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Found 76 results
  1. News Article
    The government has failed to meet most of its own deadlines for commitments to improve how the NHS uses data, including developing a cybersecurity strategy, HSJ can reveal. The delays include work to store and analyse patient data more securely, building public trust in the NHS’ use of patient data, and agreeing national strategies on cybersecurity and cloud technology. The strategy and its commitments were published following the Goldacre Review, which called for an overhaul of how NHS patient data is collected, stored and used. It came after the government was forced to indefinitely halt a controversial plan to collect all GP-held patient data in 2021, which resembled the fate of a similar data scheme in 2016. Several data projects have also come under scrutiny from doctors and campaigners in recent years, such as NHS England’s procurement of a new Federated Data Platform and a much-criticised trust’s data-sharing scheme with a credit rating company. Read full story (paywalled) Source: HSJ, 28 February 2023
  2. Content Article
    The investigation found that misidentification of the patient, and limited access to critical information about the patient at the bedside delayed his treatment. The investigation identified factors that contributed to the event. These included: access to computer systems the display of information around the bed the sharing of information among staff to support familiarity with their patients. Findings Clinical staff are not always able to access accurate, critical patient information at bedsides to support decision making in emergencies. Patient identity wristbands are not consistently checked by staff during the undertaking of clinical tasks. The expectations of how staff should identify patients in an emergency and access critical information in relation to their care cannot always be met in practice because of limitations of technology and the work environment. Concerns around confidentiality can prevent the display of critical patient information at bedsides that may be needed to support safe care, particularly in emergencies. What and how critical patient information is displayed at the bedside varies across hospitals, with differences in positioning, visibility, readability and legibility. There is no national guidance to support consistency and visibility of critical patient information on low-technology displays (whiteboards/posters) or high-technology displays (via digital systems). Lighting on hospital wards can make it difficult for staff to see critical patient information, either through too little light, or too much light causing glare. Clinical staff consistently report difficulties accessing digital systems because of limited or poorly functioning hardware. This can result in the use of less reliable, paper-based systems for accessing critical patient information. Limited interoperability of multiple digital systems means critical patient information may not be accessible or consistent across all systems used in the care of a patient. Staff need to know which systems contain the information they need. Limited ability at a national level to influence the functionality of digital systems and their procurement means healthcare organisations are implementing systems with varying design and functionality. At the hospital level, the configuration of electronic patient record systems can introduce further safety risks where the infrastructure and staff training needs necessary for successful implementation have not been fully considered, and the needs of the clinical users have not been fully established. There is variation in the words and symbols used to indicate CPR recommendations, and in the level of understanding of CPR recommendations across hospitals, that may influence responses to cardiac arrests. Nursing handovers (where information about patients is passed between nursing staff at shift changes) may not provide the information staff need to care for their patients because of where and how they are undertaken. There is no national guidance on how best to undertake handovers of care. The implementation of electronic handover systems in clinical workplaces is limited by digital infrastructure, and systems that do not meet the needs of their users. Safety recommendations HSIB makes the following safety recommendations. Office of the National Data Guardian HSIB recommends that the Office of the National Data Guardian supports local interpretation of the Caldicott Principles to give organisations and staff the confidence to display full patient names at the bedside to support correct patient identification for safer care. NHS England HSIB recommends that NHS England develops guidance to providers, via any digital maturity assessments that are developed, to help ensure critical patient information (such as patient identifiers and cardiopulmonary resuscitation status) is available to clinical staff when accessing electronic patient record systems. HSIB recommends that NHS England provides guidance to healthcare organisations to support local design and configuration of electronic patient records to enable end users to access critical patient information (such as patient identifiers and cardiopulmonary resuscitation status). HSIB recommends that NHS England, during review of relevant Health Building Notes and Technical Memoranda, includes, as a consideration, that bedside patient information should be consistently visible. HSIB recommends that NHS England assesses the priority, feasibility, and impact of future research into what and how critical information pertaining to the emergency care of patients in the acute hospital setting can be readily and reliably accessed at a patient’s bedside. Resuscitation Council (UK) HSIB recommends that the Resuscitation Council UK clarifies and promotes expectations around the sharing, presentation, and language of cardiopulmonary resuscitation recommendations in hospital ward environments in line with the findings of this investigation. British Standards Institution (BSI) HSIB recommends that the British Standards Institution, with support from relevant stakeholders, provides symbology to standardise how information relating to a patient’s resuscitation status can be displayed in digital systems. Royal College of Nursing HSIB recommends that the Royal College of Nursing develops guidance for ward-based nursing handovers with consideration of the following: how handovers are organised, their content, the environment in which they take place and the technology needed to support them. Safety observations HSIB notes the following safety observations. It may be beneficial for healthcare organisations to provide guidance to support decisions in clinical areas that balance confidentiality and the visibility of critical patient information for patient safety. It may be beneficial for healthcare organisations to assess their information technology infrastructure needs, such as equipment availability and network coverage, to enable staff to consistently access critical patient information. It may be beneficial if the language used to refer to cardiopulmonary resuscitation recommendations is standardised and clarified through the implementation of the Recommended Summary Plan for Emergency Care and Treatment.
  3. News Article
    In an eleventh-hour decision NHS England has halted the automatic, blanket roll-out of a scheme that would have given all NHS patients in England prospective online access to their GP-held records the day before it was due to come in. The high-profile scheme to enable patents to automatically view their GP records via the NHS app by 30 November, has been a key digital promise by successive Conservative health secretaries. The last-minute u-turn came following a series of talks between the British Medical Association (BMA) and NHS England, in which the BMA made clear many practices would not be ready to roll out the programme in a safe way for patients, and that it didn’t comply with their data protection obligations. The BMA says the decision is the ‘right thing to do’ for patient safety. The BMA said in a statement that while some practices were ready to implement this, many expressed concerns over safety aspects and that it wasn’t fit for purpose at the present time. Dr David Wrigley, deputy chair of GPC England at the BMA, said: “We’re pleased to hear that NHS England has decided to review the pace and timing of the automatic, mass roll-out of the Citizens’ Access programme. This is, without doubt, the right thing to do for patient safety. “We want patients to be able to access their GP medical records, but this must be done carefully, with the appropriate safeguards in place to protect them from any potential harm. “The deadline of 30 November was, for many practices, just too soon to do this, and removing it will come as a huge relief to GPs and their teams across the country.” Read full story Source: Digital Health, 30 November 2022
  4. Content Article
    Based on initial system requirements, Williams et al. designed the dashboard’s user interface over three iterations with six GPs, seven pharmacists and a member of the public. Prescribing safety indicators from previous work were implemented in the dashboard. Pharmacists were trained to use the intervention and deliver it to general practices. A web-based electronic dashboard was developed and linked to shared care records in Salford, UK. The completed dashboard was deployed in all but one (general practices in the region. By November 2017, 36 pharmacists had been trained in delivering the intervention to practices. There were 135 registered users of the dashboard, with an average of 91 user sessions a week. The authors have developed and successfully rolled out of a complex, pharmacist-led dashboard intervention in Salford, UK. System usage statistics indicate broad and sustained uptake of the intervention. The use of systems that provide regularly updated audit information may be an important contributor towards medication safety in primary care.
  5. Content Article
    Safety observation It may be beneficial for NHS care providers to explore options for the translation of written appointment communications, including pre-attendance guidance, for patients whose preferred written language is not English.
  6. News Article
    GP practices can block abusive patients from gaining automatic access to their records online if they pose a ‘risk of harm’ to staff, the Royal College of General Practice has said. Automatic access to patients’ prospective patient records is due to be switched on by the end of this month, following delays related to concerns about patient safety. But the RCGP’s toolkit on access to records said practices can refuse access to online records for patients that pose a risk of harm to others too. The guidance said access should "be refused where there is a clear risk of serious harm to the safety of the patient or members of the practice team, or to the privacy of a third party". It added: "If potentially harmful information cannot be successfully redacted and the practice remains concerned about the safety of record access for an individual patient – or in extreme cases, remains concerned that the patient may react violently to information in the record – then the practice may refuse to give the patient record access or restrict the level of access. "It may be possible to give them access to a reduced part of the record such as the Summary Care Record or restrict access to appointments and repeat prescriptions." The guidance said that records access should only be refused or restricted "after discussion with the practice leads for GP Online Services and Safeguarding or after seeking further professional advice from a local relevant agency or national medical indemnity organisation". Read full story Source: Pulse, 18 November 2022
  7. News Article
    Greg Price died of complications after testicular cancer surgery, but a review of his case found missed faxes, follow-ups and botched data-sharing ultimately cost the vibrant 31-year-old Alberta man his life. All the missteps in his case meant it took 407 days from his first complaint for Price — an engineer, pilot, and athlete — to be diagnosed with cancer. He died three months after his doctor said he should see a specialist, and while he was being passed between multiple doctors, his health data often was not. Now, his sister, Teri Price, says too little has changed in medical information-sharing in the decade since her brother's death. This, despite a review of his case — the 2013 Alberta Continuity of Patient Care Study — that recommended life-saving changes to the healthcare system to avoid more experiences like his. So, she's fighting to improve the system that she says not only failed her brother, but keeps failing to change. Price says that Canadians assume that their health information is shared between doctors to keep them safe and studied to improve the system, but often, it's not. And medical front-line staff in Canada say problems persist when it comes to sharing everything from patient information to aggregate medical and staffing data. "Information tends to be broken up between the services that patients attend," said Ewan Affleck, a doctor in the Northwest Territories who has spent his career fighting for better data access, and a member of the expert advisory arm of the Pan-Canadian Health Data Strategy Group. "The cohesion and use of health data in Canada is legislated to fail." Read full story Source: CBC News, 17 November 2022
  8. News Article
    “Failing” IT systems in the NHS are a threat to patient safety. medics have warned. Doctors and nurses should not “tolerate problems with IT infrastructure as the norm”, according to a new editorial, published in The BMJ. Experts from Imperial College London and University College London point to an incident in which IT systems at Guy’s and St Thomas’ NHS Foundation Trust – one of the largest hospital trusts in the country – went down for 10 days. The outage, caused by the July heatwave, led to procedures and appointments being postponed for a number of patients. The new editorial highlights how IT failures can restrict services as doctors are unable to access records and are prevented from ordering diagnostic tests. This can “bring a halt to the everyday business of healthcare”, they said. The authors suggest that the NHS IT infrastructure is “crumbling” and leads to “poor user experiences” as well as patient safety incidents. “Increasing digital transformation means such failures are no longer mere inconvenience but fundamentally affect our ability to deliver safe and effective care – they result in patient harm and increased costs,” they wrote. Read full story Source: 10 November 2022
  9. News Article
    Patient care is still being undermined at NHS mental health trusts and social care providers that were hit by a major cyber attack in August, doctors have warned. Three months after the major attack wiped out NHS systems, patients’ records are missing, safety has been compromised, and medication doses are at risk of being missed amid ongoing “chaos”, i News has been told. Dr Andrew Molodynski, mental health lead at the British Medical Association, said the prolonged systems failure has damaged care because records are “integral to patients’ safety”. Mental health patients’ records and safeguarding alerts have not been available in some trusts since 4 August, when NHS software provider, Advanced, was hit by a ransomware attack which targeted its Carenotes records system. A total of 12 NHS mental health trusts have been impacted by the cyber attack, potentially impacting tens of thousands of patients as well as social care providers. According to Advanced’s own hazard log spreadsheet, seen by i News, the risks associated with disruption to its server include “medication doses missed”, “required number of carers not met”, “basic needs not met, such as nutrition and personal care”, and “health needs not met, such as wound care and physical support”. Advanced said: “We recognise that the restoration process has taken longer than we had initially anticipated and we have sought to communicate as clearly and transparently as we have been able.” It said planned dates for restoring the system for each client has been communicated directly and that the “overall restoration programme remains on track”. Read full story Source: i News, 4 November 2022
  10. News Article
    General practices should delay rolling out the accelerated citizens’ access programme, due to go live on 1 November, if they have concerns over safety, the BMA has said. In guidance published on 25 October the BMA’s General Practitioners Committee said that while many practices would be able to implement the scheme before the deadline some would need more time to prepare, to ensure that they can roll it out in line with the Data Protection Act and safeguarding measures. The access scheme, led by NHS England, will automatically give patients the ability to see any new entries to their GP medical record through the NHS App. As part of safeguarding practices it will require GPs to review each record to identify any safety concerns related to providing patient access, such as in cases of domestic violence or coercive relationships. Where there are safeguarding concerns, practices can prevent patients from having automatic access by adding a specific SNOMED code to the patient’s record before 1 November 2022. David Wrigley, deputy chair of the BMA’s GP Committee for England, said, “We have a duty of care to speak up when patient safety is at risk, which is why we encourage practices even slightly unsure about whether they can deliver this programme before the start of November, to refer to our guidance. Our patients are at the heart of what we do, and we will always act in their best interests.” Read full story Source: BMJ, 26 October 2022
  11. Event
    2022 marks the 10th anniversary of “Journalen” in Sweden. It was in 2012 that Region Uppsala first give citizens online access to their electronic health records (EHR) for the first time. Since then, a lot has happened in Sweden, and today people all over Sweden have direct online access to their EHR through the e-health service “Journalen” on 1177.se. Online access to EHRs is also highly relevant internationally, and we have also invited international researchers to Uppsala to share experiences of the implementation and effects of patients online access to records throughout the world. It will be a 2-day event with invited speakers from both the US and Europe. The conference will have a scientific focus and will also be open to the public. Conference programme Register for the conference
  12. Content Article
    Thank you to everyone who has shared your powerful stories with me about your own experiences and those of family members. Your testimonies are both heartfelt and heart breaking, a very emotional read. I cannot think of a greater motivation for decision makers to do what is right, without delay. I was very privileged to meet Yasmin Golding and to hear about the #SaferMumSaferBaby campaign by the Epilepsy Society. It was humbling to hear directly from Yasmin about her hopes and fears for the future and why having information to help minimise risk would make the world of difference. Thank you Yasmin 🙏 It’s so vital that patients can get the right information about medicines to be able to make the decisions which are the safest for themselves and their families. I met with Mid and South Essex Integrated Care System and Karen Flitton for a World Patient Safety Day webinar. The theme was Medication Without Harm and it was wonderful to see so many people with a passion for patient safety. I was also very pleased to meet with the team at Healthcare Safety Investigation Branch for a morning webinar to talk about patient safety and inclusion. Thanks very much James Titcombe for the kind invitation and to everyone for your insightful questions. Patient safety in a world of ransomware attacks was part of my conversation with Nicola Byrne the National Data Guardian. With more electronic patient records and electronic prescribing, there is a risk that patients can be harmed when we don’t have timely access to information. Cyber security is key to keeping patients safe by ensuring that access to information is protected. The Speak Up Month podcast I recorded with Jayne Chidgey-Clark and the National Guardian's Office has a theme of speaking up for safety and why psychological safety is so important Listen here: https://lnkd.in/enBsUx7w Psychological safety for all was also a topic of conversation when I met with Professional Standards Authority CEO Alan Clamp. Their recent publication Safer Care for All highlights the need for a swift and coordinated system response which tackles inequalities. We can only get this right if we get it right for everyone. Such a thought provoking week- thank you to everyone who has been in touch to help me have a greater understanding about your concerns and what needs to be done to get this right. *This article was first published on LinkedIn.
  13. News Article
    An IT failure has left clinicians at ‘a number of trusts’ which use the Cerner Millennium system unable to access patient records or write discharge summaries, according to an internal trust email seen by HSJ. The email, sent to staff at Barts Health Trust this afternoon, said there was a “performance issue” with Cerner PowerChart which was affecting “a number of other trusts”. The Powerchart programme is the part of the Cerner Millennium electronic patient record system used by clinicians to process document notes, request tests, view blood tests and scan reports. At least 13 trusts in the English NHS are known to use the Cerner Millennium system but it is not yet clear how many trusts aside from Barts have been affected. One clinician told HSJ the outage was “overwhelmingly unsafe” for patients. Read full story (paywalled) Source: HSJ, 11 October 2022