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Content ArticleLATEST Patient Safety Weekly Update #5 (15 October 2020) Patient Safety Weekly Update #4 (8 October 2020) Patient Safety Weekly Update #3 (1 October 2020) Patient Safety Weekly Update #2 (23 September 2020) Patient Safety Weekly Update #1 (17 September 2020)
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Content ArticleIn order to support informed and sensitive care of women, this Royal College of Nursing publication focuses on: an overview of HPV (including the current vaccination recommendations) the national cervical screening programmes information about colposcopy key facts on cervical cancer.
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News Article
How East Cheshire NHS is tackling a major cancer problem
Patient Safety Learning posted a news article in News
East Cheshire faces a serious issue with head and neck cancer, with missed target times and inefficient practices leading to worsening outcomes for patients. That’s prompted officials from the NHS Cheshire Clinical Commissioning Group (CCG) to come up with a plan of action to tackle the problem — but as Cheshire East councillors heard this week, it’s hit a snag. Since 2014, the East Cheshire NHS Trust and Manchester Foundational Trust (MFT) have co-delivered the head and neck cancer pathway. This means that patients are seen by staff at Macclesfield Hospital for diagnostic tests — and if malignant cells are detected, then the patient will be referred on to Wythenshawe for surgery or, if sadly needed, East Cheshire’s own palliative care team for supportive care. In a presentation to CEC’s health scrutiny committee, the CCG said just 10% of patients in the borough were seen at Macclesfield within the 62-day target time in Q3 of 2019/20 — against a desired level of 85%. Simon Goff, chief operating officer of East Cheshire NHS Trust, told the committee: “There is no one stop service - which is where a patient gets diagnostics all on the same day. Biopsies are not always up to the standards required so patients need to have it again. This is a key weakness in the existing service.” The lack of a ‘one stop service’ means there are no on-site pathology services — so samples are taken off-site for testing, and with biopsies needing to be analysed within 24 hours of collection, it results in 39% of all patients having to undergo the procedure again. So what did East Cheshire do about it? The first step was to launch a consultation, with 64 former patients out of roughly 300 eligible providing feedback to the Trust over the summer. The ‘robust’ consultation, saw patients express their desire to ‘know what is going on as soon as possible’, with the ‘issue of travel being outweighed by [the desire for] a quick diagnosis’. Fortunately for health chiefs in Cheshire, there are ‘outstanding’ hospitals surrounding the county — with the Care Quality Commission giving top marks to hospitals in Salford, St Helens, and The Christie in Didsbury. So with East Cheshire’s patients happy to travel a distance in order to gain a quick and accurate diagnosis, and the existing partnership with Manchester’s trust, officials are proposing moving some patients experiencing positive diagnoses and ‘bad news’ cases to MFT sites, such as The Christie or Wythenshawe Hospital. The idea is that ‘neck lump’ patients will be immediately sent to Wythenshawe, with all other patients undergoing initial tests in Macclesfield first before being either sent home with the all clear, or referred on. Biopsies will be done in Wythenshawe, as will ‘breaking bad news’ appointments — where patients are told of a positive cancer diagnosis. Officials say this solution ‘would start to address some of the clinical and performance concerns’ by cutting the average diagnosis wait time from four weeks down to one, reducing the amount of appointments patients need to attend, and allowing for continuity of care throughout treatment. Read full story Source: Knutsford Guardian, 10 October 2020 -
News ArticleA number of patients in a cancer ward have died in hospital after a coronavirus outbreak and more have tested positive for the virus. NHS Lothian have not confirmed how many died but said it was fewer than five and a ‘very small number’ of patients. The health board is investigating the Western General Hospital in Edinburgh which has had to put measures in place to further contain the outbreak. Another six patients have tested positive for the virus so the hospital has closed the oncology ward to new patients being admitted. The hospital has also asked patients, who would usually be allowed to go home over the weekend and return to hospital on Monday, to stay in hospital the whole week. Dr Donald Inverarity, consultant microbiologist at NHS Lothian, said: ‘Our thoughts are with the family of the deceased and I would like to express our sincere condolences." "A multidisciplinary Incident Management Team was immediately established and all necessary infection control measures are in place. The situation will continue to be reviewed and monitored very closely." The health board’s Health Protection Team and the nationwide Test and Protect teams are carrying out contact tracing of visitors and outpatients where necessary. Routine coronavirus screening of staff and patients is also taking place as part of an enhanced regime. Read full story Source: Metro, 10 October 2020
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News ArticleFamous faces, including TV chefs Gordon Ramsay, Nadiya Hussein, and actress Emma Thompson are backing a major new campaign urging anyone concerned about cancer to get checked and to keep routine appointments, as new research found that even now, nearly half (48%) of the public would delay or not seek medical help at all. A fifth (22%) would not want to be a burden on the health service while a similar number said that fear of getting coronavirus or passing it onto others was a major reason for not getting help. More than four in ten people would leave it longer to get health advice than they normally would have before the coronavirus outbreak, however delaying can have serious consequences for some cancers. NHS staff have pulled out all the stops to keep cancer services going throughout the pandemic, with almost one million people referred for checks or starting treatment since the virus took hold. The NHS’s Help Us Help You access campaign will use TV adverts, billboards and social media to urge people to speak to their GP if they are worried about a symptom that could be cancer, and also remind pregnant women to attend check-ups and seek advice if they are worried about their baby. People with mental health issues are also been encouraged to access NHS support. Read full story Source: NHS England, 9 October 2020
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News ArticleAlmost one million women in the UK have missed vital breast screening due to coronavirus, a leading charity has estimated. Breast screening programmes were paused in March as the NHS focused resources on tackling the pandemic. Breast Cancer Now calculates that around 8,600 women who have not had a scan have undetected breast cancer. The scanning programme is running again, but social distancing measures have reduced capacity. Combined with the significant backlog of women waiting for a scan, and more women starting to come forward with concerns about possible symptoms, the charity warns the service is under intense pressure. Breast cancer diagnosed at a later stage can be harder to treat. Breast Cancer Now estimates that a total of 986,000 women across the UK missed their mammograms due to breast screening programmes being paused. The estimate is based on the average number of women screened per month, and the approximate length of time the screening programme was suspended, in each part of the UK. This breaks down to almost 838,000 women in England, 78,000 in Scotland, 48,000 in Wales and 23,000 in Northern Ireland. The charity is calling for an action plan and new resources to tackle the problem. Baroness Delyth Morgan, Breast Cancer Now chief executive, said: "That nearly one million women across the UK were caught up in the backlog waiting for breast screening is cause for grave concern. "Mammograms are a key tool in the early detection of breast cancer, which is critical to stopping women dying from the disease. "We understand that the breast screening programme was paused out of necessity due to the global Covid-19 pandemic, but we must now press play to ensure that all women can access breast screening, and we cannot afford for the programme to be paused again." Read full story Source: BBC News, 30 September 2020 Breast Cancer Now press release
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Content ArticleThe inquiry, launched in April, considered the provision of essential health and care services both during and after the pandemic and how the resulting pent-up demand for services would be managed and met. Representatives of the Royal Colleges, NHS Providers, the NHS Confederation, health think tanks, patients and patient groups, the Chief Executive of the NHS and other senior NHS leaders were among those who gave evidence. Members of the Committee pay tribute to frontline NHS and care staff who lost their lives to coronavirus and their bereaved families. Health and Social Care Committee Chair Rt Hon Jeremy Hunt MP said: “We are proud of the heroic contribution made by frontline NHS and care staff during this pandemic, which has saved many lives. Thanks to their efforts not a single coronavirus patient has been denied an intensive care bed or ventilator unlike in other countries. “However the pandemic has also massively impacted normal NHS services, something that could have been mitigated with earlier infection control measures in hospitals and clearer communication to patients whose care was disrupted. Weekly testing of NHS staff has been repeatedly promised in hotspot areas - but is still not being delivered. Failure to do so creates a real risk that the NHS will be forced to retreat into being a largely Covid-only service during a second spike. "We've heard of severe disruption to services, especially cancer, and here we could be looking at tens of thousands avoidable deaths within a year. If we’re to avoid this going forward it is time to give as much priority to avoiding harm and death caused by the interruption of normal NHS services and introduce mass testing for all NHS staff. Today we set out these and other steps the government and NHS leaders must take to manage services through a second wave."
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News Article
Leaked data gives first view of growing cancer waiting list post covid peak
Patient Safety Learning posted a news article in News
Official data from mid-September shows that nearly 6,400 people had waited more than 100 days following a referral to cancer services. The leaked data reveals for the first time the length of the cancer waiting list in the wake of the first pandemic peak, during which much diagnostic and elective cancer care was paused. The list consists of those waiting for a test, the outcome of a test, or for treatment. NHS England and Improvement only publish waiting times for patients who have been treated – not the number still waiting – so this information has been secret. The data, obtained from official emails seen by HSJ, showed the total number of people on the cancer waiting list grew substantially, from 50,000 to around 58,000, between the start of August and the middle of September. Of the 6,400 people recorded to be waiting more than 104 days on 13 September, 472 had a “decision to treat classification”, meaning they have cancer and are awaiting treatment. NHS England has said reducing the cancer waiting list would be overseen by a national “taskforce”, which is being chaired by national director for cancer Peter Johnson. Experts have warned the delays already stored up in the system could cost tens of thousands of lives as patients go undiagnosed or have their diagnosis and treatment later than they otherwise would. HSJ asked NHS England if harm reviews had been carried out for those on the waiting list and whether it had discovered if those waiting longer than104 days had been harmed, but did not receive an answer. Read full story (paywalled) Source: HSJ, 29 September 2020 -
News Article
Coronavirus: NHS faces pandemic 'triple whammy' this winter
Patient Safety Learning posted a news article in News
The NHS is facing a "triple whammy" of rising COVID-19 cases, a major backlog in treatment and reduced capacity due to infection-control measures, according to health bosses. The NHS Confederation report on the English NHS said more investment was desperately needed. The NHS bosses also called on ministers to be "honest and realistic" about waiting lists for treatment. It comes despite the government promising an extra £3bn this winter. That money - announced over the summer - was intended to help hospitals cope with the extra-infection control measures required and to pay for patients to be treated privately for routine treatment, such as knee and hip replacements. But hospitals are still performing only half the number of routine operations they normally would. Two million patients have already waited longer than 18 weeks for treatment, the highest number since records began, in 2007. And services in other areas, such as cancer care, are running at about three-quarters capacity. Of the more than 250 bosses who responded to the confederation's survey: fewer than one in 10 said the current level of funding allowed them to deliver safe and effective care nearly nine in 10 said a lack of funding would be a significant barrier to achieving waiting-time targets for everything from mental-health care to cancer treatment and routine operations. Read full story Source: BBC News, 29 September 2020 -
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Event
Webinar: Improving the care experiences of people with cancer
Patient Safety Learning posted a calendar event in Community Calendar
untilHanan L'Estrange-Snowdon, Picker's Insight Manager, is hosting a discussion about the care experiences of people living with cancer. Hanan is joined by Chris Graham, Picker's CEO; Ruth Hendy, Lead Cancer Nurse at UHBW and Sue Kernaghan, Cancer Patient Representative. The conversation will cover: The Cancer Patient Experience Survey (CPES). How University Hospitals Bristol and Weston are working to improve patient care. How to effectively engage patient groups. This webinar will give you a deeper understanding of the CPES survey, enabling you to use the results more effectively. There will be insights into best practice to take back to your organisation and an understanding of how to engage with your patients. Register -
News ArticleTens of thousands of people avoided going to hospital for life-threatening illnesses such as heart attacks during Britain's coronavirus crisis, data has revealed. Shocking figures reveal that admissions for seven deadly non-coronavirus conditions between March and June fell by more than 173,000 on the previous year. Previous data for England shows there were nearly 6,000 fewer admissions for heart attacks in March and April compared with last year, and almost 137,000 fewer cancer admissions from March to June. Analysis by the Daily Mail found that the trends were alarmingly similar across the board for patients who suffered strokes, diabetes, dementia, mental health conditions and eating disorders. Health experts said the statistics were 'troubling' and warned that many patients may have died or suffered longterm harm as a result. Gbemi Babalola, senior analyst at the King's Fund think-tank said: "People with some of the most serious health concerns are going without the healthcare they desperately need. Compared with the height of the pandemic, the NHS is seeing an increase in the number of patients as services restart, and significant effort is going into new ways to treat and support patients." "But the fact remains that fewer people are being treated by NHS services." Read full story Source: Daily Mail, 13 September 2020
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News ArticleMore than 1,500 breast cancer patients in UK face long waits to have reconstructive surgery after hospitals could not operate on them during the pandemic because they were tackling COVID-19. The women are facing delays of “many months, possibly years” because the NHS has such a big backlog of cases to get through, according to research by the charity Breast Cancer Now. When the lockdown began in March the NHS stopped performing breast reconstructions for women seeking one after a mastectomy as part of its wider suspension of care. That was because so many operating theatres were being used as overflow intensive care units and because doctors and hospital bosses feared that patients coming into hospital might catch Covid. The NHS started doing them again in July, but not everywhere and not in the same numbers as before. “We are deeply concerned by our finding that over 1,500 breast cancer patients may now face lengthy and extremely upsetting delays for reconstructive surgery,” said Delyth Morgan, the chief executive of Breast Cancer Now. “This will leave many women who want to have reconstruction with one breast, no breasts or asymmetric breasts for months, possibly even years.” Lady Morgan said: “Reconstructive surgery is an essential part of recovery after breast cancer for those who choose it. “Women with breast cancer have told us these delays are causing them huge anxiety, low self-esteem and damaged body confidence, and all at a time when the Covid-19 pandemic has denied them access to face to face support from healthcare professionals and charities.” Read full story Source: The Guardian, 18 September 2020
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News ArticleThe number of patients with cancer referred from screening services has fallen to nearly a third of pre-covid levels, new data shows. A total of 2,604 patients had their cancer picked up by screening services between April to July. This compares to 7,204 in the same period last year. The NHS England data covers patients receiving treatment within two months of a referral from screening services. This means the April 2020 data is largely from screening carried out before cOVID-19 saw services being shut down. From May to July this year, 1,243 patients were treated after a referral from screening services, compared to 5,406 in the same period last time. NHS England which commissions screening services from trusts said no central decision had been taken to halt screening at the height of the outbreak but said: “We know that some local providers did take the decision to pause and in those cases plans are in place to get services fully up and running again.” The national screening programmes look for bowel, breast and cervical cancers. Head of policy at Macmillan Cancer Support Sara Bainbridge said: ”Behind every missed target is a real person whose prognosis and treatment options could be severely impacted by these delays. It’s vital that people see their GP if they have symptoms, and anyone who is worried about cancer needs to know that they’ll be seen promptly and safely." “Cancer must not become the forgotten ‘C’ during this pandemic – we urgently need the government to deliver the promised recovery plan and make sure the NHS has all the staffing and resources it needs to get cancer services back on track.” Read full story (paywalled) Source: HSJ, 10 September 2020
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News Article
Plans for 150 new diagnostic hubs to cut rising waits
Patient Safety Learning posted a news article in News
Plans for up to 150 new community diagnostic hubs to tackle the NHS’ ballooning diagnostic waiting lists are included in NHS England ‘blue print plans’ leaked to HSJ. The document pointed out the hubs “were highlighted in the phase 3 letter [from Sir Simon Stevens] and will be recommended as part of new service models for diagnostics in the forthcoming [Sir Mike] Richards’ Review of Diagnostics Capacity”. It said “at least 150 community diagnostic hubs should be established in the first instance (broadly equivalent to the number of acute hospitals)” although it appears many of these may be temporary facilities. The phase 3 letter said systems should mange the “immediate growth in people requiring cancer diagnosis and/or treatment returning to the service by… the development of community diagnostic hubs” among other measures The Richards review was commissioned by NHS England in 2019 as it had long been recognised that England has one of the lowest levels in Europe of diagnostic equipment as well as a shortage in facilities and staff. Last month think-tanks warned of significant worsening of cancer outcomes because of the backlog in diagnosis and treatment created by a fall in referrals during the pandemic..." Read full story (paywalled) Source: HSJ, 4 September 2020 -
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Top 10 tips for communicating a diagnosis of mesothelioma
Patient Safety Learning posted an article in Cancers
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Mesothelioma UK: My Mesothelioma Care Passport
Patient Safety Learning posted an article in Cancers
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Could telemedicine solve the cancer backlog?
Patient Safety Learning posted an article in Telemedicine
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News Article
Chemo doorstep drops help to keep cancer patients safe
Patient Safety Learning posted a news article in News
Thousands of patients with cancer have had chemotherapy delivered to their doors so that they can more safely receive treatment during the coronavirus pandemic. Up to 10,000 chemo home deliveries were made over three months at the peak of the outbreak, avoiding the need for patients to venture out and risk infection when their immune system was low. The drops are part of the COVID-friendly treatments introduced in response to the pandemic which have helped to ensure that 85,000 people could start treatment between March and June, with latest data showing referrals beginning to recover to pre-pandemic levels. NHS staff, including community nurses and pharmacists, and volunteers have been dropping off the life-saving medication – they step back two metres when they arrive at a patient’s house, identify them and make sure they have everything they need. Hospitals have also significantly increased the use of chemo at home, with local pharmacy teams and community nurses providing the service to reduce cancer patients’ risk of exposure to the virus. The action joins a series of measures, including the rollout of COVID protected cancer hubs for treatment and introducing ‘COVIDfriendly’ cancer drugs. NHS England is spending £160 million on drugs that mean patients do not have to go to hospitals for regular checks and treatment. Dame Cally Palmer, director of cancer for the NHS in England said: “NHS staff have treated more than 108,000 patients requiring specialist hospital care for COVID-19 while also keeping other vital services such as cancer, maternity and A&E running throughout the pandemic. “The NHS has also fast tracked modern, more convenient services that help to keep patients and staff safe – from video consultations to chemotherapy delivered to patients’ doors – that have allowed 85,000 people to start cancer treatment during the pandemic.” Read full story Source: NHS Improvement, 17 August 2020 -
News Article
Breast screening women in their 40s 'could save lives'
Patient Safety Learning posted a news article in News
Screening women for breast cancer from their 40s rather than their 50s could save lives without adding to the diagnosis of harmless cancers, a UK study has found. The research was based on 160,000 women from England, Scotland and Wales, followed up for around 23 years. Lowering the screening age could save one life per 1,000 women checked, the scientists say. But experts caution there are many other considerations, including cost. Cancer Research UK says it is still "not clear if reducing the breast screening age would give any additional benefit compared to the UK's existing screening programme". The charity says the priority should be getting cancer services "back on track" for women aged 50-70, after disruption caused by the pandemic. Read full story Source: BBC News, 13 August 2020
