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Content ArticleThe Care Quality Commission (CQC) has published the first of what will be a regular series of insight documents intended to highlight COVID-19 related pressures on the sectors that CQC regulates. This document draws on information gathered through direct feedback from staff and people receiving care, regular data collection from services who provide care for people in their own homes, and insight from providers and partners. The information collected from these sources is being used to understand the wider impact of COVID-19, to share regular updates with local, regional, and national system partners and the Department of Health and Social Care, and to highlight any emerging trends and issues.
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News Article
Recovery concerns as most ICUs still well above normal capacity
Patient Safety Learning posted a news article in News
Dozens of intensive care units are still running well over their normal capacity – in some cases more than double – weeks after the peak of demand, figures seen by HSJ reveal. It contrasts with the picture painted at some government coronavirus press conferences that there is huge “spare capacity” in critical care and has been throughout the outbreak, with Downing Street charts putting England-wide occupancy at around 20% currently. The government’s assertions include the additional “surge” capacity which was hurriedly established at the start of the outbreak. But intensive care staff have been frustrated by this being labelled spare capacity, when the number of patients being treated is still well above normal levels. In addition, the ongoing reliance on keeping surge beds open – with ICUs still spilling over other spaces and calling on staff and equipment from other services – will limit hospitals’ ability to resume normal care, such as planned surgery. Steve Mathieu, a consultant in intensive care medicine in the south of England, said: “The majority of ICUs will currently be operating at over 100 per cent capacity and typically somewhere around 130-150 per cent, although there is significant regional variation". “There are uncertainties whether this will now represent the ‘new normal’ for the foreseeable future and there is a national need to plan for further potential surges in activity requiring more critical care demand." Read full story Source: HSJ, 21 May 2020 -
News Article
Coronavirus: Time running out on track and trace, NHS leaders warn
Patient Safety Learning posted a news article in News
Time is running out to finalise a track and trace strategy that would avoid a potential second surge in coronavirus cases, NHS leaders have said. The NHS Confederation warned of "severe" consequences to staff and patients if the right system was not established quickly and that lockdown measures should not be eased until a clear plan was in place. Contact tracing identifies those who may have come into contact with an infected person, either through an app or by phone and email, so they can avoid potentially passing the disease on. It follows the Prime Minister's pledge to introduce a "world-beating" contact tracing system in England from June. Niall Dickson, chief executive of the confederation, which represents health and care leaders, welcomed Boris Johnson's pledge made at Prime Minister's Questions on Wednesday. But in a letter to Health Secretary Matt Hancock, Mr Dickson said without a clear strategy the UK was at greater risk of a second peak of the virus. He said a strategy should have been in place sooner and if the right system was not instigated rapidly the ramifications for the NHS "could be severe". Speaking on the Today programme, Mr Dickson said: "We are absolutely clear that contact tracing is the right thing to do, it is absolutely critical, it has got to be in place to prevent any notion of a second surge if the lockdown is being further released." Read full story Source: 21 May 2020 -
Content ArticleThe results of this US study are consistent with findings from China and Italy, which suggest that patients with underlying health conditions and risk factors, including, but not limited to, diabetes mellitus, hypertension, COPD, coronary artery disease, cerebrovascular disease, chronic renal disease, and smoking, might be at higher risk for severe disease or death from COVID-19. This analysis was limited by small numbers and missing data because of the burden placed on reporting health departments with rapidly rising case counts, and these findings might change as additional data become available.
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Content ArticleThis data snapshot from Santoli et al. highlights the results of an examination of two data sets (Jan to April 2019 and Jan to April 2020) to assess the impact of the pandemic on pediatric vaccination in the United States. The authors found significant vaccination declines and highlight the importance of childhood vaccination to prevent future disease outbreaks.
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Content Article
Choices for the “New Normal” (4 May 2020)
Patient Safety Learning posted an article in Blogs
No one can say with certainty what the consequences of this pandemic will be in 6 months, let alone 6 years or 60. Some “new normal” may emerge, in which novel systems and assumptions will replace many others long taken for granted. But at this early stage, it is more honest to frame the new, post–COVID-19 normal not as predictions, but as a series of choices. In this article in JAMA, Donald Berwick proposes six properties of care for durable change: tempo, standards, working conditions, proximity, preparedness, and equity. -
Content Article
NHS Employers: Risk assessments for staff – COVID-19
PatientSafetyLearning Team posted an article in Staff safety
This page contains guidance for employers on how to carry out risk assessments particularly for vulnerable groups, to understand the specific risks staff members face from exposure to COVID-19 and actions which employers can take to keep staff safe. This includes staff returning to work for the NHS, and existing staff who are potentially more at risk due to their race, age, disability or pregnancy. -
Content ArticlePaul Garner is Professor at the Liverpool School of Tropical Medicine. He is Director of the Centre for Evidence Synthesis in Global Health and Co-ordinating Editor of the Cochrane Infectious Diseases Group. In this blog for BMJ Opinion, Paul describes how he has struggled in the weeks following his COVID-19 infection and the relapses in fatigues that have occurred after any exertion.
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News Article
Coronavirus: Cancer surgery delays risk 'thousands' of deaths
Patient Safety Learning posted a news article in News
The NHS must ensure cancer-surgery delays do not cost more lives than the number of COVID-19 patients saved, the Institute of Cancer Research says. In some cancers, a three-month delay could make the difference between a tumour being curable or not, Prof Clare Turnbull said. And her modelling suggested delaying surgery risked thousands of additional deaths. NHS England is already urging people to seek help for worrying symptoms, but by the end of April, cancer referrals had dropped by an estimated 70%. Cancer doctors have told BBC News of having to make difficult decisions to postpone some patients' care during the coronavirus crisis. As normal service resumed, the NHS should prioritise "certain cancer types in particular", Prof Turnbull said. Lung and colorectal cancers, for example, were particularly fast moving. But for others, such as prostate and certain breast cancers, treatment could more safely be delayed. Read full story Source: BBC News, 20 May 2020 -
News Article
Second more deadly wave of coronavirus 'to hit Europe this winter'
Patient Safety Learning posted a news article in News
European countries should brace themselves for a deadly second wave of coronavirus infections because the pandemic is not over, the World Health Organization’s top official in Europe has said. In an exclusive interview with The Telegraph, Dr Hans Kluge, director for the WHO European region, delivered a stark warning to countries beginning to ease their lockdown restrictions, saying that now is the "time for preparation, not celebration". Dr Kluge stressed that, as the number of cases of COVID-19 in countries such as the UK, France and Italy was beginning to fall, it did not mean the pandemic was coming to an end. The epicentre of the European outbreak is now in the east, with the number of cases rising in Russia, Ukraine, Belarus and Kazakhstan, he warned. Read full story (paywalled) Source: The Telegraph, 20 May 2020 -
News ArticleMore than 460 people with a learning disability have died from coronavirus in just eight weeks since the start of the outbreak in England. New data shows between the 16 March and 10 May 1,029 people with a learning disability died in England, with 45 per cent, 467, linked to coronavirus.Overall the number of deaths during the eight weeks is 550 more than would be expected when compared to the same period last year. The charity Mencap warned people with a learning disability were “being forgotten in this crisis” and called for action to tackle what it said could be “potentially discriminatory practice.” It highlighted the percentage of Covid-19 related deaths among learning disabled people was higher than those in care homes, where the proportion of Covid-19 deaths was 31 per cent for the same period. The data has been published after an outcry over the lack of transparency about the impact of Covid-19 on mental health patients and people with a learning disability or autism. Read full story Source: The Independent, 19 May 2020
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Content ArticleThis statement outlines the UK's four nations’ collective strategic priorities and approach to Allied Health Professional (AHP) rehabilitation leadership during and after COVID-19. Rehabilitation is critical to ensuring our population’s recovery from the impacts of the pandemic and the long-term sustainability of the health and social care system. AHPs are at the centre in shaping the rehabilitation agenda while working as part of the wider multidisciplinary and multiagency teams across all sectors.
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Content ArticleMental Health UK has provided information and tips for managing your mental health during the coronavirus pandemic. Whether you're social distancing or self-isolating you may be feeling anxious or stressed during this time, and that's completely normal. There are simple steps you can take to look after your mental health and wellbeing.
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Content Article
My 'false negative' COVID-19 test put others at risk
PatientSafetyLearning Team posted an article in Blogs
The following account was shared with Patient Safety Learning by a patient called Sarah. She describes her experience of attending hospital with symptoms of COVID-19 and expresses concerns that she could have infected NHS staff due to a negative test result which later turned out to be inaccurate. -
Content ArticleFrom the early stages of the COVID-19 pandemic in the UK, Patient Safety Learning has been working with others in healthcare – from patients and staff to healthcare leaders and politicians – to identify the impact the pandemic is having on non COVID-19 treatment and care, and on patient safety. Recently, Patient Safety Learning hosted a webinar, in partnership with HealthPlusCare, titled ‘Patient safety: Time for questions? Non Covid-19 care and treatment’. The webinar took place on Wednesday 6 May, with a panel consisting of: Professor Maureen Baker CBE, Chair of the Professional Records Standards Body and past Chair of the Royal College of GPs Professor Mike Bewick, Chair of CECOPS and past Deputy Medical Director to Sir Bruce Keogh at NHS England Dr Jane Carthey, Human Factors and Patient Safety Specialist Mike Fairbourn, Chair of ABHI Patient Safety Working Group and BD Country General Manager Dean Russell MP, MP for Watford and member of the Health and Social Care Select Committee Claire Cox, Patient Safety Learning’s Associate Director of Patient Safety and Critical Care Outreach Nurse Helen Hughes, Patient Safety Learning’s Chief Executive We are delighted with the success of the webinar, with 542 participants. Those who attended represented stakeholders from across the health and care system, and were well-engaged, making good use of the chat, Q&A and polls.
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Content ArticleOn 4 May 2020, a 13-strong committee convened by former UK government Chief Scientific Adviser Sir David King discussed some aspects of the science behind the UK strategy in a two and a half hour meeting. Leading experts in public health, epidemiology, primary care, virology, mathematical modelling, and social and health policy, raised ideas and issues for consideration which are shared in this report. The report does not aim to critique such work. Rather, it recognises that such solutions will take time and will still require an appropriate public health infrastructure to maximise their benefit. This is the focus of this first report and the meeting aimed to offer some constructive ideas to the governments of the UK and the devolved nations about how best to tackle this crisis, to save lives, suppress the coronavirus and get the economy moving again.
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Content Article
Rethink Mental Illness: COVID-19 and mental illness
Patient Safety Learning posted an article in Mental health
The charity Rethink Mental Illness have set up an online hub to provide practical support and information that is useful for people living with, or supporting people with mental illness during the coronavirus pandemic. -
News Article
Coronavirus: Delirium 'may be common' in Covid seriously ill
Patient Safety Learning posted a news article in News
Delirium and confusion may be common among some seriously-ill hospital patients with COVID-19, a study in The Lancet suggests. Long stays in intensive care and being ventilated are thought to increase the risk, the researchers say. Doctors should look out for depression, anxiety and post-traumatic stress disorder (PTSD) after recovery, although most patients, particularly those with mild symptoms, will not be affected by mental health problems. The evidence is based on studies of patients with severe acute respiratory syndrome (Sars) and Middle-East respiratory syndrome (Mers), as well early data on COVID-19 patients. Read full story Source: BBC News, 19 May 2020 -
News Article
Cancer referrals are being rejected by hospitals, GPs warn
Patient Safety Learning posted a news article in News
Suspected cancer patients are being refused hospital appointments despite being referred by GPs, it has emerged. Family doctors working for one NHS trust in north east London claimed that hundreds of referrals had been rejected in recent weeks. Many were for ultrasounds and chest X-rays and were sent via the two-week wait system, in which suspected cancer patients referred by GPs are seen within a fortnight. A rejection letter sent from Whipps Cross hospital seen by Pulse magazine, said the referral had been “due to the Covid-19 pandemic”. It added: “Following triage by a consultant radiologist, your imaging request has been assessed as non-urgent and cancelled.” Read full story Source: The Telegraph (18 May 202) -
News ArticleGlobal efforts to vaccinate children against fatal diseases such as measles and polio could be set back a decade due to the disruption caused by the coronavirus pandemic, Unicef has warned. Immunisation campaigns and routine vaccine services have been suspended across the world to limit the transmission of COVID-19, leaving countries with weak health systems susceptible to a resurgence in preventable illnesses once lockdown restrictions are lifted and societies reopen. More than 25 vulnerable countries have placed their immunisation programmes for measles on hold, while the delivery of Ebola vaccinations across central Africa, in countries such as the Democratic Republic of the Congo (DRC) and Central African Republic (CAR), has similarly been suspended or curtailed. “Our immediate concern is with disruption to currently available vaccines,” Dr Robin Nandy, global chief of immunisation at Unicef, told The Independent. “We expect to go back maybe five to 10 years. The longer the disruptions continue, the more concerned we are as it builds the number of susceptible kids in populations. “What we’re trying to avoid is countries recovering from the current Covid pandemic then being hit by another outbreak of a vaccine-preventable disease.” Read full story Source: The Independent, 18 May 2020
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Content ArticleIf a nasogastric tube (NGT) has been misplaced into the respiratory tract and this is not detected before fluids, feed or medication are given, death or severe harm can be caused. The consequences are even more likely to be fatal for patients who are already critically ill. Most nasogastric ‘Never Events’ of feeding into the respiratory tract through a misplaced tube continue to arise from misinterpretation of x-rays by staff who had not been given training in the ‘four criteria’ technique and were unaware that relying on the position of the tube tip alone on a radiograph can be a fatal error. BAPEN has produced this easy reference guide.
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News Article
Thousands of Covid-19 cases missed due to late warning on smell loss, say experts
Patient Safety Learning posted a news article in News
Tens of thousands of cases of COCID-19 may have been missed because of delays in warning the public that loss of taste and smell is a key symptom that should lead to self-isolation or testing, experts say. The four chief medical officers of the UK have finally made official what many scientists had been saying for weeks: that anosmia, or loss of smell, should be added to the other two main warning symptoms, a continuous cough and high temperature. Those who experience any of the three symptoms should isolate for seven days and their families for 14 days. Prof Tim Spector from King’s College London and his team said data from 1.5 million people who downloaded their symptom-reporting app suggested 50,000 to 70,000 people in the UK had been missed. As early as 1 April, they warned that people with anosmia should self-isolate. They were joined by ear, nose and throat surgeons, who said loss of taste and smell could be one of the few markers for people who were otherwise asymptomatic and potentially able to infect other people without realising they were a risk. Their professional body, ENT-UK, said they had been calling for eight weeks for anosmia to be listed as a marker for asymptomatic carriers. It issued a joint statement with the British Rhinology Society (BRS) on 20 March, it said. “We estimate that many hundreds of thousands of patients in the UK have developed anosmia as a result of COVID-19,” said Prof Claire Hopkins, the BRS president. Read full story Source: Guardian, 18 May 2020 -
Content Article
Every Mind Matters: Coronavirus and wellbeing
Patient Safety Learning posted an article in Mental health
Having good mental health helps us relax more, achieve more and enjoy our lives more. The Every Mind Matters website has expert advice and practical tips to help you look after your mental health and wellbeing. -
Content ArticleThe British public have been offered alternating periods of lockdown and relaxation of restrictions as part of the COVID-19 lockdown exit strategy. Extended periods of lockdown will increase economic and social damage, and each relaxation will almost certainly trigger a further epidemic wave of deaths. These cycles will kill tens of thousands, perhaps hundreds of thousands, of people before a vaccine becomes available, with the most disadvantaged groups experiencing the greatest suffering. There is an alternative strategy: universal repeated testing. The authors of this article published in The Lancet recommend evaluation of weekly severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antigen testing of the whole population in an entire city as a demonstration site (preferably several towns and cities, if possible), with strict household quarantine after a positive test. Quarantine would end when all residents of the household test negative at the same time; everyone else in the city can resume normal life, if they choose to.
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Content ArticleToo little, too late, says Scally, Jacobson and Abbasi in this BMJ Editorial on the government's response to COVID-19. The UK government and its advisers were confident that they were “well prepared” when COVID-19 swept East Asia. The four-pronged plan of 3 March to contain, delay, research, and mitigate was supported by all UK countries and backed, they claimed, by science. With over 30 000 hospital and community deaths by 12 May, where did the plan go wrong? What was the role of public health in the biggest public health crisis since the Spanish flu of 1918? And what now needs to be done?
