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Showing results for tags 'Wales'.
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News Article
A warning from Wales for Wes Streeting
Patient Safety Learning posted a news article in News
As the English government sets about reorganising the NHS, Robert Royce discusses the lessons it can learn from devolved healthcare in Wales Since 2009, NHS Wales has operated without a purchaser-provider split, the internal market or payment by results (PbR). In its stead, seven integrated health boards were created, funded by block allocations. NHS Wales was explicitly to be a plan-led health system based on “co-operation, collaboration and partnership working”. The Welsh Government also believed that the creation of health boards would facilitate a shift in the balance of care. That has not transpired, as can be illustrated by the proportion of total spend going to primary care. In 2013-14, health boards were spending about 25% of their total budget on primary care. In 2022-23 (last nationally available figure) it was down to around 19 per cent. The January 2025 Hywel Dda University Health Board meeting stated that between 2015-16 and 2024-25 its proportion of total expenditure on primary care had dropped by 6 per cent. The picture across the rest of Wales is probably the same, because in Wales overall the number of qualified GPs is essentially unchanged between 2021 and 2024, whilst hospital consultant whole time equivalents had gone up by 13.1%. This has taken place despite an organisational structure and funding system supposedly designed to do the opposite. The same can be said for achieving financial balance. There was an expectation that health boards would provide (and then deliver) plans that would ensure they would operate within their allocations – something that has failed to transpire. Read full story (paywalled) Source: HSJ, 16 April 2025- Posted
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'Fit and well' surgery waitlist details to be revealed in Wales
Patient Safety Learning posted a news article in News
More details on plans to only add people who are "fit and well" to surgery waiting lists and crack down on missed appointments are expected to be revealed on Monday. Health Secretary Jeremy Miles will give a speech to health leaders on the Welsh government's bid to cut waiting lists by around one quarter by March 2026. Hospital volunteer John Timmons, 70, said he saw "a ridiculous number" of patients not turning up for appointments and would support the plans. But health equality charity, Fair Treatment for the Women of Wales (FTWW), said "fear of weight stigma" could delay some people from seeking help. The proposed changes are part of a number of Welsh government ideas being discussed to improve the NHS, which has recently seen small reductions in record waiting lists. These include: Patients who miss hospital appointments twice or more being referred back to their GP, in effect placing them at the back of the queue. An improved Welsh NHS app, allowing patients to track their progress through the system and make or amend appointments. Increased levels of intervention to get patients fit for surgery, such as people being asked to lose weight or exercise more before they are placed on a waiting list. The Welsh government said patients who were fit and well before surgery were more likely to recover quickly and support would be given to get them "in the best possible shape" for treatment. Read full story Source: BBC News, 6 April 2025- Posted
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News Article
Corridor care ‘endemic’ in Welsh A&Es as RCEM research reveals shocking reality
Patient Safety Learning posted a news article in News
Every Emergency Department in Wales is caring for people in corridors new data from the Royal College of Emergency Medicine (RCEM) has revealed. The survey asked clinicians to record various data points including how many patients were in the department, how many were being treated in corridors and in ambulances, and how many were waiting to be admitted. The findings, published today (24 March 2025), reveal that all 12 EDs in Wales had people being treated in corridors or waiting areas, and on at least one of the three sample days, all had patients being cared for in the back of ambulances. In total 44% of patients in departments at the time were waiting for an in-patient bed. The results revealed that: 12 out of 12 Welsh EDs had patients being treated in corridors Of the average total of 619 patients present in EDs at the time, 13.5% were being treated on trolleys in corridors and other inappropriate spaces. A further 10.7% of patients in waiting areas were deemed as needing a clinical space. 43.9% (272) of all patients were waiting for an inpatient bed. Every ED’s cubicles were full, with the average cubicle occupancy being 176%. The highest being 278% in one department where there were 75 patients and just 27 cubicles. Responding to the findings RCEM Vice President Wales, Dr Rob Perry, said: “Recently the Welsh Government said that compromising the quality of care, privacy, or dignity of patients only happens on ‘occasions when the NHS faces exceptional pressure’. “Well our research clearly shows that exceptional pressure is now the everyday norm in Wales’ Emergency Departments. “And this must not be dismissed as just being down to but the annual seasonal upsurge. I am confident the results would be similar which ever time of the year we undertook this survey. “These findings should shock and shame the Government into action. “So called ‘corridor care’ is dangerous, degrading, dehumanising and it is now endemic here in Wales. Addressing it and its causes must be a political priority, and it must act now.” Read full story Source: Royal College of Emergency Medicine, 24 March 2025- Posted
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untilThe Professional Standards Authority for Health and Social Care and the Welsh Government invite you to their joint eighth annual Regulatory developments and the Welsh context seminar. The event will bring together those with an interest in health and care professional regulation across Wales and beyond. The theme for this year’s event is: How professional regulation can promote a safety culture Sue Tranka, Chief Nursing Officer for Wales and Nurse Director of NHS Wales, will deliver the keynote address. Key issues that will be considered on the day include: How can regulators, employers and professional groups collaborate to improve safety? How can education and training promote a safety culture? How can data be used to improve safety and how can we best engage the public with data? Register- Posted
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Content Article
The Wales Ergonomics and Safer Patients Alliance (WESPA) was formed in response to supporting the NHS during the COVID-19 pandemic. WESPA comprises early career and senior researchers from across Cardiff University (Business, Engineering, Mathematics, Medicine) with expertise in operations management, human factors and resilience engineering. We work closely with NHS professionals (clinicians, managers and executives) to model how the design of health services impact on staff and patient outcomes. WESPA's primary aim is to carry out applied research driven by clinical need by drawing upon research expertise from across Cardiff University to enable innovation and implementation of practices to improve patient safety in the NHS, by: Partnering with NHS organisations, and working directly with NHS staff, to identify improvement priorities, it will: - embed researchers-in-residence to analyse patient safety data and observe in clinical settings; - build capability to develop data infrastructures that promote timely organisational learning to inform service design, planning and management; - evaluate models of service delivery to identify where and how the service can be designed / redesigned to improve staff and patient outcomes. Leading engagement activities with key stakeholders – healthcare professionals, managers, executives, patients, services users and the public – to gain timely feedback on our research findings. Facilitating co-production activities in the NHS to maximise understanding of human factors influencing staff and patient outcomes. Engaging with the third sector and other organisations with the purpose of influencing policy and achieving impact in the NHS. Research Development and testing of methodological approaches to apply human factors theory, principles and tools in the NHS to understand and learn from complex socio-technical systems; Identification of opportunities for health systems improvement from analysis of routine patient safety data; and, Understanding complex systems by modelling and quantifying variability using the Functional Resonance Analysis Method (FRAM).- Posted
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Internationally there is recognition that a holistic quality management system (QMS) approach will enable healthcare organisations to meet the needs of their populations and continuously improve the care and experience provided. In NHS Wales, the Duty of Quality was introduced in 2023 through the Health and Social Care (Quality and Engagement) (Wales) Act 20201 and requires Welsh NHS bodies to establish an effective QMS where appropriate focus is placed upon Quality Control, Quality Planning, Quality Improvement and Quality Assurance The 90-day cycle methodology was used to explore how high performing organisations manage for quality – identifying universal findings across all the organisations, a summary of what a QMS can achieve and the importance of the role of the Board. The findings informed the development of a QMS Framework for healthcare which has supported the development of the Duty of Quality and includes: A definition of quality: Continuously, reliably and sustainably meeting the needs of the population that we serve (aligned to the Duty of Quality). A definition of QMS for NHS Wales: An operating framework to continuously, reliably and sustainably meet the needs of the population we serve. Descriptions of the four aspects within a QMS: Quality Planning, Quality Improvement, Quality Control and Quality Assurance and examples of tools and resources that can be used to support their implementation. Descriptions of the organisation enablers for a QMS: leadership, workforce and culture; learning, improvement and research; whole system approach; and, information (aligned to the Duty of Quality Standards). A methodology to implement and embed a QMS: an adaptation of Quality as an Organisational Strategy (QOS) informed by the experience of piloting the approach at directorate and organisation level.- Posted
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News Article
'There could be no NHS dentists in two years'
Patient Safety Learning posted a news article in News
A dentist says he feels "strangled" by NHS contracts and believes NHS dentists may not exist in two years' time. Dr Harj Singhrao, who has a practice in Newbridge, Caerphilly, said money was allocated on a "one size fits all basis" meaning in high need areas like his, he had to lose money in order to provide good care. It comes as the British Dental Association (BDA) Cymru published an open letter accusing the Welsh government of "peddling half- truths", adding more practices were looking to hand NHS contracts back. The Welsh government said: "We are working to ensure the NHS dental contract is fairer for patients and to the dental profession." Dentists who want to treat NHS patients sign a contract with the Welsh government, which then gives them money per patient under the condition of certain targets, such as seeing a certain number of new patients. If these targets are not met, dentists may have to pay some money back as a penalty. Dr Singhrao is the principal dentist at Newbridge Dental Care and had to pay £50,000 back to the Welsh government. He said this was because he took on too many new NHS patients, but had to close a position at his practice as a result. He said the formula of treating every patient across Wales equally "does not work". Read full story Source: BBC News, 17 February 2025- Posted
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PROMPT (Practical Obstetric Multi-Professional Training) is an evidence-based training package for local maternity staff, previously associated with improvements in maternal and neonatal outcomes, reduction in litigation related to preventable harm and improved safety culture. PROMPT has previously been disseminated internationally using a train-the-trainer model. However, this has been associated with variations in uptake, fidelity and impact. In Wales, the project was supported by Welsh Government, and a structured scaling plan was developed, encompassing ongoing implementation support from a multi-professional team. This study describes the approach and process measures for national scaling of PROMPT across 12 obstetric-led maternity units in Wales. -
News Article
‘We have to test food on our allergic toddler in A&E car park’
Patient Safety Learning posted a news article in News
The parents of a severely allergic toddler have been forced to test potentially life-threatening new foods on her in a hospital car park, because there is not enough specialist allergy care in the Welsh NHS. Nick Patterson and his wife Gemma, both 41, have to test changes to the diet of Seren, two, within running distance of an A&E department in case she goes into anaphylactic shock. Seren suffered from severe eczema when she was three months old, and her parents suspected it may have been caused by allergies; however, medical staff told them they could not run tests on her until she suffered a confirmed allergic reaction. Instead, they told the parents they should just “be brave” and feed her new foods. “It turns out we know [she is severely allergic] because one of the first times we weaned her she ended up in an ambulance to hospital,” Nick Patterson, a physics teacher from the Vale of Glamorgan, said. “Ultimately you have to be in the back of an ambulance with the blue lights on to be taken seriously.” Seren was left gasping for air as her throat closed and her lips swelled after her first taste of cheese. She was taken to the GP surgery by her parents and received two EpiPen shots, before receiving another two in the ambulance taking her to hospital. She has been admitted to hospital with several more anaphylactic reactions since then. The Pattersons said they have been unable to undertake an “oral food challenge” in the 18 months since the first time Seren went to hospital. This is a “gold standard” test, in which doctors gradually feed someone potential allergens to identify whether they can be tolerated or not. The service was not available in their local hospital run by Cwm Taf Morgannwg Health Board, but they are on the waiting list for the neighbouring Cardiff and Vale University Health Board. Read full story (paywalled) Source: The Times, 2 January 2025 -
News Article
Welsh Ambulance Service declares critical incident
Patient_Safety_Learning posted a news article in News
The Welsh Ambulance Service has declared a critical incident because of increased demand across the 999 service and extensive hospital handover delays. It said more than 340 calls were waiting to be answered across Wales at the time the critical incident was declared on Monday evening. In addition, more than half of the trust's ambulance vehicles were waiting to handover patients outside hospitals. The service is urging the public to call 999 only for serious emergencies as some patients continue to wait many hours for an ambulance. Read full story Source: BBC, 30 December 2024 -
Content Article
The Public Services Ombudsman for Wales has powers under the Public Services Ombudsman (Wales) Act 2019 to undertake ‘Own Initiative’ investigations, where evidence suggests that there may be systemic service failure or maladministration. Four local authorities were included in the investigation: Caerphilly County Borough Council, Ceredigion County Council, Flintshire County Council and Neath Port Talbot Council. The investigation considered: Whether the local authorities being investigated were meeting their statutory duties under the Social Services and Well-being (Wales) Act 2014 and its Code of Practice and The Care and Support (Assessment) (Wales) Regulations 2015. Whether those entitled to a carer’s needs assessment were being made aware and understand their right to request a carer’s needs assessment. Where carers’ needs assessments are commissioned, whether those assessment services are being delivered appropriately and whether local authorities appropriately monitor the contracting arrangements. Whether carers’ needs assessments, including those completed by commissioned service providers, are undertaken in accordance with the Social Services and Well being (Wales) Act 2014. The investigation considered evidence provided by each of the Investigated Authorities, in the form of documentary evidence and evidence from staff, evidence from commissioned service providers and their staff, evidence from those with lived experience of having their needs as carers assessed and evidence from other organisations. Advice was also sought from one of the Ombudsman’s professional advisers The investigation found: Between 10% and 12% of the population (over 5 years old) in the Investigated Authorities identified as a carer in the 2021 Census. Only 2.8% of the carer population in the Investigated Authorities had their needs assessed. Only 1.5% of the carer population in the Investigated Authorities had an assessment that led to a support plan. Many carers are not aware of their rights and are unaware of the support that may be available to them. There was evidence of carers not being fully informed of their rights by the Investigated Authorities. In some instances, carers were signposted to commissioned service providers without being informed of their rights. Carers’ needs assessments are referred to by different names, which caused confusion amongst carers and carers were sometimes unaware that their needs had been assessed. There needs to be consistency in the language used. There is lack of clear information about the process of assessment, the role of commissioned service providers (where applicable), what carers may expect from the assessment and how carers may be supported following an assessment. This would enable carers to make an informed decision about whether to have their needs assessed. Where they are undertaken, carers’ needs assessments at the Investigated Authorities are generally being completed appropriately, with the exception of young carers’ needs assessments in Ceredigion and Neath Port Talbot. Some improvements could be made to the recording of carers’ needs assessments, including the involvement of the cared for person (where feasible), the extent the carer is able and willing to provide care and the carer’s wishes in terms of work, education, training and leisure. There is a need to implement quality assurance audit processes for completed carers’ needs assessments in Caerphilly, Ceredigion and Neath Port Talbot council areas. There are discrepancies between the Investigated Authorities in the way that support provided to carers is recorded. Improved, consistent and comparable data collection could enable better analysis to drive improvement, monitor progress and identify areas in which further improvements are necessary. Carers must be offered advocacy – the decision on whether an advocate is needed is not one for the staff completing assessments to make, nor is it appropriate for the staff member to consider themself to be the advocate. The appropriateness of Direct Payments for carers is variable and 3 of the Investigated Authorities need to ensure that Direct Payments are something the carer is able to manage, with this being reviewed if circumstances change. The SSWB Act places a duty on both local authorities and health services in respect of carers. Collaboration and joint working between health services and local authorities in relation to carers and their rights is essential and should be strengthened. The recording of equality data relating to carers is limited and inconsistent at the Investigated Authorities.- Posted
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News Article
Nine hours and 52 minutes: did Dave Strachan’s ambulance wait cost him his life?
Patient Safety Learning posted a news article in News
On the evening of 15 March 2022, Dave Strachan woke up with chest pains and difficulty breathing. His wife, Lucille, called 999 and asking for an ambulance. Was Dave breathing, the call operator asked. Yes, but he has chest pains and he’s cold, said Lucille. The call operator asked her to monitor Dave, to tell them every time he took a breath, information which was then fed into a computer. Lucille was told the ambulance would take about four hours to arrive. Just before 7am, after a wait of more than seven hours, an ambulance finally pulled up to the gate. “I thought: ‘Thank God.’” says Lucille. “But before the two men got out of the ambulance, another call came in and they said: ‘We’ve got to go.’ I said: ‘What do you mean, you’ve got to go?’ They said: ‘Because we haven’t put our foot out of the cab, we have to obey orders and go to another case.’ I said: ‘Dave is really ill.’ They were embarrassed. One of them said: ‘I’m so sorry, this is a red call.’" Eventually, at 9.10am, nine hours and 52 minutes after Lucille’s first call, the ambulance arrived. Dave died of acute myocardial infarction and coronary artery atheroma. At the inquest last year, the coroner concluded that, “The time it took for an ambulance to be dispatched and arrive and convey him to hospital meant that there was a missed opportunity to have probable life-saving medical treatment.” In other words, he probably should be alive today. After Dave’s inquest, the coroner wrote a Report to Prevent Future Deaths, copies of which were sent to both the Welsh Ambulance NHS Trust and the Betsi Cadwaladr University Health Board, which provides NHS services in north Wales. The report highlighted areas of concern and two reasons for the delay were given. First was that, “All available resources were managing incidents of a higher acuity or the same category but registered prior.” The other reason why it took so long for Dave’s ambulance to come, wrote the coroner, was that “there were significant handover delays across all Betsi Cadwaladr University Health Board sites.” If an ambulance crew is unable to hand over a patient at the hospital, it can’t go and pick up the next one. “Deaths are occurring and will continue to occur as a result of delayed ambulance attendances caused by these multifactorial issues.” Lucille makes it clear she doesn’t blame anybody personally. At the end of the inquest, one of the paramedics spoke to her. “A junior ambulance lady, who hadn’t been there for very long, came over and said: ‘I want to apologise, I’ve been having sleepless nights about this.’ I said: ‘Well, you can stop that right now, Dave would not want that.’” Nor does she blame anyone at the hospital Dave was taken to. “There was a highly trained specialist waiting in an operating theatre, and the theatre staff, all waiting for him, but he couldn’t get there. It’s the system and the organisation that’s at fault.” Read full story Source: The Guardian, 13 November 2024- Posted
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Content Article
David Colin Strachan was aged 76 years when he died on 16 March 2022 at his home address in Uangollen, Denbighshire. At 23.20 hours on 15 March 2022, he experienced a sudden onset of chest pain, vomiting and became clammy with shortness of breath. A number of 999 calls were made to the Welsh Ambulance Service but it was not until 9.10am, some 9 hours and 52 hours from the initial call that an ambulance and paramedics arrived. An ECG by paramedics indicated that Mr Strachan had suffered an ST elevation myocardial infarction. He was conveyed directly to the North Wales Cardiac Centre at Ysbyty Gian Clwyd and following investigations he was transferred to the Coronary Care Unit. On arrival his breathing weakened and he died at 12.27pm on 16 March 2022 in hospital. The cause of death was recorded as: 1a. Acute myocardial infarction 1b. Coronary artery atheroma. Coroner's Matters of Concern: The causes of the ambulance delay were that all available resources were managing incidents of a higher acuity or the same category but registered prior and there were significant handover delays across all BCUHB sites. The matters of concern are longstanding and multifactorial and despite proposed future action significant concerns remain. The Welsh Ambulance Service NHS Trust and Health Board maintain that they are continuing to work closely in border to address handover delays and yet any improvements appear extremely limiting. Deaths are occurring and will continue to occur as a result of delayed ambulance attendances caused by these multifactorial issues.- Posted
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At Patient Safety Learning we often get asked by patients and families who have received poor healthcare what they need to do to make a complaint. Although we cannot get directly involved in individual cases, we have put together a simple guides on the steps you can take if you need to make a complaint about NHS care in Wales. We also have the following guides: How do I make a complaint about my NHS care in England: a simple guide for patients and families How do I make a complaint about my NHS care Northern Ireland: a simple guide for patients and families How do I make a complaint about my NHS care in Scotland: a simple guide for patients and families How do I make a complaint about my private care: a simple guide for patients and families How do I make a complaint: Sources of help and advice If you are a healthcare professional looking at these pages, the NHS Complaint Standards, model complaint handling procedure and good complaint handling guides set out how organisations providing NHS services should approach complaint handling. They apply to all NHS organisations in England and independent healthcare providers who deliver NHS-funded care. Since April 2011, the NHS Complaints Procedure in Wales has been replaced by a new system called Putting Things Right. A complaint under this new system is defined as a ‘concern’. This is when you feel unhappy about any service provided and funded by the NHS, which includes treatment funded by the NHS in Wales, even if this is provided in England. This may result in you having your concerns investigated, the offer of an apology or improvement of services. Step 1: Raising a concern If you feel able to do so, in the first instance you should try and speak to the staff who were involved in providing your care. This may enable your concerns to be resolved immediately. If this does not resolve your concerns or you do not feel able to speak to the staff, then you can contact a member of the concerns team at the NHS trust or your local health board. If your concern relates to primary care (a GP, dentist, pharmacist or optician), you can either raise your concern with the primary healthcare provider directly or contact your local health board to investigate your concerns. You should raise your concern within 12 months of the incident happening, but ideally as soon after the event as possible, so that the details are still fresh in your mind. Even if more than 12 months have passed, if there are valid reasons for the delay, such as coping with a bereavement or illness, the organisation may still agree to investigate your concerns. If you need assistance with raising your concern, you can contact Llais. Llais is an independent body which provides free and confidential complaints advocacy and support. Step 2: Public Services Ombudsman for Wales If you are not satisfied with the outcome of the investigation, you have the right to take your complaint to the Public Services Ombudsman. The Public Services Ombudsman for Wales has legal powers to look into complaints about public services in Wales, which include health boards, NHS trusts and GP services. The Ombudsman can investigate concerns where you feel you have been treated unfairly or have received an unsatisfactory service due to a failure on the part of a public service provider. You will normally be expected to make a complaint within 12 months of becoming aware of the problem. However, the Ombudsman will consider how much time the healthcare provider in question has spent dealing with your initial concern. If you feel that you have experienced medical harm, further investigations may need to be undertaken as part of NHS Redress arrangements. Step 3: Redress and compensation Redress relates to situations where you may have experienced harm as a result of your treatment. Redress is made up of either one or a combination of all of the following: An explanation. A written apology. A report on the action which has or will be taken to prevent similar incidents happening in future. An offer of financial compensation and/or remedial treatment (remedial treatment refers to medical treatment which is offered to you to try and restore you— as near as possible—to the position you would have been in had the medical harm not occurred.). Financial redress can only be considered if it is proven that the NHS organisation has failed in its duty of care and that that failure has caused the harm. This is also the case for pursuing a civil claim for negligence. Payment of financial redress will only be considered when both these tests are satisfied. Financial compensation is offered on the condition that you will not seek to pursue the same redress through further civil proceedings. In accordance with the redress regulations, you will be able to access free legal advice, but this can only be sought from solicitors with known expertise in clinical negligence who are accredited by the Law Society or AvMA.- Posted
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Eirian Edwards and Chris Subbe explain how they have implemented Martha's Rule in Wales. In April 2023 Yybyty Gwynedd Hospital officially launched the Call 4Concern service for all adult patients admitted to the hospital in Bangor, as the first site in Wales to offer such a service. Call 4Concern is the option for patients, relatives, or friends to contact a member of the Critical Care Outreach team. Locally this means that callers ring the hospital switchboard, ask for Call4Concern and get a call back to discuss their concern. The Call 4Concern service is one service model that is in line with the recommendations made by the Patient Safety Commissioner for Martha’s Rule. Since then the hospital has seen over 70 patients (1-2 per week), admitted one patient to the Intensive Care Unit, treated one patient with diabetic ketoacidosis on the ward, and adjusted treatments in a number of other patients. Most calls were from relatives, many were concerns about communication, and very few calls were made at night. Patient feedback has shown that patients really appreciate that the critical care outreach team is taking their calls seriously and that they are listening to their concerns.- Posted
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News Article
Labour plans to allow travel between England and Wales for NHS treatment
Patient Safety Learning posted a news article in News
NHS patients in Wales will be allowed to travel to England to receive care for the first time ever under plans to be announced by the Welsh secretary on Monday. Jo Stevens will tell the Labour conference in Liverpool that she is drawing up proposals to allow patients to travel between England and Wales to receive outpatient or elective treatment. Stevens will say that the move will help reduce waiting lists on both sides of the border. But with NHS struggling in Wales even more than in England, experts say any movement is more likely to be from out of Wales, potentially placing further pressure on stretched NHS trusts in England. Stevens said on Sunday: “Healthcare is one of the biggest shared challenges our two governments face and we are acting quickly to tackle it. These practical, common sense steps could deliver real change on the ground for patients and clinicians.” Read story Source: The Guardian, 22 September 2024- Posted
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The Welsh Government, in partnership with the Restraint Reduction Network and Improvement Cymru, is pleased to announce this lunchtime webinar launching a brand-new coproduced animation and additional resources to support our work to reduce restrictive practices in Wales. In this webinar, co-chaired by Joe Powell, CEO of All Wales People First and Zara Newman, Welsh Government Head of Safeguarding and Advocacy, you will learn more about restrictive practices, the Welsh Government’s Reducing Restrictive Practices Framework and the resources available to support practitioners across health, care and educational settings. The resources, including the new animation, have been developed by the Welsh Government to raise awareness of restrictive practices and their lawful use in care and educational settings. There will be opportunity to ask questions on the day. The webinar is open to all. Please note that this webinar will also be translated into Welsh in real time. Register -
Content Article
This report by the National Audit of Dementia (NAD) presents the results of the fifth round of audit data. For the first time, the audit has been undertaken prospectively, which will enable hospitals to take earlier action to improve patient care and experience. However, this has demonstrated that many hospitals still have no ready mechanism to identify people with dementia once admitted. One notable improvement is delirium screening (dementia is the biggest risk factor for developing delirium). Screening for delirium has improved from 58% in round 4 to 87% in the current audit. In addition, a high number of pain assessments are also being undertaken within 24 hours of admission (85%). Although encouraging, the report highlights that 61% of these assessments were based only on a question about pain—an approach that can be unreliable in patients with dementia. While this report acknowledges that our health services have experienced an extraordinarily difficult and challenging time, it does shine a light on a need for more training. It states that is encouraging that many staff have received Tier 1 dementia training (median 86%), but suggests that a much higher proportion of ward-based patient facing staff should have received Tier 2 dementia training (median 45%). It found that only 58% of hospitals are able to report the proportion of staff who have received training. As such, the report recommends that any member of staff involved in the direct care of people with dementia should have Tier 2 training, and this training should be recorded to provide assurance to the public and regulators. -
Content Article
Duty of Candour for Wales
Gethin posted an article in NHS Wales (Gig Cymru)
The Duty of Candour for Wales statutory guidance. From April 2023 the Duty of Candour is a legal requirement for all NHS organisations in Wales. This duty builds on the Putting Things Right process which has been in place since 2011.- Posted
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Content Article
Wales' national policy on patient safety incident reporting and management. The National Policy on Patient Safety Incident Reporting and Management published by the Welsh Government Delivery unit can be downloaded from the attachment below. It covers the following: Section 1 – Never Events list Section 2 – Reporting processes Section 3 – Guidance on specific incident types Section 4 – Joint investigation process Section 5 – Safety II guidance Section 6 – Commissioned services flowchart – NRI reporting.- Posted
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Content Article
The Digital Medicines Transformation Portfolio aims to use digital technologies to make prescribing, dispensing and administering medicines everywhere in Wales, easier, safer and more efficient for patients and professionals. It brings together the programmes and projects that will deliver a fully digital prescribing approach in all care settings in Wales. This video outlines the different elements of the portfolio that will be introduced across primary and secondary care, including the Shared Medicines Record, which will store information about a patient's medications all in one place.- Posted
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Content Article
This report by Healthcare Inspectorate Wales (HIW) relates to vascular services provided by Betsi Cadwaladr University Health Board following the de-escalation of these services as a Service Requiring Significant Improvement (SRSI). The review outlines that while progress has been made against all nine recommendations made by the Royal College of Surgeons, the health board still has improvements to make. Review recommendations The health board must consider its responsibilities in line with the NHS Wales Putting Things Right process. This is to establish whether timelier responses could have been given following the two formal complaints it received, and whether it is assured that updates were given appropriately throughout the course of the complaint investigation. The health board should set out what action will be taken to ensure that in future, people are communicated with in a timely manner when raising concerns. The health board must maintain the record keeping audit process, to assure itself that the standards expected for record keeping, are consistent and are being maintained in the immediate and long term. Particularly within its vascular services, but also across the health board. This includes record keeping for all members of the MDT. The health board must explore the reasons for reported inconsistencies in the implementation of the Diabetic Foot Pathway across its three acute sites. The health board must consider and address the issues reported to us regarding the lack of clinical areas at YG, to review patients pre and post operatively. The health board must consider the comments and findings in this report regarding staff culture and the perceptions of different teams. This is to establish whether there is learning, or development required to improve the working relationships across all teams, to support a positive working culture. The health board must consider the comments made by staff regarding the ongoing issues following the implementation of new pathways. This is to establish whether the pathways need to be revised, or further action is required for compliance with the pathways as appropriately. The health board must ensure that all staff are completing all aspects of the consent process as applicable and are documenting this within the relevant clinical records. In addition, further consent process audits must be undertaken and continue on a regular basis, with feedback provided to all staff and actions implemented as applicable. The health board must ensure that: a) All clinical record entries are filed in chronological order; b) Surgical operation records are filled promptly after the surgical procedure. The health board must address the issue where we found examples of misfiling an incorrect patient clinical record, in a different person’s record. The health board must ensure that clinical documentation entries are signed with the clinician’s name legibly printed for identification of the author. The health board must ensure a process is in place to evaluate the sustainability of its vascular service support from UHNM to determine what arrangements will be in place once current agreements end in 2024.- Posted
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- Surgery - Vascular
- Wales
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Content Article
This report published by the National Vascular Registry (NVR) contains information on emergency (non-elective) and elective procedures for the following patient groups: patients with peripheral arterial disease (PAD) who undergo either (a) lower limb angioplasty/stent, (b) lower limb bypass surgery, or (c) lower limb amputation patients who have a repair procedure for abdominal aortic aneurysm (AAA) patients who undergo carotid endarterectomy or carotid stenting.- Posted
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- Surgery - Vascular
- Audit
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Content Article
A report has been published by Healthcare Inspectorate Wales (HIW) setting out the findings of a review of patient flow in Wales. Patient flow is the movement of patients through a healthcare system from the point of admission to the point of discharge. HIW specifically examined the journey of patients through the stroke pathway. This was to understand what is being done to mitigate any harm to those awaiting care, as well as to understand how the quality and safety of care is being maintained throughout the stroke pathway. The review findings reveal consistent challenges caused by poor patient flow throughout Wales, hindering the timely and appropriate delivery of care. These challenges are wide ranging, but primarily stem from the high demand for beds combined with the complexities involved in discharging medically fit patients from hospitals. Unnecessarily long stays in hospital due to delayed discharge can place patients at risk of hospital acquired infections or deterioration whilst awaiting discharge. The bottleneck at the point of discharge has a knock-on impact on emergency departments, ambulance response times, inpatient care, planned admissions and overall staff wellbeing. These challenges are wide ranging; the high demand for inpatient hospital beds combined with the complexities with discharging medically fit patients from hospital, leads to the inpatient healthcare system across Wales operating under extreme pressure. -
News Article
Patient left permanently blind after hospital failure
Patient Safety Learning posted a news article in News
A patient was left with permanent sight loss after a hospital failed to spot the signs of a blood vessel blockage for several months. The person referred to only as Mr L, visited the emergency department at one of Wales' hospitals in January, 2018, but medics failed to consider the possibility he had suffered a watershed stroke. Details of how it took nine months before Mr L was offered a scan to consider this diagnosis have been described in a report from the Public Service Ombudsman detailing the care under Betsi Cadwaldr University Health Board. The Ombudsman, Michelle Morris, also slammed the health board for its failure to act promptly with the complaints process. She said she "cannot fail to be shocked by the fact that, although Mr L first complained to the health board in June, 2019, it took until February, 2023 for it to recognise any failings." The report details how between January and September, 2018, the health board failed to promptly and appropriately identify, investigate and treat a blockage of blood vessels in his neck (a condition called carotid artery stenosis, where the blockage restricts the blood flow to the middle of the brain, face and head). Mr L also complained that when the issue was eventually identified in September, there was a delay in getting the treatment (surgery) until November. Read full story Source: Wales Online, 2 November 2023- Posted
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- Wales
- Patient harmed
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