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News ArticleA London hospital hit by a COVID-19 outbreak that required 70 staff to self-isolate has been ordered to take stringent measures to control infection. Hillingdon Hospital NHS Foundation Trust declared a COVID-19 outbreak in July and revealed that 70 staff members, some of whom had tested positive, were self-isolating. Ambulances were forced to divert patients to other emergency departments. An investigation later found that a nurse who had COVID-19 unwittingly infected 16 others during a training session on 30 June, described by one doctor as a “super spreading event.” The Care Quality Commission (CQC), which carried out an unannounced inspection on 4-5 August, has used its urgent enforcement powers to place conditions on the trust’s registration to protect patients and staff. Nigel Acheson, the CQC’s deputy chief inspector of hospitals, said, “We found a number of concerns relating to infection control and this is why we have taken action to ensure the safety of patients, staff and visitors." “We have imposed urgent conditions upon the trust’s registration and expect the trust to focus on making the required improvements as a matter of priority. We will return to inspect and ensure that action has been taken and that improvements have been made and are being sustained.” The trust has been told it must ensure that staff and patients observe social distancing, must place personal protective equipment (PPE) in easily accessible places, and must make sure that staff wear PPE before going into high risk areas. Read full story Source: BMJ, 9 September 2020
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News ArticleA risk calculator that takes seconds to produce a score indicating a COVD-19 patient’s risk of death could help clinicians make care decisions soon after patients arrive in hospital, according to a large study conducted by a consortium of researchers across the UK. As UK COVID-19 cases rise, schools reopen and the weather gets colder, doctors at UK hospitals are expected to see an influx of coronavirus patients. Patients with COVID-19 behave very differently to patients with other conditions such as flu and bacterial pneumonia, said Dr Antonia Ho of the University of Glasgow, one of the study’s authors, and it is very challenging for doctors managing this unfamiliar disease to accurately identify those who are at high risk of deterioration or who can ride out their illness at home. “So having a tool that … can help clinicians at the front door to accurately group patients who are coming in with COVID-19 into four distinct risk categories – low, intermediate, high and very high risk – is hugely valuable,” she added. “Having an accompanying low-risk score will provide that doctor with increased confidence that the vast majority of people, patients with that low-risk score, will come to no real harm.” Read full story Source: The Guardian, 9 September 2020
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News ArticleHundreds of women with breast cancer in London were not picked up by routine screening as services closed during the lockdown, officials have estimated. Data from NHS England and Improvement’s London office said it expected 450 people to have breast cancer and have gone undiagnosed because of the heavily reduced amount of screening at the height of the outbreak. It was included in a letter from officials to local health system leaders, seen by HSJ. It said the figure was an estimate based on the 115,000 routine breast screenings that would have taken place between late March and the end of June and which had to be re-scheduled. London represents around 15% of England’s population, so a nationwide estimate would run into thousands. Responding to the figures, Breast Cancer Now chief executive Baroness Delyth Morgan said: ”While it’s encouraging that the breast screening programme in London is now back up and running, we are concerned to hear of the hundreds of potential delayed cancer diagnoses as a result of disruption due to the pandemic. The earlier breast cancer is diagnosed, the more likely treatment is to be successful." “With over a hundred thousand people missing out on vital breast screening during the pandemic in London alone, we urge the government to ensure there is sufficient capacity in the already-stretched workforce to meet the huge backlog and to avoid any cancers going undetected for longer.” Read full story (paywalled) Source: HSJ, 9 September 2020
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News Article
Covid: Wales' NHS doctors 'bullied for raising safety fears'
Patient Safety Learning posted a news article in News
Doctors in Wales have faced bullying and disciplinary action for raising concerns over working conditions and safety, a union leader has said. Dr Phil Banfield, of BMA Wales, said doctors who complained about work, both before and during the Covid pandemic, were seen as "troublemakers". He said there are worries bullying among staff will get worse as longer post-Covid waiting lists are tackled. The Welsh government said bullying of NHS staff was "entirely unacceptable". Dr Banfield, who is chairman of the BMA Welsh consultants' committee, said staff have faced the prospect of being victimised by colleagues, or even being forced to leave the Welsh NHS, for raising concerns over bullying or health and safety. He said: "Staff are quite good at raising concerns, but they don't raise concerns if they're going get in trouble for it, or they sense nothing is going to happen. What happens is you think 'I can't be bothered'. "Decent people develop a kind of learned helplessness and it means that people who keep raising concerns stand out." Read full story Source: BBC News, 15 May 2021 -
News Article
UK women forced to wear face masks during labour, charity finds
Patient Safety Learning posted a news article in News
Nearly one in five pregnant women in the UK were forced to wear a face covering during labour, according to research by a charity, despite official health guidance saying they should not be asked to do so. Women described feeling unable to breathe, having panic attacks or even being sick during labour because they were made to wear a face covering. The research was carried out by the charity Pregnant Then Screwed, who surveyed 936 women who gave birth during December. It found that 160 of those who went into labour were made to wear a face covering. This goes against current joint UK guidance, published in July 2020 by the Royal College of Midwives and the Royal College of Obstetricians and Gynaecologists. The guidance says that women should not be asked to wear a face covering of any kind during natural labour or during caesarean births because of the risk of harm and complications. Read full story Source: The Guardian, 14 May 2021 -
News Article
Government alert over surge in respiratory virus affecting babies and toddlers
Patient Safety Learning posted a news article in News
The chief medical officers of the four UK nations are set to warn about a surge in admissions of severely ill, very young children later this year, due to the resurgence of a respiratory virus which has been suppressed by anti-covid measures, HSJ can reveal. Public Health England modelling shows a possible sharp rise in cases of respiratory syncytial virus (RSV), which can cause bronchiolitis, this autumn and winter, several senior sources said. The modelling shows between 20 and 50% more cases needing hospitalisation than normal, HSJ understands. Official projections conclude that such a surge would require, at least, a doubling of paediatric intenstive care beds and a significant increase in other critlcal care resources for sick children. Most of those expected to be affected by the rise in RSV are forecast to be three years old or younger. The UK’s four chief medical officers are considering the issue and planning to write to ministers to highlight it, the sources said, while NHS England is working on a response plan, and is expected to alert local NHS leaders. Read full story (paywalled) Source: HSJ, 14 May 2021 -
News Article
Lessons to be learned from covid public inquiry, says PM
Patient Safety Learning posted a news article in News
The government is "fully committed to learning the lessons at every stage" of the pandemic, Prime Minister Boris Johnson has said. He told MPs an independent public inquiry into the handling of the pandemic would be held in spring 2022. The inquiry would place "the state's actions under the microscope", he added, and take evidence under oath. The inquiry's terms of reference have not yet been defined but would be published in "due course", he said, adding that the devolved administrations would be consulted. Mr Johnson acknowledged many bereaved families would want the inquiry to begin sooner, but said because of the threat of new variants and a possible winter surge in infections, spring next year would be the "right moment". Read full story Source: BBC News, 12 May 2021 -
News Article
The NHS Covid legacy - long waits and lives at risk
Patient Safety Learning posted a news article in News
Covid has left a toxic legacy for the NHS, with hospitals facing a huge backlog, putting lives at risk, patient groups and staff are warning. And in-depth analysis by BBC News has found: waiting lists have ballooned at some hospitals in England, with more than one out of every 10 of patients in a quarter of trusts left at least a year without treatment major disruption to cancer services, with some hospitals struggling to treat half of their patients within the target time of two months concern growing for 45,000 "missing cancer patients", after drops in GP referrals and screening services across the UK. Elaine Walsh was diagnosed with womb cancer in January. She should have been operated on within weeks, but her operation was cancelled because of the pandemic and the backlog it had caused. Elaine's story is not unique. Analysis by BBC News shows the numbers starting treatment within the target time have fallen during the pandemic. And some trusts are struggling to start treatment for even half of patients in the recommended timeframe - two months following an urgent referral from their GP. About one in every four of the patients waiting the longest has postponed treatment themselves - and nurses at the trust have been phoning and pleading with them to have treatment. This reluctance to come forward coupled with problems accessing GP and screening services at points in the pandemic is the reason why the number of patients coming forward for checks and being diagnosed has dropped. Analysis by Macmillan Cancer Support suggests across the UK there are 45,000 "missing" cancer patients. Read full story Source: BBC News, 13 May 2021 -
News Article
'Major changes needed' at Northern Ireland emergency departments
Patient Safety Learning posted a news article in News
Major change is required if Northern Ireland's emergency departments are to avoid another "exceptionally difficult" winter, a senior consultant has warned. Dr Brendan Lavery, who works for the Western Health Trust, said "standing still is not an option". He described the system as currently operating on a "knife edge". The Department of Health said it was "a very challenging time" for staff "with COVID-19 restrictions impacting on an already fragile system". Speaking to BBC News NI, Dr Lavery likened the situation to "Groundhog Day" with decade-long problems like capacity and staffing exacerbated by the lingering effect of the COVID-19 pandemic on other healthcare services. The department responded: "Well before COVID-19, there was clear evidence that our urgent and emergency care services were under increasing pressure. This is an unsustainable position that requires sustained investment and reform, including, of course, long-term investment in staffing. There is no quick or easy solution to these problems." Read full story Source: BBC News, 12 May 2021 -
News Article
How COVID-19 has disrupted efforts to care for blood cancer patients
Patient Safety Learning posted a news article in News
Blood cancer patients are one of the most vulnerable groups of people at risk of COVID-19, according to research, being 57% more likely to suffer severe disease compared to other cancer patients. Despite the high risk these patients face, charities such as Anthony Nolan, which assist blood cancer patients with finding a stem cell match, were left out of the allocated government budget that was announced in March. The cancellation of face-to-face fundraising and events, despite the increase in demand for services, have led their gross income to be down by an estimated £5.5m for 2021. Henny Braund, chief executive of the charity, said people with blood cancer and blood disorders were “heavily impacted by the pandemic and everyone who needs treatment and support must be able to access it without delay”. Read full story Source: The Independent, 9 May 2021 -
News Article
Alcohol-related deaths jumped to highest level during Covid pandemic
Patient Safety Learning posted a news article in News
The highest number of alcohol-related deaths in England and Wales since records began was seen in 2020, official data shows. A survey by the Office for National Statistics (ONS) showed that alcohol killed more people in 2020 than in any of the previous 20 years. The data also showed a rise of 20 per cent compared to 2019. Overall, there were 7,423 deaths from alcohol misuse last year, compared to 6,209 in 2019. Deaths increased from March 2020 onwards, when the coronavirus pandemic forced the UK into a series of national lockdowns. Read full story Source: The Independent, 6 May 2021 -
News ArticlePressure is growing on the government to change its stance on coronavirus infection rules which it is feared may leave NHS staff and patients at risk from airborne transmission. Experts told The Independent the current guidance from Public Health England (PHE), which effectively says staff working on general wards can rely on just surgical masks for protection, was “outdated and potentially misleading” and put NHS staff at risk. At the start of the pandemic the emphasis on stopping infection was focused around droplets containing the virus both in the air over short distances and on surfaces. Increasingly scientists have begun to warn the virus can also spread through much smaller aerosols which can remain airborne for a lot longer and over further distances. On Friday, the World Health Organisation updated its information on how Covid spreads to acknowledge the risk of aerosols and last month papers released by the government’s Scientific Advisory Group for Emergencies (Sage) said health workers may need to use better protection for longer. Read full story Source: The Independent, 6 May 2021
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News Article
Pregnant women struggling to get Covid jab says MP
Patient Safety Learning posted a news article in News
Pregnant women are struggling to get the coronavirus vaccine because clinics are unable to guarantee they will have the right type of jab available, Labour MP Stella Creasy has said. The Pfizer-BioNTech or Moderna jabs are preferable for pregnant women because there is more safety data available. But the online booking system in England does not allow them to specify which vaccine they require. Pregnant women are advised to speak to their GP instead of booking online. But Ms Creasy, 44, said GPs do not always know when local vaccination centres will have specific types of the jab available. The MP for Walthamstow, who is currently pregnant with her second child, said she had received five invitations to be vaccinated but she could not take them up because there is no system to specify she needs the Pfizer or Moderna jab. "I don't think it's been made enough of a priority because there's a presumption it will become more of a priority as they move through the age groups, which is a misreading of the data about pregnancy," she told the BBC. Read full story Source: BBC News, 7 May 2021 -
News Article
Pfizer vaccine ‘95% effective against coronavirus,’ new data shows
Patient Safety Learning posted a news article in News
Two doses of the Pfizer-BioNTech vaccine can provide more than 95% protection against infection, severe illness and death from Covid, according to a groundbreaking study in Israel. The middle eastern country currently leads the world in its inoculation programme, with more than half (56 per cent) of its population having already received both doses of the Pfizer vaccine. The research, published today in The Lancet journal, also concluded that a single dose of the jab provides 58 per cent protection against infection, 76% against hospital admission, and 77% against death. The researchers said their study highlights the importance of fully vaccinating adults against the virus but acknowledged challenges remain to get the pandemic under control – including uncertainty around how long immunity lasts, from both vaccines and natural infection, and the emergence of variants that may be resistant to jabs currently on the market. Read full story Source: The Independent, 6 May 2021 -
News Article
Covid: Depression rises in young and women during second peak
Patient Safety Learning posted a news article in News
Women and younger adults were more likely to feel depressed during the second UK coronavirus peak than men and other age groups, Office for National Statistics (ONS) data suggests. Four in 10 women aged between 16 and 29 were affected, compared to 26% of men. One in five adults experienced depression in early 2021 - more than double pre-pandemic levels. But GPs in England diagnosed fewer cases of depression in adults in 2020 compared with the year before. Many people may not be seeking medical help, the ONS says. Health experts have always warned that the combined effects of ill health, isolation and job losses during the pandemic would have a negative impact on people's mental health and wellbeing. Read full story Source: BBC News, 5 May 2021 -
News Article
Early cancer diagnoses plummeted in England during Covid pandemic
Patient Safety Learning posted a news article in News
The number of people being diagnosed with cancer early in England has plummeted during the Covid pandemic, sparking fears that many will only be treated when it is too late to save them. Official figures show a third fewer cancers were detected at stage one, when the chances of survival are highest, in the early months of the pandemic than during the same months a year before. Cancer experts fear that the figures, which have been collected by Public Health England’s National Cancer Registration and Analysis Service, mean thousands of people have the disease but have not yet started treatment because of “a shift to later diagnosis”. They urged anyone with possible symptoms of the disease to get them checked out immediately. “While it’s fantastic that Covid rates are dropping and lockdown is easing, the knock-on impact of the pandemic on cancer care cannot be overstated,” said Steven McIntosh, the executive director of advocacy and communications at Macmillan Cancer Support. “We are likely to be dealing with Covid’s long shadow for many years to come.” Read full story Source: The Guardian, 5 May 2021 -
News ArticleNearly half the hospitals targeted in covid-related spot checks were found to be breaching health and safety laws. An unpublished Health and Safety Executive report found just five out of 17 acute hospitals inspected had high levels of compliance with measures to manage the risks around covid. Meanwhile, letters were sent to eight hospitals “formally requiring them to take remedial action to remedy contraventions of health and safety law”. The remaining four hospitals were given advice. The inspections — which involved 13 hospitals in England and two each in Scotland and Wales — focused on seven areas: risk assessment; management arrangements specific to covid; social distancing; cleaning and hygiene; ventilation; dealing with suspected covid cases; and personal protective equipment. The health and safety watchdog highlighted social distancing in non-clinical areas — which covered areas outside of clinical wards such as offices, rest areas, changing rooms and workshops — as needing improvement in some hospitals. The inspectors — who visited between November last year and January this year — also found some hospitals needed more robust covid security measures if they were to comply with government guidance. HSE also noted that, although all the hospitals had adequate supplies of PPE, not all had adequate arrangements in place for ensuring it was used effectively. Read full story (paywalled) Source: HSJ, 5 May 2021
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News Article
Young people more likely to suffer rare vaccine blood clots, MHRA says
Patient Safety Learning posted a news article in News
Younger adults are particularly affected by the rare blood clotting disorder linked to the Oxford-AstraZeneca vaccine, the UK's medicines regulator has said. The Medicines and Healthcare products Regulatory Agency (MHRA) said there were 209 cases in the UK of the rare combination of blood clots with low platelet counts following being vaccinated the Oxford-AstraZeneca jab, with 41 deaths, up to 21 April. This is up from 168 cases and 32 deaths the previous week. The new data also shows 24 cases of clots in people aged 18 to 29, 28 in those in their thirties, 30 in people in their forties, 59 in people in their fifties and 57 in those aged 60 and above, with the age not known in the remaining cases. The numbers appear to rise with age but that is because more older people have been vaccinated. Fewer than one in five clots was fatal. The latest NHS England data show that 5.5 million people under 45 had received a first dose by 25 April, while 22.6 million of those 45 and over had done so. MHRA chief executive June Raine said no medicine or vaccine was without risk, but that blood clots were extremely rare. She added: “The benefits of the vaccine continue to outweigh the risks for most people. It is still vitally important that people come forward for their vaccination when invited to do so." Read full story Source: The Independent, 3 May 2021 -
News Article
Covid: Pregnant women in Wales 'still go it alone'
Patient Safety Learning posted a news article in News
Pregnant women are facing a postcode lottery over whether they can bring a partner to maternity appointments. Health boards were given flexibility in November to allow pregnant woman in low Covid rate areas to take their partners to maternity appointments. But many parts of Wales with the lowest rates are still forcing pregnant women to attend some appointments alone. There are calls, as lockdown eases, for partners Wales-wide to be allowed to all appointments and during labour. Emma Fear, 30, was not able to take her partner with her to hospital when she experienced bleeding during pregnancy in June last year and was told, alone, that she was losing her baby. She then had to repeat the news to her partner, who was waiting outside in the car. "At the time, he could have come and sat outside a pub with me, but he couldn't come with me when I'd had severe bleeding and knew I had probably lost my baby." Read full story Source: BBC News, 2 May 2021 -
News ArticlePatients are finding it increasingly hard to see their GPs, with warnings that pandemic restrictions have too often “closed the door” on NHS treatment, a report warns. The Patients’ Association survey comes as an investigation reveals that almost 100 GP surgeries closed down or merged with other practices last year. In total, almost 2.5 million patients were forced to switch to a new surgery because of 788 such closures since 2013, the freedom of information disclosures reveal . Rachel Power, chief executive of the Patients’ Association, said the findings from its survey were “worrying” and show “clear dissatisfaction” from the public. The report said: “It is increasingly clear that many patients have found that new methods for arranging appointments do not work for them, or simply that they do not understand how to go about it. GPs are the front door to the NHS, and patients are increasingly perceiving that that door is closed to them.” Roughly half of those who had telephone consultations said the experience was worse than a traditional appointment, with three times as many saying they were unhappy about their experience, compared with those offering praise. The report warns: “The data does not show a ringing endorsement of new or remote methods for accessing NHS care; indeed, in most cases patients rated these methods worse than traditional contact.” Read full story Source: The Telegraph, 30 April 2021
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News Article
Care home staff COVID vaccination levels below target in more than half LAs
Patient Safety Learning posted a news article in News
The vaccination rate for staff at older care homes is below the recommended level set by scientists in more than half of England’s local authorities, analysis of NHS England data has revealed. Data as of 18 April shows that 76 out of 149 LAs had not reached the 80% vaccination threshold for care home staff to provide a minimum level of protection against COVID-19, according to the PA news agency. In 17 areas, less than 70% of staff had received a first jab. Lambeth, where 23 cases of a South African COVID variant have been recently reported in a care home, had the lowest uptake at 52.4%. The government last week announced the launch of a five-week consultation on mandatory staff vaccination as a result of the failure in some areas to reach the designated threshold. Read full story Source: Care Home Professional. 23 April 2021 -
News ArticleHealth resources diverted to fight the COVID-19 pandemic have caused a major drop in critical preventative care in the US, including childhood vaccinations and lead screenings, sexually transmitted disease testing and substance abuse services. In short, many of the routine measures meant to keep Americans healthy – and keep American health from slipping further behind that of other developed, peer nations – have hit a worrying cliff. As attention has focused on the immediate crisis of the pandemic and the hundreds of thousands of lives lost in America, this other hidden crisis represents another layer of disaster that also has profound implications. “This is either the second or first worst pandemic in modern human history,” said Dr Howard Markel, a pandemic historian and pediatrician at the University of Michigan. “We knew there would be repercussions and unintended consequences.” Now, there is a “whole menu of neglect” to address as a national vaccine campaign allows people to slowly emerge from a year of lockdowns and social distancing. “There is no historical precedent for this,” added Markel. In the first few months of the pandemic alone, at least 400,000 children missed screenings for lead, a toxic heavy metal. Doctors and nurses ordered 3m fewer vaccines for children and 400,000 fewer for measles specifically. For the first time, clinics were forced to ration lab tests for sexually transmitted diseases as lab capacity and supplies were diverted to test for COVID-19. Contact tracers were also re-deployed from tracking chlamydia, gonorrhea and syphilis cases to finding people in contact with COVID-19 patients. Data from one large commercial lab showed 669,000 fewer HIV tests were processed. Compared to 2019, the lab diagnosed nearly 5,000 fewer cases of HIV. Delayed diagnosis can lead to people unwittingly transmitting the virus. Read full story Source: The Guardian, 26 April 2021
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News ArticlePregnant women who catch COVID-19 are over 50% more likely to experience severe complications such as premature birth, admission to intensive care and death, a major study has found. Newborns of infected women were also nearly three times more at risk of severe medical complications and close to 10% tested positive during the first few days of their life, the study of more than 2,100 pregnant women across 18 countries worldwide revealed. Scientists leading the study warned the risk to mothers and babies is greater than acknowledged at the beginning of the pandemic, and called for pregnant women to be offered a COVID-19 vaccine. Stephen Kennedy, a professor of reproductive medicine at the University of Oxford, who co-led the study, said: “We now know that the risks to mothers and babies are greater than we assumed at the start of the pandemic and that known health measures when implemented must include pregnant women. “The information should help families, as the need to do all one can to avoid becoming infected is now clear. Read full story Source: The Independent, 24 April 2021
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News Article
Heavily criticised trust recognised for improvements on infection control
Patient Safety Learning posted a news article in News
A trust which was heavily criticised for poor infection prevention and control last summer has been praised for making improvements. East Kent Hospitals University Foundation Trust was served with an enforcement notice by the Care Quality Commission in August last year, citing “serious concerns” about patient safety. The trust had twice the national rate of patients infected with COVID-19 after admission to hospital. But a new report, issued today, found significant improvements, with several areas of outstanding practice. The conditions imposed on the trust after last year’s inspection of the William Harvey Hospital in Ashford were also lifted, following the visit by the CQC in early March. Cath Campbell, CQC’s head of hospital inspections in the South East, said the improvements were particularly commendable as the trust had been under extreme pressure as a result of the pandemic. She said: “Leaders adopted learnings from other trusts, and from NHS Improvement which led to the development of a detailed infection prevention and control improvement plan. The trust then set up an improvement group to focus on implementing the actions in the plan and put a committee in place to review internal audit data and led improvements based on this information. “Although there were still one or two areas for improvement which we have advised the trust to look at now, overall this is a very positive report.” Read full story (paywalled) Source: HSJ, 23 April 2021 -
News Article
Science advisers call for better PPE for healthcare workers
Patient Safety Learning posted a news article in News
Healthcare workers have welcomed a change in scientific advice on how to protect them from coronavirus. A document by the government's scientific advisory group (Sage) says higher grade masks may be needed when caring for Covid patients. Current guidance says that thinner surgical masks are adequate, outside of intensive care units. The Department of Health said guidance "is kept under constant review" and protecting NHS staff was a priority. Some doctors described it as a "crack of light" after more than a year of campaigning for improvements. A long list of healthcare unions and professional bodies has been making increasingly desperate appeals for what are called FFP3 respirators. These are designed to filter out infectious aerosols that may be lingering in the air, particularly in close proximity to patients. Growing evidence of the risks of airborne transmission has led the government to emphasise the importance of ventilation - with the words "fresh air" now added to the public messaging. And now a technical document released by Sage concludes that healthcare workers may need higher standards of respiratory protective equipment. Read full story Source: BBC News, 24 April 2021
