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Found 177 results
  1. Community Post
    *Trigger warning. This post includes personal gynaecological experiences of a traumatic nature. What is your experience of having a hysteroscopy? We would like to hear - good or bad so that we can help campaign for safer, harm free care. You can read Patient Safety Learning's blog about improving hysteroscopy safety here. You'll need to be a hub member to comment below, it's quick and easy to do. You can sign up here.
  2. Event
    This course will offer an overview of the law relating to medical treatment decisions, both children and adults, and both for patients able to make a decision for themselves, and where best interests decisions must be made for those who cannot, and how to tell the difference. We will also look at how, and when, it may be necessary to involve the court to resolve disputes and – better – how to avoid disputes altogether. Decisions about medical treatment can be about life and death, such as withdrawal of treatment or (not) providing CPR. Or about quality of life, liberty and independence, which can be just as important. But the legal (and ethical) framework around these decisions is often misunderstood, leading to distress and disputes at the very worst of times, as we have seen in a few very high-profile cases. It can also cause uncertainty and doubt in clinicians, where the law is misunderstood as a stick to beat them with, rather than a shield to protect their reasonable decision-making. We will cover whether a patient should always get what they want, or does “doctor know best”? When a patient cannot make a decision for themselves, who gets to decide, and how should these decisions be made? What is the role of so-called “next of kin” (and did you know that there’s actually no such thing)? Can parents insist on treatment for a child when doctors think it futile? How are disputes in this context resolved and, better yet, how are they avoided? Throughout, we will talk in particular about the importance of good communication, and managing expectations, and how to ensure that clinicians are doing the right thing for the patient, as well as avoiding getting sued. Key learning objectives: To understand and apply in practice the fundamental legal framework around decisions about medical treatment, including: Rationing and resource allocation The limits of choice and autonomy The relationship between law and ethics The importance of good communication, and how to not get sued The law on consent Mental capacity and best interests decision for adults Decisions about children – Gillick competence, parental responsibility and disputes Restraint and deprivation of liberty Going to court Register
  3. Content Article
    The Patients Association has been working with the Health and Care Professions Council (HCPC) to understand the impact the English language proficiency of health and care professionals has on patient and carer experiences. The HPCP is proposing changes to its English language proficiency requirements for applicants and this blog outlines key issues that were raised in an online focus group with patients, including: The impact of English language proficiency on patient experience Creating a fair system Partnering with patients and carers
  4. Content Article
    Incorporating parental values in complex medical decisions for young children is important but challenging. This review in The Lancet Child & Adolescent Health explores what it means to incorporate parental values in complex paediatric and perinatal decisions. It provides a narrative overview of the paediatric, ethics and medical decision-making literature, focusing on value-based and ethically complex decisions for children who are too young to express their own preferences. 
  5. Content Article
    Emergency general surgery (EGS) involves care and treatment of a patient's often previously unknown disease in an unplanned interaction with the healthcare system. This leads to challenges in collecting and interpreting patient reported outcome measures (PROMs). This study in the American Journal of Surgery aimed to capture the peri-operative experiences of 30 patients at 6 to 12 months after their treatment. The authors found that: two-thirds reported feeling no choice but to pursue emergency surgery with many reporting exclusion from decision-making. Females reported these themes more commonly. patients with minor complications less frequently reported trust in their team and discussed communication issues and delays in care. patients with major complications more frequently reported confidence in their team and gratefulness, but also communication limitations. patients not admitted to the ICU more frequently discussed good communication and expeditious treatment.
  6. Content Article
    Patients for safer nuclear medicine (PSNM) is a coalition of patient advocacy groups and corporate partners demanding that patients get the information they need about extravasations so their diseases are accurately diagnosed and treated. Pam Kohl is a metastatic breast cancer patient whose length of life depends on the accuracy of her nuclear scans. During a recent scan, she was extravasated. “I felt something burn,” she says. “I really felt something wasn’t right.” Watch Pam's story and find out more about PSNM.
  7. Content Article
    This study published in BMJ Quality & Safety identified factors acting as barriers or enablers to the process of healthcare consent for people with intellectual disability and to understand how to make this process equitable and accessible. The study found that multiple reasons contribute to poor consent practices for people with intellectual disability in current health systems. Recommendations include addressing health professionals’ attitudes and lack of education in informed consent with clinician training, the co-production of accessible information resources and further inclusive research into informed consent for people with intellectual disability. Related reading on the hub: Accessible patient information: a key element of informed consent
  8. Content Article
    In this blog, Sexual and Reproductive Health Consultant, Neda Taghinejadi tells us about the coil fitting service she is part of in Oxfordshire. Neda explains how the service has integrated a number of tools, including a triage system to identify more complex cases, to help support a safe and quality service. 
  9. Content Article
    The following account has been shared with Patient Safety Learning anonymously. We’d like to thank the patient for to sharing their experience to help raise awareness of the patient safety issues surrounding outpatient hysteroscopy care.
  10. Content Article
    Patient safety and healthcare information are inextricably linked. But how can you be certain the content you’ve produced, or information you have received as a patient, is indeed ‘safe’? The sheer volume of information available is staggering – be it a leaflet about skin cancer, a poster about vaccines in your GP waiting room, a YouTube video about healthy living or a consent form for a surgical procedure. The list goes on and on and, without professional review, there really is no knowing how safe that information is. If you work in the healthcare sector, and especially if you work in the creation of healthcare information, you will probably be familiar with the Patient Information Forum and their ‘PIF TICK’. The PIF TICK provides reassurance that what is being given to patients is: safe reliable accurate accessible.   At EIDO Healthcare, we were awarded our first PIF TICK in October 2020 and have had it successfully renewed every year since. In this blog, I will talk about my experience of receiving and maintaining a PIF TICK for our library of information leaflets for patients needing surgery.
  11. Content Article
    The ethnicity data gap pertains to three major challenges to address ethnic health inequality: Under-representation of ethnic minorities in research Poor data quality on ethnicity Ethnicity data not being meaningfully analysed. These challenges are especially relevant for research involving under-served migrant populations in the UK. This study in BMC Public Health aimed to review how ethnicity is captured, reported, analysed and theorised within policy-relevant research on ethnic health inequities. The authors concluded that the multi-dimensional nature of ethnicity is not currently reflected in UK health research studies, where ethnicity is often aggregated and analysed without justification. Researchers should communicate clearly how ethnicity is operationalised for their study, with appropriate justification for clustering and analysis that is meaningfully theorised.
  12. Content Article
    In this article, published by Med Page Today, clinical trials are the cornerstone of evidence-based medicine authors argue that: "All trial results - positive, negative, and neutral - must be made publicly available to allow for transparent decision-making by patients, physicians, and regulators. Without complete data, the evidence gets distorted: harms are downplayed, and benefits are overstated."
  13. Content Article
    The NHS’s deal with the US tech company Palantir raises privacy concerns, but a unified database could be a medical gamechanger writes Martha Gill in an article for the Observer. Governments have been trying to stitch together our patchwork system for decades. Billions have been lost in these attempts. However, they always run up against the same problem: people just don’t want to share their medical data, even when assured it will be anonymised. When the government aimed to build a collection of anonymous GP health records, around a million patients opted out. The latest of these attempts has closed a loophole: patients cannot now opt out. But this has enraged civil liberties groups, which are concerned about the company chosen to merge, clean and provide tools for sorting through the data.
  14. News Article
    A surgeon has said it would have been "cruel and unacceptable" to have woken up a patient to get consent for a mesh operation. Anthony Dixon is accused of failing to provide adequate clinical care to five patients at Southmead Hospital and the private Spire Hospital in Bristol. He had pioneered the use of artificial mesh to lift prolapsed bowels. Mr Dixon appeared at a Medical Practitioners Tribunal Service (MPTS) hearing in Manchester on Thursday. He faces charges of performing procedures that were not "clinically indicated", failing to carry out tests and investigations and failing to obtain consent from patients. It followed complaints many had suffered pain or trauma after having pelvic floor surgery using artificial mesh, a technique known as laparoscopic ventral mesh rectopexy (LVMR). Giving evidence, he was asked why he did not consider waking up one female patient who underwent an LVMR, to get her consent to surgery. Mr Dixon said it would have meant giving her more drugs for pain relief and could have "multiplied the risks" to her. He is also accused of failing to advise patients about the risks of procedures, failing to discuss non-surgical options and dismissing patients' concerns when they experienced pain or other symptoms following surgery. Read full story Source: BBC News, 23 November 2023 Related reading on the hub: Woman’s mesh consent form was changed after signing – how can patients be better protected?
  15. Content Article
    Yvette Greenway-Mansfield experienced complications relating to the vaginal mesh that was used to treat a uterine prolapse. Those complications were not listed on the consent form she signed. Fortunately, she kept her copy and was able to prove this. Yvette has recently been awarded £1 million because it was found that her form had been doctored after she had signed it.   Her successful medical negligence claim was also based on the fact that alternative treatment options were not considered when they should have been. These alternatives came with fewer risks, and it was agreed that they would actually have been more suitable in her case.  In this blog, I reflect on the levels of harm caused to the patient and how digital consent forms could help protect others. 
  16. Content Article
    Paula Goss had surgery to implant rectopexy and vaginal meshes which left her with severe pain and other serious complications. In this blog, Paula talks about why she set up Rectopexy Mesh Victims and Support to campaign for adequate treatment, redress and justice for people injured by surgical mesh. She outlines the need for greater awareness of mesh injuries amongst both healthcare professionals and the public and talks about what still needs to be done to enable people to access the treatment and support they need.
  17. News Article
    A group of 67 women from Greenland are seeking compensation from the Danish government over a campaign of involuntary birth control in the 1960s. At least 4,500 women, some of them teenagers, were fitted with coils under a programme intended to limit birth rates among the indigenous population. An inquiry is due to conclude in 2025, but the women, some of whom are in their 70s, want compensation now. They are seeking 300,000 kroner (£34,880; $42,150) each. Records from the national archives showed that, between 1966 and 1970 alone, intrauterine devices (IUDs) were fitted into the women, some as young as 13, without their knowledge or consent. A commission set up by the Danish and Greenlandic governments to investigate the programme is not due to deliver its findings until May 2025. "We don't want to wait for the results of the inquiry," said psychologist Naja Lyberth, who initiated the compensation claim. "We are getting older. The oldest of us, who had IUDs inserted in the 1960s, were born in the 1940s and are approaching 80. We want to act now." Ms Lyberth said that, in some cases, the devices fitted had been too big for the girls' bodies, causing serious health complications or even infertility, while in others the women had been unaware of the devices until they were discovered recently by gynaecologists. She accused the Danish government of the time of wanting to control the size of Greenland's population in order to save money on welfare. "It's already 100% clear that the government has broken the law by violating our human rights and causing us serious harm," she said. Read full story Source: BBC News, 3 October 2023
  18. Content Article
    The relationship between patients and their data is deeply personal. This report by The Patients Association shows that patients recognise that the potential for data use to improve care is huge, and that there is widespread support for realising this potential if patients’ concerns are acknowledged and addressed. It proposes the development of a data pact to outline the relationship between patients, their data and the health system. This could be a useful first step in informing patients about how data is used in the health and care system and a starting point in improving patient confidence. To do this, the pact needs to acknowledge that the system is not perfect, as one part of building public confidence is acknowledging the reasons why at present, confidence may be low.
  19. Content Article
    This opinion piece is by Luke* who suffers from post-SSRI sexual dysfunction (PSSD) after he was prescribed a selective serotonin reuptake inhibitor (SSRI) antidepressant.  Luke introduces the condition, drawing on the experiences that others have shared through PSSD communities, to highlight the devastating impact on patients. He calls for widespread recognition, improved risk communication and better support for sufferers.  *Name has been changed
  20. Content Article
    In this podcast episode, Rosie, Sean, Carlton, and Emily share their experiences with Post-SSRI Sexual Dysfunction (PSSD), a condition where individuals face persistent sexual side effects and other side effects after taking or discontinuing certain antidepressants. Throughout the conversation, they emphasise the need for increased awareness and research on PSSD, sharing personal stories to shed light on this often-overlooked condition. Despite the challenges they face, they remain determined to advocate for recognition and support for those suffering from PSSD.
  21. Content Article
    Sexual dysfunction is a common side effect of Serotonergic antidepressants (SA) treatment, and persists in some patients despite drug discontinuation, a condition termed post-SSRI sexual dysfunction (PSSD). The risk for PSSD is unknown but is thought to be rare and difficult to assess. This study, published in the Annals of general psychiatry, aims to estimate the risk of erectile dysfunction (ED) and PSSD in males treated with SAs.
  22. Content Article
    Achieving shared interpersonal understanding between healthcare professionals, patients and families is a core patient safety challenge around the world. The SACCIA model promotes safe communication practice amongst healthcare teams and between providers patients. It was developed by Professor Annagret Hannawa, Director of the Center for the Advancement of Healthcare Quality & Safety in Switzerland. The interpersonal processes that are captured in the SACCIA acronym are considered 'safe' because they lead to a shared understanding between all care participants: Sufficiency Accuracy Clarity Contextualization Interpersonal Adaptation The five SACCIA competencies emerged from a communication science analysis of hundreds of critical healthcare incidents. They were identified as common deficient interpersonal processes that often cause and contribute to preventable patient harm and insufficient care. They therefore represent an evidence-based set of core competencies for safe communication, which constitute the vehicle to patient care that is safe, efficient, timely, effective and patient-centred.
  23. Content Article
    Consent to treatment means a person must give permission before they receive any type of medical treatment, test or examination. This must be done on the basis of an explanation by a clinician. Consent from a patient is needed regardless of the procedure, whether it's a physical examination or something else. The principle of consent is an important part of medical ethics and international human rights law. This webpage from the NHS includes information on: how consent is given and what we mean by consent assessing capacity consent from children and young people assessing capacity when consent is not needed consent and life support.
  24. News Article
    A man plans to sue a nursing home because, he says, during the pandemic his mother was put on end-of-life care without her family being told. Antonia Stowell, 87, did not have the mental capacity to consent because she had dementia, say the family's lawyers. Her son, Tony Stowell, said if end-of-life care had been discussed, he would not have agreed to it. Rose Villa nursing home in Hull says all proper process in Mrs Stowell's care was followed with precision. As a prelude to legal action, Mr Stowell's lawyers have obtained his mother's hospital records which, they say, show she was diagnosed with suspected pneumonia while living in the home. End-of-life drugs were then prescribed and ordered by medical professionals. In a statement, Rose Villa said: "We believe that our dedicated and professional team provided Antonia with the very best care under the direction of her GP and medical team, and all proper process in the delivery of this care was followed with precision." Mr Stowell's lawyers, Gulbenkian Andonian solicitors, said his mother's hospital records reveal the decision to put her on end-of-life care was made two days before the family was told. In their letter to the home announcing the planned legal action, they said Mrs Stowell could have had "48 additional hours on a ventilator with treatment… with the necessary implication that Antonia Stowell could still be with us today or at least survived". The lawyer dealing with the case, Fadi Farhat, told the BBC: "As a matter of law, there is a presumption in favour of treatment which would preserve life and prolong life, irrespective of one's age or condition. "Therefore to deviate from that presumption means a patient, or family members, should be consulted as soon as that decision is made or contemplated." He adds: "What is particularly concerning for me is this case occurred at the height of the pandemic. That should worry everybody because it demonstrates that rights can be suspended in times of crisis, when the very purpose of legal rights is to protect us during times of crisis." Read full story Source: BBC News, 9 January 2023
  25. News Article
    The high-profile Australian neurosurgeon Charlie Teo admits making an error by going “too far” and damaging a patient, but maintains she was told of the risks. The doctor on Monday appeared at a medical disciplinary hearing to explain how two women patients ended up with catastrophic brain injuries. Teo also defended allegations that he acted inappropriately by slapping a patient in an attempt to rouse her after surgery, contrasting it with Will Smith’s notorious slap of Chris Rock at the Academy Awards last year. “It wakes them up and it wakes them up pretty quickly. And I will continue to do it.” Charlie Teo tells inquiry he ‘did the wrong thing’ in surgery that left patient in vegetative state One of the issues the panel of legal and medical experts is considering is whether the women and their families were adequately informed of the risks of surgery. Both women had terminal brain tumours and had been given from weeks to months to live. They were left in essentially vegetative states after the surgeries and died soon after. “We were told he could give us more time,” one of the husbands said, according to court documents. “There was never any information about not coming out of it". Read full story Source: The Guardian, 27 March 2023
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