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In a new blog on the hub, Laura Evans discusses the lack of protection against Covid-19 for vulnerable patients when going for a GP appointment or into hospital and shares her personal experience of being dismissed when asking for basic patient safety measures to be put in place. We'd like to hear your experiences. Are you a vulnerable patient? What is your Trust or GP practice doing to make you feel safe? Please comment below (sign up first for free) or you can email us at [email protected].- Posted
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In this blog, Laura Evans discusses the lack of protection against Covid-19 for vulnerable patients when going for a GP appointment or into hospital. She shares her personal experience of being dismissed when asking for basic patient safety measures to be put in place. Imagine you are in hospital waiting to be taken down for surgery. You are informed the surgeon does not like wearing gloves, mask or headwear and says it is their personal preference. You are also informed that the operating theatre has not been cleaned since the patient before you. What do you do? Do you say something, politely reminding people of your right to be kept safe in hospital? Or do you remain silent to avoid being ridiculed or made to feel like there is something wrong with you? Of course, this scenario would never happen. It would not be tolerated by society. There are safety regulations and protocols in place to prevent, as far as reasonably possible, spread of disease in healthcare settings. However, where spread of Covid-19 is concerned, this genuine fear is the lived reality for millions of people attending healthcare appointments where their vulnerability is neither checked nor proactively catered for. Many people do not have the confidence, in some cases the wherewithal, to ask people to be careful around them in healthcare settings. Those who do ask for their needs to be met, like myself, have been condescended to and, in some instances, shouted at when arranging appointments. The only exception being when arranging appointments on the cancer pathway, where there is an acceptance that the immune system may be compromised. It is astonishing. What is it about this particular C word? Covid-19 is responsible for the deaths of over a quarter of a million people in the UK and the mass disablement of millions lucky enough to survive it but who are now living with Long Covid. There are also over a million people who shielded during the pandemic restrictions, whose clinical vulnerability has not suddenly gone away. Even if the basic human response leaves a lot to be desired, it has become an economic imperative to prevent so many people being sick. The World Health Organization only declared the emergency phase of the pandemic over, the virus itself continues to devastate lives. The number of people unable to work full time, or even work at all, since the start of the pandemic is rising sharply.[1] The number of people moving to part time work or unemployment to care for someone has also risen in the last few years.[2] A BMJ study found people living with Long Covid have lower quality of life than stage 4 lung cancer patients.[3] Covid-19 has profoundly debilitating effects on aspects of normal life, such as walking, talking, cognitive function, bathing and dressing, personal relationships with friends and family, and employment. There is a lot of rhetoric about preventative medicine; why is more not being done to protect people from these devastating consequences? It is not just Covid-19 that spreads easily when basic protections are not proactively put in place. Patients are still swabbed for MRSA in pre-op checks despite the MRSA outbreak being two decades ago. Clearly proactive prevention works. Yet, there is no routine testing for Covid and a large proportion of positive cases are hospital acquired. My local NHS Trust, Mersey and West Lancashire Teaching Hospitals, has been exemplary across its Southport and Ormskirk hospital sites wherever patients request safety precautions. Nothing is too much trouble. However, interactions with other Trusts have resulted in an appalling lack of respect and dignity, and an unnecessary battle for safe practices and care pathways. There is a worrying ‘survival of the fittest’ narrative pervading this matter, harking back to times when sick and disabled people were treated as socially embarrassing and a burden, to be hidden away and kept quiet. Anyone with the privilege of a robust immune system should ask if you would allow a medical practitioner to treat your open wound without gloves if you knew they were carrying a bloodborne infection? Any reasonable person would doubt such lapses in judgement. So why is Covid-19 different? Why should a vulnerable person be expected to tolerate lack of protections against Covid-19 and why is the NHS not compelled to put basic patient safety measures in place as they are expected to prevent spread of disease? It makes no sense. References House of Commons Library. Research Briefing. Labour Market Statistics. UK Government, 18 February 2025. Office for National Statistics. Employment in the UK: February 2025. Estimates of employment, unemployment and economic inactivity for the UK. 18 February 2025. Walker S, Goodfellow H, Pookarnjanamorakot P, et al. Impact of fatigue as the primary determinant of functional limitations among patients with post-COVID-19 syndrome: a cross-sectional observational study. BMJ Open, 2023. We would like to hear your experiences Are you a vulnerable patient? What is your Trust or GP doing to make you feel safe? You can share your experience by posting in the Comments below or join our conversation in the Community area of the hub. Related reading on the hub: “A perfect storm”: The global impact of the pandemic on patient safety Promises of Long Covid support have not materialised (a blog by Clare Rayner) Covid-19 : A risk assessment too far? A blog by David Osborn - Questions around Government governance Exploring the barriers that impact access to NHS care for people with ME and Long Covid Patient safety concerns for Long COVID patients- Posted
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There was “open warfare” between UK government departments during the pandemic, the former vaccines tsar has said, adding the failure to prioritise the needs of clinically vulnerable, immunocompromised individuals was ethically and morally wrong. Dame Kate Bingham led the vaccine taskforce (VTF) – based in the Department for Business, Energy and Industrial Strategy (BEIS) – between May and December 2020, and played a pivotal role in persuading the government to back the development of a portfolio of potential jabs, as well as securing contracts for millions of doses. But Bingham has told the Covid inquiry that when initially establishing the remit of the VTF she discovered conflict. “Therapeutics is obviously my background, so that is the natural area for me to have included in the remit,” she said. “What I did is what I would always do, which is to go and talk to the people involved, including in industry. And it was quite clear there was open warfare between BEIS and the Department of Health.” The government did not make an advance purchase of Evusheld and it was never supplied, much to the consternation of charities who warned of the impact on immunocompromised individuals, although it was available privately. Bingham said the direction of travel on Evusheld was clear to her before she left her post in December 2020, adding she vehemently disagreed with it. “I felt very strongly that we were conducting a strategy that was not following the prime minister’s goals,” she said. “So the government was following a very clear two-tier strategy where the clinically vulnerable, immunocompromised patients were being deprioritised in favour of those who were able to receive vaccines. And I felt that was manifestly wrong, both ethically and morally, but also did not follow the goals that we’d been set, which was to protect the entire population.” Read full story Source: The Guardian, 21 January 2025- Posted
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Covid inquiry told top NHS doctor was terrified
Patient Safety Learning posted a news article in News
The most senior doctor in NHS England has said he was "personally terrified" that hospitals could have been overwhelmed in the early stages of the pandemic. Prof Sir Stephen Powis told the Covid inquiry officials had drawn up a draft document advising whose care should be prioritised if the NHS found itself unable to cope with the surge in patients. The 'Covid-19 decision tool' assigned points based on a patient's age, frailty and underlying conditions. A high score meant they might not be admitted to intensive care if services were overwhelmed. The tool was never issued publicly, after it became clear infections might have already reached a peak in March 2020. Sir Stephen, who still serves as national medical director at NHS England, said the senior clinicians who were asked to draw up the plans at short notice "did a magnificent job" that "nobody ever wants to do". "But it became absolutely clear to me that this was going to be controversial, [and] that it hadn't had the opportunity to be discussed more widely with patient groups, [or] with the public," he added. Read full story Source: BBC News, 7 November 2024- Posted
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Although shame is an inevitable human experience, it is often experienced as a negative emotion that drives disconnection, psychological distress, impaired empathy and disengagement. The work of healthcare is infused with risk for shame and this Lancet article looks at the impact it can have on both staff and patients. Healthcare encounters are intimate interactions that can be overshadowed by perceived judgement and negative self-evaluation. Patients may feel ashamed, embarrassed or negatively judged about their bodies, their behaviours or their circumstances. Patient shame can be related to stigmatised experiences such as mental illness, obesity, sexually transmitted infections or substance use. The often well-intentioned “lectures” from doctors that such conditions evoke can increase shame feelings in patients who may already feel insecure or ashamed about their bodies or health conditions. Healthcare professionals can also be subject to the impact of shame as for many, identity and self-esteem are linked to achievement, reputation and belonging in their profession, all of which are, in turn, linked to patient care. They may feel inadequate or negatively judged about their skills, failures and errors, their own mental or physical illness, or their inability to “fix” a patient. The authors argue that engaging healthily with shame presents an opportunity for meaningful transformation in healthcare. Competently acknowledging, recognising and responding to shame will support humane connection, enhance psychological safety, infuse trust and instil the emotionally sensitive healthcare environments that we all need to do the vulnerable work of healing.- Posted
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Top picks: Venous thromboembolism
Patient Safety Learning posted an article in High risk areas
Blood clots, particularly deep vein thrombosis (DVT) and pulmonary embolism (PE), together venous thromboembolism (VTE), pose a significant health threat to patients. These potentially life-threatening conditions can manifest silently and without warning, making vigilance and knowledge crucial. In this Top picks, we’ve pulled together resources, blogs and reports from the hub for patients and healthcare professionals, which focus on how to recognise venous thromboembolism and how to improve patient safety. 1. Deep vein thrombosis: understanding and managing your risk In this blog, Jo Jerrome, CEO of Thrombosis UK, explains the dangers of DVT and why it is important for patients and staff to be aware of the risk factors. Jo offers advice on how we can all manage our risk of DVT. 2. HSIB - Clinical decision making: diagnosis of pulmonary embolism in emergency departments This investigation by the Healthcare Safety Investigation Branch (HSIB) explores the timely recognition and treatment of suspected pulmonary embolism in emergency departments. 3. Jenny, and why we must learn from her misdiagnosis of pulmonary embolism Jenny Edwards died in February 2022 from pulmonary embolism, following misdiagnosis. In this blog, her son Tim introduces us to Jenny, illustrating the deep loss felt following her premature passing. He talks about the care she received and argues that there were multiple points at which pulmonary embolism should have been suspected. 4. Venous thromboembolism (VTE): deep vein thrombosis and pulmonary embolism VTE is a significant cause of mortality, long-term disability and long-lasting ill-health problems – many of which are avoidable. 1 in 20 people will have a VTE at some time in their life and the risk increases with age. This NHS Resolution guide provides more information about the risks of VTE and how to spot the common signs and symptoms. 5. HSIB - The assessment of venous thromboembolism risks associated with pregnancy and the postnatal period final report This investigation by the HSIB explores the issues associated with the assessment of risk factors for venous thrombosis in pregnancy and the first six weeks after birth. 6. NHS Resolution: Working to prevent avoidable venous thromboembolism VTE is an international patient safety issue and a clinical priority for the NHS. Around half of all cases of VTE are associated with hospitalisation, with many events occurring up to 90 days after admission. It is a leading and preventable cause of death in an estimated 25,000 of hospitalised patients each year. This information leaflet highlights the cost of VTE claims and what you can do in your organisation to prevent VTE. 7. Pulmonary embolism misdiagnosis – a systemic problem Tim Edwards is a risk management expert and son of Jenny, who passed away in February 2022 from pulmonary embolism, following a misdiagnosis. Frustrated by the quality of the initial investigation that followed her death and the lack of assurance that learning would take place, Tim conducted an independent review. In this opinion piece, Tim draws on his research to highlight the key patient safety issues, and to encourage further dialogue around the topic. 8. Let's Talk Clots! Help reduce your risk of DVT and PE in hospital with this simple app Download the free Let’s Talk Clots patient information app from Thrombosis UK, and help reduce your risk of DVT and pulmonary embolism in hospital. 9. Patient Safety Spotlight Interview with Beverley Hunt, Professor of Thrombosis and Haemostasis and founder of Thrombosis UK In this interview, Beverley Hunt talks about setting up Thrombosis UK and how it has grown to have a national impact on patient safety in hospitals. She also describes the value of combining policy work with seeing patients face-to-face, and explores the need to find new ways of working to deal with the pressures facing the healthcare system. 10. Risk assessment models for venous thromboembolism in medical inpatients This cohort study in JAMA Network Open aimed to determine the prognostic performance of the simplified Geneva score and other validated risk assessment models (RAMs) to predict VTE in medical inpatients. The study provided a head-to-head comparison of validated RAMs among 1352 medical inpatients. It found that sensitivity of RAMs to predict 90-day VTE ranged from 39.3% to 82.1% and specificity of RAMs ranged from 34.3% to 70.4%. The authors concluded that the clinical usefulness of existing RAMs is questionable, highlighting the need for more accurate VTE prediction strategies. 11. HSIB: Investigation into management of venous thromboembolism risk in patients following thrombolysis for an acute stroke This HSIB investigation focused on the management of VTE risk in inpatients following thrombolysis for an acute stroke detection of medical problems (that impact on VTE risk) occurring in inpatients following thrombolysis for an acute stroke. Do you have a resource or story to share? We’d love to hear about it - leave a comment below or join the hub to share your own post.- Posted
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untilAre all of your severely immunocompromised patients aged 50 and over vaccinated against shingles? These patients are eligible for vaccination through the National programme Discuss identifying and vaccinating your most vulnerable patients, and how GSK can support you. This event is organised and funded by GSK. Further information and registration- Posted
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UK Covid-19 Inquiry website
Patient Safety Learning posted an article in Covid-19 Inquiry
The UK Covid-19 Inquiry has been set up to examine the UK’s response to and impact of the Covid-19 pandemic, and learn lessons for the future. The Inquiry’s work is guided by its Terms of Reference. Four Modules have already begun: Resilience and preparedness (Module 1) Core UK decision-making and political governance (Module 2) Impact of the Covid-19 pandemic on healthcare (Module 3) Vaccines and therapeutics (Module 4) which started on 5 June 2023. Structure of the Inquiry January 2024 newsletter Every Story Matters Every Story Matters is an online form that asks you to choose from a list of topics and then tell us about what happened. By taking part, you help us to understand the effect of Covid-19, the response of the authorities, and any lessons that can be learned. Find out more and take part. -
Content Article
The only masking that’s going on is that of the government’s continued failure to get to grips with the virus, writes George Monbiot in this Guardian opinion piece. For some people, going to hospital may now be more dangerous than staying at home untreated. Many clinically vulnerable people fear, sometimes with good reason, that a visit to hospital or the doctors’ surgery could be the end of them. Of course, there have always been dangers where sick people gather. But, until now, health services have sought to minimise them. Astonishingly, this is often no longer the case. Across the UK, over the past two years, the NHS has been standing down even the most basic precautions against Covid-19. For example, staff in many surgeries and hospitals are no longer required to wear face masks in most clinical settings. Reassuring posters have appeared even in cancer wards, where patients might be severely immunocompromised. A notice, photographed and posted on social media last week, tells people that while they are “no longer required to wear a mask in this area”, they should use hand sanitiser “to protect our vulnerable patients, visitors and our staff”. Sanitising is good practice. But Covid-19 is an airborne virus, which spreads further and faster by exhalation than by touch.- Posted
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In April 2023, National Voices held a workshop with members, supported by The Disrupt Foundation, on the unequal impact of the Covid-19 pandemic. It explored how communities and groups were affected differently by both the virus itself and the measures brought in to control it. It painted a grim picture of the ways in which the pandemic response exacerbated existing, deep-rooted inequalities across the UK and compounded the disadvantages experienced by people from minoritised communities, by disabled people and by people living with long term conditions. Just some examples include people who are immunocompromised, who were asked to go into isolation for huge periods of time and still feel completely overlooked as control measures have been lifted. Or the use of DNRs (Do Not Resuscitate orders) which were disproportionately applied to people with learning disabilities. With the Covid-19 Inquiry underway, it is imperative that we capture the lessons learnt from the pandemic, and use them to suggest action for the future. -
News Article
Covid vaccines should be available to buy privately in UK, scientists say
Patient Safety Learning posted a news article in News
Covid vaccines should be made available for people to buy privately in Britain, leading scientists have urged, amid concerns over a new wave of the virus which could worsen in autumn and winter. Unlike flu jabs, which individuals or employers can buy for about £15 from high street pharmacies, Covid jabs are only available on the NHS in the UK. This month the UK government announced that the Covid autumn booster programme would cover a smaller pool of the population than earlier vaccination drives. The age limit has been raised from 50 to 65 and above, with some younger vulnerable groups also eligible. Covid is on the rise, according to the UK Health Security Agency (UKHSA). Experts raised concerns the wave could continue to grow and add to winter pressures on the NHS. Prof Adam Finn, of the University of Bristol, a member of the UK’s Joint Committee on Vaccination and Immunisation (JCVI), said Covid jabs should be available commercially. Some employers might want to offer the vaccines to their staff, he added. Speaking in a personal capacity, Finn said: “I think it will be a good idea for vaccines to be made available to those that want them on the private market. I don’t really see any reason why that shouldn’t be happening.” Read full story Source: The Guardian, 17 August 2023- Posted
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In this study, Tsampasian et al. looked at what the risk factors were for developing post−COVID-19 condition (also known as Long Covid). The systematic review and meta-analysis of 41 studies, including 860 783 patients, found that female sex, older age, higher body mass index, smoking, preexisting comorbidities, and previous hospitalisation or ICU admission were risk factors significantly associated with developing Long Covid, and that SARS-CoV-2 vaccination with two doses was associated with lower risk of Long Covid. The findings of this systematic review and meta-analysis provide a profile of the characteristics associated with increased risk of developing Long Covid and suggest that vaccination may be protective against Long Covid.- Posted
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untilThe International Alliance of Patients’ Organizations (IAPO) and Patient Academy for Innovation and Research (PAIR Academy) in partnership with Dakshama Health are launching a series of webinars to introduce the Strategic Framework of the Global Patient Safety Challenge - Medication Without Harm. The theme of the 5th webinar of the medication without harm webinar series is "Medication safety in high-risk situations”. This webinar will emphasise how to address high-risk situations and reduce the risk of medication-related harm, within WHO’s Global Patient Safety Challenge: Medication Without Harm, to improve medication safety. The patient safety series of webinars will focus on the strategic framework of the Global Patient Safety Challenge, which depicts the four domains of the challenge: patients and the public, health care professionals, medicine, and systems and practices of medication, and the three key action areas—namely polypharmacy, high-risk situations, and transitions of care, The series of webinars will share challenges, technical strategies, tools, and patient experiences in implementing the Strategic Framework of the Global Patient Safety Challenge to reduce medication-related harm. Register #medicationwithoutharm #medicationsafety #medications #patientafety #safemeds- Posted
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untilThis webinar by the Institute for Safe Medication Practices in the US is aimed at: Pharmacists, physicians, nurses Medication safety officers Quality professionals Risk managers Leaders in pharmacy and nursing Pharmacy and anaesthesia technicians Although most medications in healthcare today have a wide margin of safety, there remains some which can cause serious harm or death if they are misused. To reduce the risk of error with these “high-alert” medications, special precautions and high leverage strategies should be implemented to avoid serious patient safety events. Many organizations have taken steps to identify these medications, but many are still less than confident that they have taken all the necessary precautions with high-alert drugs against serious patient harm. Join the ISMP faculty as we examine and define the importance of high alert medications as part of routine patient care and review the results of ISMP’s National Medication Safety Self Assessment® for High-Alert Medications with particular attention to vasopressors and insulin. Faculty will review specific safety characteristics of each these important drug classes, describe self assessment findings related to the use of these medications and discuss the necessary strategies for harm prevention when using these medications. Register for the webinar 3.00pm Eastern Time (US and Canada), 8.00pm GMT- Posted
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Some of those most at risk are still not on the Covid vaccine priority list
Patient Safety Learning posted a news article in News
With the first phase of the UK’s vaccination programme now fully under way, the government’s self-congratulatory tone suggests all clinically vulnerable groups are soon in line for protection. There’s certainly reason to be positive: millions of people are on their way to safety. But look a little closer and many high-risk people are struggling to access the vaccine. When the vaccine was first introduced last year, the Joint Committee on Vaccination and Immunisation (JCVI) put shielders – or the “clinically extremely vulnerable” (CEV) – as low as sixth on the priority list, behind older people with no underlying health conditions. It resulted in the baffling situation where a marathon-running 65-year-old was given priority for the vaccine over a 20-year-old with lung disease who needs oxygen support. The government U-turned after pressure, moving CEV people up to fourth spot behind healthy over-75s. These are complex calculations, but there are still fears some will miss out. Some young disabled people who don’t meet the government’s narrow criteria of CEV and are worried they won’t be prioritised at all. Shielders – many of whom are of working age and live with children – also have extra risk factors compared with older people. As the British Medical Association said this month, we need a more sophisticated vaccine delivery that takes into account circumstantial factors such as race, health inequality and employment. I’ve received many messages from shielders who are terrified of being forced out to work, or of schools reopening before they get their vaccine. There are also those with learning disabilities to consider. Currently, only older people with a learning disability, those who have Down’s syndrome or people who are judged as having a severe learning disability are on the priority list. This means that people with a mild or moderate learning disability aren’t prioritised at all. This is despite the fact all people with learning disabilities have a death rate six times higher than the general population. Young adults with a learning disability are 30 times more likely to die of Covid than young adults in the general population. Read full story Source: The Guardian, 3 February 2021 -
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The NHS needs to protect the GPs at high risk from covid
Clive Flashman posted a news article in News
Dr Rebecca Fisher gives the lowdown on why maintaining general practice as a ‘front door’ to the NHS that is safe for both GPs and patients is not easy. It’s fair to say that Matt Hancock’s pronouncement that henceforth all consultations should be “teleconsultations unless there’s a compelling reason not to”, has not been universally welcomed in general practice. In my surgery, practicing in a pandemic has seen us change our ways of working beyond imagination. In March, like many other practices, we shifted overnight to a “telephone first” approach. And whilst at peak-pandemic we kept face-to-face consultations to a minimum, we’re now seeing more and more patients in person again. Although many consultations can be safely done over the phone, we’re very clear that there are some patients – and some conditions and circumstances – where a patient needs a face-to-face appointment with a GP. NHS England have also been clear that all practices must offer face-to-face consultations if clinically appropriate. But maintaining general practice as a “front door” to the NHS that is safe for both GPs and patients is not easy. Options to quarantine and pre-test patients set out in national guidance and intended to help protect secondary care cannot be deployed in primary care. Other national guidance – for example regarding wearing masks in clinical sites – often seems to be issued with secondary care in mind, with little or delayed clarity for primary care. Measures like maintaining social distancing are also likely to be harder in general practice, where the ability of a surgery to physically distance staff from each other, and patients from each other and staff, is in part dependent on physical factors. Options to quarantine and pre-test patients set out in national guidance and intended to help protect secondary care cannot be deployed in primary care Things like the size and layout of a practice, or the availability of a car park for patients to wait in are hard to change quickly. Stemming from those challenges are ones related to staffing; how to keep practice staff safe from covid-19? NHS England and the British Medical Association have stated that staff should have rigorous, culturally sensitive risk assessment and consider ceasing direct patient contact where risks from covid-19 are high. The risk of catching COVID-19 – or dying from it – is not equally distributed amongst GPs. Age, sex, ethnicity, and underlying health conditions are all important risk factors. New Health Foundation research finds that not only are a significant proportion of GPs at high or very high risk of death from covid-19 (7.9 per cent), but one in three single-handed practices is likely to be run by a GP at high risk. If those GPs step back from face-to-face consultations we estimate that at least 700,000 patients could be left without access to in-person appointments. Even more concerningly, there’s a marked deprivation gradient. If GPs at high risk from COVID-19 step back from direct face-to-face appointments, and gaps in provision aren’t plugged, the patients likely to be most affected are those in deprived areas – the same people who have already been hardest hit by the pandemic GPs at high risk of death from covid are much more likely to be working in areas of greater socioeconomic deprivation. And single-handed practices run by GPs classed as being at very high risk from covid are more than four times as likely to be located in the most deprived clinical commissioning groups than the most affluent. If GPs at high risk from COVID-19 step back from direct face-to-face appointments, and gaps in provision aren’t plugged, the patients likely to be most affected are those in deprived areas – the same people who have already been hardest hit by the pandemic. Where do solutions lie? Ultimate responsibility for providing core general practice services to populations lies with CCGs. In some areas, collaborations between practices (such as GP federations and primary care networks), may be able to organise cross-cover to surgeries where face-to-face provision is not adequate to meet need. But these collaborations have not developed at equal pace across the country, have many demands on their capacity and may not be sufficiently mature to take on this challenge. These local factors – including the availability of locums – will need to be considered by commissioners. It’s vital that CCGs act quickly to understand the extent to which the concerns around GP supply highlighted by our research apply in their localities. In some cases, additional funding will be needed to enable practices to ‘buy in’ locum support for face-to-face consultations. This should be considered a core part of the NHS covid response. Face-to-face GP appointments remain a crucial NHS service, and must be available to the population in proportion with need. Just as in secondary care, protecting staff, and protecting patients in primary care will require additional investment. Failure to adequately assess the extent of the problem, and to provide sufficient resource to engineer solutions is likely to further exacerbate existing health inequalities. Original Source: The HSJ- Posted
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My brain scan was urgent, but because of Covid-19 it didn't go ahead
Clive Flashman posted a news article in News
Doctors and surgeons’ leaders have issued a warning that the NHS must not shut down normal care again if a second wave of Covid-19 hits as that would risk patients dying from lack of treatment. Here, one patient tells her story. Marie Temple (not her real name) was distraught when her MRI was cancelled in March, shortly after the UK went into lockdown and Boris Johnson ordered the NHS to cancel all non-urgent treatment. Temple, who lives in the north of England, was diagnosed with a benign brain tumour last year after suffering seizures and shortly afterwards had surgery to remove it. She had been promised a follow-up MRI scan in late March to see if the surgery had been a success, but she received a letter saying her hospital was dealing only with emergency cases and she didn’t qualify. Read the full article here.- Posted
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New analysis lays bare government’s failure to protect social care from COVID-19
Clive Flashman posted a news article in News
New analysis by the Health Foundation reveals the devastating impact the pandemic has had on social care in England. The independent charity says the findings provide further evidence that the government acted too slowly and did not do enough to support social care users and staff, and that protecting social care has been given far lower priority than the NHS. The Health Foundation finds that policy action on social care has focused primarily on care homes and that this has risked leaving out other vulnerable groups of users and services, including those receiving care in their own homes (domiciliary care). It also notes that the shortcomings of the government’s response have been made worse by longstanding political neglect and chronic underfunding of the social care system. Since March there have been more than 30,500 excess deaths* among care home residents in England and 4,500 excess deaths among people receiving domiciliary care. While high numbers of excess deaths of people living in care homes have been well reported, the analysis shows there has been a greater proportional increase in deaths among domiciliary care users than in care homes (225% compared to 208%). And while deaths in care homes have now returned to average levels for this time of year, the latest data (up until 19 June) shows that there have continued to be excess deaths reported among domiciliary care users. The Health Foundation says that decades of inaction by successive governments have meant that the social care system entered the pandemic underfunded, understaffed, and at risk of collapse. Read full article here. -
News Article
Quarter of BAME staff have not had a covid risk assessment
Clive Flashman posted a news article in News
More than a quarter of black, Asian and minority ethnic NHS staff had not yet had a risk assessment in relation to their exposure to coronavirus, according to the latest data collection by national NHS leaders. Full article here on the HSJ website (paywalled)- Posted
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Government censored BAME covid-risk review
Patient Safety Learning posted a news article in News
The government removed a key section from Public Health England’s review (published Tuesday) of the relative risk of COVID-19 to specific groups, HSJ has discovered. The review reveals the virus poses a greater risk to those who are older, male and overweight. The risk is also described as “disproportionate” for those with Asian, Caribbean and black ethnicities. It makes no attempt to explain why the risk to BAME groups should be higher. An earlier draft of the review which was circulated within government last week contained a section which included responses from the 1,000-plus organisations and individuals who supplied evidence to the review. Many of these suggested that discrimination and poorer life chances were playing a part in the increased risk of COVID-19 to those with BAME backgrounds. HSJ understands this section was an annex to the report but could also stand alone. Typical was the following recommendation from the response by the Muslim Council of Britain, which stated: “With high levels of deaths of BAME healthcare workers, and extensive research showing evidence and feelings of structural racism and discrimination in the NHS, PHE should consider exploring this in more detail, and looking into specific measures to tackle the culture of discrimination and racism. It may also be of value to issue a clear statement from the NHS that this is not acceptable, committing to introducing change.” One source with knowledge of the review said the section “did not survive contact with Matt Hancock’s office” over the weekend. Read full story Source: HSJ, 2 June 2020- Posted
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Asymptomatic people will have to self-isolate after contact with COVID-19 cases
Patient Safety Learning posted a news article in News
People will be asked to self-isolate for two weeks even if they are asymptomatic after coming into ‘high-risk’ contact with a person who has tested positive for COVID-19 – a testing chief has told NHS executives. This marks a change from the official guidance given to users of the government’s contact tracing app – on NHS’ COVID-19 website – which states: “If you do not have symptoms, you do not need to self-isolate at this time.” John Newton, a leader of the UK’s testing programme, would be “directed towards those people at high risk” instead of the wider public. He added the government faces a “huge communications exercise” next week ahead of the launch of the test and trace programme. Giving an update on the test and trace programme – which is due to launch on 1 June – Professor Newton said: “People who are deemed high risk contact of confirmed [COVID-19] cases will be told to self-isolate for 14 days, even if they have no symptoms at the time. Professor Newton said: “The point is there will still be a requirement to contain the virus, but the impact in terms of containment will be directed towards those people at high risk so the rest of the population can enjoy more normal life." He said the programme’s success would depend on the public’s response in terms of: Presenting themselves for a test if they have symptoms; Providing the information needed to identify high risk contacts; and Those people identified as high risk contacts complying with advice to self-isolate. Read full story Source: HSJ, 21 May 2020- Posted
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During the first wave of the COVID-19 pandemic in England, several population characteristics were associated with an increased risk of death from the virus, including age, ethnicity, income, deprivation, care home residence and housing conditions. Public health agencies wanted to understand how these vulnerability factors were distributed across their communities. Daras et al. from the NIHR Applied Research Collaboration North West Coast (NIHR ARC NWC) analysed 6,789 small areas in England and assessed the association between COVID-19 mortality in each area and five vulnerability measures relating to ethnicity, poverty, and prevalence of long-term health conditions, living in care homes and living in overcrowded housing. They developed a Small Area Vulnerability Index (SAVI) modelling tool, which forecasts the vulnerability of the local population to the virus. The data identified noticeably higher levels of vulnerability to COVID-19 clustered within specific communities in the North West, West Midlands and North East regions. -
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'High risk' list misses off thousands of people
Patient Safety Learning posted a news article in News
Thousands of people have been missed off the government's high risk list for Covid-19 despite meeting the criteria. Among them have been transplant patients, people with asthma and some with rare lung diseases. Many are worried it will affect their ability to access food and medical supplies as they shield from the virus, unable to leave their homes for at least 12 weeks. "It's like she's been forgotten," said Bev Pearson, mother of 20-year-old heart transplant patient Lucy Pearson. Miss Pearson, from Whitsbury in Fordingbridge, Hampshire, had her transplant 14 years ago and still visits hospital for regular check-ups. She has been shielding in the home she shares with her mother, brother and sister - none of whom have been venturing out in an attempt to protect her. Despite registering her daughter on the government list herself, she said she had received no confirmation. When she asked her GP she was told it had "nothing to do with the surgery", she added. Read full story Source: BBC News, 7 April 2020- Posted
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Covid-19 vaccination is effective for cancer patients but protection wanes much more rapidly than in the general population, a large study has found. Vaccine effectiveness is much lower in people with leukaemia or lymphoma, those with a recent cancer diagnosis, and those who have had radiotherapy or systemic anti-cancer treatments within the past year, according to the research published in Lancet Oncology. The authors of the world’s largest real world health system evaluation of Covid-19 in cancer patients highlighted the importance of booster programmes, non-pharmacological strategies, and access to antiviral treatment programmes in order to reduce the risk that Covid-19 poses to cancer patients. Peter Johnson, professor of medical oncology at the University of Southampton and joint author of the study, said, “This study shows that for some people with cancer, covid-19 vaccination may give less effective and shorter lasting protection. This highlights the importance of vaccination booster programmes and rapid access to covid-19 treatments for people undergoing cancer treatments.” Study leader, Lennard Lee, department of oncology, University of Oxford, said, “Cancer patients should be aware that at 3-6months they are likely to have less protection from their coronavirus vaccine than people without cancer. It is important that people with a diagnosis of cancer are up to date with their coronavirus vaccination and have had their spring booster if they are eligible.” Read full story Source: BMJ, 24 May 2022 -
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IMPARTS is an evidence based website with guides aimed at people with long term conditions (such as acute kidney injury, COPD and diabetes) and COVID-19. IMPARTS has put together a list of resources from condition-specific charities which they hope will help and provide reassurance during this time. This includes specific advice on the following: Coping with stress during COVID-19 (World Health Organisation) Sleep anxiety: tips to manage and improve sleep (The Sleep Council) Looking after your mental health during Coronavirus (The Mental Health Foundation) Coronavirus and your wellbeing (MIND) COVID recovery online course (Lancashire Teaching Hospitals NHS Foundation Trust) Health unlocked – a holistic approach to healthcare OCD and COVID-19 survival tips (OCD UK).- Posted
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