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Content ArticleDiagnostic errors are a known patient safety concern across all clinical settings, including the emergency department (ED). The authors from the John Hopkins University conducted a systematic review to determine the most frequent diseases and clinical presentations associated with diagnostic errors (and resulting harms) in the ED, measured error and harm frequency, as well as assessing causal factors.
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- Diagnosis
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Content ArticleAn estimated 1.3 billion people—16% of the global population—experience a significant disability today. People with disabilities have the right to the highest standard of health, however, this report by the World Health Organization (WHO) demonstrates that while some progress has been made in recent years, many people with disabilities continue to die earlier and have poorer health than others. The report demonstrates how these poor health outcomes are due to unfair conditions faced by people with disabilities in all areas of life, including in the health system itself.
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- Disability
- Health inequalities
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Content ArticleThe Sentinel Stroke National Audit Programme (SSNAP), which assesses the care provided for patients during and after they receive inpatient care following a stroke, has published its ninth annual report. Based on data from April 2021 to March 2022, the report aims to identify which aspects of stroke care need to be improved with a particular focus on changes in stroke care over the last two years and the ‘roads’ that need to be followed in order to restore the quality of care. SSNAP measures the process of care against evidence-based quality standards referring to the interventions that any patient may be expected to receive. These standards are laid out in the latest clinical guidelines and include: whether patients receive clot busting drugs (thrombolysis). interventions for clot retrieval (thrombectomy). how quickly they receive a brain scan. how much therapy is delivered in hospital and at home.
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Content ArticleThe Stroke Association's Saving Brains campaign aims to raise awareness of thrombectomy, a game-changing surgical treatment for stroke that many patients in the UK are currently missing out on. Thrombectomy can prevent further damage occurring to the brain in people having a stroke. It is a time-critical treatment and there is variation in access to the procedure across the country, In this video, stroke patients Karen and Phil talk about their experiences of treatment. Karen was able to have a timely thrombectomy and regained full mobility immediately following the procedure. Phil wasn't able to access thrombectomy due to the service not being available in his area at weekends; as a result, his recovery has been slower and more difficult.
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- Stroke
- Surgery - Vascular
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Content ArticleThe CVDPREVENT audit contributes to a strategic objective outlined in the NHS Long Term Plan to prevent 150,000 strokes, heart attacks and cases of dementia over the next ten years. The audit works with system partners to drive cardiovascular disease (CVD) quality improvement. Mary Wills is a patient representative for the CVDPREVENT audit, and in this blog she describes her family's experience of CVD and why she was keen to get involve in CVDPREVENT. She talks about the value of hearing from other patients and carers in the first Patient Panel meeting and being invited to contribute to CVDPREVENT Steering Group meetings.
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- Medicine - Cardiology
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News Article
Millions in poor health due to lack of rehab after illness, warns UK report
Patient Safety Learning posted a news article in News
Millions of people in the UK are suffering poor health because they miss out on vital rehabilitation after strokes, heart attacks and cancer, which in turn is also heaping further pressure on the NHS, a damning report warns. Physiotherapists say some groups of patients are particularly badly affected. Without access to these services, many patients desperately trying to recover from illness became “stuck in a downward spiral”, they said, with some developing other health conditions as a result. The new report by the Chartered Society of Physiotherapy (CSP) says millions of people in marginalised communities, including those from ethnic minorities, are not only more likely to live shorter lives, but also spend a greater proportion of their lives struggling with health difficulties. Vital services that could tackle those inequities are either unavailable or poorly equipped to meet their needs, the report warns, adding that “some communities face particular barriers”. Prof Karen Middleton, the chief executive of the CSP, said: “Rehabilitation services have been under-resourced for decades and were not designed coherently in the first place. This has exacerbated poor health outcomes, particularly for people from marginalised groups. “It’s not only the individual who suffers. Without adequate access to rehabilitation, health conditions worsen to the point where more and more pressure is eventually piled on struggling local health systems and other public services. “We desperately need a modernised recovery and rehabilitation service that adequately supports patients following a health crisis and prevents other conditions developing.” Read full story Source: The Guardian, 21 September 2022- Posted
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Content ArticleResearch suggests that there is a wide gap in knowledge about how medical conditions affect men and women differently, and about the conditions that only affect women. As a result, women are receiving poorer medical advice and diagnosis, often leading to worse outcomes. This handbook published by digital healthcare provider Livi looks at some of the evidence surrounding sex-based health inequalities and how they are affecting women in the UK.
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- Womens health
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Content Article
NHS England: Stroke toolkit
Patient Safety Learning posted an article in Other conditions and diseases
Stroke is a serious life-threatening medical condition that occurs when the blood supply to part of the brain is cut off. It is the fourth largest cause of death and the leading cause of disability, with almost two thirds of stroke survivors leaving hospital with a disability in the UK.- Posted
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News Article
Ysbyty Glan Clwyd: Stroke patients would rather go to England
Patient Safety Learning posted a news article in News
People would rather go to England if they had a stroke than use the A&E at a north Wales hospital, a health watchdog has said. Inspectors said there was a "clear and significant risk to patient safety" after inspections at the department in Ysbyty Glan Clwyd, Denbighshire. North Wales Community Health Council's Geoff Ryall-Harvey said it was the "worst situation" they had seen. The report said inspectors found staff who were "working above and beyond in challenging conditions" during a period of "unrelenting demand". Many staff told them they were unhappy and struggling to cope. They said they did not feel supported by senior managers. However inspectors said that the health board was not fully compliant with many of the health and care standards, and highlighted significant areas of concern, which could present an immediate risk to the safety of patients, including: Doctors were left to "come across" high-risk patients instead of being alerted to them. Patients were not monitored enough - including a suspected stroke patient and one considered a suicide risk. Children were at serious risk of harm as the public could enter the paediatric area unchallenged. Inspectors found evidence of children leaving unseen or being discharged against medical advice. Betsi Cadwaladr health board said it was committed to improvements. Read full story Source: BBC News, 8 August 2022 -
Content ArticleThrombectomy is a game-changing treatment for stroke. It changes the course of recovery from stroke in an instant, significantly reducing the chance of disabilities like paralysis, visual impairment and communication difficulties. It is also extremely cost-effective. Rolling out thrombectomy fully could save the UK £73 million a year, by reducing demand for rehabilitation and community support services. But thrombectomy isn’t currently available for everyone who needs it (~10% of all stroke patients). The treatment is subject to a postcode lottery and in 2020/21, nearly 80% (5,889) of patients in England who needed a thrombectomy missed out. This report from the Stroke Assoication features some of the amazing people working tirelessly to improve outcomes for stroke patients, under challenging circumstances and often at a personal cost. And most importantly, it shows how truly life-changing thrombectomy can be for patients. The Stroke Association hopes this report will galvanise action at government and ICS levels that will benefit both stroke patients and professionals. They must urgently secure access to a 24/7 thrombectomy service, for every stroke patient who needs.
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- Medicine - Stroke
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News Article
Over 47,000 stroke patients to ‘miss out on a miracle treatment’
Patient Safety Learning posted a news article in News
A new report by the Stroke Association released today warns that, if the thrombectomy rate stays at 2020/21 levels, 47,112 stroke patients in England would miss out on the game changing acute stroke treatment, mechanical thrombectomy, over the length of the newly revised NHS Long Term Plan. This year, NHS England missed its original target to make mechanical thrombectomy available to all patients for whom it would benefit – only delivering to 28% of all suitable patients by December 20212. The Stroke Association’s ‘Saving Brains’ report calls for a 24/7 thrombectomy service, which could cost up to £400 million. But treating all suitable strokes with thrombectomy would save the NHS £73 million per year. Stroke professionals quoted in the report cite insufficient bi-plane suites, containing radiology equipment, as a barrier to a 24/7 service. The Stroke Association is calling for: The Treasury to provide urgent funding for thrombectomy in the Autumn Budget 2022, for infrastructure, equipment, workforce training and support, targeting both thrombectomy centres and referring stroke units. Department of Health and Social Care to develop a sustainable workforce plan to fill the gaps in qualified staff. NHS England to address challenges in transfer to and between hospitals in its upcoming Urgent & Emergency Care Plan. Putting innovation - such as artificial intelligence (AI) imaging software and video triage in ambulances - into practice. Juliet Bouverie, Chief Executive of the Stroke Association said: “Thrombectomy is a miracle treatment that pulls patients back from near-death and alleviates the worst effects of stroke. It’s shocking that so many patients are missing out and being saddled with unnecessary disability. Plus, the lack of understanding from government, the NHS and local health leaders about the brain saving potential thrombectomy is putting lives at risk. There are hard-working clinicians across the stroke pathway facing an uphill struggle to provide this treatment and it’s time they got the support they need to make this happen. It really is simple. Thrombectomy saves brains, saves money and changes lives; now is the time for real action, so that nobody has to live with avoidable disability ever again." Read full story Source: The Stroke Association, 28 July 2022 -
News Article
Londoners several times more likely to get life-saving treatment
Patient Safety Learning posted a news article in News
The NHS and the Treasury need to make a renewed commitment to increasing the number of patients who benefit from thrombectomy, the Stroke Association has said, as it revealed the service was dependent on just 106 doctors in England. New analysis due to be published by the charity later this week – and shared with HSJ – also found only a quarter of thrombectomy units are open 24 hours, seven days a week, with 42% only operating during office hours and Monday to Friday. Despite an NHS long-term plan target of treating 10% of strokes with a thrombectomy by this year, only 2.8% were benefitting in December 2021 – a smaller proportion than in the US or some other Western European nations. It means nearly 6,000 people who could benefit from thrombectomy are missing out, the charity has calculated. The Stroke Association’s report also highlighted large apparent regional variation in the share of stroke patients receiving the treatment — with London patients several times more likely to receive the treatment than elsewhere. Read full story (paywalled) Source: HSJ, 27 July 2022 -
News Article
Multiple deaths due to care delays highlighted in damning CQC report
Patient Safety Learning posted a news article in News
Dozens of patients died or suffered ‘severe harm’ after long waits for ambulances during a three-month period in a health system facing ‘extreme pressure’ on its emergency services. The 29 serious incidents in Cornwall included patients waiting many hours for assistance despite being in “extreme pain”, patients having suspected sepsis, patients in cardiac arrest, and patients experiencing a stroke. The incidents were reported to the Care Quality Commission by staff at South Western Ambulance Service Foundation Trust during an inspection of the Cornwall integrated care system’s urgent and emergency care services. According to the CQC, the pressures on the ambulance service were “unrelenting”, while “significant work” was needed to “alleviate extreme pressure”. This meant there was a “high level of risk to people’s health when trying to access urgent and emergency care in the county”, the report said. Read full story (paywalled) Source: HSJ, 27 May 2022- Posted
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Content ArticleThe Regulation and Quality Improvement Authority (RQIA) has published its independent 'Review of the implementation of recommendations to prevent choking incidents in Northern Ireland'. The Review examined the measures and governance arrangements in place to prevent choking, in line with current guidance, focusing on the work undertaken in high-risk areas across health and social care, including stroke care, care of the elderly and services for those with physical and/or mental health and learning disabilities. The Review found that there was a clear and urgent need to improve the quality and safety of care provided to people at risk of choking. The key recommendations in the Review include: training for staff including clinicians, catering and domestic teams; shorter waiting times for assessment by Speech and Language Therapy; better systems for communication between staff, and safer systems for ordering and storing food.
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News Article
Officials sound alarm on ambulance stroke response times
Patient Safety Learning posted a news article in News
National NHS officials have called for ambulance response times for stroke cases to be “urgently reviewed”. A report on stroke services by Getting it Right First Time – an NHS England national programme – recommends modelling the impact of a change to the categorisation by ambulance services of suspected strokes. The GIRFT report notes that the time between symptom onset and arrival at hospital has increased by 41 minutes over the last seven years, yet faster access to emergency stroke care gives a better chance of survival and reduces the impact on quality of life for survivors. Strokes are currently treated as “category two” incidents, meaning they should get a response within 18 minutes. However, patients are currently experiencing much longer waits, as average response times were more than three times this in March. Since the introduction of the current system of categorisation in 2017-18, the 18 minute target for category two calls was only ever hit for a few months, at the height of the covid pandemic, when call-outs were abnormally low. However, when asked about the issue, Janette Turner, the academic who led research on the last official review of ambulance response times, warned that moving all suspected strokes to category one could lead to longer responses for the most serious calls. Read full story (paywalled) Source: HSJ, 4 May 2022 -
News Article
Stroke and heart patients routinely waiting over an hour for ambulance
Patient Safety Learning posted a news article in News
Stroke and heart attack victims are now routinely waiting more than an hour for an ambulance, after a further fall in performance in recent weeks, and with hospital handover delays hitting a new high point, HSJ reveals. Figures for ambulance performance this week, seen by HSJ, showed average response times for category two calls at more than 70 minutes for successive days. 3,000 patients may have suffered “severe harm” from delays in February, ambulance chief executives say. Several well-placed sources in the sector said response times had deteriorated further this month, and that more than half of ambulance trusts were this week seeing average category two responses of longer than an hour. Some cited an average category two response last week of around 70 minutes, with the services under huge pressure from a combination of demand, long handover delays, and covid-related sickness. Category two calls include patients with suspected heart attacks and strokes, and the national target for reaching them is 18 minutes. The figures seen by HSJ for this week showed average response times for category one calls — the most serious, including cardiac arrests and other immediately life threatening emergencies — of more than 10 minutes on Wednesday, against a target of just 7 minutes. Monthly average performance for category one has never reached 10 minutes. Read full story (paywalled) Source: HSJ, 1 April 2022- Posted
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- Stroke
- Heart disease
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Content ArticleThis report by the Healthcare Safety Investigation Branch (HSIB) has been published as part of a pilot launched to evaluate HSIB’s ability to carry out effective local investigations at specific hospitals and trusts, while still identifying and sharing relevant national learning. After an evaluation, it will be decided whether this model can be implemented more widely by HSIB. The investigation reviewed the case of a patient who had a stroke and was due to be taken to his local hospital emergency department (ED), but the ED advised paramedics this was not possible as their stroke service was closed. The alternative was to take him to a neighbouring hospital, but they also advised that they could also not take the patient. This was then referred back to the original ED, who restated their position, eventually leading to the neighbouring hospital agreeing to accept the patient. Once the patient arrived he then had to wait 40 minutes in an ambulance as the ED was very busy.
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- Stroke
- Emergency medicine
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Content ArticleThis report examines the impact of the Covid-19 pandemic on people living with long-term conditions and highlights that many have deteriorated faster than usual due to being unable to access rehabilitation services. It makes recommendations to the government aimed at restoring rehabilitation support services. The report was produced collaboratively by The Alzheimer's Society, The Stroke Association, Macmillan Cancer Support, The Centre for Mental Health, Age UK, The College of Podiatry, The Royal College of Speech and Language Therapists, The Royal College of Occupational Therapists, The Chartered Society of Physiotherapy and The British Dietetic Association.
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- Underlying health conditions
- Dementia
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Content ArticleChristoph Diener, from the faculty of medicine at the University of Duisburg-Essen in Germany, reports on the latest publications from the European Stroke Organisation on the management and prevention of stroke, including: managing blood pressure in the first 24 hours space-occupying brain infarctions the new guidelines on transient ischaemic attacks and minor stroke treatment options for patients with carotid stenosis rare thrombosis complications following COVID-19 vaccinations.
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Content ArticleThis manifesto was created by the Community Rehabilitation Alliance, a collective of 50 charities, trade unions and professional bodies coming together to call on all political parties to ensure there is equal access to high quality community rehabilitation services for all patients.
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- Medicine - Rehabilitation
- Community care
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Content ArticleThis patient decision aid from the National Institute for Health and Care Excellence (NICE) aims to help family members and carers of severe stroke patients under 60 understand the risks and benefits of decompressive hemicraniectomy, so that they can make an informed decision about treatment.
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- Decision making
- Patient engagement
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Content ArticleThis short animation from SameYou, a charity working to develop better recovery treatment for survivors of brain injury and stroke, highlights the stories of survivors of brain injury and stroke. It is linked with their report, The Untold Story of Brain Injury.
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Content ArticleThis report from SameYou, a charity working to develop better recovery treatment for survivors of brain injury and stroke, draws on the experiences of over 1,400 survivors of brain injury and stroke, as well as the experiences of their friends and family members. It highlights the lack of support for survivors and recommends some ways forward to improve outcomes.
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News ArticleA new study by Staffordshire University shows that people who understand their ‘heart age’ are more likely to make healthy lifestyle changes. 50 preventable deaths from heart attack or stroke happen every day and Public Health England’s online Heart Age Test (HAT) allows users to compare their real age to the predicted age of their heart. The tool aims to provide early warning signs of cardiovascular disease (CVD) risk, encouraging members of the public to reduce their heart age through diet and exercise and to take up the offer of an NHS Health Check. CHAD Research Associate Dr Victoria Riley, who led the study, said: “Deaths from heart attack or stroke are often preventable and so addressing health issues early is incredibly important. Our findings show that pre-screening tests, such as the HAT, can encourage individuals to evaluate their lifestyle choices and increase their intentions to change behaviour.” Read full story Source: Brigher Side of News, 10 October 2021
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- Heart disease
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Content Article
What's your heart age? NHS Health Check
Patient Safety Learning posted an article in Heart conditions
A new study by Staffordshire University shows that people who understand their ‘heart age’ are more likely to make healthy lifestyle changes. 50 preventable deaths from heart attack or stroke happen every day and Public Health England’s online Heart Age Test (HAT) allows users to compare their real age to the predicted age of their heart. The tool aims to provide early warning signs of cardiovascular disease (CVD) risk, encouraging members of the public to reduce their heart age through diet and exercise and to take up the offer of an NHS Health Check.- Posted
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- Heart disease
- Coronary heart disease
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