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Found 124 results
  1. News Article
    Thousands of pests including rats, cockroaches and bedbugs have been found at NHS hospitals in England as the health service buckles under a record high repair bill. Hospital bosses are having to spend millions of pounds on pest control after discovering lice, flies and rodents in children’s wards, breast clinics, maternity units, A&E departments and kitchens, in the most graphic illustration yet of the dismal and dangerous state of the NHS estate. NHS bosses have repeatedly warned ministers of the urgent need to plough cash into fixing rundown buildings in order to protect the safety and dignity of patients and staff. The maintenance backlog now stands at £11.6bn in England. Figures obtained under freedom of information laws and reviewed by the Guardian suggest the NHS is struggling to cope with an army of pests plaguing decrepit hospitals. There were more than 18,000 pest incidents in the last three years, the NHS data reveals. There were 6,666 last year, equivalent to 18 a day. The figures also show NHS bosses are having to spend millions of pounds calling out pest control and dealing with infestations, with £3.7m spent in the last three years. Read full story Source: The Guardian, 9 April 2024
  2. News Article
    Eight hospitals in England have fire safety warnings attached to them, with half in place since 2022 or earlier, HSJ can reveal. All are enforcement notices issued by fire brigades when serious risks are not being managed. Issues raised include risk assessments, maintenance, and emergency routes. There were more than 1,300 fires across the NHS trust estate in 2022-23, according to official estates data, which was an increase of 18% on the year before. NHS Providers deputy chief executive Saffron Cordery said the figures highlighted the “urgent need” to address maintenance backlog – which includes fire safety – across the NHS estate. The overall backlog figure has been growing yearly and is approaching £12bn. Ms Cordery said: “Greater capital investment is essential to enabling a safe environment for patients and staff.” Rory Deighton from NHS Confederation said more than a decade of underinvestment was behind the “dilapidated” state of the NHS estate. Read full story (paywalled) Source: HSJ, 5 April 2024
  3. News Article
    There was an “unacceptable delay” and “failure to act with candour” in how a trust responded to a serious risk from staff nitrous oxide exposure, an independent investigation has found. Mid and South Essex Foundation Trust found levels of nitrous oxide far above the workplace exposure limit at Basildon Hospital’s maternity unit during routine testing in 2021. However, staff were only notified and a serious incident declared more than a year later. The exposure related to a mixture of nitrous oxide and oxygen, commonly known as gas and air, used during births. While short-term exposure is considered safe, prolonged exposure to nitrous oxide could lead to potential health issues. Chief executive Matthew Hopkins has apologised, after a report by the Good Governance Institute said: “The inquiry found that there was an unacceptable delay in responding to and mitigating a serious risk that had been reported… As a result of this failure to act on a known risk, midwives and staff members on the maternity unit were exposed to unnecessary risk or potential harm from July 6 2021 to October 2022." Read full story (paywalled) HSJ, 14 February 2024
  4. Content Article
    An otherwise healthy patient is taken to the operating room for the removal of a neck mole under monitored sedation. After the patient is given two litres of oxygen through nasal cannula and administered intravenous sedation, an alcohol-based skin preparation is applied to the surgical field. As the surgeon uses electrocautery to coagulate bleeding, a flash occurs, and the surgical drapes ignite. After extinguishing the fire by pouring water on the surgical field, assessment of the patient reveals second-degree burns on the patient’s face. Oxygen from the nasal canula had accelerated the fire and caused the nasal cannula to melt and adhere to the patient’s face. The patient was transferred to the burn unit for care, and ultimately required reconstructive plastic surgery. This case illustrates one type of injury that can be sustained during a surgical fire.  The Joint Commission issues this alert to help healthcare organizations recommit to surgical fire prevention.
  5. Content Article
    The helicopter, G-MCGY, was engaged on a Search and Rescue mission to extract a casualty near Tintagel, Cornwall and fly them to hospital for emergency treatment. The helicopter flew to Derriford Hospital (DH), Plymouth which has a Helicopter Landing Site (HLS) located in a secured area within one of its public car parks. During the approach and landing, several members of the public in the car park were subjected to high levels of downwash from the landing helicopter. One person suffered fatal injuries, and another was seriously injured. The investigation carried out by the Air Accidents Investigation Branch identified the following causal factors: The persons that suffered fatal and serious injuries were blown over by high levels of downwash from a landing helicopter when in publicly accessible locations near the DH HLS. Whilst helicopters were landing or taking off, uninvolved persons were not prevented from being present in the area around the DH HLS that was subject to high levels of downwash. Helicopters used for Search and Rescue and Helicopter Emergency Medical Services (HEMS) perform a vital role in the UK and, although the operators of these are regulated by the UK Civil Aviation Authority, the many helicopter landing sites provided by hospitals are not. It is essential that the risks associated with helicopter operations into areas accessible by members of the public are fully understood by the HLS Site Keepers, and that effective communication between all the stakeholders involved is established and maintained. Therefore, nine Safety Recommendations have been made to address these issues.  
  6. Content Article
    Theatres are a high risk area. This poster from the Association for Perioperative Practice and BD illustrates how to plan and practise to manage a surgical fire. Download a pdf of the poster from the attachment below.
  7. Content Article
    Shift work can introduce additional health, safety and wellbeing challenges. This article explore some of these challenges, including the increased risk of injury or illness, sleep and fatigue problems, psychological health, and suggest ways you can ensure safe and healthy shift work.
  8. News Article
    Britain’s safety at work regulator refused to investigate reports from NHS trusts that 10 frontline staff had died as a result of catching Covid-19 during the pandemic. The Health and Safety Executive (HSE) declined to look into at least 89 dangerous incidents that NHS trusts said involved healthcare workers being exposed to Covid, including 10 deaths. The stance taken by the HSE, which oversees workplace health and safety and can bring prosecutions, is disclosed in freedom of information requests by the Pharmaceutical Journal. It has prompted concern that the regulator is too strict in its definition of workplace harm. It found that 173 trusts in England submitted at least 6,007 reports about employees’ exposure to Covid-19 in the course of their duties to the HSE between 30 January 2020 and 11 March 2022, under the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations (RIDDOR). They included 213 “dangerous occurrences”, which are incidents that have the potential to cause significant harm; 5,753 cases where a staff member had caught Covid-19; and 41 deaths among people who had been exposed to the disease at their workplace. However, the HSE refused to look into five Covid deaths reported under the RIDDOR scheme by the Yorkshire ambulance service (YAS) because of what it considered a lack of evidence. The regulator also decided not to look into the Covid deaths of five staff at University College London hospital acute trust, despite the trust’s belief they had caught it at work. “The HSE found that there was no reasonable evidence that the infection was contracted at work,” a trust spokesperson said. Shelly Asquith, the health, safety and wellbeing officer at the Trades Union Congress, said the HSE’s decisions and claimed lack of evidence was “really concerning”. It suggested a continued “element of denial about Covid being airborne and it not being possible to necessarily pinpoint where exactly somebody was exposed once it’s in the air”, she added. Read full story Source: Guardian, 26 May 2022
  9. News Article
    Patients’ lives are at risk because NHS hospitals have been allowed to crumble into disrepair, with ceilings collapsing and power cuts disrupting surgery. The number of clinical incidents linked to the failure to repair old buildings and faulty equipment has tripled in the past five years, an investigation by The Times found. Hundreds of vital NHS operations and appointments are being cancelled as a result of outdated infrastructure, undermining attempts by doctors to tackle record waiting lists. Recent incidents include an unconscious patient on a ventilator being trapped in a broken lift for 35 minutes and power running out as a patient lay in an operating theatre. On Saturday, April 23, a five-hour power cut at the Royal London Hospital in east London led to the cancellation of operations including two lifesaving kidney transplants, and meant women giving birth had to be transferred to different maternity units in the backs of taxis. Hospitals have also recorded hundreds of rat and pest infestations, and some rooms containing patients have been left “overflowing with raw sewage”. Read full story (paywalled) Source: The Times, 2 May 2022
  10. News Article
    A patient was left traumatised when his body caught on fire halfway through surgery - leaving his insides scorched. Mark, 52, went to hospital for a routine abscess removal - but woke up to the news that a freak accident in theatre had sparked an horrific blaze. A diathermy machine, used to stop bleeding, caused a swab to catch fire - before flames burnt their way through his exposed flesh, Mark explained. It took over a year for Mark - not his real name - to recover from his dreadful injuries - and the emotional scarring it caused. Between 2008 and 2018, 37 cases were acknowledged by NHS trusts across Britain. But from 2009 to 2019, it has paid out nearly £14 million in compensation settlements and legal fees. Fires such as these are often fuelled by leaking oxygen - and are caused by faulty machinery or sparking equipment. Campaigners are concerned that UK hospitals are lagging behind other countries in recording surgical fires and introducing protocols to reduce both their frequency and severity. Theatre scrub nurse Kathy Nabbie has spent the past five years trying to make colleagues more aware of the threat of surgical fires. In 2017 - after hearing how a woman in Oregon, USA, had suffered severe burns when her face was set alight in surgery - she made a simple safety checklist. Her Fire Risk Assessment tool allowed colleagues to check for the presence of elements that together might cause a fire to break out. But senior staff failed to implement the initiative and - when a surgical fire actually took place three months later - Kathy learned that her laminated checklist had simply been put in a drawer. “I couldn’t believe it,” she said. “After that they did start using it, but why on earth should it have taken an actual fire to persuade them?” Read full story Source: The Sun, 7 April 2022 Further reading What can we do to improve safety in the theatre? Reflections from theatre nurse Kathy Nabbie How I raised awareness of fires in the operating theatre - Kathy Nabbie
  11. News Article
    Trusts have been told to check the safety of their helipads after an accident in a hospital car park left a pensioner dead. Jean Langan, 87, was blown over by the “downwash” of air from a helicopter at Derriford Hospital last year. She was walking through a car park at the hospital after an appointment when she fell and hit her head as an HM Coastguard helicopter landed on the hospital’s helipad. Another elderly woman broke her pelvis. Now the Health and Safety Executive has written to trust chief executives reminding them of their duty to manage health and safety risks around helipads. These risks include downwash from helicopters, the moving parts of helicopters, and the design and location of helipads. Read full story (paywalled) Source: HSJ, 2 August 2023
  12. News Article
    Thirty-four hospital buildings in England have roofs made of concrete that is so unstable they could fall down at any time, ministers have admitted. The revelation has prompted renewed fears that ceilings at the hospitals affected might suddenly collapse, injuring staff and patients, and calls for urgent action to tackle the problem. Maria Caulfield, a health minister, made the disclosure in a written answer to a parliamentary question asked by the Liberal Democrats’ health spokesperson, Daisy Cooper. Caulfield said surveys carried out by the NHS found that 34 buildings at 16 different health trusts contained reinforced autoclaved aerated concrete (RAAC), which one hospital boss has likened to a “chocolate Aero bar”. RAAC was widely used in building hospitals and schools in the 1960s, 70s and 80s but has a 30-year lifespan and is now causing serious problems. In 2020 Simon Corben, NHS England’s director of estates, declared that RAAC planks posed a “significant safety risk” because their age meant they could fall down without warning. Read full story Source: The Guardian, 14 August 2022
  13. News Article
    A trust which rented 1,100 lone worker alarms has found just four were in use after a year. Sussex Partnership Foundation Trust rented the system for five years, with the contract starting in early 2021. But a year later only 51 of the units were assigned to a user, and just four were being used. Most of the users had not completed their training and 19 had not even logged into the system to set up a profile, according to an annual health and safety report covering 2021-22. The health and safety report said: “Unfortunately the system has yet to demonstrate value for money as the uptake within services across the trust is very poor, despite the extensive work by the health and safety team to encourage uptake.” This had included demonstrating the system at multiple meetings and trying to raise awareness. A spokesperson from Sussex Partnership Foundation Trust said: “The lone worker system is one of the ways we ensure the safety of our staff who work alone. It has taken time to embed the new system due to the changes in working practices during the pandemic. However, in recent months we have seen the number of staff actively using the system increasing." “There is more we are doing to ensure wider take-up and implementation, through a programme of engagement and training.” Read full story (paywalled) Source: HSJ, 9 August 2022
  14. News Article
    People would rather go to England if they had a stroke than use the A&E at a north Wales hospital, a health watchdog has said. Inspectors said there was a "clear and significant risk to patient safety" after inspections at the department in Ysbyty Glan Clwyd, Denbighshire. North Wales Community Health Council's Geoff Ryall-Harvey said it was the "worst situation" they had seen. The report said inspectors found staff who were "working above and beyond in challenging conditions" during a period of "unrelenting demand". Many staff told them they were unhappy and struggling to cope. They said they did not feel supported by senior managers. However inspectors said that the health board was not fully compliant with many of the health and care standards, and highlighted significant areas of concern, which could present an immediate risk to the safety of patients, including: Doctors were left to "come across" high-risk patients instead of being alerted to them. Patients were not monitored enough - including a suspected stroke patient and one considered a suicide risk. Children were at serious risk of harm as the public could enter the paediatric area unchallenged. Inspectors found evidence of children leaving unseen or being discharged against medical advice. Betsi Cadwaladr health board said it was committed to improvements. Read full story Source: BBC News, 8 August 2022
  15. News Article
    NHS England has called for a “deep dive” into local evacuation and shelter arrangements, amid ongoing concerns about outdated and unsafe estate. NHS England’s director of emergency preparedness, resilience and response Stephen Groves wrote to trusts: “Following the publication of the updated evacuation and shelter guidance for the NHS in England, and recent work driven by the heightened risk associated with reinforced autoclaved aerated concrete (RAAC), the 2022-23 EPRR annual deep dive will focus on local evacuation and shelter arrangements.” The letter, sent at the end of last week, comes amid growing concerns about NHS estate, including RAAC planks which were used in constructing public sector buildings in the 1960s, 70s and 80s. Areas to be examined in the deep dive vary by type of organisation. However, according to a self-assessment tool referenced in the letter, questions for providers include: whether they have “a process in place to triage patients in the event of an incident requiring evacuation and/or shelter of patients”; whether there are “effective arrangements in place to support partners in a community evacuation, where the population of a large area may need to be displaced”; and whether “evacuation and shelter arrangements include resilient mechanisms to communicate with staff, patients, their families and the public, pre, peri and post evacuation”. Read full story (paywalled) Source: HSJ, 5 August 2022
  16. News Article
    An unfortunate series of events involving a magnetic resonance imaging (MRI) machine led to the death of a man at a hospital in India. Rajesh Maruti Maru, a 32-year-old, was thrust into the MRI machine while he was visiting an elderly relative at the BYL Nair Charitable Hospital in Mumbai, India. As the Hindustan Times reports, the man was apparently told by a junior member of staff to carry a metal cylinder of liquid oxygen into a room containing an MRI machine. Unbeknownst to everyone, the MRI machine was turned on. This caused Maru to be suddenly jolted pulled towards the machine, causing the oxygen tank to rupture and leak. The man later died after inhaling large amounts of oxygen. His body also bled heavily as a result of the accident. "When we [the hospital staff] told him that metallic things aren't allowed inside an MRI room, he said 'sab chalta hai, hamara roz ka kaam hai' [it's fine, we do it every day]. He also said that the machine was switched off. The doctor, as well as the technician, didn't say anything,” Harish Solanki, Maru's relative, told NDTV. "It's because of their carelessness that Rajesh died," Solanki added. Police are currently examining the CCTV footage of the incident and have arrested at least two members of hospital staff for the negligence. The local government has also awarded the man's family 500,000 rupees ($7,855) in compensation. Read full story Source: IFL Science, 29 January 2018
  17. News Article
    Two-thirds of defective breathing machines distributed by the health service have not been repaired or replaced in the 12 months since they were subject to a worldwide recall over safety concerns. Philips Respironics last year issued a field safety notice for a series of ventilation devices because the polyester-based foam used to dampen the noise of the machines can break down. The foam particles or potentially toxic chemicals may be inhaled or ingested by patients. Almost 8,000 of the affected machines have been contracted by the Health Safety Executive (HSE) for use in hospitals and private homes, including 6,394 continuous positive airway pressure (CPAP) devices, 1,348 bilevel positive airway pressure (BPAP) devices, and 147 mechanical ventilators. However, the HSE told The Times that only 2,723 devices had been repaired or replaced a year after the recall was announced. A spokesman did not respond when asked if the HSE was concerned about patient safety, given that more than 5,000 devices have not been attended to. Read full story (paywalled) Source: The Times, 8 July 2022
  18. News Article
    The chief executive of a hospital has said the building is not in a condition "we should expect any of our nearest and dearest to receive care" in. Kettering General Hospital chief executive Simon Weldon described the site as "a big hotchpotch of things, some things that are new, about 10 years old, to things that are 100 years old, and everything in between". He added: "Those are not conditions a modern hospital should be proud of, those are not conditions we should ask any staff to work in, they are not the conditions we should expect any of our nearest and dearest to receive care." The initial £46m the hospital was award in 2019 was to replace the temporary "power plant". Mr Weldon said he would submit a business case to get money "to fix the vital infrastructure work that will keep this site safe". But he said the hospital really needed to be rebuilt, and that "fixing the hospital would be bad value for taxpayers". Read full story Source: BBC News, 7 July 2022
  19. News Article
    When Amy Fantis gave birth to her first child two years ago, the labour was rapid, lasting only about four hours, and she was reliant on gas and air. Her second baby is due in just a few days — but the hospital has, like others around Britain, imposed a ban on the popular form of pain relief. Fantis, 36, from Broxbourne, Hertfordshire, is one of many women affected by the decision of several NHS trusts to suspend the use of the gas because of fears that midwives and doctors have been exposed to unsafe levels for prolonged periods. In some hospitals, levels of the nitrous oxide and oxygen mix are more than 50 times higher than the safe workplace exposure limits. In a survey of more than 16,600 women who gave birth last year, the Care Quality Commission found that 76% of respondents used gas and air at some point during labour. Although short-term use of the gas in childbirth is harmless to women and their babies, long-term exposure for midwives and doctors can affect the body’s ability to absorb vitamin B12, damaging nerves and red blood cells and causing anaemia. It is not believed that any NHS staff have become ill as a result of long-term exposure to gas and air. NHS England and the Health and Safety Executive recently warned other hospitals that they need to check the ventilation on maternity wards and ensure staff are kept safe. NHS England is planning to send out new guidance to trusts on the issue after a series of hospitals had to stop using the gas. Read full story (paywalled) Source: The Times, 25 February 2023
  20. News Article
    Only half the recommended number of medical staff were on duty at the O2 Brixton Academy on the night of a crush at the south-west London venue. Industry guidelines suggest there should have been medical cover of at least 10 people, including a paramedic and a nurse, but no paramedics or nurses were present. Rebecca Ikumelo, 33, and security guard Gaby Hutchinson, 23, died in hospital following the crowd surge on 15 December 2022 at the concert. The medical provider, Collingwood Services Ltd, said it was "fully confident" its team had "responded speedily, efficiently and with best practice". Two whistleblowers who regularly work for Collingwood Services Ltd at Brixton told BBC Radio 4's File on 4 programme that medical cover at the south London gig had been "inadequate". Neither of them was there when the crush happened, but one said he had spoken to colleagues who were. "[They] had two student paramedics, so they're basically unqualified," said one whistleblower. "They have to be supervised by a paramedic, not by anybody of a lower grade. They didn't have appropriate supervision." Read full story Source: BBC News, 23 February 2023
  21. News Article
    Nitrous oxide levels on Watford General Hospital's maternity suite far exceeded legal limits during peak periods, a BBC investigation has found. In February 2022, air monitoring showed levels of almost 5,000 parts per million (ppm) - 50 times what is safe. The hospital's trust said it had since installed machines to remove the gas. It was one of a number of nitrous oxide incidents reported by NHS trusts to the Health and Safety Executive (HSE), Freedom of Information data has shown. The HSE disclosed the details following a request for its notifications under the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013 (RIDDOR). There were 11 notifications to the HSE between August 2018 and December 2022 from seven NHS trusts and one private hospital in relation to nitrous oxide - almost all relating to maternity units. Monitoring has led to a string of NHS trusts suspending the use of Entonox - a mixture of nitrous oxide and air used to assist women in labour with pain relief. NHS bosses acknowledge there is "limited research on the occupational exposure to Entonox, and the long-term health risks this may pose", though at least one expert has played down the risk. But staff working in maternity units face uncertainty due to prolonged periods of time spent in affected areas, with particular concerns over Vitamin B deficiency due to exposure. Read full story Source: BBC News, 13 February 2023
  22. News Article
    East Kent Hospital University Foundation Trust has been criticised for failures in services by the Care Quality Commission, after an unannounced inspection last month, years after major problems began to come to light. The Care Quality Commission has highlighted: Issues with processes for fetal monitoring and escalation at the William Harvey Hospital, Ashford. There had been “incidents highlighting fetal heart monitoring” problems in September and October, and the trust’s measures to improve processes were not “embedded and understood by the clinical team”; Slow maternity triage, due to staffing problems, and infection control problems at the William Harvey. The trust is reviewing how issues with infection prevention and control and cleanliness were not identified or escalated; and Fire safety issues at the Queen Elizabeth, the Queen Mother Hospital, in Thanet with problems linked to fire doors and an easily accessible secondary fire escape route. Three years ago issues with reading and acting on fetal monitoring were highlighted at the inquest into baby Harry Richford, whose poor care by the trust led to an independent inquiry into widespread failings in its maternity services, led by Bill Kirkup. Read full story (paywalled) Source: HSJ, 6 February 2023
  23. News Article
    Six wards in a busy London Hospital, added at a cost of £24 billion during the pandemic, are lying empty because the builders did not install sprinklers. With the NHS in crisis, the Royal London Hospital in east London, has had to mothball the space, which is large enough to take 155 intensive care beds, while officials work out what to do with it. They have no patients in it since last May. Source: The Sunday Times, 29 January 2023 Shared by Shaun Lintern on Twitter
  24. News Article
    High levels of microplastics have been found in operating theatres by researchers who highlighted the “astoundingly high” amounts of single-use plastic used in modern surgical procedures. A team from the University of Hull found the amount of microplastics in a cardiothoracic operating theatre was almost three times that found in homes, and said this identifies another route through which the tiny particles can enter the human body, with unknown consequences. The study, published in the journal Environment International, is the first to examine the prevalence of microplastics in surgical environments. The team analysed levels in the operating theatre and the anaesthetic room in cardiothoracic surgeries and discovered an average of 5,000 microplastics per metre squared when the theatre was in use. Jeanette Rotchell, professor of environmental toxicology at the university, said the types of microplastic particles identified relate to common plastic wrapping materials and could also come from blister packs, surgical gowns, hairnets and drapes for patients. Prof Rotchell said: “Although we know microplastics are in the air in a variety of settings, we can’t yet say what the consequences are or whether microplastics are harmful to health. Researchers have yet to establish this. Read full story Source: The Independent, 27 January 2023
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