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News Article
Coeliacs may soon no longer need to eat large amounts of gluten – the very thing suspected of making them sick – to get an accurate diagnosis. Australian research published in the journal Gastroenterology showed a blood test for gluten-specific T cells had a high accuracy in diagnosing coeliac disease, even when no gluten was eaten. Around 1% of people in western countries have coeliac disease, an autoimmune condition in which gluten causes an inflammatory reaction in the small bowel. Currently, every approved method to diagnose it requires people to eat gluten, the paper said. Current testing methods – blood tests or a gastroscopy – require weeks of a person eating gluten, while often enduring symptoms such as diarrhoea, abdominal pain and bloating. Despite the importance of early diagnosis, the researchers said many people are deterred because they do not want to get sick from the tests. More than one in two cases of coeliac disease are either undiagnosed or diagnosed late, prior research has shown. “There are likely millions of people around the world living with undiagnosed coeliac disease simply because the path to diagnosis is difficult, and at times, debilitating,” said Assoc Prof Jason Tye-Din, a senior author of the paper and head of the Coeliac Research Laboratory at the Walter and Eliza Hall Institute of Medical Research (WEHI) in Melbourne, Australia. The new research could be a “game-changer”, helping address “one of the biggest deterrents in current diagnostic practices”, Tye-Din said. Read full story Source: The Guardian, 10 June 2025- Posted
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News Article
Trusts ordered to help with ‘heartbreaking’ diagnostic delays
Patient Safety Learning posted a news article in News
NHS England has told trusts they must help neighbours to cut the number of children waiting for hearing tests, even if it affects their own performance. NHS England co-medical director for secondary care Meghana Pandit has written to regional and integrated care board leaders warning that some areas have fallen behind in responding to serious concerns about paediatric audiology. In 2023, an NHSE audit found that more than a thousand children might have been misdiagnosed or had problems missed. As of February, 1,374 children were still waiting to be seen, and of the 775 who had been assessed, 31 had suffered severe or permanent harm and another 76 moderate harm. Trusts that have previously confirmed that children had diagnoses missed include Barts Health Trust, Worcestershire Acute Hospitals Trust, and Northern Lincolnshire and Goole Foundation Trust. Professor Pandit said some areas had missed the national “ambition” of recalling and reassessing all patients by the end of March. They are then due to be discharged or have started treatment by the end of September. ICBs now have until 20 June to submit detailed plans on how they will achieve this, and providers are expected to prioritise the reassessments. The letter, written with chief scientific officer Sue Hill and diagnostics director Rhydian Phillips, said: “The risk of decline in an individual provider’s diagnostic six-week wait performance should not be a reason to decline support to this process. It has been agreed nationally that the review, recall and reassessment process should be prioritised in the short term.” Read full story (paywalled) Source: HSJ, 6 June 2025- Posted
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Content Article
Diabetes UK has launched their new ‘10 Year Vision: For diabetes prevention, care and treatment’, setting out a clear plan for the UK government about how it can improve health outcomes and tackle inequality for people living with diabetes by 2035. The UK government will publish its 10 Year Health Plan in June, which will set out how the health service can make a shift from sickness to preventing ill health. If the government is to succeed with this aim, diabetes must be at the heart of its plans. The ‘10 Year Vision’ gives the government a clear plan for how it can improve health outcomes and tackle inequalities for people living with diabetes, and how this can be achieved by 2035. This vision involves: Stemming the rise in type 2 diabetes – improving our food environment and delivering high-quality support to help people reduce their risk of type 2 diabetes. Ensuring early and accurate diagnosis - which is key to setting people up to manage their diabetes and, in turn, preventing serious complications. Transforming diabetes care and treatment – to help people with diabetes live well. Most diabetes complications can be prevented with simple interventions like annual checks, access to the right treatments and technology, and a focus on reducing health inequalities. Accelerating innovation – Investing in diabetes research and ensuring new treatments and technologies are available to people with diabetes quickly. -
Content Article
NHS England: Urgent and emergency care plan 2025/26
Patient Safety Learning posted an article in NHS England
This report sets out how the NHS will resuscitate urgent and emergency care, with a focus on getting patients out of corridors, keeping more ambulances on the road, and enable those ready to leave hospital to do so as soon as possible. Summary of actions and impact for patients and carers Focus as a whole system on achieving improvements that will have the biggest impact on urgent and emergency care services this winter By the year-end, with improvement over winter, we expect to: Reduce ambulance wait times for Category 2 patients – such as those with a stroke, heart attack, sepsis or major trauma – by over 14% (from 35 to 30 minutes). Eradicate last winter’s lengthy ambulance handover delays by meeting the maximum 45-minute ambulance handover time standard, helping get 550,000 more ambulances back on the road for patients. Ensure a minimum of 78% of patients who attend A&E (up from the current 75%) are admitted, transferred or discharged within 4 hours, meaning over 800,000 people a year will receive more timely care. Reduce the number of patients waiting over 12 hours for admission or discharge from an emergency department compared to 2024/25, so this occurs less than 10% of the time. This will improve patient safety for the 1.7 million attendances a year that currently exceed this timeframe. Tackle the delays in patients waiting to be discharged – starting with the nearly 30,000 patients a year staying 21 days over their discharge-ready-date, saving up to half a million bed days annually. Increase the number of children seen within 4 hours, resulting in thousands of children every month receiving more timely care than in 2024/25. Develop and test winter plans, making sure they achieve a significant increase in urgent care services provided outside hospital compared to last winter Improve vaccination rates for frontline staff towards the pre-pandemic uptake level of 2018/19. This means that in 2025/26, we aim to improve uptake by at least 5 percentage points. Increase the number of patients receiving urgent care in primary, community and mental health settings, including the number of people seen by Urgent Community Response teams and cared for in virtual wards. Meet the maximum 45-minute ambulance handover time standard. Improve flow through hospitals, with a particular focus on reducing patients waiting over 12 hours, and making progress on eliminating corridor care. Set local performance targets by pathway to improve patient discharge times, and eliminate internal discharge delays of more than 48 hours in all settings. Reduce length of stay for patients who need an overnight emergency admission. This is currently nearly a day longer than in 2019 (0.9 days) and needs to be reduced by at least 0.4 days . Reduce the number of patients who remain in an emergency department for over 24 hours while awaiting a mental health admission. This will provide faster care for thousands of people in crisis every month. National improvement resource and additional capital investment is simplified and aligned to supporting systems where it can make the biggest difference Allocating over £370 million of capital investment to support: Around 40 new same day emergency care centres and urgent treatment centres. Mental health crisis assessment centres and additional mental health inpatient capacity to reduce the number of mental health patients having to seek treatment in emergency departments. Expansion of the Connected Care Records for ambulance services, giving paramedics access to the patient summary (including recent treatment history) from different NHS services, enabling better patient care and avoiding unnecessary admissions.- Posted
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Event
Continuing with the JCI Patient Safety Grand Rounds, the next session of the Grand Round is “Diagnostic Safety: From Error to Excellence in Patient Care. This strengthens the global efforts to improve diagnostic safety, building on the World Patient Safety Day theme of 2024. The upcoming session will feature a compelling conversation between internationally recognised leaders in the field. Dr. Hardeep Singh, Professor of Medicine at Baylor College of Medicine, will be joined by Dr. Laura Zwaan, Associate Professor at the Institute of Medical Education Research Rotterdam, Dr. Elizabeth Liz Mort, Vice President and Chief Medical Officer at The Joint Commission, and Dr. Neelam Dhingra, Vice President and Global Chief Patient Safety Officer at Joint Commission International JCI invites you to register now to be part of this important initiative and share this information with your networks and social media channels. The registration is complimentary. Register -
Content Article
Despite its prevalence, treatment of hypothyroidism has long divided opinion in the research and clinical fields. In a paper for Nature Reviews Endocrinology, I share my experience as a patient living with hypothyroidism for 16 years, as well as the difficulties I have faced in achieving consistent and effective treatment tailored to my individual needs. Hypothyroid patients will recognise many aspects of their own journey in this personal report. Achieving a prompt, accurate diagnosis and appropriate, effective treatment is difficult, sometimes impossible. NHS guidance is confusing and restrictive. There have been huge advances in the science of endocrinology in recent decades that has not filtered down to those at the coal face, dealing with patients.- Posted
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- Diagnosis
- Medicine - Diabetes and Endocrinology
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News Article
New technology should be paid for ‘like medicines’, says NICE chief executive
Patient Safety Learning posted a news article in News
The purchase of approved digital products and services used for diagnosing and treating NHS patients should be reimbursed centrally, the chief executive of the National Institute of Health and Clinical Excellence has told HSJ. Sam Roberts said this was “the minimum a citizen should expect from a digitised health service” and that she was determined “to get that into the [government’s 10-Year Health] plan”. She described the different financial arrangements for NICE-approved digital products and services as “outrageous”, and said they should instead be treated “like medicines”. In a wide-ranging interview with HSJ, the NICE CEO also said: She wanted NICE to “lead the charge” in determining which digital innovations the NHS should adopt NICE would issue more guidance on which medicines it had previously recommended should no longer be used A new approach was needed to deal with the impending wave of expensive “preventive medicines” such as the new wave of weight-loss drugs. Read full story (paywalled) Source: HSJ, 3 June 2025- Posted
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Content Article
The annual Cancer in the UK report summarises key data across the cancer pathway, including prevention, diagnosis, treatment and outcomes. It looks at where progress is being made and what challenges remain in the UK. Evidence in this report shows that improvements can be made across the cancer pathway – preventing cancers, diagnosing patients earlier and ensuring patients have access to the best treatment options – to attain outcomes that are among the best in the world. The report concludes by setting out the priority actions that are vital to addressing challenges faced by cancer services and lays out how data-led insights can strengthen our ability to beat cancer- Posted
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- Cancer
- Patient death
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News Article
‘Revolutionary’ DNA blood test to offer thousands in England tailored cancer care
Mark Hughes posted a news article in News
Thousands of cancer patients in England are to benefit from a DNA blood test that saves lives by fast-tracking them on to personalised treatments. In a world-first, the NHS will offer patients with lung and breast cancer – two of the most common forms of the disease – a liquid biopsy that detects tiny fragments of tumour DNA. Rapid results from the groundbreaking test mean patients can immediately be offered drugs and treatments specifically tailored to the genetic profile of their disease, significantly increasing their survival chances and paving the way for a new era of precision medicine. Read full article Source: The Guardian, 29 May 2025 -
Content Article
With hopes for the far-reaching impact of artificial intelligence (AI) on health care remaining as strong as ever, the NIHR Rapid Service Evaluation Team have conducted a review of the literature on the role of AI in radiology diagnostics. Emma Dodsworth and Rachel Lawrence describe the three findings from the work that stood out the most. -
Content Article
NHS Race and Health Observatory Review of Neonatal Assessment and Practice in Black, Asian, and Minority Ethnic Newborns highlighted the need for educational resources to help healthcare professionals assess babies with dark skin tones, who are at higher risk of developing jaundice and experiencing delayed diagnosis and treatment. This new infographic for health care professionals, “10 Steps to spot Jaundice in Black and Brown babies” was designed by Dr. Helen Gbinigie, Neonatal Consultant at Medway Hospital and Clinical Lead for KM LMNS; and Dr. Oghenetega Edokpolor, ST5 Paediatric Trainee at Medway Hospital, in collaboration with the NHS Race and Health Observatory. It’s a vital tool in pursuing the Observatory’s aims to reduce neonatal ethnic health inequalities.- Posted
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News Article
‘Life saving’ rapid test not available at most CDCs
Patient Safety Learning posted a news article in News
Patients are facing “unnecessary and worrying” waits because a rapid heart failure test is not available at most of the NHS’s 169 community diagnostic centres (CDC), experts have told HSJ. An analysis by HSJ of data from the Alliance for Heart Failure found that as of October 2024 virtually no trusts and ICBs reported offering rapid NT-proBNP in their CDCs. The rapid version gives a result with minutes, while a regular test must be sent away to a lab for analysis. The research, exclusively shared with HSJ, also found that CDCs offering the rapid NT-proBNP test are mainly located on hospital-based sites – and not in the community. A further 14 trusts operating across 10 integrated care systems said that the rapid test is, or might be, added to their CDC offer. The Royal College of Pathologists and the British Society for Echocardiography have both called for it to be made available in all CDCs. They have claimed this would cut unnecessary waits for patients, reduce inappropriate referrals and ease pressure on diagnostic services. “This is an essential test which should be available in all CDCs”, said Dan Augustine, president of the British Society for Echocardiography. “Many people who are suspected of having heart failure are currently referred for echocardiograms. For those who do not have heart failure, this means an unnecessary and potentially worrying wait. It also puts added pressure on already struggling echocardiographers.” Read full story (paywalled) Source: HSJ, 19 May 2025- Posted
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Content Article
Tackling bias in healthcare (29 April 2025)
Patient Safety Learning posted an article in Health inequalities
Bias in the way medical research is carried out means that new medicines for diseases such as cancer – as well as the tools used to diagnose patients with some conditions – are disproportionally tested on people of European heritage. This can lead to those not represented in the data being misdiagnosed as well as some treatments not working as well as they should. From the Ghanaian scientist helping to develop cancer treatments which work better for African people, to the team in England using AI to diagnose dementia in communities where English isn’t widely spoken, in this programme we will meet the solution-seekers trying to make healthcare more equal.- Posted
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Content Article
Diagnostic uncertainty was relatively common in critically ill children admitted to the paediatric intensive care unit (PICU), an AHRQ-funded study in Critical Care Medicine concluded. Diagnostic uncertainty is the subjective perception of clinicians of their inability to provide an accurate explanation of a patient’s health problem. Researchers aimed to identify the frequency and factors associated with diagnostic uncertainty among critically ill children admitted to PICU. They reviewed the medical records of 882 patients admitted to one of four PICUs. Diagnostic uncertainty at admission was observed in 228 out of 882 patients. They also found a significant association between diagnostic uncertainty and diagnostic error. Researchers highlighted the need for more research and better strategies to address diagnostic uncertainty.- Posted
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Content Article
Orthopaedic surgeon Sunny Deo has spent three decades diagnosing and treating knee joint issues. In this blog, Sunny argues that the healthcare community needs to take a more nuanced approach to diagnosis and decision making so that it can provide patients with safer, more appropriate treatment options. He reflects on why medicine prefers simple answers and looks at how this affects patient care. He goes on to explore how better data collection and the use of artificial intelligence (AI) could provide a more accurate picture of complexity and allow treatment options to be better tailored to individual patients’ needs. "To know the patient that has the disease is more important than to know the disease that the patient has." William Osler, father of modern medicine, 1849-1919. Diagnosis is the process of identifying the nature of an illness or other problem by examining the symptoms and objective findings from investigations. In modern medicine, it is a key focal point of the assessment and management of all patients. A huge amount of clinical medicine training is focused on the art and science of obtaining a diagnosis, and this focus continues into medical practice. The ease of getting to a diagnosis ranges from the glaringly obvious, the so-called ‘spot diagnosis’, through to cases that are very difficult to solve. In between these extremes there is a range from delayed to missed to incorrect diagnosis. The aim of doctors over the centuries has been to work out diagnoses from patients’ symptoms, presenting features (clinical signs) and, in the past century or so, from the evidence of clinical investigations. Quite often, symptoms, signs and investigations produce consistent patterns, and it is these patterns that are taught to medical and other healthcare professionals. This is how diagnoses and outcomes are portrayed in television series or films—just think back to the last episode of Casualty or Grey’s Anatomy you watched. It's also how things often appear in internet searches and on websites and social media. Seeking simple answers to complex questions However, the reality is different. When a patient is sitting in front of me, what I hear and observe may not exactly be what the textbooks, evidence or research tells me I should be seeing. But because we are wired and trained to recognise patterns, we tend to look for diagnoses and solutions that fit within the well-worn narrative. What if the pattern doesn’t fit the actual diagnosis? There are classic presentations for nearly every condition, and these are what you tend to find at the start of a Google search or when using NHS Choices. The expectation of typical symptoms sometimes means we ignore what we might see as annoying variance, superfluous detail or the patient embellishing the truth. This discordance then causes tension with a very basic trait of humans: when we’re faced with a difficult problem, we still seek the simplest solution. This is an evolutionary feature hardwired into us to optimise survival chances. It means we often believe there is a truth to be found that will provide us with a definite answer. From this answer we will come to the best, and ideally only, ‘correct’ solution. Patients who don’t fit the set patterns of diagnosis may then run into trouble when we offer them what is considered to be the ideal treatment. This is an important problem in clinical thinking, language and practice. As a medical community, we tend to create oversimplified approaches based on research that looks for binary answers to complex questions. This research evidence may be based on a small, highly selective ‘typical’ patient cohort, but its findings and conclusions are then translated on to the entire population. This approach results in poor patient outcomes and experience for a small but significant proportion of patients. Pathways designed for ideal diagnoses can cause harm to patients Over my 30 years as an orthopaedic surgeon, 15 as a knee specialist, I have seen that the assessment and treatment of any given condition isn't quite as predictable as we would like it to be. While many patients fit the pattern we are expecting, some do not. I would empirically put the proportion at 60:40, but some unpublished research we did a decade ago suggested the proportion of truly ‘typical’ case presentations for a common condition is much lower. For example, we found that in the case of suspected meniscal tear, this diagnosis actually applied to only 33% of patients with a variety of other diagnoses accounting for the rest. It gets worse when large organisations start to lump patients into a category by condition in a ‘one diagnosis fits all’ strategy. When this approach is taken, there are winners and losers. The winners are those patients whose condition very closely matches the classic presentation of a given condition in isolation. Let’s take the example of knee osteoarthritis—patients with the ‘right type’ of symptoms, physical signs and x-ray changes are generally more likely to do well. Their recovery is more likely to sit within the knowledge base of treating the condition that has evolved over the past half-century. In contrast, patients whose symptoms and test results fall outside of this category may be less likely to do well or recover in the predicted timeframe. This also applies to patients with additional diagnoses or conditions, often termed comorbidities, which may interact, usually in a bad way, with the condition at hand. Failure to consider other diagnoses, either by over-focus on one condition causing wilful ignorance, inattention or lack of attention, may lead to unexpected poor outcomes from a given treatment. It may also mean that the symptoms from the condition that the patient presents with are worse than expected. This doesn’t mean that they won't gain any benefit from a particular treatment, but the risks and potential outcomes may not be communicated adequately by the patient’s healthcare team, if at all. For example, for patients with painful knee osteoarthritis, the current diagnosis to treatment logic runs like this: Knee osteoarthritis is a painful condition. Total knee replacement surgery is a validated safe procedure with significant improvements in quality of life. Other treatment options do not produce as much positive therapeutic benefit compared to total knee replacement surgery. Therefore, total knee replacement surgery is the only treatment for painful knee osteoarthritis. However, there are patients for whom knee replacement surgery is not a safe or practical option, and these patients may benefit from alternative treatments that are not currently offered as they are seen as providing limited benefit. This may be because the participants in trials undertaken over the years had varying diagnoses, meaning that true comparisons of alternative options may have had additional interacting diagnoses or failed to account for differing severity. Understanding the spectrum of complexity As healthcare professionals, we have a duty to diagnose patients as accurately as possible. In orthopaedics, if treatments go wrong or are poorly undertaken, it may lead to prolonged or permanent pain or disability, and we obviously want to avoid this as much as possible. Incomplete identification and documentation of all relevant symptoms and health conditions can potentially lead to an increased risk of treatment failure and complications. Our priority should be to identify these diagnoses or diagnostic clusters as accurately as possible. I think these are basic principles we need to apply to create better systems and improved care for as many patients as possible. In my view, there are grades of ‘atypical patients’ and I have devoted the past decade to trying to demonstrate this, with surprisingly stiff resistance from peer-reviewed journals and funding organisations. I have tried to move away from lumping all patients into a single category. I have done some research on seemingly straightforward soft tissue problems and osteoarthritis in the knee. My initial analysis suggests that we need to collect more detailed and accurate data, rather than simplifying data into minimum datasets. This is where AI can really come into its own, not as a diagnostic tool initially, but as a powerful aid to unlocking and interpreting some of the diagnostic interactions that create problems for patients. However, the use of AI does need to be undertaken with extreme care and consideration, and this isn’t always happening currently. To offer healthcare that is truly person-centred, we need to look beyond our well-worn simple answers and solutions. By using better data and new machine learning tools to understand the nuances of each person’s condition and how it relates to their wider health, we can offer treatment options that are safer, kinder and more cost-effective. Share your views We would love to hear your views on the issues highlighted in Sunny’s blog Are you a clinician who would like to share your experiences? Do these challenges resonate with you? Or are you a patient who has experienced complications because of poor, missed or inadequate diagnosis? Add your comment below (you will need to be a hub member and signed in) or contact us at [email protected] and we can share your story anonymously. Related content on the hub: Using data to improve decision making and person-centred care in surgery: An interview with Sunny Deo and Matthew Bacon Diagnostic errors and delays: why quality investigations are key- Posted
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- Surgery - Trauma and orthopaedic
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Content Article
Lorraine Parker’s death was the third within three months at Royal Berkshire Foundation Trust following surgery by the same consultant colorectal surgeon. With the permission of both families, the coroner referred to two previous inquests – Mr MR (date of death 4 March 2024), and Mr ME (date of death 28 December 2023) – to focus on the trust’s death investigation processes, and how efficient they have been in terms of picking up issues following each of these deaths. The coroner instructed independent colorectal surgery experts to comment on the management, using two different experts for the three cases. The coroner made the following findings: In the case of Mr ME, a significant surgical error was made when a healthy part of the bowel was removed instead of the area with the cancer, resulting in a much more extensive operation and Mr ME dying around 5 weeks later. This was discussed in a morbidity and mortality meeting, which ends with the simple phrase “await coroner’s report”. A structured judgment review was carried out by a consultant colorectal colleague on 4 May 2024, over four months after the death. According to this review, all of the care given to Mr ME was either “good” or “excellent”. A further structured judgement review took place. It would appear that none of the colorectal surgeons was willing to carry this out, resulting in the need for a gastroenterologist to conduct a second review in July 2024, by which time the surgeon had already been suspended from major operative work. It is important to note that in a clinical governance meeting in February 2024 (ie before either of these structured judgement reviews) it was noted that there were “no learning points identified” in relation to Mr ME’s case. In the case of Mr MR, a structured judgement review took place conducted by a consultant surgical colleague. This report was poor and the coroner wrote to the Chief Medical Officer about it after the inquest. It has the look of the briefest of reviews and tick box exercises. Again, all of the management is referred to as “good”. Mr MR’s case was not discussed during the March 2024 morbidity and mortality meeting, despite the fact that a later death (Lorraine Parker’s, on 30 March 2024) was discussed then. Mr MR’s case did not go to a morbidity and mortality meeting discussion until May 2024. The reasons for this remain unclear. In Lorraine’s case, there was a morbidity and mortality meeting discussion in March 2024 (or perhaps shortly thereafter). The April clinical governance meeting minutes refer to Lorraine’s case and again state “no learning points”. None of these three cases has been the subject of a detailed PSIRF report. Matters of concern On the evidence from the three inquests referred to, the Royal Berkshire Hospital’s death investigation process is not working well. Evidence of delayed morbidity and mortality meetings with no clear system for ensuring that these discussions happen timeously. There is little (if any) record of areas of concern identified at meetings – whether at morbidity and mortality meetings or clinical governance meetings. There is delayed escalation of concerns. Structured judgement reviews are at best, poor, and at worst, defensive. Delayed or no scrutiny of cases being reported to the coroner because the cause of death is unnatural, given that medical examiners are not funded to scrutinise those cases. Opportunities for early learning are therefore being lost. Systems of collating and providing medical records and clinical governance records to the coroner (and presumably to others involved in death investigation) are unreliable. The coroner is concerned about whether the trust has done enough to deal with the concerns about this particular surgeon, not just in the Berkshire area, but more widely.- Posted
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News Article
Patient suffered diagnosis delay after junior doctor missed 'red flags' in A&E
Patient Safety Learning posted a news article in News
A patient suffering from a perforated bowel had their diagnosis delayed after a junior doctor missed “red flags” during an assessment in A&E. After arriving at the emergency department of an NHS Forth Valley hospital, the patient was initially assessed by a junior doctor who ordered various tests and investigations. They were later moved to the acute assessment unit and diagnosed with a perforated bowel. The patient developed sepsis after undergoing emergency surgery. The patient’s child complained to the Scottish Public Services Ombudsman (SPSO) about their parent’s treatment. Specifically, they complained about the delay in identifying their parent’s condition, which they believe led to a worse outcome. NHS Forth Valley acknowledged that a more senior doctor may have identified the cause quicker, but that the care provided was reasonable, and that the complaint had led to learning and ongoing development. In putting together their report, the SPSO took independent advice from an emergency medicine consultant. It found that there were “a number of red flags” when the patient was admitted and that it did “not appear” they had been reviewed by a senior clinician. Issues were also found in the patient’s documentation; no intimate examination was recorded, and there was a “lack” of documentation around the interpretation of an X-ray. Overall, the report concluded that the initial assessment delayed diagnosis of the perforated bowel and was likely to have had a “significant effect” on the patient’s outcome. Read full story Source: STV News, 29 April 2025- Posted
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- Diagnosis
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Content Article
The Rare Autoimmune Rheumatic Disease Alliance (RAIRDA) has launched a report revealing that individuals living with rare autoimmune rheumatic diseases (RAIRDs) experience stark variations in their care and treatment. The report, developed in partnership with Ipsos, draws on survey responses from over 1,300 people across the UK and paints a concerning picture: nearly one in three respondents waited more than five years for a diagnosis, with the average wait time standing at two and a half years. Key findings from the report include: 86% of those who waited over five years for a diagnosis said it negatively impacted their ability to complete everyday tasks. 73% reported a negative effect on their mental health. 66% of working individuals said their condition impacted their ability to work effectively. Only 16% of respondents felt they had sufficient access to information and support. Just 26% had confidence in their GP’s understanding of their condition. RAIRDA is calling for urgent action. The report sets out a series of practical policy recommendations, including: The introduction of clear and measurable targets for timely referrals and treatment. A named care coordinator for every person with a RAIRD. Increased investment in research to improve diagnostic pathways.- Posted
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- Rare diseases
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Content Article
A correct diagnosis is essential to understand a patient’s condition and determine the most beneficial management in partnership with that patient. Despite the simplicity of “a correct diagnosis,” terminology and methods differ when defining success and failure in diagnosis and diagnostic processes. Like a multi-faceted prism, different terms describe varying perspectives, insights, or challenges (Figure). This diversity reflects the inherent complexity of diagnosing, as well as the potential for different stakeholders to have different goals or perspectives for diagnostic improvement. This issue brief explores a variety of terms and perspectives that describe aspects of diagnostic success or consequences of diagnostic failure. It provides historical context, underlying assumptions, implications, limitations, and appropriate use of terms. This summary is directed to clinicians, researchers, and others select the most suitable word or phrase for their purposes and understand the terminology others use. There is no single best term for all circumstances or perspectives, rather many lenses, depending on the paradigm, orientation, and purpose, through which we can view diagnosis and diagnostic improvement.- Posted
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News Article
Over 150,000 more people in England have ME than previously thought, study finds
Patient Safety Learning posted a news article in News
More than 150,000 more people in England are living with chronic fatigue syndrome (CFS) than was previously estimated, according to a study that highlights the “postcode lottery” of diagnosis. The research, published in the peer-reviewed journal BMC Public Health, involved researchers from the University of Edinburgh analysing NHS data from more than 62 million people in England to identify people who had been diagnosed with myalgic encephalomyelitis (ME)/chronic fatigue syndrome or post-viral fatigue syndrome. The data was examined by gender, age and ethnicity, and grouped by different areas of England. ME, also known as chronic fatigue, is a long-term condition with its main symptoms being extreme fatigue, brain fog, and issues with sleep. The condition’s key feature is known as post-exertional malaise, which is a delayed dramatic worsening of these symptoms following minor physical effort. There is currently no diagnostic test or cure for the disease and its causes are unknown. The findings showed that the lifetime prevalence of chronic fatigue for women and men in England may be as high as 0.92% of the population for women, and 0.25% for men. This is equivalent to about 404,000 people overall. The study also revealed stark ethnic inequalities relating to chronic fatigue diagnoses rates. White people with ME in England were almost five times more likely to be diagnosed with the condition than other ethnic groups. People from Black and Asian backgrounds were least likely to be diagnosed with the condition, with rates between 65% and 90% lower than their white counterparts. Read full story Source: The Guardian, 22 April 2025 Related reading on the hub: Exploring the barriers that impact access to NHS care for people with ME and Long Covid- Posted
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- ME/ Chronic fatigue syndrome
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Content Article
People with Myalgic Encephalomyelitis (ME/CFS; sometimes referred to as chronic fatigue syndrome) experience poor health-related quality of life and only rarely recover. ME/CFS has no curative treatment, and no single diagnostic test. Public health and policy decisions relevant to ME/CFS require knowledge of its prevalence and barriers to diagnosis. The research, published in BMC Public Health, analysed NHS data from more than 62 million people in England to identify people who had been diagnosed with myalgic encephalomyelitis (ME)/chronic fatigue syndrome or post-viral fatigue syndrome. The data was examined by gender, age and ethnicity, and grouped by different areas of England. The findings showed that the lifetime prevalence of chronic fatigue for women and men in England may be as high as 0.92% of the population for women, and 0.25% for men. This is equivalent to about 404,000 people overall.- Posted
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- ME/ Chronic fatigue syndrome
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News Article
Young professionals go private for MRI scans and cancer checks
Patient Safety Learning posted a news article in News
Young professionals are giving up on the NHS and going private for cancer checks and diagnostic scans, new data shows. A record one million people received health tests and scans privately last year, as the public grew increasingly disillusioned with long and stressful waits for GP appointments and checks. The report by the Independent Healthcare Provider Network (IHPN) found that demand for private health tests has soared among working-age professionals in their twenties, thirties and forties. Experts said this reflects a desire to get “peace of mind” for worrying symptoms quickly and on demand. Adults are placing a premium on being able to book appointments at a convenient time and location, often opting for private clinics near their workplace so they can pop out during lunch breaks. David Hare, the chief executive of IHPN, said: “This latest research from IHPN shows that going private for vital scans and tests is becoming increasingly normalised, with speedy access to appointments and the ability to receive results often within 48 hours a key attraction for patients looking for much-needed peace of mind and value for money. “This is particularly the case for younger people, who are accustomed to high quality, convenient and personalised services in many other aspects of their lives, and hugely benefit from the increasing number of private diagnostics services available near their homes and workplaces.” Read full story (paywalled) Source: The Times, 14 April 2025 -
News Article
'We wait too long for endometriosis diagnoses'
Patient Safety Learning posted a news article in News
After seven years of doctors discounting my symptoms, Ellie Tutt joined the end of a fifty-five-week-long waiting list to find out whether she had endometriosis. About 1.5 million women in the UK, external are thought to have the condition, which causes pain and extreme tiredness as a result of tissue similar to the womb lining growing elsewhere in the body. But for many of these women, it is taking a long time to get a diagnosis. Endometriosis can cause chronic pain, heavy bleeding and, if untreated, organ damage, external and infertility. Despite this, Dr Kate Dyerson, a GP from Berkshire, said it was taking some women four or five trips to their doctor before they were taken seriously. She said: "I think there's a degree of ignorance among the medical profession as to how many women are affected." Women's medical problems had long been dismissed, she said, adding many doctors would assume a teenager was just adjusting to period pains. "I don't think it's sexist so much, I think it's that inbuilt sense that women have periods, periods are unpleasant, we don't want to talk about them, and if they hurt, well, take your pain elsewhere." Dr Dyerson said it took an average of eight years for women to get a diagnosis and felt GPs needed to get better at making referrals. Read full story Source: BBC News, 16 April 2025- Posted
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Content Article
Live stream recording of Day 1 of the 7th Global Summit on Patient Safety, organised by the Department of Health of the Republic of the Philippines and co-sponsored by the World Health Organization (WHO). This event focuses on advancing international efforts to improve healthcare quality and safeguard patients worldwide. It brings together global leaders, experts and stakeholders to discuss and shape the future of patient safety. Advancing Patient Safety Reporting and Learning Systems can be found at 2:46:57 Plenary 3 on AI and health can be found at 08:05:10 Related reading on the hub: 15 hub top picks for the 7th Global Ministerial Summit for Patient Safety- Posted
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- Global health
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Content Article
The 7th Global Ministerial Summit for Patient Safety, organised by the Department of Health of the Republic of the Philippines and co-sponsored by the World Health Organization (WHO), takes place on 3-4 April 2025 in Manila. This event focuses on advancing international efforts to improve healthcare quality and safeguard patients worldwide. It brings together global leaders, experts and stakeholders to discuss and shape the future of patient safety. Global Ministerial Summits on Patient Safety aim to drive forward the global patient safety movement. Beginning in 2016, they have helped to keep patient safety high on policy makers’ agendas and helped the build the momentum needed to create the first World Health Organization (WHO) Global Patient Safety Action Plan, published in August 2021. This year’s Summit in Manilla seeks to support the implementation of the Global Patient Safety Action Plan, embracing the theme "Weaving Strengths for the Future of Patient Safety Throughout the Healthcare Continuum." The event highlights the current implementation progress, showcasing diverse approaches and strategic plans adopted by countries. The Summit will include discussions around: The role of patient engagement in bridging patient safety gaps. Diagnostic safety. Leveraging artificial intelligence (AI) and technology for patient safety. Creating psychologically safe and healthy workplaces. Investing in patient safety for sustainable healthcare. There will be sessions across the two days looking at each of these issues, within the broader context of integrating patient safety in all aspects of healthcare delivery and at all levels of care as a foundation of resilient and sustainable healthcare systems. To support the Global Ministerial Summit, Patient Safety Learning has pulled together some key resources from the hub around these key themes being discussed at the Summit. Patient engagement 1 WHO: Patient safety rights charter The Patient safety rights charter is a key resource intended to support the implementation of the Global Patient Safety Action Plan 2021–2030: Towards eliminating avoidable harm in health care. The Charter aims to outline patients’ rights in the context of safety and promotes the upholding of these rights, as established by international human rights standards, for everyone, everywhere, at all times. 2 Championing the patient voice: a recent discussion with the Patient Safety Commissioner at the Patient Safety Partners Network The role of Patient Safety Commissioner for England was created by the UK Government after a recommendation from the Independent Medicines and Medical Devices Safety Review, chaired by Baroness Julia Cumberlege. The Patient Safety Commissioner acts as a champion for patients, leading a drive to improve the safety of medicines and medical devices. This blog provides an overview of a Patient Safety Partners Network meeting where members were joined by Professor Henrietta Hughes, Patient Safety Commissioner for England. 3 Providing patient-safe care begins with asking and listening... really listening! Dan Cohen is an international consultant in patient safety and clinical risk management, and a Trustee for Patient Safety Learning. In this blog, Dan talks about how patient-safe care is all about collaborating and listening to your patients to find out what really matters to them. He illustrates this in a case study of his own personal experience whilst working as a clinician in the USA. Diagnostic safety 4 The economics of diagnostic safety Diagnosis is complex and iterative, therefore liable to error in accurately and timely identifying underlying health problems, and communicating these to patients. Up to 15% of diagnoses are estimated to be inaccurate, delayed or wrong. Diagnostic errors negatively impact patient outcomes and increase use of healthcare resources. This Health Working Paper from the Organisation for Economic Co-operation and Development (OECD) defines the scope of diagnostic error and illustrates the burden of diagnostic error in commonly diagnosed conditions. It also estimates the direct costs of diagnostic error and provides policy options to improve diagnostic safety. 5 Improving diagnostic safety in surgery: A blog by Anna Paisley Good outcomes for surgical patients require accurate, timely and well-communicated diagnoses. In this blog, Anna Paisley, a Consultant Upper GI Surgeon, talks about the challenges to safe surgical diagnosis and shares some of the strategies available to mitigate these challenges and aid safer, more timely diagnosis. 6 How early diagnosis saves lives: case study on aortic dissection In this blog, The Aortic Dissection Charitable Trust explains why timely and accurate diagnosis of aortic dissection is critical for saving lives. By sharing Martin’s recovery story, they illustrate the positive impact of prompt testing and treatment. The blog highlights the need to improve patient safety relating to aortic dissection, calling for increased education and awareness among healthcare professionals; improved clinical guidelines and protocols; and heightened vigilance in recognising and responding to the symptoms of aortic dissection. Artificial intelligence (AI) and technology 7 Patient Safety and Artificial Intelligence: Opportunities and Challenges for Care Delivery (IHI Lucian Leape Institute) In January 2024, the Institute for Healthcare Improvement (IHI) Lucian Leape Institute convened an expert panel to explore the promise and potential risks for patient safety from generative artificial intelligence (genAI). The report that followed summarises three user cases that highlight areas where genAI could significantly impact patient safety: in documentation support, clinical decision support and patient-facing chatbots. 8 AI in healthcare translation: balancing risk with opportunity In an increasingly global healthcare environment, with patients and professionals from many different cultural and linguistic backgrounds, precision in medical document translation is key. In this blog, Melanie Cole, Translations Coordinator at EIDO Systems International, talks about the challenges, risks and opportunities for using AI in healthcare translation. 9 Integrated human-centred AI in clinical practice: A guide for health and social care professionals This is a guide for designers, developers and users of AI in healthcare. It outlines general principles health and social care professionals should consider, a case study drawn from clinical practice and a directory of resources to find out more. It includes key questions that clinicians and AI developers need to answer together to ensure the best possible outcomes. It follows on from the CIEHF's White Paper, Human Factors in Healthcare AI, which sets out a human factors perspective on the use of AI applications in healthcare. Psychological safety 10 Speak up for Safety: A new workshop for healthcare staff about the importance of Just Culture The culture of a healthcare organisation can determine how safe its staff members feel to raise concerns about patient safety. Bella Knaapen, Surgical Support Governance & Risk Management Facilitator and Sarah Leeks, Senior Health & Wellbeing Practitioner at Norfolk and Norwich University Hospitals NHS Foundation Trust, have developed ‘Speak Up For Safety’, a Just Culture training workshop that aims to help staff, at all levels, understand the importance of creating an environment that encourages people to share concerns and feedback. 11 Balancing care: The psychological impact of ensuring patient safety In this blog, Leah Bowden, a patient safety specialist, reflects on the impact her job has on her mental health and family life. She discusses why there needs to be specialised clinical supervision for staff involved in reviewing patient safety incidents and how organisations need to come together to identify ways we can support our patient safety teams. 12 Amy Edmonson: The importance of psychological safety As a leader how can you foster a work environment where people feel safe to speak up, share new ideas and work in innovative ways? In this video from the Kings Fund, Amy Edmondson, Novartis Professor of Leadership and Management at the Harvard Business School, talks about the importance of psychological safety in health and care and what leaders can do to create it. Sustainability 13 The Royal College of Surgeons of Edinburgh: Green Theatre Checklist Healthcare services globally have a large carbon footprint, accounting for 4-5% of total carbon emissions. Surgery is particularly carbon intensive, with a typical single operation estimated to generate between 150-170kgCO2e, equivalent to driving 450 miles in an average petrol car. The UK and Ireland surgical colleges have recognised that it is imperative for us to act collectively and urgently to address this issue. The Royal College of Surgeons of Edinburgh have collated a compendium of peer-reviewed evidence, guidelines and policies that inform the interventions included in the Intercollegiate Green Theatre Checklist. This compendium should support members of the surgical team to introduce changes in their own operating departments. 14 Communicating on climate change and health: Toolkit for health professionals Communicating the health risks of climate change and the health benefits of climate solutions is both necessary and helpful. Health professionals are well-placed to play a unique role in helping their communities understand climate change, protect themselves, and realize the health benefits of climate solutions. This toolkit from WHO aims to help health professionals effectively communicate about climate change and health. 15 Climate change: why it needs to be on every Trust's agenda The NHS has declared climate change a health emergency, but are trust leaders and healthcare staff talking and acting on this? Angela Hayes, Clinical Lead Sustainability at the Christie Foundation Trust and a hub Topic leader, discusses climate change and the impact it has on all of our lives and health. She believes healthcare professionals have a moral duty to act, to protect and improve public health, and should demand stronger action in tackling climate change. If you would like to write a blog or have a resource to share on any of the themes highlighted in this blog, please get in touch. Contact the hub team at [email protected] to discuss further.- Posted
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- Global health
- AI
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