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Showing results for tags 'Tests / investigations'.
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News Article
Home blood test kits ‘piling work on NHS’
Patient Safety Learning posted a news article in News
Private companies are offering “misleading” home blood-testing kits that fuel health anxieties and pile pressure on the NHS, a report has suggested. There has been a boom in sales of the kits, which promise to reveal everything from cancer risk to how long patients can expect to live. But an investigation by the BMJ found these “unnecessary and potentially invasive tests” can be misleading and generate false alarms. The NHS is then left to “clear up the mess” as worried patients see GPs for reassurance or extra tests, piling more pressure on the overstretched service. One GP described patients coming in “clutching the results of private screening tests”, with doctors asked to review the results. The companies have been criticised for not providing sufficient follow-ups after the “poor quality and overhyped” tests, and for misleading results such as wrongly telling people their test levels are outside the “normal” range. Bernie Croal, president of the Association for Clinical Biochemistry and Laboratory Medicine, said: “Most of the online [tests] will send the results to the patient with at best a sort of asterisk next to the ones that are abnormal, with advice to either pay some more money to get some sort of health professional to speak about it or go and see your own GP.” Doctors are calling for the tests to be more tightly regulated by the health watchdog, the Care Quality Commission. Read full story (paywalled) Source: The Times, 27 October 2022 -
Content ArticleThis editorial in BMJ Quality & Safety looks at the need for urgent improvement in the test result management and communication process in primary care. The authors highlight the inconsistency in tracking and communicating test results and look at potential solutions to reduce the patient safety risks associated with test results. They look at the evidence surrounding automated alerts built into provider IT systems and giving patient direct access to test results through apps, highlighting the growing importance of patients in safeguarding their own care through actively pursuing test results.
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- Diagnosis
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Content ArticleRates of blood testing in primary care are rising. Communicating blood test results generates significant workload for patients, GPs, and practice staff. This study from Watson et al. explored GPs’ and patients’ experience of systems of blood test communication. The study found that methods of test result communication varied between doctors and were based on habits, unwritten heuristics, and personal preferences rather than protocols. Doctors expected patients to know how to access their test results. In contrast, patients were often uncertain and used guesswork to decide when and how to access their tests. Patients and doctors generally assumed that the other party would make contact, with potential implications for patient safety. Text messaging and online methods of communication have benefits, but were perceived by some patients as ‘flippant’ or ‘confusing’. Delays and difficulties obtaining and interpreting test results can lead to anxiety and frustration for patients and has important implications for patient-centred care and patient safety.
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News Article
GP test result confusion puts patients at risk
Patient Safety Learning posted a news article in News
Patients are being put at risk because GPs wrongly assume they will actively seek their test results, a study says. Researchers from the University of Bristol said the mismatched expectations could harm patients, with delayed diagnosis a likely result. The study found: “Doctors expected patients to know how to access their test results. In contrast, patients were often uncertain and used guesswork to decide when and how to access their tests. Patients and doctors generally assumed that the other party would make contact, with potential implications for patient safety.” Dr Jessica Watson, a GP and doctoral research fellow at the Centre for Academic Primary Care at the university, who led the study, said: “GPs have a medico-legal and ethical responsibility to ensure they have clear, robust systems for communicating test results.” Watson added: “Relying on patients to get in contact and making assumptions about their knowledge of how to do so were particular risks highlighted.” Read full story (paywalled) Source: The Times, 12 July 2022- Posted
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Content ArticleClosed-loop communication—when every test result is sent, received, acknowledged and acted upon without failure—is essential to reduce diagnostic error. This requires multiple parties within the healthcare system working together to refer, carry out tests, interpret the results and communicate them in language the patient can understand. If abnormal test results are not communicated in a timely manner, it can lead to patient harm. This Quick Safety case study looks at the case of a 47-year-old school teacher who had a screening mammogram. The radiologist identified a suspicious area of calcifications, which required follow up. The patient’s GP was not on the same electronic medical record (EMR) as the imaging centre and, because of front office changes, missed the notification to follow up. The patient was told that the radiologist would contact her if the results were abnormal and therefore assumed she was okay. A year later when seeing her GP, the patient was told that she needed follow-up testing and that she had stage 3 cancer. Her lesion had grown significantly, and she now required surgery, chemotherapy and radiation for advanced breast cancer. The case study suggests safety actions that should be considered to prevent this error from happening again.
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- Imaging
- Reports / results
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Content ArticleMany people with Long Covid experience varying levels of long-term cognitive impairment, but the causes of this are not well understood. This preprint longitudinal observational study aimed to identify links between cognitive impairment and different biomarkers in people with Long Covid. The authors reported the findings of 128 prospectively studied patients who had tested positive for Covid. They looked at: lung function, physical and mental health at two months post diagnosis. blood cytokines, neuro-biomarkers and kynurenine pathway (KP) metabolites at 2-, 4-, 8- and 12-months post diagnosis. The study identified that KP metabolites were significantly associated with cognitive decline and could therefore offer a potential therapeutic target for treating cognitive impairment related to Long Covid.
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- Long Covid
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Content ArticleThis retrospective cohort study in the British Journal of General Practice aimed to identify opportunities for timely investigations or referrals in patients presenting with potential symptoms of colon and rectal cancer, or abnormal blood tests. The study found evidence that patients with these cancers presented with low haemoglobin, high platelets and high inflammatory markers as early as nine months pre-diagnosis, and the authors suggest that starting cancer-specific investigations or referrals earlier may be beneficial in patients with some of these diagnostic markers.
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News Article
Inadequate Reading surgery had 'backlogs of test results', CQC says
Patient Safety Learning posted a news article in News
A GP surgery that provides treatment to about 5,600 patients has been placed in special measures by a regulator. London Street Surgery, in Reading, Berkshire, was found to have "significant backlogs of test results and care-related tasks". The Care Quality Commission (CQC) found there was "poor identification of risks to patients" during an inspection in April. The surgery has been approached for comment. The regulator rated the surgery's safety and leadership as inadequate, and said it had insufficient processes to ensure services' safety and effectiveness. Repeat prescriptions and medicines were "not managed safely", which could have posed risks to patients, and there were "risks associated" with the storage of blank prescriptions, it found. Staff training was "not monitored appropriately" and inspectors found patients with learning disabilities were not provided with health checks to make sure their wellbeing was properly monitored. Read full story Source: BBC News, 7 June 2022- Posted
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- GP practice
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Content ArticleHospitals are rejecting GP referrals for investigations and outpatient treatment at an increasing rate. In this blog, Patient Safety Learning looks at the patient safety issues caused by rejected referrals and lack of capacity in outpatient specialities. We call for the government and NHS leaders to investigate the problem and take action to mitigate risks to patient safety.
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Content ArticlePositive defensive medicine describes an approach to healthcare that involves excessive testing, over-diagnosing and overtreatment. Negative defensive medicine, on the contrary, describes an approach where doctors avoid, refer or transfer high risk patients. This article in Patient Safety in Surgery examines how both defensive medicine approaches can contribute to medical errors.
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Community PostAre you a GP or other healthcare professional working in primary care? Have you noticed an increase in rejected referrals to outpatient services/for scans and other investigations? How have changes to the referral system affected you? What communication relating to referrals have you received recently from the NHS? What has the impact been on your own workload and wellbeing, and the safety of patients? Please share your experiences with us so we can continue to highlight this important issue.
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News Article
Basildon Hospital blood tests contaminated in 'major failure'
Patient Safety Learning posted a news article in News
THE majority of blood tests taken at Basildon Hospital to identify life-threatening illnesses have been contaminated in a “major failure”. An investigation has been launched by health bosses, with staff shortages allegedly causing the issue with “blood cultures”. Blood cultures, which look for germs or fungi in the blood and more deadly bacteria are routinely carried out ahead of operations. However, latest figures show that 70% of tests taken in the year up to January 2022 were found to be contaminated, leading to treatment being delayed as patients are re-tested. The normal limit of contaminated tests would be below 3%. The issue was raised at a joint board meeting of the clinical commissioning groups, which oversee local healthcare, on 24 March. Katherine Kirk, chairman of quality and governance committee at the Basildon and Brentwood group, said: “If I’m understanding this right and it’s about the effectiveness of blood tests, what’s going on? It’s clearly a major failure.” Read full story Source: The Echo, 4 April 2022- Posted
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- Blood / blood products
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Content ArticleThe spread of the Covid-19 pandemic presented significant challenges in the management of patients with chronic diseases like multiple sclerosis (MS). This article in Frontiers in Neurology looks at how telemedicine was used as an alternative to face-to-face consultations with MS patients during the pandemic. Recognising the variation in care that occurred as different centres adopted telemedicine, they make a series of recommendations for the use of telemedicine in managing MS patients.
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- Multiple sclerosis
- Pandemic
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Content ArticleThis Prevention of Future Deaths report relates to the death of four patients who all died from endoscopic retrograde cholangio-pancreatography (ERCP) related complications, within a six-month period. All four patients had their treatment carried out by the same doctor during his training for this high-risk procedure. In her report, the Coroner Laurinder Bower raises concerns about the systems in place to gain consent and inform patients of the risks of these procedures.
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- Patient death
- Coroner reports
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Content ArticleThis case study looks at the issue of using ethyl chloride spray during fetal blood sampling procedures, which leaves a plastic residue on the babies scalp.
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- Obstetrics and gynaecology/ Maternity
- Baby
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Content ArticleWaiting is a feature of public healthcare systems but must be managed to avoid adverse impacts on patients. The NHS sets performance standards for waiting times for elective and cancer care. Its performance against these was deteriorating before the COVID-19 pandemic and has worsened since it began. Millions of patients’ care was disrupted, meaning backlogs increased. This report looks in detail at backlogs and waiting times for elective and cancer care in the NHS in England. It explains how the current increased backlogs and waiting times have arisen, including the impact of the COVID-19 pandemic. The report sets out: how waiting times performance for elective and cancer care are tracked in the NHS, and how long patients have been waiting relative to the performance standards; the causes of increasing longer waits before the pandemic and the disruption caused by the pandemic; and the steps the Department and NHSE&I have already taken to address the increasing backlogs and waiting times, and the constraints and challenges the NHS faces in making a full recovery.
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- Cancer
- Lack of resources
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News ArticleThe NHS may be missing more than 9 million referrals, while patients face a “postcode lottery” for cancer treatment and routine operations, a parliament watchdog has warned. Millions of patients have either avoided or been unable to obtain healthcare during the pandemic leaving the NHS with a potential unknown backlog of operations, which could push the national waiting list to 12 million by 2025. A report from the government’s National Audit Office today also warned patients across England are facing a postcode lottery in terms of waits with some hospital waiting lists far larger than others following the pandemic. Eve Byrne, head of campaigns and public affairs, at Macmillan Cancer Support, said: “This report confirms what we hear day in, day out from people living with cancer. Chronic staffing shortages are already having a devastating impact on cancer patients, and we have major concerns that is only set to worsen without urgent action. She said the government’s plan to tackle operations backlog must be backed up by steps to ensure enough nurses staff. “Without these critical pieces of the puzzle, we risk increasing numbers of people facing later diagnoses, poorer care and potentially worse chances of survival. This has to change,” she added. Read full story Source: The Independent, 1 December 2021
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- Cancer
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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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News ArticleGPs are failing to urgently refer patients with “red flag” signs of suspected cancer to a specialist, research suggests. Six out of 10 patients in England with key symptoms indicating possible cancer did not receive an urgent referral for specialist assessment within two weeks, as recommended in clinical guidelines, according to a new study. Nearly 4% of these patients were subsequently diagnosed with cancer within the next 12 months. The findings were published in the journal BMJ Quality & Safety. In the study, researchers analysed records from almost 49,000 patients who consulted their GP with one of the warning signs for cancer that should warrant referral under clinical guidelines. Of the 29,045 patients not referred, 1,047 developed cancer within a year (3.6%). Early diagnosis and prompt treatment is crucial to survival chances. Every four-week delay in cancer treatment increases the risk of death by 10%. Read full story Source: The Guardian, 5 October 2021
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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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Content Article
Prevention of Future Deaths report – Jamie Poole
Patient Safety Learning posted an article in Coroner reports
Jamie Lee Poole was diagnosed required the lifesaving surgery of a kidney transplant in 2011. After the transplant she was placed on a dose of immunosuppressant to prevent rejection of the transplanted kidney. One of the known side effects of the use of the medication is that it can cause low levels of magnesium within the body. Jamie was admitted to the Royal Stoke University Hospital on 27 June 2017 with low levels of magnesium and low calcium and was treated for correction of electrolyte disturbance. On the 28 June 2017 she was found on the floor having collapsed. It was discovered that she had significant swelling on her brain. This was caused by a lack of oxygen to the brain, which was either caused by a heart problem or a seizure, which on balance would have been caused by the low levels of magnesium. She was transferred to the intensive care unit at the Royal Stoke University, Stoke-on-Trent where she died.- Posted
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- Coroner
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Content ArticleMissed or failure to follow up on test results threatens patient safety. This qualitative study from Dahm et al. used volunteers to explore consumer perspectives related to test result management. Participants identified several challenges that patients experience with test-results management, including systems-level factors related to the emergency department and patient-level factors impacting understanding of test results.
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News ArticleWomen aged 70 or over are receiving substandard care to tackle ovarian cancer with one in five patients in their seventies getting no treatment whatsoever, a new study has found. A report from Ovarian Cancer Action revealed almost half of patients in their 70s do not undergo surgery to treat the disease, even though it provides the best long-term prognosis for one of the most common types of cancer in women. In total, around one in five (22%) of ovarian cancer patients aged 70 to 79 and three in five women with ovarian cancer who were over 80 years old were given no treatment for the disease. The inadequate healthcare given to older ovarian cancer patients causes a disproportionately high short term death rate for them, the study found. The study found older patients are substantially less likely to be referred by their GP for diagnostic tests such as ultrasounds when ovarian cancer symptoms surface. Dr Susana Banerjee, a consultant medical oncologist at The Royal Marsden, said: “With an ageing population, many more patients with ovarian cancer are over the age of 70, so there is an urgent need to understand the best way to effectively treat older women." “Optimising patients for treatment through frailty assessments and interventions, sharing best practice across cancer centres and representing older patients in clinical trials are important steps towards ensuring equal access to effective and tolerable treatment that could help more women live beyond their diagnosis, with a good quality of life, no matter their age.”
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- Older People (over 65)
- Cancer
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News Article
Smear tests: Women to trial 'do-it-at-home' kits for NHS
Patient Safety Learning posted a news article in News
About 31,000 women in London are being offered "do-it-at-home" tests to check for early warnings of cervical cancer, as part of an NHS trial. It could be a way to encourage more women to get screened, experts hope. Embarrassment, cultural barriers and worries about Covid, along with many other factors, can stop women going for smear tests at a clinic or GP surgery. Smear-test delays during the pandemic prompted calls for home-screening kits from cervical cancer charities. The swabbing involves using a long, thin cotton bud to take a sample from inside the vagina, which is then sent by post for testing. If the results reveal an infection called human papillomavirus (HPV) they will be invited to their GP for a standard smear test to closely examine the cells of their cervix. Dr Anita Lim, from King's College London, who is leading the YouScreen trial, said: "Women who don't come for regular screening are at the highest risk of developing cervical cancer. "So it is crucial that we find ways like this to make screening easier and protect women from what is a largely preventable cancer. Self-sampling is a game-changer." Read full story Source: BBC News, 24 February 2021- Posted
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