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Patient Safety Learning

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  1. Patient Safety Learning
    Homeless people will be prioritised for coronavirus vaccinations alongside adults in at-risk groups, the government has said.
    Matt Hancock, the health secretary, said the decision would “save more lives among those most at risk in society”.
    It comes after the Joint Committee on Vaccination and Immunisation, which said those experiencing rough-sleeping or homelessness were likely to have underlying health conditions and should be offered vaccinations alongside those in priority group six.
    "People experiencing homelessness are likely to have health conditions that put them at higher risk of death from COVID-19.
    He added: "This advice will help us to protect more people who are at greater risk, ensuring that fewer people become seriously ill or die from the virus."
    Read full story
    Source: The Independent, 11 March 2021
  2. Patient Safety Learning
    Women are being encouraged to share their experiences of the health and care system via a call for evidence aimed at improving healthcare for women.
    Launching to coincide with International Women’s Day, the call for evidence will form the basis of a landmark government-led Women’s Health Strategy, to improve the health and wellbeing of women across England and place women’s voices at the centre of their care.
    By better understanding women’s experiences, the government can ensure key parts of the health service are meeting women’s needs as they should be.
    Matt Hancock, Health and Social Care Secretary, said: "The healthcare system needs to work for everyone, and we must address inequalities which exist within it. Improving women’s health, especially at older ages, is critical for a fair health and care system in the future." 
    "To build this strategy, we need to hear from those who it directly impacts. I urge all women, and those who have experiences or expertise in women’s health, to come forward and share their views with us to inform the future of this important strategy."
    Nadine Dorries, Minister for Women’s Health, said: "Women’s experiences of health care can vary and we want to ensure women are able to access the treatment and services they need. It’s crucial women’s voices are at the front and centre of this strategy so we understand their experiences and how to improve their outcomes."
    "I urge every woman, and anyone who cares for women, to feed into this call for evidence and help shape the future of women’s health."
    Read press release
    Complete survey (consultation closes at 11:45pm on 30 May 2021)
    Source: GOV.UK, 6 March
  3. Patient Safety Learning
    People will be able to check if they have bowel cancer by swallowing a tiny capsule containing miniature cameras, in an extension of patient self-care.
    In what experts described as a trend towards more NHS at-home care, hastened by the COVID-19 pandemic, thousands of people in England will be able to avoid the discomfort of having a camera inserted into their bowel by instead swallowing a capsule the size of a cod liver oil tablet.
    Pictures transmitted from inside their body during the painless procedure will help doctors judge whether the person has bowel cancer, the second deadliest form of the disease in the UK.
    The boss of the NHS in England said the procedure, known as a colon capsule endoscopy, is an example of “sci-fi” medicine increasingly deployed to improve care. One of the country’s top doctors said the capsules illustrated a major shift of healthcare out of hospitals that will see more and more diagnosis and treatment of illness done at home.
    Prof Martin Marshall, chair of the Royal College of GPs, said: “We’re aware that some patients are reluctant to seek help for certain cancers because the diagnostic tests available can be invasive, so this is a fascinating development and we will be very interested to see the results of the trial.
    “GPs are preparing for an upsurge in cases of suspected cancer cases post-Covid, and the capsule cameras and new test for cervical cancer are welcome developments that could enable more patients to monitor and manage their own health at home without embarrassment or discomfort.”
    Read full story
    Source: The Guardian, 11 March 2021
  4. Patient Safety Learning
    Former staff at a Midlands acute trust have raised concerns over a ‘toxic management culture’ and ‘unsafe’ staffing levels within its maternity services, HSJ has learned.
    Two clinicians who recently worked within Sandwell and West Birmingham Hospital Trust’s maternity department have sent a letter to the Care Quality Commission outlining a series of concerns.
    The letter, seen by HSJ, claimed there was a “toxic management culture alongside poor leadership” within the trust’s senior midwifery team.
    It added: “This had led to 100 per cent turnover in staff within the middle management line… There is no confidence in the current leadership structure and no confidence that staff will be listened to and heard.”
    HSJ also understands there are also concerns around the service within the trust’s management.
    Although they do not raise direct patient safety concerns, the clinicians said the problems were “mostly long-standing” and had “deteriorated to the point where there is now a risk to patient safety”.
    They added: “We are raising these concerns now with the CQC as we feel we have not been listened to and changed effected in a timely manner.”
    Read full story (paywalled)
    Source: HSJ, 10 March 2021
  5. Patient Safety Learning
    Cancer patients are much less protected against COVID-19 than other people after one dose of the Pfizer vaccine, the first real-world study in this area suggests.
    With a 12-week wait for the second dose this could leave them vulnerable, says the King's College London and Francis Crick Institute research team. An early second dose appeared to boost cancer patients' protection.
    Cancer charities are calling for the vaccine strategy to be reviewed.
    But Cancer Research UK said the small study had not yet been reviewed by other scientists and people undergoing cancer treatment should continue to follow the advice of their doctors.
    The government said it was focused on "saving lives" and the antibody response "was only part of the protection provided by the vaccine".
    About 1.2 million people at very high risk of being seriously ill with COVID-19 were prioritised for a first vaccine dose in the first phase of the UK rollout, which includes people with specific cancers.
    The UK government decided to extend the gap between first and second jabs from three to 12 weeks in late December to give more people some protection as soon as possible.
    Dr Sheeba Irshad, oncologist and senior study author from King's College London, said the findings were "really worrying" and recommended an urgent review of the timing of doses for people in clinically extremely vulnerable groups.
    "Until then, it is important that cancer patients continue to observe all public health measures in place such as social distancing and shielding when attending hospitals, even after vaccination," she said.
    The study, which recruited 205 people, included 151 with solid cancers, such as lung, breast and bowel, or blood cancers. The researchers tested volunteers for antibodies and T-cells in their blood, which signals that the immune system can protect against illness from the virus in the future.
    Three weeks after one dose, an antibody response was found in 39% of people with solid cancers, 13% of people with blood cancer and 97% of people with no cancer.
    Following a second dose three weeks after the first, which some cancer patients received, there was a sharp rise in their antibody response against the coronavirus, to 95%. However, among those who had to wait longer for their second dose, there was no real improvement in protection.
    Read full story
    Source: BBC News, 11 March 2021
  6. Patient Safety Learning
    A doctor told a panel investigating an NHS trust there has been a "cultural shift" in the way staff communicate with patients and their families.
    Southern Health NHS Foundation Trust is being investigated after failures in its care of five patients who died between 2011 and 2015.
    Dr Susie Carman said staff went through a "rough patch" when they "felt worried about doing the wrong thing". She said there was "more confidence" among staff to communicate better.
    The inquiry, which is due to last six weeks, is probing how the trust currently handles complaints, communicates with families of patients, and carries out investigations.
    It follows a report by Nigel Pascoe QC that found Southern Health, one of the biggest psychiatric trusts in England, acted with "disturbing insensitivity and a serious lack of proper communication" to family members.
    Dr Carman said there had since been a "genuine culture shift from the top of the organisation".  She believed the trust could "still do things better" in its communication methods but said there was "more will about understanding why it (communication) is so important".
    The inquiry heard that a patient's "consent to share" information or not could present an "obstacle" in communicating with families and carers.
    Ahead of the inquiry, the bereaved families decided to withdraw from the process after they claimed to have been "misled, misrepresented and bullied" by the NHS.
    Read full story
    Source: BBC News, 10 March 2021
  7. Patient Safety Learning
    Joanna Herman, a consultant in infectious diseases, had high hopes when Boris Johnson announced £10m for long Covid clinics. Five months on, she is yet to be referred to one.
    "Despite the government recently giving £18.5m research funding for the disease, it feels as though all focus is now on the vaccine and the lifting of lockdown, while those living with long Covid have been largely forgotten," says Joanna.
    Her initial illness was, by definition, a mild case of Covid: no hospital admission and no risk factors for severe disease. Months later she found herself experiencing crashing post-exertional fatigue, sporadic chest pains and a brain that felt it was only half functioning. And she is not alone. According to a study published last September from researchers at King’s College London, 60,000 people in the UK were likely to have been suffering from long Covid. The actual number is now probably far higher.
    There are now 69 long Covid clinics up and running across the country, according to the NHS England website. Yet Joanna has not been able to access one – and neither have others she knows with long Covid.
    Joanna asked doctors in her field what was happening with long Covid clinics in their local areas. She contacted 18 infectious disease colleagues based in teaching hospitals around the country. Of the 16 who responded, 6 had formal long Covid clinics. Some said that provision for the disease was woefully inadequate, while others reported they only saw only patients who had been admitted to hospital with acute COVID-19. In her own local teaching hospital, funding for long Covid patients is scattered across various departments and there is no dedicated team for these patients.
    "...it feels as though many long-haulers remain in a post-viral sea, looking for a mooring in the hope that something can be offered. We’ve known about this disease since last summer, and it has been officially recognised since October, but we’re only just starting to understand how to support those living with it"
    Read full story
    Source: The Guardian, 10 March 2021
  8. Patient Safety Learning
    Scientists are questioning the reliability of algorithms used to trawl through patients’ health records and flag those who should be asked to shield and prioritised for vaccination.
    GPs have reported being contacted by young, healthy patients confused as to why they have been told they are at high risk, or have been invited for a COVID-19 jab.
    The Joint Committee on Vaccination and Immunisation (JCVI) has defined nine priority groups for vaccination, including everyone aged over 50, plus frontline health and social care workers and people aged 16–64 with serious health conditions.
    The QCovid risk prediction algorithm, introduced last month, combines various characteristics, including age, sex, ethnicity and body mass index (BMI), to estimate the risk of catching, being admitted to hospital, or dying from Covid-19.
    However, the algorithm appears to throw up certain inconsistencies. For example, if a patient’s weight or ethnicity are not recorded on their health records, QCovid automatically ascribes them a BMI of 31 (obese) and the highest risk ethnicity (black African), meaning they are more likely to be invited for a vaccine. One York-based GP, Dr Abbie Brooks, has identified 110 seemingly healthy individuals who were added to the shielding list and invited to book a vaccine last month.
    Although it will not harm younger, healthier individuals to receive a jab before their peers, it may mean more vulnerable people have to wait longer for their doses.
    “I can see that they don’t want to miss out people, which may be why they’re taking this conservative approach, but the problem is that when you make that prioritisation, you are pushing others further down the line,” Irene Petersen, professor of epidemiology and health informatics at University College London, said.
    Read full story
    Source: The Guardian, 9 March 2021
  9. Patient Safety Learning
    A long-delayed review into West Suffolk Foundation Trust board members’ alleged bullying of whistleblowers is now due to be published ‘by the spring’, senior figures familiar with the process have told HSJ.
    The news comes amid calls from senior medics and a campaign group for the review — originally due for publication in April 2020 — to be published as soon as possible.
    The review was set up to investigate the “handling and circumstances surrounding concerns raised in a letter that was sent in October 2018, to the relative of a patient who had died in the Suffolk hospital”.
    The letter was sent to the family of Susan Warby, 57, who died at West Suffolk Hospital in August 2018 after suffering multi-organ failure and other complications. The letter’s anonymous author raised serious concerns about her treatment by the trust.
    The trust launched an investigation, involving fingerprinting and handwriting experts, to find the letter’s author. The process, led by the trust’s senior management, prompted staff to report they felt harassed and bullied, and unions to label the process a “witch hunt” (See box below: Timeline of West Suffolk bullying allegations).
    NHS England and Improvement is overseeing the probe, which was ordered by ministers in January 2020. The coronavirus pandemic caused publication to be pushed back until December, but no official reasons have been given for the further delay.
    Read full story (paywalled)
    Source: 9 March 2021
  10. Patient Safety Learning
    NHS clinics were still seeing just two-thirds of the number of chronic pain patients they normally would by the end of last year, with some patients having waited a year or more.
    In Ayrshire and Arran, 94 of the 112 chronic pain patients seen between October and December – equivalent to nearly 84% – had been on the waiting list for their first appointment for 52 weeks or longer. Only nine were seen within the 18-week target.
    This was by far the worst performance for any health board in Scotland.
    Pain relief clinics across NHS Scotland were paused for four months at the beginning of the pandemic, leading to reports that some patients with problems such as nerve damage and arthritis were paying thousands of pounds to travel to private facilities in England for medical infusions or injections to ease their symptoms.
    In a statement at the end of last year, Joanne Edwards, the director of acute service at NHS Ayrshire and Arran, apologised for the delays, saying the coronavirus pandemic "has had a significant impact on the capacity of the chronic pain service".
    Ms Edwards said the health board was increasing the number of face to face and telephone clinics that the chronic pain team can undertake, adding that an "enhanced clinical review" of the waiting list was also being carried out to prioritise patients for appointment based on clinical need.
    Read full story
    Source: The Herald, 10 March 2021
  11. Patient Safety Learning
    The NHS Covid symptom checker has been criticised by a study which found it may not pick up some people who are seriously ill. By being told to stay at home rather than consult a doctor, they may not receive treatment quickly enough.
    NHS Digital says the 111 online service, used more than 3.9 million times in the past year, is not a diagnostic tool. The symptom checker has been constantly revised and updated, it adds.
    The NHS 111 online Covid symptom checker asks a series of set questions about symptoms in order to offer people advice on their condition and what to do next.
    The study, in BMJ Health and Care Informatics, used 50 simulated cases to compare online checkers used during the pandemic from four countries - UK, US, Japan and Singapore.
    It found the symptom checkers used by the UK and US were half as likely to advise people to consult a doctor as the systems used in Japan and Singapore. Japan and Singapore also had the lowest case fatality rates of the four nations.
    Despite improvements in the safety of the NHS 111 symptom checker since the research was carried out in April, the researchers said they still have "ongoing concerns".
    Read full story
    Source: BBC News, 9 March 2021
  12. Patient Safety Learning
    Patients with coronavirus have been discharged from a hospital and infected family members, a councillor claimed.
    Heather Kidd,  a Liberal Democrat member of Shropshire Council, said a woman in south Shropshire told her that her husband had been "sent home with Covid". 
    She initially found evidence of four cases but said those were the "tip of the iceberg" with more coming to light.
    The medical director of Shrewsbury and Telford Hospital NHS Trust (SaTH) said they were following guidelines, but would look into the "concerning" cases.
    Ms Kidd said since she first spoke out, she had been contacted by a number of people who have had Covid-positive family members discharged from the Royal Shrewsbury Hospital and the Princess Royal in Telford back into their homes.
    Arne Rose, the medical director at SaTH, said there was now a "special swab squad" testing patients every 24 hours as opposed to every 48 hours. He said some patients, who after 28 days of their first positive Covid test were no longer considered infectious, would be the subject of a "careful risk assessment".  They could then be discharged with advice on self-isolating at home.
    "The cases... sound concerning," Mr Rose said, adding he would investigate to "learn if anything went wrong."
    Read full story
    Source: BBC News, 7 March 2021
  13. Patient Safety Learning
    A baby boy was starved of oxygen and died after being left half-delivered for almost a quarter of an hour during a “chaotic” breech birth in an NHS maternity unit.
    Midwives failed to recognise baby Theo Ellis was in the breech, or bottom first, position until his mother Laura Ellis, 34, was already in advanced labour at Surrey’s Frimley Park Hospital.
    What followed was a catalogue of errors by midwives and doctors who failed to heed the emergency situation and raised the alarm too late.
    At one stage a paediatrician was made to stand outside the room by midwives while junior staff struggled to deliver Theo alone. A senior obstetrician was in surgery and a miscommunication by midwives and an on-call consultant meant she did not arrive until Theo was already dead.
    After his parents brought legal action against the NHS, Frimley Park Hospital has now admitted mistakes led to Theo’s death in April 2019.
    Ms Ellis and husband James are angry their son was classed as being stillborn which meant a coroner was not allowed to investigate his care during an inquest. There have been repeated calls to change the law to ensure the deaths of babies like Theo are investigated.
    His mother told The Independent: “I walked in with a healthy baby. I’d looked after him for nine months and they killed him in the process of giving birth. The hospital get to write that he was stillborn, which obviously is a huge benefit to them, because the coroner can’t get involved, which to me is just staggering."
    Read full story
    Source: The Independent, 9 March 2021
  14. Patient Safety Learning
    Younger adults and those living in poorer neighbourhoods and black people have the highest levels of vaccine hesitancy, new survey data from the Office for National Statistics has shown.
    The vast majority of Britons back the COVID-19 vaccines and are keen to be inoculated, with more than 9 out 10 people being positive about the jab. But the ONS said data from a survey between 13 January and 7 February revealed reluctance among less than 10% of the population.
    It found more than 4 in 10 of black or black British adults reported vaccine hesitancy, the highest of all ethnic groups, while adults aged 16-29 were most likely to report hesitancy, at around 1 in 6 or 17%.
    Adults living in the most deprived areas of England were more likely to report vaccine hesitancy at 16%, compared with 7% of adults in the least deprived areas of England.
    This has been evident in the take up of the vaccine among some deprived areas of the country which have struggled to vaccinate everyone in priority groups. Even among NHS and social care staff there has been reported hesitancy over vaccines, particularly among BAME staff.
    Read full story
    Source: The Independent, 9 March 2021
  15. Patient Safety Learning
    The unlawful or inappropriate use of “do not attempt cardiopulmonary resuscitation” (DNACPR) orders by some clinicians risks undermining the care of terminally ill patients, almost 40 leading doctors, nurses and charities have warned.
    During the coronavirus pandemic repeated examples of unlawful decisions have emerged including widespread blanket orders on care home residents and patients with learning disabilities.
    Now the charity Compassion in Dying along with Marie Curie, Hospice UK and Sue Ryder, as well as more than 30 GPs, nurses and doctors, are warning more must be done to listen to patients and their families.
    In a joint statement, signed by more than 30 clinicians, they warn: “There have been examples of poor practice in relation to DNACPR decision-making during the pandemic, and the distressing impact this has had on patients and families cannot be underestimated. It is essential to thoroughly understand and learn from these cases to ensure that they do not happen again."
    “We are aware that the benefits of DNACPR decisions can be easily undone if they are not accompanied by honest, open and sensitive communication with a person’s healthcare team. To ensure that everybody who encounters a DNACPR discussion has a positive experience, we need to do more to listen to individuals and their families; their wishes must be sought and documented, their questions answered and their feelings acknowledged.
    “A DNACPR decision must always involve the person, or those close to them, and should be part of a wider conversation about what matters to that individual.”
    Read full story
    Source: The Independent, 8 March 2021
  16. Patient Safety Learning
    A survey of an area’s GPs and other primary care staff found those from a minority ethnic background feel they are less involved in decision making and less respected by their colleagues, according to results shared with HSJ.
    The survey, instigated by GPs in Doncaster, South Yorkshire, also found more staff from a minority ethnic background said they had experienced some form of bullying or harassment, including “instances of physical violence”.
    The work is thought to be unusual in primary care — annual “workforce race equality standard” surveys are required by NHS England for NHS trusts and, in the past year, clinical commissioning groups, but not in primary care. 
    The survey in October was instigated by Doncaster Primary Care BAME Network and facilitated by Doncaster clinical commissioning group. It was sent to GPs and practice staff, community pharmacy staff, and other “healthcare professionals” in primary care. There were 136 respondents.
    The report of the results said minority ethnic staff felt they were less able to make decisions to improve the work of primary care, less involved in decisions regarding their area of work and less respected by their colleagues compared with their white colleagues.
    Read full story (paywalled)
    Source: HSJ, 9 March 2021
  17. Patient Safety Learning
    A study is under way in the Southern Health Trust area to investigate possible links between Type 1 diabetes and COVID-19.
    A consultant paediatrician said there has been an increase in the number of young people being diagnosed since the beginning of the pandemic.
    Last year, the trust said there were 41 new cases, its highest yearly total on record. 
    Dr Sarinda Millar specialises in Type 1 diabetes in children and young people.
    "We are having more diagnoses, specially since the start of 2021 but more last year, as well," she said. "...in January we had nine new cases of Type 1 diabetes in children and young people in one week alone in our trust area," she said.
    "In other years, we wouldn't even have had one every week. And regionally, we have all seen an increase in Type 1 diabetes which leads us to question is COVID-19 in some way related?"
    Because of the increase in Type 1 diabetes over the past year, the Southern Trust is commissioning fresh research on the matter.
    "It is quite a wide piece of research we are hoping to do," Dr Millar said. "As well as looking to see if these children have been exposed to Covid, looking at their antibody status, we also want to know what other implications COVID-19 has had. For example, have families delayed bringing their child to hospital? We have seen that children are presenting sicker."
    Read full story
    Source: BBC News, 8 March 2021
  18. Patient Safety Learning
    A woman is taking legal action against an NHS trust over the “diabolical” and discriminatory treatment of her profoundly deaf husband, who died of cancer in May last year.
    Susan Kelly, who is also deaf, is angry that her husband, Ronnie, was at no point during two hospital admissions and an outpatient appointment provided with a British Sign Language (BSL) interpreter. Instead, her hearing daughter, Annie Hadfield, was asked to translate his terminal diagnosis, when he was told to “get his affairs in order” and given between two weeks and two months to live, while his wife was left outside the room. He died just over two weeks later at home.
    Medical staff at Sheffield Teaching Hospitals NHS trust also placed a “do not resuscitate” (DNR) order on Kelly, who had Alzheimer’s disease, during his first hospital admission in late April without either his consent or consulting his wife or daughter. His family found out only after their barrister obtained his hospital notes.
    Susan Kelly told the Observer through an interpreter: “I didn’t know what DNR meant. I had no idea. I was really shocked. They’d never asked me anything about it. That wasn’t right, it was wrong. Ronnie wouldn’t have known what it meant.”
    Annie Hadfield added: “I thought it was actually quite diabolical.”
    The trust is undertaking a review to understand what happened. David Hughes, medical director, said: “We do acknowledge that we have more to do to support patients and relatives who have hearing impairments and it is an area of work we are actively looking at to make improvements.”
    Read full story
    Source: The Guardian, 7 March 2021
  19. Patient Safety Learning
    As many as 6 million “hidden” patients could join the queue for NHS treatment in the coming months, swelling official waiting lists to records not seen for more than a decade, health chiefs have warned.
    In the wake of a Budget that offered no new investment for the health service ministers must level with the public that previous guarantees on waiting times are now impossible to meet, the head of the NHS Confederation has said.
    In an interview with The Independent, Danny Mortimer said some patients should expect to wait many months, or possibly even beyond a year, for their treatment.
    He said: “It's going to take many years to recover the waiting list position to where we want it to be.
    “We have to be realistic about the time that it will take us to address these issues, and the government have to be realistic about what it will take particularly if this week’s Budget is an indication that actually there won’t be money made available to the NHS to truly address these issues.
    “The government has to take responsibility for explaining to the public what the consequences of that are.”
    Read full story
    Source: The Independent, 7 March 2021, 
  20. Patient Safety Learning
    Sufferers say they have had little specialist help despite NHS England setting up dedicated clinics.
    “It’s not that I feel I have been abandoned, I think that is perfectly obvious,” says Rachel Pope. “If you speak to any long Covid patient, they have been abandoned.”
    Until exactly a year ago – 5 March 2020 – Pope was “an incredibly fit woman”. A senior lecturer in European prehistory at the University of Liverpool, her work and lifestyle were very active. But after falling ill to Covid, she spent four months unable to walk, then three more when she could manage little more than “a sort of shuffle”.
    She still has a host of symptoms, “but the most debilitating is the fact that I still can’t do more than 2,000 steps in a day. Until a few weeks ago, I was still choking every day. There’s a lot of nasty stuff that [long Covid sufferers] are living with, without treatment.
    “It’s not a great situation to be in. I mean, we didn’t die. But this isn’t exactly living either.”
    A year into the pandemic, accounts such as Pope’s have become dispiritingly familiar, as the experiences of the many thousands who have struggled for months with long Covid, often alone and unsupported, are emerging.
    Read full story
    Source: The Guardian, 5 March 2021
  21. Patient Safety Learning
    Nurse leaders are lobbying government to update "fundamentally flawed" guidance on personal protective equipment.
    The Royal College of Nursing says the existing recommendations are based on out-of-date evidence. One nurse told the BBC she had not been allowed to wear a higher-grade mask, despite having to go into the homes of patients with Covid.
    The nurse, who wishes to remain anonymous, wanted to use what's known as an FFP3 mask that filters out infectious aerosols. But she says her employers insisted on following national guidance, that most health staff should wear thinner surgical masks, instead.
    This comes at a time of mounting concern among many healthcare organisations that personal protective equipment (PPE) is inadequate.
    A new report for the Royal College of Nursing (RCN) criticises the official guidelines for PPE as "fundamentally flawed" because they're based on out-of-date evidence. It says that the risk of infection by aerosols is not given enough emphasis and that key research papers highlighting the possibility of airborne transmission have not been considered.
    The RCN's report concludes that key research papers on aerosols appear to have been ignored and that the terms used to search for new papers were likely to be "biased against" those on airborne transmission.
    The lead author of the study, Prof Dinah Gould, says she is "very disappointed" at the review for not taking into account the latest science.
    "A year into the pandemic, the review needs replacing. It needs updating and we should be able to offer healthcare workers and patients better than what we're offering them now."
    Read full story
    Source: BBC News, 7 March 2021
  22. Patient Safety Learning
    The UK should steel itself for a “difficult autumn” and “hard winter” of illnesses because people have lived for an unusually long period without exposure to respiratory viruses, one of the country’s top medics has warned.
    Dr Susan Hopkins, the head of Covid strategy for Public Health England, said population immunity to viruses other than Covid-19 could be lower than usual and that a surge in flu was probable.
    She said the NHS must be better prepared than it was last autumn, when new, faster-spreading variants of coronavirus emerged forcing the country into lockdown for the third time.
    Speaking on the BBC One’s The Andrew Marr Show Hopkins said: “I think we have to prepare for a hard winter, not only with coronavirus, but we’ve had a year of almost no respiratory viruses of any other type. And that means, potentially the population immunity to that is less."
    “So we could see surges in flu. We could see surges in other respiratory viruses and other respiratory pathogens.”
    A record number of people, about 30 million in total, were invited for a free flu jab last autumn as ministers feared it would add to strains on the NHS. 
    “It’s really important that we’re prepared from the NHS point of view, from public health and contact tracing, that we have everything ready to prepare for a difficult autumn,” she said. “We hope that it won’t occur and it will be a normal winter for all of us.”
    Read full story
    Source: The Guardian, 7 March 2021
  23. Patient Safety Learning
    A leading doctor has said the NHS should expect to treat up to a million people for long Covid in the aftermath of the pandemic.
    Long Covid affects about 1 in 10 people of any age infected with coronavirus, and sufferers can experience symptoms including breathlessness, chronic fatigue, brain fog, anxiety and stress for several months after contracting COVID-19.
    The likelihood of experiencing long-term symptoms does not appear to be linked to the severity of the initial virus and people with mild symptoms at first can still have debilitating long Covid.
    The absence of long Covid registers makes it difficult to measure the scale of the problem, and major studies into the condition are ongoing in an attempt to identify causes and potential treatments.
    But one of Britain’s leading doctors, who spoke on condition of anonymity, estimates that about a million people will need care for long Covid as the NHS recovers from the effects of the pandemic.
    “Although officially about 4 million people have had Covid, in reality, it’s about 8 million or 9 million,” the anonymous doctor told The Guardian. 
    “If 10% of those people have got something, then it could be almost a million people, and that’s enormous.”
    Read full story
    Source: The Independent, 7 March 2021
  24. Patient Safety Learning
    NHS hospitals have been forced to pay millions of pounds to regulators after wrongly claiming their maternity units were among the safest in the country.
    Seven NHS trusts, including some now at the centre of major care scandals, will have to pay back a total of £8.5m after self-assessments of their maternity services were found to be false.
    Families whose babies died as a result of avoidable errors at some of the hospitals told The Independent it was further evidence of poor governance and management failings.
    NHS Resolution, which acts as the health service’s insurer for clinical negligence, launched the maternity incentive scheme in 2018 in an effort to focus action on 10 key safety areas in maternity, including ensuring they have systems in place to review deaths, monitor women and plan staffing levels as well as reporting incidents to the Healthcare Safety Investigation Branch which investigates maternity incidents in the NHS.
    Among the trusts forced to give money back over the first two years of the scheme include Shrewsbury and Telford Hospital Trust, which paid back £953,000. An inquiry into its maternity service found a dozen women and more than 40 babies died as a result of poor care in one of the largest maternity scandals in NHS history.
    East Kent Hospitals University Trust, which is facing an inquiry into baby deaths and a criminal prosecution by the Care Quality Commission over the death of baby Harry Richford in 2017, face paying back £2.1m over two years.
    Derek Richford, who helped expose failings at East Kent after the death of his grandson, told The Independent it was “abhorrent” that the trust claimed “vital NHS funds by falsely claiming that they had achieved 10/10 for maternity safety when the truth was in fact 6/10. East Kent Trust did this two years running and even when asked to check their submission, reconfirmed the erroneous data to NHS Resolution.”
    An evaluation of the scheme by NHS Resolution said it was “recognised that recent examples of poor governance from trusts in relation to the certification of submissions require further action”.
    Read full story
    Source: The Independent, 7 March 2021
  25. Patient Safety Learning
    People with asthma who are eligible for a coronavirus vaccine are being refused it by some GPs who are not following government guidance, the BBC has found.
    An NHS England letter sent to GPs in mid-February says people who have "ever had an emergency asthma admission" to hospital fall into priority group six, which is currently being vaccinated.
    But some patients are being told a hospital admission within the past 12 months is required.
    GPs say they look at various factors, including age and ethnicity, as well as some degree of clinical judgement, the Royal College of GPs said.
    Charity Asthma UK says a lot of people have been in touch with them to report this issue, and they've had thousands of calls to their helpline asking for advice on coronavirus and the vaccine rollout over the past year.
    Sarah Woolnough, chief executive of Asthma UK and the British Lung Foundation, said: "We know that there are different interpretations of the official guidance from GP surgery staff and we're not sure why exactly this is happening."
    "We know that GPs are very busy and trying to vaccinate so many people quickly, and keep on top of very complex daily new information about COVID-19 and the vaccination programme. But it's essential that GPs follow official guidance, so that people with asthma who need to be prioritised are protected now.''
    Read full story
    Source: BBC News, 5 March 2021
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