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Found 457 results
  1. Content Article
    This report, from the Healthcare Safety Investigation Branch (HSIB), provides insight into a current safety risk that was identified on a referral. The referral was about difficulties in identifying clinical deterioration in patients with COVID-19 on general wards. The Royal College of Physicians (RCP) highlighted the issue of rapid deterioration in oxygenation in patients with COVID-19 and how this might relate to the use of early warning scores.
  2. Content Article
    In this article, published by Refinery 29, author Sarah Graham talks about gender bias in healthcare and the risk to patient safety.
  3. Content Article
    This bedside guide, from the Chartered Institute of Ergonomics and Human Factors, is intended for the use of all healthcare staff who are looking after adult patients with tracheostomies. The tasks described should not be attempted by those who have not received training or been deemed as competent in tracheostomy care and management. This guide includes posters, checklists and practical resources to aid the safe care of patients with tracheostomies.
  4. News Article
    A former senior NHS official plans to sue the organisation after he had to pay a private hospital £20,000 for potentially life-saving cancer surgery because NHS care was suspended due to COVID-19. Rob McMahon, 68, decided to seek private treatment after Worcestershire Acute Hospitals NHS trust told him that he would have to wait much longer than usual for a biopsy. He was diagnosed with prostate cancer after an MRI scan on 19 March, four days before the lockdown began. McMahon was due to see a consultant urologist on 27 March but that was changed to a telephone consultation and then did not take place for almost two weeks. “At that appointment, the consultant said: ‘Don’t worry, these things are slow-growing. You’ll have a biopsy but not for two or three months.’ I thought, ‘that’s a long time’, so decided to see another consultant privately for a second opinion.” A PET-CT scan confirmed that he had a large tumour on both lobes of the prostate and a biopsy showed the cancer was at risk of breaking out of the prostate capsule and spreading into his body. He then paid to undergo a radical prostatectomy at a private Spire hospital. “This is care that I should have had on the NHS, not something that I should have had to pay for myself. I had an aggressive cancer. I needed urgent treatment – there was no time to waste,”, he said. “With the pandemic, he added, “it was almost like a veil came down over the NHS. He worked for the NHS for 17 years as a manager in hospitals in London, Birmingham and Redditch, Worcestershire, and was the chief executive of an NHS primary care trust in Leicester.” Mary Smith of Novum Law, McMahon’s solicitors, said: “Unfortunately, Rob’s story is one of many we are hearing about from cancer patients who have been seriously affected by the disruption to oncology services as a result of COVID-19." Read full story Source: The Guardian, 11 July 2020
  5. Content Article
    Early clinical experiences have demonstrated the wide spectrum of COVID-19 presentations, including various reports of atypical presentations of COVID-19 and possible mimic conditions. This article, published in the BMJ, summarises the current evidence surrounding atypical presentations of COVID-19 including neurological, cardiovascular, gastrointestinal, otorhinolaryngology and geriatric features. 
  6. Event
    until
    The number one focus in the world right now is health care and the critical need to bring greater efficiency to treating patients. During the COVID-19 pandemic, vast amounts of information are rapidly cross-crossing the globe. Governments, health systems, and research communities in the European region are looking to learn as much as possible from each other, as quickly as possible, about the nature of COVID-19 and the most effective interventions for preventing and treating it. We cannot afford to ignore the clear signs pointing to a new future of increased care needs, labour shortages, and operational strain. From COVID-19 to general routine care, we must act now to ensure that no patient waits for the care they need. For health care professionals looking to structure their leadership plans around lessons learned in the field comes the 'Hospital Flow in the UK: During and Beyond COVID-19'. In this online course from the Institute for Healthcare Improvement (IHI), health care leaders address challenges and share successes, best practices, and strategies to effectively advance the long-term goal of improving community health in a post-COVID world. Experts will discuss noteworthy global challenges and responses to COVID-19, specifically focusing on efforts in the United Kingdom (UK) to monitor and quickly improve treatment for patients across the care continuum. Further information and registration
  7. Content Article
    An increasing number of people with confirmed or suspected COVID-19 are continuing to struggle with prolonged, debilitating and sometimes severe symptoms months later.[1] Many were never admitted to hospital and have instead been trying to manage their symptoms and recovery at home. These patients are sometimes referred to as the ‘long-haulers’ or described as having ‘post-acute’, ‘chronic’ or ‘long-term’ COVID-19. Here, we will use the term ‘Long COVID’. With social distancing restrictions still in place, patients in the UK and across the world have been turning to social media support networks[2] to connect with others who are experiencing similar challenges. These patients have raised very credible concerns about the care they are receiving[3] and the uncertainties they face. Their concerns are revealing many implications for patient safety. We have recently shared on the hub the story of Dr Jake Suett[4], one of the many people experiencing symptoms of Long COVID. When we conclude this article, we will return to his story and highlight the changes that he is calling for. However, first, we will focus on the patient safety aspects of Long COVID, highlighting key areas of concern and action needed (a full list of actions can be found summarised here).
  8. Content Article
    This article from Perlin et al. discusses how a 173-hospital system used technology as a strategy to reduce sepsis-related mortality system-wide by real-time dissemination of basic laboratory and clinical data to alert teams to patients exhibiting signs of sepsis risk.
  9. Content Article
    The Care Quality Commission (CQC) inspected 65 services that provides solely cosmetic surgery and/or hair transplant surgery. This represents just under two thirds of those currently registered. Professor Ted Baker, CQC’s Chief Inspector of Hospitals has written to all independent cosmetic surgery providers. His letter highlights these emerging concerns and clarifies the standards of patient care that CQC expect and patients deserve. It also reminds providers of their responsibility to deliver safe and effective services.
  10. Content Article
    This ‘Erice Call for Change’ is a report from a group of experts, patients and patient representatives who met in Erice in September 2019 following previous similar meetings after the original Erice Declaration (1996). The aim of the meeting was to discuss the challenge of causal complexity and individual variation in modern healthcare. The group’s concern was the impact that new clinical decision-making tools, based on statistical correlations in large databases, could have on individual patient care if they replace other types of clinical investigation and knowledge. The group calls for a change in the approach to the care of the individual patient, and indicates some specific challenges to overcome for such changes to happen.
  11. News Article
    More children died after failing to get timely medical treatment during lockdown than lost their lives because of coronavirus, new research by the Royal College of Paediatrics and Child Health (RCPCH) suggests. Six children under the age of 16 have died from COVID-19 in Britain since the pandemic began, according to the Office for National Statistics (ONS). However, seeking medical help too late was a contributory factor in the deaths of nine children in paediatric care new analysis has found, with the figure likely to be higher. A survey of 2,433 paediatricians, carried out by the RCPCH, found that one in three handling emergency admissions had dealt with children who turned up later than usual for diagnosis or treatment. Read full story (paywalled) Source: The Telegraph, 25 June 2020
  12. News Article
    Low dose dexamethasone reduces deaths in patients hospitalised with COVID-19 who need ventilation, according to preliminary results from the RECOVERY trial. The drug was also found to reduce deaths by one-fifth in other hospitalised patients receiving oxygen only, but no benefit was seen among COVID-19 patients who did not need respiratory support. The chief investigators from the University of Oxford trial said that the findings represent a “major breakthrough” which is “globally applicable” as the drug is cheap and readily available. Peter Horby, Professor of Emerging Infectious Diseases at the University of Oxford and a chief investigator on the trial, added, “This is the only drug that has so far been shown to reduce mortality, and it reduces it significantly. It is a major breakthrough.” Read full story Source: BMJ, 16 June 2020
  13. News Article
    A leading doctor has warned that trusts will struggle to get back to anything like pre-covid levels of endoscopy services and will need to prioritise which patients are diagnosed. Endoscopy procedures are part of the diagnostic and treatment pathway for many conditions, including bowel cancer and stomach ulcers. Most hospitals have not done any non-emergency procedures since the middle of March because they are aerosol generating — meaning a greater covid infection risk and need for major protective equipment. Although some areas are now starting to do more urgent and routine work, capacity is severely limited. Kevin Monahan, a consultant gastroenterologist at St Marks’s Hospital, part of London North West Healthcare Trust, and a member of the medical advisory board for Bowel Cancer UK, said the time taken for droplets to settle in rooms after a procedure can be up to an hour and three quarters, depending on how areas are ventilated. Only then can the room be cleaned and another patient seen. Dr Monahan said his trust had restarted some endoscopy work and was currently doing around 17 per cent of its pre-covid activity. “We can provide a maximum of about 20 per cent of normal activity — and that is using private facilities for NHS patients,” he said. “I am not at all confident we will be able to double what we are doing now, even in three to four months’ time." Read full story Source: HSJ, 12 June 2020
  14. News Article
    The government urgently needs to set out a plan to reduce the huge backlog of patients waiting for NHS treatments unrelated to COVID-19 in the wake of the pandemic, the BMA has said. The call came as the BMA released the results of its latest survey of over 8000 doctors. It found that more than half (3754 of 7238) were either not very confident or not confident at all that their department would be able to manage patient demand as NHS services resumed. “The government must be honest with the public about the surge to come and start meaningful conversations with frontline clinicians about how we can, together, begin to tackle the backlog,” said the BMA’s chair of council, Chaand Nagpaul. “Covid-19 has brought with it the worst health crisis in a century. The NHS must not return to its previous perilous state.” Read full story Source: BMJ, 4 June 2020
  15. News Article
    The postponement of tens of thousands of hospital procedures is putting the lives of people with long-term heart conditions at risk, according to the British Heart Foundation. The coronavirus pandemic has created a backlog which would only get larger as patients waited for care, it said. People with heart disease are at increased risk of serious illness with COVID-19, and some are shielding. The BHF estimates that 28,000 procedures have been delayed in England since the outbreak of coronavirus in the UK. These are planned hospital procedures, including the implanting of pacemakers or stents, widening blocked arteries to the heart, and tests to diagnose heart problems. People now waiting for new appointments would already have been waiting for treatment when the lockdown started, the charity said, as it urged the NHS to support people with heart conditions "in a safe way". Read full story Source: 5 June 2020
  16. News Article
    A trial has been launched in the UK to test whether ibuprofen can help with breathing difficulties in COVID-19 hospital patients. Scientists hope a modified form of the anti-inflammatory drug and painkiller will help to relieve respiratory problems in people who have more serious coronavirus symptoms but do not need intensive care unit treatment. Half the patients participating in the trial will be administered with the drug in addition to their usual care, while the other half will receive standard care to analyse the effectiveness of the treatment. Read full story Source: The Independent, 3 June 2020
  17. News Article
    The use of electroconvulsive therapy (ECT) to treat depression should be immediately suspended, a study says. ECT involves passing electric currents through a patient's brain to cause seizures or fits. Dr John Read, of the University of East London said there was "no place" for ECT in evidence-based medicine due to risks of brain damage, but the Royal College of Psychiatrists said ECT offers "life-saving treatment" and should continue in severe cases. The National Institute for Health and Care Excellence (NICE) currently recommends the use of ECT for some cases of moderate or severe depression as well as catatonia and mania. However, peer-reviewed research published in the journal Ethical Human Psychology and Psychiatry concludes "the high risk of permanent memory loss and the small mortality risk means that its use should be immediately suspended". In response to the study, the Royal College of Psychiatrists said ECT should not be suspended for "some forms of severe mental illness". Dr Rupert McShane, chair of the college's Committee on ECT and Related Treatments, said there was evidence showing "most people who receive ECT see an improvement in their condition". "For many, it can be a life-saving treatment," he said. "As with all treatments for serious medical conditions - from cancer to heart disease - there can be side-effects of differing severity, including memory loss." Read full story Source: BBC News, 3 June 2020
  18. News Article
    About 2.4 million people in the UK are waiting for cancer screening, treatment or tests, as a result of disruption to the NHS during the past 10 weeks, according to Cancer Research UK. It estimates 2.1 million have missed out on screening, while 290,000 people with suspected symptoms have not been referred for hospital tests. More than 23,000 cancers could have gone undiagnosed during lockdown. Chief executive Michelle Mitchell said COVID-19 has placed an "enormous strain on cancer services". "The NHS has had to make very hard decisions to balance risk," she said. "...there have been some difficult discussions with patients about their safety and ability to continue treatment during this time. Prompt diagnosis and treatment remain crucial to give people with cancer the greatest chances of survival and prevent the pandemic taking even more lives." To ensure no-one is put at risk from the virus now that cancer care is returning, Cancer Research UK said "frequent testing of NHS staff and patients, including those without symptoms" was vital. Read full story Source: BBC News, 1 June 2020
  19. News Article
    Dental practices in England have been told they can reopen from Monday 8 June, if they put in place appropriate safety measures. All routine dental care in England has been suspended since 25 March. The British Dental Association (BDA) has welcomed the announcement but says key questions remain. Currently, any patient with an emergency dental problem is supposed to be referred to an Urgent Dental Care (UDC) hub for treatment. In a letter to all practices, NHS England's chief dental officer, Sara Hurley, said: "Today, we are asking that all dental practices commence opening from Monday, 8 June for all face-to-face care, where practices assess that they have the necessary IPC and PPE requirements in place." The BDA said that while dentists would be relieved by the announcement, the ability of practices to reopen would depend on the availability of personal protective equipment (PPE). "It is right to allow practices to decide themselves when they are ready to open. Dentists will be keen to start providing care as soon as is safely possible, but we will need everyone to be patient as practices get up and running," said BDA chairman Mick Armstrong. Read full story Source: BBC News, 28 May 2020
  20. News Article
    Selected NHS coronavirus patients will soon be able to access an experimental treatment to speed up their recovery, with the health secretary Matt Hancock suggesting it is probably “the biggest step forward’’ in medication since the beginning of the COVID-19 crisis. The anti-viral drug remdesivir will be made available to patients meeting certain clinical criteria to support their recovery in hospital. The drug is currently undergoing clinical trials around the world, including in the UK, and peer-reviewed data showed it can shorten the time to recovery by about four days. Treatment will initially be prioritised for patients who have the greatest likelihood of deriving the most benefit, according to the Department of Health and Social Care (DHSC). Satisfied the drug can help boost recovery, the government’s Medicines and Healthcare products Regulatory Agency (MHRA) approved the use of remdesivir through its early access to medicines scheme. The experimental anti-viral drug was granted emergency authorisation to treat Covid-19 in the US by the Food and Drug Administration earlier this month. Read full story Source: The Independent, 26 May 2020
  21. News Article
    NHS England has said disabled and vulnerable patients must not be denied personalised care during the coronavirus pandemic and repeated its warning that blanket do not resuscitate orders should not be happening. In a joint statement with disabled rights campaigner and member of the House of Lords, Baroness Jane Campbell, NHS England said the COVID-19 virus and its impact on the NHS did not change the position for vulnerable patients that decisions must be made on an individualised basis. It said: “This means people making active and informed judgements about their own care and treatment, at all stages of their life, and recognises people’s autonomy, as well as their preferences, aspirations, needs and abilities. This also means ensuring reasonable adjustments are supported where necessary and reinforces that the blanket application of do not attempt resuscitation orders is totally unacceptable and must not happen.” Read full story Source: The Independent, 26 May 2020
  22. Content Article
    Alexander James Davidson was aged 17 years and 6 months when he died at the Queens Medical Centre on 26 February 2018. Alex was previously fit and well before suddenly taking ill with abdominal pain on 17 January 2018. Between that date and his admission to the Queens Medical Centre on 8 February 2018, Alex made contact with his GP on three occasions, had four telephone triage assessments undertaken by the NHS 111 service and two admissions to his local Accident & Emergency Department at the Kingsmill Hospital. Alex’s symptoms of sudden onset acute abdominal pain, tachycardia, and vomiting and diarrhoea were attributed either to stress or to a bout of gastroenteritis. At no stage prior to 8 February 2018 was gallstones or pancreatitis considered as a differential diagnosis. When Alex was eventually admitted to the Queens Medical Centre Emergency Department on 8 February 2018, he was found to be septic as a result of an infected and necrotic pancreatic pseudocyst, which had evolved as a complication of gallstone pancreatitis, a rare condition in someone of Alex’s age. Despite medical intervention, Alex did not survive. The inquest explored the medical treatment and intervention that Alex received in the six weeks prior to his death. The medical evidence concluded that the pancreatic pseudocyst had likely formed by the time Alex began vomiting on 18 January 2018, and from that point onwards, it was unlikely he would survive even with treatment on account of the high mortality rate associated with this condition
  23. Content Article
    Sebastian Hibberd, 6 years old, became ill on Saturday 10 October having developed intussusception of the bowel. He deteriorated over the weekend. His father sought medical advice on the Monday from NHS 111 and from his GP's surgery. Sebastian's condition went unrecognised as being life threatening. There were several missed opportunities for him to receive life saving treatment. Sebastian suffered a cardiac arrest and transferred to Derriford Hospital where he sadly died in the Emergency Department shortly after his arrival on the 12 October.
  24. News Article
    The leader of the NHS’ pandemic testing programme has highlighted concerns about the rate of COVID-19 transmissions in hospitals, HSJ can reveal. NHS England’s patient safety director Dr Aidan Fowler told an industry webinar that he and his team “are concerned about the rates of nosocomial spread within our hospitals”. Dr Fowler leads the NHS and Public Heath England testing programme (know as “pillar one”). He said the concerns had led to a focus on discovering where transmissions of covid-19 are occurring in hospitals, and how the NHS can reduce the rate of staff and patients becoming infected while on the NHS estate. His comments come as the NHS attempts to restart the provision of routine elective care and prepares for a significant increase in emergency admissions. The NHS has been told to create separate areas for covid positive and negative patients where possible, regardless of what they are being treated for. Patients are being to self-isolate at home for two weeks before attending hospital for treatment. Read full story Source: HSJ, 18 March 2020
  25. Content Article
    Conscious sedation can help a patient undergo dental treatment. There are several reasons why they may need sedation – anxiety, medical needs or complex treatment. The Care Quality Commission (CQC) outlines the regulations and standards of conscious sedation.
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