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Patient Safety Learning

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  1. Patient Safety Learning
    Codeine linctus, an oral solution or syrup licensed to treat dry cough in adults, is to be reclassified to a prescription-only medicine due to the risk of abuse, dependency and overdose, the Medicines and Healthcare products Regulatory Agency (MHRA) has announced.
    Codeine linctus is an opioid medicine which has previously been available to buy in pharmacies under the supervision of a pharmacist but will now only be available on prescription following an assessment by a healthcare professional.
    Since 2019, there have been increasing reports in the media of codeine linctus being misused as an ingredient in a recreational drink, commonly referred to as ‘Purple Drank’.
    The decision to reclassify the medicine has been made following a consultation with independent experts, healthcare professionals and patients. 992 responses were received.
    The consultation was launched by the MHRA after Yellow Card reports indicated instances of the medicine being abused, rather than for its intended use as a cough suppressant.
    Dr Alison Cave, MHRA Chief Safety Officer, said: "Patient safety is our top priority. Codeine linctus is an effective medicine for long term dry cough, but as it is an opioid, its misuse and abuse can have major health consequences."
    Alternative non-prescription cough medicines are available for short-term coughs to sooth an irritated throat, including honey and lemon mixtures and cough suppressants.
    Patients are urged to speak to a pharmacist for advice and not to buy codeine linctus from an unregistered website as it could be dangerous.
    Read full story
    Source: MHRA, 20 February 2024
  2. Patient Safety Learning
    A suicidal man died hours after being discharged from a scandal-hit hospital which is at the centre of a probe into the care of Nottingham triple killer Valdo Calocane.
    Daniel Tucker was released from a mental health ward at Highbury Hospital in Nottingham last year and died shortly afterwards, having taken a toxic substance he had purchased online.
    An inquest into his death last week found there were multiple failings by Nottinghamshire Healthcare Foundation Trust in the lead-up to Tucker’s death, with no appropriate care plan or risk assessment in place for him before or after his discharge.
    The 10-day hearing heard he had been discharged from the hospital on 22 April, despite having shared suicidal intentions with staff just days before. The jury concluded that failures by staff to ensure an appropriate plan for him contributed to his death.
    It comes after health secretary Victoria Atkins ordered the Care Quality Commission to carry out an inquiry into Nottinghamshire Healthcare. The probe will look at the handling of Calocane, who had been discharged from Highbury Hospital and was a patient under the trust’s community crisis services when he stabbed three people to death in a brutal knife rampage.
    Read full story
    Source: The Independent, 18 February 2024
  3. Patient Safety Learning
    Michelle Nolan takes morphine daily for the pain she has lived with for 14 years after botched surgery at the hands of a once renowned surgeon.
    She suffered irreversible nerve damage in July 2010 when John Bradley Williamson, a former president of the British Scoliosis Society, inserted a screw that was too long into her spine at Spire Manchester Hospital.
    The 49-year-old from Chadderton, near Oldham, needs crutches and lost her job as a legal secretary and later her house and marriage. “I lost everything because of him,” she said. “I thought I was the only one he had harmed.”
    She was not. Families and patients operated on by Williamson over two decades at the Salford Royal Hospital, Spire Manchester Hospital and the Royal Manchester Children’s Hospital, have formed a support group and want a full recall of all of his patients.
    They fear some could be suffering without realising they are victims of poor care.
    Williamson told the coroner investigating Catherine’s death that her surgery “progressed uneventfully” and “the blood loss was perhaps a little higher than one would usually anticipate but was certainly not extreme”.
    Yet days after her death, Williamson sent an internal letter to the hospital’s haematology department head Simon Jowitt describing the surgery as “difficult” and involving “a catastrophic haemorrhage”.
    Read full story (paywalled)
    Source: The Times, 18 February 2024
  4. Patient Safety Learning
    The government is considering plans to allow dentists from abroad to work without taking an exam to check their education and skills.
    The proposal, which is subject to a three-month consultation, aims to address the severe shortage of NHS dentists.
    It is hoped a quicker process would attract more dentists.
    The British Dental Association has accused the government of avoiding the issues "forcing" dentists to quit.
    The proposal forms part of the government's £200 million NHS Dental Recovery Plan for England, announced earlier this month.
    Under the plan, dentists could also be paid more for NHS work, while so-called "dental vans" would be rolled out to areas with low coverage, alongside an advice programme for new parents.
    There is also a proposal of £20,000 bonuses for dentists working in under-served communities, as part of an effort to increase appointment capacity by 2.5 million next year.
    At present, overseas dentists are required to pass an exam before they can start work in the UK - the new idea would see the General Dental Council (GDC) granted powers to provisionally register them without a test.
    Stefan Czerniawski, executive director of strategy at the GDC said: "We need to move at pace, but we need to take the time to get this right - and we will work with stakeholders across the dental sector and four nations to do so."
    Read full story
    Source: BBC News, 17 February 2024
  5. Patient Safety Learning
    A woman said she has been unable to get her ADHD medication for months.
    Hannah Huxford, 49, from Grimsby is one of thousands of patients unable to get hold of medicine to manage their symptoms due to a national shortage.
    Mrs Huxford, who was diagnosed with the condition two years ago, described the situation as a "huge worry".
    The Department of Health and Social Care (DHSC) said it had taken action to improve the supply of medicines but added that "some challenges remain".
    Mrs Huxford said the medicine made a "huge difference" and got her life back on track.
    "It enables me to function and concentrate so I can be more proactive, I can be more productive," she explained.
    She said she had been unable to get her usual supply since October 2023 and has to ration what she can get hold of.
    "Christmas time it was just getting beyond a joke. I was going back to the pharmacy, probably two or three times in a month, just to collect the little IOUs and it was getting to the point where that, in itself, was becoming a stress," she said.
    "All of a sudden, if this medication is taken away from me, I'm frightened that I will go back to not being able to cope."
    James Davies, from the Royal Pharmaceutical Society, said the supply shortage has been caused by manufacturing problems and an increase in demand.
    "There are more people who are being diagnosed with ADHD, more people seeking to access ADHD treatments. That's not just related to the UK, this is a global problem," he said.
    Mr Davies said some ADHD medication has come back into stock but added "it's quite a fluid situation at the moment".
    Read full story
    Source: BBC News, 19 February 2024
    Have you (or a loved one) ever been prescribed medication that you were then unable to get hold of at the pharmacy? 
    To help us understand how these issues impact the lives of patients and families, please share your experience and insights in our community thread on the topic: 
     
    You'll need to register with the hub first, its free and easy to do. 
    We would also like to hear from pharmacists working in community or hospital settings, and others who have insights to share on this issue. What barriers and challenges have you seen around medication availability? Is there anything that can be done to improve wider systems or processes?
  6. Patient Safety Learning
    Patients are facing delays stuck on hidden waiting lists that do not show up in the official figures in England, a BBC News investigation reveals.
    The published waiting list stands at 7.6 million - but the true scale of the backlog is thought to be much higher.
    This is because patients needing ongoing care are not automatically included in those figures - even if they face major delays.
    NHS England said hospitals should be monitoring and counting such cases.
    But BBC News found evidence suggesting this is not always the case.
    The problem affects patients receiving ongoing care, as well as those removed from waiting lists even before starting treatment.
    BBC News has spoken to patients waiting months and even years for vital treatment, such as cancer care, spinal treatment and others at risk of going blind because of deteriorating eyesight.
    Hospitals are meant to return patients facing unnecessary delays to the waiting list to ensure they are counted in the backlog figures.
    But of 30 NHS trusts asked by BBC News how regularly this was happening, only three could provide figures.
    Karen Hyde, from Insource, a company that helps hospitals manage waiting lists, said the guidance was "commonly ignored".
    "This is a huge issue. The NHS does not incentivise hospitals to keep a close eye on these patients.
    "We know there are long waits for those on the waiting list. For those not on the official waiting list, it is likely to be even worse - but the figures are not published."
    Read full story
    Source: BBC News, 19 February 2024
  7. Patient Safety Learning
    Italy will carry out an inquiry into its handling of the coronavirus pandemic in a move hailed as “a great victory” by the relatives of people killed by the virus but criticised by those who were in power at the time.
    Italy was the first western country to report an outbreak and has the second highest Covid-related death toll to date in Europe, at more than 196,000. Only the UK’s death toll is higher.
    The creation of a commission to examine “the government’s actions and the measures adopted by it to prevent and address the Covid-19 epidemiological emergency” was approved by the lower house of parliament after passing in the senate.
    Consuelo Locati, a lawyer representing hundreds of families who brought legal proceedings against former leaders, said: “The families were the first to ask for a commission and so for us this is a great victory. The commission is important because it has the task, at least on paper, to analyse what went wrong and the errors committed so as not to repeat the massacre we all suffered.”
    Read full story
    Source: The Guardian, 15 February 2024
  8. Patient Safety Learning
    A trust’s main maternity unit has been rated “inadequate” and given a warning notice amid concerns delayed Caesarean sections are causing harm to babies.
    The Care Quality Commission (CQC) told Maidstone and Tunbridge Wells Trust to make significant improvements in how quickly it carries out emergency C-sections, the regulator said in a report today.
    The trust was also told to improve risk management, governance and oversight of services at its Tunbridge Wells Hospital.
    Inspectors found between April and July last year, 42% of “category 1” emergency Caesareans – defined as those posing an immediate threat to the life of the woman or foetus — at the Tunbridge Wells Hospital were delayed. The National Institute for Health and Care Excellence says these should be carried out “as soon as possible and in most situations within 30 minutes of making the decision”.
    The report identified “ongoing recurrent delays” to emergency Caesareans overnight, as the trusts did not have a second theatre available.
    This “meant an increased risk of harm, including cases reported by the service such as babies with ‘acute foetal hypoxia’ had emerged due to delayed births”, the inspection report said.
    It also criticised the trust for not responding to a high level of post-partum haemorrhages, some of which had caused “moderate” harm.
    Read full story (paywalled)
    Source: HSJ, 16 February 2024
  9. Patient Safety Learning
    Areas across England where the highest proportion of ethnic minorities live have the poorest access to GPs, with experts attributing this disparity to an outdated model being used to determine funding.
    As of October 2023, there were 34 fully qualified full-time-equivalent GPs per 100,000 patients in the areas with the highest proportion of people from ethnic minority backgrounds, according to a Guardian analysis of NHS Digital and census data.
    This is 29% lower than the 48 general practitioners per 100,000 people serving neighbourhoods with the highest proportion of white British people.
    Although ethnic minorities tend to be younger than the white British population, minority ethnic areas still have the lowest number of GPs per person even when factors such as age, sex and health necessities are considered.
    Prof Miqdad Asaria at the London School of Economics department of health policy said it was “very concerning” that ethnic minorities “have systematically poorer access to primary care which is likely to be a key driver of current and future health inequalities”.
    “Primary care plays a crucial role in preventing disease, diagnosing and treating illness, and facilitating access to specialist or hospital treatment for people who need it,” he added.
    Read full story
    Source: The Guardian,15 February 2024
  10. Patient Safety Learning
    Ambulance trusts have often prioritised capacity and response times over dealing with cases of misconduct, a review of culture in the sector for NHS England has found.
    The review says ambulance trusts need to “establish clear standards and procedures to address misconduct”.
    The work was carried out by Siobhan Melia, who is Sussex Community Healthcare Trust CEO, and was seconded to be South East Coast Ambulance Service Foundation Trust interim chief from summer 2022 to spring last year.
    Her report says bullying and harassment – including sexual harassment – are “deeply rooted” in ambulance trusts, and made worse by organisational and psychological barriers, with inconsistencies in holding offenders to account and a failure to tackle repeat offenders.
    She says “cultural assessments” of three trusts by NHSE had found “competing pressures often lead to poor behaviours, with capacity prioritisation overshadowing misconduct management”, adding: “Staff shortages and limited opportunities for development mean that any work beyond direct clinical care is seen as a luxury or is rushed.
    “Despite this, there is a clear link between positive organisational culture and improved patient outcomes. However, trusts often focus on meeting response time standards for urgent calls, whilst sidelining training, professional development, and research.”
    Read full story (paywalled)
    Source: HSJ, 15 February 2024
  11. Patient Safety Learning
    An integrated care board (ICB) has found its handling of whistleblowing “not fit for purpose”, after a complaint about safety incidents not being properly investigated.
    A report by North West London ICB, obtained by HSJ, states: “The whistleblowing policy is not fit for purpose and requires immediate updating. The [Freedom to Speak Up] Guardian has been left blank and the policy does not include key components of best practice.”
    It also found the “whistleblower should have been provided with a substantive response to their concerns within 28 days” but in fact waited 98 working days, “due to delays with starting the whistleblowing component of the grievance”.
    The ICB reviewed its processes after a complaint from a staff member who raised concerns early last year about “a lack of, or poor, response” to reported patient safety incidents in the system, which are meant to be routinely reviewed by ICBs “prior to closure”. 
    Read full story (paywalled)
    Source: HSJ, 15 February 2024
  12. Patient Safety Learning
    The number of patients waiting more than 12 hours for a bed on a ward after being seen in A&E in England was 19 times higher this winter than it was before the pandemic, figures show.
    There were nearly 100,000 12-hour waits in December and January - compared with slightly more than 5,000 in 2019-20.
    A decade ago these waits were virtually unheard of - in the four winters up to 2013-14 there were fewer than 100.
    The King's Fund said long delays were at risk of becoming normalised.
    It said the pressures this winter had received little attention compared with last winter, despite no significant improvement in performance.
    During December 2023 and January 2024, 98,300 patients waited more than 12 hours for a bed on a ward after A&E doctors took the decision to admit them.
    The Northern Ireland branch of the Royal College of Emergency Medicine (RCEM) said the pressures were "unsurmountable" and it was having a detrimental impact on patients.
    Read full story
    Source: BBC News, 15 February 2024
  13. Patient Safety Learning
    "Cultural and ethnic bias" delayed diagnosing and treating a pregnant black woman before her death in hospital, an investigation found.
    The probe was launched when the 31-year-old Liverpool Women's Hospital patient died on 16 March, 2023.
    Investigators from the national body the Maternity and Newborn Safety Investigations (MSNI) were called in after the woman died.
    A report prepared for the hospital's board said that the MSNI had concluded that "ethnicity and health inequalities impacted on the care provided to the patient, suggesting that an unconscious cultural bias delayed the timing of diagnosis and response to her clinical deterioration".
    "This was evident in discussions with staff involved in the direct care of the patient".
    The hospital's response to the report also said: "The approach presented by some staff, and information gathered from staff interviews, gives the impression that cultural bias and stereotyping may sometimes go unchallenged and be perceived as culturally acceptable within the Trust."
    Liverpool Riverside Labour MP Kim Johnson said it was "deeply troubling" that "the colour of a mother's skin still has a significant impact on her own and her baby's health outcomes".
    Read full story
    Source: BBC News, 16 February 2024
  14. Patient Safety Learning
    A Mississippi prison denied medical treatment to an incarcerated woman with breast cancer, allowing her condition to go undiagnosed for years until it spread to other parts of her body and became terminal, according to a lawsuit filed on Wednesday.
    Susie Balfour, 62, alleges that Mississippi department of corrections (MDOC) medical officials were aware she might have cancer as early as May 2018, but did not conduct a biopsy until November 2021, one month before she was released from prison. It was not until January 2022, after she left an MDOC facility, that a University of Mississippi Medical Center doctor diagnosed her with stage four breast cancer, according to her federal complaint.
    Her lawsuit and medical records paint a picture of a prison healthcare system that deliberately delayed life-saving healthcare and for years repeatedly failed to conduct follow-up appointments that the MDOC’s contracted clinicians recommended.
    Read full story
    Source: The Guardian, 14 February 2024
  15. Patient Safety Learning
    The doctor in charge of medical training for NHS England has apologised unreservedly to the family of a medic who took her own life.
    Dr Vaish Kumar, a junior doctor, left a suicide note blaming her death entirely on the hospital where she worked, her family revealed last year.
    Dr Kumar, 35, was wrongly told she needed to do a further six months of training before starting a new role.
    It meant she was forced to stay at Queen Elizabeth Hospital (QE) in Birmingham, where she had been belittled by colleagues, an inquest heard.
    In a letter to Dr Kumar's family, seen by the BBC, NHS bosses admitted she did not need to do the extra training.
    Dr Navina Evans, chief workforce and training education officer for England, told the family in the letter: "I wish to unreservedly apologise for these mistakes and for the impact they would have had.
    "As an organisation we are determined to learn... not only across the Midlands but across England as a whole."
    Read full story
    Source: BBC News, 13 February 2024
  16. Patient Safety Learning
    A woman who described the time in her life after a pelvic mesh implant as "soul destroying" said proposed government compensation was "disappointingly low".
    Claire Cooper, from Uckfield, is one of around 100,000 women across the UK who had transvaginal mesh implants.
    England's patient safety commissioner suggested compensation could start at around £20,000.
    Ms Cooper, 49, was originally given the mesh implant as a treatment for incontinence after childbirth.
    However, after struggling with pain following the operation, Ms Cooper claimed doctors treated her as if she were "psychotic" and "a nuisance".
    She said her experience was one of being "mocked".
    "It was just soul destroying," Ms Cooper told BBC Radio Sussex. "I lost my fight because I was met at every turn with resistance so I just lost the ability to advocate for myself."
    Ms Cooper eventually had surgery to remove the mesh, which she said one doctor compared to "cheese cutting wire". She is still living with chronic pain.
    Read full story
    Source: BBC News, 15 February 2024
    Further reading on the hub:
    Doctors shocking comments to women harmed by mesh
     
  17. Patient Safety Learning
    More than 100 patients who had eggs and embryos frozen at a leading clinic have been told they may have been damaged due to a fault in the freezing process.
    The clinic, at Guy's Hospital in London, said it may have unwittingly used some bottles of a faulty freezing solution in September and October 2022.
    But it said it did not know the liquid was defective at the time.
    One patient at a second clinic, Jessop Fertility in Sheffield, has also been affected, the BBC has learned.
    The fertility industry regulator, the Human Fertilisation and Embryology Authority (HFEA), said it believes the faulty batch was only distributed to those two clinics.
    It is believed that many of the patients affected have subsequently had cancer treatment since having their eggs or embryos frozen, which may have left them infertile. This means they now may not be able to conceive with their own eggs.
    Guy's Hospital's Assisted Conception Unit is now being investigated by the HFEA, because of a delay in informing people affected.
    Read full story
    Source: BBC News, 14 February 2024
  18. Patient Safety Learning
    England’s largest hospital trust has written to GPs warning their patients face 15-week waits for routine MRIs, ultrasound and CT scans.
    Guy’s and St Thomas’ Foundation Trust in central London said it was prioritising suspected cancer and other “urgent cases”, meaning “unfortunately waiting times for routine patients are now an average of 15-16 weeks for an appointment against a target of six weeks”.
    This is much worse than national averages, which December figures showed were 3.2 weeks, 2.5 weeks and 3.3 weeks for MRI, CT and ultrasound waits respectively.
    It its letter to GPs in Lambeth and Southwark – its main patches – GSTT said: “Current imaging referral demand outstrips capacity, despite these services consistently delivering near 120 per cent levels of activity compared to 2019-20.
    “The radiology service is exploring multiple routes to increase imaging capacity, including increased weekend working, insourcing and outsourcing contracts, but there is still a significant shortfall of slots every week.”
    In particular, it said primary care staff should expect long waits for the reporting of routine MRI scans.
    Read full story (paywalled)
    Source: HSJ, 13 February 2024
  19. Patient Safety Learning
    The family of a man who needlessly died after a 12-hour delay in surgery have called for changes at a troubled NHS trust as regulators expressed alarm about patient safety and waiting times.
    The Care Quality Commission (CQC) upgraded the surgery department at the Royal Sussex county hospital in Brighton from “inadequate” to “requires improvement” at a time when it is at the centre of a police investigation into dozens of patient deaths, allegations of negligence and cover-up.
    In their report, the regulator expressed concern about already long and lengthening waiting times, repeated cancelled operations and staff shortages that could compromise safety.
    The inspection report comes as the Guardian can reveal the trust apologised and settled with the family of Ralph Sims, who died aged 65 after heart surgery in April 2019 when doctors failed to act appropriately to a drop in his blood pressure.
    Sims, who was a keen runner, suffered a drop in blood pressure and developed an irregular heart rhythm eight hours after surgery to replace an aortic valve at the hospital.
    An internal investigation into Sims’ treatment acknowledged that hospital staff failed to “recognise the significance of the fall in blood pressure”.
    University Hospitals Sussex NHS foundation trust, which runs the hospital, accepted that the father of three should have returned to surgery to identify the cause of his deterioration. Instead, medics decided that he should be observed overnight.
    Due to another emergency case, an angiogram was not carried out on Sims until just before noon the following day – 12 hours after the drop in pressure. The delay caused irreversible – and avoidable – heart muscle damage, leading to his death five weeks later.
    The family said: It added: “Whilst the trust has apologised to our family it feels hollow. Ralph’s death was entirely unnecessary, and despite the issues in his care, it took the trust several years to apologise.”
    Read full story
    Source: The Guardian, 14 February 2024
  20. Patient Safety Learning
    Hundreds of frontline NHS staff are treating patients despite being under investigation for their part in an alleged “industrial-scale” qualifications fraud.
    More than 700 nurses are caught up in a potential scandal, which a former head of the Royal College of Nursing said could put NHS patients at risk.
    The scam allegedly involves proxies impersonating nurses and taking a key test in Nigeria, which must be passed for them to become registered and allowed to work in the UK.
    “It’s very, very worrying if … there’s an organisation that’s involving themselves in fraudulent activity, enabling nurses to bypass these tests, or if they are using surrogates to do exams for them because the implication is that we end up in the UK with nurses who aren’t competent,” said Peter Carter, the ex-chief executive of the RCN and ex-chair of three NHS trusts.
    He praised the Nursing and Midwifery Council (NMC) for taking action against those involved “to protect the quality of care and patient safety and the reputation of nurses”.
    Nurses coming to work in the UK must be properly qualified, given nurses’ role in administering drugs and intravenous infusions and responding to emergencies such as a cardiac arrest, Carter added.
    Forty-eight of the nurses are already working as nurses in the NHS because the NMC is unable to rescind their admission to its register, which anyone wanting to work as a nurse or midwife in Britain has to be on. It has told them to retake the test to prove their skills are good enough to meet NHS standards but cannot suspend them.
    The 48 are due to face individual hearings, starting in March, at which they will be asked to explain how they apparently took and passed the computer-based test (CBT) of numeracy and clinical knowledge taken at the Yunnik test centre in the city of Ibadan. The times recorded raised suspicions because they were among the fastest the nursing regulator had ever seen.
    Read full story
    Source: The Guardian, 14 February 2024
  21. Patient Safety Learning
    More than 100 families looking after severely disabled adults and children outside hospital, have told the BBC that the NHS is failing to provide enough vital support.
    The NHS says help is based on individual needs and guidelines ensure consistency across England and Wales. However, some families describe the system as adversarial.
    Only those living outside hospital with life-limiting conditions, or at risk of severe harm if they don't have significant support, get this help from the NHS.
    It is provided through a scheme called Continuing Healthcare (CHC) for adults, and its equivalent for under-18s, Children and Young People's Continuing Care.
    Cases in England are decided by NHS Integrated Care Boards (ICBs) - panels responsible for planning local health and care services. In Wales, they are overseen by local health boards.
    The BBC has heard from 105 families who described serious concerns with how the two schemes are working - with most calling for reform.
    One young man with 24-hour needs hasn't received any CHC help despite being eligible since February 2023 - his parents, who first applied for support on his behalf nearly two years ago, currently provide round-the-clock care
    Another family were told overnight care for their teenage child - who is non-verbal, has severe mobility issues and requires 24/7 support - would be reduced from seven down to three nights a week, without a reason being given.
    Read full story
    Source: BBC News, 14 February 2024
  22. Patient Safety Learning
    There was an “unacceptable delay” and “failure to act with candour” in how a trust responded to a serious risk from staff nitrous oxide exposure, an independent investigation has found.
    Mid and South Essex Foundation Trust found levels of nitrous oxide far above the workplace exposure limit at Basildon Hospital’s maternity unit during routine testing in 2021. However, staff were only notified and a serious incident declared more than a year later.
    The exposure related to a mixture of nitrous oxide and oxygen, commonly known as gas and air, used during births. While short-term exposure is considered safe, prolonged exposure to nitrous oxide could lead to potential health issues.
    Chief executive Matthew Hopkins has apologised, after a report by the Good Governance Institute said: “The inquiry found that there was an unacceptable delay in responding to and mitigating a serious risk that had been reported… As a result of this failure to act on a known risk, midwives and staff members on the maternity unit were exposed to unnecessary risk or potential harm from July 6 2021 to October 2022."
    Read full story (paywalled)
    HSJ, 14 February 2024
  23. Patient Safety Learning
    Community Pharmacy Scotland (CPS) is calling for all pharmacy staff to be allowed to prepare and assemble medication without requiring supervision from a pharmacist or pharmacy technician.
    Its comments came in its response to a Department of Health and Social Care consultation on pharmacy supervision, published on 7 December 2023, which sets out proposals to amend the Medicines Act 1968 and The Human Medicines Regulations 2012.
    The consultation includes proposals to enable pharmacists to authorise pharmacy technicians to carry out, or supervise others carrying out, the preparation, assembly, dispensing, sale and supply of medicine; to enable pharmacists to authorise any member of the pharmacy team to hand out checked and bagged prescriptions in the absence of a pharmacist; and to allow pharmacy technicians to supervise the preparation, assembly and dispensing of medicines in hospital aseptic facilities
    In its response, the CPS disagreed with the first of these proposals, arguing that “the preparation and assembly of [pharmacy] and [prescription-only] medications can be safely carried out from a registered pharmacy premises, without requiring supervision by a Responsible Pharmacist or an authorised pharmacy technician”.
    CPS also said there is “a major flaw in the logic” of the government proposal because “it relies heavily on individuals rather than on safe systems”, making the proposed new way of working “vulnerable to changes in personal circumstance”.
    “The environment, technology, training, conditions and [standard operating procedures] in the community pharmacy setting have a bigger effect on safety of preparation and assembly than supervision by an individual,” the response said.
    Read full story
    Source: The Pharmaceutical Journal, 12 February 2024
  24. Patient Safety Learning
    Dozens of new allegations of sexual assault and abuse, including claims of rape and of patients being made pregnant, have emerged following an investigation into Britain’s mental health wards.
    One patient with a mental health disorder became pregnant by a member of staff. Allegations of rape, and of children being groomed by healthcare assistants, were among the 40 horrifying new reports of abuse made against rogue NHS Trusts.
    The investigation, conducted by The Independent, alongside Sky News, revealed more than 20,000 allegations of sexual assault and harassment across more than 30 NHS England mental health trusts since 2019.
    Several patients, who have come forward with their own harrowing stories, had allegedly been harmed by healthcare assistants, who currently are not regulated.
    Natalie, whose name has been changed, was one of several patients groomed and asked to share sexually explicit photos by a healthcare assistant working at a children’s mental health ward in 2020.
    Natalie, who was 16 at the time, told The Independent: “The first few conversations [after I was discharged] were very innocent. However after weeks and months, he started speaking in a sexual nature, asking me to send explicit photos of myself, posting explicit photos of himself and asking to meet up for sexual advances, I didn’t realise it at the time, but he was grooming me; this was all over Snapchat.
    “I feel and still feel very small, and that I wasn’t looked at as a person [by the hospital], and they only saw me as a patient with no feelings that mattered. It felt like another incident at ... that just got swept under the rug.”
    Read full story
    Source: The Independent, 10 February 2024
  25. Patient Safety Learning
    The trusts where maternity care has deteriorated the most according to patient surveys have been identified by the Care Quality Commission.
    The regulator collected responses from 25,515 patients about their experiences of antenatal care, labour, birth and postnatal care across 121 trusts in February 2023. 
    It then analysed where experiences of care were substantially better or worse overall when compared with survey results across all trusts in England.
    Survey responses also painted a deteriorating picture of maternity care nationally, with answers to 11 questions showing a statistically significant downward trend compared to five years ago.
    Five trusts were categorised as “worse than expected”, where patients’ experiences of using their services were substantially worse than the average.
    Read full story (paywalled)
    Source: HSJ, 12 February 2024
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