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Found 41 results
  1. News Article
    More than a quarter of ‘critical incidents’ have been declared by just four trusts since the start of the crisis in urgent and emergency care. Data obtained by HSJ shows 241 critical incidents have been declared by organisations due to “operational” or “system pressures” between April 2021, when long waits for urgent care began to surge upwards, and last month. Four trusts account for 68 of these (28%). Critical incidents are declared when the level of disruption “results in an organisation temporarily or permanently losing its ability to deliver critical services, or where patients and staff may be at risk of harm”. These incidents may require “special measures and support from other agencies, to restore normal operating functions,” according to the NHS England definition. Most critical incidents were only in place for a few days before being stood down by the trust or system, but some were in place for much longer – sometimes for several months at a time, the data suggests. Read full story (paywalled) Source: HSJ, 25 October 2023
  2. News Article
    People who seek help for mental health issues should be asked about problem gambling in the same way they are asked about drugs, smoking and alcohol, new guidance has suggested. According to the National Institute for Health and Care Excellence (NICE), those who visit an NHS health professional in England for depression, anxiety or thoughts about self-harm or suicide because of a possible addiction, such as alcohol or drugs, could be at a greater risk of harm from gambling. NICE said questions should be asked about patients’ gambling habits to ensure they could cope with their thoughts and urges. In new draft guidance, it suggested patients should be encouraged to assess the severity of their gambling by using a questionnaire available on the NHS website. Those who scored eight or higher should seek support and treatment from gambling services. Read full story Source: The Guardian, 5 October 2023
  3. News Article
    A district general hospital has accused a major teaching trust of ‘failing to adhere to arrangements’ made around the provision of acute stroke services, sparking patient safety warnings in a local integrated care board’s (ICB) risk register. Harrogate and District Foundation Trust’s accusation that its neighbour, Leeds Teaching Hospitals Trust, is failing to comply with protocol around acute stroke pathways was published in West Yorkshire ICB’s risk register. The ICB’s September risk register also said the “risk to patient safety is significant and probable if the situation remains unresolved”. The issues centre on the provision of hyper-acute stroke unit beds, which provide the first two to three days of care for patients with newly diagnosed strokes, and what happens to patients requiring acute stroke care following their initial HASU stay. West Yorkshire ICB said in its September’s performance report that the problem had “grown due to two recent clinical incidents,” but added “there is no quick solution to this problem”. Harrogate has raised concerns with the ICB in recent months that “a number of patients are not receiving HASU level care at Leeds”. Read full story (paywalled) Source: HSJ, 3 October 2023
  4. News Article
    Proposals by the Scottish Government to give a licence to unregistered professionals to carry out cosmetic procedures are “fundamentally flawed” and put lives at risk, leading nurses in the field have warned. A consultation has been launched seeking views on plans for a new regulatory regime of non-surgical aesthetic treatments that pierce or penetrate the skin like dermal fillers or lip enhancements. Ministers want to bring non-health professionals under existing legislation allowing them to obtain a licence to perform these procedures in unregulated premises such as beauty salons and hairdressers. The move comes after a UK-wide review carried out in 2013, by then NHS medical director Sir Bruce Keogh, identified that little regulation existed within the cosmetic industry. Since then there has been growing concern that people are coming to physical and psychological harm from treatments gone wrong. Leaders at the British Association of Cosmetic Nurses (BACN) told Nursing Times that they were “totally opposed” to non-medical practitioners carrying out injectable beauty procedures. BACN Chair Sharon Bennett said holding a medical, nursing or dentistry qualification should be a “basic prerequisite” before being accepted to an aesthetics training course. SHe said BACN believed even clinically trained practitioners, including nurses, needed further training in aesthetics before working in this “specialist” area. “[This is] because there is no educational framework, training or statutory provision to establish or task beauty therapists to detect disease, care for patients or carry out medical treatment, so to do so would breach public health safety and endanger lives.” Read full story Source: The Nursing Times, 20 January 2020
  5. News Article
    A Derby doctor who has been the subject of eight tribunals in less than nine years has been sanctioned for a further four months. Dr Anatta Nergui was originally found guilty of misconduct in 2014 and has been found to have not fully reflected on the severity of his offending in six different hearings since. The psychiatrist was suspended by the Medical Practitioner Tribunal Service (MPTS) in 2014 for running a website and blog which offered incorrect medical advice to those who got in contact with him. In 20 of 22 cases, he was found to have failed to recommend that the patient saw a doctor or psychiatrist, and failed to recommend a counselling or psychotherapy course in 30 cases, among other complaints, which put patients at "significant risk of harm". The latest tribunal aimed at assessing his fitness to practice, held in March 2022, has imposed a further four months of conditions on him, after the MPTS found that "despite there being a low risk of repetition, the remediation had not yet been completed", according to the chair of the tribunal, Jetinder Shergill. In the MPTS determination, released on Thursday (March 17), Mr Shergill said: "While the tribunal was satisfied that there is sufficient evidence Dr Nergui is a competent and safe doctor, there remains a lingering concern that he did not appreciate the findings made against him from the patient’s perspective and/or did not express this in a clear, cogent manner. The tribunal considered that Dr Nergui might have benefitted from seeking feedback from a trusted colleague or mentor, reflecting on what went wrong and setting out his thought processes on avoiding similar risk. "In short, the self-reflection has led Dr Nergui down a restricted path of understanding, leading him to focus on the legal aspects of the process and semantics rather than the primary issue which was one of patient safety. If he had sought the input of a third party, it may have led to him developing an alternative view rather than the binary approach that he has adopted. This left the tribunal with the view that whilst there has been some insight, remediation is not yet complete." Read full story Source: Derbyshire Live, 18 March 2022
  6. News Article
    The risk to patients will only get worse unless the government reaches an agreement to prevent further strikes, NHS leaders have warned. In a letter to the prime minister and health secretary, they said there was "deep worry" about today's strike. People are being asked to only call 999 in a life-threatening emergency, but NHS England says emergency care will continue to be provided. Ambulance response times are already twice as long as two years ago. The letter, signed by the leaders of NHS Confederation and NHS Providers, says the action being taken by ambulance workers "isn't just about pay but working conditions: many have said they are doing this because they no longer feel able to provide the level of care that their patients need and deserve." They urged ministers to "do all you can to bring about an agreed solution". Health Secretary Steve Barclay said the pay deal on offer to both ambulance staff and nurses had been agreed by an independent pay review body. In England, eight out of the 10 major ambulance services have declared critical incidents - a sign of the intense pressure they are already under. Ministers have urged the public to take extra care and suggested they avoid contact sports and unnecessary car journeys. Read full story Source: The Guardian, 21 December 2022
  7. News Article
    Health minister Will Quince has warned the public to avoid any “risky activities” on Wednesday as ambulance drivers stage strike action. The NHS is set to be hit by major disruption as ambulance workers including paramedics, control room workers and technicians walk out in England and Wales. During the strike, the military will not drive ambulances on blue lights for the most serious calls but are expected to provide support on other calls. Mr Quince urged the public to avoid anything risky on Wednesday, telling BBC Breakfast: “Where people are planning any risky activity, I would strongly encourage them not to do so because there will be disruption on the day.” The health minister did not offer examples of what might be defined as risky behaviour but told the public that in any emergency calling 999 should still be the first option. Read full story Source: The Independent, 20 December 2022
  8. Content Article
    Sleep deprivation due to extended work hours and circadian disruption has long been a concern in medicine. The levels of continuous duty and work hours for health care personnel are much greater than those allowed in the transportation and nuclear-power industries. The problem is most severe for residents in training but extends to experienced physicians and nurses. Clinicians who have been deprived of sleep are part of a health care system in trouble. A report from the Institute of Medicine concluded that the system fails to ensure that patients are safe or that the quality of care they receive is high. In this article, David Gaba and Steven Howard discuss current and proposed policies concerning clinicians' work hours and fatigue.  
  9. Content Article
    In this article, published by the Betsy Lehman Center, the author reviews Dr. René Amalberti's work which explains in detail why and how groups of workers can fall into risky habits over time.
  10. News Article
    In March, while the UK delayed, Ireland acted. For many this may prove to have been the difference between life and death. The choices our governments have made in the last month have profoundly shaped what risks we, as citizens, are exposed to during the course of this pandemic. Those choices have, to a large extent, determined how many of us will die. At the time of writing, 365 people have died in Ireland of COVID-19 and 11,329 have died in the UK. Adjusted for population, there have been 7.4 deaths in Ireland for every 100,000 people. In the UK, there have been 17 deaths per 100,000. In other words, people are dying of coronavirus in the UK at more than twice the rate they are dying in Ireland. In her article, Elaine Doyle explores why this might be. Read full story Source: The Guardian, 14 April 2020
  11. News Article
    Two out of five GPs have still not received any personal protective equipment (PPE) against coronavirus, a Pulse survey suggests. The poll of over 400 GPs saw 41% of respondents say they have not received any PPE, while a further 32% said they had not received enough. Just 15% of GPs said they have sufficient PPE, with the remainder unsure. This comes despite NHS England promising last week that it would ship PPE free of charge to practices. The Welsh Government made the same announcement this week, while in Scotland health boards should be distributing PPE. A GP who has received no proper equipment, Dr Kate Digby, in Cirencester, said she feels "woefully underprepared". She told Pulse: "I'm becoming increasingly concerned at the lack of resources being provided for frontline primary care". Read full story Source: Pulse, 2 March 2020
  12. News Article
    Hundreds of people with haemophilia in England and Wales could have avoided infection from HIV and hepatitis if officials had accepted help from Scotland, newly released documents suggest. A letter dated January 1990 said Scotland’s blood transfusion service could have supplied the NHS in England and Wales with the blood product factor VIII, but officials rejected the offer repeatedly. Large volumes of factor VIII were imported from the US instead, but it was far more contaminated with the HIV and hepatitis C viruses because US supplies often came from infected prison inmates, sex workers and drug addicts who were paid to give blood but not screened. The death of scores of people with haemophilia and blood transfusion patients and the infection of thousands of others across the UK in the contaminated blood scandal has been described as the worst health disaster to hit the NHS. The latest document was released under the Freedom of Information Act to campaigner Jason Evans, whose father died in 1993 having contracted hepatitis and HIV. In it, Prof John Cash, a former director of the Scottish Blood Transfusion Service, said the decision not to use Scotland's spare capacity to produce Factor VIII for England was "a grave error of judgement". Read full story Source: The Guardian, 3 January 2020
  13. News Article
    A woman has died after being set on fire during surgery in Romania, the country’s health ministry has said, in a case that has cast a spotlight on the ailing Romanian health system. The patient, who had pancreatic cancer, died on Sunday after suffering burns to 40% of her body when surgeons used an electric scalpel despite her being treated with an alcohol-based disinfectant. Contact with the flammable disinfectant caused combustion and the patient “ignited like a torch”, Emanuel Ungureanu, a Romanian politician, said. A nurse threw a bucket of water on the 66-year-old woman to prevent the fire from spreading. The health ministry said it would investigate the “unfortunate incident”, which took place on 22 December. “The surgeons should have been aware that it is prohibited to use an alcohol-based disinfectant during surgical procedures performed with an electric scalpel,” the Deputy Minister, Horatiu Moldovan, said. Read full story Source: The Guardian, 30 December 2019 the hub has a number of posts on preventing surgical fires: Surgical fires: nightmarish “never events” persist MHRA. Paraffin-based skin emollients on dressings or clothing: fire risk (18 April 2016) National Patient Safety Agency: Fire hazard with paraffin-based skin products (Nov 2007) How I raised awareness of fires in the operating theatre
  14. Content Article
    A review of government policies tackling smoking, poor diet, physical inactivity and harmful alcohol use in England.
  15. Content Article
    The Global Drug Policy Index provides a score and ranking for each country to show how much their drug policies and their implementation align with the UN principles of human rights, health and development. It offers an important accountability and evaluation mechanism in the field of drug policy.
  16. Content Article
    In this article in the Pharmaceutical Journal, Carolyn Wickware asks if liquid morphine should be reclassified. She cites research that Oramorph or oral morphine sulphate solution was directly linked to the cause of death in 13 reports since 2013.
  17. News Article
    Many doctors from black, Asian and minority ethnic backgrounds say key risk assessments have still not taken place, or have not been acted on. About 40% of UK doctors in the UK are from BAME backgrounds, yet 95% of the medics who have died from coronavirus were from minority backgrounds. The NHS said last June that its trusts should offer risk assessments to staff, but hundreds told a poll for BBC News that they were still awaiting assessments or action. Of 2,000 doctors who responded, 328 said their risks hadn't been assessed at all, while 519 said they had had a risk assessment but no action had been taken. Another 658 said some action had been taken, with just 383 reporting their risks had been considered in detail and action put into place to mitigate them. One of those who responded was Dr Temi Olonisakin, a junior doctor in London who has Type 1 diabetes. She had her risk assessment early on in the pandemic. "It was as comprehensive as a side A4 paper can be," she says. "I think for a lot of people it felt more like a tick-box exercise, and one that could be used to say: 'We've done what we need to do to make people feel safe' - but I'm not sure in reality that's how people felt." Read full story Source: BBC News, 26 March 2021
  18. News Article
    A mental health trust prosecuted for failings after 11 patients died must make further safety improvements, the Care Quality Commission (CQC) said. Inspectors found safety issues on male wards and psychiatric intensive care units run by Essex Partnership University NHS Foundation Trust (EPUT). The Trust said it had taken "immediate action" to remedy the concerns. In November, EPUT pleaded guilty to safety failings related to patient deaths between 2004 and 2015. The CQC's report followed inspections in October and November last year at the Finchingfield Ward - a 17-bed unit in the Linden Centre in Chelmsford which provides treatment for men experiencing acute mental health difficulties. The CQC said the visit was prompted "due to concerning information raised to the commission regarding safety incidents leading to concerns around risk of harm". The inspection, which looked at safety only, found the following concerns: Some staff did not follow the required actions to maintain patient safety. Closed-circuit television showed staff who were meant to be observing were not present, and this contributed to an incident of patient absconding. Staff did not keep accurate records of patient care and managers did not check the quality and accuracy. of notes. Shifts were not always covered by staff with appropriate experience and competency Stuart Dunn, head of hospital inspection at the CQC, said EPUT had "responded quickly to concerns raised" including improving security measures. Read full story Source: BBC News, 14 January 2021
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  20. Content Article
    Continuing the 'Why investigate' series, in this blog, Martin Langham looks at collecting data, introduces the idea of measurement, and asks what published science is there for testing it ‘beyond reasonable doubt’.
  21. Content Article
    Despite many investigations and inquiries into violent incidents in mental health settings, resulting in reports and guidelines, safety considerations for mental health staff continue to be an issue of serious concern. This report from the Royal College of Psychiatrists attempts to address the safety needs of psychiatrists. Psychiatrists from different disciplines are likely to be exposed to different degrees of threat to their safety, but no particular branch of psychiatry is immune. In the same vein, the context in which psychiatric practice is delivered will also have a bearing on the likelihood of violence, be it on in-patient units, in out-patient settings, in accident and emergency departments, in prisons and other custodial institutions, or in patients’ homes.
  22. Content Article
    A set of 5 infographics describing the the factors that influence the risk of nosocomial transmission of infections (such as Covid19), and how health and care staff can take action to manage the risks and reduce the infection rate. The factors explained are: People Equipment Task Environment Organisation
  23. Content Article
    Healthcare organisations are committed to the safety of the patients receiving care, treatment, and services. Healthcare organisations are also committed to the safety of those who serve those patients – healthcare workers, whether they be nurses, physicians, medical technicians, pharmacists, lab workers, housekeeping staff. This new book from The Joint Commission pulls together a collection of checklists to keep those healthcare workers safe from chemical and physical hazards, infectious agents, workplace violence, ergonomic problems, work-related stress, and more. The checklists are built upon authoritative guidelines from OSHA, NIOSH, CDC, and others and are intended to simplify healthcare worker safety. Most of the checklists are intended for use by health care workers themselves, depending upon their clinical or other responsibilities. Some of the checklists are intended for management to ensure that policies, procedures, and resources are in place to ensure health care worker safety in all areas of the organization. All of the checklists are straightforward and easy to use and understand and cover the key areas of risk for healthcare workers. Each section of checklists is introduced by compelling statistics that show how dangerous working in the health care environment can be, without proper precautions. The checklists provide the procedures or must-do activities to ensure that health care workers are as safe as can be.  Sample pages
  24. Content Article
    Human factors and ergonomics (HFE) approaches to patient safety have addressed five different domains: usability of technology; human error and its role in patient safety; the role of healthcare worker performance in patient safety; system resilience; and HFE systems approaches to patient safety.
  25. Content Article
    Harold Shipman was an English doctor who killed approximately 15 patients while working as a junior hospital doctor in the 1970s, and another 235 or so when working subsequently as a general practitioner. Is it possible to learn general lessons to improve patient safety from such extraordinary events? In this paper, published in the US Journal of the Royal Society of Medicine, it is argued that it is not possible fully to understand how Shipman came to be such a successful and prolific serial killer, nor to learn how the safety of healthcare systems can be improved, unless his diabolical activities are studied using approaches developed to investigate patient safety.
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