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News Article
Parents fear spread of ‘associate’ doctors at NHS will end in more tragedies
Patient Safety Learning posted a news article in News
A 30-year-old actress whose symptoms were dismissed as anxiety died of a blood clot. Emily Chesterton believed she had seen a GP, but had in fact been seen twice by a physician associate (PA), a newer type of medical role that involves significantly less training. Her parents, Brendan and Marion Chesterton, both 64 and retired teachers, said they have serious concerns about plans for thousands more PAs to be employed to combat staff shortages as part of the NHS Long Term Workforce Plan. Chesterton’s calf pain and shortness of breath should have suggested a pulmonary embolism and meant she was sent to A&E. A coroner concluded this would probably have saved her life. Instead she was told to take anxiety pills. She collapsed that evening. She was taken to hospital but her heart stopped and she could not be revived. Read full story (paywalled) Source: The Times, 10 July 2023 -
Content ArticleThis infographic by artist Sonia Sparkles highlights ways to prevent patient falls in hospital. A wide range of graphics relating to patient safety, healthcare and quality improvement is available on the Sonia Sparkles website.
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News Article
Reliance on physician associates risks patient safety, doctors say
Patient Safety Learning posted a news article in News
The use of non-medics in clinical roles is leading to deaths and missed diagnoses, senior doctors have warned. Hundreds of doctors have signed an open letter to the leadership of the Royal College of Physicians (RCP), urging them to take a stand over the rollout of physician associates (PAs). PAs are a newer type of medical role that involves significantly less training than doctors receive. The NHS has used PAs since 2003 but concerns have emerged in recent months about them taking on more advanced work than is appropriate. NHS England set out plans earlier this year to expand their numbers significantly amid ongoing staff shortages. Now an open letter to the RCP’s council, to date signed by 46 fellows of the college and 194 other doctors, sets out concerns ranging from patient safety and liability to the fact that newly qualified PAs can earn more than newly qualified doctors. They say: “There have been several high-profile incidents in which serious illness was missed by a PA when undertaking a role that would normally be filled by a doctor. In some cases, avoidable deaths have resulted. “Given that some of these conditions required more advanced training than the PA had received, the implication is that rare avoidable deaths are a price society must pay for the replacement of medical staff with non-medical staff. We believe this trade-off must be debated widely not just by doctors but also by the lay public.” Read full story (paywalled) Source: The Times, 5 October 2023 -
Event
HSIB: Investigative interviewing
Patient Safety Learning posted an event in Community Calendar
This practical course offers an overview of the principles that underpin a professional safety investigation interview with either a member of staff, a patient or a family. The course aligns to the PSIRF guidance on a systems approach to interviews. The course includes: Planning and preparing for an interview Using a structured hierarchy of questions to facilitate comprehensive, accurate information Asking system-focused questions Closing an interview Register -
Event
HSIB: Investigative interviewing
Patient Safety Learning posted an event in Community Calendar
This practical course offers an overview of the principles that underpin a professional safety investigation interview with either a member of staff, a patient or a family. The course aligns to the PSIRF guidance on a systems approach to interviews. The course includes: Planning and preparing for an interview Using a structured hierarchy of questions to facilitate comprehensive, accurate information Asking system-focused questions Closing an interview Register -
Event
HSIB: Investigative interviewing
Patient Safety Learning posted an event in Community Calendar
This practical course offers an overview of the principles that underpin a professional safety investigation interview with either a member of staff, a patient or a family. The course aligns to the PSIRF guidance on a systems approach to interviews. The course includes: Planning and preparing for an interview Using a structured hierarchy of questions to facilitate comprehensive, accurate information Asking system-focused questions Closing an interview Register -
Event
HSIB: Demystifying thematic analysis
Patient Safety Learning posted an event in Community Calendar
This session will provide an opportunity to ‘have a go’ and discuss some of the challenges and practical aspects of using thematic analysis for the purpose of learning from patient safety issues. This course is 3 hours long. On completion of the course you will receive a certificate of attendance, and as this course is CPD accredited you are awarded 3 CPD points. Register -
Event
HSIB: Demystifying thematic analysis
Patient Safety Learning posted an event in Community Calendar
untilThis session will provide an opportunity to ‘have a go’ and discuss some of the challenges and practical aspects of using thematic analysis for the purpose of learning from patient safety issues. This course is 3 hours long. On completion of the course you will receive a certificate of attendance, and as this course is CPD accredited you are awarded 3 CPD points. Register -
Event
HSIB: Demystifying thematic analysis
Patient Safety Learning posted an event in Community Calendar
untilThis session will provide an opportunity to ‘have a go’ and discuss some of the challenges and practical aspects of using thematic analysis for the purpose of learning from patient safety issues. This course is 3 hours long. On completion of the course you will receive a certificate of attendance, and as this course is CPD accredited you are awarded 3 CPD points. Register -
Event
HSIB: Demystifying thematic analysis
Patient Safety Learning posted an event in Community Calendar
untilThis session will provide an opportunity to ‘have a go’ and discuss some of the challenges and practical aspects of using thematic analysis for the purpose of learning from patient safety issues. This course is 3 hours long. On completion of the course you will receive a certificate of attendance, and as this course is CPD accredited you are awarded 3 CPD points. -
News Article
Trust sent domestic abuse victim’s address to ex-partner, says regulator
Patient Safety Learning posted a news article in News
A trust has been reprimanded by the Information Commissioner’s Office (ICO) for exposing a domestic abuse victim to risk by disclosing their address to an ex-partner. University Hospitals Dorset Foundation Trust is one of only seven organisations in the UK – and the only NHS organisation – to have received a reprimand since July 2022 for a data breach involving a victim of domestic abuse. According to new details released by the ICO, University Hospitals Dorset received a reprimand in April this year over a procedure it had in place that, when sending correspondence by letter, would include the full addresses of all recipients of that letter without their consent to do so. In the case that was referred to the ICO, the subject of the data breach had their full address revealed to their ex-partner despite previous allegations of abuse, which has created a “risk of unwanted contact which will remain”. The ICO concluded that, while the subject did not request their address be withheld, it would not be a reasonable expectation that personal information would be shared without prior consent. The report raised concerns that UHD did not have a clear policy in place for managing situations where there are parental disputes and that no formal training was provided to administrative staff for dealing with such circumstances. Read full story (paywalled) Source: HSJ, 2 October 2023 -
News Article
NHS only gains one ‘full-time’ GP for every two trainees, report finds
Patient Safety Learning posted a news article in News
The NHS has to train two GPs to produce one full-time family doctor because so many have started to work part-time, new research reveals. The finding helps explain why GP surgeries are still struggling to give patients appointments as quickly as they would like, despite growing numbers of doctors training to become a GP. The disclosure is contained in a report by the Nuffield Trust health thinktank that lays bare the large number of nurses, midwives and doctors who quit during their training or early in their careers. “These high dropout rates are in nobody’s interest,” said Dr Billy Palmer, a senior fellow at the thinktank and co-author of the report. “They’re wasteful for the taxpayer, often distressing for the students and staff who leave, stressful for the staff left behind, and ultimately erode the NHS’s ability to deliver safe and high-quality care.” Read full story Source: The Guardian, 28 September 2023 -
Content Article
The SACCIA approach by Professor Annagret Hannawa
Patient-Safety-Learning posted an article in Culture
Achieving shared interpersonal understanding between healthcare professionals, patients and families is a core patient safety challenge around the world. The SACCIA model promotes safe communication practice amongst healthcare teams and between providers patients. It was developed by Professor Annagret Hannawa, Director of the Center for the Advancement of Healthcare Quality & Safety in Switzerland. The interpersonal processes that are captured in the SACCIA acronym are considered 'safe' because they lead to a shared understanding between all care participants: Sufficiency Accuracy Clarity Contextualization Interpersonal Adaptation The five SACCIA competencies emerged from a communication science analysis of hundreds of critical healthcare incidents. They were identified as common deficient interpersonal processes that often cause and contribute to preventable patient harm and insufficient care. They therefore represent an evidence-based set of core competencies for safe communication, which constitute the vehicle to patient care that is safe, efficient, timely, effective and patient-centred. -
News Article
Lip fillers: Call for tighter regulation after botched treatments
Patient Safety Learning posted a news article in News
Lip fillers have grown increasingly popular but the industry is "like the wild west", experts warn, with many patients left in pain and embarrassed by their appearance. As Harriet Green left a salon after getting an injection to add volume to her lips, she was reassured the excess swelling would go down. But three months later her lips were still so bloated she could not close her mouth properly. The 22-year-old from Acle in Norfolk needed three corrective procedures - costing a total of more than £700 - to get them back to normal. Dr Saba Raja, a GP who runs her own aesthetics clinic in Norwich, says she is increasingly having to correct treatments which have gone wrong, describing the experience as "really distressing". "Every month I'm getting enquires from young girls who have gone to a non-medical practitioner for lip or tear trough fillers under the eye and had complications. "They often try to contact the practitioner but due to lack of training they are unable to deal with the complications. It is becoming more and more of a problem." Dr Raja describes the industry as "like the wild west", with people injecting patients "out of the back of their cars" and in kitchens. "Anti-wrinkle injections (Botox) are prescription-only but the injector can be anybody who has been on a day course. Dermal filler (for the lips and face) is not even a prescription-only medication, you can buy it off any website," she says. "A lot of non-medical practitioners are buying cheap filler online, with no idea where it has come from. We really need strict regulations and minimum training standards." Read full story Source: BBC News, 9 May 2023 -
Content ArticleOne in three medical students plan to quit the NHS within two years of graduating, either to practise abroad or abandon medicine altogether, according to a survey published in BMJ Open. Poor pay, work-life balance and working conditions of doctors in the UK were the main factors cited by those intending to emigrate to continue their medical career. The same reasons were also given by those planning to quit medicine altogether, with nearly 82% of them also listing burnout as an important or very important reason. The findings from the study of 10,486 students at the UK’s 44 medical schools triggered calls for action to prevent an exodus of medical students from the NHS.
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Content Article
A strategy for the care workforce (TUC, August 2023)
Patient-Safety-Learning posted an article in Social care
The Trade Unions Congress (TUC) is proposing a new care workforce strategy for England, developed with trade unions and informed by the voice and experiences of care workers. This strategy document sets out the critical building blocks to ensure care workers are valued and supported, as a key means of addressing the current staffing crisis and improving access to and quality of social and childcare services. -
Content ArticleLearn about some of the clinical supervision models used for registered healthcare professionals to enhance personal and professional development.
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News Article
Blackpool death: Abortion sepsis risk training inadequate
Patient Safety Learning posted a news article in News
Doctors are receiving "inadequate" training about the risk of sepsis after a mother-of-five died following an abortion, a coroner has warned. Sarah Dunn, 31, died of "natural causes contributed to by neglect" in hospital on 11 April 2020, an inquest found. Assistant coroner for Blackpool and Fylde, Louise Rae, said Ms Dunn had been treated as a Covid patient even though the "signs of sepsis were apparent". Her cause of death was recorded as "streptococcus sepsis following medical termination of pregnancy". In her record of inquest, the coroner noted Ms Dunn was admitted to Blackpool Victoria Hospital in Lancashire on 10 April 2020. She was suffering from a streptococcus infection caused by an early medical abortion on 23 March, which had produced sepsis and toxic shock by the time she was admitted to hospital. The coroner said "signs of sepsis were apparent" before and at the time of Ms Dunn's hospital admission but she was instead treated as a Covid-19 patient. "Sepsis was not recognised or treated by the GP surgery, emergency department or acute medical unit and upon Sarah's arrival at hospital, the sepsis pathway was not followed," she added. Read full story Source: BBC News, 19 May 2022 -
News Article
NHS risks losing GPs to ‘nonsensical’ immigration rules, Priti Patel told
Patient Safety Learning posted a news article in News
Hundreds of overseas-born trainee GPs are at risk of deportation because of “nonsensical” immigration rules, the profession’s leader has warned Priti Patel. The NHS risks losing much-needed family doctors unless visa regulations are overhauled to allow young medics to stay in Britain at the end of their GP training, Prof Martin Marshall said. Marshall, the chair of the Royal College of GPs, has written to Patel, the home secretary, demanding that she scrap “bureaucratic” hurdles affecting would-be GPs from abroad. He told the Guardian: “At a time when general practice is experiencing the most severe workload pressures it has ever known, it is nonsensical that the NHS is going to the expense of training hundreds of GPs each year who then face potential deportation by the Home Office because of an entirely avoidable visa issue. “We cannot afford to lose this expertise and willingness to work in the NHS, delivering care to patients, due to red tape.” The threat to foreign-born GP trainees has arisen because current immigration rules state that “international medical graduates” (IMGs) can be given indefinite leave to remain only after they have been in the country for five years, but GP training lasts for only three years. Read full story Source: The Guardian, 17 May 2022 -
News Article
Staff warn of ‘worsening’ culture at beleaguered trust
Patient Safety Learning posted a news article in News
The culture at a long-troubled ambulance trust is ‘worsening, not improving’, its staff have told a health watchdog. Concerns about culture and patient safety at East of England Ambulance Service Trust (EEAST) were raised to inspectors at the Care Quality Commission (CQC) during an inspection of the trust last month, according to public documents. In a feedback letter to the trust following the inspection, the CQC said staffing at EEAST’s control room was below planned levels, and the inspectors were “not assured that staffing levels met the demands within the service and this may impact on patient safety when managing the high volume of calls”. The trust, which is in the equivalent of special measures and currently rated “requires improvement” by the CQC, has had long-standing cultural problems and last year signed a legal agreement with the Equality and Human Rights Commission on how it would protect staff from sexual harassment. According to the feedback letter, staff described a “worsening, not improving, culture” and said the workforce was “tired” and not receiving mandatory training, one-to-ones with managers or appraisals. The letter, published in the trust’s latest board papers, also reported inspectors raising concerns about potential risks to patients over the management of the trust’s call stack and a lack of consistency over “standard operating procedures”. Additionally, some staff in the control room on an accelerated training programme were unable to undertake full patient assessments and had to call for assistance from others. Read full story (paywalled) Source: HSJ, 11 May 2022 -
News Article
Governance scandal trust failing to manage complaints
Patient Safety Learning posted a news article in News
A trust which is facing major governance issues is failing to respond to hundreds of complaints properly, with patients and families waiting more than twice as long as the NHS target for responses to their concerns, an external review has found. Cornwall Partnership Foundation Trust, which is subject to regulatory action by NHS England, was found to be “not classifying complaints, concerns and comments accurately”, while staff had “no formal training”, meaning complaints were “not investigated appropriately”. Last year, the trust was embroiled in a governance scandal in which NHSE investigated multiple allegations of finance and governance failings, resulting in the departure of former CEO Phil Confue. Rachel Power, chief executive of the advocacy group Patients Association, told HSJ patient complaints often contain “vital intelligence” on how trusts can improve services and “essential warnings about any area where things might be going wrong”. According to the review, the backlog had stemmed from several factors. These included more work being needed on investigations that had not been thorough enough, and the relevant service teams not responding to enquiries by the complaints team. Additionally, there was a “lack of formal monitoring and review” to ensure complaint points were reported appropriately and consistently, and an “apparent lack of accountability by local teams for complaints” triaged through the trust’s patient liaison and complaints team. Read full story (paywalled) Source: HSJ, 12 April 2022- Posted
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News Article
GP practices training receptionists to do blood tests
Patient Safety Learning posted a news article in News
A number of London GP practices are training their receptionists to do blood tests, Pulse has learned. Professor Sir Sam Everington, a GP and chair of Tower Hamlets CCG, told Pulse that ‘lots of practices’ in the area have taken the step, including his own. Training a receptionist to carry out blood tests – which can be done in just six weeks – provides much-needed support to pressured practices, he said. Dr Everington told Pulse: ‘A lot of our receptionists have signed up to be phlebotomists and they love it because actually, phlebotomy is not just about taking blood. "You get to know all the patients with long-term conditions and so our phlebotomists know all these patients." He added that reception teams are a ‘fertile recruitment ground’ for a phlebotomist. They can ‘manage even the most terrified patients’ and have ‘amazing’ clinical skills. Dr Everington suggested that training receptionists as phlebotomists can help build trust with patients who are suspicious about having to describe their symptoms for triage by reception staff. But he said that the extra role just ‘acknowledges’ that all members of practice staff are ‘part of the clinical team’. He told Pulse: "In our practice, we all train together. We have meetings together, the whole team, and it’s acknowledging in this modern world that actually every member of your staff is a clinician – part of the clinical team – because there are always things they will do or can do that will have an impact clinically." "There isn’t a hidden supply of GPs out there in the next few years. It takes 10 years to train GPs so actually help is going to come from a wider team base." Read full story Source: Pulse, 31 March 2022 -
News Article
Learning disability training for all nurses set to be mandated in law
Patient Safety Learning posted a news article in News
Members of the House of Lords have passed an amendment to the Health and Care Bill to enshrine mandatory training for health and care staff on learning disabilities and autism in law. The Oliver McGowan Mandatory Training in Learning Disabilities and Autism programme is being developed by Health Education England in partnership with organisations such as Skills for Care and the Department of Health and Social Care, and alongside Oliver’s family. “It means that organisations have no choice but to free up their staff to attend this training” The training is named after Oliver whose death shone a light on the need for health and social care staff to have better training on learning disabilities and autism, and has been campaigned for by his parents Paula and Tom McGowan who believe his death was avoidable. The 18-year-old, who had mild hemiplegia, focal partial epilepsy, a mild learning disability and high-functioning autism, died in November 2016 after he was given antipsychotic medication even though he and his family warned it could be harmful to him. Following campaigning efforts and a consultation on training proposals for health and care staff, in November 2019, the government committed to developing a standardised training package. It draws on existing best practice, the expertise of people with autism, people with a learning disability and family carers and subject matter experts. Read full story Source: Nursing Times, 18 March 2022 -
News Article
791 medical graduates could miss out on NHS junior doctor training
Patient Safety Learning posted a news article in News
The highest ever number of medical students have been told there are no places for them this year, despite the health service’s crippling shortage of medics. The risk that young would-be doctors may not be allocated to start their training at a hospital in the UK has sparked concern among the medical students affected, as well as medical organisations. Pressure is growing for action to close the gap between the number of training places available across the NHS and the number of graduates seeking one, so medical talent is not wasted and hospitals hire as many fresh recruits as they can to help tackle the widespread lack of medics. Doctors are worried that the mismatch between demand for and supply of training places will lead to the NHS missing out on medics it sorely needs and that some of those denied a place will either go to work abroad instead or give up medicine altogether. The most recent official figures showed that the NHS in England is short of almost 8,200 doctors. Dr Dustyn Saint, a GP in Norfolk, tweeted the health secretary, Sajid Javid, about the situation, saying: “Sajid Javid sort this out! You know how much general practice needs these people in a few years, standing by and doing nothing is inexcusable.” Another doctor said: “It’s bonkers that 800 would-be doctors could be denied training places at a time when the NHS in England is short of 8,200 doctors.” The British Medical Association has voiced concern about the large number of unallocated medics. “Now we have a situation where a record number are left with unnecessary uncertainty about where they are headed this August,” said Khadija Meghrawi, the co-chair of its medical students committee. “In a time where student mental health is declining, this additional source of uncertainty and stress is particularly unfair.” Read full story Source: The Guardian, 15 March 2022 -
News Article
RCN launches toolkit to help nursing staff raise concerns
Patient Safety Learning posted a news article in News
The Royal College of Nursing (RCN) has designed a 'Raising Concerns toolkit', which includes information to help members navigate the process of escalation, from identifying a potential concern through to formally reporting it to senior colleagues. It’s been designed to help members decide when to escalate a workplace issue and includes a flowchart to support them in deciding what, when and how to report concerns. The toolkit outlines the types of concerns that might be raised such as staffing and patient safety, a lack of support or training, as well as cultural or criminal issues. It supports nursing staff to understand the importance of remaining factual, staying neutral and keeping records of events. RCN Deputy Director of Nursing Eileen Mckenna said: “We know that raising a concern at work isn’t easy, but it safeguards nursing staff and can provide learning opportunities. Our Raising Concerns toolkit can be used by nurses, nursing associates, students and health care support workers in the NHS and independent sector to help them through the process of escalating an issue. “All workplaces that employ nursing staff should have a culture of safety and focus on system learning, not individual blame in the event of a mistake being made. We will always support members who challenge unsafe practices, processes or conditions at work in the interests of their own safety and that of patients. It’s an important skill that promotes psychological safety, a positive learning environment and wellbeing.” Read full story Source: RCN, 2 March 2022
