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News Article
Would you want to be treated by a 'medic' with just two years' training?
Patient Safety Learning posted a news article in News
Peter Marshall was delighted when he finally got an appointment after calling his GP surgery for several days. On the day, he saw a young medic who said his excruciating stomach pain was caused by irritable bowel syndrome (IBS) and suggested over-the-counter peppermint tablets to ease the discomfort. And off the 69-year-old retired IT specialist went, happy to have a diagnosis and treatment. In fact, Peter hadn't had an appointment with a GP — he had been seen by a physician associate (PA). This is a type of healthcare worker whose numbers are about to soar in the NHS in order to reduce the pressure on doctors so that they can concentrate on the most complex and seriously ill patients. It all sounds like a great idea. Indeed, PAs are now being employed across areas that are particularly stretched, with around a third of PAs working in GP surgeries and 10% in A&E departments, according to the latest census by the Royal College of Physicians. But they are actually spread across 46 NHS specialties, from urology and surgery to cardiology and mental health. In this role, they are permitted to carry out a range of medical tasks, from performing physical examinations, diagnosing patients and analysing test results to running clinics and performing minor procedures — as well as doing home visits — all under the supervision of a doctor. However, in the case of Peter Marshall, although he was reassured by his diagnosis, his symptoms were, in fact, a sign of bowel cancer — and he died nine months later, in January this year. His sister, who has told Good Health his story, says: 'My brother had no idea that he had seen a PA and not a qualified doctor — he didn't know the word physician associate even existed, no one does.' The family, from London, later received an apology from the PA. 'Patients are so desperate to get an appointment with their GP, you are grateful to see anyone and whatever they say, you accept,' she says. Read full story Source: Daily Mail, 9 October 2023 -
Content Article
In this blog, Professor of Medical Education Kate Owen explains how her team has embedded a session on patient safety in the final year curriculum at Warwick Medical School. Using a real-life story posted on the Care Opinion website, the session gives medical students an opportunity to use investigation tools, understand NHS reporting systems and consider the importance of compassionate communication with harmed patients and their families. -
Content Article
In a recent report, the Professional Standards Authority (PSA) for Health and Social Care sets out its view on the biggest challenges affecting the quality and safety of health and social care. In this blog, Alan Clamp, PSA's chief executive, summarises these challenges and the possible solutions. You can also read Patient Safety Learning's reflections on the PSA report here.- Posted
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Content Article
This is part of our series of Patient Safety Spotlight interviews, where we talk to people working for patient safety about their role and what motivates them. Tracey talks to us about how her love of applying psychology led to her role in patient safety, the importance of putting users at the centre of developing the Patient Safety Incident Response Framework (PSIRF), and what we can learn from magicians about patient safety.- Posted
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Content ArticleThis report by the Nuffield Trust looks at workforce training issues in England, arguing that the domestic training pipeline for clinical careers has been unfit for purpose for many years. It presents research that highlights leaks across the training pathway, from students dropping out of university, to graduates pursuing careers outside the profession they trained in and outside public services. Alongside high numbers of doctors, nurses and other clinicians leaving the NHS early in their careers, this is contributing to publicly funded health and social care services being understaffed and under strain. It is also failing to deliver value for money for the huge taxpayer investment in education and training.
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Content ArticleNHS England provides regular updates on progress with the implementation of the Digital Clinical Safety Strategy to show how they've captures insights about digital clinical safety, how they are training their workforce to support safety in this area and how they use technology to drive safer care.
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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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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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