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News Article
Seven more avoidable sepsis deaths spark coroner warnings
Patient Safety Learning posted a news article in News
Preventable deaths of seven people from sepsis – including four children – have prompted coroners to flag major concerns about NHS services’ management of the condition. Since the start of March, six English coroners have sent formal warnings to trusts, NHS England and the government warning of systemic failures to spot sepsis and delays in administering antibiotic treatments. It comes after an HSJ investigation in February uncovered more than 30 avoidable deaths from sepsis, and undertook analysis of internal figures revealing repeated failures by NHS trusts to provide prompt treatment. Coroner warnings since March include: Two notices were sent this week by Nottingham assistant coroner Elizabeth Didcock to Sherwood Forest Hospitals Foundation Trust, raising concerns over its ability to provide safe paediatric care following the deaths of 10-week-old Tommy Gillman and five-year-old Meha Carneiro from sepsis; A warning from earlier in April criticising University Hospitals Birmingham FT for its failure to treat 56-year-old Tracey Farndon’s sepsis and low blood pressure. Read full story (paywalled) Source: HSJ, 17 April 2024 -
News Article
Report suggests people with breast cancer are being ‘systematically left behind’
Patient Safety Learning posted a news article in News
Many people with breast cancer are being “systematically left behind” due to inaction on inequities and hidden suffering, experts have said. A new global report suggests people with the condition are continuing to face glaring inequalities and significant adversity, much of which remains unacknowledged by wider society and policymakers. The Lancet Breast Cancer Commission highlights a need for better communication between medical staff and patients, and stresses the importance of early detection. It also highlights the need for improved awareness of breast cancer risk factors, with almost one in four cases (23%) of the disease estimated to be preventable. The Lancet Commission’s lead author, Professor Charlotte Coles, department of oncology, University of Cambridge, said: “Recent improvements in breast cancer survival represent a great success of modern medicine. “However, we can’t ignore how many patients are being systematically left behind. “Our commission builds on previous evidence, presents new data and integrates patient voices to shed light on a large unseen burden. “We hope that by highlighting these inequities and hidden costs and suffering in breast cancer, they can be better recognised and addressed by healthcare professionals and policymakers in partnership with patients and the public around the world.” Read full story Source: The Independent, 15 April 2024 -
Content Article
The Lancet Breast Cancer Commission (15 April 2024)
Patient Safety Learning posted an article in Cancers
Despite tremendous advances in breast cancer research and treatment over the past three decades—leading to a reduction in breast cancer mortality of over 40% in some high-income countries—gross inequities remain, with many groups being systematically left behind, ignored, and even forgotten. The work of the Lancet Breast Cancer Commission highlights crucial groups, such as those living with metastatic breast cancer, and identifies how the hidden costs of breast cancer and associated suffering are considerable, varied, and have far-reaching effects. The Commission offers a forward-looking and optimistic road map for how the health community can course correct to address these urgent challenges in breast cancer. -
Content ArticleThere is a growing momentum around the world to foster greater opportunities for the involvement of mental health service users in their care and treatment planning. In-principle support for this aim is widespread across mental healthcare professionals. Yet, progress in mental health services towards this objective has lagged in practice. Francis et al. conducted a systematic review of quantitative, qualitative and mixed-method research on interventions to improve opportunities for the involvement of mental healthcare service users in treatment planning, to understand the current research evidence and the barriers to implementation. Overarching barriers to shared and supported decision-making in mental health treatment planning were: (1) Organisational (resource limitations, culture barriers, risk management priorities and structure); (2) Process (lack of knowledge, time constraints, health-related concerns, problems completing and using plans); and (3) Relationship barriers (fear and distrust for both service users and clinicians). On the basis of the barriers identified, recommendations are made to enable the implementation of new policies and programmes, the designing of new tools and for clinicians seeking to practice shared and supported decision-making in the healthcare they offer.
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Content ArticleSevere myalgic encephalomyelitis or chronic fatigue syndrome (ME/CFS) in children and young people is a little-understood condition which significantly impacts education, development and quality of life. This study in BMJ Paediatrics Open used data from a population-wide surveillance study to explore the screening investigation, referral and management of suspected cases of paediatric severe ME/CFS. The authors found that full investigation is frequently incomplete in children and young people with suspected severe ME/CFS. Recommendations for referral and management are poorly implemented—in particular the needs of children and young people who are unable to leave their home might be poorly met.
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Content Article
NHS England: Pharmacy First
Patient-Safety-Learning posted an article in Community pharmacies
This webpage provides information about the Phramacy First service, launched in England in January 2024. Pharmacy First builds on the NHS Community Pharmacist Consultation Service which enables patients to be referred into community pharmacy for a minor illness or an urgent repeat medicine supply. Pharmacy First adds to this by enabling community pharmacies to complete episodes of care for seven common conditions following defined clinical pathways: Acute otitis media (middle ear infection) Impetigo Infected insect bites Shingles Sinusitis Sore throat Uncomplicated urinary tract infections -
Content ArticleAround 1 in 5 children have eczema (also known as atopic eczema or atopic dermatitis). They typically have inflamed and dry, itchy skin. During flare-ups (periods of worsening symptoms), their skin becomes vulnerable to cracks, bleeding and infection. Eczema impacts quality of life; it can impair sleep, ability to concentrate at school, self-confidence and mood. The condition is usually long-term (chronic), although it improves, or even clears completely, in some children as they get older. Even so, it is one of the most common reasons for children and young people to seek medical care. Community pharmacists and GPs are the first port of call and, while there is no cure, treatments can soothe sore skin, reduce itching, improve the appearance of the eczema, and reduce infections.
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Content ArticleCurrently, it is estimated that more than one in five people in the UK are living in poverty. This King's Fund analysis reveals that people living in poverty find it harder to live a healthy life, live with greater illness, face barriers to accessing timely treatment, and die earlier than the rest of the population. The analysis looks at the link between poverty and each of the following: prevalence of ill health difficulties accessing health care late or delayed treatment poorer health outcomes. The long read argues that while the NHS can, and should, do more to make timely care accessible to deprived communities, wider government and societal action is needed to address the root causes of poverty.
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Content Article
Top picks: 12 research papers on Long Covid
Patient Safety Learning posted an article in Blogs
We are seeing more and more people who have been devastated by the long-lasting impact of Covid-19. Long Covid is a relatively new condition which is still being studied and the need for more awareness and advocacy has never been greater. Scientists are carrying out large-scale clinical trials and researchers are on the hunt for new therapies in the hope that patients with Long Covid will finally see improvements in treatment and support for their symptoms. In this Top picks blog, shared on International Long Covid Awareness Day, we highlight 12 recent research papers on Long Covid. -
News ArticleAt least 50,000 people will die from pancreatic cancer over the next five years unless the government gives more funding to improve how quickly the condition is diagnosed and treated, a major charity has warned. Pancreatic Cancer UK hit out at 50 years of “unacceptably slow progress” compared to other types of cancer as it warned that thousands of lives will be lost unless £35m of “urgent” investment is put towards improving survival rates of the disease. The charity predicted that pancreatic cancer – described by experts as the “quickest-killing cancer” – is expected to kill more people each year than breast cancer by 2027, which would make it the fourth-biggest cause of cancer deaths in the UK. The charity has also called for a commitment to treat everyone diagnosed with the cancer within 21 days, which it says would double the number of people getting treatment in time. Figures show that, compared to the 52.5% survival rate across the 20 most common cancers in the UK, those with pancreatic cancer have just a 7% survival rate. Around 10,500 people are diagnosed with the disease each year, with 9,558 deaths a year, according to Cancer Research UK, with more than half of people dying within three months of diagnosis. Read full story Source: The Independent, 12 March 2024
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News Article
Thousands of A&E patients wait longer than a day for treatment
Patient Safety Learning posted a news article in News
More than 7,300 people waited longer than 24 hours for emergency treatment in Scottish hospitals last year, with the longest wait more than 122 hours. Public Health Scotland statistics obtained by Scottish Labour through freedom of information (FoI) revealed that 7,367 patients were in an emergency department for more than 24 hours before being discharged, admitted or transferred in 2023. The longest wait in A&E last year occurred at NHS Ayrshire and Arran’s University Hospital Crosshouse, where a patient waited more than 122 hours, or the equivalent of five days. Waits of more than 88 hours were recorded in NHS Borders, and 72 hours in NHS Lanarkshire. Dame Jackie Baillie, Scottish Labour’s health spokeswoman, has demanded action from Neil Gray, the health secretary. “Scotland’s A&E departments are in the grip of a deadly crisis, with lives being put on the line day in and day out,” she said. “That some people have waited days — even a working week — to be seen is dangerous and disgraceful. “Hard-pressed A&E staff are working tirelessly to look after patients, but SNP mismanagement has created a perfect storm in our hospitals. Neil Gray has inherited an NHS in deadly disarray from his colleagues. “It’s time for action to be taken now to bolster A&E departments by tackling delayed discharges and investing in primary care to avoid putting further pressure on hospital services.” Read full story (paywalled) Source: The Times, 11 March 2024 -
News Article
Ombudsman warns over-stretched doctors could put cancer patients at risk
Patient Safety Learning posted a news article in News
England’s NHS Ombudsman has warned that cancer patients could be put at risk because of over-stretched and exhausted health staff working in a system at breaking point and delays in diagnosis and treatment. The Parliamentary and Health Service Ombudsman (PHSO) revealed that between April 2020 and December 2023, his Office carried out 1,019 investigations related to cancer. Of those 185 were upheld or partly upheld. Issues with diagnosis and treatment were the most common cancer-related issues investigated by PHSO. These issues included treatment delays, misdiagnosis, failure to identify cancer, the mismanagement of conditions, and pain management. Complaints about cancer care also included concerns about poor communication, complaint handling, referrals, and end-of-life care. Most investigations were about lung cancer, followed by breast cancer and colorectal cancer. The Ombudsman recently closed an investigation around the death of Sandra Eastwood whose cancer was not diagnosed for almost a year after scans were not read correctly. The delay meant she missed out on the chance of treatment which has a 95% survival rate. In 2021, PHSO published a report about recurrent failings in the way X-rays and scans are reported on and followed up across the NHS service. Mr Behrens said, “What happened to Mrs Eastwood was unacceptable and her family’s grief will no doubt have been compounded by knowing that mistakes were made in her care. “Her case also shows, in the most tragic of ways, that while some progress has been made on my recommendations to improve imaging services, it is not enough and more must be done. “Government must act now to prioritise this issue and protect more patients from harm.” Read full story Source: Parliamentary Health and Health Service Ombudsman, 9 March 2024 -
News Article
Menopause is not a disease, say experts
Patient Safety Learning posted a news article in News
The menopause is not a disease and is being “over-medicalised”, experts have said. High-income countries, including the UK, commonly see menopause as a medical problem or hormone-deficiency disorder with long-term health risks “that are best managed by hormone replacement (therapy)”, they said. Yet, around the world, “most women navigate menopause without the need for medical treatments”, the experts, including from the Royal Women’s Hospital in Melbourne, Australia, and King’s College London, said. They argued there is a lack of data on whether health problems are caused by menopause or simply by ageing. In a first paper in The Lancet Series on the menopause, the experts said: “Although management of symptoms is important, a medicalised view of menopause can be disempowering for women, leading to over-treatment and overlooking potential positive effects, such as better mental health with age and freedom from menstruation, menstrual disorders, and contraception.” Series co-author Professor Martha Hickey, from the University of Melbourne and Royal Women’s Hospital, said: “The misconception of menopause as always being a medical issue which consistently heralds a decline in physical and mental health should be challenged across the whole of society. “Many women live rewarding lives during and after menopause, contributing to work, family life and the wider society. “Changing the narrative to view menopause as part of healthy ageing may better empower women to navigate this life stage and reduce fear and trepidation amongst those who have yet to experience it.” Read full story Source: The Independent, 5 March 2024 -
Content Article
Lancet Series: Menopause 2024
Patient Safety Learning posted an article in Women's health
Menopause is an inevitable life stage for half the the world’s population, but experiences vary hugely. Some women have few or no symptoms over the menopause transition while others have severe symptoms that impair their quality of life and may be persistent. Many women feel unsupported as they transition menopause. To better prepare and support women, the Lancet Series on menopause argues for an approach that goes beyond specific treatments to empower women with high-quality information, tools to support decision making, empathic clinical care, and workplace adjustments as needed. Targeted support is needed for groups who experience early menopause or treatment-induced menopause, and for those at increased risk of mental health problems. The authors recognise how gendered ageism may contribute to negative experiences of menopause and call for reduced stigma and greater recognition of the value and contribution of older women. Further reading on the hub: The impact of menopause on mental health (HSSIB blog All-Party Parliamentary Group on Menopause: Inquiry to assess the impacts of menopause and the case for policy reform - conclusions Raising awareness of surgical menopause -
Content ArticleElective care refers to when patients receive non-urgent treatment, normally in hospital, including, tests and scans, outpatient care, surgery and cancer treatment. The NHS is currently seeing long waiting times for some elective procedures, with the Government setting an ambition to reduce elective waiting times to less than a year by 2025. Increased waiting times mean patients have to wait longer for the care they need. This can lead to patients suffering increased pain, their condition may worsen, or they may develop other illnesses associated with the reason that they are waiting for elective care. This can cause both physical harm and mental distress to patients, their families, and carers. The Health Services Safety Investigations Body (HSSIB) Senior Safety Investigator, Neil Alexander, blogs about the challenges facing the NHS in tackling the elective care backlog and how learning from our investigation reports may be able to help the NHS rise to this challenge.
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News Article
NHS to target same elective activity next year
Patient Safety Learning posted a news article in News
Health systems will be asked to deliver the same amount of elective activity next year as they were tasked with completing in 2023-24, HSJ understands. Local leaders have been issued with varying interim targets for 2024-25 that produce an average national threshold of 7% more activity than pre-covid levels, on a value-weighted basis. It means the target for the current year has effectively been rolled over into next, suggesting the elective recovery is a year behind schedule. Even if systems hit their thresholds next year, they will still fall well short of the central target set out in the elective recovery plan in 2022. Recent weeks have seen other elective ambitions ditched or watered down, including the prime minister’s headline pledge to bring the overall waiting list down. It is likely a result of the government accepting it cannot push more elective activity due to ongoing strikes and overspending. Read full story (paywalled) Source: HSJ, 27 February 2024 -
News Article
UK trails other countries on waiting times for cancer treatment, study finds
Patient Safety Learning posted a news article in News
Cancer patients in the UK wait up to seven weeks longer to begin radiotherapy or chemotherapy than people in comparable countries, research has revealed. The stark findings are yet more damning evidence of the extent to which the UK lags behind other nations, as experts warn that people’s chances of survival are being affected by long waits for treatment. In the first research of its kind, experts at University College London analysed data from more than 780,000 cancer patients diagnosed between 2012 and 2017 in four comparable countries: Australia, Canada, Norway and the UK. Eight cancer types were included: oesophageal, stomach, colon, rectal, liver, pancreatic, lung and ovarian cancer. The two studies, published in the Lancet Oncology, were the first to examine treatment differences for eight cancer types in countries across three continents. UK patients experienced the longest waits for treatment, the research found. The average time to start chemotherapy was 48 days in England, 57 in Northern Ireland, 58 in Wales and 65 in Scotland. The shortest time was 39 days in Norway. In radiotherapy, the UK fared even worse. It took 53 days on average for treatment to begin in Northern Ireland, 63 in England, 79 in Scotland and 81 in Wales. Cancer Research UK, which part-funded the two studies, said delays to begin treatment were partly a result of the UK government’s lack of long-term planning on cancer in recent years. Countries with robust cancer strategies backed by funding had seen better improvements in survival rates, it said. Read full story Source: The Guardian, 27 February 2024 -
News Article
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 -
Content ArticleIn this Guardian opinion piece, John Harris looks at reports of people with severe eating disorders being discharged from NHS services in the East of England. He shares the stories of several patients who are desperate to recover from their eating disorders, but have been discharged from specialist services because they are not showing progress in recovery. The article looks at the growth of a narrative that suggests some patients should not be treated if their eating disorder has reached a very severe state and highlights the way that this may be affecting practice and posing a significant risk to patient safety.
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Content ArticleEarly-onset colon cancer (EOCC) is increasing in the US and disproportionately affects African-Americans. This analysis in the American Journal of Surgery aimed to compare EOCC survival among Black and White patients after matching relevant socio-demographic factors and stage. The authors found that Black patients with stage 3 EOCC are less likely to receive chemotherapy and have worse survival than White patients. They call for further research to identify potential factors driving this inequality.
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News Article
Cancer waiting times in 2023 worst on record in England
Patient Safety Learning posted a news article in News
Cancer waiting times for 2023 in England were the worst on record, a BBC News analysis has revealed. Only 64.1% of patients started treatment within 62 days of cancer being suspected, meaning nearly 100,000 waited longer than they should for life-saving care. The waits have worsened every year for the past 11. Macmillan Cancer Support chief executive Gemma Peters called the figures "shocking". "This marks a new low and highlights the desperate situation for people living with cancer," she said. "Behind the figures are real lives being turned upside down, with thousands of people waiting far too long to find out if they have cancer and to begin their treatment, causing additional anxiety at what is already a very difficult time. "With over three million people in the UK living with cancer and an ageing population, this is only set to rise." The records go back to 2010, shortly after the cancer target was introduced. However, improvements have been made over the course of 2023 in how quickly patients are diagnosed with 72% told whether they have cancer or not within 28 days of an urgent referral. Read full story Source: BBC News, 8 February 2024 -
News Article
Long Covid: NHS legal action launched by family of girl
Patient Safety Learning posted a news article in News
The mother of an 11-year-old Aberdeenshire girl with Long Covid has launched a legal action against their health board, in what lawyers claim is the first case of its kind in Scotland. Helen Goss, from Westhill, is seeking damages from NHS Grampian on behalf of her daughter, Anna Hendy. The action claims the health board is responsible for "multiple failings" in Anna's treatment and care. The claim alleges failings were avoidable, that they caused Anna "injury and damage", and led to her condition worsening. Anna became unwell after contracting Covid in 2020. The action alleges a number of failings by the health board. These include claims that requests for Anna to be referred to the specialist paediatric services of immunology and neurology were refused. It also claims no further help was offered after Anna was diagnosed with Chronic Fatigue Syndrome (CFS) and Paediatric Acute-onset Neuropsychiatric Syndrome (PANS). And it says these failings "could have been avoided had NHS Grampian followed contemporary guidance on diagnosis and treatment". Read full story Source: BBC, 19 January 2024 -
Content ArticleThe economic impact of managing Long Covid in primary care is unknown. In a study published in BMC Primary Care, Tufts et al. estimated the costs of primary care consultations associated with Long Covid and explored the relationship between risk factors and costs. The study found that costs of primary care consultations associated with Long Covid in non-hospitalised adults are substantial. Costs are significantly higher among those diagnosed with Long Covid, those with Long Covid symptoms, older adults, females, and those with obesity and comorbidities.
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Content ArticleIn the challenging journey of addiction recovery, trust is a cornerstone of success. For individuals seeking help and the healthcare providers who guide them, it forms the bedrock upon which every aspect of treatment rests. Therefore, building trust in addiction treatment is a vital component that can determine the course of recovery.
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News Article
People in UK turning to DIY health treatment amid shortage of GP appointments
Patient Safety Learning posted a news article in News
Almost one in four people have bought medicine online or at a pharmacy to treat their illness after failing to see a GP face to face, according to a UK survey underlining the rise of do-it-yourself treatment. Nearly one in five (19%) have gone to A&E seeking urgent medical treatment for the same reason, the research commissioned by the Liberal Democrats shows. One in six (16%) people agreed when asked by the pollsters Savanta ComRes if the difficulty of getting an in-person family doctor appointment meant they had “carried out medical treatment on yourself or asked somebody else who is not a medical professional to do so”. Ed Davey, the leader of the Liberal Democrats, said delays and difficulty in accessing GP appointments constituted a national scandal, and face-to-face GP appointments had become “almost extinct” in some areas of the country. He said: “We now have the devastating situation where people are left treating themselves or even self-prescribing medication because they can’t see their local GP.” Dr Richard Van Mellaerts, the deputy chair of the British Medical Association’s GP committee in England, said: “While self-care and consulting other services such as pharmacies and NHS 111 will often be the right thing to do for many minor health conditions, it is worrying if patients feel forced into inappropriate courses of action because they are struggling to book an appointment for an issue that requires the attention of a GP or a member of practice staff.” Read full story Source: The Guardian, 2 January 2024
