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In January 2025, the Republican majority in the House of Representatives’ Budget Committee offered a list of possible spending reductions to offset revenue losses from proposed tax cuts. In May, the Committee advanced a bill incorporating several reductions on the list. The Committee estimated that the 6 largest potential Medicaid cuts (for example, work requirements for some Medicaid enrollees) would each reduce the federal government’s Medicaid outlays by at least $100 billion over 10 years. On the basis of the Committee’s estimates of savings; Congressional Budget Office analyses; and peer-reviewed studies of the coverage, financial, and health impacts of past Medicaid expansions and contractions, the authors project the likely effects of each option and of the House bill advanced by the Budget Committee in May. Each option individually would reduce federal Medicaid outlays by between $100 billion and $900 billion over a decade, increase the ranks of the uninsured by between 600 000 and 3 900 000 and the annual number of persons forgoing needed medical care by 129 060 to 838 890, and result in 651 to 12 626 medically preventable deaths annually. Enactment of the House bill advanced in May would increase the number of uninsured persons by 7.6 million and the number of deaths by 16 642 annually, according to a mid-range estimate. These figures exclude harms from lowering provider payments and shrinking benefits, as well as possible repercussions from states increasing taxes or shifting expenditures from other needs to make up for shortfalls in federal Medicaid funding. Policy makers should weigh the likely health and financial harms to patients and providers of reducing Medicaid expenditures against the desirability of tax reductions, which would accrue mostly to wealthy Americans.- Posted
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Doctors at Department of Veterans Affairs (VA) hospitals nationwide could refuse to treat unmarried veterans and Democrats under new hospital guidelines imposed following an executive order by Donald Trump. The new rules, obtained by the Guardian, also apply to psychologists, dentists and a host of other occupations. They have already gone into effect in at least some VA medical centers. Medical staff are still required to treat veterans regardless of race, color, religion and sex, and all veterans remain entitled to treatment. But individual workers are now free to decline to care for patients based on personal characteristics not explicitly prohibited by federal law. Language requiring healthcare professionals to care for veterans regardless of their politics and marital status has been explicitly eliminated. Doctors and other medical staff can also be barred from working at VA hospitals based on their marital status, political party affiliation or union activity, documents reviewed by the Guardian show. The changes also affect chiropractors, certified nurse practitioners, optometrists, podiatrists, licensed clinical social workers and speech therapists. In making the changes, VA officials cite the president’s 30 January executive order titled “Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government”. The primary purpose of the executive order was to strip most government protections from transgender people. The VA has since ceased providing most gender-affirming care and forbidden a long list of words, including “gender affirming” and “transgender”, from clinical settings. Medical experts said the implications of rule changes uncovered by the Guardian could be far-reaching. They “seem to open the door to discrimination on the basis of anything that is not legally protected”, said Dr Kenneth Kizer, the VA’s top healthcare official during the Clinton administration. He said the changes open up the possibility that doctors could refuse to treat veterans based on their “reason for seeking care – including allegations of rape and sexual assault – current or past political party affiliation or political activity, and personal behavior such as alcohol or marijuana use”. Read full story Source: The Guardian, 16 June 2025- Posted
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As part of my quality improvement study at university, I developed and introduced an oxygen reference card that was shown to improve newly qualified clinical staffs' knowledge and confidence when using an oxygen cylinder. The project's literature review captured that clinical staff may not have the memory recall to support them in clinical practice and, therefore, a lack of embedded knowledge, which could compromise care. It is paramount that users of oxygen cylinders have the knowledge to understand how to use a cylinder safely and to understand how to assess the remedial gas in the cylinder to support oxygen administration. The study found that there is minimal training accessed to support staffs' knowledge and skill foundations for using cylinders. The outcome of the study recommended that there needs to be better support for clinical staff to use cylinders within their pre/post training to be able to using the device correctly. Introducing a oxygen reference card that they could keep on them whilst at work is a useful tool to support decision-making when using the cylinder. You can download the card from the attachment below. Both NAMDET – National Association of Medical Device Educators and Trainers and Northumbria Healthcare Facilities Management - NHS FOUNDATION supported the QI project.- Posted
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A senior figure in the health service has criticised it for deep-seated racism after his mother “got a black service, not an NHS service” before she died. Victor Adebowale, the chair of the NHS Confederation, claimed his mother Grace’s lung cancer went undiagnosed because black people get “disproportionately poor” health service care. The NHS’s failure to detect her cancer while she was alive shows that patients experience “two different services”, based on the colour of their skin, Adebowale said. His mother, Grace Amoke Owuren Adebowale, a former NHS nurse, died in January aged 92. He highlighted her care and death during his speech this week at the NHS Confederation’s annual conference as an example of “persistent racial inequalities in NHS services”. His remarks prompted fresh concern about the stark differences between the care received by those from black and other ethnic minority backgrounds and white people. “My mum, who worked for many years as a nurse, died earlier this year at the age of 92. It was difficult. It was not the dignified death that we would have wanted for her,” Adebowale told an audience of NHS bosses. “It wasn’t the death she deserved. So it makes me clear about the need to address the inequity. I think she got a black service, not an NHS service.” Read full story Source: The Guardian, 14 June 2025- Posted
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The conversation around Artificial Intelligence in healthcare is evolving. We are moving beyond the hype of algorithms and automation, and beginning to ask the more important questions: How do we ensure AI serves our people and patients? How do we adopt it in ways that strengthen the health and care system as a whole? What kind of leadership do we need to make that happen? More than that, how do we harness the reality of AI now even as we set a path for AI in the future? It is no longer enough to explore what AI can do. We must focus on how it should be done and why. Dr Nnenna Osuji explores the shift from 'what' to 'how' in her blog. Related reading on the hub: AI in London healthcare: The reality behind the hype- Posted
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Artificial intelligence (AI) is often portrayed with the ability to transform the delivery of care, improving patient outcomes, and easing pressures on an overstretched health system. While its potential is undeniable, the conversation around AI can sometimes become tangled with hype, complexity, and uncertainty. The reality is that AI is not a magic bullet, but another tool in our broader mission to solve the pressing healthcare challenges we are facing and redesign a more resilient health system. London is uniquely positioned to lead the way in transforming healthcare delivery, access, and experience. With world-class medical institutions, top-tier universities, and a thriving tech ecosystem, the city is at the forefront of innovation. Its rich, diverse multimodal data resources could further help to advance AI development. Many London NHS providers are already pioneering AI adoption, piloting solutions in diagnostics, workflow automation, and intelligent proactive care, exploring the art of possible of AI to drive smarter, more efficient, and patient. However, every deployment of AI needs to be purposeful, evidence-based, and aligned with real system needs. This report from the UCL Partners Health Innovation is about cutting through the noise around AI, and offering a better understanding of its current adoption within the London system. It presents insights from across different providers into where AI is making an impact, the obstacles its facing, and what needs to change to unlock its potential.- Posted
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‘Blame shunting’ by providers leads to poor emergency care, says NHSE
Patient Safety Learning posted a news article in News
The ‘inability or unwillingness’ of some NHS and social care providers to work together has contributed to an ‘unimaginable’ deterioration in emergency care performance, according to NHS England The claim is made in the urgent care recovery plan for 2025-26, released by NHS England and the Department of Health and Social Care. The plan includes a new target to reduce 12-hour accident and emergency waits and pledges to invest £370m of capital funding in improving urgent care and mental health facilities. The plan said, “Each part of the system has responsibility for improving urgent and emergency care performance. However, blame shunting has become a feature in some poorly performing systems and can no longer be tolerated." National urgent care director Sarah-Jane Marsh told HSJ that “the duty to collaborate and work together and do the best for patients is on all trust boards, and it shouldn’t rely on some overseer to make sure that happens. It’s a fundamental part of being a leader”. Trusts will be told to ensure the proportion of patients waiting over 12 hours for admission, transfer or discharge from A&E remains less than 10%. The 45-minute “maximum” ambulance handover time will become mandatory across all trusts ahead of winter, according to the plan. Chief executive of the College of Paramedics, Tracy Nicholls, said, “The plan sets out progressive structural proposals that have the potential to enhance public safety and strengthen paramedic autonomy. However, it may underestimate key challenges, including workforce readiness, the capacity of the mental health system, and practical implications of the Right Care, Right Person model. Without urgent alignment of funding, training, and alternative care pathways, there is a real risk that paramedics could be left navigating a reform process that shifts responsibility without equipping them with the necessary tools and support. Read full story (paywalled) Source: HSJ, 5 June 2025 Related reading on the hub: How corridor care in the NHS is affecting safety culture: A blog by Claire Cox My experience of the 'Wait 45' policy - Florence in the Machine A silent safety scandal: A nurse’s first-hand account of a corridor nursing shift- Posted
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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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How remote patient monitoring is revolutionising patient safety
Lesley Barton posted an article in Telehealth
This article explores how remote patient monitoring (RPM) is transforming patient safety by enabling continuous, real-time tracking of health data outside clinical settings. It provides a comprehensive overview of RPM technologies, their clinical benefits, implementation challenges and best practices. It highlights the growing importance of RPM in proactive care models and its role in reducing hospital readmissions, improving medication adherence and supporting vulnerable patient populations. How is remote patient monitoring changing patient safety? A Mass General Brigham study of 10,803 participants found that RPM reduced mean blood pressure from 150/83 to 145/83, which significantly lowers cardiovascular disease risk.[1] RPM technologies provide clinicians with real-time data streams; this allows for quick interventions when patient conditions change. The continuous monitoring bridges dangerous gaps between appointments where medical complications developed undetected. Beyond crisis prevention, RPM enhances medication safety through adherence tracking and creates comprehensive longitudinal health records revealing subtle trends conventional episodic care might miss. The benefits reach vulnerable groups—elderly, rural and mobility-limited patients—who now get regular supervision free of transportation constraints, creating safety nets once inaccessible under conventional care models. Real-time monitoring: a lifeline for early intervention and patient safety RPM provides regular data collection that serves as a buffer against avoidable harm by detecting minute physiological changes that indicate clinical deterioration. RPM significantly bolsters patient safety by enabling early detection of health deteriorations, thereby facilitating timely interventions. A study published in NPJ Digital Medicine analysed 29 studies across 16 countries and found that RPM interventions led to a reduction in hospital readmissions and emergency department visits.[2] Specifically, the study highlighted that RPM demonstrated positive outcomes in patient safety and adherence, and improved patients' mobility and functional statuses. This early warning feature considerably improves patient safety by enabling timely clinical interventions before symptoms worsen. A known patient with serious congestive heart failure can also be given diuretic adjustments remotely, avoiding hospitalisation. RPM also decreases the risks associated with medications by enabling physicians to identify missed doses and adverse reactions. Long-term data further strengthens safety by showing patterns—like low oxygen levels at night in chronic obstructive pulmonary disease (COPD) patients—that single tests might miss. Personalised interventions are supported by this fine-grained understanding, especially for high-risk populations such as patients living in rural areas that have improved access to attentive monitoring. By combining speed and accuracy, RPM transforms patient safety to an actionable, data-driven and efficient procedure rather than a fixed objective. Key technologies driving remote patient monitoring: enabling safer, data-driven care Remote patient monitoring depends on a complex ecosystem of linked technology that extends clinical supervision outside of facility boundaries. Wearable devices form the basic foundation of this system—with regulatory-approved sensors capturing vital metrics continuously. RPM is transforming healthcare by shifting from reactive to proactive safety strategies. These digital systems continuously track vital signs, medication compliance and physiological parameters outside traditional clinical settings. This enables early detection of deterioration before serious complications arise. Advanced cardiac monitors identify arrhythmias with 98% accuracy and smart glucose sensors provide real-time glycaemic information via subcutaneous readings. Connected devices for tracking urinary patterns help physicians diagnose various types of incontinence without requiring in-person assessments, improving dignity and convenience for patients with mobility challenges. Smart inhalers with embedded sensors record medication usage patterns and technique, enabling precise interventions for respiratory conditions. Mobile applications are a link between patients and clinical teams—with simple dashboards that show health trends and medication adherence. These platforms usually combine clinical protocols, secure messaging systems and alerts based on preset thresholds. Backend analytics platforms transform raw physiological data into clinically relevant insights through sophisticated algorithms. These systems analyse longitudinal data against established baselines to detect minor abnormalities that precede clinical deterioration. According to studies, these predictive capacities can detect sepsis 6–12 hours earlier than traditional approaches, considerably increasing survival rates.[3] Secure, Health Insurance Portability and Accountability Act (HIPAA) compliant electronic health record (EHR) integration—using end-to-end encryption and strict authentication—creates comprehensive patient profiles, enabling better-informed treatment decisions. Implementing remote patient monitoring: main challenges RPM has numerous benefits in healthcare, but putting it into practice involves challenges that need thoughtful solutions. Digital literacy gaps create accessibility barriers, particularly among elderly populations where only 64% report comfort with technology-based healthcare tools according to the Journal of the American Geriatrics Society survey of 3,450 seniors.[4] Privacy concerns are significant as continuous monitoring generates sensitive health data that requires strong security. To maintain patient trust while meeting regulatory standards, healthcare centres must use end-to-end encryption, unambiguous consent mechanisms and transparent data governance frameworks. Another problem is clinical workflow integration; RPM systems that function without the use of EHR platforms result in documentation silos. Customised integration pathways that embed remote monitoring data within regular clinical interfaces are required for successful RPM implementation. When clinicians get an overwhelming number of notifications, the intended safety benefits are undermined. Effective systems use tiered alert processes with tailored thresholds that are based on patient baselines rather than population norms. These graduated notification systems ensure that important notifications receive necessary attention while preventing frequent low-risk alerts. As healthcare organisations face these issues, good implementation frameworks that include technical assistance, privacy safeguards and workflow optimisation are relevant to fulfilling RPM's full potential. Best practices for patient-centered remote monitoring Effective RPM is beyond technological equipment; it requires an effective structure that can only come from consistent planning and review. Healthcare organisations should establish dedicated implementation teams comprising clinicians, IT staff and patient advocates to gather diverse viewpoints and boost adoption of RPM. This cross-functional strategy improves RPM acceptance and sustainability while lowering possible resistance. Healthcare administrators should train providers thoroughly on both technical use of medical devices and data interpretation. A 2023 NEJM Catalyst study of 76 healthcare centres showed that centres with robust training of healthcare professionals had 43% higher RPM use after a year compared to those with minimal training.[5] Healthcare professionals should also be trained to focus equally on patient support through easy enrolment, clear instructions in multiple languages and in-person device training. Dedicated tech support channels should be created for RPM users in order to prevent frustration whenever there is a network glitch. Clear clinical protocols defining intervention thresholds, escalation pathways and response timeframes should be made to transform data into actionable intelligence. Rigorous quality assurance measures—including regular connectivity testing, data validation audits and patient usability assessments—safeguard programme integrity. Periodic review cycles examining alert frequency, response times and intervention outcomes help refine system parameters for maximum clinical utility. The most effective RPM programmes integrate patient feedback mechanisms allowing continuous refinement of interfaces, alert frequencies, and educational materials based on real-world experience. Conclusion RPM is improving healthcare from reactive to preventive care. As technology advances, these systems will become standard practice. Future developments will include smaller sensors, longer battery life and better connectivity—making monitoring easier for patients while improving data quality. Better predictive analytics will help physicians identify health problems earlier with greater accuracy. Beyond helping patients, RPM is changing organisational safety culture by expanding care beyond hospitals. This shift represents a major advancement—creating continuous monitoring systems that protect patients throughout their healthcare journey and redefining patient safety for modern medicine. References 1. Mass General Brigham. Mass General Brigham Remote Healthcare Delivery Program Improves Blood Pressure and Cholesterol Level, 9 November 2022. 2. Ying Tan S, et al. A systematic review of the impacts of remote patient monitoring (RPM) interventions on safety, adherence, quality-of-life and cost-related outcomes. NPJ Digital Medicine 2024; 7: 192. 3. King J, et al. Early Recognition and Initial Management of Sepsis in Adult Patients. Ann Arbor (MI): Michigan Medicine University of Michigan, 2023. 4. American Geriatrics Society 2024 Annual Scientific Meeting. Journal of the American Geriatrics Society 2024; 72: III-VI. 5. Barrett JB, et al. Reduced Hospital Readmissions Through Personalized Care: Implementation of a Patient, Risk-Focused Hospital-Wide Discharge Care Center. NEJM Catal Innov Care Deliv 2025;6(6). DOI: 10.1056/CAT.24.0420. Further reading on the hub Putting patients at the heart of digital health Digital diagnosis—what the doctor ordered? Electronic patient record systems: Putting patient safety at the heart of implementation How do we harness technology responsibly to safeguard and improve patient care?- Posted
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A Brighton GP surgery is under threat despite providing excellent services and strong links to the local community. This decision flies in the face of the proven 'social value' being delivered and potentially puts patients at risk. The reasons are presented in this excellent article which exposes the continued 'race to the bottom' due to an apparently unnecessary tendering exercise, a decision made behind closed doors and a failure to consult. Quote from Polly Toynbee's article in the Guardian: "Here’s the puzzle. Andrew Lansley’s calamitous system that opened the NHS to “any willing provider” to compete for contracts was supposedly swept away in 2022, replaced with ICBs that strove for cooperation across all NHS and social services in England. Yet some ICBs still apply the old competitive impulse to NHS services, even though they now have an obligation to ensure that tenders help to reduce inequalities."- Posted
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USA: House passes Trump’s agenda bill
Patient Safety Learning posted a news article in News
The House of Representatives passed the President Donald Trump-backed “One Big Beautiful Bill” in a 215-214 vote on 22 May after debating for hours overnight on the controversial legislation that includes significant cuts to Medicaid. Healthcare revisions to the multitrillion-dollar legislation include a two-year acceleration of Medicaid work requirements for able-bodied people ages 18-64 no later than 31 December 2026. The work requirements were originally set for 2029, but have been accelerated to generate faster savings. Gender transition procedures will no longer be covered by ACA plans beginning 1 January 2027. The bill, which President Trump and GOP leaders argue is aimed at tackling “waste, fraud and abuse,” now heads to the Senate, where Republicans hold a 53-47 majority. However, it is not clear when the vote will be held. The bill’s revisions have also resulted in backlash from several healthcare advocacy groups. America’s Essential Hospitals President and CEO Bruce Siegel, MD, MPH, said that their organisation “strongly opposed” the “deep Medicaid cuts” in the bill, highlighting that the cuts would “threaten the health and well-being of millions of Americans.” Read full story Source: Becker's Hospital Review, 22 May 2025- Posted
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Dementia is caused by different diseases, including Alzheimer’s disease and vascular dementia, which affect memory, thinking and the ability to perform daily tasks. The number of people being diagnosed with dementia is increasing. In February 2025, nearly half a million people in England had a dementia diagnosis. The likelihood of developing dementia, becoming an informal carer or both in a lifetime in the UK is 55% (around 1 in 2). This Care Quality Commission (CQC) report looked at people's experiences of living with dementia when using health and adult social care services, including the experiences of families and carers. It sets out the main themes that influence whether an experience is good or poor, and what health and care services are doing to improve these experiences. CQC will use the findings in this report to help shape their work to define what good care looks like for people with dementia and inform the next phase of CQC’s Dementia Strategy. The CQC Dementia Strategy has 6 core objectives: CQC will co-produce evidence-based statutory guidance for what good dementia care looks like and link to good practice guidance under our assessment framework. CQC will apply the statutory guidance across their regulatory activity. CQC will use their independent voice to tackle inequalities and encourage improvement and innovation. The CQC will be a dementia-friendly and inclusive organisation to benefit our staff and the wider public. CQC staff will receive comprehensive dementia training and work with partners to influence training and competency for the health and social care workforce. CQC will actively work in partnership with key stakeholders to collectively affect real change. Work will be focused on the following areas: Developing statutory guidance and defining good practice CQC will work towards achieving objective 1 to develop statutory guidance. CQC will: involve people with lived experience, carers and a wide range of other stakeholders in co-production, ensuring the guidance is led by the voice and experiences of people who use services carry out research into the characteristics of effective dementia care, including learning from other countries and regulators, as well as further information gathering to develop a robust evidence base on which to build the statutory guidance principles. Learning and development needs of CQC’s workforce To ensure they are effective in our regulation of services for people with dementia, CQC will ensure that they understand and respond to the learning needs of their own staff in this area. This includes carrying out a learning needs analysis, defining learning objectives and developing training and guidance for CQC staff aligned to the statutory guidance we publish. Engagement and communication CQC will apply a wide range of tools and approaches to involve people, carers, key stakeholders and CQC staff in the development of this work. They will continue to work collaboratively with other key stakeholders and policymakers on joint improvement ambitions and actions that enable good dementia care, in areas like workforce, system pathways and technology. They will share updates on our work with the public, providers and other partners and share future opportunities to get involved.- Posted
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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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In this blog, Siân Slade shares how, through her research interest into the difficulties of navigating the healthcare system in Australia, she created a policy and advocacy project: #NavigatingHealth. The aims of the project are to streamline the silos and address the fragmentation of healthcare by bringing together all those who are developing solutions to enable patients and carers to better navigate healthcare journeys. Background About 10 years ago, I listened to a friend’s experience navigating cancer and puzzled over the challenges encountered. These made me question my prior assumption of 'patient-centricity' across healthcare. In 2015, the Organisation for Economic Co-operation and Development (OECD) released a report highlighting the complexities of the Australian healthcare system. This led me to realise that while we do have patient-centred care, it is often provider dependent, not system-wide, and relies on the patient (or carer) to navigate the system; a time when individuals are at their most vulnerable. Given 'the standard you accept is the standard you walk past”, I decided to do 'my bit' to address this. I enrolled in a Master of Public Health, researching healthcare navigation in Australia. I found there was a fragmented approach to try and address an already fragmented problem. This led me to embark on a PhD as well as develop a policy and advocacy platform: #NavigatingHealth. Setting up a national network and community of practice My focus has always been on a practical approach that solves problems for individuals but also seeks to understand how to scale these at a systems level to sustain change in the long-term. If this was a known problem, why was nothing being done to address it? Surely this was something government were addressing... or there must be an app? I spoke to lots of people—patients, carers, speakers at conferences, those who had written books of their healthcare experience and, yes, those developing apps. Everyone agreed it was a problem, but nothing was addressing the totality of the problem. The problem was not just in navigating healthcare, but also the challenges navigating related systems, such as those for people with disabilities, or for aged care, as well as social services and education. #NavigatingHealth started life as two, 60-minute webinars held in mid and late September 2021, supported by the Australian Disease Management Association. The inaugural webinar speakers provided vignettes across a life journey—from childhood through to getting older—based on their own lived-experiences as patients, carers or professionals (not-for-profit, health services and government). The positive reception of the webinars led to setting up a bimonthly national network and community of practice in Australia that ran until the end of 2024. The meetings were deliberately not recorded to build a safe space for people to share ideas, build tacit (word of mouth) knowledge and a like-minded solutions focused community. Summaries of all the events and speakers are available on the #NavigatingHealth project page. In health, information and projects evolve. Building an online community was low-cost and accessible to everyone. The success of the Australian approach led to a series of global webinars using the same format of expertise provision from individuals in research, policy, and advocacy and health services. The first global webinar was held in 2022 attracting over 20 countries. Connecting and collaborating The 'glocal' community continues to grow. Projects are constantly evolving, elevating and expanding as well as exiting often impacted by funding constraints. In the spirit of a complex adaptive learning health system, core to our success is the community knowledge built through relationships, trust, like-values and non-linear interactions. Taking an approach that is resourceful versus one requiring constant resourcing (we use accessible tools such as LinkedIn and more recently Bluesky) to provide an effective, free platform to keep individuals in touch with one another. Our dedicated #NavigatingHealth project page on the Nossal Institute for Global Health website at the University of Melbourne acts as a central hub for events and resources. The genesis during the pandemic and expansion virtually through Teams and Zoom, as well as in-person post-pandemic, has enabled different ways to expand the national community, the global network and we welcome all-comers. The project is voluntary and our success is based on linking people, developing relationships, sharing expertise, maintaining momentum and the opportunity we all have to impact into #NavigatingHealth. The annual forums, 2024 #NavigatingHealth Simplifying Complexity and 2025 #NavigatingHealth Enabling Patients, System-Wide, focused on bringing together colleagues nationally in Australia. The in-person workshops created the opportunity to build community, share ideas, leverage learnings and also provide educational content. These collaborations have allowed development of materials for curriculum and teaching, and an evolving conversation about the importance of systems-thinking. We developed a short global project collecting stories from individuals who are happy to be involved. Our video, NavigatingHealth - why this matters, provides a glimpse of our approach. Looking forward The Future of Health Report published in 2018 highlights that our health systems, locally and globally, will change from 'one size fits all' to one that is personalised. The challenge is how? Future of Health Report, CSIRO 2018. The 'secret sauce' is that by working collaboratively we can all be part of evolving and effecting systems change. The work is underpinned by equity and a focus on enabling early access to care, addressing barriers, such as financial or cultural constraints, and helping to make visible information asymmetries and power imbalances to ensure effective collaboration and co-production. Building on the success of our past forums, planning for 2026 is underway. Block out 1 April 2026 in your calendar for the inaugural #NavigatingHealth Day! Our collective expertise is our power—let’s do this! Want to know more? Please get in touch with Siân at [email protected] or via LinkedIn. Further reading on the hub: The challenges of navigating the healthcare system How the Patients Association helpline can help you navigate your care Lost in the system? NHS referrals- Posted
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The NHS’s total liabilities for medical negligence have hit an “astounding” £58.2bn amid ministers’ failure to improve patient safety, an influential group of MPs have warned. The Commons public accounts committee (PAC) said the “jaw-dropping” sums being paid to victims of botched treatment and government inaction to reduce errors were “unacceptable”. The Department of Health and Social Care (DHSC) has set aside £58.2bn to settle lawsuits arising from clinical negligence that occurred in England before 1 April 2024, the PAC disclosed. “The fact that government has set aside tens of billions of pounds for clinical negligence payments, its second most costly liability after some of the world’s most complex nuclear decommissioning projects, should give our entire society pause,” said Sir Geoffrey Clifton-Brown, the PAC chair. “This is a sign of a system struggling to do right by the people it is designed to help,” he added. The PAC urged ministers to take urgent steps to reduce “tragic incidences of patient harm” and to also end a situation where lawyers take an “astronomical” 19% of the compensation awarded to those who are successful in suing the NHS. That amounted to £536m of the £2.8bn that the health service in England paid out in damages in 2023-24 – its record bill for mistakes. “Far too many patients still suffer clinical negligence which can cause devastating harm to those affected,” and the ensuing damages drain vital funds from the NHS, the report said. Read full story Source: The Guardian, 14 May 2025- Posted
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AHCS Honorary Fellows 2025 now open - deadline 12 June 2025
Patient Safety Learning posted a news article in News
The Academy for Healthcare Science (AHCS) has announced that Stage 1 of the Honorary Fellowships 2025 is now open. The AHCS Honorary Fellowships set up in 2016 to recognise the work, vision, support and input individuals who have supported AHSC in theirdevelopment and growth, in one or more of the below key areas: To the formation, development, running or ideals and standards of the AHCS. To the promotion and development of key aspects of Healthcare Science. In areas relating to Healthcare Science and your help in promoting the professions and raising public awareness of Healthcare Science In providing excellence in UK healthcare in your capacity as Presidents of Royal Colleges, medical journalists, civil servants, manufacturers, etc. Nominations are received and reviewed by the Honorary Fellows Nominations Group and their recommendations submitted to the Professional Council for approval. Eligibility criteria for an individual to be considered for Honorary Fellowship are an outstanding contribution: a) To the formation, development and operation of the AHCS and/or b) To the development and delivery of Healthcare Science in the UK. International nominations can be considered if the contribution has influenced the delivery of healthcare science in the UK and/or c) To the significant promotion within the profession and/or in raising public awareness of the contribution of Healthcare Science in the UK and/or d) By individuals who have worked for the AHCS, either as staff members or in a voluntary capacity. Read more Source: AHCS. -
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Trump’s 2026 budget plan cuts healthcare funds
Patient Safety Learning posted a news article in News
President Donald Trump unveiled his fiscal 2026 budget proposal on 2 May, cutting non-defense federal spending by $160 billion. The budget provides resources to HHS to promote nutrition, physical activity, healthy lifestyles and more, according to the White House press release. The funds will also tackle “over-reliance on medications and treatments” as well as food and drug quality and safety. The VA medical centers will receive additional funds for healthcare services. Qualified veterans can also receive care from local community providers to expand access for those who otherwise would have to drive hours for care. The budget would cut funds nearly in half for the National Institutes of Health and CDC. The budget further would eliminate divisions for the CDC focused on disease and injury prevention, including gun violence. It would also cut the programmes for environmental health, global health and public health preparedness, according to The Times. The CDC’s focus would narrow to cover just infectious disease. President Trump’s budget proposes $1 billion cuts from the Substance Abuse and Mental Health Services Administration. The budget does not cut funding for Medicare or Medicaid. Read full story Source: Becker's Hospital Review, 2 May 2025- Posted
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Nigel Crisp, independent member of the House of Lords, discusses the risk and opportunities of the closure of NHS England. Success will depend on how this massive change is managed and on creating a workable future relationship between ministers and NHS organisations.- Posted
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In many ways the year 2000 was the start of the safety movement as we know it today. There are many safety scholars out there who will cite the work as far back as the late 1800s that helped our thinking in patient safety and the brilliance of our anaesthetic colleagues who were in fact the first people to coin the term ‘patient safety’ in the 1970s. However…the year 2000 heralded the seminal document published in the UK by the then Chief Medical Officer Sir Liam Donaldson, ‘an organisation with a memory’ after convening a group of safety experts, including James Reason, to understand what we needed to do to improve patient safety in the NHS. Because things are changing again … those words ‘an organisation with a memory’ are hugely important. It is vital to remember the past and think about what we can learn from it . Hindsight is a wonderful way of looking back at the valuable lessons for the future, writes Suzette Woodward.- Posted
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To raise decision quality, non-medical options must be considered. Anna Dixon, MP and health policy expert, and Connie Jennings, director of stronger communities for the Walsall Housing Group, share insights with the hosts of The Choice podcast .- Posted
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untilJoin Aqua for their national event, ‘Transforming Tomorrow Through Leadership and Improvement Today’ to connect, learn, and shape the future of health and care through co-production and partnership working. It will be bringing together healthcare leaders, innovators, and change-makers for an afternoon of insightful discussion and meaningful connections as we mark 15 years of the Advancing Quality Alliance being the leading improvement partners. With an exciting line-up of speakers and time for discussion and networking, this event is an opportunity for you to gain fresh perspectives and reconnect with peers. Register- Posted
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The Centers for Medicare & Medicaid Services (CMS) is a federal agency in the United States that administers major healthcare programmes, including Medicare, Medicaid, the Children's Health Insurance Program (CHIP), and the Health Insurance Marketplace. CMS Administrator Mehmet Oz has set out his vision for the agency, including a commitment to President Trump’s “Make America Healthy Again” agenda and modernisng Medicare, Medicaid and the ACA marketplace. As a first step, CMS will implement President Trump’s executive order from February aimed at boosting healthcare price transparency. The order directs the Department of Health and Human Services (HHS), and the Labor and Treasury departments to “rapidly implement and enforce” healthcare price transparency enforcement regulations that the president introduced during his first term. It will work to streamline access to life-saving treatments by “equipping providers with better patient information versus unnecessary paperwork.” The agency did not elaborate further on how it would streamline care access. Identifying and eliminating fraud, waste and abuse is a top priority for the agency. During his confirmation hearing process, Dr Oz promised scrutiny of the Medicare Advantage program amid allegations of widespread fraud, and expressed concerns about MA sales and brokers encouraging seniors to switch to MA policies for financial gain. CMS will focus on prevention, wellness and chronic disease management. HHS Secretary Robert F. Kennedy Jr. has identified chronic disease as a key priority under his leadership. He has criticised the influence of the pharmaceutical and food industries, linking issues like obesity and diabetes to ultra-processed foods, federal subsidies and dietary guidelines. He has called for reforms targeting food additives, pesticides and environmental health risks, alongside overhauls of agencies like the CDC and FDA. Read full story Source: Becker's Hospital Review, 10 April 2025- Posted
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On the 10 April 2025, the Health Services Safety Investigations Body (HSSIB) published a report looking at how care is co-ordinated for people with long-term conditions. In particular, the investigation considered the role of ‘care co-ordinator’ to understand how care is co-ordinated within the existing workforce. In this blog, Patient Safety Learning sets out its reflections on the findings and recommendations in this report. HSSIB investigates patient safety concerns across the NHS in England and in independent healthcare settings where safety learning could also help to improve NHS care. Their latest report looks at primary and community care co-ordination for people with long-term conditions, specifically considering the role of ‘care coordinator’ in this context.[1] While language around the care coordination is varied, the role of care co-ordinated is defined by NHS England as follows: “Care co-ordinators help to co-ordinate and navigate care across the health and care system, helping people make the right connections, with the right teams at the right time. They can support people to become more active in their own health and care and are skilled in assessing people’s changing needs. Care co-ordinators are effective in bringing together multidisciplinary teams to support people’s complex health and care needs.”[2] In this blog we set out our reflections on the findings and recommendations in this HSSIB investigation. Challenges navigating the healthcare system Navigating the healthcare system in the UK can be complex and frustrating for patients, families and carers. At Patient Safety Learning we hear time and time again about the lack of joined up care and communication within and across organisations. Failing to share the right information at the right time can create significant patient safety risks. Poor communications, both with patients and between healthcare professionals, can result in misunderstandings and mistakes resulting in poor outcomes and potentially patient harm. In a recent series of blogs published on the hub, patients and their relatives shared with us the challenges and barriers they have faced when trying to navigate the healthcare system.[3] The concerns and issues raised in this HSSIB investigation echo many of the key themes we identified in our new blog series. Confusing communications HSSIB’s report refers to the case of a child prescribed anti-epileptic medication by a specialist hospital to reduce the number and severity of their seizures. It then details the difficulties the parents subsequently found in getting this medication through their GP or consultant. The parents highlighted concerns about the lack of communication between the separate services, with the report noting: “The parents told the investigation that they were ‘exhausted’ because of the effort they had had to put in over the years to connect services together, having to tell the same story over and over again, while having to provide care for their child.” Delays to treatment The investigation report also highlights the case of a middle-aged professional working man who suffered a stroke. He received hospital care to treat and manage his healthcare needs; however, once discharged he encountered significant difficulties when seeking appropriate support for his additional healthcare needs. HSSIB highlighted how he had told them it required significant effort from him directly to ensure the right level of care was maintained for his needs. Recounting his experience, the report states: “He said that these multiple agencies ‘all operate in their own silos’ and not as a team, and that ‘there was nobody to create that team [a cross-system team aware of all his health and care concerns]’. The way that he and his wife cope with this situation is that they ‘manage the team’ to connect the individual parts of the system and get the care he needs.” Impact on mental health HSSIB also spoke to a man in his late seventies who is the main carer for his wife. She has multiple long-term conditions that require primary, secondary and community care. Reflecting on the impact that coordinating her care had on their lives, the report noted: “The husband explained that his role of care co-ordinator had placed a considerable burden on him, which led him to ‘feel overwhelmed’. He said that because he needing to act as her ‘co-ordinator’ he was unable to spend time with his wife as her husband. He also described having to administer medication and dress his wife’s wound which caused her considerable pain.” HSSIB’s investigation also highlights broader areas of concern relating to the coordination of care in the healthcare system, again mirroring themes raised we heard from patients in our recent blog series. Difficulties sharing information The investigation highlights a recurring concern around problems sharing patient information and the negative impact of this on coordinating a patient’s care. It highlights both issues of digital systems in different organisations not being compatible with one another and other barriers, stating: “Healthcare professionals described the challenges in information sharing. Digital patient records could not be viewed across primary, community, secondary and tertiary care because information technology systems are unable to ‘talk to each other’. They also said that sometimes they were unsure whether patient information could be shared as it was ‘protected information’. This was a particular problem when trying to share information between health and social care.” A complex and confusing system The report also reflects more broadly on how accessing and navigating health and care services can be difficult and complex, and potentially overwhelming for patients. This was highlighted by examples such as this from the investigation: “A GP practice told the investigation that it had tried to put together an easy-to-read document explaining the care pathway for patients with dementia, including contact numbers and ways to access services. The GP practice went on to say that the system was so complex that it was unable to bring together all the information. It stated: ‘We are healthcare professionals and we can’t do this, so how can patients cope?’” Safety recommendations A theme that runs throughout HSSIB’s investigation is that there is a clear need and support for the role of care co-ordination. It highlights that while patients and carers can, and often do, themselves act in this role, when they are unwell or unable to do so a patient’s care can be significantly impacted. The report states that the availability of care co-ordination varies widely across the system. This is a particular issue for those living with multiple long-term conditions as there is no single centralised care co-ordination function to span across primary, secondary and tertiary care. Concluding its investigation, HSSIB recommends that: NHS England/Department of Health and Social Care, working with other relevant organisations, reviews and evaluates the implementation of the care co-ordinator role. This is to ensure that all patients with long-term conditions have their care co-ordinated and that they have a single point of contact 24 hours a day, 7 days a week, to help them with any queries or concerns that they may have. The Department of Health and Social Care works with NHS England and other stakeholders to develop a strategy that ensures that all diseases are given parity and that all people with a long-term condition in primary, secondary, tertiary and community or social care have their care effectively co-ordinated across multiple agencies. This is to ensure that people with long-term health conditions have co-ordinated care plans with effective communication between services and a single point of contact for concerns or questions. Patient Safety Learning agrees that there needs to be greater time and investment into care coordination. On the first recommendation, we would note that seeking to ensure all patients with long-term conditions have a single point of contact 24 hours of day, 7 days a week, would be a significant shift from the status quo. This would require a clear commitment of both financial and workforce resources from NHS England and the Department of Health and Social Care to deliver. In considering how this might be approached, it would also be important to consider: How this can be flexible depending on the long-term condition in question. Different conditions will require different levels and types of coordination. Systemic barriers that result in many of the difficulties navigating the care system would not be addressed by implementing this recommendation. For example: – We would continue to have various digital systems in primary, secondary and tertiary care that lack interoperability (the ability of computer systems or software to exchange and make use of information). – Non-digital communication barriers that prevent cross-organisational sharing of information in the NHS, ranging from data sharing restrictions to cultural attitudes within organisations, would also remain. On the second recommendation we agree with the principle of this, that there needs to be parity for people with a long-term condition and an expectation that their care is effectively co-ordinated across multiple agencies. Poorly coordinated care is not only confusing and frustrating for patients but also creates safety risks that can result in serious avoidable harm. Concluding comments The challenges of navigating the healthcare system discussed in this report are not a new issue, but a long-standing set of problems that do not have a simple solution. Their impact on patient experiences and outcomes is exacerbated in the current environment, when our healthcare system that is under increasing pressure and in a “critical condition”.[4] Patient Safety Learning believes that care co-ordination should form an important area of focus for the UK Government’s forthcoming 10 Year Health Plan. If it is to achieve its strategic ‘shift’ of moving the future of the NHS from "hospital to community" this will require a healthcare system where patients aren’t simply left to "join the dots for patient safety".[5] This will require organisational and leadership commitment to take forward the issues raised in this HSSIB investigation. The needs of patients should be central to improving health and care services, actively listening and acting on their experiences and insights when things go wrong for safety improvement. References HSSIB. Workforce and patient safety: primary and community care co-ordination for people with long-term conditions, 10 April 2025. NHS England. Care co-ordinators, Last accessed 10 April 2025. Patient Safety Learning. The challenges of navigating the healthcare system, 24 February 2025. UK Parliament. NHS: Independent Investigation, Hansard, Volume 753, 12 September 2024. Department of Health and Social Care, Independent report: Review into the operational effectiveness of the Care Quality Commission, 15 October 2024. Related reading Digital-only prescription requests: An elderly woman sent round the houses How the Patients Association helpline can help you navigate your care Lost in the system? NHS referrals Navigating the healthcare system as a university student: My personal experience The challenges of navigating the healthcare system: David's story The challenges of navigating the healthcare system: Sue's story Share your story What has been your experience of navigating the healthcare system? What is and isn’t working? How does it feel as a patient or carer when you hit barriers? Has your health been affected? Share your story in our community forum or contact our editorial team at [email protected].- Posted
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People who have a long-term condition may be in contact with multiple health and care organisations and may experience harm if their care is not co-ordinated. This investigation focuses on people with long-term conditions and how their care is co-ordinated, specifically considering the role of ‘care co-ordinator’. It is intended for healthcare organisations, policymakers and the public to help improve patient safety in relation to co-ordinating care for people with long-term or complex healthcare needs. Findings The NHS has produced a definition of the professional role of NHS care co-ordinator. However, there is variation in how this role is implemented. Other national organisations have different definitions of care co-ordination and care navigation, which can create ambiguity for people overseeing these roles. There is not a single person/role/organisation responsible for co-ordinating care for people with long-term or complex health and care needs across multiple health and care organisations. The health and care system frequently fails to support care co-ordination across multiple care pathways and instead focuses on individual diseases or issues. This can leave people who have complex long-term conditions with uncoordinated care. Accessing and navigating health and care services can be difficult and complex, and patients and carers would like improved service integration and care co-ordination. Patients and carers act as a central point for information and contact for providers, but when they are unwell or unable to do this, care can be impacted. People who are unable to navigate the health and care system can experience deterioration of health, miss appointments or their care may become delayed or forgotten about, meaning they may need more intense treatment in the future or longer stays in hospital. Patients and carers have to retell their health history to different health and care providers. They believe the system is not joined up and that information does not flow across health and care organisations, or that different parts of the system cannot access information from other providers. When patients are discharged from a health or care setting out of normal working hours they do not always know who they can speak to about any concerns or their ongoing care. Different methods of sharing health and care information can create an information gap, particularly out of hours and at the weekend, resulting in a situation where not all health and care staff have the appropriate information to make decisions. Patients and carers can feel exhausted, burnt out, frustrated, angry and guilty, among other emotions. Patients and carers physical and mental health may deteriorate because of the extra burden of navigating the health and care system. Patients and carers may disengage with the health and care system because they are exhausted and frustrated. This may lead to poor outcomes for both patients and carers. There are different ways of supporting care co-ordination across the system, some of which are assisted by the charity sector. Safety recommendations HSSIB recommends that NHS England/Department of Health and Social Care, working with other relevant organisations, reviews and evaluates the implementation of the care co-ordinator role. This is to ensure that all patients with long-term conditions have their care co-ordinated and that they have a single point of contact 24 hours a day, 7 days a week, to help them with any queries or concerns that they may have. HSSIB recommends that the Department of Health and Social Care works with NHS England and other stakeholders, to develop a strategy that ensures that all diseases are given parity and that all people with a long-term condition in primary, secondary, tertiary and community or social care have their care effectively co-ordinated across multiple agencies. This is to ensure that people with long-term health conditions have co-ordinated care plans with effective communication between services and a single point of contact for concerns or questions. Safety observation Health and care organisations can improve patient safety by allocating a point of contact for patients and/or their carers when people are discharged from services out of normal working hours. This will ensure patients and their carers are able to escalate any concerns relating to their ongoing care and drive improvements in care co-ordination. Related reading on the hub: Read Patient's Safety Learning's response to the findings and recommendations of this HSSIB report- Posted
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The aim of this article published in BMJ Quality & Safety is to provide an estimate of the proportion of the general public reporting healthcare-related harm in Great Britain, its location, impact, responses post-harm and desired reactions from healthcare providers. Key findings In this survey 9.7% participants reported harm caused by the NHS in the last 3 years through treatment or care (6.2%) or the lack of access to care (3.5%). The main location where the harm first occurred was hospitals. A total of 37.6% of participants reported a moderate impact and 44.8% a severe impact of harm. The most common response to harm was to share their experience with others (67.1%). Almost 60% sought professional advice and support, with 11.6% contacting the Patient Advice and Liaison Service (PALS). Only 17% submitted a formal complaint, and 2.1% made a claim for financial compensation. People wanted treatment or care to redress the harm (44.4%) and an explanation (34.8%). Two-thirds of those making a complaint felt it was not handled well and approximately half were satisfied with PALS. Experiences and responses differed according to sex and age (eg, women reported more harm). People with long-term illness or disability, those in lower social grades, and people in other disadvantaged groups reported higher rates and more severe impact of harm. This study used a broader and more inclusive definition of harm and was conducted during the COVID-19 pandemic, making comparison to previous surveys challenging.- Posted
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