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News Article
Betsi Cadwaladr did not discuss resuscitation decision with family
Patient Safety Learning posted a news article in News
A health board has apologised to the family of a patient after medical staff failed to consult with them over a decision not to resuscitate her. While the decision was clinically justified, the public services ombudsman for Wales said Betsi Cadwaladr health board did not discuss it with the patient and her family. The ombudsman, Michelle Morris, also upheld a complaint by the patient's daughter, identified only as Miss A, that her mother's discharge from Ysbyty Gwynedd in Bangor was "inappropriate" and that insufficient steps were taken to ensure her needs could be safely met at home. The final complaint, which was also upheld, was that medics failed to communicate with the family about the deteriorating condition of the patient, identified as Mrs B, which meant a family visit was not arranged before she died. In her report she said the Covid pandemic had contributed to the failings, but added "this was a serious injustice to the family". As well as apologising to the family, she asked that all medical staff at Ysbyty Gwynedd and Ysbyty Penrhos Stanley be reminded of the importance of following the proper procedure when deciding when a patient should not be resuscitated. Read full story Source: BBC News, 6 February 2023 -
Content ArticleFebruary 2023 - Patient feedback, Trust's Patient and Public Voice Policy, Patient Safety Partners, safe wheelchair risk assessment, referral to prolonged jaundice clinic. patient-safety-newsletter-february2023.pdf January 2023 - Dementia friendly ward, National Audit for Inpatient Falls (NAIF), investigation training, CQUINS, ePMA, Health Visitor teams. patient-safety-newsletter-janaury2023.pdf December 2022 - Supporting hydration (HCSW Innovation Idea project), deteriorating patient thematic review, investigation training, checking the right saline, Professional Nurse Advocacy, Medical Device Safety Lead. patient-safety-newsletter-december2022.pdf November 2022 - Reducing the use of fall alarms, wound photography, defining levels of assistance when moving patients, Duty of Candour. patient-safety-newsletter-november2022.pdf October 2022 - Reminiscence Interactive Therapeutic Activities RITA systems, pressure ulcers on heels, post falls checklist, importance of carers care plans, Datix and LfPSE. patient-safety-newsletter-october2022 (1).pdf September 2022 - World Patient Safety Day, ordering and fitting mattress toppers, PSIRF, Sussex interpreting services, risk assessment to prevent pressure sores. patient-safety-newsletter-september2022.pdf August 2022 - Thematic review to discuss falls on the unit, Duty of Candour requirement, reporting a pressure ulcer on Datix, UTC and learning disability health facilitation team table top, care home matrons. patient-safety-newsletter-august2022.pdf July 2022 - Collaboration with the IC24 Roving GP service, critical limb ischaemia, Genius 2 and 3 thermometers, implementing the Patient Safety Strategy, introducing Professional Nurse Advocates and Patient Safety Learning's hub. patient-safety-newsletter-july2022.pdf June 2022 - New visual fluid chart tool, bruising in children who are not independently mobile, end PJ paralysis campaign, investigation training and the importance of personalised communication. patient-safety-newsletter-june2022 (1).pdf May 2022 - Why frailty matters’ week, audit of unstageable pressure ulcers reported on Datix and risk assessing pressure ulcer equipment. patient-safety-newsletter-may2022 (1).pdf April 2022 - ICUs engaging in recent table tops to discuss the falls prevention on the ward, paraffin fire risk leaflet, improving the environment for patients with dementia and safeguarding babies. patient-safety-newsletter-april2022.pdf March 2022 - Patients leaflet on what to expect from therapy during ICU admission and the aim of rehabilitation on the unit, falls alarm, falls in toilets and bathrooms, food fortification, project to develop better tools to monitor food and fluid intake, new or changing confusion, and the importance of end of life care. patient-safety-newsletter-march2022 (1).pdf February 2022 - Homeless Health Inclusion Team, ensuring an MDT falls review, following the no response policy, End of Life Care plan and alerts on SystmOne. patient-safety-newsletter-february2022 (2).pdf January 2022 - patient-centred care, NEWS2 on paper, ensuring safe use of Smartcards, fluid balance charts and the importance of education. patient-safety-newsletter-january2022.pdf December 2021 - a PCN Quality feedback session, the impact of student projects, safe use of wheelchairs on the ICU, the delirium alert on SystmOne and the Herbert protocol patient-safety-newsletter-december2021 (1).pdf November 2021 - hover jacks, taking photos of pressure ulcers, enhanced care assessments, an update from the deteriorating patient and resuscitation lead, and ensuring effective communication. patient-safety-newsletter-november2021 (1).pdf
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News Article
North East ambulance staff lacked critical medicines, CQC finds
Patient Safety Learning posted a news article in News
Ambulance crews in the North East frequently responded to emergencies without access to life-saving drugs, a damning inspection report has found. The study of North East Ambulance Service NHS Trust (NEAS) concluded patients were potentially put at risk by the poor management of medicines. The Care Quality Commission (CQC) found a deterioration of services and rated NEAS's urgent care as "inadequate". In response, NEAS said it had faced a year of "unprecedented pressures". The damaging assessment follows the launch of a full independent NHS review into numerous "tragic failings" involving patients. Announcing the review, the then health secretary Sajid Javid said he was "deeply concerned" about claims NEAS had covered up mistakes. Whistleblowers have told Newsnight multiple deaths were not investigated properly because information was not always provided to coroners and families. Read full story Source: BBC News, 1 February 2023 -
Event
HoPE Storytelling Festival - Made by Mortals
Sam posted a calendar event in Community Calendar
To share the learning and resources from the award-winning (The Royal Society of Public Health - Arts in Health 2022) community partnership programme between Tameside and Glossop Integrated Care NHS FT, Made By Mortals CIC (arts organisation) and over 50 patients with a broad range of lived experience- including mental ill health, learning disability, autism, English not as their first language, and people that identify as non-binary. The project used immersive audio case studies coproduced by patients, including the use of music, sound effects, and drama, together with an interactive workshop that challenged volunteers and staff at the hospital to take a walk in the patient’s shoes. The experiential community-led training raised awareness of the challenges that people with protected characteristics and additional needs face. This work supported Tameside and Glossop Integrated Care NHS FT ongoing approach to quality and diversity and supported attendees to adapt their behaviours to create an empathetic and person-centred environment. Register -
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HoPE Storytelling Festival - Dreams Session
Sam posted a calendar event in Community Calendar
untilEveryone makes stories during sleep that can metaphorically depict our waking life experiences and concerns. Have you wondered what waking life memories have led to a dream? Discuss a recent or important or intriguing dream you have had. While you discuss it, Julia Lockheart captures your dream narrative in a work of art drawn and painted onto pages taken from the first English translation of Freud’s book The Interpretation of Dreams. After the session the dreamer will receive a high quality mounted Giclée print of the artwork to display at home and discuss with family and friends. The event is part of the DreamsID (Dreams Illustrated and Discussed, Dreams Interpreted and Drawn) art science collaboration. Dr Julia Lockheart is Associate Professor at Swansea College of Art, University of Wales Trinity Saint David, and Associate Lecturer at Goldsmiths, University of London. Professor Mark Blagrove is Professor of Psychology at Swansea University and researches the science of sleep and dreaming. Register -
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HoPE Storytelling Festival - A peer-led digital patient storytelling model
Sam posted a calendar event in Community Calendar
untilA peer-led digital patient storytelling model. 'Stories place patients at the heart of our work to discover what truly matters most'. In 2020, the patient and public engagement team at Royal Brompton and Harefield Hospitals recruited patients, staff and volunteers to take part in digital patient storytelling training. At this session, you will meet this pioneering peer team who, starting as absolute beginners, lead this work, their motivation, and their training experience. How recording of a patient's experience can be transformed into video stories that celebrates great care, can provide vital learnings, and highlight potential future improvements. Register -
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Content ArticleHe looks at the following claims: “The NHS has has plenty of money pumped into it by this Government and well above inflation.” “We are funded as well, if not better than many/most systems now, so resource is not an excuse” "This Government has recruited X thousand additional nurses and Y thousand additional doctors” “We need to move towards a European style social insurance based model as those systems have better outcomes and no other country has copied the NHS” “The NHS wastes far too much money on useless, overpaid managers and people in non-jobs” “People should take more responsibility for their own health so we can become a wellness service not an illness service" The NHS is in need of root and branch reform but always resists it." Ten point plan to tackle the problems faced by the NHS Train enough staff at home to meet future workforce needs Have a proper short, medium and long term workforce plan for health and social care Treat existing staff better and more flexibly to help retention and morale Use ethical immigration policy to attract and keep key workforce groups who trained overseas or come here for lower paid but vital care work Reverse the cuts in bed capacity and invest more in capital expenditure on buildings, facilities, equipment and functioning IT Come up with a long term sustainable plan for social care funding and provision, reverse the cuts and plan for future rises in care needs Invest properly in public health and prevention policy – addressing wider determinants of preventable ill health across the life course, health inequalities and inequalities in access to healthcare and ensure that health is a key part of all public policy making Accept that this focus on prevention does involve state intervention in key areas around housing, education, food, drink, obesity, smoking and mental health. Level with the public about what can realistically be expected in terms of access, wait time, staffing and the time it will take to recover from the disruption caused by covid. Better to under promise and over deliver rather than vice versa Restore annual funding increases to the NHS to at least the historic average
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Click on each heading to access the relevant content. 1. Presenting complaint: use of language that disempowers patients In this BMJ article, Caitríona Cox and Zoë Fritz argue that outdated medical language that casts doubt, belittles, or blames patients jeopardises the therapeutic relationship and is overdue for change. 2. NIHR - Health information: are you getting your message across? This resource collection from the National Institute for Health and Care Research includes research on the impact of unclear health messages, how we can help people understand health information and which groups of the population may need extra support. 3. The Obs Pod, by obstetrician Florence Wilcock (Episodes 22 and 23: Language) In episodes 22 and 23 of the Obs Pod podcast, obstetrician Florence Wilcock discusses how the language used in her field can have a detrimental impact on the women and families being cared for. 4. NHS England - Language Matters: language and diabetes This guidance by NHS England sets out practical examples of language that will encourage positive interactions with people living with diabetes and subsequently positive outcomes. 5. Why language matters in social care “Words can invite people in, or keep them out”. Listen to this five minute podcast about why language matters and the impact this has on people who access services, hosted by Linda Doherty from Think Local, Act Personal. 6. "We couldn’t talk to her”: a qualitative exploration of the experiences of UK midwives when navigating women’s care without language Women with little-to-no English continue to have poor birth outcomes and low service user satisfaction. When language support services are used it enhances the relationship between the midwife and the woman, improves outcomes and ensures safer practice. This study aims to understand the experiences of midwives using language support services. 7. Lost for words: Healthwatch evidence on how language barriers contribute to health inequalities Based on research conducted by Healthwatch, this report examines the difficulties that patients with little or no English encounter at every stage of their healthcare journey. Have your say Have you ever been affected by the language used in healthcare? Perhaps you've felt excluded or offended by the words used. Or maybe you have an example of how clear and inclusive language made you feel safer as a patient? You might be a member of staff who has made changes to the way they communicate face-to-face or in writing to help improve outcomes and strengthen patient-provider relationships. Please let us know your thoughts by commenting below (register for free here first). Or you can get in touch with us directly to share your insights at content@PSLhub.org -
Content ArticleHow to offer safety-netting advice Build safety-netting into the entire consultation; it should not be rushed at the end. Use simple terms and avoid jargon and abbreviations (but include appropriate technical terms); tailor advice and address potential sources of anxiety (for instance being young or a first-time parent). Consider grouping chunks of information to help the patient remember the advice. Give people the opportunity to share their expectations and concerns, and address these in the safety-netting plan. What advice to give: the safety-netting plan Explain and discuss uncertainties and the follow-up plan. Offer an initial diagnosis, explain how long you expect symptoms to last (or how they might change), give practical tips for self-care and symptom management (which give people a sense of control) and instructions for when they should be concerned. Personalise someone’s risk based on their characteristics (such as age or medical history) and not on population data. The plan should also be personalised and address factors that might make an individual less likely to follow advice (for instance if they have had a previous missed diagnosis). Give the patient the opportunity to ask questions and to share in decision-making. Actively check the patient’s understanding. Acknowledge the patient’s ability to make judgements about their own health, and to change their mind about a plan.
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Content ArticleThe three strands of the strategic plan PatientsVoices@RCoA aims to achieve its purpose and vision by focusing on our three strategic pillars: 1. Strengthening our voice PatientsVoices@RCoA will: establish ourselves as the voice of patients for anaesthesia and perioperative care improve our knowledge of healthcare services (especially anaesthesia and perioperative care) and the challenges members face so we can contribute authoritatively and effectively to College activities improve the breadth and depth of our influence by continuing to build a diverse team and champion equality, diversity and inclusion in everything we do and say. 2. Improving how we communicate the views of patients internally and externally PatientsVoices@RCoA will: be visible and audible advocates for the College and PatientsVoices@RCoA by utilising opportunities to raise our profile and promote meaningful patient engagement engage with stakeholders in a constructive and supportive way when representing the voice of patients explore ways of extending our reach by improving our understanding of a broader range of patients’ and the public’s views and priorities. 3. Increasing our impact by developing effective ways of working PatientsVoices@RCoA will: develop and use a variety of approaches to ensure patients’ voices positively impact on the College’s activities and recommendations about patient care evolve into an influential team whose members work effectively and efficiently whilst enjoying and valuing their individual roles with the College ensure we use our resources wisely to realise our potential contribution to the College whilst minimising our impact on the environment. If you would like to find out more about the work of PatientsVoices@RCoA, please get in contact with patientsvoices@rcoa.ac.uk.
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Content ArticleNHS England asks all organisations to undertake this review and: 1 Respond back to NHSE in relation to: Communication barriers. Reduced patient engagement (activation) in their care. Workforce’s conscious & unconscious biases. Biases that are embedded across the system. Transitions of care. Inaccessibility of care (including digital exclusion, and geographical isolation). Limited insights/data. 2 Adapt their existing Equalities Impact Assessment to reflect this new tool. 3 What specific next actions are you taking as a team that can publish as part of the patient safety health inequalities roadmap? E.g, Adapting existing Equalities Impact Assessment (EQIA)/Project/programme plan. Creating new SMART objectives/programmes of work/targets. Revisiting the data/evidence base relating to inequalities or updating your monitoring process. Revising/expanding the scope of ongoing stakeholder involvement.
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Organisational culture and patient safety poster
Hugh Wilkins posted an article in Good practice
A high resolution image of the poster with full references can be downloaded by clicking on the attachment below. Organisational culture and patient safety (ver 2) (2).pdf- Posted
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Live podcast: The healing power of human connection and personalised care
Patient Safety Learning posted a calendar event in Community Calendar
PRSB is hosting a live podcast which will feature a vibrant discussion on the importance of human connection and personalised approach in providing care. Attendees will hear from Sarah Woolf, Movement Psychotherapist, who will talk about her own experience of how personalised care helped her recover from her condition, not only physically, but also emotionally and mentally. Sarah had the chance to describe her story in an article for the BMJ. The podcast will provide the opportunity for Q&A, and attendees will also be encouraged to share their own experiences and how they think personalised care can meet people's needs and expectations of care. The event is free to attend and everyone is welcome to join. Register -
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Content ArticleEight steps toward creating more psychological safety at work Make psychological safety an explicit priority. Facilitate everyone speaking up. Establish norms for how failure is handled. Create space for new ideas (even wild ones) Embrace productive conflict Pay close attention and look for patterns Make an intentional effort to promote dialogue Celebrate wins
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Content ArticleRecommendations Disaster planning – No hospital had disaster plans for a prolonged, noninfluenza pandemic and all failed to imagine and plan for a second wave that might be worse than the first. The development of templates for local responses to major disasters, developed by experts, would relieve smaller organisations of tasks for which they do not have the appropriate staff, skills or experience. Estates – The problem of ageing and often inadequate infrastructure was a dominant theme. Problems with estates actually drove, and constrained, the pandemic response. A national stocktake of the shortcomings of hospital estates needs to be urgently undertaken, in preparation for any future pandemics. The Health Infrastructure Plan needs to be reviewed in light of the pandemic, with a view to ensuring robust supplies of oxygen and adequate ventilation and appropriate infection control measures in all hospitals, rather just in the planned new builds. Capacity – Concerns over capacity are tightly linked to the above issues with estates and buildings. Most organisations struggled with bed capacity in all clinical areas (ED, ICU and the downstream wards) even prior to the pandemic. Those that were able to readily expand capacity were those that, by chance, had unused spaces that could be rapidly repurposed. This points to the urgent need for the capacity of smaller hospitals to meet their current need, particularly with regard to intensive care provision, as well as giving consideration to how surge capacity can be embedded within organisations. Management – No organisation felt that all aspects of their management and communications were entirely right, and the interviews highlighted a number of problems with approaches taken by different organisations. The most pervasive issue was a failure to recognise that different stages of the pandemic would require different approaches. The transition out of the ‘emergency’ phase of the pandemic proved to be particularly problematic almost regardless of the approach taken. The other major issue was the extent to which organisations were able to put in place managerial structures which were robust and responsive, capable of both making short-term/tactical and long-term/strategic decisions. Few organisations actively built ‘learning loops’ into their pandemic response. These findings suggest that improving the ‘situational awareness’ of executive teams about what types of management ought to be used when, and how to switch modes, would be highly beneficial. The appreciation of streamlined processes and speedier decision-making suggests that thought ought to be given to how aspects of this can be retained, while still ensuring quality controls and good governance. Dealing with difficult behaviour – Even in organisations where operational issues could be considered to have been well managed, perverse behaviours were able to disrupt aspects of the pandemic response. Questions over who is responsible for the management of staff and to what extent staff can be compelled need to be explored at national and local levels, and the question of what the appropriate response is to such difficult behaviour needs to be answered. Mental health and wellbeing – All organisations took mental health and wellbeing seriously, putting in place programmes of support for staff. We had not expected the levels of distress that were shown from our cohort of interviewees, which strongly suggests the resources in place to support the emotional health and mental wellbeing of senior managers is s inadequate and this needs to be addressed urgently at local and national level.
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