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When the Covid-19 pandemic arrived in the UK in March 2020, Professor Paul Elkington and a team at University Hospital Southampton NHS Foundation Trust (UHS) quickly developed a new form of respiratory protective equipment (RPE) called PeRSo (Personal Respirator Southampton) for hospital staff to use. PeRSo is a portable, wearable device which blows air through a HEPA filter into a hood, providing a high level of protection against respiratory infection. In this interview, Paul describes how, working with industry partners, his team was able to provide 3,500 members of staff at UHS with PeRSo during the pandemic. Describing the impact this had on staff morale and Covid infection rates, he explains why PeRSo is a preferable alternative to the FFP3 masks recommended by the Government during the pandemic. Paul outlines how, in the event of another pandemic, providing personal respirators would offer effective protection for healthcare workers and the wider population at relatively low cost. He also outlines what the Government needs to do to ensure the UK is prepared for future pandemics, including making changes to the regulatory framework and incentivising the development of personal respirators designed specifically for infection control. Further reading on the hub: A personal respirator to improve protection for healthcare workers treating Covid-19 (PeRSo) Powered respirators are effective, sustainable and cost-effective Personal Protective Equipment for SARS-CoV-2 Respiratory protective equipment: An unequal solution for healthcare workers? A blog by David Osborn "Forgotten heroes" – the sequel: a blog and resources from David Osborn

Mental Health Awareness Week is an annual event which aims to raise awareness and promote open conversations about mental health.  In this Top picks, we’ve pulled together resources, blogs and reports from the hub that focus on improving patient safety across different aspects of mental health services and also supporting staff with their own mental health and wellbeing. 1 Restraint Reduction Network: Supporting people with lived experience As all forms of restrictive practice can result in harm, it is important that people are able to identify restrictive practices and challenge their inappropriate use. The Restraint Reduction Network have a range of resources that people with lived experience, parents and carers may find helpful. The resources are designed to support people to understand what restrictive practices are, when and why they might be used, people’s rights, and how to identify and challenge unacceptable and unethical practices. 2 Harry’s story: Acute Behavioural Disturbance In December 2022, Harry Vass died after experiencing Acute Behavioural Disturbance (ABD) and a complex disturbance in normal physiology. Harry’s death was found to be avoidable as carers were not fully aware of this condition associated with acute psychosis. In this blog, Harry’s mother Julie describes the barriers they faced in getting the right support and care for Harry before he died and highlights the need for healthcare staff to have a greater awareness of ABD and the associated risks of a medical emergency. You can also read a second blog by Julie, where she explains more about Acute Behavioural Disturbance and the changes she believes are needed to make sure patients like Harry are cared for appropriately. 3 Life Beyond the Cubicle: eLearning to support working well with families during mental health crises A set of eLearning modules designed to educate and update clinicians on the importance of involving families wherever possible during mental health crises to improve patient care, avoid harm and reduce deaths. They were developed as a partnership between Oxford Health NHS Foundation Trust and Making Families Count, with funding from NHS England South East Region (HEE legacy funds). The resources have been co-produced by people with lived experience as patients, family carers and clinicians, supported by an Advisory Group drawn from a wide range of expertise, tested in eleven NHS Trusts and independently evaluated. 4 Mental health crises: how to improve care In May 2024, National Institute for Health and Care Research (NIHR) Evidence held a webinar on care for adults in mental health crisis. The webinar shared research findings on what works in community crisis care, how acute day units compare to crisis resolution teams and whether peer-supported self-management can reduce acute readmissions. This Collection summarises the 3 research projects presented at the webinar. It includes video clips from the speakers and incorporates quotes from the day. The information will be useful for anyone involved in commissioning or delivering mental health crisis services. 5 Self-harm: assessment, management and preventing recurrence This new guideline from the National Institute for Health and Care Excellence (NICE) covers assessment, management and preventing recurrence for children, young people and adults who have self-harmed. It includes those with a mental health problem, neurodevelopmental disorder or learning disability and applies to all sectors that work with people who have self-harmed. The guideline sets out some important principles for care and treatment. For example, it states that self-harming patients treated in primary care must receive regular follow-up appointments, regular reviews of self-harm behaviour and a regular medicines review. 6 Hope Virgo: What needs to happen to stop people with eating disorders being failed by the healthcare system? In this blog, Hope Virgo, author and Secretariat for the All Party Parliamentary Group (APPG) on Eating Disorders, examines the crisis that continues in eating disorder services in the UK and the devastating impact this is having on patients and their families. She highlights how failures in services lead to avoidable deaths. Hope shares the key recommendations from a new report by the APPG and calls for adequate funding and attention to ensure people with eating disorders receive the help they need to recover. 7 Rethinking doctors’ mental health and the impact on patient safety: A blog by Ehi Iden This blog by Ehi Iden, hub topic lead for Occupational Health and Safety, reflects on the increasing workload and pressure healthcare professionals face, the impact this has on patient safety and why we need to start 're-humanising' the workplace. He highlights that, “It takes a safe healthcare worker to deliver safe healthcare to patients.” 8 Zero Suicide Alliance training The Zero Suicide Alliance is a collaboration of NHS trusts, charities, businesses and individuals who are committed to suicide prevention in the UK and beyond. Their website offers free online training courses to teach people the skills and confidence to have potentially life-saving conversations with someone they’re worried about. They offer short online modules covering general suicide awareness, social isolation and suicide in veterans and university students. 9 How can our team move past a traumatic event? After an extreme traumatic event there are things that you can do to help yourself, and your colleagues, to move on. Fiona Day, medical and public health leadership coach and chartered coaching psychologist, Stacey Killick, consultant paediatrician at Glan Clwyd Hospital, and Lucy Easthope, professor in practice at Durham University’s Institute of Hazard, Risk, and Resilience and adviser on disaster recovery give their tips in this BMJ article. 10 Blog: Shifting the dial on mental health support for young black men In this blog for NHS Confederation, Kadra Abdinasir talks about how mental health services have failed to engage with young black men, and describes how services need to change to overcome the issue. She argues that delivering effective mental health support for young black men requires a move away from a crisis-driven response, to investment in system-driven, community-based projects. Kadra looks at learning from Shifting the Dial, a three-year programme recently piloted in Birmingham as a response to the growing and unmet needs of young black men aged 16 to 25. A recent report on the project found that most young men involved in Shifting the Dial reported good outcomes related to their wellbeing, confidence, sense of belonging and understanding of mental health. 11 Vicarious trauma: The invisible epidemic In healthcare, an insidious epidemic lurks beneath the surface, affecting the very individuals tasked with providing care: vicarious trauma by empathy. Despite its profound impact, this phenomenon remains largely unrecognised and under-discussed within the sector. As leaders, it is imperative that we shed light on this invisible trauma and acknowledge it as one of the greatest challenges facing our industry, as Margarida Pacheco explains in this blog. 12 Beyond stereotypes: A lived experience guide to navigating support for disordered eating Disordered eating can affect anyone, but it can be confusing to understand and recognise it in our own personal experiences. This guide, published by East London NHS Foundation Trust, is a snapshot of how adults in East London have navigated those experiences of uncertainty while seeking support for disordered eating. For many of the contributors, preconceptions about what an eating disorder is (or isn’t) have previously acted as a barrier to seeking or receiving support. It also contains advice on how to seek support for disordered eating. 13 “The alarming rate of suicide among healthcare workers should be a wake-up call in the urgent need to support them” Frontline19 was established at the start of the Covid pandemic as an urgent response to support frontline workers who were under extreme pressure and experiencing significant mental health challenges. Psychotherapist Claire Goodwin-Fee is the founder and CEO of Frontline19. In this blog, Claire explains how systemic pressures and stigma around mental health are continuing to leave healthcare staff extremely vulnerable. 14 Blog: Why harmful gender stereotypes surrounding men’s approaches towards their feelings need challenging This blog explores why men are reluctant to seek support when they are struggling with their mental health and why the suicide rate is so high. It looks at initiatives that exist to encourage men to seek help and highlights what more could be done to support mens’ mental health. 15 Learning how to protect the health system by protecting the caregivers This commentary in JAMA Network Open looks at the increasingly recognised problem of burnout among US healthcare professionals. General Social Survey data suggest that almost one-half of US health care workers experienced symptoms of burnout often or very often in 2022, up from less than one-third in 2018. The article explores research that demonstrates the extent of the issue and highlights studies looking at ways to reduce burnout. The authors conclude that systemic change will be required to tackle the issue. 16 Time for a rebalance: psychological and emotional well-being in the healthcare workforce as the foundation for patient safety In this editorial for BMJ Quality and Safety, Kate Kirk explains why staff well-being is the foundation to improving patient safety. 17 Top tips and key actions for successful collaborative partnership working across mental health services These top tips and key actions have been co-developed to support effective collaborative partnership working in the planning and delivery of community mental health services. They recognise that every heath and care system will experience challenges in relation to partnership working given the statutory and cultural differences of organisations working across the mental health pathways and that there will be different arrangements to frame local partnership working, including for example a Section 75 agreement. 18 Balancing care: The psychological impact of ensuring patient safety In this blog, Leah Bowden, a patient safety specialist, reflects on the impact her job has on her mental health and family life. She discusses why there needs to be specialised clinical supervision for staff involved in reviewing patient safety incidents and how organisations need to come together to identify ways we can support our patient safety teams. Have your say Do you have any stories, insights or resources related to mental health? We would love to hear from you! Comment below (register for free here first) Get in touch with us directly to share your insights.

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