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Content Article
On the 19 March 2025 the Department of Health launched a consultation on the introduction of a new Regional Framework for Learning and Improvement from Patient Safety Incidents and supporting documentation to replace the current Serious Adverse Incident (SAI) Procedure in Northern Ireland. As part of this process, the Patient & Client Council held a public engagement event on this issue. This included members of the public with lived experience of the current SAI process, those with a general interest, members of the voluntary and community sector, health and social care staff and leaders, healthcare regulation and Patient & Client Council members. This report summarises the views expressed in this event and follow-up written responses shared with Patient & Client Council. They heard from a range of views and experiences, and we have collated these under key themes arising from the engagement conversations. Some of these themes were reflected in the answers to more than one question.- Posted
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News Article
'I'm terrified of food - but I can't get specialist eating disorder treatment'
Patient Safety Learning posted a news article in News
A woman whose wait for a diagnosis of a lesser known eating disorder left her feeling like a "problem that cannot be solved" has called for reform of how the condition is treated by Northern Ireland's health service. Sinead Quinn, from Londonderry, said binge eating compulsions had made her "a prisoner in her own home, afraid of food and afraid of herself". Binge Eating Disorder (BED) is not currently treated by eating disorder services in Northern Ireland - patients are instead referred to general mental health services. The Department of Health said regional adult eating disorder services were commissioned to treat anorexia, bulimia and atypical presentations of these conditions. BED is the second most common eating disorder in the UK, after atypical eating disorders, according to UK health assessment body NICE, external. The Department of Health said it did not collate data on how many people in Northern Ireland are living with BED. It also said there was no current review of the way the condition is treated. Experts say specialist care within the health service is urgently needed to help people get a formal diagnosis and recover from BED. Prof Laura McGowan, from the Centre for Public Health at Queen's University, hopes the recently announced roll-out of a regional obesity management service for Northern Ireland would include screening of eating disorders like BED. "BED is simply not widely recognised and the services for it not widely commissioned," she said. "For BED patients, especially those living with obesity, there is such an unmet need." Read full story Source: BBC News, 5 June 2025- Posted
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News Article
The health minister has said the recruitment of up to 26 emergency medicine consultants will help stabilise and strengthen the healthcare workforce in Northern Ireland. The Department of Health said some of the consultants are already in post, with the others set to begin in their roles across all five health trusts by the end of the year. It said funding for the new posts comes from reducing spending on locum doctors in emergency departments and that it comes as part of work to find roles for newly-qualified consultants in the health system. Mike Nesbitt said everyone was "acutely aware of the very significant pressures" on emergency departments. "Both staff and patients want us to do all we can to alleviate those pressures and that's been a central focus for my department and trusts in recent months." Prof Lourda Geoghegan, deputy chief medical officer, said she was "very encouraged" by early reports on the impact of the new consultants, who had not only helped reduce locum spending but also increased the "presence of senior decision-making in emergency departments". Read full story Source: BBC News, 27 May 2025- Posted
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- Emergency medicine
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News Article
Poor mental health a 'common phenomenon' in healthcare staff
Patient Safety Learning posted a news article in News
A charity set up to help doctors and healthcare professionals with their mental health in Great Britain has extended its services to Northern Ireland. Doctors In Distress was established by Amandip Sidhu in 2019, when his consultant cardiologist brother took his own life due to "overwhelming work pressure and burnout". Mr Sidhu said he came to learn that this is "a common phenomenon" within healthcare professions. Figures, published by the British Medical Association (BMA) NI show that 62% of doctors in Northern Ireland report "higher than normal levels fatigue or exhaustion". Speaking to the BBC's Good Morning Ulster programme on Wednesday, Dr Alan Stout from the BMA said the figures show that the problem is "more acute in Northern Ireland". Mr Stout welcomed the charity's services to Northern Ireland, but said "we need to go further", and "a dedicated health service for doctors in Northern Ireland" is required. Read full story Source: BBC News, 30 April 2025- Posted
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- Mental health
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Event
Things can and do go wrong in health and social care. There is an expectation that when things do go wrong, HSC organisations treat those affected with respect, compassion and honesty. That they help members of the public understand what happened and they demonstrate that they have learned from the incident, to reduce the risk of it happening again. Recommendations arising from a number of Inquiries and Reviews have contributed to a clear and strong evidence base underpinning the need to redesign the current approach to learning following Adverse Incidents and SAIs. The Department of Health is therefore holding a public consultation on the redesign of the current Serious Adverse Incident (SAI) procedure in Northern Ireland. The SAI review process is intended to play an important role in securing improvements in the quality and safety of health and social care (HSC) services by ensuring that incidents are identified, reported and investigated as appropriate so that learning can be shared across the HSC system. Some of the key aims of the new draft Framework include: Providing a more streamlined and simplified process for reviewing Patient Safety Incidents, to ensure reviews are of a high quality; Place all those affected at the heart of the process; Focus on understanding how and why a Patient Safety Incident has occurred to identify system-wide learning leading to demonstrable and sustainable improvements in care. The proposed framework for Learning and Improvement from Patient Safety Incidents will form a key part of the HSC’s patient safety system and it is therefore crucially important that it is the right approach. The Department of Health would therefore like to hear directly from the public on these important proposals. The PCC is facilitating an online consultation event, to be led by Department of Health officials, on Thursday 15 May 2025, at 17:30. This event will also assist those intending to make a written response to the consultation. Register- Posted
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- Northern Ireland
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Content Article
This Independent Report led by Professor Mary Renfrew was commissioned in May 2023 by the Department of Health (DoH) Northern Ireland (NI). It forms part of a broad programme of work to receive assurance on the safety of maternity and neonatal services for the population of NI. It resulted from two related developments: A request from the Coroner for Northern Ireland that the Department of Health NI take action to investigate her concerns following an inquest into the death of a baby that raised questions about care in Freestanding midwifery led units (MLUs). In the inquest report the Coroner identified a number of practice and system failings and shortcomings including the management of shoulder dystocia, fetal macrosomia (the baby being large for gestational age), and raised maternal body mass index (BMI). At the time of the inquest, all Freestanding MLUs in NI were closed. The Coroner found that a comprehensive review of the number of staff, experience, training, and policies should be conducted by the DoH, in the event of these Units reopening in the future. In response to this request, the Permanent Secretary asked the Chief Nursing Officer (CNO) for NI, along with the Midwifery Officer, to instigate an inquiry into the issues highlighted by the Coroner. Several other reports, both local and national, concerning the safety of services for pregnant women, new mothers, and babies required consideration of the wider health service context that influences midwifery and maternity care and services. In summary, the report advocates for the following changes: A shared strategic vision for safe, quality midwifery and wider maternal and newborn services in Northern Ireland with a regional framework for action. A reconfigured relationship with women, families and communities, ensuring respectful personalised care for all and a genuine voice in shaping services. A consistent, region-wide, evidence-informed approach to planning, funding, standards, provision, monitoring, and review of maternity and neonatal services. Improving clinical, psychological, and cultural safety and equity for women, babies and families across the whole continuum of care and in all settings. Changing the prevailing work culture to implement an enabling environment for all staff and managers, including ensuring midwives are represented at senior management levels, tackling silo working, and developing an open learning culture at every level of the system. Supporting midwives to provide quality midwifery care and services across the whole continuum of maternal and newborn care, with investment in community as well as hospital services, and increasing midwives’ influence over the safety and quality of care and services. Better oversight through improved accountability, monitoring, evaluation, and research. A unified approach to education and training of all staff, including leadership development - especially for midwives - and capacity building for the future.- Posted
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News Article
Fake weight loss injections with dirty needles being sent to NI
Patient Safety Learning posted a news article in News
Illegal weight loss injections with dirty needles are being sold over social media and sent to people in Northern Ireland, a BBC investigation has found. BBC News NI made test purchases of syringes which claimed to contain semaglutide, a prescription-only drug, via Facebook from sellers based in England. When tested, the liquid was not semaglutide but did contain carnitine – a supplement that can be bought on the high street. The Police Service of Northern Ireland (PSNI) said it was working at an international level to root out criminal gangs selling illicit jabs manufactured in unhygienic labs. So-called skinny jabs are prescribed weight loss injections that work by making you feel fuller and less hungry. In Great Britain, semaglutide is available on the NHS as part of a weight management programme. However, in Northern Ireland it is not as there is no specialist weight management service, but it is available on private prescription. The Department of Health in Northern Ireland said people were putting themselves at serious risk buying from sellers on social media sites. Read full story Source: BBC News, 14 April 2025- Posted
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- Obesity
- Medication
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News Article
Obsolete imaging equipment raises concerns in NI hospitals
Patient Safety Learning posted a news article in News
A report from the Northern Ireland Audit Office has found that 16% of imaging equipment used in healthcare settings is “effectively obsolete”. Comptroller and Auditor General Dorinnia Carville has raised concerns over the “substantial proportion of out-of-date equipment” and a growing gap between demand and capacity. Northern Ireland’s Department of Health said that while some of the equipment base “would ideally be replaced at a quicker rate”, it remains “safe and fit for purpose”. The report noted that around 90% of all hospital patients have images taken and interpreted. It said that increasing recognition of the benefits of imaging services has resulted in a “growing demand for them”. The report added: “Combined with changing patient demographics, and an absence of sustainable funding and resources, capacity has been unable to keep pace.” The report found that between 2018 and 2024, the health service delivered a total of 350,000 fewer scans (MRI, CT, and non-obstetric ultrasound scans) than what was required to meet demand. Similarly, waiting lists and waiting times for imaging services have risen in that period. The report said that timely replacement of imaging equipment is one of the “key components to service delivery and quality”. It said: “Currently 16% of all HSC imaging equipment is over 10 years old and is effectively obsolete. Older equipment can result in increased downtime and maintenance costs. It can also be potentially slower, reducing the number of patients which can be scanned, and may produce lower quality images meaning an increased risk of missed disease.” Read full story Source: Medscape, 31 March 2025- Posted
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- Screening
- Medical device / equipment
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Content Article
Sir Justice O’Hara’s report raises serious concerns about the standard of healthcare delivered to five children who tragically died in Northern Ireland as a result of hyponatremia related illnesses between 1995-2001. The report also identified system failures in the investigation of the deaths. This is the joint response to the report from the Royal College of Paediatrics and Child Health, Royal College of Surgeons (England), Royal College of Surgeons (Edinburgh), Royal College of Anaesthetists and Royal College of Pathologists.- Posted
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Content Article
In this blog, Patient Safety Learning highlights key issues included in its response to the Department of Health consultation on the draft ‘Being Open’ Framework and establishment of a Duty of Candour in Northern Ireland. In December 2024, the Department of Health launched a public consultation asking for views on its draft ‘Being Open’ Framework. Describing the proposed Framework, Health Minister Mike Nesbitt stated: “The ‘Being Open’ Framework aims to ensure that individuals within our health and social care system are fully empowered to exercise candour and openness, and that health and social care organisations have in place the necessary support and systems required to enable and nurture a truly open culture.”[1] The Framework aims to address some of the recommendations made in the 2018 report from the Inquiry into Hyponatraemia Related Deaths (IHRD) by Justice O’Hara KC.[2] This Inquiry was published following an extensive investigation into the deaths of five children in hospitals. The report’s recommendations included the introduction of a Duty of Candour in Northern Ireland. The purpose of the ‘Being Open’ Framework set out in the consultation document is as follows: To improve patient safety and the quality of services by developing an open, just and learning culture. To ensure that all people in contact with healthcare organisations (employees, patients, relatives and the public) can expect to be treated in an open, fair and compassionate way. That patients and those supporting them will be listened to, understood and treated with respect. That healthcare staff are entitled to visible, engaged and inclusive leadership. That senior leaders will listen to concerns and create safe spaces for learning. That learning will be promptly disseminated across the system.[3] Below we summarise the key points included in Patient Safety Learning’s response to this public consultation. Openness and culture The ‘Being Open’ Framework at its core places a strong emphasis on the principle of openness in the healthcare system. It looks at this on three levels: Routine openness: being honest in everyday care and communication. Learning from mistakes: reflecting on errors to improve and avoid repeating them. When things go wrong: clear communication and accountability when harm is caused. We welcome the Framework’s commitment to openness with patients and its focus on learning from mistakes. We stated this in our consultation response, while highlighting the need for proposed training and support for staff to be accompanied by a commitment by their organisation to support a culture of openness. We believe that this requires a clear leadership commitment to create a working environment for their staff where they feel psychologically safe to raise patient safety concerns. In our response, we also mentioned the importance of being open with patients and families following patient safety incidents and in the incident investigation process itself. To facilitate this, we set out that: It is important for staff to understand who is responsible for ensuring meaningful and compassionate engagement with patients and families. This needs to be accompanied by processes that enable organisations to evaluate how both to assess and meet the needs of patients and families in these processes. Having sufficient well-trained staff, with time for engagement, is essential if this is to be achieved. These issues around patient safety investigations is something we will come back to in more detail at a later date as part of our response to the new public consultation on the redesign of the current Serious Adverse Incident procedure for Northern Ireland.[4] Duty of Candour The consultation poses questions about the introduction of a Statutory Duty of Candour for organisations and individuals in Northern Ireland, a key recommendation of the IHRD. In our response, we state our support for this. Everyone working in healthcare must be open and honest in all their dealings with patients and the public. We also make clear that the introduction of Duty of Candour is a process that takes time and requires significant resources to embed. Highlighting the challenges of this, we pointed to the experience of introducing a Statutory Duty of Candour for health and care providers in England, first enshrined in law for all NHS Trusts in 2014. As results of last year’s call to evidence illustrate, even now there is still a significant gap between what is said and understood in regard to Duty of Candour, and what takes place in practice at many healthcare organisations.[5] Patient Safety Commissioner We also expressed our support for the potential introduction of a new role of Independent Patient Safety Commissioner in Northern Ireland. This is one of the options that the ‘Being Open’ Framework suggests exploring to help to monitor and scrutinise its implementation. This new post alone cannot improve openness and patient safety. However, with the right remit and responsibilities, we believe that it could play a potentially important role in supporting this and championing the voice of patients. In our response, we stressed that if such a role was introduced it was important to ensure that they had a clear remit, with the ability to advocate for systemic improvement and look at safety issues across health and care. The Patient Safety Commissioner for England currently has a remit that is restricted to medicines and medical devices, which in our view places an unnecessary limitation on the role. This can also create confusion for patients who want to highlight a clear patient safety issue that does not fall under the guise of medicines and medical devices. This can reinforce an inequity of treatment for patients affected by these issues, with there being no alternative pathway for them to raise such concerns outside the Commissioner’s scope. This is a problem that has been highlighted directly by the inaugural Patient Safety Commissioner for England, Professor Henrietta Hughes.[6] We also stated the need to ensure that a new Patient Safety Commissioner in Northern Ireland would have clear operational independence. They should feel able to ‘speak truth to power’ and represent the best interests of patients and the wider public. To support this aim, we believe that this role would need to be independent from those funding and delivering healthcare. Finally, we noted that it would be useful for the new postholder to establish a strong working relationship with the Patient Safety Commissioner for England and, when appointed, the Patient Safety Commissioner for Scotland. This would enable them to coordinate in the future on emerging patient safety concerns and share examples of good practice. Engaging with patients and the Patient and Client Council One area where we felt that the ‘Being Open’ Framework could be strengthened was in relation to patient engagement and involvement. While further changes may emerge in this area from feedback to the consultation itself, we also highlighted in our response the value of giving greater consideration to the role the Patient and Client Council (PCC) can play in the delivery of this. The PCC is a statutory body in Northern Ireland that provides a powerful and independent voice for patients, clients, carers and communities on health and social care issues through: Representing the interests of the public. Promoting the involvement of the public. Assisting people in making, or intending to make, a complaint. Promoting the provision by health and social care bodies of advice and information to the public about the design, commissioning and delivery of services. Undertaking research into the best methods and practices for consulting and engaging the public.[7] We believe that these functions of the PCC align with the core aims of the ‘Being Open’ Framework, and their existing knowledge and experience could help to support the implementation of this. Commenting on specific aspects of this, we noted the following points: In potentially creating a new Patient Safety Commissioner role, consideration would need to be given as to how its remit and responsibilities relate to and complement the existing role of the PCC. When discussing “Openness with a focus on learning” and “Openness when things go wrong”, the Framework talks about organisations having patient safety incident investigations that involve patients. The PCC’s work involving patients and communities in the design, delivery and evaluation of services could support embedding these principles in practice. Training and education We also welcome proposals in the ‘Being Open’ Framework to provide training and support to staff to properly understand and exercise their responsibilities to be open routinely and focused on learning and when things go wrong. In our consultation response we also placed particular emphasis on the need to consider how this applies to those in leadership positions. At Patient Safety Learning we believe that good leadership can drive patient safety performance, supporting learning from unsafe care and putting in place clear governance processes to enable this. In our Patient Safety Standards we identify the need for Board members (Executives and Non Executives) and governors to be provided with training and support in relation to compliance with Duty of Candour and being open as a key requirement for healthcare organisations.[8] We believe there would be value in also reflecting that in the ‘Being Open’ Framework. Concluding comments We strongly support the introduction of the ‘Being Open’ Framework in Northern Ireland. We also welcome that it directly acknowledges the importance of having a clear implementation plan to take this work forward. Importantly, it also recognises that neither legislation nor policy alone will necessarily inspire the behaviours that are intrinsic to an open organisation, emphasising the importance of taking action needed to promote behaviours and beliefs that enable this. In our concluding comments to the consultation, we highlighted further consideration how the implementation of the Framework could potentially form part of a wider application of a safety management system approach to health and social care in Northern Ireland. A safety management system is a proactive approach to managing safety that is used in other industries. It sets out the necessary organisational structures and accountabilities to manage safety risks. It requires safety management to be integrated into an organisation’s day-to-day activities.[9] References Department of Health. Consultation on ‘Being Open’ Framework and Duty of Candour launched, 10 December 2024. IHRD. Report of the Inquiry into Hyponatraemia related Deaths, 31 January 2018. Department of Health. Draft Regional being Open Framework for the HSC, 10 December 2024. Department of Health. Framework for Learning and Improvement from Patient Safety Incidents Consultation, 11 March 2025. Department of Health and Social Care. Findings of the call for evidence on the statutory duty of candour, 26 November 2024. Emily Townsend. Safety watchdog urges Streeting to expand her role. HSJ, 24 October 2024. PCC. Who we are and what we do. Last accessed 28 March 2025. Patient Safety Learning. Why Standards? Last Accessed 24 March 2025. HSSIB. Safety management systems: accountability across organisational boundaries, 13 February 2025.- Posted
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Content Article
This guidance aims to provide an overview and an understanding and the benefits of AAR and advice to assist with its introduction and implementation within services so that it adds value and is sustainable.- Posted
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- PSIRF
- After action review
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Content Article
The Department of Health is undertaking a consultation on the introduction of a new Regional Framework for Learning and Improvement from Patient Safety Incidents and supporting documentation to replace the current Serious Adverse Incident (SAI) Procedure in Northern Ireland. The closing date is 20 June 2025 at 5.00pm. The proposed new draft Regional Framework for Learning and Improvement from Patient Safety Incidents is intended to replace the existing SAI procedure in Northern Ireland. Evidence from inquiries and reports – including the Regulation and Quality Improvement Authority Review of Systems and Processes for Learning from Serious Adverse Incidents, the inquiry into Hyponatraemia-related Deaths report and the Independent Neurology Inquiry - highlight that aspects of the current SAI procedure need to be refreshed and redesigned. The key aims of this new draft Framework is to: Providing a more streamlined and simplified process for reviewing Patient Safety Incidents, to ensure reviews are of a high quality; Place all those affected at the heart of the process; Focus on understanding how and why a Patient Safety Incident has occurred to identify system-wide learning leading to demonstrable and sustainable improvements in care. The consultation will focus on the following four draft documents: The Framework for Learning and Improvement from Patient Safety Incidents Regional Standards for the Conduct of Patient Safety Incident Learning Reviews Principles for Engaging, Involving and Supporting All those Affected by a Patient Safety Incident Principles for Engaging, Involving and Supporting Staff Affected by a Patient Safety Incident- Posted
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- Patient safety incident
- Investigation
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News Article
Elderly patients' five-day wait in 'intolerable' A&E
Patient Safety Learning posted a news article in News
Two elderly patients have been in the emergency department (ED) of the Royal Victoria Hospital (RVH) in Belfast for more than five days, BBC News NI can reveal. This comes after more than 500 patients were unable to be discharged from Northern Ireland's hospitals on Sunday night, despite being medically fit. With no suitable care for them in the community, it meant they remained in beds preventing other sick people from being admitted to hospital wards. Lead nurse Claire Wilmont said that staff in the RVH were "treating the most vulnerable elderly sick patients in an intolerable environment". At 17:00 GMT on Monday, 1,052 people were in Northern Ireland's nine EDs, up from 797 on Sunday night. There were 349 people who had waited more than 12 hours. The Department of Health said longer-term solutions required sustained investment and reform. Read full story Source: BBC News, 6 January 2025- Posted
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- Older People (over 65)
- Accident and Emergency
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Event
untilThe Professional Standards Authority (PSA) and the Patient and Client Council (PCC) have complementary organisational objectives of public protection and representing the interests of the public in health and social care. This event will focus on how we can improve patient safety by embracing the public as assets and developing workplace culture. This event builds on ongoing conversations across the system, including those hosted by PCC at NICON and we consider that it will have significant relevance for a number of key focus areas across Health and Social Care (HSC) in Northern Ireland, including the Department of Health’s openness work, the duty of candour and emerging issues from public inquiries. The event is aimed at leaders across the HSC, healthcare regulators, the voluntary and community sectors, representative bodies and members of the public. It will take the format of two panel discussions following on from presentations by our speakers, with opportunities for Q&A from participants. Confirmed speakers include: Sarah Castell, Chief Executive of Involve and Co-Author of the Citizens White Paper Helen Hughes, Chief Executive of Patient Safety Learning Jim Wilkinson, Deputy Secretary, Healthcare Policy Group, Department of Health Patricia Donnelly OBE, Chair of the Assurance Group for the Department of Health Northern Ireland, Independent Inquiries Programme Management Board Paula Bradley, PCC Council Member Matthew Redford, Chief Executive of the General Osteopathic Council Dr Nazia Latif, Regulatory Quality and Improvement Authority Professor Owen Barr, Professor of Nursing and Intellectual Disabilities, Ulster University Paul Whiteing, Chief Executive, Action Against Medial Accidents Peter McBride, Independent Consultant. Register -
Content Article
The Northern Ireland Public Services Ombudsman has released its Ombudsman Report for 2023-24. Commenting on its release, Ombudsman Margaret Kelly said: “Resolving complaints as early as possible is much more effective and less costly than an elongated complaints process. In this report I am reflecting on the importance of improving and building public trust through robust investigation and meaningful learning from complaints. This has included the critical role of complaints as an early warning system in improving patient safety, the vital importance of complaints and engagement with local communities on the environment, and the importance of listening to complaints from some of the most vulnerable in our society, particularly those who may be experiencing housing difficulties. More broadly this year we have also focused on introducing statutory complaints standards for public bodies. This is fundamental to improving trust in our public services. Mistakes and errors are unfortunately a part of life and can never be fully eradicated. However, together we must move from a culture which is sometimes defensive with a lack of openness towards a culture which values complaints as an opportunity to learn and prevent future harm.”- Posted
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News Article
Northern Ireland women face 'foetal scan discrimination'
Patient Safety Learning posted a news article in News
Pregnant women in Northern Ireland face discrimination over not being offered early scans for foetal abnormalities, according to gynaecology experts. Early scans are routine in the rest of the UK. Several patients, who contacted BBC News NI, described the trauma they experienced after their "non-viable" pregnancies were not detected until about 20 weeks. In Scotland, Wales and England antenatal screening which tests for anomalies is offered to all pregnant women in the first trimester – between 11 and 13 weeks. The Royal College of Obstetrics and Gynaecology (RCOG) said women in Northern Ireland have foetal abnormalities diagnosed "too late" and should not have to wait until their 20-week scan. Dr Caitriona Monaghan, a consultant in maternal foetal medicine, said the late diagnosis can limit access to care. Read full story Source: BBC News, 3 October 2024- Posted
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- Northern Ireland
- Pregnancy
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Content Article
In March 2024 the Northern Ireland Public Services Ombudsman (NIPSO) brought together a range of voices to help look at ways of improving patient safety and public trust in our health and social care system. With a keynote address from Sir Robert Francis KC, the conference looked at issues such as how to build an open learning culture, and how to design systems which have the interests of patients at their core. The conference report, presentations and recording are available. Conference report (16.3 MB, pdf) Conference programme (18.47 MB, pdf) Opening and keynote address (6.37 MB, pptx) Building an open and just culture (4.57 MB, pptx) Patient-centred safety systems (10.6 MB, pptx) Implementing an effective learning culture (6.22 MB, pptx) Addressing inequalities in patient safety (22.26 MB, pptx) Presentations (3.7 MB, pptx)- Posted
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- Northern Ireland
- Organisational learning
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Content Article
At Patient Safety Learning we often get asked by patients and families who have received poor healthcare what they need to do to make a complaint. Although we cannot get directly involved in individual cases, we have put together a simple guide on the steps you can take if you need to make a complaint about NHS care in Northern Ireland. We also have the following guides: How do I make a complaint about my NHS care in England: a simple guide for patients and families How do I make a complaint about my NHS care in Scotland: a simple guide for patients and families How do I make a complaint about my NHS care in Wales: a simple guide for patients and families How do I make a complaint about my private care: a simple guide for patients and families How do I make a complaint: Sources of help and advice If you are a healthcare professional looking at these pages, the NHS Complaint Standards, model complaint handling procedure and good complaint handling guides set out how organisations providing NHS services should approach complaint handling. They apply to all NHS organisations in England and independent healthcare providers who deliver NHS-funded care. If you are unhappy with the care and treatment you have received from health or social care services in Northern Ireland, you have the right to make a complaint. Your concerns could be about any aspect of your care. Step 1: Make a complaint to the practitioner or institution concerned You can speak directly to a member of staff involved in your care about your complaint and ask for a copy of the complaints procedure. If your complaint relates to services provided by a GP, dentist, pharmacist or optician you can contact the Health and Social Care Board’s complaints office. They will then act as a go-between and offer an ‘honest broker’ service. They may also offer conciliation services if appropriate. If the complaint is about a nursing or residential home, you should contact the home directly, addressing your complaint to the home manager. There are six health and social care trusts in Northern Ireland. Details are available on the Northern Ireland healthcare gateway. If the NHS organisation thinks that your complaint has been fully investigated, they should send you a full written response. They should also tell you what to do next if you are not satisfied. If you remain unhappy, you can refer your complaint to the Northern Ireland Commissioner for Complaints (the Ombudsman). The Ombudsman will then consider whether this is a matter they can investigate—see Step 2. Step 2: Northern Ireland Commissioner for Complaints The Ombudsman can investigate: All complaints about health and social care services including hospitals, GPs and dentists. Private sector complaints where health and social care are funding the care or service. Cases of unfair treatment or poor service where the complaint has not been resolved to your satisfaction. Complaints relating to professional judgement of clinical decisions in a healthcare setting, as well as how your complaint has been handled. The Ombudsman cannot investigate. Private medical care. Complaints relating to access to information and the Data Protection Act. If more than six months have passed since the completion of the public body’s consideration of your complaint then the Ombudsman may not be able to investigate. However, they may be prepared to extend the time frame and you should ask for any special circumstances, such as ill health, to be taken in to account You should make a complaint in writing or by using the forms available on the Ombudsman’s website. The Ombudsman can make recommendations about what should be done to make matters right including changes in practice. They cannot award compensation or take disciplinary action against individual members of staff. If you need help to raise your concerns, you can contact the Patient and Client Council’s complaint support officers by telephone, email, letter or through their website. They will listen to your experiences and offer the advice or support that you need. Step 3: Judicial review In some cases, it may be appropriate to use the judicial review procedure, particularly if you need to urgently challenge a decision made by an NHS organisation, for example, a decision not to provide certain treatment. Judicial review is a remedy of last resort and will only rarely be applicable to NHS complaints. You will need a solicitor to offer you specialised advice about whether there are grounds to make an application for judicial review. They will also offer you advice on whether it is worthwhile becoming involved in what can be an expensive and complex legal procedure. The Law Society provides a list of lawyers who specialise in medical matters.- Posted
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- Northern Ireland
- Complaint
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Content Article
In April 2022, an investigation commenced into the communications provided to patients and/or their carers following placement on a waiting list in Northern Ireland. The primary focus of the investigation is the adequacy of Trust communications to patients, and/or their carers, across various stages of the waiting list process, with significant consideration being given to the content of the Integrated Elected Access Protocol (Department of Health guidance), and its application by the Trusts. The objective was to determine whether or not systemic maladministration has arisen within the communication practices of the Northern Ireland Health and Social Care Trusts (the Trusts) and whether improvements are required. It also aims to publicise what patients and/or their carers should expect from waiting list communications. The Investigative Methodology drew evidence from a wide range of sources. This included extensive queries and information requests to the Trusts and the Department; a General Public survey (with 646 responses); a General Practitioner (GP) survey (with 321 responses); follow up interviews with a number of General Public and GP survey respondents; and a number of Case Study reviews.- Posted
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- Northern Ireland
- Investigation
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Content Article
This report published by the National Vascular Registry (NVR) contains information on emergency (non-elective) and elective procedures for the following patient groups: patients with peripheral arterial disease (PAD) who undergo either (a) lower limb angioplasty/stent, (b) lower limb bypass surgery, or (c) lower limb amputation patients who have a repair procedure for abdominal aortic aneurysm (AAA) patients who undergo carotid endarterectomy or carotid stenting.- Posted
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- Surgery - Vascular
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Urgent funding is required to clear waiting list backlogs and drive Northern Ireland's long-term healthcare transformation, the Northern Ireland Audit Office has said in a new report which outlines the health service's "critical situation" after almost a decade of worsening waiting lists for elective care. The NI Audit Office looked at waiting list data from 2014 to 2023. It found the number of patients waiting for elective care has risen by 452,000 during that nine-year period. The Audit Office also said: "Available information suggests waiting list performance levels are significantly worse in Northern Ireland compared with the other UK regions." The report makes a series of recommendations: The very long waiting times across all the main elective specialisms further underlines the range and scale of difficulties facing stakeholders. The Department and trusts should review the key causal factors influencing outcomes across the various elective specialisms and assess if action plans in place to address these need to be radically strengthened. Waiting list pressures are currently particularly acute for Neurology, Dermatology, ENT and General Surgery (initial outpatient appointments) and ENT, T&O Surgery, and General Surgery (hospital admission). To support the introduction of local RTT measurement and targets, DoH must strive to ensure that the Encompass programme remains on course for implementation by its scheduled deadlines, and that it is fully capable of such reporting. In the interim, it should use the December 2022 comparative figures as a baseline and continue regularly monitoring performance on that basis, to determine if the HSC performance gap with England and Wales is narrowing or increasing, and also identify if any best practice there, which has helped ensure performance has not deteriorated to the same extent, can be further implemented locally. Whilst action is underway to try and address issues around trust performance and patient DNAs, and the Department is now trying to centrally drive improvements, the Department and trusts now need to explicitly quantify the increased capacity and activity required to sustainably reduce waiting times, and assess how this can be achieved at each trust, through both improving the efficiency of current operations and progressing HSC transformation. It recommends that the Department identifies the investment necessary to ensure the HSC sector can function more efficiently and sustainably, including reducing waiting times to targeted levels. It should also demonstrate and quantify, in business case terms, if such investment can ultimately secure better longer-term value for money and patient outcomes, and the likely implications of failing to secure such funding. This will help DoH demonstrate how more sustainable funding arrangements can better support its objectives. As DoH and the Trusts seek to incrementally build increased dedicated elective capacity, they should monitor its impact on waiting times, and assess whether the additional facilities are having the desired success and impact. If waiting times are not reducing appreciably, they should assess the extent of further dedicated capacity required across key specialisms. Given the current situation, the Department should firstly confirm the robustness of its estimate of the funding required to fully implement the Framework in preparation for any potential introduction of long-term budgets. Until it has greater certainty on the availability of recurrent funding, it should rank or prioritise the actions likely to have greatest impact on waiting times and allocate available recurrent and non-recurrent funding towards these on this basis. The Department should set revised Framework targets as soon as feasible. The limited implementation of previous strategies means the Department’s regular progress assessments on the Framework is welcome. Going forward, these should identify the specific work which must be progressed over the next reporting period to ensure milestones are met, who is responsible for driving this, progress against targets and timelines, and whether emerging evidence means any actions should be redesigned or reprioritised. Progress should continue being publicly reported, setting out why any actions are behind schedule, and whether, and how, this can be rectified. Close working between the various stakeholders involved in workforce-related issues is required, to ensure stronger elective care workforce planning. The stakeholders should now take stock of how their work is progressing and collectively agree the priority areas which require further attention to ensure the HSC elective workforce has the right capacity and capability to drive HSC transformation. Based on the current situation and workforce deficits, revised projections and plans should be developed, together with targets and strategies for achieving these. Increased use of the IS is likely to be necessary for the foreseeable future to address the colossal patient backlog. In preparation for any progress in approving multi-year budgets, DoH should set out its strategic plans for expanding use of the IS, and continue to clarify with the sector the degree to which it can build additional capacity to help clear the backlogs.- Posted
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Michael Watt hearing: Lawyers withdraw over mental health concerns
Patient Safety Learning posted a news article in News
Lawyers for a doctor at the centre of Northern Ireland's biggest patient recall have withdrawn from his new fitness to practise hearing. Legal representatives for Michael Watt said they are "concerned about his serious mental health condition". They told the Medical Practice Tribunal Service that the continuation of the hearing in public "presents a real risk to his mental health". A new fitness to practise hearing began in September. The legal team has also formally withdrawn an application to the tribunal for Michael Watt to remove himself from the medical register. It followed a ruling by the High Court earlier this year to quash a decision where he previously was voluntary erased from the medical register. The tribunal is inquiring into the allegation that, between 7 and 22 of October 2018, Michael Watt underwent a General Medical Council assessment of the standard of his professional performance. It is alleged that that performance was unacceptable in the areas of maintaining professional performance, assessment, clinical management, record keeping and relationship with patients. Read full story Source: BBC News, 27 October 2023- Posted
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Women 'angry and frustrated' over smear test review
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Women affected by a review of cervical smears in the Southern Health Trust have said they are "angry, frustrated and scared" for their future. About 17,500 patients in the trust are to have their previous smears re-checked as part of a major review of cervical screening dating back to 2008. Some of these women will be recalled to have new smear tests carried out. But the process has not started yet and will take at least six months to complete. Letters were sent out by the trust earlier this month to those affected. The Southern Trust says it expects to recall around 4,000 women for a new smear test after it reviews 17,368 historic slides. The Trust's medical director, Dr Steve Austin, told its board meeting that the review of slides was expected to start next week. It also emerged that the number of calls from concerned women has increased with many asking for more "specialist" answers. Read full story Source: BBC News, 27 October 2023- Posted
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Mum fears her son could die waiting for life changing surgery
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The mother of a four-year-old boy with complex needs said she fears he could die waiting for life-changing surgery. Collette Mullan made the claim to BBC Spotlight as it examined the scale of hospital waiting lists. Northern Ireland has the worst waiting times in the UK, with more than half a million cases queued for an outpatient or inpatient appointment. The Department of Health has described current waiting lists as "entirely unacceptable". Óisín, from County Londonderry, has a number of health conditions including cerebral palsy, and is currently waiting for two procedures. He is fed with a tube that carries his food through his nose into his stomach, but since it was inserted six months ago, his mum Collette said he has struggled to breathe. Óisín is now waiting to have the nasogastric tube removed and replaced by a different feeding system which goes directly to his stomach. Collette said she was told it could be a three-year wait for the procedure. She is concerned that Óisín's cerebral palsy puts him at a greater risk of complications, saying she had been warned there was a danger he could aspirate. "He could die. Anything going into his lung really, it could be very dangerous," she said. Read full story Source: BBC News, 3 October 2023- Posted
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Launch of new centre to promote patient safety in NI
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A new regional centre which promotes the reporting of suspected safety concerns associated with healthcare products has been launched in Northern Ireland. The Yellow Card centre for Northern Ireland will bring together a dedicated team to increase awareness, educate, and promote reporting of suspected adverse events to the Medicines and Healthcare products Regulatory Agency (MHRA) Yellow Card scheme. The Yellow Card scheme provides a mechanism for patients, care givers and healthcare staff to report suspected safety concerns associated with healthcare products. Speaking at the launch of the new service, Northern Ireland Chief Pharmaceutical Officer Professor Cathy Harrison said: “Collecting and monitoring information on possible adverse effects of medications and healthcare products is vital to ensuring patient safety. "It is fitting that the launch of the Yellow Card centre for Northern Ireland coincides with World Patient Safety Day on 17 September, with this year’s theme of "Engaging patients for patient safety". "The Yellow Card scheme puts the patient voice at its heart. By voluntarily reporting issues, patients, families and care givers can play a crucial role in their own care, and the safety of healthcare as a whole. I welcome the launch of the new regional centre and would encourage anyone who has suspected safety concerns to report them.” Read full story Source: Department of Health (Northern Ireland), 13 September 2023- Posted
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