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Content Article
Molnupiravir plus usual care versus usual care alone as early treatment for adults with COVID-19 at increased risk of adverse outcomes (PANORAMIC): an open-label, platform-adaptive randomised controlled trial (22 December 2022)
Patient Safety Learning posted an article in Data, research and statistics
The safety, effectiveness, and cost-effectiveness of molnupiravir, an oral antiviral medication for SARS-CoV-2, has not been established in vaccinated patients in the community at increased risk of morbidity and mortality from COVID-19. In this study, Butler et al. aimed to establish whether the addition of molnupiravir to usual care reduced hospital admissions and deaths associated with COVID-19 in this population. The authors conclude that molnupiravir did not reduce the frequency of COVID-19-associated hospitalisations or death among high-risk vaccinated adults in the community. -
Content ArticleA Channel 5 News investigation has found nearly three quarters of people getting help for Long Covid weren't given a face-to-face appointment. It's estimated 2.1 million UK people have the condition. A Long Covid hauler herself, 5 News reporter Ruth Liptrot looks at where we're at with finding a treatment.
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Content ArticlePatients are facing increased delays at almost every stage of their NHS treatment, as the health system struggles to find the resources to deal with demand. The latest data shows waiting lists across England have surpassed record highs every month for two years running, one of many major challenges currently facing the NHS. But what impact does this have on ordinary people trying to access the NHS in 2022? Through a combination of interviews with health professionals and analysis of official data, the Guardian has plotted the journeys of four fictional patients through their NHS journey and how waiting times have changed at each stage of their treatment and recovery.
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Content ArticleThis is an Adjournment Debate from the House of Commons on Wednesday 30 November 2022 on patient safety concerns relating to the diagnosis of pulmonary embolisms.
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Content ArticleA complaint from a patient was made to the Scottish Public Services Ombudsman (SPSO) about the care and treatment provided during the period January 2018 to September 2021. In January 2018 the patient underwent emergency surgery for a perforated sigmoid diverticulum (a complication of diverticulitis, an infection or inflammation of pouches that can form in the intestines). An emergency Hartmann's procedure (a surgical procedure for the removal of a section of the bowel and the formation of a stoma - an opening in the bowel) was performed. In April 2018, the patient was seen in an outpatient clinic and informed it would be possible to have a stoma reversal. The patient complained that the Board had continually delayed the stoma reversal surgery which they required, which as of September 2021 had not taken place. The patient also complained that Covid-19 could not account for the delays between the Board informing patient they were ready for surgery around December 2018 and the start of the pandemic in March 2020. The patient noted that as a consequence they had developed significant complications: a large hernia. The patient added that this had severely impacted their personal life and self-esteem, and left them unable to work and reliant on welfare benefits.
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News ArticlePatients from minority groups are facing longer wait times for potentially life-saving lung cancer treatment compared to their white counterparts, according to a study. Experts warn that disparities can have real consequences – the earlier treatment is initiated, the better the health outcomes for patients. Researchers at the University of Virginia (UVA) Cancer Centre reviewed data from more than 222,700 patients with non-small cell lung cancer across the US. The findings, published in the scientific journal Health Equity, showed that the mean time for radiation initiation was 61.7 days. Broken down by ethnicity, white patients had to wait only 60.9 days, while Black patients had a wait time of 65.9 days, meanwhile for Asian patients, it was 71.9 days. A single-week delay in treatment could lead to a 3.2% and 1.6% increase in the risk of death for patients with stage I and stage II non-small cell lung cancer, respectively. “Our results suggest that non-white lung cancer patients have delayed time to cancer treatment compared with white patients, and this is not limited to a particular type of treatment facility,” said senior researcher Rajesh Balkrishnan, PhD, of UVA Cancer Center and the University of Virginia School of Medicine’s Department of Public Health Sciences. “Collaboration among providers and community stakeholders and organisations is much needed to increase accessibility and patient knowledge of cancer and to overcome existing disparities in timely care for lung cancer patients.” Scientists cite multiple reasons for the racial disparities, including health insurance – non-white patients are more likely to be uninsured, face greater socioeconomic barriers to care and may be perceived by doctors as being at risk for not following through with treatment plans. Read full story Source: The Independent, 26 October 2022
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News ArticleA Harley Street doctor suspended for working while testing positive for Covid at the height of the pandemic has said that his patient’s cancer treatment took priority. Dr Andrew Gaya was found to have “blatantly disregarded” the rules by going to work at a centre for patients with brain tumours after he tested positive for the disease. The “highly regarded” consultant oncologist “dishonestly” misled colleagues that he was safe to work by keeping his positive test secret, a tribunal found. Dr Gaya, whose work is at the forefront of tumour care and has been described as “world class”, said he defied Covid-19 rules because he believed “the risk of harm to his patient” in delaying treatment was “greater than the risk he posed”. Now, the doctor of 27 years has been suspended for three months at a Medical Practitioners’ Tribunal. Read full story (paywalled) Source: The Times, 20 Ocotober 2022
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News ArticleA woman says she was forced to pay around £25,000 for private healthcare to treat endometriosis after her symptoms were “overlooked” for eight years. Aneka Hindocha, 34, started voicing her concerns about painful periods when she was aged 25 but says she was initially told by doctors this was normal. Ms Hindocha, who described the pain of endometriosis as “someone ripping your insides out”, says the condition should have been diagnosed sooner but argued women’s pain often gets overlooked and ignored. Endometriosis is a very common chronic inflammatory condition, impacting an estimated 1.5 million women in the UK. An inquiry by the All-Party Political Group found that like Ms Hindocha, it takes an average of eight years to get a diagnosis. The condition sees tissue comparable to womb-lining grow in other places in the body - with symptoms often debilitating and spanning from infertility to painful periods, tiredness, pain while having sex, as well as depression and anxiety. “I was told painful periods were normal, which they are not, but I believed that at the time,” Ms Hindocha told The Independent. “I thought the issue was me. I thought I was being a hypochondriac.” Her health massively deteriorated in the summer of 2020 and she became bedbound for three days. “I needed someone to find out what was wrong with me,“ Ms Hindocha added. “I was crying I was in so much pain.” She says that two years later she still had not received her laparoscopy despite the fact her pain was getting more severe and so she ended up paying for a private scan. She finally got diagnosed with stage 4 endometriosis a week later. “By the time of having my surgery at the end of February 2022, it had been nearly two years on the NHS waiting list and I was still being told to wait.” Read full story Source: The Independent, 18 October 2022
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News Article
NI Health: Cancer treatment waits show 'system is failing'
Patient Safety Learning posted a news article in News
The number of people in Northern Ireland waiting more than a month to start cancer treatment is five times higher than a decade ago. Macmillan Cancer research collated between April 2011 and March 2012 said on average 18 people each month waited more than a month for treatment. By March 2022 that monthly figure had increased to 92 people - or by more than 400%. Macmillan Cancer said the jump revealed a system that was "failing" patients. Sarah Christie, Macmillan policy and public affairs manager, told BBC News NI that the figures revealed a "dark insight into a healthcare system that is failing time and again to meet the needs of people living with cancer". Ms Christie said: "People have a right to be frustrated. They deserve access to care at the right time. "We need a government in place so that change can happen and, crucially, that the three-year budget that had been planned before the executive collapsed can be signed off. "It is impossible to deliver transformation on short-term budget." Read full story Source: BBC News, 29 September 2022- Posted
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News Article
New national deadline to eliminate two-year waiters
Patient Safety Learning posted a news article in News
NHS England has issued a new deadline to treat patients who have been waiting more than two years for treatment, a month after saying it had ‘virtually eliminated’ the longest waits, it has emerged. The goal of no-one waiting more than 104 weeks for treatment by July this year was one of the first milestones in the elective recovery plan hammered out between NHSE and ministers. They were not eliminated by the end of July, but the number was reduced to 3,000, having stood at 22,000 in January. The remaining group consisted of nearly 1,600 patients who had been offered faster treatment elsewhere but did not want to travel, 1,000 who required complex treatment and could not be transferred to another provider and 168 who were not treated by the deadline, according to information issued in the summer by NHSE. Now integrated care systems have been told there is a new “national expectation” to treat the remaining, final two-year waiters by the end of September. HSJ was told the goal has been framed as an ambition rather than a target because it includes patients who have chosen to wait longer. Read full story (paywalled) Source: HSJ, 21 September 2022- Posted
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- Long waiting list
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Content ArticleThe COVID-19 Recovery Committee has published its report on Long Covid and post-Covid syndrome, urging the Scottish Government to take action to address the stigma surrounding the condition and improve awareness among the public and healthcare professionals. The inquiry focussed on the awareness and recognition, therapy and rehabilitation, and study and research linked to Long Covid, with the Committee noting “concern” in their findings over reports of patients being unable to get the correct diagnosis and the lack of treatment for common conditions associated with the condition. The Committee said it was “deeply saddened” to learn about the stigma faced by those with lived and living experience of Long Covid, and the report highlights the impact that the lack of awareness and recognition of Long Covid can have on those with the condition.
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Content ArticleCancer patients and their carers face a multitude of challenges in the treatment journey; the full scope of how they are involved in promoting safety and supporting resilient healthcare is not known. This study from Tillbrook et al. aimed to undertake a scoping review to explore, document, and understand existing research, which explores what cancer patients and their carers do to support the safety of their treatment and care.
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Content ArticleChronic pain is the most common complication affecting adults with sickle cell disease (SCD).Pain profoundly affects people’s quality of life, functional ability, and health care utilization. Clinicians are often unsuccessful at addressing chronic pain in SCD, especially among the large number of patients for whom nonopioid analgesics aren’t sufficient and those who have developed opioid tolerance. Why aren’t we doing better? In this perspective article in the New England Journal of Medicine, Childerhose et al. discuss how a biopsychosocial model can help capture people’s experience of chronic pain by affirming that biologic, neuropsychological, and socioenvironmental elements play a role in pain-related processes.
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Content ArticleTo receive and participate in medical care, patients need high quality information about treatments, tests, and services—including information about the benefits of and risks from prescription drugs. Provision of information can support ethical principles of patient autonomy and informed consent, facilitate shared decision making, and help to ensure that treatment is sensitive to, and meets the needs and priorities of, individuals. Patients value high quality, written information to supplement and reinforce the verbal information given by clinicians. This is the case even for those who do not want to participate in shared decision making. The aim of this study was to evaluate the frequency with which relevant and accurate information about the benefits and related uncertainties of anticancer drugs are communicated to patients and clinicians in regulated information sources in Europe. The findings of this study highlight the need to improve the communication of the benefits and related uncertainties of anticancer drugs in regulated information sources in Europe to support evidence informed decision making by patients and their clinicians.
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Content ArticleIf you are considering 'going private' for the first time, it can be confusing and overwhelming. Private Healthcare Information Network (PHIN) has created some short videos to guide you through your private healthcare journey and demonstrate how the PHIN website and search function can help you. These videos for patients clarify some essential healthcare terms and shows how you can use PHIN's website to make informed decisions when considering private medical treatment. Have a watch, or if you prefer to read the information instead, PHIN has also included the text from each video below it. PHIN is an independent, government-mandated organisation publishing performance and fees information about private consultants and hospitals.
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Content ArticleTo mark International Women’s Day, host Helen McKenna speaks with Professor Dame Lesley Regan and Dr Janine Austin Clayton about women’s health journeys from start to finish. They explore why women can struggle to get medical professionals to listen to them and the impact this has on diagnosis and treatment, as well as the mental and physical effects on women themselves.
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Content ArticleThe UK Rare Diseases Framework was published in January 2021 and set out a shared vision for addressing health inequalities and improving the lives of people living with rare diseases across the UK. This is England’s second Rare Diseases Action Plan, following the commitment to publish action plans annually during the lifetime of the UK Rare Diseases Framework. This action plan has been developed in close collaboration with delivery partners across the health system and the rare disease community. It reports on progress against the 16 actions set out in the first Rare Diseases Action Plan and announces 13 new specific, measurable actions for the next year under the framework’s priority areas and underpinning themes.
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News Article
Stubborn cancer backlog at record high
Patient Safety Learning posted a news article in News
The number of people waiting more than two months to start cancer treatment remained over 30,000 — double the pre-covid level — for three months to the end of October, according to new data published. NHS England previously committed to bringing the number of people waiting longer than 62 days to be diagnosed and begin treatment, after referral for suspected cancer, to pre-pandemic levels – roughly 14,000 – by March 2023. But the number has been generally growing since the spring, and remained above 30,000 from August through to the end of October, the latest figures available. September and October’s monthly totals were higher than the previous monthly peak in May 2020, after services were disrupted in the first covid wave. The increase in waiters this year has been caused by diagnostic and treatment capacity falling short of an increased number of referrals. Matt Sample, policy development manager at Cancer Research UK, said: “While it’s good to see significant numbers of people coming forward with potential cancer symptoms, performance against key targets are among the worst on record, continuing a trend that existed long before the pandemic hit, with one target having been missed for almost seven years.” Read full story (paywalled) Source: HSJ, 8 December 2022- Posted
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News ArticleThe government is setting up 19 more diagnostic centres in communities across England to help tackle the Covid backlog. Ninety one are already open and have delivered more than 2.4 million tests, checks and scans since last summer, ministers say. It is hoped the centres will speed up access to services for patients, thereby reducing waiting times. Seven million people in England are now waiting for hospital treatment. GPs can refer patients to community diagnostic centres so that they can access life-saving checks and scans, and be diagnosed for a range of conditions, without travelling to hospital. Some are located in football stadiums and shopping centres and can offer MRI and CT scans, as well as x-rays. In September, according to the government, the hubs delivered 11% of all diagnostic activity - and its ambition is for 40% to be achieved by 2025. Read full story Source: BBC News, 7 December 2022
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Big UK trial to find best drugs to fight flu
Patient Safety Learning posted a news article in News
With flu cases rising, UK Covid scientists are turning their attention to finding the best life-saving drugs to fight the winter virus. A trial will run across 150 hospitals this year and next, recruiting thousands of patients. Flu vaccines help prevent infection but each year some people become very sick. And antiviral tablets - given within a couple of days of symptoms developing - are designed to reduce the severity of these bad infections. One of the pills the Imperial College London team will be testing is oseltamivir, or Tamiflu. It is recommended to treat severe flu - but whether it saves lives is unclear. Funded by the National Institute for Health and Care Research, the Randomised, Embedded, Multi-factorial, Adaptive Platform Trial for Community-Acquired Pneumonia (Remap-Cap) will study how good the treatments are at reducing deaths and intensive care admissions. Chief investigator Prof Anthony Gordon told BBC News: "We want to learn at pace what works, just like we did during Covid. "We'll test multiple treatments in different combinations. Some are antivirals that stop the virus, others are steroids or other treatments that work on how the body responds to infections. "We hope that our trial will help to find urgently needed flu treatments rapidly. Our Covid trial changed clinical practice globally and we hope we can impact flu treatment and reduce winter pressures on the NHS in the same way." Read full story Source: BBC News, 29 November 2022- Posted
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News Article
NHS’s flagship £360m system to slash waiting lists delayed
Patient Safety Learning posted a news article in News
A flagship programme intended to bring down NHS waiting backlogs is to be delayed after becoming mired in bureaucracy. The £360 million federated data platform is seen as critical to reducing waiting lists, with a record 7.1 million people now waiting for treatment. When the plans were announced in the spring, health chiefs said that the system would be an “essential enabler to transformational improvements” across the NHS. Experts have warned that progress in clearing the lists has been set back by chaotic recording systems. While NHS data was found to be littered with errors, such as duplicate entries and dead patients, many patients in need of follow-up care are not recorded once they have had their first slot. Read full story (paywalled) Source: The Telegraph, 25 November 2022- Posted
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Scotland’s NHS ‘already two-tier’ as more pay to go private
Patient Safety Learning posted a news article in News
Nicola Sturgeon has been accused of running a two-tier NHS after it emerged that tens of thousands of patients are going private for crucial operations and healthcare. Anas Sarwar, the Scottish Labour leader, cited figures that showed more than 39,000 patients underwent private procedures in the past year. These included thousands of hip and knee surgeries, costing an average of £12,500 per patient. “Often these are people who are forced to borrow money, turn to family and friends, or even remortgage their home to get healthcare that should be free at the point of need,” Sarwar told MSPs at first minister’s questions. He said that almost 2,000 people had gone for private treatment for endoscopies and colonoscopies, more than 7,800 for cataract surgery and 3,500 have had a hip or knee replacement in a private hospital. “These figures make clear that under the SNP, healthcare in Scotland is already a two-tier system,” he added. Read full story (paywalled) Source: The Times, 24 November 2022- Posted
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Young mother reveals sepsis warning signs after losing both feet and 10 fingers
Patient Safety Learning posted a news article in News
A young mother lost both her feet and all 10 fingers to sepsis after a significant delay in treatment, an investigation has found. Sadie Kemp has been left permanently disabled from the “dangerous condition”, whilst an NHS hospital probe found a 3.5 hour delay in starting her care. Sadie is now calling for lessons to be learned after the internal report found numerous concerns in her treatment that ultimately led to her needing multiple amputations. The 35-year-old mother-of-two first attended A&E with agonising back pain caused by a kidney stone on Christmas night 2021. She was given pain relief at Hinchingbrooke Hospital, Cambridgeshire, and sent home to return the following morning for a kidney scan. She returned the same night at 4am as her pain endured. An assessment at 5.40am found she may have also been suffering from sepsis, but the step-by-step guide to chart and treat the illness was not found in her notes as being done at the time. The investigation found not only should the sepsis have been discovered and treated sooner, but the “lack of effective treatment” of the sepsis prior to the surgery meant she needed prolonged critical care. Read full story Source: The Independent, 22 November 2022- Posted
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Europe faces ‘cancer epidemic’ after estimated 1m cases missed during Covid
Patient Safety Learning posted a news article in News
Experts have warned that Europe faces a “cancer epidemic” unless urgent action is taken to boost treatment and research, after an estimated 1m diagnoses were missed during the pandemic. The impact of Covid-19 and the focus on it has exposed “weaknesses” in cancer health systems and in the cancer research landscape across the continent, which, if not addressed as a matter of urgency, will set back cancer outcomes by almost a decade, leading healthcare and scientific experts say. A report, European Groundshot – Addressing Europe’s Cancer Research Challenges: a Lancet Oncology Commission, brought together a wide range of patient, scientific, and healthcare experts with detailed knowledge of cancer across Europe. One unintended consequence of the pandemic was the adverse effects that the rapid repurposing of health services and national lockdowns, and their continuing legacy, have had on cancer services, on cancer research, and on patients with cancer, the experts said. “To emphasise the scale of this problem, we estimate that about 1m cancer diagnoses might have been missed across Europe during the Covid-19 pandemic,” they wrote in The Lancet Oncology. “There is emerging evidence that a higher proportion of patients are diagnosed with later cancer stages compared with pre-pandemic rates as a result of substantial delays in cancer diagnosis and treatment. This cancer stage shift will continue to stress European cancer systems for years to come. “These issues will ultimately compromise survival and contribute to inferior quality of life for many European patients with cancer.” Read full story Source: The Guardian, 15 November 2022 -
News Article
Fear and trauma - the long waits for cancer care
Patient Safety Learning posted a news article in News
There has been a sharp rise in long waits for cancer therapy in the past four years, BBC analysis shows. The number waiting more than the 62-day target time for therapy in the past year has topped 67,000 across England, Northern Ireland and Scotland - twice as many as the same period in 2017-18. Waits are also getting worse in Wales, but data does not go that far back. The national cancer director for the NHS in England said staff were striving to catch up on the backlog of care, but experts warned the problems could be putting patients at risk. Steven McIntosh, of Macmillan Cancer Support, told the BBC that the delays were "traumatic" and people were living "day-by-day with fear and anxiety". He said the situation was "unacceptable" and could even be having an impact on the chances of survival. Describing the NHS as "chronically short-staffed", he said: "The NHS doesn't have the staff it needs to diagnose cancer, to deliver surgery and treatment, to provide care, support and rehabilitation." Read full story Source: BBC News, 9 November 2022