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News Article
Lateral flow tests could cost care home visitors £73 a month
Patient Safety Learning posted a news article in News
Lateral flow tests could cost care home visitors £73 a month, a leading UK charity has said, as it renewed calls to keep the devices free in such settings. The government has previously announced that free testing for the general public will end from 1 April, and that this will include care home visitors. However, charities have warned the shift away from free tests could place a heavy financial burden on those visiting care homes, where testing is still advised. James White, the head of public affairs and campaigns at the Alzheimer’s Society, said the proposed charge on lateral flow tests for visitors to care homes was a cruel tax on care. “Over the past two years, we’ve consistently heard many tragic stories from families struggling to visit their loved ones in care homes. For many people with dementia, this isolation has led to a significant deterioration in their condition and mental health,” he said. “With infection rates rising once again, the government must provide free lateral flow tests for all visitors to care homes so that families are not put in an agonising position where they are forced to ration visits, leaving people with dementia once again isolated and alone.” Caroline Abrahams, Age UK’s charity director, said: “No one should have to pay out of their own pocket for tests in circumstances where the expert advice is clear that testing remains an important safeguard against Covid,” she said. “If care home visitors are going to continue to be asked to keep testing to protect their loved ones, it would be completely unacceptable to expect them to pay.” Read full story Source: The Guardian, 15 March 2022 Further reading Visiting restrictions and the impact on patients and their families: a relative's perspective -
News ArticleA leading figure in the World Health Organisation Foundation has criticised the UK’s move to dismantle its Covid testing programme as the disease surges in other parts of the world. Mr Anil Soni, chief executive of the WHO Foundation, said in an interview with The Independent that maintaining surveillance over Covid-19 was “incredibly important” and the “dismantling of the testing infrastructure here strikes me as very worrying.” The WHO Foundation chief warned people were “looking the other way” from counties where there is low vaccine coverage to maintain the hope that Covid is over. He warned low vaccine coverage is a “petri dish” for future variants to breed and that the acute phase of the pandemic could not be over until this is addressed. When asked about the UK’s plans to end its NHS Test and Trace programme Mr Soni said: “I’m very concerned about it. “What we’ve seen is, it’s incredibly important to maintain surveillance, and countries in southern Africa should be applauded for detecting Omicron as quickly as they did. Those surveillance systems need to be in place around the world. “We also want to make sure that testing is widely available so that people, when they become infectious, can be aware of their status and keep others safe. For testing not to be available and for us to be moving too quickly to normalcy creates risk.” Mr Soni said the world’s position with Covid was “precarious” and highlighted the surge being seen in Hong Kong, where “health centres are at the verge of collapse, because of how many people are sick”. Read full story Source: The Independent, 10 March 2022
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News Article
UTI testing '50 years out of date'
Patient Safety Learning posted a news article in News
A painful infection that mainly affects women is too often dismissed as "women's problems". One in every two women suffer a urinary tract infection (UTI) and they are the second most common infection globally. Among those affected is Hannah Hanratty, 36, who suffered months of agony despite multiple negative tests. During her pregnancy, Mrs Hanratty felt the "razor-blade burning pain" when passing urine. It soon developed into a constant pain. Two weeks after giving birth she needed antibiotics following a routine procedure and said the pain immediately went. "It was a UTI all along that just hadn't been picked up by the tests," she said. Now Dr Emma Hayhurst, a senior lecturer in Molecular Biology at the University of South Wales, has developed a device to improve testing and said the current system is "50 years out of date". At the moment a UTI patient may be asked to provide a urine sample which is sent for analysis, with tests back in two to three days. "That's not good enough, we need to make it quicker," said Dr Hayhurst, explaining that the device she's working on would reduce that. "Within 30 minutes the clinician will be able to say what bacteria is causing the UTI and indeed whether there is a UTI in the first place." Dr Hayhurst has received a £50,000 Women in Innovation Award to further her work, but also in recognition of her position as a female role model in the field of science, technology, engineering and medicine - or STEM subjects, as they're also known. "We should be listening to the women who are telling us this is a problem in their lives, but we know many feel like they are being dismissed," she said. Wales' Health Minister Eluned Morgan is due to publish a quality statement on women's health in the summer, and has announced funding for each health board to have a specialist endometriosis nurse. "I feel I have particular responsibility, as the first woman health minister in a long time, to make sure we look at the issue of women's health in a lot more detail," she said. "There are clearly some gaps, certainly when it comes to research, but also in terms of where people are concentrating their efforts and investment. "Quite often, women are not heard in the same way as men are heard and we've really got to make sure we are rebalancing that unconscious bias." Read full story Source: 7 March 2022 -
Content ArticleGovernment must take a cautious and evidence-based approach to exiting the pandemic, factoring in six key elements for a fail-safe exit strategy.
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News Article
Ministers warned getting rid of free Covid tests will lead to £500 ‘caring tax’
Patient Safety Learning posted a news article in News
Abolishing free Covid tests for those who look after the vulnerable will amount to a “tax on caring” that would cost them more than £500 a year, ministers have been warned. All remaining domestic Covid regulations that restrict public freedoms are ending, with Boris Johnson announing a move away from government intervention to “personal responsibility”. However, the scale of free testing to be retained is still being thrashed out within government. Current data suggests that nearly 4 million people take regular Covid tests, including those who visit and help vulnerable relatives. That number also includes vulnerable people who work in settings that could put them at greater risk, where they have face-to-face contact with others. Research based on the average cost of tests internationally, compiled by the Liberal Democrats, suggests that people who take two tests a week face an average bill of £534 a year. It comes after the government’s own scientific advisers have warned that removing free testing will “increase anxiety” and limit the “social participation outside the home” of those who are clinically vulnerable or who live with someone in that position. “Charging people for the tests they need to safely see vulnerable loved ones is a tax on caring that risks leaving millions of people in lockdown by stealth,” said Ed Davey, the Lib Dem leader. “It means vulnerable people will see fewer loved ones and will be able to enjoy less of their lives. It is unfair and unjust. Ministers need to scrap these plans to stop a ‘cost of living with Covid’ crisis. Throughout the pandemic, people have been trying hard to do the right thing and keep others safe. The government should not be making that harder.” Read full story Source: The Guardian, 19 February 2022 -
News ArticleToday the Government is expected to announce the end to all Covid restrictions, including ending self-isolation and free testing in the country. However, in an open letter to the UK's Chief Medical Officer and Chief Scientific Officer, the UK science and medical communities say this is a "HUGE mistake". The open letter expresses concern about the Government plans to end testing, surveillance surveys and legal isolation of Covid-19 cases and asks the Government to clarify the scientific advice underpinning these policy decisions as they do not believe there is a solid scientific basis for the policy. "It is almost certain to increase the circulation of the virus and remove the visibility of emerging variants of concern." "The emergence of new variants and a resultant wave of infections can occur very quickly, potentially within just several weeks. The ability to rapidly detect and characterise new variants and to scale up necessary responses (such as TTI and vaccinations) quickly will be very important. Considerations for future response preparedness and surveillance infrastructure should take this into account." "We believe humanity is in a race against the virus." The letter goes on to say that some form of surveillance must be continued to ensure the situation is well understood and new variants of concern identified. Lack of testing is not only detrimental to controlling the spread of SARSCoV2 and detecting new variants, it also puts people who develop Long Covid at a great disadvantage by not having a confirmation of their infection, which is integral to the diagnosis, support and care they need to receive. For the 1 in 4 people in the UK who are clinically vulnerable, the current approach appears a perilous and politicised pandemic response. The authors of the letter are asking members of the UK science and medical communities to sign the open letter. Read the letter in full and sign here
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Content ArticleIn this primer for Patient Safety Network, the authors examine the issues surrounding diagnostic error and delay during the Covid-19 pandemic. They discuss the following issues: Biases in the diagnostic process - availability bias, anchoring bias, implicit biases Diagnostic testing for active SARS-CoV-2 Infection Clinical implications of diagnostic error
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Content ArticleIn this article for The BMJ, Ingrid Torjesen looks at new data from Japan that suggest patients with the omicron variant of Covid-19 shed virus for longer after symptoms emerge, than with other Covid-19 variants. This has a potentially significant impact on hopes of shortening the period of isolation for people testing positive. The article examines new evidence from Japan that suggests that with omicron, the peak of virus shedding may be two or three days later than with other variants. It also looks at the relative value of self-isolation in the UK while omicron is circulating so widely in the community, with up to two-thirds of cases now undetected by testing.
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Content ArticleProfessor Ahmet Fuat, North East and North Cumbria Cardiac Network Heart Failure Lead, shares how one tool is helping reduce the current pressures and deliver better outcomes for patients. NT-proBNP testing – a NICE recommended diagnostic tool – is being used to rule out heart failure in primary care. In the North East and North Cumbria, patients must have an NT-proBNP test to be referred for an echocardiogram. This mandated testing helps them to streamline the diagnosis journey for heart failure patients by confirming or ruling out heart failure at the earliest possible opportunity, and reducing unnecessary referrals for echos. For patients, this saves time and distress, and for GPs and Nurse Practitioners, which reduces the number of repeat visits these patients often need to make.
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News ArticleNHS staff absences due to covid have risen by a further 11,000 staff in a week in England, figures seen by HSJ reveal. At a national level, the number of absences for covid-related reasons - including isolation - rose to about 44,200 on 29 December, up from 32,800 on 22 December. The 29 December figure has pushed up overall absence for all reasons to 103,727 - 7.8% of the total reported workforce - the leaked data shows. Numerous senior NHS managers have said their main concern at present is about the level of staff absences, which in some cases is undermining services, with staff having to be redeployed to support others. There is concern about it rising further in the new year. One trust is looking at whether staff who test positive could opt to work on wards dedicated to covid patients. Louise Ashley, the chief executive of Dartford and Gravesham Trust in Kent, tweeted yesterday that some nurses had asked if they could come into work while positive but asymptomatic. Ms Ashley later confirmed to HSJ that the trust had assessed the request and “unfortunately” had to refuse it. The two main reasons for the decision were that staff may have the more dangerous Delta strain and that it be too difficult to keep them isolated from other staff. She added: ”I am amazed at their commitment to their patients and colleagues – very humbling after the two years they have been through. We are seeing high levels of staff absenteeism but we are hurrying through PCR tests to get staff back to work and are managing safe staffing levels currently.” There is also growing concern over NHS staff access to testing, which is required to enable contacts to come to work if they are negative. Read full story (paywalled) Source: HSJ, 31 December 2021
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News Article
Lateral flow tests to be ‘constrained’ over next two weeks, warns Sajid Javid
Patient Safety Learning posted a news article in News
The health secretary, Sajid Javid, has warned MPs he may need to “constrain” the Covid testing system over the next fortnight, as demand for lateral flow kits surges. Ministers have repeatedly encouraged members of the public to test themselves using a lateral flow device (LFD) before attending gatherings or meeting vulnerable relatives. However, test kits have repeatedly been unavailable online in recent days, and many pharmacies have complained of being unable to secure them. Labour has accused the government of presiding over a “shambles”, with many members of the public struggling to obtain tests despite ministers putting testing at the centre of efforts to control the spread of Omicron. Demand for the tests has also been boosted by a change in quarantine rules that allows people to emerge from self-isolation after seven days instead of 10, as long as they carry out two negative lateral flow tests. In a letter sent to MPs on Wednesday evening, Javid acknowledged the intense strain being put on the system as cases of the Omicron variant continue to increase, with 183,037 new infections recorded on Wednesday. “In light of the huge demand for LFDs seen over the last three weeks, we expect to need to constrain the system at certain points over the next two weeks to manage supply over the course of each day, with new tranches of supply released regularly throughout each day,” he wrote. Read full story Source: The Guardian, 30 November 2021 -
News Article
Mass rapid tests in Liverpool cut hospital stays by a third
Patient Safety Learning posted a news article in News
Mass lateral flow testing cut the number of people needing hospital treatment for Covid by 32% and relieved significant pressure on the NHS when the measures were piloted last year, a study has shown. Liverpool conducted the first city-wide testing scheme using rapid antigen tests in November last year, amid debate about whether or not lateral flow tests (LFTs) were accurate enough to detect the virus in asymptomatic carriers. It expanded the project to cover the whole of the Liverpool region, offering people LFTs whether or not they had symptoms. Key workers did daily tests before going to work to show they were not infectious. Now an analysis has shown that it was more successful than Liverpool’s scientists and public health teams had anticipated, after they compared Covid cases and outcomes in the region with other parts of England. Professor Iain Buchan, dean of the Institute of Population Health, who led the evaluation, said: “This time last year, as the Alpha variant was surging, we found that Liverpool city region’s early rollout of community rapid testing was associated with a 32% fall in Covid-19 hospital admissions after careful matching to other parts of the country in a similar position to Liverpool but without rapid testing. “We also found that daily lateral flow testing as an alternative to quarantine for people who had been in close contact with a known infected person enabled emergency services to keep key teams such as fire crews in work, underpinning public safety.” Read full story Source: The Guardian, 19 December 2021 -
Content ArticleThis report, published by the Agency for Healthcare Research and Quality (AHRQ) in the United States, presents findings from a review of 5,500 patient safety records in which the Covid-19 public health emergency was included as part of the description of the event or unsafe condition. It forms part of a series of Network of Patient Safety Databases Data Spotlight reports.
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News Article
Immensa lab closed one month after ‘unusual’ Covid results first detected
Patient Safety Learning posted a news article in News
Authorities were aware of discrepancies in Covid test results across England one month before the lab responsible was ordered to shut down its operations, legal papers show. An estimated 43,000 incorrect false negative tests were processed for the NHS by the Immensa laboratory in Wolverhampton between 8 September and 12 October. UK Health Security Agency became aware of an “unusual spike” in suspicious test results on 14 September, with large numbers of people testing positive on lateral flow devices but negative via PCR. It took a month before the UKHSA determined that the “likely cause was a technical issue at the Immensa laboratory”, according to court papers filed by the government in response to a lawsuit. The Independent also revealed in October how machines at the Wolverhampton lab were poorly maintained, concerns over quality control dismissed and untrained staff regularly “left to their own devices”. Samples at the site were wrongly processed or cross-contaminated, leading to incorrect test results, while faulty air conditioning and fluctuating humidity levels within the lab also led to spoiled tests, whistleblowers said. Read full story Source: The Independent, 22 December 2021 -
News ArticleThe spread of the Omicron variant, which is racing through the population at a staggering speed, has brought renewed focus to the value and reliability of the at-home lateral flow test (LFT). These rapid testing devices were initially viewed with caution by some scientists, who were concerned that the LFTs simply weren’t effective enough in detecting infections. But as more data has accumulated over the past year, the consensus around the devices has shifted and become far more positive. Research from University College London, published in October, suggested that LFTs are likely to be more than 80 per cent effective at detecting Covid, and up to 90 per cent effective for those who are most infectious. However, the emergence of Omicron has changed the conversation. Its rapid acceleration throughout the UK, with more than a million infections expected by next week, has placed the country’s key testing routes – both at-home (LFT) and lab-based (PCR) – under immense strain. “Testing capacity will almost certainly fail to keep up with Omicron,” said Dr Jeffrey Barrett, director of the Covid-19 Genomics Initiative at the Wellcome Sanger Institute. “Even with best efforts we can scale supply linearly, but demand will grow exponentially.” Experts have called on the government to temporarily drop the reliance on PCR lab testing, which typically takes 24 hours or more to return a result but is seen as more reliable, in favour of the lateral flow devices. These can be taken from the comfort of your own home and give a result in a matter of minutes. “LFT will be good enough, especially on people showing symptoms,” said Alan McNally, a professor of microbial evolutionary genomics at Birmingham University. Read full story Source: The Independent, 17 December 2021
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News Article
Covid PCR test market a ‘rip-off jungle’, says ex-chair of competition regulator
Patient Safety Learning posted a news article in News
The former chairman of the UK competition regulator has condemned the market for PCR tests for travellers, describing it as a “rip-off jungle”. After the reimposition of the requirement to take the tests on return from abroad, Lord Tyrie accused the government of once again allowing the companies offering PCR tests to manipulate the system by making them available at unrealistic prices. “For this policy to get into a mess once might be seen as a misfortune but for it to resurface again after all the warnings over the summer would have to be described as carelessness,” he told BBC Radio 4’s Today programme. “It was a scandal waiting to happen and it’s now happened and it needs very urgent action.” Last week, the Guardian revealed that a slew of the cheapest deals on PCR tests had been removed from the government website amid concerns travellers were being misled by companies advertising the coronavirus testing service for less than a £1. Private companies offering day two tests for travellers are listed on a government website for consumers to search. However, most of the deals were found to not be suitable for most travellers as they were often offered in only one location, on limited dates and only available to those who could attend in person. “It appears that some of the worst practices – misleading online advertisements, overpricing, unacceptably poor service among them – are still widespread,” said Tyrie, the former head of the Competition and Markets Authority, and the ex-chair of the Treasury select committee. Read full story Source: The Guardian, 8 December 2021 -
News Article
Scotland to rollout diabetes test for Type 1 patients
Patient Safety Learning posted a news article in News
Misdiagnosed Type 1 diabetes patients could be freed from the need to take insulin after a new test is rolled out. Scotland will become the first country to offer the C-peptide blood test to all patients who have had a Type 1 diagnosis for at least three years. The test shows how much insulin a patient's body is producing itself. A pilot by NHS Lothian allowed some people who had been taking insulin to stop or reduce the treatment. The test will be available from 1 November. C-peptide testing, which has been used as part of diagnosis for some patients for many years, can help distinguish whether a patient has Type 1 or Type 2 diabetes. C-peptide is made in the body at the same time as insulin. By testing levels of C-peptide, doctors can work out how much insulin a diabetes patient is making themselves. If C-peptide is present in significant amounts, it might indicate that the person does not have Type 1 diabetes at all, and consequently may not need daily insulin injections. The tests will be offered at hospital diabetes centres. Public Health Minister Maree Todd said that tackling diabetes was a priority for the Scottish government and that she wanted everyone living with diabetes to access safe, effective healthcare, treatment and support. She said: "Type 1 diabetes is a significant health challenge right across the world." Read full story Source: BBC News, 31 October 2021 -
News ArticleDeborah Birx, who was the White House coronavirus response coordinator under President Donald Trump, has told a congressional inquiry that at least 129 000 lives could have been saved if his administration had provided adequate testing and properly communicated the gravity of the situation to the public. But the election year “just took people’s time away and distracted them from the pandemic,” she told the House Select Subcommittee on the Coronavirus Crisis. “I felt like the White House had gotten somewhat complacent through the campaign season.” Asked if Trump did everything he should have to counter the pandemic, she said, “No. And I’ve said that to the White House. I believe I was very clear to the president in specifics of what I needed him to do.” “If we had fully implemented the mask mandates, the reduction in indoor dining, the getting friends and family to understand the risk of gathering in private homes, and we had increased testing, then we probably could have decreased fatalities by 30-40%.” That would amount to at least 129 000 preventable covid deaths over the course of the Trump presidency, which saw roughly 429 000 reported deaths attributed to the coronavirus." Read full story Source: BMJ, 28 October 2021
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News ArticleThe laboratory at the centre of the Covid testing fiasco returned just four positive results out of more than 2,400 tests sent to it from one city, the Guardian has learned, raising questions about why it was not discovered sooner. The positivity rate of just 0.2% from Sheffield tests sent to the Wolverhampton lab run by Immensa contrasts sharply with the national rate of about 5-8% at the time of the scandal. Data released under freedom of information laws by Sheffield city council showed there were four positive results, 2,391 negative and 13 void results processed by the lab from 1 September until it was suspended in mid-October. The disclosure also shows the scandal covers local authorities as far away from Wolverhampton as Yorkshire, with the UK Health Security Agency refusing to disclose which areas are affected beyond saying they are mostly in south-west England. One expert suggested there should have been about 200 positive results based on prevalence figures from the time. Kit Yates, a senior lecturer in mathematics at Bath University, said the country needed to see a full list of all the walk-in/drive in centres that were affected. “It’s all well and good notifying those people who were tested, but because of the nature of this communicable disease, this scandal now reaches well beyond those people,” he said. “The public deserve to know if their area was affected.” Read full story Source: The Guardian, 27 October 2021
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News Article
UK lab investigated for false negative Covid tests is not fully accredited
Patient Safety Learning posted a news article in News
The private laboratory that is under investigation for potentially issuing more than 40,000 false negative Covid tests was not fully accredited to perform the work, contrary to assurances made by health officials. The UK’s independent accreditation service, Ukas, told the Guardian on Monday that neither Immensa Health Clinics Ltd nor its sister company, Dante Labs, had ever been accredited by the service, and that it had informed the Department of Health that statements suggesting otherwise were incorrect. The UK Health Security Agency announced on Friday that it was suspending operations at Immensa’s laboratory in Wolverhampton pending an investigation into concerns that at least 43,000 people with coronavirus had been wrongly told their swabs tested negative for the virus. Because many of the individuals would have believed the typically more accurate PCR tests performed by Immensa over simpler lateral flow tests, there is a substantial risk they unwittingly spread the virus on to thousands more people. Read more Source: The Guardian, 18 October 2021 -
Content ArticleA new report from two House of Commons committees highlights the UK’s failed pandemic response. Martin McKee, professor of European Public Health, London School of Hygiene & Tropical Medicine, unpicks the findings.
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News Article
Covid test lab suspended over wrong results
Patient Safety Learning posted a news article in News
Around 43,000 people in England may have been wrongly told their Covid-19 test was negative because of errors at a lab. Testing at the Wolverhampton laboratory has been suspended following an investigation by NHS Test and Trace. It is now contacting those affected, mainly in the south west region, to ask them to take another Covid test. Concerns were raised when people had positive lateral flow tests but negative PCR results from the lab. Read full story Source: BBC News, 15 October 2021 -
Content ArticleA major report from a year-long joint inquiry by the House of Commons Health and Social Care Committee and Science and Technology Committee has now been published and offers a forensic analysis of six aspects of the government’s response to covid. Chris Ham is chair of the Coventry and Warwickshire Integrated Care System, Co-Chair of the NHS Assembly and non-executive director of the Royal Free London Hospitals NHS Foundation Trust, and gave evidence to the inquiry. In this BMJ Opinion article, Chris discusses the report, the recommendations and the omissions.
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News Article
COVID-19: Government’s handling of pandemic had “big mistakes,” MPs say
Patient Safety Learning posted a news article in News
The government’s actions in dealing with the COVID-19 pandemic have received a mixed review from MPs in a report that set out the successes and failures of the UK response. Although the joint report from the House of Commons’ Science and Technology Committee and Health and Social Care Committee praised the UK’s covid vaccination programme as highly effective, it also condemned serious errors, especially delayed lockdowns and how a test, trace, and isolate system was set up. Overall, the MPs’ inquiry found that some government initiatives were examples of global best practice but that others represented “serious mistakes.” The UK’s pandemic planning was based too narrowly on a flu model that had failed to learn the lessons from the SARS, MERS, and Ebola epidemics, said the MPs, which meant that its covid planning was worse than in other countries. Delays in establishing an adequate test, trace, and isolate system hampered efforts to contain the outbreak, said the MPs, and the government’s initial decision to delay a comprehensive lockdown had revealed its then “fatalistic” assumption that it was impossible to suppress the virus, which amounted, in practice, to accepting that herd immunity by infection was inevitable. The report said that many thousands of deaths could have been avoided if the government had not let hospitals discharge people into care homes in the initial phase of the pandemic and that this showed the “longstanding failure” to give social care sufficient priority and the same attention as the NHS. Read full story Source: BMJ, 12 October 2021 -
Content ArticleThis leaflet produced by Clare Rayner for The PACS (Post-Acute Covid Syndrome) International Working Group provides information for patients on diagnosing Covid-19 without a positive swab test.
