly the patients. Systems are already operating in America and Germany and the EU has formulated a directive for all European countries to adopt a system that protects all European citizens. The False Medicine Directive (FMD) registration database tracks all medicines from the manufacturer through to the patient in a unified way across the whole of Europe. Across the EU those who manufacture, sell or dispense medicines must comply with new track and trace regulations. Find out more from the FMD plus website.
