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Found 184 results
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Content ArticleUp 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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Content ArticleThis cross-sectional study in BMJ Evidence-Based Medicine aimed to understand the relationship between financial conflicts of interest and recommendations for atrial fibrillation (AF) screening in the UK. The authors looked at whether the UK media recommend for or against screening for AF and the financial conflicts of interests of AF screening commentators. The authors found that the vast majority of UK media promotes screening for AF, in contrast to the position of the independent UK National Screening Committee, which recommends against screening. Most commentators, internal NHS organisations and UK charities promoting screening had a direct or indirect financial conflict of interest. Independent information was rare and the reasons for this are unknown. They recommend readers consider the potential impact of financial conflicts on recommendations to screen.
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Content ArticleThis short report from the National Vascular Registry (NVR) provides information on medical devices implanted during primary and revision abdominal aortic aneurysm (AAA) repair procedures during the past three years. In response to the Cumberlege review in 2020, the NVR has enabled information on implantable devices used in aortic aneurysm repairs to be entered in its datasets from July 2020. This was accompanied by the launch of the revision aortic datasets, which capture revision procedures both after open repair and endovascular stent grafting for abdominal aortic aneurysm (AAA). In total, there were 10,678 AAA procedures in the NVR performed from 1st January 2020 to 31st July 2022 and 5,383 (50%) contained information on implanted devices. This report also contains information on the: patterns for elective and non-elective procedures. type of repair for elective and non-elective surgery, for example, open procedures. type of device and components used during the procedures.
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Content ArticleThis study in Plos One used a prospective error analysis method—the Systematic Human Error Reduction and Prediction Approach (SHERPA)—to examine the process of dispensing medication in community pharmacy settings and identify solutions to avoid potential errors. These solutions were categorised as strong, intermediate or weak based on an established patient safety action hierarchy tool. The authors identified 88 potential errors with a total of 35 remedial solutions proposed to avoid these errors in practice. Sixteen (46%) of these remedial measures were categorised as weak, 14 (40%) as intermediate and 5 (14%) as strong according to the Veteran Affairs National Centre for Patient Safety action hierarchy. The authors suggest that future research should examine the effectiveness of the proposed remedial solutions to improve patient safety.
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Content ArticleThis study in eClinicalMedicine aimed to bring together the global evidence on the prevalence of persistent symptoms in people who had experienced Covid-19 infection. The authors found, across the 194 studies included in the systematic review, that 45% of Covid-19 survivors, regardless of hospitalisation status, were experiencing a range of unresolved symptoms at around four months after infection. The authors state that current understanding is limited by heterogeneous study design, follow-up durations and measurement methods, and highlight that definition of subtypes of Long Covid is unclear, which hampers effective treatment and management strategies.
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Content Article
National Patient Safety Alert: Class 4 medicines defect information: Prenoxad 1mg/ml solution for injection, Macarthys Laboratories (Aurum Pharmaceuticals Ltd), due to potential missing needles in sealed kits, NatPSA/2022/009/MHRA (10 November 2022)
Patient-Safety-Learning posted an article in Medicines and Healthcare products Regulatory Agency (MHRA)
Macarthys Laboratories (trading as Martindale Pharma, an Ethypharm Group Company), has notified the MHRA that a limited number of Prenoxad kits (also called packs) in a batch marketed in France have missing needles. Naloxone is a drug that reverses the effects of an opioid overdose. If no needles are present in the kit, there is a risk that patients, members of the public and/or healthcare professionals may not be able to administer life-saving doses of naloxone from these kits in an emergency. This may impede the treatment for a patient with an opioid overdose, which may result in delay to intervention and possible death. Although no reports of UK marketed kits with missing needles have been received to date, the potential for kits to contain fewer than two needles in all distributed batches cannot be excluded based on the investigation by the company. However, due to the critical need for this product, the specified batches are not being recalled. This alert is for action by: primary and secondary care, specifically those involved in outreach services. -
Content ArticleThis report by LCP Health Analytics, looks at how inequalities across the medicine life cycle impact patients and populations. It paints a vision of what success could look like, and proposes specific, feasible calls to action across industry, health technology assessment (HTA) bodies and players that could transform the role of the life science sector in reducing inequalities and fostering healthy populations. The report identifies two key challenges in addressing health inequalities that are tractable, and where the life science sector is most likely to make commitments and contributions: Multimorbidity is increasing and embedding inequalities in health Financial incentives across health systems are not aligned with patient and population health
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Content ArticleThe Health Equity Network will launch in January 2023 and aims to build momentum for health equity across the UK. It will provide an opportunity for public and private sector organisations, community and voluntary groups and individuals to share their work on health equity and to engage across the country with others with the same interests. This article describes how the Network will work and offers the opportunity to register interest in joining.
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Content ArticleThis article from Reuters highlights the results of a survey of 1,002 people which was conducted in October 2022 by market research company Censuswide on behalf of recruitment website Indeed. The survey showed that more than three quarters of British people who have suffered persistent ill health following a Covid-19 infection have had to cut back or change the work they do.
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Content ArticleAdam Tasker spent over a decade in the Royal Navy before starting medical training at the University of Warwick. In this article for BMJ Leader, he reflects on a near miss incident that he was involved in while working as a Helicopter Warfare Officer, examining his attitudes and those of his colleagues, and the practices and behaviours of the squadron’s leaders. He compares his experience in the Royal Navy to that of his experience as a medical student, and identifies lessons that are relevant to medical training, professional expectations and the management of clinical incidents. These lessons aim to support the implementation of a Just Culture within the NHS.
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Content ArticleUnpaid carers play a substantial and vital role in meeting social care needs. The care they provide has enormous value, both for the people they care for and for wider society. Many carers experience great satisfaction from their role, and through the help and support they provide to friends and family members they may also reduce the costs of formal social care provision. At the same time, caring responsibilities can come at a high personal and financial cost, despite the 2014 Care Act giving carers the right to receive support. 1 in 5 carers report feeling socially isolated and 4 in 10 report financial difficulties because of their caring role. This report by The Health Foundation aims to explore national data on the number of unpaid carers and trends over time, as well as which groups are more likely to have caring responsibilities and who they provide care for. It gives an overview of the types of support available to carers, and what we know–and don’t know–about how many carers are accessing support.
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Content ArticleThis report is the National Confidential Inquiry into Suicide and Safety in Mental Health's (NCISH) annual report on UK patient and general population data for 2010-2020. It includes findings relating to people aged 10 and above who died by suicide between 2010 and 2020 across all UK countries as well as people under mental health care who have been convicted of homicide, and those in the general population.
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Content ArticleThe National Clinical Guideline for Stroke for the UK and Ireland provides authoritative, evidence-based practice guidance to improve the quality of care delivered to every adult who has a stroke in the United Kingdom and Ireland, regardless of age, gender, type of stroke, location, or any other feature. The guideline is intended for: Those providing care – nurses, doctors, therapists, care staff. Those receiving care – patients, their families, their carers. Those commissioning, providing or sanctioning stroke services. Anyone seeking to improve the care of people with stroke. The guideline is an initiative of the Intercollegiate Stroke Working Party.
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Content ArticleIn this article, critical criminologist Sharon Hartles looks at the ongoing fight for justice by families affected by the hormone pregnancy test (HPT) Primodos. Primodos was given to thousands of women in the 1960s and 70s which has been linked to miscarriages, birth defects and stillbirth. The Department of Health and Social Care (DHSC) and pharmaceutical company Bayer are applying to strike out court proceedings against them in a civil litigation case brought by the Association for Children Damaged by Hormone Pregnancy Tests (ACDHPT). This would prevent a five-day hearing scheduled to take place at the Royal Courts of Justice in May 2023 from going ahead. The article outlines the argument brought by the DHSC and Bayer that no additional evidence has been found to warrant the case being brought by the ACDHPT. It then goes on to highlight recent research that has established a causal link between HPTs and birth malformations and that therefore gives credence to the litigation. Sharon highlights the importance of the legal system acknowledging and confronting the damage inflicted upon the families affected by the use of Primodos, many of whom have been seeking justice for decades. Related reading Primodos, mesh and sodium valproate: Recommendations and the UK Government’s response (Sharon Hartles, August 2021) Sodium Valproate: The Fetal Valproate Syndrome Tragedy A year on from the Cumberlege Review: Initial reflections on the Government’s response (Patient Safety Learning, 23 July 2021)
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Content ArticleA key priority for all involved in the development, manufacture and prescription of medicines is safety. To keep patients safe, regulators and pharmaceutical manufacturers have a statutory obligation to provide product information covering the most important instructions on how to take medicines correctly. This report by Kent Surrey Sussex Academic Health Science Network (AHSN) outlines the findings of a project around the accessibility of medication information. Patients, carers, healthcare professionals (HCPs) and senior healthcare system stakeholders were asked what they think about current medicines product information, and if it could be improved using digital solutions.
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Content ArticleThis correspondence published in Anaesthesia reflects on the recent guidance released by the Difficult Airway Society and the Association of Anaesthetists, 'Implementing human factors in anaesthesia: guidance for clinicians, departments and hospitals'. The authors highlight that although the guidance is a positive step forward in improving system safety in anaesthesia, there is a need to include a broader range of Human Factors (HF) specialists in the development of guidelines such as these. They call for a higher level of collaboration between clinicians and HF specialists to ensure that healthcare system safety can benefit from years of HF expertise.
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Content ArticleThis article by Till Bruckner of Transparimed outlines how a new UK law will affect how clinical trial results are reported. The UK Government will introduce a legal requirement to make the results of all clinical trials public within 12 months of trial completion. Any company or university breaking the law will be refused permission to start new trials.
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Content ArticleThis article in the journal Oral and Maxillofacial Surgery for the Clinician looks at the importance of recognising and addressing human factors in surgery. It explores human factors in the context of optimising individual performance, enhancing team working to improve patient safety, and creating better working lives for healthcare professionals across surgery and medicine.
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Content ArticleThis report by the Royal College of General Practitioners (RCGP) sets out recommendations for the Government to tackle the workforce and workload crisis in general practice, and support GPs and their teams to meet the healthcare challenges of the 21st century. Based on a survey of more than 2,600 GPs and other practice team members from across the UK, the report provides a snapshot of what frontline staff have faced during one of the most difficult winters experienced in the NHS, and what they think needs to happen to make general practice more sustainable. Respondents describe a profession in crisis, with unmanageable workload and workforce pressures fuelling an exodus of fully qualified GPs.
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Content ArticleResearchers writing in the Journal of the Royal Society of Medicine say that while UK life expectancy has increased in absolute terms over recent decades, other, similar countries are experiencing larger increases. In 1952, when Queen Elizabeth II came to the throne, the UK had one of the longest life expectancies in the world, ranking seventh globally behind countries such as Norway, Sweden and Denmark. In 2021 the UK was ranked 29th. The researchers show the rankings of the G7 countries at each decade from 1950 to 2020. The G7 is a collection of countries with advanced economies (UK, Canada, France, Germany, Italy, Japan and the U.S.) that represent about half of global economic output.
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Content ArticleAt least 1 in 5 mothers experience a perinatal mental health (PMH) problem, making mental illness the most common serious health problem that a woman might experience in the perinatal period. This resource was produced by the Institute of Health Visiting (iHV) in partnership with the Maternal Mental Health Alliance (MMHA). It draws together principles collated from a comprehensive desktop evidence review of current policy, research, reports and literature on what good PMH care looks like. It aims to support individuals, services, pathways, multiagency groups and networks across health, public health, social care and non statutory services to consider: Where are we now? Is the care we currently provide good enough? What do families want mental health care in the perinatal period to look like?
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Content ArticleThis article in Social Science & Medicine aims to show how patients’ contributions to their safety in hospital are less about involvement as a deliberate intervention, and more about how patients manage their own vulnerability in their interactions with staff. The article outlines the conflict between the current focus on encouraging patients to speak up, raise queries and take ownership of their healthcare, and the relational vulnerability created by the 'sick role'—an established societal role that excuses people from their normal duties in society and entitles them to seek help. The authors highlight that supporting staff to elicit concerns from patients, and offer assurance that challenge is welcome, will be crucial in creating an environment where patients can become fully involved in own safety.
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Content ArticleThe NHS was struggling before Covid-19 and was further severely disrupted by the pandemic. As a result, it is now dealing with a massive backlog in elective care. This blog by Saoirse Mallorie, Senior Analyst at The King's Fund, looks at the causes and state of the backlog and identifies ways to tackle the issue, including increasing workforce and investment, innovation and focusing on prevention.
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Content ArticleEmergency care services in the UK face an unparalleled crisis, with more patients than ever before experiencing extremely long waiting times in Emergency Departments (EDs), associated with patient harm and excess deaths. This explainer from the Royal College of Emergency Medicine (RCEM) outlines the latest data on ED waiting times and the impact this is having on patient safety.
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Content ArticleThis ethnographic qualitative study in the BMJ aimed to describe how patients are engaged with cancer decisions in the context of multidisciplinary teams (MDT) and how MDT recommendations are carried out in the context of a shared decision. The study was carried out at four head and neck cancer centres in the north of England. The authors found that the current model of MDT decision-making does not support shared decision-making, and may actively undermine it. They recommend the development of a model that allows the individual patient more input into MDT discussions, and where decisions are made on potential treatment options rather than providing a single recommendation for discussion with the patient. Deeper consideration should be given to how the MDT incorporates the patient perspective and/or delivers its discussion of options to the patient.
