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News Article
NHS ombudsman warns hospitals are cynically burying evidence of poor care
Patient Safety Learning posted a news article in News
Hospitals are cynically burying evidence about poor care in a “cover-up culture” that leads to avoidable deaths, and families being denied the truth about their loved ones, the NHS ombudsman has warned. Ministers, NHS leaders and hospital boards are doing too little to end the health service’s deeply ingrained “cover-up culture” and victimisation of staff who turn whistleblower, he added. In an interview with the Guardian as he prepares to step down after seven years in the post, Rob Behrens claimed many parts of the NHS still put “reputation management” ahead of being open with relatives who have lost a loved one due to medical negligence. The ombudsman for England said that although the NHS was staffed by “brilliant people” working under intense pressures, too often his investigations into patients’ complaints had revealed cover-ups, “including the altering of care plans and the disappearance of crucial documents after patients have died and robust denial in the face of documentary evidence”. Read full story Source: The Guardian, 17 March 2024- Posted
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Australian doctor suspended amid investigation into woman’s death after abortion
Patient Safety Learning posted a news article in News
A doctor working at a women’s health clinic in Melbourne has been suspended as a regulator revealed it was aware of concerns about other practitioners there. The facility’s boss claims it is a “witch hunt”. It follows the death of 30-year-old mother Harjit Kaur, who died in January at the Hampton Park Women’s Clinic after what was described as a “minor procedure”. It was later identified as a pregnancy termination. The Australian Health Practitioner Regulation Agency (Ahpra) has confirmed Dr Rudolph Lopes’ registration had been suspended but did not reveal the reason behind the decision. His registration details show he was reprimanded in 2021 for failing to respond to the regulator’s inquiries. “[The regulator] has received a range of concerns about a number of practitioners associated with the Hampton Park Women’s Clinic,” Ahpra said in a statement. “[The regulator] has established a specialist team to lead a co-ordinated examination of these issues which involve multiple practitioners across a number of professions and across a number of practice locations.” Ahpra chief executive, Martin Fletcher, said he was “gravely concerned by the picture that is emerging.” “We have taken strong action to protect the public while our investigations continue,” Fletcher said. “National boards stand ready to take any further regulatory action needed to keep patients safe. “While the coroner continues to examine the tragic death of a patient, our inquiries are focusing on a wider range of issues that our investigations bring to light.” Read more Source: The Guardian, 15 March 2024 -
News Article
Parents watched 18 month old die after Shrewsbury hospital failings
Patient Safety Learning posted a news article in News
Alice and Lewis Jones were forced to watch their 18-month-old baby die in front of them after a failure by a scandal-hit NHS trust left him with a “catastrophic brain injury” following his birth. Their son Ronnie was one of hundreds of babies who have died following errors by Shrewsbury and Telford Hospital, where the largest NHS maternity scandal to date was previously uncovered by The Independent. Two years later, Mr and Mrs Jones are calling for the Supreme Court to overturn a controversial decision in February which ruled bereaved relatives could not claim compensation over the psychological impact of seeing a loved one die, even if it was caused by medical negligence. It comes after the trust admitted to failings in a letter to the parents’ lawyers. Ronnie’s birth in 2020 fell outside of the Ockenden review and his parents have warned it showed failures were still occurring despite warnings made during the inquiry. Within the Ockenden inquiry, multiple cases of staff failing to recognise and act upon CTG training were found, and the final report recommended all hospitals have systems to ensure staff are trained and up to date in CTG and emergency skills. The report also said the NHS should make CTG training mandatory and that clinicians must not work in labour wards or provide childbirth care without it. A CTG measures a baby’s heart and monitors conditions in the uterus and is an important measure before birth and during labour to observe the baby for any signs of distress. Ms Jones said: “We knew about the Ockenden review, but everything at Telford was new and so I think we just assumed that lessons had been learned, the same thing wouldn’t happen to us.” Ronnie’s parents are campaigning to reverse the Supreme Court which ruled that “secondary victims” – including parents who are not directly harmed by the birth – are not eligible to bring claims for psychiatric injury following medical negligence. Read full story Source: The Independent, 14 March 2024- Posted
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Mental health trust failed to heed safety warnings, campaigners say
Patient Safety Learning posted a news article in News
A mental health trust linked to thousands of unexpected patient deaths repeatedly failed to act on coroners' safety warnings, campaigners say. BBC News has been given exclusive access to new evidence from coroners' reports gathered by a campaign group. It wants a criminal investigation into why so many patients died at Norfolk and Suffolk NHS Foundation Trust - and has sent police the evidence. Campaigners, including patients and bereaved families, claim it is failing to make vital safety improvements despite promising to do so. Last summer, a report found more than 8,000 mental-health patients had died unexpectedly in Norfolk and Suffolk between 2019 and 2022. This is defined as the death of a patient who has not been identified as critically ill or whose death is not expected by the clinical team. The new evidence, based on 38 coroners' prevention of future death (PFD) reports since 2013, suggests there were repeated warnings more patients could die unless safety issues were addressed, including: dangerously poor record-keeping and communication family concerns being ignored unsafe levels of staffing at the trust. And campaigners say the trust's failure to improve safety has led to more deaths. Read full story Source: BBC News, 12 March 2024- Posted
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News ArticleBereaved relatives have accused ministers of dragging their feet over an inquiry into the death of almost 2,000 patients across NHS mental health trusts in Essex. The inquiry has still not started more than eight months after the announcement that it would be relaunched with beefed-up powers. In June last year, the government gave in to pressure from families and the then chair of the inquiry, granting it legal powers to compel witnesses to give evidence. In December, the new terms of reference were sent to ministers, setting out what the inquiry will investigate. But the terms of reference have yet to be approved by ministers, leaving relatives frustrated, with another “unnecessary” death reported a few weeks ago. Melanie Leahy, whose son, Matthew, died at the Linden Centre in Chelmsford in 2012, said: “I know that this inquiry, the first of its kind nationally, if carried out in a timely and comprehensively investigative manner, it has the power to prevent more deaths, not just in Essex but all over the UK. “Why am I and all the other bereaved families and injured individuals still waiting? Worse, why are we being met with such callous and terrifying indifference? Why are our legal team being ignored? We can only conclude that our government simply does not care. If the government continues to drag its feet in this way then they must be held to account for their failings. If there are more deaths during this interminable wait, this government needs to be held responsible.” Read full story Source: The Guardian, 12 March 2024
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Priory healthcare group fined £650,000 over death of patient
Patient Safety Learning posted a news article in News
The Priory healthcare group has been fined more than £650,000 over the death of a 23-year-old patient who was hit by a train after absconding from a mental health hospital. Matthew Caseby, a personal trainer, was able to leave Birmingham’s Priory hospital Woodbourne by scaling a wall after being “inappropriately unattended” for several minutes in September 2020, an inquest jury ruled in 2022. The healthcare company pleaded guilty to a criminal safety failing linked to the death of a patient, breaching the 2008 Health and Social Care Act, at Birmingham magistrates court on Friday. The London-based provider was charged after an investigation into the death of Caseby conducted by the Care Quality Commission. Caseby’s father, Richard Caseby, who had been campaigning for a prosecution of the healthcare organisation, told the court the company attempted to “evade accountability for its gross failures”. In a victim impact statement which he presented as part of the prosecution on Friday, he said: “I found it unbelievable that a private company commissioned by the NHS to care for its most vulnerable psychiatric patients in the greatest crisis of their lives could be so cruel and resort to such desperate tactics to hide the truth.” Read full story Source: The Guardian, 8 March 2024- Posted
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Content ArticleLewis Chilcott was 23 years old when he died at Royal Sussex County Hospital in Brighton. In this blog, his father Simon describes what happened to Lewis and how his family was treated by the hospital following Lewis’s death. Simon continues to call for greater transparency in the investigation process and improvements to the way hospitals engage with bereaved families.
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Content ArticleAdverse safety events (ASE) are common in paediatric out-of-hospital cardiac arrests (OHCA). This retrospective chart review study sought to estimate the prevalence of adverse safety events in children under age 18 experiencing OHCA. The researchers found that 60% of those children experienced at least one severe ASE, with the highest odds of ASE occurring when the OHCA was birth-related.
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Coroners' death reports reveal rise in NHS warnings
Patient Safety Learning posted a news article in News
Coroners in England and Wales sent 109 warnings to health bodies and the government in 2023 highlighting long NHS waits, staff shortages or a lack of NHS resources, the BBC has found. The number of cases identified that were linked to NHS pressures was the highest in the past six years. Prevention of future death reports (PFDs) are sent when a coroner thinks action is needed to protect lives. About 35,000 inquests take place in England and Wales each year. In a fraction of those - about 450 - the coroner writes a PFD, or Regulation 28, report. The BBC analysed 2,600 PFDs - and supporting documentation - sent between 2018 and 2023. The proportion of the total number of PFD reports that referenced an NHS resource issue rose to one in five in 2023, from one in nine in the two years before Covid. Of the 540 reports written last year, 109 were found that highlighted a long wait for NHS treatment, a shortage of medical staff or a lack of NHS resources such as beds or scanners. Of these, 26 involved mental illness or suicide, and 31 involved ambulances and emergency services. The government says it "responds to, and learns from, every report". Read full story Source: BBC News, 8 March 2024- Posted
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Content ArticleThis is my story, as a bereaved mother, about lessons I have learnt following the unexpected death of my previously well 25-year-old daughter Gaia in University College Hospital London (UCLH) in July 2021. I have written 11 patient safety lessons in the hope this helps other families be more assertive if they have a critically sick relative in hospital. Believe me, you must be pushy to be allowed into a hospital ward, even more so ITU. I went to visit my critically sick daughter at around 10am on a Sunday morning, but was not allowed on to the ward. A senior nurse told me to GO HOME using the 'Covid' excuse. I was shut out from the bedside of my critically ill only child. I have set up TruthForGaia.com to share learnings more widely. Please take a look. I hope sharing this may contribute to reducing avoidable deaths from brain conditions which can be only too easily assumed to be intoxication, especially on weekends. I believe raised intracranial pressure (high pressure in the skull) needs more awareness and training. When will UCLH hold a medical grand round on my daughter's case?
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Content ArticleHospital nurse staffing, and the proportion of nurses with bachelor’s education, are associated with significantly fewer deaths after routine surgery, according to research published in the Lancet. A team of researchers conducted the study across nine European countries and found that a better educated nursing workforce reduced unnecessary deaths. Every 10%increase in the number of bachelor’s degree educated nurses within a hospital is associated with a 7% decline in patient mortality. Patients in hospitals, in which 60% of nurses had bachelor’s degrees and nurses cared for an average of six patients, had almost 30% lower mortality than patients in hospitals in which only 30% of nurses had bachelor’s degrees and nurses cared for an average of eight patients. The study shows that, in hospitals in England, an average only of 28% of bedside care nurses had bachelor’s degrees, among the lowest in Europe, which averaged 45%. The study shows that increasing the production of graduate nurses is necessary if the NHS is to realise the potential of lower patient mortality and fewer adverse patient outcomes.
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News ArticleHarry Miller was a popular teenager, appreciated for his sharp humour, ability to get on with anyone and eagerness “for the next adventure”. In the autumn of 2017, he was struggling with difficult thoughts and feelings of anger. Harry, who was 14 and lived in south-west London, confided his inner turmoil to friends and family. “I’m just having these anger rages,” he told his mother one day. “It’s like I just go crazy suddenly and I can’t control it. I don’t know what’s going on.” Two years previously, Harry had been prescribed the drug montelukast for his asthma. Unbeknown to his parents, a range of psychiatric reactions had been reported in association with montelukast treatment, including aggression, depression and suicidal thoughts. Harry’s parents, Graham and Alison Miller were not properly warned of the potential side effects. Their son was referred to the NHS child and adolescent mental health services in January 2018, but he missed an appointment because it was sent to the wrong person. On 11 February 2018, Harry was found dead in the family home, with an inquest later recording a verdict of suicide. He was described in a tribute by friends at St Cecilia’s Church of England school in Southfields, south-west London, as a “super star burning brightly”. Two years after his death, his father read an online warning about the adverse reactions involving montelukast by the Medicines and Healthcare Products Regulatory Agency (MHRA). It said these could very rarely include suicidal behaviour. Graham Miller said: “It is an absolute outrage that parents are being given psychoactive substances to give to their children without proper warning of the risk.” This weekend, the MHRA has confirmed that the drug is under review. A montelukast UK action group is calling for more prominent warnings of the drug’s possible side effects. Read full story Source: BBC News, 3 March 2024
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Content ArticleDr Georgia Richards provides oral evidence to the UK Parliamentary Justice Select Committee's follow-up inquiry to the Coroner Service on 20 February 2024. Watch all of the evidence given by Georgia including: Part 1: Inconsistencies in coroner reports Part 2: Could sanctions improve the Coroner Service? Part 3: Improving the status and ability of coroner reports Part 4: Barriers to making changes Part 5: The potential future utility of the Tracker In part 1, shown in the below video, Dr Richards is asked what the evidence is for variation in writing coroner reports in England and Wales.
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News ArticleA hospital trust has admitted that a young autistic boy should still be alive had they delivered the appropriate level of care. In an exclusive interview with ITV News, the day before the inquest into his death, Mattheus Vieira's heartbroken parents described him as "special", adding: "And special in a good way, not just special needs." "People may think because he was autistic he was difficult, but it's not the case, he was very easy. "He was the boss of the house, we just miss his presence." Mattheus, aged 11, was taken to King's Lynn Hospital, in Norfolk, with a kidney infection. He struggled to cope with medical staff taking observations, and his notes recorded him as "uncooperative". His dad, Vitor Vieira, told ITV News: "He doesn't like to be touched, even a plaster he doesn't like. "And they say 'Oh he does not co-operate'. He was an autistic boy, what do you expect? Mr Vieira believes staff did not understand his son's behaviour. Mattheus was non verbal and so unable to articulate his distress. Observations were dismissed as "inaccurate" by some medical staff. In fact, they were accurate and indicated that his kidney infection had developed into septic shock. He suffered a cardiac arrest and died, aged 11. Read full story Source: ITV News, 26 February 2024
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Content ArticleHospitals with high mortality and readmission rates for patients with heart failure (HF) might also perform poorly in other quality concepts. Wang et al. sought to evaluate the association between hospital performance on mortality and readmission with hospital performance rates of safety adverse events. They found that patients admitted with HF to hospitals with high 30-day all-cause mortality and readmission rates had a higher risk of in-hospital adverse events. There may be common quality issues among these 3 measure concepts in these hospitals that produce poor performance for patients with HF.
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News Article
Nottingham hospitals: NHS paid out £101m over maternity failings
Patient Safety Learning posted a news article in News
The NHS paid out tens of millions of pounds over maternity failings at a hospital trust which is the subject of a major inquiry. Including legal fees, £101m was paid in claims against Nottingham University Hospitals (NUH) between 2006 and 2023. NUH is facing the UK's largest-ever maternity review, with hundreds of baby deaths and injuries being examined. Experts say lives could be saved if the trust invested more in learning from its mistakes. The NHS paid the money in relation to 134 cases over failings at the Queen's Medical Centre (QMC) and City Hospital. The majority - £85m - was damages for families who were successful in proving their baby's death or injury was a result of medical negligence. Read full story Source: BBC News, 28 February 2024- Posted
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News Article
Baby death inquiries are poor and incomplete, experts say
Patient Safety Learning posted a news article in News
Deaths of newborn babies should be more thoroughly investigated by health boards in Scotland, experts have said after reviewing an increase in infant mortality. The team found inquiries into baby deaths conducted by health boards were “poor quality, inconsistent and incomplete”. The experts added that information about staffing levels on maternity wards at the time of the deaths was so poor that they could not draw any conclusions. They were also unable to determine if health boards enlisted independent, external advisers when considering if deaths could have been prevented. Helen Mactier, a retired neonatologist and chairwoman of the Neonatal Mortality Review, said: “This review has helped to get a clearer understanding of the increase in neonatal deaths that occurred in 2021-22. “We understand that there are still unanswered questions, and our recommendations are focused on ensuring that future opportunities to learn are not missed and acted on in a timely and comprehensive manner.” Read full story (paywalled) Source: The Times, 27 February 2024- Posted
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Content ArticleNicholas Gerasimidis had a history of mental illness manifesting as obsessive compulsive disorder (OCD) and anxiety. In 2022, his condition deteriorated. His GP referred him twice to the Community Mental Health Team but the referrals were rejected with medication being prescribed instead, together with advice to contact Talking Therapies. He was taken on to CMHT workload after being assessed by the Psychiatric Liaison Team in Royal Cornwall Hospital in November 2022. The preferred course of treatment was psychological treatment in the form of Cognitive Behavioural Therapy with Exposure Response Prevention. There was a waiting list of a year. In May 2023, Mr Gerasimidis became worse. It was felt an informal admission to hospital was required but a bed was not available. He was found hanged at his home address on 3 June 2023.
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Over 30 sepsis deaths linked to ‘systemic’ failings, investigation reveals
Patient Safety Learning posted a news article in News
Major progress made in sepsis care during the previous decade has been significantly reversed amid repeated failures in recognising and treating the condition. HSJ has identified 31 deaths in the last five years where coroners have warned of systemic problems with diagnosing and treating sepsis, including nine cases relating to children. Many of the deaths were deemed avoidable. Meanwhile, investigations suggest a majority of acute trusts are failing to record their treatment rates for sepsis, which is deemed a crucial aspect of driving improvements. Repeated shortcomings raised by coroners, including 10 separate cases in 2023, include delays or failures to administer antibiotics, not following protocols for identifying sepsis, and inaccurate, missed or skipped observations. Health ombudsman Rob Behrens, who issued a report on sepsis failures last year, said the same mistakes were “clearly being repeated time and time again”. He added: “What is chilling to me is that these [coroners’ reports] fit in almost exactly with the issues we raised in our sepsis report… and even the 2013 sepsis report issued by my predecessor, including unnecessary delays, wrong diagnosis, and failure to provide adequate plans for sepsis.” Read full story (paywalled) Source: HSJ, 27 February 2024- Posted
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News Article
Newly installed EPR contributed to A&E death, warns coroner
Patient Safety Learning posted a news article in News
A newly installed electronic patient record contributed to the “preventable” death of a 31-year-old woman in an emergency department, a trust has been warned. Emily Harkleroad died at University Hospital of North Durham in December 2022 following “failures to provide [her] with appropriate and timely treatment” for a pulmonary embolism, a coroner has said. The inquest into her death heard emergency clinicians had raised concerns about a newly installed electronic patient record, provided by Oracle Cerner, which they said did not have an escalation function which could clearly and quickly identify the most critical patients. The inquest heard the new EPR, installed in October 2022, did not have a “RAG rating” system in which information on patient acuity “was easily identifiable by looking at a single page on a display screen” – as was the case with the previous IT system. The software instead relied on symbols next to patients’ names which indicate their level of acuity when clicked on, but did “not [provide] a clear indication at first glance” of their level of acuity. Rebecca Sutton, assistant coroner for County Durham and Darlington, said that “errors and delays” meant Ms Harkleroad did not receive the anticoagulant treatment that she needed and “which would, on a balance of probabilities, have prevented her death”. “It is my view that, especially in times of extreme pressure on the emergency department, a quick and clear way of identifying the most critically ill patients is an important tool that could prevent future deaths.” Read full story (paywalled) Source: HSJ, 23 February 2024- Posted
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Content ArticleOn 18 December 2022, Emily Harkleroad collapsed when out with a friend. She was taken by ambulance to the University Hospital of North Durham Emergency Department. Despite staff recognising that pulmonary embolism was the likely diagnosis, there were failures to provide Emily with appropriate and timely treatment for pulmonary embolism. Errors and delays in the Emily’s medical treatment resulted in her not receiving the anticoagulant treatment that she needed, and which would, on a balance of probabilities, have prevented her death. She died as a result of pulmonary embolism in the early hours of 19 December 2022 at the University Hospital of North Durham.
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Baby loss certificates introduced in England
Patient Safety Learning posted a news article in News
Bereaved parents who lose a baby before 24 weeks of pregnancy in England can now receive a certificate in recognition of their loss. Ministers say they have listened to bereaved parents who have gone through the painful experience of miscarriage. Campaigners said they were "thrilled" that millions of families would finally get the formal acknowledgement that their baby existed. All parents who have experienced baby loss since September 2018 can apply. They should visit the gov.uk website - applicants must be at least 16 years old, have been living in England at the time of the loss and be one of the baby's parents or surrogate. In Wales, there are plans to deliver a similar scheme. Babies who are born dead after 24 completed weeks of pregnancy are called stillbirths, and their deaths are officially registered. But this does not happen for babies who die before that stage. Pregnancy loss or miscarriage before 24 weeks is the most common complication of pregnancy, experienced by an estimated one in five women in the UK. Read full story Source: BBC News, 21 February 2024 -
Content ArticleOn 29 December 2022, Shahzadi Khan was detained under section 2 of the Mental Health Act due to her mental state and the risks she presented. She was found to have had a manic episode with psychotic symptoms. Due to a lack of beds, she was placed in a privately-run mental health hospital in Norfolk. She remained there until her discharge to the family home on 26 January 2023. She was commenced on Olanzapine and Zopiclone for her mental health whilst an inpatient. Her diagnosis on discharge was mania with psychotic symptoms. She was to remain on olanzapine in the community. Her placement out of area contributed to disjointed and inadequate discharge planning to support her in the community and was exacerbated by poor communication between the team managing out of area placements and the local team. As a consequence, the aftercare planning did not take place in accordance with S117 Mental Health Act. This was exacerbated by a failure by all health professionals involved in her care within the mental health trust to recognise that she needed to be referred on to the Trafford Shared Care pathway. A referral would have ensured she received support and care for at least 12 weeks when she returned to the community. There is no clear reason for this failure. She was seen by the Home-Based Treatment Team (HBTT) on 28 January and 2 February, then discharged back to her GP. Within a week of that discharge from HBTT, which meant she had been left with no mental health support, she had deteriorated significantly. On 9 February her GP sent her to hospital for emergency assessment due to her presentation. She was discharged home to be seen by the Home- Based Treatment Team on 11th February. She was seen by that team on 11, 12, and 13 February. There was still no recognition of the fact that the Trafford policy was not being followed. She had indicated her lack of compliance with olanzapine, suicidal thoughts and her behaviour on 13th February was erratic. On 14 February 2023 she took a fatal overdose of prescribed zopiclone at her home address.
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Italy announces inquiry into its handling of Covid-19 pandemic
Patient Safety Learning posted a news article in News
Italy will carry out an inquiry into its handling of the coronavirus pandemic in a move hailed as “a great victory” by the relatives of people killed by the virus but criticised by those who were in power at the time. Italy was the first western country to report an outbreak and has the second highest Covid-related death toll to date in Europe, at more than 196,000. Only the UK’s death toll is higher. The creation of a commission to examine “the government’s actions and the measures adopted by it to prevent and address the Covid-19 epidemiological emergency” was approved by the lower house of parliament after passing in the senate. Consuelo Locati, a lawyer representing hundreds of families who brought legal proceedings against former leaders, said: “The families were the first to ask for a commission and so for us this is a great victory. The commission is important because it has the task, at least on paper, to analyse what went wrong and the errors committed so as not to repeat the massacre we all suffered.” Read full story Source: The Guardian, 15 February 2024- Posted
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'Ethnic bias' delayed care before Liverpool woman's death
Patient Safety Learning posted a news article in News
"Cultural and ethnic bias" delayed diagnosing and treating a pregnant black woman before her death in hospital, an investigation found. The probe was launched when the 31-year-old Liverpool Women's Hospital patient died on 16 March, 2023. Investigators from the national body the Maternity and Newborn Safety Investigations (MSNI) were called in after the woman died. A report prepared for the hospital's board said that the MSNI had concluded that "ethnicity and health inequalities impacted on the care provided to the patient, suggesting that an unconscious cultural bias delayed the timing of diagnosis and response to her clinical deterioration". "This was evident in discussions with staff involved in the direct care of the patient". The hospital's response to the report also said: "The approach presented by some staff, and information gathered from staff interviews, gives the impression that cultural bias and stereotyping may sometimes go unchallenged and be perceived as culturally acceptable within the Trust." Liverpool Riverside Labour MP Kim Johnson said it was "deeply troubling" that "the colour of a mother's skin still has a significant impact on her own and her baby's health outcomes". Read full story Source: BBC News, 16 February 2024- Posted
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