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Found 260 results
  1. News Article
    The UK health department was forced to write down £14.9bn worth of personal protective equipment and other medical items, according to a report by the independent public spending watchdog, which also issued a scathing criticism of the UK Health Security Agency. The National Audit Office said that the Department for Health and Social Care did not complete an “effective programme of year-end stock counts” to assess the quality and quantity of coronavirus-related items, such as lateral flow tests. During the last two financial years, the DHSC reported nearly £15bn of write down costs associated with PPE and other health items. The department estimated that the continuing cost of storage and disposal of excess and unusable equipment stands at £319mn. The watchdog found a “lack of adequate governance, oversight and control” at the UKHSA. It noted that due to a “lack of sufficient, appropriate audit evidence and significant shortcomings in financial control” the NAO was unable to provide an audit opinion on the 2021-22 accounts of the agency. Read full story (paywalled) Source: Financial Times, 27 January 2023
  2. News Article
    The deaths of two nurses from Covid-19 in the early days of the pandemic have been ruled as industrial disease. Gareth Roberts, 65, of Aberdare, and Domingo David, 63, of Penarth, were found to have been most likely to have contracted the virus from colleagues or patients while working for hospitals under the Cardiff and Vale University Health Board. The senior coroner Graeme Hughes concluded on Friday that although they were given appropriate personal protective equipment (PPE), Roberts and David were “exposed to Covid-19 infection at work, became infected and that infection caused” their deaths. He made a finding of industrial disease. Roberts’ family had argued for a conclusion of industrial disease, while the health board had made the case for ruling that both deaths were from natural causes. Unions are campaigning for Covid-19 to be considered an industrial disease by the UK government so workers affected by it would receive greater financial support. Read full story Source: The Guardian, 13 January 2023
  3. Content Article
    The IIAC recommends the following prescription should be added to the list of prescribed diseases for which benefit is payable. This applies to workers in hospitals and other healthcare settings and care home/home care workers working in proximity to patients in the two weeks prior to infection: Persisting pneumonitis or lung fibrosis following acute Covid-19 pneumonitis. Persisting pulmonary hypertension caused by a pulmonary embolism developing between 3 days before and 90 days after a diagnosis of Covid-19. Ischaemic stroke developing within 28 days of a Covid-19 diagnosis. Myocardial infarction developing within 28 days of a Covid-19 diagnosis. Symptoms of Post Intensive Care Syndrome following ventilatory support treatment for Covid-19.
  4. News Article
    A surge in Covid cases over winter could lead to harsh visiting restrictions being reimposed in care homes and hospitals, MPs and campaigners have warned. Families are still facing a “postcode lottery” of Covid restrictions in care homes, with visiting times restricted and personal protective equipment (PPE) obligatory. However MPs are worried that some will reimpose even harsher measures if Covid cases rise this winter. Daily global Covid infections are projected to rise slowly to around 18.7 million by February, up from the current 16.7 million average daily cases this October. MPs are calling for the government to enact legislation that would enshrine the right for an essential care giver to be present with their loved ones in care settings. Liberal Democrat MP Daisy Cooper said that one of her constituents, Lynn, was not allowed into a hospital A&E ward to see her husband Andy when his dementia deteriorated over Christmas last year. The hospital refused to let Andy have any visitors for two weeks until Ms Cooper intervened. When she was allowed in, Lynn was distraught to find that Andy had lost a significant amount of weight in the weeks he was isolated. Ms Cooper continued: “We have come a long way since last Christmas, and since the start of the pandemic, but as winter approaches the NHS and care settings are once again expected to struggle with a surge in Covid cases. “It is not inconceivable that what happened to Lynn and Andy could happen again to them and to many others.” Read full story Source: Independent, 30 October 2022 Further hub reading Visiting restrictions and the impact on patients and their families: a relative's perspective It’s time to rename the ‘visitor’: reflections from a relative Mother knows best – a blog by Dr Abha Agrawal
  5. News Article
    Trainee medics battling Ebola in Uganda's virus epicentre accuse the government of putting their lives at risk. "Most times you come into contact with a patient and you use your bare hands," one worker told the BBC anonymously. All trainees at Mubende's regional hospital say they are on strike and are demanding to be moved somewhere safer. But Ugandan health ministry spokesman Emmanuel Ainebyoona told the BBC there was "no strike at the hospital". Yet all 34 of the hospital's interns - including doctors, pharmacists and nurses - have announced their decision to strike in a joint statement. They say they are being put at undue risk because they lack appropriate safety kit, risk allowances and health insurance. Six interns at the hospital have already been exposed to the virus, and are awaiting their test results in isolation. Read full story Source: BBC News, 26 September 2022
  6. News Article
    A coroner has said she does not understand why frontline workers were not required to wear a mask during lockdown after hearing a paramedic had died with Covid. A two-day inquest into the death of Peter Hart, who died on his 52nd birthday, concluded on Tuesday (September 13) with assistant coroner Dr Karen Henderson ruling the father-of-three died of natural causes caused by Covid. She said on the balance of probabilities he caught the disease while working at East Surrey Hospital, where he died on May 12, 2020. During the onset of the pandemic only healthcare workers tending to those suspected of having Covid-19 were required to wear personal protective equipment (PPE). In accordance with national guidelines, Mr Hart, who was treating patients not suspected of having the virus, did not need to. “Retrospectively it is difficult to comprehend why the national guidance said PPE did not need to be used for all patients and healthcare workers at the earliest opportunity,” Dr Henderson said. “Although there appears a lost opportunity to ensure maximum protection I make no finding of fact whether this contributed to Mr Hart’s death. “Patients not suspected to have Covid were not expected to wear face masks. This is in effect a perfect storm and given evidence of Mrs Hart I am satisfied Mr Hart contracted Covid during his work at East Surrey Hospital,” she added. Read full story Source: Surrey Live, 13 September 2022
  7. Content Article
    Key findings Knowledge of the Directive requirements decreased significantly between 2017 and 2021, with <60% of participants answering correctly in 2021, Nurses’ attendance in specific courses dropped to 25% in 2021 compared to 54% in 2017. Over 75% of hospitals introduced multiple safety-engineered devices (SED), though total replacement occurred in <50% of cases; routine SED availability increased for blood collection (89%) and venous access devices (83%). Incorrect behaviours in handling sharps decreased significantly over time. Nurses’ HBV vaccination coverage was high (89% in both surveys); in the last year, 97% were vaccinated against Covid-19, and 47% against influenza. Average annual injuries per hospital did not increase significantly (32 in 2021 vs. 26 in 2017). In 2017, nurses’ perceived safety barriers were working in emergency situations (49%) and lack of resources (40%); in 2021, understaffing (73%), physical fatigue (62%), and handling difficulties while wearing full protective equipment (59%). Safety measures were implemented in Italian hospitals, and although the average injuries per hospital did not show a decrease, these measures could have helped protect healthcare workers during the pandemic, mitigating its potential impact on the increase in situations at risk of injury. Further reading An uncharted safety gap: inconsistent access to home sharps disposal in the UK Needlestick injuries – making the point for safety Injection technique and dual safety in diabetes care - a new SHBN working group to tackle safety risks
  8. Content Article
    Key points in this article include: Glove misuse contributes to the transmission of healthcare-associated infectionsAppropriate and timely hand hygiene is essential in preventing transmission of infectionsEmotion, socialisation and personal preference influence health professionals’ glove useFear about contracting Covid-19 has dominated decision-making about glove useGlove misuse may have increased rates of hospital-acquired infections during the Covid-19 pandemic
  9. Content Article
    Providing the background for this review, the WHO introduces this report by highlighting that the pandemic has, and continues to, impact on every facet of healthcare systems across the world. It states that: “… the unanticipated surge of COVID-19 cases, the pandemic has created an unprecedented demand for care leading to a global strain on health systems, mot of which were not fully prepared to handle large-scale emergencies. The pandemic has emphasized the high risk of avoidable harm to patients, health workers, and the general public, and has identified a range of safety gaps across all core components of health systems at all levels. The impact of the pandemic is still unfolding and will have long-term ramifications.”[2] The report highlights that healthcare systems have faced a significant challenge in seeking to deliver safe care during the pandemic, including: Treating a significantly higher number of patients than normal as a result of Covid surges, while managing the subsequent disruption this has had on non-Covid care and treatment. The safety impact of staff shortages because of high numbers of Covid cases. Risks to infection control posed by the scarcity of key safety products such as Personal Protective Equipment (PPE). The significant toll on healthcare professionals, both in terms of their personal safety and general wellbeing, with heightened work-related stress and burnout. While it focused on the patient safety challenges that have been posed by the pandemic, it does however highlight some positive developments for patient safety relating to changes to care and treatment during this period: The focus on fighting Covid-19 has in some cases functioned as a stimulus to breaking down barriers between individuals and institutions delivering health and social care, encouraging more information sharing and collaborative working. We have seen the rapid development of new means to combat the virus, such as vaccines, diagnostics, and therapeutics. New positive healthcare innovations and changes to service delivery have emerged in response to pandemic, such as the communication tool CARDMEDIC.[3] There has been an increased public awareness of the importance of mental health and caring for healthcare professionals, which is fundamentally linked to ensuring patient safety.[4] Safety risks and avoidable harm “… COVID-19 has caused a “perfect storm” in the field of patient safety, and heightened the need to have further research in the area and identify and implement initiatives that ensure safer care, especially in the context of outbreaks and emergencies.”[2] The core of this WHO report is focused on six interlinked thematic areas where it seeks to summarise the main risks and harm implications of the pandemic for patient safety: 1. Health services Under this broad heading the report groups a wide range of different patient safety issues impacting on the delivery of healthcare services, including: Increased risks of healthcare-associated infections, including Covid-19 transmission in hospitals.[5] Safety incidents relating to medication use, including those exacerbated by redeploying staff members to areas they are less familiar with and the absence of family members and carers to provide input and knowledge of patients’ conditions. Diagnostic errors involving both patients with Covid-19 and non-Covid conditions, ranging from false negative test results to diagnosis errors because of system strain. Disruption to non-Covid care, treatment and diagnostic services. 2. Health and safety of health workers This theme covers a number of staff safety issues that impact on their ability to deliver safe care, such as exposure and risk of Covid infection, burnout from working in a highly pressured environment, and moral injury as a result of having to make increasingly difficult decisions about prioritising the case for seriously ill patients.[6] 3. Patients, families and communities, including inequities This heading groups together a larger number of issues that broadly concern patients, including: The pandemic both exposing and exacerbating existing health inequalities and gaps in health outcomes.[7] Impact of the pandemic on people living in long-term care settings. Patient safety issues here range from high numbers of potentially preventable deaths in care homes to the impact of prolonged periods of isolation with limited visits by friends and family members. Restrictions on visitation policies more broadly, concerning both the psychological consequences for patients and the safety consequences when family members and carers are not present to potentially help identify incidents and errors. The spread and impact of Long Covid.[8] 4. Leadership, governance and financing This theme considers the wider impact of the pandemic of healthcare systems, considering the safety roles play by organisational and national leaders, gaps that have been exposed in terms of system preparedness for a pandemic, and the financial impact of this on healthcare systems and their workforces in the long-term. 5. Communication and management of health information The report notes that the rapid spread of information has been one of the hallmarks of this pandemic, which has itself posed safety challenges. In particularly it cites the risk and harm from misinformation and disinformation about Covid-19, treatments and vaccines, and the limits of health data in countries where the healthcare system itself is under resourced. 6. Development and supply chain of medical products, vaccines and technologies The final theme is concerned with the safety implications related to products and resources needed to fight the pandemic. It highlights shortages and issues in the global and local supply chain related to essential safety related medical products, such as PPE and vaccines, as examples of this. Patient Safety Learning’s reflections We were pleased to be one of the international organisations who were able to contribute to the work of this review. The nature of this type of report however means inevitably there will always be gaps or areas that could potentially have been covered in more depth. Below we highlight three of note: Long Covid and its safety implications Millions of people across the world are living with Long Covid, a term created by patients to describe the prolonged, fluctuating symptoms following Covid-19. This WHO review does briefly refer to this under the heading ‘Post-Covid-19 condition’ however we believe this could be significantly expanded upon to include a range of safety issues encountered by people living with this condition, including: Inconsistent care and contradicting advice. Public health messaging not reflecting of the risks associated with Long Covid. How people living with Long Covid should be communicated and engaged with. Knowledge gaps among healthcare professionals on the nature of Long Covid and good practice in diagnosis and treatment. Patient safety reporting during the pandemic Another area this report also touches on, where we believe further research is needed, concerns the disruption of routine patient safety activities during the pandemic, in particular patient safety incident reporting. In our view, this area requires a much more detailed review as healthcare systems still have a limited understanding of the impact on avoidable harm. We cannot clearly say whether there has been an increase in avoidable harm in this period. At the height of Covid infections, many healthcare systems de-prioritised reporting of incidents of unsafe care, redirecting staff time to clinical care and other pandemic related activities. On paper this has resulted in a reduction in reports of unsafe care, most likely to be because of reductions in reporting.[9] Most of our existing estimates of levels of avoidable harm in health and social care still pre-date the pandemic. With less reporting and fewer investigations taking place during this period, we are less knowledgeable about the scale and causes of avoidable harm. Without this knowledge and insight, health systems are going to be compromised in their understanding and less able to respond to with appropriate and targeted action. Ongoing disruption and recovery of non-Covid care and treatment Understandably much of the focus of this review is on the impact of the Covid-19 pandemic on patient safety at the height of infection levels. In this context it does consider in some detail the safety implications of the disruption to non-Covid care, treatment and diagnostic services. We believe that in considering the implications of the Covid-19 pandemic on patient safety, there is a compelling case for further work being required looking at the long-term impact of the disruption it has caused to healthcare systems and its ongoing impact. This includes, but is not limited to: Safety challenges in prioritising and reducing backlogs in care and treatment. Long-term needs of patients who have significantly deteriorated while waiting for care and treatment. Managing these challenges in the face of global healthcare workforce shortages. Turning insights into action “Significant opportunities lie ahead for patient safety improvement in the context of the pandemic. Many instances of risks and avoidable harm identified in this rapid review are still ongoing and if unaddressed are likely to prevail again no matter what pathogen the next pandemic will involve.”[2] Towards the end of this review, WHO identify a number of potential opportunities and activities to build on lessons learned from the pandemic. Below we highlight several actions they identify which we believe all countries should be actively reviewing and considering how they can be applied to their healthcare systems: The report highlights numerous safety risks, varying from adequate infection and prevention control measures to overburdened workforces. There needs to be additional research and action in each of these areas on a country-by-country basis. More work is needed to identify best practices and lessons learned from this period, which can help to inform future interventions and contribute to building safer and more resilient health systems. Healthcare systems should seek to build on successful advances in areas such as digital innovation, increasing transparency, open and frequent bidirectional communication, data sharing, collaboration, and teamwork with the breakdown of traditional silos, and the rapid adoption of selected patient safety practices. There should be a concerted effort to develop protections for the health, safety and well-being of healthcare professionals. These should be aligned with patient safety, infection prevention and control, and other health workforce programmes. There is an opportunity to embed patient safety in design and development of health care systems, products and processes. Further work should be undertaken to employ multidisciplinary approaches to patient safety, which could yield lessons to inform the development and implementation of patient safety strategies and innovations for a safer healthcare systems. Health systems need to be better prepared for unexpected and emerging threats and seek to address current structural inequities. While the above points are taken from this report, they are not constituted as formal recommendations. The main thrust toward the end of this review is to point towards the recently developed WHO Global Patient Safety Action Plan 2021-2030 as providing a comprehensive framework to address the safety gaps identified in this report.[10] We believe there would be value in the WHO inviting all countries and healthcare systems to reflect on the findings of this review and formally consider the implications of Covid-19 on their health system. They could then report back on their assessment and the improve actions they aim to deliver, in the context of the Global Patient Safety Action Plan, enabling the WHO to collate and assess this to take forward learning and action in a collective global drive to reduce avoidable harm. References 1. Patient Safety Learning, Covid-19 – the ongoing impact of the pandemic on patient and staff safety, 14 December 2021. 2. WHO, Implications of the COVID-19 pandemic for patient safety: A rapid review, 5 August 2022. 3. Rachael Grimaldi, The story behind CARDMEDIC, Patient Safety Learning’s the hub, 28 May 2020. 4. Patient Safety Learning, Why is staff safety a patient safety issue?, 3 September 2020. 5. Healthcare Safety Investigation Branch, COVID-19 transmission in hospitals: management of the risk – a prospective safety investigation, 29 October 2020. 6. Suzanne Shale, Moral injury and the COVID-19 pandemic: reframing what it is, who it affects and how care leaders can manage it, 17 July 2020. 7. NHS Confederation, The unequal impact of COVID-19: investigating the effect on people with certain protected characteristics, 15 June 2022. 8. Patient Safety Learning, Long Covid: Information gaps and the safety implications, 7 June 2021. 9. Shawn Kepner and Rebecca Jones, 2020 Pennsylvania patient safety reporting: an analysis of serious events and incidents from the nation’s largest event reporting database. Patient Saf. 2021; 3(2): 6-21. 10. WHO, Global Patient Safety Action Plan 2021-2030, 3 August 2021.
  10. Content Article
    The measures proposed by Independent SAGE are: Clear and consistent messaging concerning Covid risk and risk mitigation, reinforced by public statements by those in positions of authority. Increased efforts to promote vaccine uptake, among all age groups,4 and with particular emphasis on groups among whom uptake has been low, in particular ethnic minority communities.5 This should be coupled with a clear long term plan to address waning immunity and immune escape by new variants. Installing and/or upgrading ventilation/air filtration in all public buildings, with schools an urgent priority over the summer holidays. Provision of free lateral flow tests to enable everyone to follow existing public health guidelines. Financial and other support for all workers to self-isolate if infected. Systematic promotion of the use of FFP2/FFP3 masks in indoor public spaces and public transport when infection rates are high. Increased support for the equitable global provision of vaccines and anti-virals.
  11. News Article
    It would be “sensible” for hospitals to reintroduce mandatory mask-wearing, the chair of the Joint Committee on Vaccination and Immunisation has said, as several trusts in England and Wales announced the move. When NHS rules on wearing masks in England were dropped on 10 June, local health bodies were given the power to draft their own policies. Their guidance, however, is no longer legally enforceable. Figures from NHS England show there were about 10,658 patients hospitalised with coronavirus on Monday. Infections have doubled in a fortnight across England – with about 1,000 patients being admitted with the virus each day. Prof Andrew Pollard, who is also the director of the Oxford Vaccine Group, which developed the AstraZeneca jab, said there were an “extraordinary” number of cases at the moment. “I certainly know more people now who have had Covid than at any time in the past,” he told the BBC Radio 4’s Today programme. “Because there’s so much in the community, anything we can do in our hospitals to reduce the potential outbreaks make sense and so the mandatory mask wearing in hospitals is very sensible policy,” he added. Read full story Source: The Guardian, 5 July 2022
  12. Content Article
    Complaints from staff are not being heeded. Why is it that healthcare staff's opinions and pleas for their safety and the safety of patients do not matter? Here are just some examples of where safety has been compromised: Disposable gowns are being reused by keeping them in a room and then reusing after 3 days. There were no fit tests. Staff were informed by management that "one size fits all, no testers or kits available and no other trusts are doing it anyway". Only when the Health and Safety Executive (HSE) announced recently that fit tests were a legal requirement, then fit tests were given. I queried about fit checks only to discover that it was not part of the training and, therefore, staff were wearing masks without seals for three months before fit tests were introduced and even after fit tests! I taught my colleagues how to do fit checks via telephone. There was no processes in place at the hospital to aid staff navigation through the pandemic (no red or green areas, no donning or doffing stations, no system for ordering PPE if it ran out); it was very much carry on as normal. A hospital pathway was made one week ago, unsigned and not referenced by governance, and with no instructions on how to don and doff. Guidelines from the Association for Perioperative Practice (AFPP) and Public Health England (PHE) for induction and extubation are not being followed – only 5 minutes instead of 20 minutes. Guidelines state 5 minutes is only for laminar flow theatres. None of the theatres in this hospital have laminar flow. One of my colleagues said she was not happy to cover an ENT list because she is BAME and at moderate/high risk with underlying conditions. She had not been risk assessed and she felt that someone with lower or no risk could do the list. She was removed from the ENT list, told she would be reprimanded on return to work and asked to write a report on her unwillingness to help in treating patients. The list had delays and she was told if she had done the list it would not have suffered from delays. Just goes to show, management only care about the work and not the staff. It was only after the list, she was then risk assessed. Diathermy smoke evacuation is not being used as recommended. Diathermy is a surgical technique which uses heat from an electric current to cut tissue or seal bleeding vessels. Diathermy emissions can contain numerous toxic gases, particles and vapours and are usually invisible to the naked eye. Inhalation can adversely affect surgeons’ and theatre staff’s respiratory system. If staff get COVID-19 and die, they become a statistic and work goes on as usual. The examples listed above are all safety issues for patients and staff but, like me, my colleagues are being ignored and informed "it's a business!" when these safety concerns are raised at the hospital. The only difference is they are permanent staff and their shifts cannot be blocked whereas I was a locum nurse who found my shifts blocked after I spoke up. Why has it been allowed to carry on? Why is there no Freedom To Speak Up Guardian at the hospital? Why has nothing been done? We can all learn from each other and we all have a voice. Sir Francis said we need to "Speak Up For Change", but management continues to be reactive when we try to be proactive and initiate change. This has to stop! Actions needed We need unannounced inspections from the Care Quality Commission (CQC) and HSE when we make reports to them. Every private hospital must have an infection control team and Freedom To Speak Up Guardian in post.
  13. News Article
    Hospitals are bringing back requirements for masks on wards just weeks after rules were relaxed as Covid rates spike, The Independent can reveal. Experts have warned of a surge in cases, believed to be the fifth wave, with one in 40 people in the UK testing positive for the virus. Meanwhile, latest NHS data shows more than 8,000 Covid-positive patients on wards following a warning of a “deleterious” impact on hospital waiting times. In response, three major hospital trusts have told staff they must wear masks, with warnings more must follow if the NHS is to handle another wave of Covid. Dr Tim Cooksley, president of the Society for Acute Medicine told The Independent: “Over the past 2 years Covid has highlighted and exacerbated what was an already growing crisis. “High staff absence levels, burn-out and low morale have dominated staff landscapes during this time and continue to do so. Future waves and potentially large numbers of upcoming flu cases will only serve to deepen these problems making the hopes of patients, clinicians and politicians alike of elective recovery seem somewhat fanciful." Read full story Source: The Independent, 29 June 2022