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Found 182 results
  1. Content Article
    The trend towards health system mergers and acquisitions in the US is likely to continue in 2024. Mergers can be beneficial. However, post-merger integration can take years to complete and can have an adverse effect on patient safety, care culture and care quality. Some healthcare researchers have dubbed mergers as 'life events' for health systems.[1] Health system mergers and acquisition projects need to include a special task force to assess the risks to patient safety management practices. 
  2. News Article
    Cancer patients in the UK wait up to seven weeks longer to begin radiotherapy or chemotherapy than people in comparable countries, research has revealed. The stark findings are yet more damning evidence of the extent to which the UK lags behind other nations, as experts warn that people’s chances of survival are being affected by long waits for treatment. In the first research of its kind, experts at University College London analysed data from more than 780,000 cancer patients diagnosed between 2012 and 2017 in four comparable countries: Australia, Canada, Norway and the UK. Eight cancer types were included: oesophageal, stomach, colon, rectal, liver, pancreatic, lung and ovarian cancer. The two studies, published in the Lancet Oncology, were the first to examine treatment differences for eight cancer types in countries across three continents. UK patients experienced the longest waits for treatment, the research found. The average time to start chemotherapy was 48 days in England, 57 in Northern Ireland, 58 in Wales and 65 in Scotland. The shortest time was 39 days in Norway. In radiotherapy, the UK fared even worse. It took 53 days on average for treatment to begin in Northern Ireland, 63 in England, 79 in Scotland and 81 in Wales. Cancer Research UK, which part-funded the two studies, said delays to begin treatment were partly a result of the UK government’s lack of long-term planning on cancer in recent years. Countries with robust cancer strategies backed by funding had seen better improvements in survival rates, it said. Read full story Source: The Guardian, 27 February 2024
  3. Content Article
    "Our #health system in the UK is in a mess. It has failed to modernise (by this I mean to become fully accountable to #patients and the public, and truly patient-led). Instead, the system has become more and more hierarchical, bureaucratic and crony ridden, mostly as a result of constant meddling and pointless reorganisations instigated by politicians. All political parties in government for the past 30 years have had a hand in this decline." This is my view? What is yours? A new Inquiry gives us all an opportunity to have our say. I am proud to have worked in and for the NHS for most of my working life; proud to have been trained in the #NHS and proud of the work being carried out by clinical teams today. Great work which has benefited patients, often not because of the leadership but despite of the leadership. I'm retired so I can say what I like. If I were working and said anything even vaguely like criticism, however constructive it was, I would be out of a job and my career would be blighted for life. I'm speaking from experience here, unfortunately. I urge everyone to respond to the consultation (link below). In your response think forensically and write it as a statement of truth. Acknowledge the successes and areas that have delivered safe and effective services. If you are being critical give examples and say if it is an opinion or back up what you say with evidence. If we work together across boundaries we can develop a truly patient-led NHS.
  4. News Article
    The UK has some of the worst cancer survival rates in the developed world, according to new research. Analysis of international data by the Less Survivable Cancers Taskforce found that five-year survival rates for lung, liver, brain, oesophageal, pancreatic and stomach cancers in the UK are worse than in most comparable countries. On average, just 16% of UK patients live for five years with these cancers. Out of 33 countries of comparable wealth and income levels, the UK ranks as low as 28th for five-year survival of both stomach and lung cancer, 26th for pancreatic cancer, 25th for brain cancer and 21st and 16th for liver and oesophageal cancers respectively. The six cancers account for nearly half of all common cancer deaths in the UK and more than 90,000 people are diagnosed with one of them in Britain every year. The taskforce calculated that if people with these cancers in the UK had the same prognosis as patients living in countries with the highest five-year survival rates – Korea, Belgium, the US, Australia and China – then more than 8,000 lives could be saved a year. Anna Jewell, the chair of the Less Survivable Cancers Taskforce, said: “People diagnosed with a less survivable cancer are already fighting against the odds for survival. If we could bring the survivability of these cancers on level with the best-performing countries in the world then we could give valuable years to thousands of patients. “If we’re going to see positive and meaningful change then all of the UK governments must commit to proactively investing in research and putting processes in place so we can speed up diagnosis and improve treatment options.” Read full story Source: The Guardian, 11 January 2023
  5. Content Article
    The following account has been shared with Patient Safety Learning anonymously. We’d like to thank the patient for to sharing their experience to help raise awareness of the patient safety issues surrounding outpatient hysteroscopy care.
  6. Content Article
    “Crisis,” “collapse,” “catastrophe” — these are common descriptors from recent headlines about the NHS in the UK. In 2022, the NHS was supposed to begin its recovery from being perceived as a Covid-and-emergencies-only service during parts of 2020 and 2021. Throughout the year, however, doctors warned of a coming crisis in the winter of 2022 to 2023. The crisis duly arrived. In this New England Journal of Medicine article, David Hunter gives his perspective on the current state of the NHS.
  7. Content Article
    The UK is the “sick man” of Europe at the moment—on almost every health indicator including life expectancy, healthy life expectancy, obesity rates and healthcare capacity—we lag behind our peers. Recent data from the Office for National Statistics shows the substantial impact this is having on our national prosperity. The number of people who cannot work primarily because of long-term illness reached a record nearly 2.6 million. In this article for The Guardian, Professor Dame Sally Davies, former chief medical officer for England, argues that this is not the first time the UK has lagged behind on health outcomes and faced the associated economic harm. During the 19th-century Industrial Revolution and the 20th-century post-war period, Britain faced health crises that, like today’s, also undermined labour supply, economic participation and growth. She highlights that in both of these instances, national leaders implemented bold new public health strategies on both health and economic grounds and asks the question, 'Why is the Government not taking a more comprehensive policy approach to tackling the serious health issues we face in 2023?'
  8. Content Article
    The Prescribing Safety Assessment (PSA) is a 60-question exam required as part of UK medical training to progress from FY1 to FY2. This independent review into the PSA was commissioned by the Medical Schools Council (MSC) together with the British Pharmacological Society (BPS) in the summer of 2022. It suggests a strategic future direction for the PSA and addresses how the PSA has impacted prescribing assessment and practice for medical students and Foundation Year 1 (FY1) doctors. It is intended to support national decision making about the future of UK prescribing assessment in the context of the imminent introduction of the Medical Licensing Assessment (MLA).
  9. News Article
    A group of potent synthetic opioids called nitazenes have been linked to a rise in overdoses and deaths in people who use drugs, primarily heroin, in England over the past two months, drug regulators have warned. The Office for Health Improvements and Disparities has issued a National Patient Safety Alert on potent synthetic opioids implicated in heroin overdoses and deaths. In the past 8 weeks there has been an elevated number of overdoses (with some deaths) in people who use drugs, primarily heroin, in many parts of the country (reports are geographically widespread, with most regions affected but only a few cities or towns in each region). Testing in some of these cases has found nitazenes, a group of potent synthetic opioids. Nitazenes have been identified previously in this country, but their use has been more common in the USA. Their potency and toxicity are uncertain but perhaps similar to, or more than fentanyl, which is about 100x morphine. The National Patient Safety Alert provides further background and clinical information and actions for providers.
  10. News Article
    US health officials are monitoring an unusual situation in the UK, where COVID-19 cases and hospitalisations are simultaneously climbing due to the BA.2 subvariant, CNN reports. COVID-19 cases were up 52% in the UK last week compared with the week prior, and hospitalisations were up 18%t over the same period, according to the UK Coronavirus Dashboard. The seemingly in-tandem ascent of cases and hospitalisations is unusual, given that increases in COVID-19 cases preceded increases in hospitalisations by about 10 days to two weeks in previous waves. "So we're obviously keenly interested in what's going on with that," Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases, told CNN. Dr Fauci said in conversation with his U.K. counterparts, they attribute the rising cases and hospitalisations to three things, listed in order of contribution: the BA.2 variant, which is more transmissible than the original omicron; the opening of society, with people socializing indoors without masks; and waning immunity from vaccination or prior infection. Hospitalisations in the U.K. raise questions, given that BA.2 doesn't appear to cause more severe disease. "The issue with hospitalization is a little bit more puzzling, because although the hospitalizations are going up, it is very clear their use of ICU beds has not increased," Dr. Fauci said. "So are the numbers of hospitalizations a real reflection of COVID cases, or is there a difficulty deciphering between people coming into the hospital with COVID or because of COVID?" Read full story Source: Becker Hospital Review, 16 March 2022
  11. News Article
    The UK’s status as a global leader on vaccination is at risk because of falling uptake rates among children and an “alarming” decline in clinical trial activity, MPs have warned. The Health and Social Care Committee said in a report that it was concerned that England did not meet the 95% target for any routine childhood immunisations in 2021-22.1 Committee chair Steve Brine MP said that new spikes in measles cases in London and the West Midlands because of low uptake of MMR vaccines should be a “massive wake-up call” for the government to take action. “Vaccination is the one of the greatest success stories when it comes to preventing infection. Unless the government tackles challenges around declining rates of childhood immunisations and implements reform on clinical trials, however, the UK’s position as a global leader on vaccination risks being lost,” he said. The Health and Social Care Committee said, “It is unacceptable that there are people who are unable to take advantage of the important protection that vaccination offers because of practical challenges of time and location that can and must be tackled.” Read full story Source: BMJ, 27 July 2023
  12. News Article
    The UK risks becoming highly reliant on overseas care workers after nearly 58,000 visas were issued for the sector last year, a report says. Analysis by the Migration Observatory at the University of Oxford found that the demand for foreign staff had left the NHS and care homes open to “vulnerabilities” including “exposure to international competition for health workers and risks of exploitation”. The study, commissioned by the employment group ReWAGE, also examined where care workers were coming from. In 2022, 99% of care workers sponsored for work visas in the UK were from non-EU countries. The top countries were India (33%), Zimbabwe (16%), Nigeria (15%) and the Philippines (11%). Dr Madeleine Sumption, the director of the Migration Observatory, said: “Health and care employers have benefited a lot from international recruitment. “But relying this much on overseas recruits also brings risks. For example, care workers on temporary visas are vulnerable to exploitation and the rapid growth in overseas recruitments makes monitoring pay and conditions a real challenge.” Read full story Source: The Guardian, 27 June 2023
  13. News Article
    New plans to strengthen the regulation of medical devices to improve patient safety and encourage innovation have been published. Following the UK’s exit from the European Union (EU), the Medicines and Healthcare products Regulatory Agency (MHRA) has a unique opportunity to improve how medical devices and in vitro diagnostic medical devices (IVDs) are regulated in the UK. The package of reforms will apply to medical devices such as hearing aids, x-ray machines and insulin pumps; new technologies such as smartphone apps and Artificial Intelligence (AI); as well as certain cosmetic products like dermal fillers. The new measures include: Strengthening the MHRA’s powers to act to keep patients safe. Giving the public and patients greater assurance on both the performance and safety of the highest-risk medical devices, such as those which need to be implanted. Increasing the scope and extent of regulation to respond to public need. Enhancing systems that are already in place to better protect users of medical devices and certain cosmetic products, and providing greater assurance of their performance and safety. Addressing health disparities and mitigating identified inequities throughout medical devices development and use. Mitigating against inequities in medical devices, ensuring they function as intended for diverse populations. The government has launched a review into the potential equity issues in the design and use of medical devices to tackle health inequalities and will update in due course. Making the UK a focus for innovation, and the best place to develop and introduce innovative medical devices. Ensuring the new regulatory framework encourages responsible innovation so that patients in the UK are better able to access the most advanced medical devices to meet their needs. Setting world-leading standards and building the new UKCA mark. Transforming a new stamp of certification, replacing the CE mark, into a trusted brand that signifies global safety, health and environment protection standards have been met for medical device products. This will in turn boost the MHRA’s global reputation and growing partnerships with other regulators. Health and Social Care Secretary Sajid Javid said: "Now we have left the EU, these new changes will allow innovation to thrive and ensure UK patients are among the first to benefit from technological breakthroughs." "We are now able to introduce some of the most robust safety measures in the world for medical devices to ensure patients are protected." Read press release Source: Gov.UK, 26 June 2022
  14. News Article
    Life expectancy in the UK has grown at a slower rate than comparable countries over the past seven decades, according to researchers, who say this is the result of widening inequality. The UK lags behind all other countries in the group of G7 advanced economies except the US, according to a new analysis of global life expectancy rankings published in the Journal of the Royal Society of Medicine. While life expectancy has increased in absolute terms, similar countries have experienced larger increases, they wrote. In the 1950s, the UK had one of the longest life expectancies in the world, ranking seventh globally behind countries such as Denmark, Norway and Sweden, but in 2021 the UK was ranked 29th. The researchers said this was partly due to income inequality, which rose considerably in the UK during and after the 1980s. Prof Martin McKee, of the London School of Hygiene & Tropical Medicine, said: “That rise also saw an increase in the variation in life expectancy between different social groups. One reason why the overall increase in life expectancy has been so sluggish in the UK is that in recent years it has fallen for poorer groups". Read full story Source: The Guardian, 16 March 2023
  15. Content Article
    This Quality Standard from the National Institute for Health and Care Excellence (NICE) has been updated to instruct healthcare professionals to diagnose women under the age of 65 with a urinary tract infection (UTI) if they have two or more key symptoms.
  16. Content Article
    NHS Providers offers a board development programme that aims to improve the effectiveness of NHS boards and organisations through practical, interactive training and development delivered by expert trainers with extensive senior-level sector experience. This webpage contains information about the board development programme including: core training modules. in-house training. induction programmes. bespoke development programmes.
  17. Content Article
    The National Institute for Clinical Excellence (NICE) updated their guidance for continuous glucose monitoring (CGM) in 2022, recommending that CGM be available to all people living with type 1 diabetes. This review in the journal Diabetes, Obesity and Metabolism aimed to compare regulatory standards for CGM in the UK and Europe, with those applied in the USA by the Food and Drug Administration (FDA) and in Australia by the Australian Therapeutic Goods Administration (TGA). It describes the processes in place and highlights that the criteria applied in the UK for assessing accuracy do not translate into real-life performance. The authors offer a framework to evaluate CGM accuracy studies critically and conclude that FDA- and TGA-approved indications match the available clinical data, whereas CE marking indications applied in the EU can have discrepancies. They argue that the UK can bolster regulation, but that this need to be balanced to ensure that innovation and timely access to technology for people with type 1 diabetes are not hindered.
  18. Content Article
    This investigation by the Healthcare Safety Investigation Branch (HSIB) explored the detection and diagnosis of jaundice in newborn babies, in particular babies born prematurely (before 37 weeks of pregnancy). Specifically, it explored delayed diagnosis due to there being no obvious visual signs of jaundice apparent to clinical staff. Jaundice is a condition caused by too much bilirubin in a person’s blood. Bilirubin is a yellow substance produced when red blood cells are broken down. If left undiagnosed and untreated, high bilirubin levels in newborn babies can lead to significant harm. Newborn babies have a higher number of red blood cells in their blood which increases their risk of jaundice. Jaundice can cause yellowing of the skin and whites of the eyes; however, sometimes the visual signs of jaundice are not obvious, particularly for premature or newborn babies with brown or black skin. The reference event for this investigation was the case of baby Elliana, who was born at 32 weeks and 1 day via a forceps delivery and then transferred to the Trust’s special care baby unit (SCBU). Elliana was assessed on admission to the SCBU by staff as a clinically stable premature baby and a routine blood sample was taken from around two hours after her birth to establish a baseline. Analysis of the blood sample indicated bilirubin was present and so the level was measured. This result was uploaded onto the Trust’s computer system alongside the results of the blood tests that had been requested by the clinical team. The bilirubin result was seen by a SCBU member of staff who recognised that the level was high, indicating the possible need for treatment. However, this member of staff was then required to attend an emergency and the bilirubin result was not acted upon. Another blood sample was taken when Elliana was two days old and was uploaded to the Trust’s computer system. It is unclear if this bilirubin result was seen by staff; it was not documented in clinical records and was not acted upon. Over the next two days, Elliana continued to show no visible signs of jaundice that were detected by staff and she was documented to be developing well. When Elliana was five days old, a change in her skin colour was observed and visible signs of jaundice were detected. A further blood sample was taken which showed she had a high level of bilirubin in her blood and treatment was started accordingly. Elliana’s bilirubin levels returned to within acceptable levels over the next three days and she was subsequently discharged home.
  19. Content Article
    This study by a team at the University of Derby in the British Journal of Anaesthesia used experimental psychology methods to explore the potential benefits of colour-coded compartmentalised trays compared with conventional trays in a visual search task.  The authors found that errors were detected faster when presented in the colour-coded compartmentalised trays than in conventional trays, a finding that was replicated for correct responses for error-absent trays. Overall, colour-coded compartmentalised trays were associated with significant performance improvements when compared with conventional trays.
  20. Content Article
    When Covid-19 first struck the UK, the disease was described as 'a great leveller'. But it soon became clear that Covid's impacts were not evenly distributed—we may have been in the same storm, but we were in different boats. In this episode of All in it together, guests Charlotte Augst, Halima Begum, Beth Kamunge-Kpodo, Professor Sir Michael Marmot and Pastor Mick Fleming discuss unequal outcomes during the Covid-19 pandemic.
  21. Content Article
    This article presents data on how deprivation affects life expectancy and health life expectancy at birth. It highlights a difference in life expectancy of around 9 years for males and 8 years for females between the most and least deprived deciles of society.
  22. Content Article
    This article in iNews looks at a major new study in The BMJ by researchers in Israel which suggests that symptoms of Long Covid end within a year in most people with the condition. The study looked at information on a number of symptoms linked to Long Covid, including loss of taste and smell, breathing problems, concentration and memory issues, weakness, palpitations and dizziness. The research also demonstrated the role of Covid vaccines in improving outcomes for people with Long Covid. However, the article also highlights cautions from experts who note that people who got Long Covid after a more serious case of the virus were not included in the study, and their symptoms typically last longer than for those who got the condition after a mild infection. The authors also highlight that these results do not match up with the latest data from the Office for National Statistics (ONS). According to the ONS, 57% people reporting symptoms in December 2022 said that they had had long Covid symptoms for at least one year, with 30 per cent reporting that symptoms had lasted for at least two years.
  23. Content Article
    This paper in the journal RSC Advances aimed to track changes in chemical bonding taking place in PP meshes on the nanoscale via mechano–chemical processes. The authors used the novel and advanced spectroscopic characterisation technique secondary electron hyperspectral imaging (SEHI) to build high resolution chemical maps. Polypropylene (PP) surgical mesh is associated with serious clinical complications when used in the pelvic floor for repair of stress urinary incontinence or support of pelvic organ prolapse. While manufacturers claim that the material is inert and non-degradable, there is a growing body of evidence that asserts PP fibres are subject to oxidative damage. Material surgically removed from patients suffering with clinical complications has shown some evidence of fibre cracking and oxidation. It has been proposed that a pathological cellular response to the surgical mesh contributes to medical complications, but the mechanisms that trigger the specific host response against the material are not well understood.  The study presented key insights into the mechano–chemistry reaction of PP which can cause polymer oxidation, changes in molecular structure, crack/craze formation and the release of etched oxidised insoluble particles. SEHI, provided a new route to link the effect of localised stresses to reactions of mechano–chemistry within PP. The method of mechanical distension testing during hydrogen peroxide exposure followed SEHI image analysis could form the basis of an “early warning” system which has the ability to identify materials which are not appropriate for use as medical implants.
  24. Content Article
    This article for ABC News looks at a study conducted by researchers from the Bond University and other Australian universities about the impact of the 'hero' and 'angel' narratives applied to nurses during the Covid-19 pandemic. They interviewed critical care nurses in the UK, Australia and North America about their perceptions of these terms. The study found that nurses felt the labels devalued their professionalism, created unreasonable expectations, contributed to gender stereotypes and increased burn-out by putting emphasis on showing up for work even when nurses are unwell. The study also highlighted that nurses responded more positively to the terms 'hero' and 'angel' when used by patients, as opposed to governments and the media.
  25. Content Article
    Up to 30% of healthcare spending is considered unnecessary and represents systematic waste. While much attention has been given to low-value clinical tests and treatments, much less has focused on identifying low-value safety practices in healthcare settings. This study in the Journal of Patient Safety surveyed healthcare staff in the UK and Australia to identify safety practices perceived to be of low value. Staff who took part in a survey as part of the study frequently identified the following categories of practices as being low-value: paperwork, duplication and intentional rounding. Five cross-cutting themes (for example, 'covering ourselves') offered an underpinning rationale for why staff perceived these practices to be of low value. The authors conclude that in healthcare systems under strain, removing existing low-value practices should be a priority.
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