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Content ArticleThis year marks the NHS's 75th anniversary, and is an important moment to look back at where the service has come from, consider where it stands today and to look forward to how it needs to change to meet future needs. This report from the NHS Assembly draws on the feedback of thousands of people who have contributed to a rapid process of engagement with patients, staff and partners. It aims to help the NHS, nationally and locally, plan how to respond to long term opportunities and challenges. It sets out what is most valuable about the NHS, what most needs to change, and what is needed for the NHS to continue fulfilling its fundamental mission in a new context.
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Content ArticleDevices and internet connectivity are essential for effective digital services but so are good design, co-development and trust. The use and beneficial impact of digital technologies and data is much more likely if technology is useable and trusted, while also meeting the needs and expectations of staff and patients. This King's Fund 3-minute read looks at human factors of digital healthcare.
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Content ArticleTechnology holds promise for the future of healthcare. It can prevent illness, enable early diagnosis, empower health management and support general wellbeing. But how might people use technology to have more control over their health and wellbeing? And do they want to? This report explores the role of technology in managing, improving and supporting health and wellbeing. The NHS Confederation, in partnership with Google Health, commissioned Ipsos to explore people’s behaviours, attitudes and beliefs about responsibility and control when it comes to their health, the role that health technologies play in this and their expectations about the future of healthcare. A survey of more than 1,000 adults in the UK – a third of whom live with one or more long-term conditions (LTCs) – and interviews with individuals with LTCs and who have frequent interaction with the health system, forms the centrepiece of this report.
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Content ArticleThe widespread adoption of effective hybrid closed loop systems would benefit people living with type 1 diabetes by improving the amount of time spent within target blood glucose range. Hybrid closed loop systems (also known as 'artificial pancreas' typically utilise simple control algorithms to select the best insulin dose for maintaining blood glucose levels within a healthy range. Online reinforcement learning has been utilised as a method for further enhancing glucose control in these devices. Previous approaches have been shown to reduce patient risk and improve time spent in the target range when compared to classical control algorithms, but are prone to instability in the learning process, often resulting in the selection of unsafe actions. This study in the Journal of Biomedical Informatics presents an evaluation of offline reinforcement learning for developing effective dosing policies without the need for potentially dangerous patient interaction during training.
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Content ArticleA key benefit of the new Learn from Patient Safety Events (LFPSE) service is its introduction of machine learning to hugely enhance the NHS’s capabilities for processing and analysing records of patient safety events. This podcast discusses how we plan to introduce machine learning in LFPSE, how this will support the NHS to improve patient safety, what changes staff will see as a result, our longer-term ambitions, and how providers can get involved in shaping this exciting new revolution in patient safety learning.
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Content ArticleThe government has published its mandate to NHS England. This mandate is intended to apply from 15 June 2023 until a new mandate is published. NHS England has a duty to seek to achieve the objectives in the mandate. The Secretary of State keeps progress against the mandate under review, setting out his views in an annual assessment which is laid in Parliament and published. The government will agree with NHS England how it should report on overall progress against the mandate to support the Secretary of State in keeping this under review. This will include reporting at agreed intervals on other delivery expectations listed beneath the objectives.
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Content ArticleThis is the recording of a roundtable hosted by the Institute of Health & Social Care Management (IHSCM) about virtual wards. Roy Lilley, IHSCM Chair and health policy analyst, discusses reducing waiting times, being innovative and sustainable and improving patient outcomes and patient journeys with a panel of speakers. The panel includes: Kris Glover, MD & Founder of Neon Health Solutions Paul Rylance, CTO, JKMCare Dr Folarin Majekodunmi, Director at Peopletoo
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Content ArticleTwo information technology (IT)-based interventions, which aim to improve prescribing safety in primary care, have been rolled out across England over the past few years. Researchers identified five strategies which could help ensure that the systems continue to have an impact over the longer term. The first system (computerised decision support, or CDS) raises a warning when a clinician is about to prescribe a medicine that could increase a patient’s risk of harm. The second method (PINCER) is led by pharmacists; it searches people’s medical notes to identify potential errors that have already happened. Pharmacists, GPs and other clinicians work together to investigate and correct any errors. The research team examined documents, interviewed relevant professionals and carried out workshops which also involved members of the public. They identified strategies that could help ensure that these systems have an ongoing impact in primary care.
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Content ArticleMedicines can be purchased online from anywhere in the world. In 2021, nearly 53 million items were dispensed from online pharmacies in England, up 300% since 2016. In this blog, Dr Georgia Richards outlines the need for caution when buying medicines online, highlighting that online purchase of medications was cited in 16 Prevention of Future Deaths (PFD) reports between 2013 and 2019. She highlights coroners concerns concerns about: the ease of obtaining drugs via the Internet without any contact with the patient’s medical practitioner or access to the patient’s records. the inability to limit the volume or the frequency of ordering. issues with the regulation of supply, importation and delivery of controlled class A drugs via the international and UK postal system. lack of regulation of the dark web.
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News ArticleGrail, a company that developed blood tests to detect cancer, mistakenly sent approximately 400 customers letters saying they might be positive for the disease, The New York Times has reported. Grail's Galleri test uses blood to detect cancer signals shared by 50 types of cancers and is available only by prescription, according to the report. Grail said in a statement that one of its vendors sent hundreds of letters with incorrect test results due to a "software configuration issue." "No patient health information has been disclosed or breached due to this issue, and no patient harm or adverse events have been reported," Grail's statement said. The issue was not caused by incorrect test results, according to the company. More than half of people who received the erroneous letter had not yet had their blood drawn for the test. PWNHealth said in a statement that the system it uses to send template messages to people had a "misconfiguration." Read full story Source: Becker's Hospital Review, 4 June 2023
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Content Article
The TEC Action Alliance, in partnership with over 30 organisations, has released a challenge paper titled “Technology-Enabled Lives: Delivering Outcomes for People and Providers.” The paper highlights the lack of widespread adoption of digital social care services despite the public’s desire for technology to better support those who draw on social care and health services. The paper reveals that only a handful of councils, housing, and care organisations are delivering digital care in people’s homes at scale. This is despite evidence that using technology in social care keeps people safe, healthy, and happy at home. -
Event
HFMA members' summer series
Patient Safety Learning posted an event in Community Calendar
untilThis unique series of online events will provide Healthcare Financial Management Association (HFMA) members with a variety of engaging sessions over three days. The programme will be centred around several key themes: Career development – including resilience training, progression within the NHS, qualifications mapping and developing your personal brand. The bigger picture – technologies of the future, system working, diversity and inclusion. Thought leadership – case studies from across the four nations of the NHS, with real-life examples. At the halfway point of the year, the event will reflect on what’s gone on in the past six months and considering the learnings to take forward and how to make improvements. By the end of the three days, you’ll be well equipped to take on the second half of the year both on a personal, and professional level. Best of all, this event is free to HFMA members. All registered delegates will have access to all the session on demand for 3 month after the event. Speakers will include: Jo Howarth, CEO of The Happiness Club Max Siegel, LGBTQ+ content creator, activist, educator and speaker. Jennifer Holloway, personal brand specialist and author Helen Hughes, CEO Patient Safety Learning. Download programme Register -
Content ArticleThis is the recording of a webinar hosted by The Patients' Association, looking at how virtual wards work and patients' experiences of virtual wards. A panel answered questions about who was suitable for care on a virtual ward, how they are staffed and what happens if you're not tech-savvy. The panel was: Jono Broad, a patient leader in the southwest of England. He is a Senior Manager for Personalised Care, NHS England South West, works on patient experience, safety and quality. Emma Matthews, Regional Community Development Lead NHS England South West, Consultant Practitioner Older People and Frailty. Dr Shelagh O’Riordan, Consultant Community Geriatrician at Kent Community Health NHS Foundation Trust and Professional Adviser to the virtual ward team at NHS England. She is also Clinical Director for Frailty in East Kent and runs a large frailty virtual ward. Dr Crystal Oldman CBE, Chief Executive, The Queen's Nursing Institute. Crystal qualified as a nurse at University College Hospital, London. In 2017, Crystal was awarded a CBE in the Queen’s Birthday Honours List for services to community nursing and her leadership of the QNI. Crystal is an Honorary Professor at London South Bank University. Patients Association member, Alan Bellinger, who represents patients on the Hospital at Home programme in Hertfordshire, and is a patient representative on the Eastern Academic Health Science Network Review of Remote Monitoring.
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News Article
‘Archaic’ and risky patient records still used by most GP practices
Patient Safety Learning posted a news article in News
Most GP practices in England are still using ‘archaic’ Lloyd George paper records despite a commitment to digitise them, HSJ has found. NHS England’s 2019 GP contract included a commitment to do away with the so-called “Lloyd George envelopes” – named after the early 20th century prime minister who introduced a pre-NHS health insurance scheme – and digitise them by 2022-23. The NHS stopped issuing new envelopes for first-time registrations in January 2021. But Freedom of Information requests submitted by HSJ have revealed that the famous brown paper records, some of them many decades old, are still widely used in England. Where they are still used, staff typically use electronic records for new information, but have to find and consult the paper records occasionally, when they need older information. This is less efficient than if the records had been digitised, and storing the paper records takes up several rooms in many practices. Read full story (paywalled) Source: HSJ, 5 June 2023 -
News Article
Error causes 800 patients to be wrongly removed from waiting list
Patient Safety Learning posted a news article in News
A trust is carrying out a review after hundreds of patients were wrongly removed from the waiting list and potentially missed out on treatment. York and Scarborough Teaching Hospitals Foundation Trust told HSJ that roughly 800 patients of its referral to treatment waiting list, were affected. A serious incident was declared after it emerged some patients “had their referral to treat clocks stopped erroneously, resulting in patients not receiving treatment”, according to a report to the trust board. The trust said reviews were under way but had not yet identified any cases of “moderate or significant clinical harm”, although it admitted some patients had been significantly delayed. Read full story (paywalled) Source: HSJ, 2 June 2023 -
News Article
Over 80% of GP practices lack crucial technology, warns NHSE lead
Patient Safety Learning posted a news article in News
Only 10-15% of GP practices are using all three of the ‘modern’ patient access tools — including overhauling their approach to triage — which are at the centre of NHS England’s primary care recovery plan, its GP lead has told HSJ. Amanda Doyle, national director for primary care and community services, told HSJ this was its current estimate of the share of practices which already have in place all three of: digital phone systems; online messaging; and modern triage, response and care navigation. These are cornerstones of the primary care recovery plan,published by the government and NHS England this month, which says they are prerequisites for offering “modern general practice access”. Read full story (paywalled) Source: HSJ, 23 May 2023 -
Eventuntil‘Nurses are voting with their feet’, so said a report by the RCN in February of this year, describing the mass exodus of tens of thousands of skilled and experienced nurses. With workforce challenges an indisputable pressure facing the NHS, how can virtual wards be a part of the solution to address these pressures and support future resilience. Join this animated and thought-provoking discussion on “New Ways of Nursing”, chaired by Natasha Phillips, Chief Nursing Information Officer for NHS England, to explore how tech-enabled virtual wards have the potential to enable teams to work in new and innovative ways, release capacity, retain staff and help ICSs meet ambitious targets. Headline discussion points: How virtual wards are addressing workforce capacity issues. Case studies of tech-enabled virtual wards that have improved efficiency and patient outcomes. How virtual wards can offer news ways of engaging with the workforce that enhance wellbeing without compromising patient care. What attendees will learn: How tech enabled virtual wards are addressing NHS capacity issues head-on. How to set up a virtual ward for success and ensure buy-in from all stakeholders. The opportunity present for teams who embrace tech-enabled virtual wards. Register
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Content ArticleRemote digital postoperative wound monitoring provides an opportunity to strengthen postoperative community care and minimise the burden of surgical-site infection (SSI). This study aimed to pilot a remote digital postoperative wound monitoring service and evaluate the readiness for implementation in routine clinical practice. It concluded that remote digital postoperative wound monitoring successfully demonstrated readiness for implementation with regards to the technology, usability, and healthcare process improvement.
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News Article
Untested AI-based tools could harm patients, WHO warns
Patient Safety Learning posted a news article in News
As excitement builds throughout health and information systems worldwide over the rich potential benefits of new tools generated by artificial intelligence (AI), the World Health Organization (WHO) has called for action to ensure that patients are properly protected. Cautionary measures normally applied to any new technology are not being exercised consistently with regard to large language model (LLM) tools, which use AI for crunching data, creating content, and answering questions, WHO warned. “Precipitous adoption of untested systems could lead to errors by healthcare workers, cause harm to patients, erode trust in AI, and thereby undermine or delay the potential long-term benefits and uses of such technologies around the world,” the agency said. As such, WHO proposed that these concerns are addressed and clear evidence of benefits are measured before their widespread use in routine health care and medicine. Read full story Source: United Nations News, 16 May 2023 -
Content ArticleThis article looks at the experience of Tammy Dobbs, who has cerebral palsy and requires extensive support from home carers to carry out daily tasks. In 2016, Tammy's care needs were reassessed by the state of Arkansas where she lives, and the hours of support she was eligible to receive were cut in half. The change in eligibility was due to a new state-approved algorithm that had calculated her support needs in a new way, in spite of the fact that there was no change to her level of need. The situation caused Tammy much distress and resulted in drastic life changes. The article highlights the issues associated with the use of algorithms to determine need and allocate resources in health and social care. It also raises questions about what transparency means in an automated age and highlights concerns about people’s ability to contest decisions made by machines.
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Content ArticleThis case study published by The Beryl Institute looks at an initiative to collect real-time feedback on patient experiences at the Stanford Health Care emergency department in California. Previously, the department had sent a survey to patients well after their visit, but the team realised that capturing this information sooner was critical. Matthew Lim, Patient Experience Manager at Stanford Health Care describes the practical and replicable steps the organisation took in implementing a QR code-based feedback system. He describes the results, lessons learned and potential future developments.
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Content ArticleThis white paper from CEMBooks aims to unpick some of the deeper issues surrounding bed block and emergency department crowding from the perspective of a frontline medic with two decades of emergency and flow management experience. It aims to provide a greater understanding of the factors influencing the current situation and the measures used to define it followed by some practical implementable solutions.
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EventIt is now clear that hormone pregnancy test Primodos, the epilepsy drug sodium valproate, and that pelvic mesh causes avoidable harm to many thousands of women and children. Yet recognising these potential harms took many years, and it is still the case that the service does not know the identities of all those affected or potentially affected. The main reason is lack of data. Knowing which patients have received which medicines and devices where, and quickly connecting longer-term outcomes, has traditionally been somewhere between impossible and extremely slow and difficult. Unnecessary harm has often been the result. So how can the NHS solve this issue? What do we know about the traditional challenges with traceability in healthcare and the shortcomings of current data collection techniques? How can it be ensured that the right products are being used for the right patient? What approaches and technologies might solve these challenges, ensuring that the right products are being used for the right patient? How could this fit into wider digital transformation work, and resulting data best be used to improve patient safety and outcomes? This HSJ webinar, run in association with GS1 UK, will bring together a small panel to consider the answers to these important questions. Register
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News Article
New artificial intelligence tool can accurately identify cancer
Patient Safety Learning posted a news article in News
Doctors, scientists and researchers have built an artificial intelligence (AI) model that can accurately identify cancer in a development they say could speed up diagnosis of the disease and fast-track patients to treatment. Cancer is a leading cause of death worldwide. It results in about 10 million deaths annually, or nearly one in six deaths, according to the World Health Organization. In many cases, however, the disease can be cured if detected early and treated swiftly. The AI tool designed by experts at the Royal Marsden NHS foundation trust, the Institute of Cancer Research, London, and Imperial College London can identify whether abnormal growths found on CT scans are cancerous. The algorithm performs more efficiently and effectively than current methods, according to a study. The findings have been published in the Lancet’s eBioMedicine journal. “In the future, we hope it will improve early detection and potentially make cancer treatment more successful by highlighting high-risk patients and fast-tracking them to earlier intervention,” said Dr Benjamin Hunter, a clinical oncology registrar at the Royal Marsden and a clinical research fellow at Imperial. Read full story Source: The Guardian, 30 April 2023- Posted
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Content ArticleAlarms are signals intended to capture and direct human attention to a potential issue that may require monitoring, assessment or intervention. They play a critical safety role in high-risk industries such as healthcare, which relies heavily on auditory and visual alarms. While there are some guidelines to inform alarm design and use, alarm fatigue and other alarm issues are challenges in the healthcare setting. The automotive, aviation, and nuclear industries have used the science of human factors to develop alarm design and use guidelines. This study in the journal Patient Safety aimed to assess whether these guidelines may provide insights for advancing patient safety in healthcare.
