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News Article
Digital mental health tools to be regulated
Patient Safety Learning posted a news article in News
Recent years has seen a large, and rapid, growth in the availability of digital mental health tools. Do an online search for 'NHS Mental Health Apps' and an abundance of options will appear. These online tools can be helpful for people experiencing mental health problems, however, the Medicines Health and Regulatory products Agency (MHRA) said, they "present regulatory challenges" - such as clarity around whether they are medical devices and, if so, which risk classification they fall under. "Digital mental health tools offer millions of people vital support and guidance to explore and help manage their mental health issues every day," said Johan Ordish, head of software and artificial intelligence (AI) at the MHRA. He pointed out, however, that there are a number of "regulatory complexities" in establishing when these products should be regulated and what evidence they must have to demonstrate safety and effectiveness. Minister for Mental Health, Dr Caroline Johnson, said: "Digital mental health tools can be incredibly useful to help build resilience and prevent problems worsening, but it’s crucial these are regulated properly." To address these vital issues MHRA and NICE will explore and produce guidance on regulating digital mental health tools, using £1.8m funding by Wellcome over 3 years. The project will review key aspects of medical device regulations to produce guidance that will support digital mental health in several significant areas – including: Determining what qualifies as a medical device. The risk classification the devices would fall under. A review of the current evidence base for the devices. The MHRA explained that to achieve this it will "engage with" and "learn from" those with lived experience, subject experts, and patients, to inform their conclusions. Read full story Source: Medscape UK, 11 October 2022 -
News Article
NHSE drops tech target
Patient Safety Learning posted a news article in News
NHS England has revealed it is no longer planning to meet a long-term plan maternity digitisation target, because of a change of approach. Under the heading of “empowering people”, the 2019 long-term plan promised to extend digital access to maternity records to the whole country by 2023-24. This was in addition to digitising the so-called red book, which is used to track the health of babies and young children. It followed a recommendation in the 2016 Better Births report, led by former health minister Baroness Julia Cumberlege and commissioned by NHS England. It was intended to reduce bureaucracy and improve safety, as well as provide parents with better information. However, a paper prepared by chief nursing officer Ruth May for NHSE’s October board meeting said while the organisation “remains committed” to digitising the records, meeting the 2024 deadline would be a challenge due to “varying levels of digital maturity and change capacity across maternity services”. In response, Royal College of Obstetricians and Gynaecologists president Edward Morris told HSJ: “While we recognise the enormous pressures that maternity services are currently facing, we are disappointed that NHSE is no longer on track to meet the target to digitise maternity records by 2024. “This programme of digitisation will help realise our ambition for more effective use of data collected during pregnancy, to help identify and prevent the future onset of disease and improve outcomes for women and their babies. “If digital maternity records are to become part of the wider shift to electronic patient records, it is vital that this information is still accessible to both women and healthcare professionals as an important tool for shared decision making.” Read full story (paywalled) Source: HSJ, 11 October 2022 -
News Article
Remote monitoring service to be expanded in Norfolk following success
Patient Safety Learning posted a news article in News
Norfolk Community Health and Care it is using a remote monitoring service from Inhealthcare which allows patients to monitor their vital signs at home and relay readings via a choice of communication channels to clinicians who monitor trends and intervene if readings provide any cause for concern. Analysis of the six months before and after introduction showed a significant reduction in hospital bed days, A&E attendances, GP visits and out-of-hours appointments. Lead heart failure nurse at the trust, Rhona Macpherson, spoke to Digital Health News about the impact of the services on patients and nurses. For Macpherson, the service has helped promote self-management. “We give each of the patients a set of scales, blood pressure monitor and pulse oximeter and we get them to do their observations,” she said. “So we’re promoting self-management and looking at things but also it means that we can get accurate information on what’s happening with their observations. “We then set parameters to alert if they go outside of the parameters, and it just means we can intervene much more quickly than we would do, and we can see what’s going on between our visits as well as what’s happening when we’re actually there.” The service has transformed working practices for nurses, increasing efficiency and saving valuable time. Macpherson said: “We’re using the technology to try and make ourselves a little bit more efficient, so it’s saving on the travel time and face to face visits. “We can do a lot more with telephone. We’ve got the option of using video, but telephone is actually quite useful. So it’s less face to face visits, less travel and also, we’re trying to empower the patients to do their own observations and monitor themselves, rather than us just doing it for them.” -
News Article
Centre has ‘lost the narrative’ over NHSE merger
Patient Safety Learning posted a news article in News
The NHS should reduce the number of different electronic patient records (EPRs) used by trusts and instead rely on a smaller set of suppliers with nationally agreed prices, according to the CEO of NHS Digital. Simon Bolton, who is also NHS England’s interim chief information officer, also said NHSD and NHSE had “lost the narrative a little bit” over their forthcoming merger, due to a “fixation” with reducing NHSE staff numbers by a third; and that the centre of the NHS remained too “autocratic and authoritarian”. Mr Bolton said there were “too many” different EPRs used in the health service and said no private sector organisation would allow such variability for so long. His comments come amid a national drive to improve the uptake and quality of EPRs across NHS providers, following new technology targets set by the government earlier this year. Read full story (paywalled) Source: HSJ, 28 September 2022 -
Content ArticleThe Operating Room Black Box (OR Black Box) is a system that collects, stores and analyses a large amount of data from the operating room beyond just surgical video, such as video and audio of the operating room and patient physiology data. In this episode of the Behind the Knife podcast, Dr. Teodor Grantcharov, one of the creators of the OR Black Box, talks about how the technology can be used to enhance surgical training. Using the system for feedback through self-directed review, coaching and integrated AI analysis has changed the way we can learn and teach in surgery, and may have implications for the future of evaluation and assessing credentials.
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Content ArticleThe objective of this study from Sharma et al. was to evaluate the accuracy of a new elective surgery clinical decision support system, the ‘Patient Tacking List’ (PTL) tool (C2-Ai(c)) through receiver operating characteristic (ROC) analysis. They found that the PTL tool was successfully integrated into existing data infrastructures, allowing real-time clinical decision support and a low barrier to implementation. ROC analysis demonstrated a high level of accuracy to predict the risk of mortality and complications after elective surgery. As such, it may be a valuable adjunct in prioritising patients on surgical waiting lists. Health systems, such as the NHS in England, must look at innovative methods to prioritise patients awaiting surgery in order to best use limited resources. Clinical decision support tools, such as the PTL tool, can improve prioritisation and thus positively impact clinical care and patient outcomes.
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Content ArticlePatient safety in oncology should remain a standard indicator of quality of care and a critical objective on the EU health policy agenda as all European citizens deserve the same level of safeguarding and protection at all stages of their healthcare. Patient safety is also a critical indicator of life overall, as any irreversible or reversible patient safety issue potentially affects the quality of life. This report from the European Network for Safer Healthcare calls for 10 actions for European policy makers and national health authorities.
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Content ArticleIn this article, published by Inflect Health, ER doctor Josh Tamayo-Sarver explains what happened when he asked artificial intelligence chatbot ChatGPT to provide possible diagnoses based on his case notes.
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Content ArticleTechnologies abstract intelligence and provide predictor and precision insight in workflows that manage disorders, similar to cardiology and hematological disease. Positive perceptions of Artificial Intelligence (AI) that support Machine Learning (ML) and Deep Learning (DL) manage transformations with a safe system that improves wellbeing. In sections, workflow introduces an eXamination (X = AI) as an end-to-end structure to culture workstreams in a step-by-step design to manage populace health in a governed system. The author undertook structure and practice reviews and appraised perspectives that impact the management of AI in public health and medicine.
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Content ArticleTechnologies to assist with diabetes treatment and care have evolved rapidly over the past two decades. With each new innovation coming to the market, there are hopes that technologies will solve the numerous, complex issues related to diabetes. However, although it has been demonstrated that overall, these technologies—when available—bring major benefits to people living with diabetes, they do not make the condition disappear. This article in Diabetes Epidemiology and Management discusses the interconnections between technologies and diabetes distress, an often under-acknowledged consequence of the continuous demands of diabetes.
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Content ArticleIn this podcast, Care Opinion Chief Executive James Munro speaks to Alex Gillespie and Tom Reader of the Department of Psychological and Behavioural Science at LSE about their research paper 'Online patient feedback as a safety valve: An automated language analysis of unnoticed and unresolved safety incidents'. Their research analysed over 146,000 stories on Care Opinion using an automated machine-learning approach. Key findings included: automated analysis can reliably detect patient safety issues reported by patients. online patient safety concerns are associated with hospital level mortality. staff reported patient safety concerns are not associated with hospital level mortality.
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Content ArticleFalsified, fake or counterfeit medicines are medicines disguising themselves as authentic, and they can pose significant health risks. 96% of websites selling medicines operate illegally–but research suggests that over 50% of people are not aware of this. This blog highlights the issue of counterfeit Parkinson's medications being sold illegally online. Mike Isles, Executive Director of the Alliance for Safe Online Pharmacy in the EU describes their high prevalence and gives tips for people with Parkinson's on how to stay safe when buying medicines online.
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Content ArticleIn January 2023, Newmarket Strategy and BD, a global medical technology company, were part of a delegation of UK health leaders travelling to the global healthcare conference Arab Health in Dubai, United Arab Emirates. The purpose of the visit was to learn more about Connected Medication Management (CMM) and the role it can play in solving some of the most pressing challenges faced by health systems today. Connected Medication Management is a technology-driven approach to medication management that uses digital and automation technologies. It aims to optimise medication use by reducing medication errors to improve patient safety, whilst delivering productivity gains for the NHS. It also frees up nursing and other clinical staff to provide more patient care.
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Content ArticleThe first ever HETT North event, which brought together digital health leaders from across the country, took place in March 2023 in Manchester. The event highlighted the latest advancements in digital healthcare, and this blog reports on the final keynote session of the day, which focused on ‘Assessing the landscape of digital health transformation – past, present & future’. Key topics included identifying underlying issues that need to be addressed to allow for digital transformation, and the policy surrounding digital transformation in Integrated Care Systems (ICSs). Alongside Clive Flashman, Patient Safety Learning's Chief Digital Officer, the panel included: Sam Shah, Chair, HETT Steering Committee Henrietta Mbeah-Bankas, Head of Blended Learning & Digital Learning & Development Lead, Health Education England Tremaine Richard-Noel, Head of Emerging Technology, Northampton General Hospital NHS Foundation Trust Liz Ashall-Payne, CEO, ORCHA You can watch a video of the discussion on Youtube.
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Content ArticleThis report by the Royal College of General Practitioners (RCGP) sets out recommendations for the Government to tackle the workforce and workload crisis in general practice, and support GPs and their teams to meet the healthcare challenges of the 21st century. Based on a survey of more than 2,600 GPs and other practice team members from across the UK, the report provides a snapshot of what frontline staff have faced during one of the most difficult winters experienced in the NHS, and what they think needs to happen to make general practice more sustainable. Respondents describe a profession in crisis, with unmanageable workload and workforce pressures fuelling an exodus of fully qualified GPs.
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Content ArticleSome medical mistakes have been stubbornly hard to eliminate. Now, hospitals hope technology can make a difference. This Washington Post article highlights are some of the biggest problems that caregivers are trying to address with technology.
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Content ArticleDigital technologies can change how care is delivered, making health and care services more accessible, flexible, person centred, and a better experience for patients and staff while also improving efficiency. However, there is no guarantee of these positive effects until digitally enabled services are inclusive and meet the expectations of staff and the public. In this King's Fund long read, explore what digital exclusion is, who is commonly assumed to be excluded, and what can be done to mitigate digital exclusion.
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Content ArticleHighland Marketing interviews Clive Flashman, independent consultant, chief digital officer at Patient Safety Learning and director of strategy at ORCHA. Clive has a longstanding interest in using health tech to engage patients and improve safety. He argues that to make real progress, the NHS needs to start taking a systems view, rather than a tactical view, of its adoption.
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Content ArticleIn this National Health Executive article, Dr Tom Milligan, Clinical Lead for Diabetes in Humber and North Yorkshire, discusses how ICB-led text messaging could dramatically increase patients' participation in programmes where other methods of patient outreach have already been tried.
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News Article
Ministers consider staff body cameras to tackle NHS mental health abuse scandals
Patient Safety Learning posted a news article in News
Ministers are considering the use of body cameras within mental health units as part of the government’s response to NHS abuse scandals, The Independent has learned. Senior sources with knowledge of the conversation between the Department for Health and Social Care and the NHS have raised concerns about the plans. There are fears that using the technology in mental health units could have implications for human rights and patient confidentiality. One senior figure criticised the proposals and said: “The DHSC are all talking about body-worn cameras, closed circuit TV, etc... The whole thing is fraught with huge difficulties regarding human rights, about confidentiality. They are thinking about it [cameras] and it is ridiculous.” The DHSC’s mental health minister Maria Caulfield said in parliament earlier this month that she and health secretary Steve Barclay were due to meet with NHS officials to discuss what response was needed to recent exposes of abuse within mental health services. It comes after a string of reports from The Independent, BBC Panorama and Dispatches revealing abuse of inpatients. The Panorama and Dispatches reports included video evidence of abuse captured by hidden cameras. Following a scathing independent review into the deaths of three young women, Tees, Esk and Wear Valleys NHS Trust said it is piloting the use of body-worn cameras across 10 inpatient wards “to support post incident reviews for staff and patients.” Read full story Source: The Independent, 23 November 2022 -
News Article
Half of ICSs lack plan against ‘constantly evolving’ cyber attacks
Patient Safety Learning posted a news article in News
At least half of integrated care systems (ICS) lack plans for responding to cyberattacks, at a time of increasing cyber risks, HSJ can reveal. The findings also come at a time when the threat posed by cyber attackers is “constantly evolving”, and in the wake of a recent high-profile attack on a supplier to several trusts. In August 2021, NHS England published a framework – What Good Looks Like – to set out what ICSs and member organisations must achieve to be considered digitally mature. Requirements included that all ICSs should have a system-wide plan for “maintaining robust cybersecurity” with “centralised capabilities to provide support across all organisations”. However, 20 ICSs have told HSJ they do not yet have such a cybersecurity strategy or plan in place. Nine ICSs said they did, while the remaining 13 ICSs did not respond. This is despite the NHS being subjected to a growing number of cyber attacks. In 2020-21, NHS Digital reported the health service had been targeted roughly 21 million times on a monthly basis, which marked an increase since before the pandemic. Most of these are malicious emails containing malware and are automatically blocked by cyber defence and monitoring systems. However, in August, a dozen mental health trusts and several NHS 111 and urgent care providers were badly affected by a cyber attack on one of their IT suppliers, Advanced. Several trusts have not yet regained full access to their electronic patient record three months on from the attack. Read full story (paywalled) Source: HSJ, 11 November 2022 -
News ArticleThe South East Coast Ambulance Service declared a Critical Incident last night. The NHS Foundation Trust - which serves Kent, Surrey, West Sussex and East Sussex and part of north-eastern Hampshire around Aldershot, Farnborough, Fleet and Yateley - is urging the public to only call 999 in a 'serious emergency'. This is because of IT issues which have resulted in the loss of its Computer Aided Dispatch (CAD) system. In a statement issued on social media at around 9pm, the Ambulance Service said: "We have tonight (10 November) declared a Critical Incident following IT issues which resulted in the loss of our CAD (Computer Aided Dispatch) and the need to move to our back-up telephone systems. "While we are working hard with our IT providers to find a solution to the issue, and have implemented well-rehearsed contingency plans, the loss of the CAD, along with the high demand we are facing across our region tonight, is placing significant pressure on our services. "We continue to answer calls and respond to patients but urge people to only call 999 in the event of a serious emergency and to make use of services, including NHS 111 Online, for help and advice. "We would like to thank our staff and volunteers for their hard work and commitment at this challenging time and assure the public that we are doing everything we can to resolve the issue as quickly as possible." Read full story Source: Kent Live, 10 November 2022
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News Article
Doctors warn failing NHS IT systems ‘undermining’ patient safety
Patient Safety Learning posted a news article in News
“Failing” IT systems in the NHS are a threat to patient safety. medics have warned. Doctors and nurses should not “tolerate problems with IT infrastructure as the norm”, according to a new editorial, published in The BMJ. Experts from Imperial College London and University College London point to an incident in which IT systems at Guy’s and St Thomas’ NHS Foundation Trust – one of the largest hospital trusts in the country – went down for 10 days. The outage, caused by the July heatwave, led to procedures and appointments being postponed for a number of patients. The new editorial highlights how IT failures can restrict services as doctors are unable to access records and are prevented from ordering diagnostic tests. This can “bring a halt to the everyday business of healthcare”, they said. The authors suggest that the NHS IT infrastructure is “crumbling” and leads to “poor user experiences” as well as patient safety incidents. “Increasing digital transformation means such failures are no longer mere inconvenience but fundamentally affect our ability to deliver safe and effective care – they result in patient harm and increased costs,” they wrote. Read full story Source: 10 November 2022 -
News Article
NHS cyber attack hits patient care with records left in ‘chaos’ three months on
Patient Safety Learning posted a news article in News
Patient care is still being undermined at NHS mental health trusts and social care providers that were hit by a major cyber attack in August, doctors have warned. Three months after the major attack wiped out NHS systems, patients’ records are missing, safety has been compromised, and medication doses are at risk of being missed amid ongoing “chaos”, i News has been told. Dr Andrew Molodynski, mental health lead at the British Medical Association, said the prolonged systems failure has damaged care because records are “integral to patients’ safety”. Mental health patients’ records and safeguarding alerts have not been available in some trusts since 4 August, when NHS software provider, Advanced, was hit by a ransomware attack which targeted its Carenotes records system. A total of 12 NHS mental health trusts have been impacted by the cyber attack, potentially impacting tens of thousands of patients as well as social care providers. According to Advanced’s own hazard log spreadsheet, seen by i News, the risks associated with disruption to its server include “medication doses missed”, “required number of carers not met”, “basic needs not met, such as nutrition and personal care”, and “health needs not met, such as wound care and physical support”. Advanced said: “We recognise that the restoration process has taken longer than we had initially anticipated and we have sought to communicate as clearly and transparently as we have been able.” It said planned dates for restoring the system for each client has been communicated directly and that the “overall restoration programme remains on track”. Read full story Source: i News, 4 November 2022 -
Content ArticleNearly half of all adults and approximately 8% of children (aged 5-17) worldwide have a chronic condition. Yet, studies have consistently shown that adherence to medication is poor; estimates range from under 80% to under 50%, with an average of 50%. There could be a considerable improvement in health outcomes (and consequently longevity), not only by developing new drugs, but by helping people adhere to existing treatment regimens that have already been researched, tested and prescribed for them. But adherence isn’t usually prioritised by governments, health providers or healthcare professionals (HCPs). Adherence isn’t measured at a national level for any disease, apart from in Sweden where hypertension is recorded. And as governments don’t prioritise adherence, health providers aren’t measured or incentivised for improving it, meaning HCPs may not have the time and resources (or reminders) to focus on it during consultations. This report from the International Longevity Centre-UK (ILC) makes a series of recommendations.
