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Found 2,339 results
  1. Content Article
    This document, developed by McMaster University's School of Rehabilitation Science in Canada, provides a guide for rehabilitation practice during the COVID-19 crisis. Informed by the best available evidence, including consultation with the clinical community, this living document consolidates findings from resources for front line rehabilitation professionals.
  2. News Article
    Over 90 civil society groups and individual signatories are calling on all public authorities and private sector organisations to protect those who expose harms, abuses and serious wrongdoing during the COVID-19 crisis. Since the beginning of the COVID-19 emergency, worrying reports concerning hospitals and public authorities retaliating against healthcare professionals for speaking out about the realities of COVID-19 have emerged worldwide, from China to the United States. Transparency International urges decision-makers at the highest level to resist the temptation to control the flow of information and instead offer assurances to individuals who witness corruption and wrongdoing to blow the whistle. Marie Terracol, Whistleblowing Programme Coordinator at Transparency International said: “The need for transparency and integrity, heightened in this time of crisis where abuses can cost lives, illustrates the essential role of those who speak up in the public interest." “National governments, public institutions and companies should listen to workers and citizens who come forward and report abuses they witness and protect them from retaliation, including in countries which still do not offer robust legal whistleblower protection. If people feel they can safely make a difference by speaking up, more instances of abuses will be prevented and addressed, and lives might be saved.” Read full story Source: Transparency International. 22 April 2020
  3. News Article
    A new risk tool could be used to identify those most at threat from COVID-19, so GPs can give patients tailored advice, health officials have said. Scientists at Oxford University are working on a clinical risk prediction model, which aims to give individuals more precise information about the likely impact of the disease on them, instead of a blanket approach. Health officials said the plans aimed to allow “very individualised discussions” between patients and their doctors, in the event of future outbreaks, particularly as winter approaches. Read full story (paywalled) Source: The Telegraph, 23 June 2020
  4. News Article
    Discharging patients into care homes in England in early April, when the number of coronavirus cases was rapidly increasing, was neither reckless nor wrong, the Department of Health and Social Care’s (DHSC) most senior civil servant has claimed. Faced with aggressive questioning from MPs on the powerful public accounts committee on Monday, Sir Chris Wormald, permanent secretary at the DHSC, said the guidance for discharge was correct based on the information available at the time. Conservative MP Sir Geoffrey Clifton-Brown said to Wormald: “You were discharging them from hospital into care homes when care homes were already in dire trouble, some of the most vulnerable people in society, the testing wasn’t available, PPE [personal protective equipment] wasn’t available, the training wasn’t available. Wasn’t this a pretty reckless policy by the government?” Wormald replied: “We don’t believe that. Now, as Prof [Stephen] Powis [national medical director of NHS England] described, at this point Covid was not considered to be widespread in the community.” A clearly frustrated Clifton-Brown interrupted him saying there were already 1,000 care homes with coronavirus cases at the beginning of April. He also questioned why detailed advice in relation to coronavirus for the social care sector had not been issued until 15 April, almost a month after the equivalent information was provided to the NHS. Read full story Source: The Guardian, 23 June 2020
  5. News Article
    The 2.2 million people who have been self-isolating in England during the pandemic will no longer need to shield from 1 August. From 6 July, they will be able to meet up outdoors, in a group, with up to five others and form 'support bubbles' with other households. The measures can be eased because infection rates are falling, the government says. Among the list of people who should be shielding are solid organ transplant recipients, cancer patients undergoing chemotherapy, pregnant women with heart disease and people with severe respiratory conditions such as cystic fibrosis and severe asthma. The government says it has worked with clinicians, GPs, charities, the voluntary sector and patient groups on the changes, but some charities are criticising the relaxing of the advice, saying many of the people they support do not feel it is safe to stop shielding. Read full story Source: BBC News, 23 June 2020
  6. Content Article
    The COVID-19 pandemic has uncovered serious gaps in the healthcare systems of many nations. In particular, it exposes a fragmented global governance system that does not have the structures to coordinate the pooling and sharing of resources needed to combat pandemics. Since the early days of the pandemic, medical protectionism has emerged as nations scrambled for their own stocks of personal protective equipment and ventilators. COVID-19 vaccines could be the next example. Already there is a danger of a vaccine bidding war, with governments competing for a limited number of doses, well before a vaccine even reaches the market. It is imperative that more governments and pharmaceutical companies agree to shoulder the costs of vaccine research and manufacturing, and to share data and technologies. They need to commit to WHO allocation guidelines and cooperate globally to distribute vaccines fairly to those at greatest risk. A pandemic vaccine needs strong global governance behind it.
  7. Content Article
    There is clear evidence that COVID-19 does not affect all population groups equally. Many analyses have shown that older age, ethnicity, male sex and geographical area, for example, are associated with the risk of getting the infection, experiencing more severe symptoms and higher rates of death. This work has been commissioned by the Chief Medical Officer for England to understand the extent that ethnicity impacts upon risk and outcomes. The Public Health England (PHE) review of disparities in the risk and outcomes of COVID-19 shows that there is an association between belonging to some ethnic groups and the likelihood of testing positive and dying with COVID-19. Genetics were not included in the scope of the review.
  8. News Article
    Leading clinicians have written to Boris Johnson warning the UK faces a "second health catastrophe" because so many non-Covid patients are missing out on treatment as a result of the pandemic. The letter warns that “lives are being put at risk” and that action is needed immediately. It comes as new figures show as many as one in six (10 million) people will be on the NHS waiting list by the end of the year. The letter, signed by ten specialists, including cancer doctors, patient safety experts, CQCs and medical negligence lawyers, states: “We are increasingly concerned about the impact, including avoidable harm and death caused by the continuing unavailability of urgent diagnostics and treatment for thousands of non-COVID patients. “The backlog of such cases is now significant and worsening. We implore the central and devolved Governments of the UK to take urgent strategic action, including in co-ordination and co-operation with each other, to prevent this becoming a second and perhaps even more serious health catastrophe arising from the pandemic in the UK.” The letter was also signed by barrister Theo Huckle QC, Professor John Fairclough of Swansea and Cardiff Met Universities, Nick Brown of Doughty Street Chambers and Helen Hughes, Chief Executive, Patient Safety Learning. Cases which have come to the attention of the signatories include Sherwin Hall, 27, a father of one from Leeds, who made 13 visits to hospital during the COVID-19 lockdown before getting a cancer diagnosis for the pain in his groin. He said of his case: “I am very angry at the way I have been treated due to COVID-19 and the delay on my cancer treatment and now I am fighting for my life. Read full story Source: Express, 21 June 2020
  9. News Article
    A new coronavirus test which could replace the existing a nose and throat swab is being piloted in Southampton. People will be able to simply spit into a pot at home before the sample is sent off to check whether they have COVID-19. If successful, the saliva test could become an alternative to the existing swab which some people find uncomfortable and can provoke coughing and spluttering. Read full story Source: The Independent, 22 June 2020
  10. Content Article
    A significant number of people, who may or may not have been acutely unwell with COVID-19, are experiencing a prolonged and debilitating recovery at home. Symptoms and experiences of care seem to vary greatly among this group, sometimes known as the COVID-19 ‘long-haulers’. Many are finding comfort and reassurance through online communities, set up by and designed for patients who are struggling to get back on their feet.
  11. Content Article
    The International Society of Pharmacovigilance share their first infographic for patients and carers on using medicines safely during the COVID-19 pandemic. They developed the tool because of the difficulties experienced with obtaining and using medicines safely during the COVID-19 pandemic.
  12. Content Article
    ECRI position paper looking at post-intensive care syndrome (PICS) after covid. PICS, a nonspecific syndrome that results from physical, mental, and emotional stresses associated with critical illness and treatment in intensive care units.
  13. Content Article
    Implementation of high reliability principles in healthcare delivery is recognized as an effective strategy for reducing harm to patients and healthcare workers. With the coronavirus disease 2019 (COVID-19) pandemic upon us, our emergency departments (EDs) are facing an unprecedented safety threat. How does a high reliability ED function during a pandemic, and what are the most important strategies for keeping ourselves and our patients safe? Thull-Freedman et al. discuss this in a commentary in the Canadian Journal of Emergency Medicine.
  14. Content Article
    According to experts, older adults with or without pre-existing chronic conditions are at higher risk of COVID-19 infection and are also more likely to have severe cases requiring intubation, ventilator support, and intensive care. In fact, the CDC reports that about 8 of 10 COVID-19 deaths in the U.S. have been adults over the age of 65 years, with the majority over 85 years of age. The risk of contracting and dying from COVID-19 is an even greater problem in the almost 16,000 U.S. nursing homes, where there are concentrated numbers of older adults with chronic disease and frailty. This PSNet Patient Safety Primer looks at the patient safety problems for older adults.
  15. News Article
    NHS trusts could be asked to create shared waiting lists for elective care under plans being considered by national leaders. HSJ understands that NHS England chief executive Sir Simon Stevens is to write to all NHS organisations early next month to lay out plans for phase three of the recovery from covid. The letter is expected to focus on the importance of working at a system level to get more services up and running. Senior NHS sources said the recovery plans are likely to include proposals for creating pooled system-level waiting lists between trusts, but there is still internal debate over the extent to which changes could effectively be mandated; for example, by attaching significant incentive funds. The move appears to be aimed at ensuring an “equitable level of care” across a patch. In a statement, NHSE said individual providers’ would ultimately still have responsibility and accountability for their waiting lists, even where this might be “supplemented” by system-wide arrangements. Read more Source: HSJ, 19 June 2020
  16. News Article
    The UK’s failure to report how many people have recovered from COVID-19 has been criticised by public health experts, who say a huge proportion of cases have remained “invisible” to the health service. Britain is an outlier internationally in not reporting the number of people who have recovered from COVID-19 alongside statistics on deaths and numbers of identified cases. Chile is the only other nation not to share this information out of the 25 countries with the highest reported incidence. A failure to monitor those who test positive for COVID-19 outside of hospital has left people feeling unsupported and alienated from the health system, the experts say. There is concern that because the majority of community cases have not been logged in patient records, it will be more challenging to research the long-term consequences of the disease. Prof Devi Sridhar, the chair of global public health at the University of Edinburgh, said: “Not tracking people in the community, for me, [is] so astonishing. These people are completely invisible in the health system.” Read full story Source: The Guardian, 18 June 2020
  17. Content Article
    After the COVID-19 pandemic is over, a key issue remains for the UK’s NHS: Will there be less avoidable patient harm, fewer occurrences of “never events,” and fewer headline grabbing patient safety crises? John Tingle explores this further in his blog for the Bill of Health. John Tingle is a regular contributor to the Bill of Health blog and is a Lecturer in Law at Birmingham Law School in the UK and a Visiting Professor of Law, Loyola University Chicago, School of Law.
  18. Content Article
    Six years ago The Snowy White Peaks of the NHS highlighted the scale of race discrimination in the NHS, the UK’s biggest employer of Black and Minority Ethnic (BME) staff. COVID-19 has shown so much more needs to be done. 300 health and social care staff have died so far from COVID-19, a disproportionate number of BME heritage. We know NHS staff infection was overwhelmingly due to occupational exposure whose causes are varied but include the disproportionate BME staff role in patient-facing services, their poorer access to appropriate PPE, the greater reluctance of BME staff to raise concerns, disproportionate deployment into “hotter” roles, and the greater presence of BME colleagues amongst agency staff. BME staff have been largely absent from decision-making. The COVID-19 impact on BME staff, and Black Lives Matter, has prompted promises to tackle racism more resolutely. So what should NHS leaders do to ensure faster progress to tackle workforce race discrimination? Roger Kline, in this BMJ Leader blog, has ten suggestions for Boards and Integrated Care System system leaders.
  19. News Article
    Low dose dexamethasone reduces deaths in patients hospitalised with COVID-19 who need ventilation, according to preliminary results from the RECOVERY trial. The drug was also found to reduce deaths by one-fifth in other hospitalised patients receiving oxygen only, but no benefit was seen among COVID-19 patients who did not need respiratory support. The chief investigators from the University of Oxford trial said that the findings represent a “major breakthrough” which is “globally applicable” as the drug is cheap and readily available. Peter Horby, Professor of Emerging Infectious Diseases at the University of Oxford and a chief investigator on the trial, added, “This is the only drug that has so far been shown to reduce mortality, and it reduces it significantly. It is a major breakthrough.” Read full story Source: BMJ, 16 June 2020
  20. News Article
    Doctors fear a rise in stillbirths and babies with impaired growth because pregnant women were too scared to seek help during the pandemic. At a Royal Society of Medicine webinar on pregnancy and Covid, medics expressed concern that women in need of urgent attention had kept away from maternity services, for fear of catching the infection. In other cases, those with worrying symptoms which could mean their baby was at risk may have stayed away because they feared putting pressure on services, doctors said. Dr Maggie Blott, head of obstetrics at the Royal Free London Foundation trust, said: “A lot of the work that we do is is prevention, and a lot of women that we see, turn up for hospital as an emergency - have concerns around abdominal pain, reduced foetal movements, all sorts of things.” Read full story (paywalled) Source: The Telegraph, 18 June 2020
  21. Content Article
    The COVID-19 pandemic has brought health inequalities into sharp focus. The unequal impacts of the virus are also extending inequalities in mental health. This briefing paper, produced by Centre for Mental Health and supported by 13 other national mental health charities, explores the mental health inequalities that are associated with the pandemic in the UK. It finds that the virus and the lockdown are putting greater pressure on groups and communities whose mental health was already poorer and more precarious. Groups of people whose mental health is at greatest risk include those with existing mental health problems, people with long-term physical conditions, women and children experiencing violence and abuse, and Black, Asian and minority ethnic communities. The combination of existing structural inequalities and the unequal impacts of the pandemic mean that people whose mental health was at greatest risk prior to COVID-19 are likely to bear the brunt of the emergency longer term.
  22. Content Article
    The pandemic has shown us health service transformation needs to go hand in hand with more beds and resources. The big challenge for all of us now is to to stand back and say: what has this taught us about the strengths and weaknesses of our healthcare system? What did we get right and wrong? The NHS has done an amazing job, proving itself very agile, very productive and very flexible. It’s been a process of constant learning. But there’s a very big backlog of people needing care, because we had this huge emptying out of hospitals and many NHS services were paused, notably elective surgery. Sir Jim Mackey, Chief Executive of Northumbria Healthcare NHS foundation trust and former Chief Executive of NHS Improvement, thinks private hospitals can help the NHS get on top of the backlog, to agreed standards and with the NHS paying. He tells the Guardian that it’s wrong that patients have to wait too long to get treatment and the public won’t care who provides that care.
  23. Content Article
    University Hospitals of Morecambe Bay NHS Foundation Trust (UHMBT) is setting out its priorities for the remainder of the coronavirus (COVID-19) pandemic and into the future. The pandemic has meant that certain plans have had to be put temporarily on hold but the Trust says there are important areas that can and will be developed over the next few months and into 2021. Quality and safety of care remain the main priorities so the Trust is now focusing on four key areas to ensure that services recover and improve as the country emerges from the pandemic. 
  24. News Article
    In a major U-turn, the UK is ditching the way its current coronavirus-tracing app works and shifting to a model based on technology provided by Apple and Google. The Apple-Google design has been promoted as being more privacy-focused. However, it means epidemiologists will have access to less data. The government now intends to launch an app in the autumn, but it says the product may not involve contact tracing at that point. Instead the software may be limited to enabling users to report their symptoms and order a test. Baroness Dido Harding - who heads up the wider Test and Trace programme - will only give the green light to actually deploying the Apple-Google technology if she judges it to be fit for purpose, which she does not believe is the case at present. It is possible this may never happen. Read full story Source: BBC News, 18 June 2020
  25. Content Article
    The NIHR-funded and supported study RECOVERY (Randomised Evaluation of COVid-19 thERapY) has announced that the steroid dexamethasone has been identified as the first drug to improve survival rates in certain coronavirus patients.
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