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Found 105 results
  1. News Article
    Coeliacs may soon no longer need to eat large amounts of gluten – the very thing suspected of making them sick – to get an accurate diagnosis. Australian research published in the journal Gastroenterology showed a blood test for gluten-specific T cells had a high accuracy in diagnosing coeliac disease, even when no gluten was eaten. Around 1% of people in western countries have coeliac disease, an autoimmune condition in which gluten causes an inflammatory reaction in the small bowel. Currently, every approved method to diagnose it requires people to eat gluten, the paper said. Current testing methods – blood tests or a gastroscopy – require weeks of a person eating gluten, while often enduring symptoms such as diarrhoea, abdominal pain and bloating. Despite the importance of early diagnosis, the researchers said many people are deterred because they do not want to get sick from the tests. More than one in two cases of coeliac disease are either undiagnosed or diagnosed late, prior research has shown. “There are likely millions of people around the world living with undiagnosed coeliac disease simply because the path to diagnosis is difficult, and at times, debilitating,” said Assoc Prof Jason Tye-Din, a senior author of the paper and head of the Coeliac Research Laboratory at the Walter and Eliza Hall Institute of Medical Research (WEHI) in Melbourne, Australia. The new research could be a “game-changer”, helping address “one of the biggest deterrents in current diagnostic practices”, Tye-Din said. Read full story Source: The Guardian, 10 June 2025
  2. News Article
    Patients are facing “unnecessary and worrying” waits because a rapid heart failure test is not available at most of the NHS’s 169 community diagnostic centres (CDC), experts have told HSJ. An analysis by HSJ of data from the Alliance for Heart Failure found that as of October 2024 virtually no trusts and ICBs reported offering rapid NT-proBNP in their CDCs. The rapid version gives a result with minutes, while a regular test must be sent away to a lab for analysis. The research, exclusively shared with HSJ, also found that CDCs offering the rapid NT-proBNP test are mainly located on hospital-based sites – and not in the community. A further 14 trusts operating across 10 integrated care systems said that the rapid test is, or might be, added to their CDC offer. The Royal College of Pathologists and the British Society for Echocardiography have both called for it to be made available in all CDCs. They have claimed this would cut unnecessary waits for patients, reduce inappropriate referrals and ease pressure on diagnostic services. “This is an essential test which should be available in all CDCs”, said Dan Augustine, president of the British Society for Echocardiography. “Many people who are suspected of having heart failure are currently referred for echocardiograms. For those who do not have heart failure, this means an unnecessary and potentially worrying wait. It also puts added pressure on already struggling echocardiographers.” Read full story (paywalled) Source: HSJ, 19 May 2025
  3. News Article
    Artificial intelligence is being hailed as a potential game-changer in prenatal care, cutting down the time it takes to identify fetal abnormalities by almost half, according to a groundbreaking new study. Researchers at King’s College London and Guy’s and St Thomas’ NHS Foundation Trust found as well as being faster, AI is just as accurate as traditional methods, offering the potential to revolutionise the 20-week scan. The technology, tested in the first trial of its kind, could significantly reduce scan times, easing anxiety for expectant parents and freeing up sonographers to focus on potential problem areas. The AI also proved more reliable than human sonographers in taking crucial measurements. This improved accuracy offers the potential for earlier detection of potential issues, allowing medical professionals to intervene sooner if required. The AI tool was also found to alter the way in which the scan is performed, as sonographers no longer needed to pause, save images or measure during the scan. Read full story Source: The Independent, 27 March 2025
  4. News Article
    Influencers are appealing to emotional narratives around health and often “fearmongering” to promote controversial medical tests on social media, a new study has found, in ways that are overwhelmingly misleading and fail to mention potential harms. The research, led by the University of Sydney, published in the journal JAMA Network Open, investigated five tests being discussed on social media despite limited evidence of their benefits for generally healthy people and concerns about overdiagnosis. These were full-body magnetic resonance imaging (MRI) scans; genetic testing claiming to identify early signs of 50 cancers; blood tests for testosterone levels; the anti-Mullerian hormone (AMH) or “egg-timer” test, which surveys a woman’s egg count; and the gut microbiome test. The study’s lead author, Dr Brooke Nickel, said posts about these tests came from a “wide range” of account holders, from major influencers to “everyday girl-next-door” accounts, as well as news outlets, doctors and the companies making the tests. “Across the board, they were being promoted misleadingly,” she said. Nickel said the tests were being promoted under the guise of empowerment: early screening as a way for people to take control of their own health. However, as Nickel noted: “These tests carry the potential for healthy people to receive unnecessary diagnoses, which could lead to unnecessary medical treatments or impact mental health.” Read full story Source: The Guardian, 26 February 2025
  5. Content Article
    More information about "The challenges of navigating the healthcare system: Margaret's story"
    We hear time and time again on the hub about the lack of joined up care and communication within and across organisations. Patients and their families and carers not knowing who to contact to chase up a referral, systems not joined up, lack of communication, having to repeat the patient’s history and medications to every new healthcare professional they see because the notes haven’t been shared or clinicians "don’t have time to read them all". These issues are widespread and urgently need to be addressed if we are to prevent people falling through the gaps and suffering worse health outcomes. In this blog, *Margaret shares her and family's experiences of trying to coordinate their elderly father's upcoming surgery. Interoperability issues My father has dementia and has a complex set of health issues, as a lot of elderly people do. He has a number of comorbidities, including vascular, heart, and cognition and memory problems, that has meant coordinating his care between the care home, his GP, the local hospital and a specialist hospital has been quite complex. There have been multiple issues but there were two that stood out. The first issue was at the diagnostic stage. My father has severe vascular problems and he needed fairly urgent and necessary surgery. In order to assess whether he was suitable for surgery, given his heart condition, he needed a scan. We have had problems in the past in getting access to scans on his heart so the GP said in order to move things on quicker it would be good to get the scan done privately. As the surgery was urgent, we paid to get the scan done at a private diagnostic centre. However, when it came to getting the information from the private diagnostic centre to the tertiary hospital where he was being treated we encountered problems. The hospital couldn’t access the scans from the private hospital because they were two different systems which meant there was an interoperability issue as the two systems ‘didn’t talk to each other’. One of the suggestions I was given was that I could drive to the private diagnostic centre, which was about a 40 mile drive from my house, with a CD, and then they would download the scans onto the CD and I could then drive back to the hospital, which was about another 35 mile drive. There were multiple calls and this was really quite distressing for our family because we knew my father needed access to the scans urgently. In the end they said they’d do another scan in the hospital. Although I don't think there were any kind of safety issues with my father having another scan, it did mean that not only did it cause delays and stress for my father and the family, it was also a cost to the NHS, which could have been avoided. Communication problems between departments Then around the same time, the hospital wanted to do another scan on my father to prepare for the surgery. Again, as it was urgent, I kept ringing the hospital asking if he had his scan yet but because my father was under the vascular and cardiac departments it was often difficult to know who to speak to because one department needed information from the other and they hadn't received it. So I’d get through to one department who then told me to phone another department, or I would be put on hold by someone from admin who didn’t know the answer and would say they’d ring back but didn’t because they were very busy. As a carer/relative you don’t know what’s happening and you become worried that your loved one is lost in the system. I persisted in phoning but, coincidentally, at the same time my sister visited my father’s house to pick up some bits for him. She saw there was a letter from the hospital so she opened it and it was a letter inviting my father in to have an outpatient appointment scan in the hospital he was an inpatient in! I ended up going to PALS. The lady I spoke to was understanding, sympathetic, kind and highly efficient. But she told me this happened all the time as the radiology department doesn't have access to the hospital's IT system, so they wouldn't know my father was an inpatient and would have just invited him in in a timely way but they would have done that as if he was an outpatient. I coordinated between the different departments and we finally got the scan for my father, he had the surgery and survived. However, these delays could have compromised his health because the surgery was urgent and if he had deteriorated whilst waiting that may have killed him. As a family we were very conscious that time was of the essence and we had to push continuously. Lack of information given to families These are just two examples from a multiple of occasions where we as a family were trying to get information. My father was elderly and wouldn’t have questioned the doctor. And because of his cognition issues due to his dementia, and also because he was on high doses of pain medication, he becomes confused and we couldn’t always rely on what he told us. However, often the healthcare professionals wouldn’t tell us things, despite me being next of kin and with documented power of attorney, and told us to speak to my father. So as a carer or relative you are trying to join the dots and work within a health system that isn’t coordinated. What I want to see change On the face of it they may seem like quite small examples, but when they build up, they are significant in terms of risk. My father was a high-risk patient and if it wasn’t for our diligence and persistence he would have fallen through the cracks, to a significant detriment to his health. I didn’t want there to be avoidable harm, an investigation and ‘lessons learned.’ I want us to be working in a coordinated and proactive manner to recognise the risks and void any harm. And for that insight to be used to ensure systems and processes are improved for the benefit of other patients and families. Also, I want opportunities to share my experience, not as a formal complaint but for genuine interest in our family’s customer experience. Again, for learning and future preventative action not for blame. *The names in this blog have been changed to ensure anonymity. Are you a patient, relative or carer frustrated with navigating the healthcare system? Or is your GP practice or Trust doing something innovative to make it easier for patients? We would love to hear your stories. Please add to our community forum (you will need to register with the hub, it's free and easy to sign up) or email us at [email protected]. Related reading The challenges of navigating the healthcare system: David's story The challenges of navigating the healthcare system: Sue's story Navigating the healthcare system as a university student: My personal experience Lost in the system? NHS referrals "I love the NHS, BUT..." Preventing needless harms caused by poor communication in the NHS (DEMOS, November 2023) Robust collaborative practice must become the bedrock of modern healthcare Robbie: A homeless patient’s struggles with the system Digital-only prescription requests: An elderly woman sent round the houses Lost in the system: the need for better admin Digital-only prescription requests: An elderly woman sent round the houses
  6. News Article
    Two couples have told the BBC they went through with abortions after an NHS trust mistakenly told them their unborn babies had serious genetic conditions. They say errors by doctors at the Nottingham University Hospitals NHS Trust led to them terminating their pregnancies. Another family say a last-minute scan on the day they were due to have an abortion changed their minds and they are now the parents of a healthy nine-year-old boy. The trust, which is currently at the centre of the largest maternity inquiry in the history of the NHS, said its foetal medicine teams strived to provide "compassionate and professional" care. Ms Carly Wesson and her partner Carl Everson were expecting their first child in January 2019, when a 12-week scan indicated their baby had a high chance of having Down's Syndrome. They were offered a test, known as chorionic villus sampling (CVS), to check if their baby had any genetic or chromosomal conditions. Two days later, the foetal care team at City Hospital in Nottingham told them the initial results indicated their daughter had a rare genetic condition called Patau's Syndrome, which often results in miscarriage, stillbirth, or the baby dying shortly after birth. Results from a more detailed analysis of the sample were due back two weeks later. The couple asked if it might show a different outcome, but they say their consultant advised them it would not. The couple decided to have an abortion. Six weeks after the abortion, they were asked to attend a meeting at City Hospital, which they assumed was a routine follow-up. "[The consultant] just walked in and the first thing she said was 'I have got something to tell you, your results have changed'," says Ms Wesson. The second test, called a long term CVS culture, showed their daughter had no chromosomal abnormality. When they asked if their daughter would have survived, Ms Wesson says the doctor told the couple: "Well, you could have miscarried anyway." "That's always stuck with me - it was almost malicious," she says. An investigation into the death carried out by the trust said the second test showed "all 50 cells studied had a normal chromosome compliment". The first test result - which the couple say was the basis on which they decided to terminate the pregnancy - had been a false positive. This is "a well-recognised hazard of early CVS results", the investigation found. Read full story Source: BBC News, 6 February 2025
  7. News Article
    Eight women whose smear tests were misread by screeners went on to develop cancer, a major review into cervical screening at the Southern Health Trust has found. A further 11 women's slides were found to have pre-cancerous changes in the cells when they were reviewed and had to receive treatment. All these women had either pre-cancerous changes to their cervix or were diagnosed with another significant gynaecological condition when their smears were reviewed. The review was triggered when the diagnoses of three women were investigated as a Serious Adverse Incident. Two of the women, Lynsey Courtney and Erin Harbinson, have since died. More than 17,000 were approached to have their smear tests rechecked. The examination of cancer screening at the Southern Health Trust over 13 years found that many women were failed after some screeners underperformed and went unchecked by management for years. Stella McLoughlin from the campaign group Ladies with Letters described what had happened as unforgivable and called for a public inquiry. "This has been an absolute scandal from start to finish and was allowed to go on for 10 years," she added. "Smears being misread, people not being held to account, screeners not being managed properly - all of this is affecting real people." Read full story Source: BBC News, 11 December 2024
  8. News Article
    Hundreds of patients are being contacted over potentially incorrect results at a second NHS trust, as more laboratories report concerns over diabetes tests, HSJ understands. Bedfordshire Hospitals Foundation Trust was the first to report an issue over blood tests earlier this year, saying up to 11,000 patients may have received the wrong results – including a misdiagnosis of diabetes. But the Medicines and Healthcare Products Regulatory Agency has confirmed to HSJ that other laboratories across the country have reported concerns over the same device, which measure glucose control. The Hb1AC blood test is used to diagnose diabetes and prediabetes, as well as manage existing conditions. A spokeswoman said clinical care was unlikely to have been affected, but doctors were reviewing individual circumstances and patients would be contacted if they needed a new test. Several field safety notices have now been published for the Premier Hb9210 HbA1c analyser device, manufactured by Trinity Biotech. Dr Janine Jolly from MHRA said the regulator was working closely with the manufacturer to ensure corrective actions were being put in place. Read full story (paywalled) Source: HSJ, 27 November 2024
  9. News Article
    Hundreds of patients are being contacted over potentially incorrect results at a second NHS trust, as more laboratories report concerns over diabetes tests, HSJ understands. Bedfordshire Hospitals Foundation Trust was the first to report an issue over blood tests earlier this year, saying up to 11,000 patients may have received the wrong results – including a misdiagnosis of diabetes. But the Medicines and Healthcare Products Regulatory Agency has confirmed to HSJ that other laboratories across the country have reported concerns over the same device, which measure glucose control. The Hb1AC blood test is used to diagnose diabetes and prediabetes, as well as manage existing conditions. One affected trust is Maidstone and Tunbridge Wells FT, which said around 1,500 patients had been identified for a retest following a technical issue affecting results in July. A spokesman said the problem was escalated to the supplier as soon as possible, and that affected patients would be contacted by GPs. Read full story (paywalled) Source: HSJ, 27 November 2024
  10. Content Article
    Climate change is leading to a rise in heat-related illnesses, vector-borne diseases, and numerous negative impacts on patients’ physical and mental health outcomes. Concurrently, healthcare contributes about 4.6% of global greenhouse gas emissions. Low-value care, such as overtesting and overdiagnosis, contributes to unnecessary emissions. This review describes diagnostic excellence in the context of climate change and focus on two topics. First, climate change is affecting health, leading to the emergence of certain diseases, some of which are new, while others are increasing in prevalence and/or becoming more widespread. These conditions will require timely and accurate diagnosis by clinicians who may not be used to diagnosing them. Second, diagnostic quality issues, such as overtesting and overdiagnosis, contribute to climate change through unnecessary emissions and waste and should be targeted for interventions. The review also highlight implications for clinical practice, research, and policy. The findings call for efforts to engage healthcare professionals and policymakers in understanding the urgent implications for diagnosis in the context of climate change and reducing global greenhouse gas emissions to enhance both patient and planetary outcomes.
  11. Content Article
    Errors associated with failures in filing, actioning and communicating blood test results can lead to delayed and missed diagnoses and patient harm. This study aimed to audit how blood tests in primary care are filed, actioned and communicated, to identify areas for patient safety improvements. What this study adds When primary care clinicians retrospectively reviewed the electronic health records of 2572 patients who had recent blood tests, around 10% disagreed with the initial clinician’s actioning of test results. Out of the 1132 patients where an action (such as ‘book an appointment’) was specified, there was evidence in the electronic health records that this did occur in 89.7% (varying between 45.2% and 100% in participating practices). In 47% of patients (n=1210) there was no evidence in the electronic health records that results had been communicated to the patient. Around 50% of participating practices who completed a follow-up questionnaire had used their benchmarked results to stimulate quality improvement (QI) activities, practice learning or educational activities. How this study might affect research, practice or policy This research demonstrates variation in the way blood test results are actioned and communicated to patients, with important patient safety implications. We have shown that using a collaborative model of research in primary care can help stimulate QI and could help widen participation in research beyond traditionally ‘research active’ general practices.
  12. Community Post
    Are you a GP or other healthcare professional working in primary care? Have you noticed an increase in rejected referrals to outpatient services/for scans and other investigations? How have changes to the referral system affected you? What communication relating to referrals have you received recently from the NHS? What has the impact been on your own workload and wellbeing, and the safety of patients? Please share your experiences with us so we can continue to highlight this important issue.
  13. Content Article
    Postpartum hypertensive disorders pose a serious health risk to new mothers; nearly 75 percent of maternal deaths associated with hypertensive disorders occur in the postpartum period. For the past decade, the obstetrics department at the Hospital of the University of Pennsylvania (HUP) has tried to lower these risks by checking patients’ blood pressure after they are released from the hospital. Their initial efforts to have patients return to the office for an in-person blood pressure check shortly after discharge yielded disappointing results, so the team revamped their approach and ultimately developed an extremely successful program called Heart Safe Motherhood. The programme started when the team at HUP gave a small group of women a blood pressure cuff each. They told them they would receive text messages after discharge instructing them to take their blood pressure at 8am, and that they would need to send in the reading. At 1pm, they would get another text requesting that they send their blood pressure again. This article describes how Heart Safe Motherhood evolved to improve the likelihood of mothers submitting their readings, and how the programme was scaled up to five hospitals in the group. It looks at how the approach has helped tackled health inequalities and improved the safety of postpartum mothers.
  14. Content Article
    Urgent funding is required to clear waiting list backlogs and drive Northern Ireland's long-term healthcare transformation, the Northern Ireland Audit Office has said in a new report which outlines the health service's "critical situation" after almost a decade of worsening waiting lists for elective care. The NI Audit Office looked at waiting list data from 2014 to 2023. It found the number of patients waiting for elective care has risen by 452,000 during that nine-year period. The Audit Office also said: "Available information suggests waiting list performance levels are significantly worse in Northern Ireland compared with the other UK regions." The report makes a series of recommendations: The very long waiting times across all the main elective specialisms further underlines the range and scale of difficulties facing stakeholders. The Department and trusts should review the key causal factors influencing outcomes across the various elective specialisms and assess if action plans in place to address these need to be radically strengthened. Waiting list pressures are currently particularly acute for Neurology, Dermatology, ENT and General Surgery (initial outpatient appointments) and ENT, T&O Surgery, and General Surgery (hospital admission). To support the introduction of local RTT measurement and targets, DoH must strive to ensure that the Encompass programme remains on course for implementation by its scheduled deadlines, and that it is fully capable of such reporting. In the interim, it should use the December 2022 comparative figures as a baseline and continue regularly monitoring performance on that basis, to determine if the HSC performance gap with England and Wales is narrowing or increasing, and also identify if any best practice there, which has helped ensure performance has not deteriorated to the same extent, can be further implemented locally. Whilst action is underway to try and address issues around trust performance and patient DNAs, and the Department is now trying to centrally drive improvements, the Department and trusts now need to explicitly quantify the increased capacity and activity required to sustainably reduce waiting times, and assess how this can be achieved at each trust, through both improving the efficiency of current operations and progressing HSC transformation. It recommends that the Department identifies the investment necessary to ensure the HSC sector can function more efficiently and sustainably, including reducing waiting times to targeted levels. It should also demonstrate and quantify, in business case terms, if such investment can ultimately secure better longer-term value for money and patient outcomes, and the likely implications of failing to secure such funding. This will help DoH demonstrate how more sustainable funding arrangements can better support its objectives. As DoH and the Trusts seek to incrementally build increased dedicated elective capacity, they should monitor its impact on waiting times, and assess whether the additional facilities are having the desired success and impact. If waiting times are not reducing appreciably, they should assess the extent of further dedicated capacity required across key specialisms. Given the current situation, the Department should firstly confirm the robustness of its estimate of the funding required to fully implement the Framework in preparation for any potential introduction of long-term budgets. Until it has greater certainty on the availability of recurrent funding, it should rank or prioritise the actions likely to have greatest impact on waiting times and allocate available recurrent and non-recurrent funding towards these on this basis. The Department should set revised Framework targets as soon as feasible. The limited implementation of previous strategies means the Department’s regular progress assessments on the Framework is welcome. Going forward, these should identify the specific work which must be progressed over the next reporting period to ensure milestones are met, who is responsible for driving this, progress against targets and timelines, and whether emerging evidence means any actions should be redesigned or reprioritised. Progress should continue being publicly reported, setting out why any actions are behind schedule, and whether, and how, this can be rectified. Close working between the various stakeholders involved in workforce-related issues is required, to ensure stronger elective care workforce planning. The stakeholders should now take stock of how their work is progressing and collectively agree the priority areas which require further attention to ensure the HSC elective workforce has the right capacity and capability to drive HSC transformation. Based on the current situation and workforce deficits, revised projections and plans should be developed, together with targets and strategies for achieving these. Increased use of the IS is likely to be necessary for the foreseeable future to address the colossal patient backlog. In preparation for any progress in approving multi-year budgets, DoH should set out its strategic plans for expanding use of the IS, and continue to clarify with the sector the degree to which it can build additional capacity to help clear the backlogs.
  15. News Article
    About 17,500 women in Northern Ireland are to have their smear tests re-checked as part of a major review of cervical screening dating back to 2008. Some of these women will be recalled to have new smear tests carried out, BBC News NI can reveal. The Southern Trust said that the women affected should receive letters by post from Tuesday. It follows a highly critical report commissioned by the Royal College of Pathologists (RCPath). It found: Several cytology staff were "significantly underperforming". Mechanisms to check their work were flawed. Action taken by management was inadequate over many years. While a majority of negative results issued by the laboratory were correct, a "significant number" of these would likely have been identified as "potentially abnormal" by other laboratories. Read full story Source: BBC News, 9 October 2023
  16. News Article
    Women are being unnecessarily alarmed about their risk of breast cancer by consumer genetic test results that do not take family history into account, researchers have said. Women who discover outside a clinical setting that they carry a disease-causing variant of the BRCA1 or BRCA2 genes may be told that their risk of breast cancer is 60-80%. But analysis of UK Biobank data suggests the risk could be less than 20% for those who do not have a close relative with the condition. Dr Leigh Jackson, of the University of Exeter’s medical school, who is the lead author of the analysis published in the journal eClinical Medicine, said that in extreme cases this could result in women unnecessarily undergoing surgery. “Being told you are at high genetic risk of disease can really influence levels of fear of a particular condition and the resulting action you may take,” he said. “Up to 80% risk of developing breast cancer is very different from 20%.” Until recently, women who received BRCA results did so because they had attended clinic due to symptoms or a family history of disease. However, an increasing number are now learning of their genetic risk after paying for home DNA testing kits or taking part in genetic research, without ever having any personal link with breast cancer. Read full story Source: The Guardian, 15 September 2023
  17. News Article
    Patients with cancer symptoms could bypass their GP in the future and go straight for a scan, the health secretary has suggested, in the latest “radical” attempt by the government to cut huge NHS waiting lists. The suggestion, which comes as the government is expected to reduce the number of NHS cancer waiting time targets, could form part of proposals to “design out bottlenecks” in the NHS system, Steve Barclay said in an interview. Health department officials are reportedly working on proposals that would mean some patients experiencing cancer symptoms could go straight to an NHS diagnostic centre – or “one-stop shop” – without a GP referral. “We are very much looking at those patient pathways,” Barclay told the Daily Telegraph. “Where there are bottlenecks in the system of referral from the GP, is there scope to go direct to the relevant diagnostic test or to the clinician? Breast cancer is a good example because almost always the GP refers on … and therefore there’s an opportunity to design out bottlenecks in the system.” Read full story Source: Guardian, 16 August 2023
  18. Content Article
    This Healthcare Safety Investigation Branch (HSIB) investigation focuses on the systems used by healthcare providers to book patient appointments for clinical investigations, such as diagnostic tests and scans. ‘Clinical investigation booking systems’ are used throughout the NHS to support the delivery of patient care. Healthcare services use paper-based or fully electronic systems, or a combination of the two (hybrid systems), to communicate to patients the time, date and location of their appointment. These systems also produce information for patients about actions they need to take to prepare for their appointment. Written patient communication is a key output of clinical investigation booking systems. This investigation examines the safety implications of patient communications, produced by booking systems, that do not account for the needs of the patient. In addition, it looks at why patients are ‘lost to follow-up’ after an appointment is cancelled, rescheduled or not attended. Lost to follow-up is the term used to describe a patient who does not return for planned appointments (whether for continued care or evaluations) or is no longer being tracked in the healthcare system when they should be. The reference event for this investigation was a child of Romanian ethnicity who was referred for an MRI scan, which required a general anaesthetic. The scan was booked, and a letter was sent to the child’s parents including the appointment details and pre-appointment instructions. The Trust’s booking system was only able to produce appointment letters in English, and there were no Trust processes or policies to routinely translate written appointment information. The family recognised key details in the written information, including the time, date and location of the scan. However, they were not able to understand the instructions about the child not eating or drinking (fasting) for a certain amount of time before the scan. When the family attended the appointment for the scan, the child had eaten. This meant the MRI scan could not be completed and it was therefore cancelled. When the scan was finally carried out cancer was diagnosed. The child received treatment, but sadly the disease progressed and they were placed on a palliative care pathway and died. Findings Written communications to patients about radiology appointments are routinely sent in English only. Healthcare staff expect that written appointment information will be translated by a patient’s friend or family member. NHS England standards do not require written appointment information to begiven in any non-English language, other than for people with a disability. Confusion about the requirements for appointments can result in delayed care and additional costs if appointments need to be rebooked. The language needs of patients are not always clearly understood. There is differing national guidance as to whether written communication needs should be recorded. The national NHS system that holds patient information and populates it into many trust systems (the Personal Demographics Service) can store information on patients’ preferred written communication methods. However, this information is often not entered into the system. Administrative staff are not routinely involved in assessing and testing electronic booking systems before they are implemented. Recommendations HSIB recommends that NHS England develops and implements a standard for healthcare providers on supplying written appointment information in languages other than English. Safety observations It may be beneficial for NHS care providers to explore options for the translation of written appointment communications, including pre-attendance guidance, for patients whose preferred written language is not English. Safety actions It may be beneficial if the ‘preferred written communication method’ field of the Personal Demographics Service system is completed for patients who require written communications in a language other than English. It may be beneficial if NHS trusts identify mechanisms to appreciate the language needs of their patient demographic and adjust the written communications accordingly. It may be beneficial to clarify the roles and functions of national organisations in supporting the health inequalities landscape. It may be beneficial for NHS healthcare providers to incorporate the NHS Service Standard into agreements with third-party developers of electronic clinical investigation booking systems.
  19. Content Article
    Study into patient attitudes and perspectives related to viewing immediately released test results through an online patient portal. In this survey study of 8139 respondents at four US academic medical centres, 96% of patients preferred receiving immediately released test results online even if their healthcare practitioner had not yet reviewed the result. However a subset of respondents experienced increased worry after receiving abnormal results.
  20. News Article
    There is huge regional variation in the rate at which health systems are preventing patients joining the elective waiting list through “advice and guidance” to GPs, according to analysis by HSJ. Some systems – including Northamptonshire – have managed to ramp up these “diverts” to such an extent that they now report around one A&G case to every 3.5 cases cleared from the waiting list through treatment or seeing a consultant. This contrasts with others, such as Lancashire and South Cumbria, which only reports one A&G case for every 16 cleared from the waiting list. Advice and guidance involves GPs consulting specialists before making direct referrals and around half the time this results in a referral being avoided. The model is set to be a cornerstone of NHS England’s new outpatient transformation strategy, which is due imminently. Victoria Tzortziou-Brown, vice chair of the Royal College of GPs, said the analysis “confirms reports we’ve heard from our members – that there is too much regional variation in the use of the ‘advice and guidance’”. She added: “Some GPs report that when advice and guidance is properly resourced and well implemented, it can be a helpful tool for improving communications with their colleagues in secondary care. “[But] it is clear that more time, funding and capacity needs to be dedicated to allow clinicians to communicate efficiently and effectively whilst respecting professionalism.” Read full story (paywalled) Source: HSJ, 9 April 2024 Related reading on the hub: Rejected outpatient referrals are putting patients at risk and increasing workload pressure on GPs
  21. News Article
    A prostate cancer patient went a year without a check-up because his referral to a consultant was lost. An inquest into the death of Thomas Ithell also heard that when the error was spotted it was not recorded because staff at Wrexham Maelor Hospital were too busy. The 77-year-old from Wrexham died in November 2022 after being admitted to hospital with shortness of breath. Assistant Coroner for North Wales East and Central, Kate Robertson, has submitted a Prevention of Future Deaths report to the health board in relation to Mr Ithell's case. As well as concerns over the lack of an investigation, she also questioned how the patient's follow-up appointment was missed. "There have been no assurances as to what, if any, changes and learning have been identified other than a tracking system for PSA monitoring," she wrote, referring to a type of blood test that helps diagnose prostate cancer. She was also concerned to learn that the hospital's Datix system - used for reporting incidents such as Mr Ithell's - had been described as "not user-friendly". Time constraints also sometimes prevented staff from completing these reports, thereby failing to trigger subsequent investigations by the board, the assistant coroner added. "I remain incredibly concerned that where matters are not raised in accordance with internal health board processes that assurances given to me in previous Prevention of Future Deaths reports cannot be supported," Ms Robertson added. Read full story Source: BBC News, 27 January 2024
  22. News Article
    One of the biggest challenges facing clinicians who treat Long Covid is a lack of consensus when it comes to recognising and diagnosing the condition. But a new study suggests testing for certain biomarkers may identify Long Covid with accuracy approaching 80%. Effective diagnostic testing would be a game-changer in the Long Covid fight, for it’s not just the fatigue, brain fog, heart palpitations, and other persistent symptoms that affect patients. Two out of three people with Long Covid also suffer mental health challenges like depression and anxiety. Some patients say their symptoms are not taken seriously by their doctors. And as many as 12% of Long Covid patients are unemployed because of the severity of their illness and their employers may be sceptical of their condition. Researchers at Cardiff University School of Medicine in Cardiff, Wales, United Kingdom, tracked 166 patients, 79 of whom had been diagnosed with Long Covid and 87 who had not. All participants had recovered from a severe bout of acute Covid-19. In an analysis of the blood plasma of the study participants, researchers found elevated levels of certain components. Four proteins in particular—Ba, iC3b, C5a, and TCC—predicted the presence of Long Covid with 78.5% accuracy. "I was gobsmacked by the results. We’re seeing a massive dysregulation in those four biomarkers," says study author Wioleta Zelek, PhD, a research fellow at Cardiff University. "It’s a combination that we showed was predictive of Long Covid.." Read full story Source: Medscape, 29 November 2023
  23. News Article
    Nearly 500 women had to have their cervical smear tests redone after it emerged the nurse who carried them out was not qualified. 'Dishonest' Alison Watts failed to tell her bosses at an NHS surgery that she failed her course and continued screening women for almost two and a half years. When it was discovered Watts had not passed the qualification, 461 women had to be recalled to have the cervix test again so they could have 'quality assured' tests. Now Watts has been struck off for the shocking breach of trust, with a tribunal ruling that she put patients at 'significant risk of harm'. A Nursing and Midwifery Council [NMC] report said: 'This was not a single instance of misconduct but involved 461 patients over a two year period. There is evidence of sustained dishonesty and deep-seated attitudinal issues.' Read full story Source: Daily Mail, 26 January 2021
  24. News Article
    A blood test designed to detect more than 50 types of cancer at an early stage will be trialled by the NHS. More than 165,000 people in England will be offered the tests from next year. If successful, the NHS hopes to expand it to 1m people from 2024. Sir Simon Stevens, NHS England chief executive, said early detection had the potential "to save many lives". While some welcomed the pilot, others cautioned the test was still untried and untested. Developing a blood test for cancer has been keeping scientists busy for many years without much success. Making one that's accurate and reliable has proved incredibly complex - the danger is that a test doesn't detect a person's cancer when they do have it, or it indicates someone has cancer when they don't. This test, developed by the Californian firm Grail, is designed to detect molecular changes in the blood caused by cancer in people with no obvious symptoms. As part of a large-scale pilot, also funded by the company, 140,000 participants aged between 50 and 79 will be asked to take the tests for the next three years. Another 25,000 people with possible cancer symptoms will also be offered testing after being referred to hospital in the normal way. Read full story Source: BBC News, 27 November 2020
  25. News Article
    Doctors are being told to "think carefully" before ordering any tests for their patients, amid shortages caused by a supply chain failure at a major diagnostics company. Swiss pharmaceutical firm Roche said problems with a move to a new warehouse had led to a "very significant" drop in its processing capacity. A spokesman said COVID-19 tests would be prioritised, but the backlog could affect tests including for cancer and heart disease. One NHS trust in the south west has already advised its GPs to stop all non-urgent blood tests. A memo seen by the BBC, sent to clinicians within a large hospital trust in London, said leaders were "preparing for a sustained disruption". "We urgently need all clinical teams to only send tests that are absolutely essential for immediate patient care, delaying testing where possible," it said. Thyroid and cortisol tests were unavailable, while certain cholesterol, liver function and inflammation tests were "severely restricted". Read full story Source: BBC News, 7 October 2020

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