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Found 1,312 results
  1. News Article
    The NIHR-supported PRINCIPLE trial is to start investigating the inhaled corticosteroid budesonide to find out if it can help treat COVID-19 in patients who aren’t in hospital. Led by the University of Oxford, the PRINCIPLE is the UK’s national platform trial for COVID-19 treatments that can be taken at home. It is evaluating treatments that can help people aged over 50 recover quickly from COVID-19 illness and prevent the need for hospital admission. The study, funded by NIHR and UK Research and Innovation (UKRI) has so far recruited more than 2100 volunteers from across the UK with support from NIHR’s Clinical Research Network. Inhaled budesonide is often used to treat asthma and chronic obstructive pulmonary disease, with no serious side-effects associated with short-term use. In some patients with COVID-19, the body’s immune response to the virus can cause high levels of inflammation that can damage cells in the airways and lungs. Inhaling budesonide into the airways targets anti-inflammatory treatment where it is needed most, and can potentially minimise any lung damage that might otherwise be caused by the virus. Patients taking part in the study will be randomly assigned to receive an inhaler in the post, alongside the usual care from their clinician. They will be asked to inhale two puffs twice a day for 14 days with each puff providing a 400 microgram dose of budesonide. They will be followed up for 28 days and will be compared with participants who have been assigned to receive the usual standard-of-care only. Read full story Source: National Institute for Health Research, 27 November 2020
  2. Content Article
    Influencing systemic change at an international level Through our six foundations for safer care, as outlined in A Blueprint for Action, we influence systemic change, in the UK and internationally, by: Calling for action to improve safety in all of the six foundations. Proposing new health and social care policy, and responding critically to policy consultations. Sharing learning on patient and staff safety in all areas of health and social care. Working directly with staff and patients on areas of safety that are the most important to them. Identifying and contributing to campaigns for patient and staff safety. Collaborating and creating safety partnerships with healthcare organisations, patient groups and patient safety leaders. Developing organisational safety improvement programmes, including new standards for patient safety and an associated accreditation framework. Central to all of our activities is the hub, our learning platform for patient safety, offering a powerful combination of tools, resources, stories, ideas, case studies and good practice to anyone who wants to make the care environment safer for patients and staff. the hub has flourished as a platform for patient safety the hub was launched at our Patient Safety Learning conference in October 2019. We have seen incredible growth of the hub over the course of 2020. To date, the hub has received over 111,000 visits, over 77,000 unique visitors, over 290,000 page views and multiple conversations on our community forum. It offers 4,000 knowledge resources and has 1,250 members from 500 different organisations. Members come from 41 different countries, with visitors spanning 174 countries. We are encouraged by these numbers and the continued growth of the hub. But perhaps more than this, we are proud of the relationships the hub is facilitating, the campaigns it is supporting, and the application of knowledge and improvements in patient safety that are happening as a result. Here are just a few examples: After a theatre nurse spoke up about an unsafe event she had witnessed, instead of the trust taking action, managers blocked her shifts. After sharing her story anonymously on the hub, the patient safety issue was highlighted more widely and we supported the nurse to begin working with the CQC to initiate an investigation. In the hub Communities area, patients are giving accounts of their experiences and helping to highlight patient safety issues, such as painful hysteroscopies and a lack of information and support for Long COVID patients. Trusts, such as the Homerton University NHS Foundation Trust, are sharing new initiatives and good practices that have gone on to be successfully implemented in other trusts and organisations. Jonathan Hazan, Chair of the Board of Trustees, comments: “Patient Safety Learning is still a new organisation and it is significant that we have been able to achieve so much influence in such a short time. Much of this is a result of the effectiveness of the hub as a platform for spreading ideas and actions, and I would like to thank patients, healthcare workers and all our other partners for contributing to our story.” So, what patient safety issues did we focus on and influence in 2020? As well as the hub, we published 38 new blogs on the Patient Safety Learning website, highlighting patient safety issues, responding to consultations, promoting World Patient Safety Day and reporting back on workshops, webinars and collaborations. We have been engaging with partners to call for the NHS and Government to act urgently and reduce avoidable harm in the following areas: The impact of the pandemic on patient safety, especially in non COVID care. Advice and support for people living with Long COVID. Painful hysteroscopies. Staff safety. Learning from, and implementing the recommendations of, the Cumberlege Review. Look out for our new blog series this month Over the coming weeks, we will be publishing five mini blogs on each of these topics, accompanied by short videos from members of the Patient Safety Learning team. Our aim with this series is to give you an insight into the work we’ve been doing in 2020, how we are making progress with our goal of improving patient safety and how we plan to build on this work in the future.
  3. News Article
    COVID-19 could be causing lung abnormalities still detectable more than three months after patients are infected, researchers suggest. A study of 10 patients at Oxford University used a novel scanning technique to identify damage not picked up by conventional scans. It uses a gas called xenon during MRI scans to create images of lung damage. Lung experts said a test that could spot long-term damage would make a huge difference to Covid patients. The xenon technique sees patients inhale the gas during a magnetic resonance imaging (MRI) scan. Prof Fergus Gleeson, who is leading the work, tried out his scanning technique on 10 patients aged between 19 and 69. Eight of them had persistent shortness of breath and tiredness three months after being ill with coronavirus, even though none of them had been admitted to intensive care or required ventilation, and conventional scans had found no problems in their lungs. The scans showed signs of lung damage - by highlighting areas where air is not flowing easily into the blood - in the eight who reported breathlessness. The results have prompted Prof Gleeson to plan a trial of up to 100 people to see if the same is true of people who had not been admitted to hospital and had not suffered from such serious symptoms. He is planning to work with GPs to scan people who have tested positive for COVID-19 across a range of age groups. The aim is to discover whether lung damage occurs and if so whether it is permanent, or resolves over time. Read full story Source: BBC News, 1 December 2020
  4. News Article
    The government has admitted the NHS in England does not have enough nurses and doctors to keep all its services running if there is a third spike in coronavirus cases as leaked figures show the number of staff off work because of the virus rising. An analysis of the impact of coronavirus, released by Downing Street on Monday, warned that even with a 6% growth in NHS staff since August 2019 and extra funding “there is a trade-off between the NHS’s ability to deliver COVID-19 and non-Covid-19 care in the event that COVID-19 hospitalisations rise”. It also warned of the psychological effects on staff saying: “It would be expected that higher rates of post-traumatic stress disorder (PTSD) would be seen amongst health and social care staff.” New leaked NHS data for England on Monday shows more than 82,000 NHS staff are absent from work with more than two-fifths, 42 per cent, linked to coronavirus either due to sickness or because they need to self-isolate. This includes almost 27,000 nurses and 4,000 doctors absent from NHS wards. Hospital leaders reiterated the strain the NHS was under in a briefing to MPs ahead of the vote on local tier restrictions today. Read full story Source: The Independent, 1 December 2020
  5. Content Article
    Key findings 45% of respondents have seen a permanent increase in the critical care capacity of their directorates. However, when asked if they consider any increase in capacity to be adequately staffed only 18% of respondents agreed. 60% of respondents reported that their units are still attempting to follow the Guidelines for the Provision of Intensive Care Services (GPICS) but 54% of respondents have seen some relaxation of those standards including to their medical staffing. 80% of respondents increased their working hours, and 71% report covering sick consultant colleagues. Future uncertainties affect the wellbeing of the Faculty’s fellows and members. How hospital structures support those working in critical care is vitally important for both recruitment and retention. 88% of respondents had leave cancelled. Work/life balance is extremely important. Whilst the vast majority of respondents were happy to deliver the needed increase in work in the first wave, to do this over subsequent waves of the pandemic becomes increasingly difficult for individuals and their family. Supporting professional activities and agreed job plans will be even more important in subsequent COVID-19 waves. Faculty fellows and members understood the impact the first wave of COVID-19 had on non-critical care staff, and hugely appreciated their response to the crisis. The flexible increase in staffing was so important for care, although the drop in GPICS standards underlines the need to increase the underlying critical care capacity, and the multi-disciplinary workforce. Key recommendations GPICS standards exist for reasons of best care, safety and governance. Units should be attempting to adhere to them or working towards achieving them. Inability to meet GPICS standards needs to be brought to the attention of management structures within hospitals and plans for addressing deficiencies identified and implemented. Supporting and maintaining the wellbeing of critical care staff is vitally important. Not only for recruitment by attracting multi-disciplinary team members in, but also for their retention in the specialty. Staff must not be taken for granted and listening to the voices from the frontline is only the start of this process. Enhanced Care recommendations, written and promoted by the Faculty, will allow for greater flexibility in future responses to surges in demand as well as safer care for those needing a higher level of care. Critical Care Directorates should make the case widely within their hospitals for enhanced surgical and medical care.
  6. Content Article
    Key points The impact of the COVID-19 pandemic has been severe in England and has affected disproportionally people who use and provide long-term care. Since the beginning of the pandemic and until the 6 November, 15,659 people had died in the care home and their deaths were linked to COVID-19 in the death register. An estimate of the deaths of care home residents (including those who died in hospital) suggests that, until the 13 November, 20.799 care home residents died whose deaths were attributed to COVID-19. An estimate of excess deaths in care homes suggests that 22,948 more people died until the 30 October, compared to the previous 5 years. This would represent around 5% all care home residents. There have also been increased deaths among people receiving care at home, people who work in social care provision, and the people with learning disabilities and dementia. The initial COVID-19 policy responses did not adequately consider the social care sector. A social care action plan was not introduced until mid-April, almost a full month after the Prime Minister announced the country would go into lockdown. With the response almost entirely focused on the NHS, too little consideration was given to the fragmented social care system, which was already in a fragile state prior to the pandemic, and into which many people were being discharged from hospital. Delays in access to personal protective equipment and staff and service user testing are likely to have contributed to the high death toll in the sector. Since the first wave, there has been improvement in terms of availability of guidance, access to Personal Protection Equipment and testing. In the second wave, care providers continue to face challenges with testing capacity (and speed), visiting policies and the financial implications of the additional costs of the pandemic and decreases in revenue. In the absence of standardised and robust national data on the sector, finding data about the impact of the pandemic on people who use and provide long-term care remains a challenge. The pandemic has laid bare long-standing problems in the long-term care system in England, such as the fragmentation of responsibilities, funding and workforce pressures, as well as the unequal relationship between the health and social care systems and the invisibility of groups such as working age adults with disabilities and unpaid carers in social care planning.
  7. News Article
    There are serious concerns over the funding and staffing numbers available for new ‘long-covid’ clinics, while patient groups ‘remain in the dark’ over their locations. Last month, NHS England announced there would be 40 clinics around the country, to start opening at the end of November, with £10m of funding to cover set-up and operational costs until March 2021. But several speakers at HSJ’s inaugural virtual respiratory forum last week said there were still uncertainties and concerns about the capacity to provide the clinics. Dr Jon Bennet, a respiratory consultant and chair of the British Thoracic Society, said staffing the respiratory rehabilitation services within the clinics would be challenging, as “there isn’t at the moment sufficient capacity”. Read full story (paywalled) Source: HSJ, 29 November 2020
  8. Event
    A Westminster Health Forum policy conference with: Dr Clifford Mann, National Clinical Director, Urgent and Emergency Care, NHS England and NHS Improvement Dr Katherine Henderson, President, Royal College of Emergency Medicine Jessica Morris, Nuffield Trust; Dr Nick Scriven, The Society of Acute Medicine; Sandie Smith, Healthwatch Cambridgeshire and Peterborough; and Deborah Thompson, NHS Acute Frailty and Ambulatory Emergency Care Networks and NHS Elect Delegates will discuss key developments and challenges in the context of service changes in response to the COVID-19 pandemic, and the ongoing implementation of the NHS Long Term Plan. Register
  9. Event
    Currently very little is known about the clinical, biological, psychological and socio-environmental impact of COVID-19. While most people may have uncomplicated recoveries, some experience prolonged or new symptoms and complications. The wide range of Long Covid symptoms documented indicates that multiple body systems are involved. Some of the more commonly reported symptoms include fatigue, breathing difficulties, joint pain, chest pain, as well as muscle weakness and neurological symptoms. These are common among both people who were hospitalised in the early phase of COVID-19 and those who were not. Systematic reviews show that people worldwide are experiencing prolonged symptoms of COVID-19. There are implications at an individual level for people’s quality of life and their ability to work, as well as at a socioeconomic level due to the risk of widening health inequalities. As well as breadth of the physical, psychological and social complications, there is a need to understand the causes (aetiology) of the symptoms and complications experienced. It is also vital to be able to identify people at higher risk of Long Covid, as well as interventions that might reduce that risk, and support rehabilitation and recovery. There is an urgent need for robust scientific studies into the long-term impact of COVID-19 in both adults and children, and for healthcare providers to be informed to support prevention, assessment, rehabilitation and interventions to improve recovery and patient outcomes. With this need in mind, ISARIC and GloPID-R are organising the Long Covid Forum on December 9 and 10, 2020 in collaboration with the Long Covid Support. The objectives of the forum will be: to gain a better understanding of Long Covid; the science and the personal impact to define research gaps for funders and researchers to take forward. Register
  10. Event
    The Chronic Long Covid19 support group presents this international conference for patients. Presenters: Dr David Tuller, Global Public Health Expert, University of Berkeley, California: graded exercise therapy/cognitive behavior therapy treatment approach to ME and why it should not be used for long-covid patients. Nikita Alexandrov biochemist/biohacker, University of Alabama, USA: COVID-19 and the elephants in the room – big misconceptions and important out of the box observations made so far. Secondary infections: why there is no real cytokine storm concern and the issue of mast cell activation. Book your place
  11. News Article
    New Covid guidance for hospitals could see more patients receiving face-to-face visits from loved ones. NHS Wales has given health boards and hospices flexibility to allow visits based on local levels of COVID-19. Until now accompanying people to medical appointments and hospital visits have not been allowed, with a few exceptions. It also allows for pregnant women in low Covid rate areas to take their partners to maternity appointments. The Welsh Government said the new flexibility was "due to the changing picture of coronavirus transmission across Wales, with significant variations in community transmission across different parts of the country and differences in the rate of nosocomial transmission". Read full story Source: BBC News, 30 November 2020
  12. News Article
    Health inspectors in England have been moving between care homes with high levels of COVID-19 infection without being tested, raising fears they have put more residents at risk of catching the virus, leaks to the Guardian have revealed. In recent weeks all care home inspections carried out in the north of England have been of infected homes, including a facility where 38 of the 41 people receiving care and 30 staff – almost half of the workers – had tested positive, internal documents from the Care Quality Commission (CQC) show. Over the last two months inspectors have been checking infection control procedures and care standards in up to 600 care homes, many of which were dealing with outbreaks of COVID-19, but the Department of Health and Social Care (DHSC) has yet to provide testing. The CQC said on Friday it was expecting to start testing inspectors “in the coming weeks”. Weekly Covid deaths in care homes have been rising. In the week to 20 November, 398 people were notified to the CQC as having died from Covid, up from 138 a month earlier. The death toll remains lower than at the peak of the pandemic, when more than 2,500 people were dying a week in late April. The situation has sparked “very real anxieties about contracting the disease” and spreading it between infected homes, the leaked memos reveal. One inspector described work to his managers as like “going into the eye of the storm”. Read full story Source: The Guardian, 27 November 2020
  13. News Article
    A woman has become blind after her monthly eye injections were delayed for four months during lockdown. Helen Jeremy, 73, said everything she enjoyed doing has "gone out of the window" after losing her eyesight. She has glaucoma and was diagnosed with age-related macular degeneration four years ago. Monthly injections controlled the condition and meant she could still drive and play the piano. However, her appointments were cancelled when the pandemic struck and her eyesight deteriorated. "I was panicking. It was terrifying. Because I'm a widow I'm on my own and it was awful," she said. "Suddenly my eyesight was basically gone. By the time of my next appointment I was told there was no point in going on with these injections because the damage had been done to the back of my eye." Thousands more people in Wales are at risk of "irreversible sight loss" because of treatment delays, RNIB Cymru warns. The Welsh Government said health boards are working to increase services. Read full story Source: BBC News, 27 November 2020
  14. News Article
    NHS trust chief executives have told HSJ they need more clarity the Pfizer-BioNTech covid vaccine is safe to reassure their worried staff. Trusts were told last week they need to be ready to start vaccinating their staff from early next month. On Tuesday, it was confirmed that they would initially be asked to use the covid vaccine produced by Pfizer and BioNTech, assuming it is granted a licence by the Medicines and Healthcare products Regulatory Agency. Speaking at the HSJ Provider Virtual Summit, St George’s University Hospitals Foundation Trust chief executive Jacqueline Totterdell said there was a lot of “anxiety” around the vaccine among her staff. Leeds Community Healthcare Trust chief Thea Stein added leaders in her city feel “anxious and uncertain”. Ms Totterdell said: “As a responsible officer for 9,000 staff, I also need to be clear that the vaccination is safe. That bit of narrative just needs to come out from the centre, about the reasons why they think it is safe. “I think there is a lot of anxiety, and some of the polls we’ve done around south west London show that as little as 50 per cent of people are willing just to have it without any of that [assurance]." Northumbria Healthcare FT chief executive Sir Jim Mackey, who also spoke at the summit, admitted he was “a bit surprised” by some staff who said they were not going to get the vaccine. The former NHS Improvement chief added: “I think when it actually comes to it, and we get the messaging right about it, not just the responsibility for you but also your responsibility for the people you work with… then the vast majority of people will get it and take confidence in the fact that it’s been developed really quickly and effectively. “These things don’t get signed off if they’re dangerous, so we need to embrace it as the thing that’s going to get us back to normal.” Read full story (paywalled) Source: HSJ, 26 November 2020
  15. Event
    How are we ensuring that patient and staff safety is being prioritised during the pandemic? Presenters: Helen Hughes, Chief Executive, Patient Safety Learning, Dr Abdulelah Alhawsawi, Director General, Saudi Patient Safety Center, Professor Ted Baker, Chief Inspector of Hospitals, Care Quality Commission It can be argued that staff safety has not been prioritised as it should have been in recent years. The Covid-19 pandemic has reinforced this. It has exposed risks to staff physical and mental wellbeing, with inadequate Personal Protective Equipment (PPE), intensely difficult physical and psychological working conditions, and, tragically, it has resulted in deaths from exposure to Covid-19 as a result of inadequate infection control. The importance of overarching leadership for patient safety in health and social care is a key concept. Ensuring that leaders embed staff safety into safety programmes is essential. Some of the core issues that the panel will be exploring: How are leaders ensuring patient and staff safety during the pandemic? Are we doing enough? How are we prioritising patient access to non Covid care and treatment? Are we doing enough to encourage just and learning cultures and staff speaking up for safety? How are we sharing learning and knowledge on safe treatment and care? How are system and professional regulators ensuring that patient safety is a priority? Register
  16. News Article
    Across Britain, intensive care nurses and doctors are being pushed to their limits as they try to save lives from coronavirus. During 12-hour shifts in sweltering conditions, they are faced with technical and emotional challenges that many have never faced as they tackle a virus that has swept across the globe in a matter of days, threatening to kill tens of thousands in the UK. Britain has yet to even hit the peak of infections, but intensive care specialists are already asking how long they can keep working relentlessly. “We are trained for and used to dealing with difficult and emotional scenarios, but this is like a major incident that never ends,” says critical care nurse Karin Gerber. As an advanced nurse practitioner in critical care outreach, the 47-year-old sees patients in hospital who are getting sicker and may need to be admitted to intensive care. She says she has never seen anything “at this intensity”. The Royal London Hospital is at the forefront of the capital’s fight against the virus and has created more than 200 extra beds at its Whitechapel site in east London. They are filled with COVID-19 patients. Simon Richards, senior charge nurse at the Royal London’s critical care unit, tells The Independent: “In 20 years as a nurse this situation is by far the worst I have ever seen and totally unexpected, but the team spirit that people have shown has been amazing. “It’s extremely difficult, we are working so hard. The whole team is being pushed to their limit and you do wonder how long can this be sustained for? I wish we could see light at the end of the tunnel.” Read full story Source: The Independent, 24 November 2020
  17. News Article
    Hospital trusts have been put on notice that the challenging storage requirements of the first covid vaccines are likely to mean the vaccination of their staff will have to form the vanguard of the planned roll-out next month due. HSJ reported last week that healthcare staff would share priority with “care home residents and staff” in the vaccine roll-out. However, a letter sent to trust chief executives by NHS England seeks to clarify the situation by stressing that “different vaccines are likely to be better suited to different settings because the vaccines are likely to have different storage, reconstitution and administration requirements”. “Given what we currently know about the first expected vaccine, the imperative is that NHS trusts are ready to start vaccinating from the beginning of December.” Trusts are one of several components of the vaccination programme that includes primary care-run sites, mass vaccination centres, and “roving” visits to those who need them. Local systems and regional teams will decide “the most appropriate combination of models required to deliver the vaccine to their local populations based on local needs” the letter says. However, during the early stages of the roll-out this is likely to be dictated by the vaccine types that become available. Read full story (paywalled) Source: HSJ, 25 November 2020