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News ArticleThe number of weekly coronavirus deaths in England and Wales has risen to its highest figure since early June, new statistics show. In the week ending 23 October, a total of 978 registered deaths mentioned COVID-19 on the death certificate, according to the Office for National Statistics (ONS). This marks a 46% increase on the number of deaths reported in the previous week, and is the highest figure on record since 12 June. Of the 978 deaths that involved COVID-19, 874 had this recorded as the underlying cause of death (89.4 per cent), the ONS said. Read full story Source: The Independent, 3 November 2020
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News Article
1 in 3 doctors have suffered verbal or physical abuse during COVID-19
Patient Safety Learning posted a news article in News
Over a third (35%) of healthcare professionals say they have suffered verbal or physical abuse from patients, or patients’ relatives during COVID-19, according to a survey by Medical Protection. The Medical Protection survey of 1250 doctors in the UK, also showed that a further 7% have experienced verbal or physical abuse from a member of the public outside of a medical setting, with some saying they have been sworn at for using the NHS queue at the supermarket. This follows reports that GP’s are facing abuse and complaints from patient’s who believe they aren’t offering enough face-to-face appointments, despite face-to-face appointments increasing in recent months. Medical Protection said the abuse presents yet another source of anxiety for doctors at the worst possible time. In the same survey, 2 in 5 doctors say their mental wellbeing is worse compared to the start of the pandemic. “I have been sworn at for using the NHS queue at the supermarket.” “I have had more unpleasantness from patients in the last 6 months than in all my previous 50 years in healthcare.I am almost at the point of stopping all clinical practice.” “There is too much verbal abuse to mention but the most upsetting is patients believing that we haven`t been open – we are all on our knees.” Read full story Source: Medical Protection, 31 October 2020 -
Content ArticleAs the race to develop a vaccine for COVID-19 has reached phase 3 clinical trials, concerns are increasing about the low rates of trial participation in important subgroups, including Black communities. Recent data show that although Black people make up 13% of the US population, they account for 21% of deaths from COVID-19 but only 3% of enrollees in vaccine trials. This problem threatens both the validity and the generalisability of the trial results and is of particular concern in vaccine trials, in which differences in lifetime environmental exposures can result in differences in immunologic responses that could affect both safety and efficacy. Despite long-standing calls from the Food and Drug Administration (FDA) and the National Institutes of Health (NIH) to improve the participation of underrepresented subgroups in drug trials, the problem persists. Warren et al., in an article in the New England Journal of Medicine, explore what the barriers are to greater participation of Black people in COVID-19 trials.
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News Article
Judge says care home residents in England are legally allowed visitors
Patient Safety Learning posted a news article in News
A senior judge has said friends and family can legally visit their loved ones in care homes, in an apparent challenge to recent government policy that has in effect banned routine visits in areas of high COVID-19 infection. Mr Justice Hayden, vice-president of the court of protection which makes decisions for people who lack mental capacity, said courts are concerned about the impact on elderly people of lockdowns. He has circulated a memo that sets out his analysis that regulations do “permit contact with relatives” and friends and visits are “lawful”. He was responding to guidance from the Department of Health and Social Care (DHSC) last month telling thousands of care homes in England that visiting should be stopped in areas with tier 2 and tier 3 lock down restrictions, apart from in exceptional circumstances such as the end of life. It triggered blanket prohibitions by some councils and sparked anguish from relatives who warn a lack of contact is leading to misery and early death in some cases. Within a week, Gloucestershire county council told care homes in its area to stop visits until next spring. With the England-wide lockdown starting on Thursday, care home providers, families and groups including Age UK and Alzheimer’s Society, have called on ministers to this time make clearer provisions for visiting. Hayden said exceptions in the existing regulations mean contact with residents staying in care homes is lawful for close family members and friends. He said the court of protection was concerned about “the impact the present arrangements may have on elderly people living in care homes,” citing their suffering. Read full story Source: The Guardian, 2 November 2020 -
EventWestminster Health Forum policy conference. The agenda: Assessing the impact of COVID-19 on the ethnic minority community, and priorities for improving health outcomes. The health and social care response to inequality through the pandemic and taking forward new initiatives. Understanding the data and risk factors for COVID-19 in ethnic minority groups. Wider health inequalities faced by people in ethnic minorities - addressing underlying factors, and the role of COVID-19 recovery strategies in supporting long-term change. Priorities for providing leadership in tackling health inequalities in the workforce. Driving forward and ensuring race equality in the NHS. Providing support to the ethnic minority health workforce and taking forward key learnings from COVID-19. Next steps for action in race disparity in healthcare. Book
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News Article
Hospitals 70% cent more full than April
Patient Safety Learning posted a news article in News
There are 70% more people in hospital now as when England was approaching its spring COVID-19 peak, and twice as many non-covid patients, according to official figures leaked to HSJ. In some regions, the contrast is even sharper. In the North East and Yorkshire, where COVID-19 hospitalisations are still mounting rapidly, there are now twice as many patients in acute hospitals than there were in early April. The information also shows that there are now 13% more patients than there were on 3 April in mechanical ventilation beds – which are reserved for the most seriously ill patients. These include more than double the number of non-covid patients than there were in the spring. The information — shared with HSJ and The Independent by NHS sources — also reveals that 1 in 10 hospital beds are now occupied by confirmed covid patients – up from about 6% two weeks ago. Read full story Source: HSJ, 3 November 2020 -
News Article
NHS bosses accused of ‘putting politics before patient safety’
Patient Safety Learning posted a news article in News
An NHS hospital at the epicentre of the coronavirus second wave is facing the threat of action by the care watchdog as it struggles to keep patients safe, The Independent has learned. Senior NHS bosses in the northwest region have been accused of putting politics ahead of patient safety and not doing enough to help the hospital to cope with the surge in Covid patients in recent weeks. The Care Quality Commission (CQC) warned the Liverpool University Hospitals Trust on Friday that it could face action after an inspection carried out last week in response to fears raised with the regulator. In a message to his colleagues on Friday, Liverpool University Hospitals (LUH) Trust medical director Tristan Cope warned the hospital had been overwhelmed by coronavirus and standards of care could no longer be maintained. He criticised NHS England and said the trust had been “abandoned” as coronavirus cases surged. He confirmed the CQC’s intention to take action against the trust but said the regulator had failed to appreciate the pressure staff in the hospital were under. Dr Cope, a consultant in anaesthesia and critical care, said: “LUH is now essentially overwhelmed by the demand. We cannot maintain patient flow and usual standards of care. We have put forward a proposal to further reduce elective [planned] activity, but maintaining capacity for the most urgent cases that would suffer from a two-four week delay." “It is a very sound plan that our divisional teams have worked up. However, NHS England are prevaricating and delaying with the usual request for more detail, more data, etc. It is clear to me that the politics is outweighing the patient safety issues of the acute crisis." Read full story Source: The Independent, 3 November 2020 -
News Article
COVID-19: Liverpool to pilot city-wide coronavirus testing
Patient Safety Learning posted a news article in News
People in Liverpool will be offered regular COVID-19 tests under the first trial of whole city testing in England. Everyone living or working in the city will be offered tests, whether or not they have symptoms, with follow-up tests every two weeks or so. Some will get new tests giving results within an hour which, if successful, could be rolled out to "millions" by Christmas, the government says. Liverpool has one of the highest rates of coronavirus deaths in England. The latest figures show the city recorded 1,754 cases in the week up to 30 October. The average area in England had 153. The pilot aims to limit spread of the virus by identifying as many infected people as possible, and taking action to break chains of transmission. It is thought around four-fifths of people who are infected with coronavirus show no symptoms. Read full story Source: BBC News, 3 November 2020 -
EventuntilIt is impossible in the year 2020 to ignore the glaring inequalities in our healthcare system. The disproportionate impact of COVID-19 on Black, Asian and minority ethnic communities, coupled with local Black Lives Matter activity following the killing of George Floyd, underscore the threat systemic racism poses to lives in the UK as well as the US. Though these events have prompted much discussion in the medical community, this injustice is not new: data has long demonstrated a link between ethnicity and health outcomes. What can we, as doctors and medical managers, do to close this health gap and ensure all patients can expect the same quality of care, treatment and outcomes in the future? Seeking to answer this question, the BMA committee for medical managers (CMM) are hosting a free, online panel discussion to explore how increasing diversity in medical leadership can lead to better outcomes for all. Register
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EventuntilConnect Health “Change” has developed a series of webinars to make and embed transformation in healthcare. Aimed at system leaders and clinicians across the NHS, the webinars provide practical solutions to the challenging issues we are all grappling with. As the lasting effects of COVID-19 emerge from the near overwhelming demands on the acute services, the need for long term support and rehabilitation for survivors is becoming increasingly clear. But the how is still very much a matter up for debate. This webinar is a must for anyone involved in the design, delivery and commissioning of post COVID rehabilitation/ community services as well as those involved in public and population-health . The webinar will explore: Are traditional community services set up to provide COVID rehab? Or, is there a need for specialist services to focus on supporting COVID recovery? Who are the best clinicians to provide rehab to COVID patients? How we approach COVID rehab from a commissioning perspective? Registration
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News ArticleSeveral hospitals in the north of England are already at full capacity and may have to start moving patients to other regions, doctors have warned. Consultants fear that if Covid infection rates do not begin to fall significantly the NHS will be overwhelmed in less than a month from now. Members of the British Medical Association have reported that Intensive Care Units (ICU) in a number of regions, including Manchester, Liverpool and Hull, are close to capacity as the number of people hospitalised with COVID-19 continues to grow. Dr Vishal Sharma, chairman of the BMA’s consultants committee, told The Telegraph: “Capacity in the north of England is at the limits and in some places above the limit. Our next concern is ICU capacity, which is always tight at this time of year, even without Covid.” Dr Sharma said some general ward beds could be adapted to provide intensive breathing support for Covid patients, and the re-opening of Manchester’s Nightingale Hospital may also take the pressure off ICU departments. But more radical steps may have to be taken if numbers of hospitalised patients continue to rise. “We may have to move patients around the country to create extra capacity, but if the whole country starts to struggle things will get very difficult." Read full story Source: The Telegraph,
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News ArticleA month-long national lockdown in winter will take a heavy toll on people's mental health, charities fear. Paul Farmer, chief executive of mental health charity Mind, says it could be "the greatest test of our mental health this year”, not just for the public but for healthcare staff who are "working tirelessly, but may be struggling with their mental health too”. Both Mind and Carers UK say the Government has to learn from mistakes in the first wave and make sure people can get help early on. Mind has also urged the Government to support those who feel alone through a second lockdown in England, with Mr Farmer saying there is an “urgent need” for a winter mental health support package including in-person and online services. Read full story Source: The Independent, 1 November 2020
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News Article
UCL researchers publish ‘Find, Test, Track, Isolate and Support’ Covid dashboard
Clive Flashman posted a news article in News
Researchers at UCL-led collaboration i-sense, have published a dashboard to collate data on five stages, Find, Test, Track, Isolate and Support, with an aim to provide a complete picture of the pandemic. The i-sense COVID Response Evaluation Dashboard (COVID RED) collates and presents data from the Office of National Statistics, Public Health England, and the NHS under five categories; Find, Test, Track, Isolate and Support for those asked to Isolate (FTTIS). It presents indicators of performance under each of these headings, and identifies areas where more data is needed. Co-developer Professor Christina Pagel, UCL Mathematics & Physical Sciences, said: “Increasing volumes of data are being shown in the media and in government press conferences as a basis for local tightening of restrictions.” “However, these data are often from disparate sources, and are not linked together to give a more complete picture of how we are doing. This was the motivation behind our dashboard development. We wish to contribute to the public understanding of COVID-19’s spread, and support policymakers in identifying current areas of the Find, Test, Trace, Isolate and Support structure requiring strengthening.” Read full article Source: Health Tech Newspaper, 30 October 2020 To access the dashboard, click here -
Content ArticleThe coronavirus pandemic has magnified a myriad of challenges in the healthcare sector. Whilst there is no magic cure, a change in culture can deliver seemingly miraculous benefits including reducing the effects of staff burnout, delivering a higher quality of care and increasing productivity. It is well within the remit of leaders, who can use their power, to influence workplace culture and drive positive change from within. Phil Taylor of RLDatix explores this further in his blog.
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News Article
Tens of thousands of NHS staff off sick because of COVID-19, data reveals
Clive Flashman posted a news article in News
Almost half of all staff absence linked to coronavirus in parts of northern England Tens of thousands of NHS staff are off sick or self-isolating because of coronavirus, according to data shared with The Independent as the second wave grows. In some parts of northern England, more than 40% – in some cases almost 50% – of all staff absences are linked to COVID-19, heaping pressure on already stretched hospitals trying to cope with a surge in virus patients. The problem has sparked more calls for wider testing of NHS staff from hospital leaders and nursing unions who warned safety was being put at risk because of short staffing on wards. Across England, more than 76,200 NHS staff were absent from work on Friday – equivalent to more than 6% of the total workforce. This included 25,293 nursing staff and 3,575 doctors. Read full article Source: The Independent, 1 November 2020 -
Content Article
The National Institute for Health and Care Excellence (NICE), is developing the COVID-19 guideline: management of the long-term effects of COVID-19. The final scoping document and associated project papers are now available. -
Content ArticleMaintaining safe elective surgical activity during the global coronavirus disease 2019 (COVID‐19) pandemic is challenging and it is not clear how COVID‐19 may impact peri‐operative morbidity and mortality in this population. Therefore, adaptations to normal care pathways are required. Here, Kane et al. establish if implementation of a bespoke peri‐operative care bundle for urgent elective surgery during a pandemic surge period can deliver a low COVID‐19‐associated complication profile. Kane et al. present a single‐centre retrospective cohort study from a tertiary care hospital of patients planned for urgent elective surgery during the initial COVID‐19 surge in the UK between 29 March and 12 June 2020.
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News ArticleA total of 338 patients with a diagnosis of COVID-19 were discharged from Scottish hospitals into care homes in the three months from March this year, says a report from Public Health Scotland. The discharges were necessary to free up space in hospitals for COVID-19 patients but some care home owners have claimed that it introduced the virus into their premises, causing almost 2000 deaths across Scotland.2 Public Health Scotland says that most of the 3599 discharges that took place in the busiest month of March were among people who had never been tested. Of the 650 who were tested, 78 were positive, but the discharges still went ahead. Scotland has been found to have the highest rate of COVID-19 related deaths in care homes of any part of the UK. Read full story Source: BMJ, 29 October 2020
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News Article
Report into Covid-related whistleblowing calls to the Protect advice Line
Clive Flashman posted a news article in News
What does whistleblowing in a pandemic look like? Do employers take concerns more seriously – as we would all hope? Does the victimisation of whistleblowers still happen? Does a pandemic compel more people to speak up? We wanted to know, so Protect analysed the data from all the Covid-19 related calls to theirr Advice Line. They found: * 41% of whistleblowers had Covid-19 concerns ignored by employers * 20% of whistleblowers were dismissed * Managers more likely to be dismissed (32% ) than non-managers (21%) They found that too many whistleblowers feel ignored and isolated once they raise their concerns and that these failing are a systematic problem. Protect, which runs an Advice Line for whistleblowers, and supports more than 3,000 whistleblowers each year, has been inundated with Covid-19 whistleblowing concerns, many of an extremely serious nature. Its report, The Best Warning System: Whistleblowing During Covid-19 examines over 600 Covid-19 calls to its Advice Line between March and September. The majority of cases were over furlough fraud and risk to public safety, such as a lack of social distancing and PPE in the workplace. -
News ArticleNHS staff and their families accounted for one in six patients in hospital with Covid, due in part to inadequate personal protective equipment (PPE), new research suggests. A study of hospitals from March to June revealed that healthcare workers in patient-facing roles were around three times more likely to be hospitalised with the virus than the general population. Writing in the BMJ, the study's authors called for an urgent focus on how COVID-19 spreads around hospitals to prevent a similar toll in future waves of the pandemic. They also call for hospitals to consider re-deploying staff with vulnerable family members away from high-risk zones. Read full story Source: The Telegraph, 29 October 2020
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Content ArticleHealthcare workers and their families account for 17% of hospital admissions for COVID-19 in the working age population (18-65 years), finds new research published in the BMJ. Shah et al. assessed the risk of hospital admission for COVID-19 among patient facing and non-patient facing healthcare workers and their household members. The study revealed that healthcare workers in patient-facing roles were around three times more likely to be hospitalised with the virus than the general population. The authors call for an urgent focus on how COVID-19 spreads around hospitals to prevent a similar toll in future waves of the pandemic. They also call for hospitals to consider re-deploying staff with vulnerable family members away from high-risk zones.
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News ArticleDelays in discharging patients from hospitals is making pressure on the NHS from the second wave of coronavirus worse, hospital chiefs have warned. Some hospitals are already reporting almost all of their beds are full with patients as the number of coronavirus cases continues to surge with more patients needing hospital care every day. Doctors have told The Independent the lack of discharges means fewer beds are free and some hospitals are seeing long waits in A&E for beds to become available. NHS Providers chief executive Chris Hopson said: “Some of our chief executives are saying they are seeing bed occupancy levels of 92, 93, 94 per cent at the end of October when they would normally expect these to be 86, 87, 88 per cent. “Given where we are in terms of the winter cycle, and the fact we are not really at the beginning of winter yet, that is a worry." “There are much higher bed occupancy levels now than you would normally expect to see at this time of the year.” Without enough spare beds, hospitals will not be able to go ahead with planned surgeries and will have to make patients wait longer for a bed in accident and emergency departments. Read full story Source: The Independent, 30 October 2020
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News ArticleSenior clinicians say their trust board has caved into political pressure by making an ‘unsafe’ decision to re-open a small emergency department — having previously suggested this would not happen if there was a second wave of coronavirus. In a letter to management at Lancashire Teaching Hospitals Foundation Trust, seen by HSJ, a group of 17 emergency medicine consultants have raised serious concerns over the planned re-opening of the accident and emergency department at Chorley and South Ribble Hospital next week. The unit, which has long suffered from staffing shortages and temporary closures, was again closed on a temporary basis at the start of the coronavirus pandemic. When covid subsided in the summer, plans were put forward to reopen it in the autumn. However, when announcing this, chief executive Karen Partington said: “It is really important that everybody recognises that if covid-19 cases begin to rise significantly, or other safety concerns are identified, we will need to revisit the situation.” The letter from the clinicians, addressed to trust clinical director Graham Ellis, said: “We consider that the trust has been subjected to an undercurrent of external pressure which has resulted in an unsafe decision being taken to re-open the ED prematurely…" Read full story (paywalled) Source: HSJ, 30 October 2020
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Content ArticleThis Healthcare Safety Investigation Branch (HSIB) report charts a four-month patient safety investigation that was launched following concern that patients were contracting COVID-19 after being admitted to hospital. The report references data presented to SAGE in mid-May that suggested around 20% of patients were reporting symptoms seven days after admission. The aim of the investigation was to understand the factors that could contribute to the risk of transmission, how the NHS operates to reduce that risk and where there may be opportunities to reduce that risk even further. The investigation represented the voices of those working across the health service, from strategic national planners to hospital porters. It also captured experiences of patients and families, providing further insight into the challenges of managing the transmission of COVID-19.
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News ArticleAmbulance chiefs have warned coronavirus precautions in hospital emergency departments are putting patients’ lives at risk because of long delays before patients are being treated. West Midlands Ambulance Service has written a formal warning to three hospitals in the region over the delays to handing over patients from ambulance to hospital staff. In one case, a patient was left waiting with ambulance crews for up to three and a half hours. According to the letter, obtained by the Health Service Journal, the delays are being caused because of tougher infection control measures with ambulance bosses warning the situation is “dangerous”. Director of nursing Mark Docherty said the delays meant ambulances could not be sent to “life threatening emergencies”, and warned: “Lives will be put at risk and patients will come to harm as a result”. He added: “I alerted you to a serious concern about patients being kept on ambulances outside your hospital. Of great concern is the fact that a hospital risk assessment identifies this process as a mitigation to reduce risk in your hospital…" Read full story Source: The Independent, 29 October 2020
