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Patient Safety Learning

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  1. Patient Safety Learning
    Young and previously healthy people with ongoing symptoms of COVID-19 are showing signs of damage to multiple organs four months after the initial infection, a study suggests.
    The findings are a step towards unpicking the physical underpinnings and developing treatments for some of the strange and extensive symptoms experienced by people with “long Covid”, which is thought to affect more than 60,000 people in the UK. Fatigue, brain fog, breathlessness and pain are among the most frequently reported effects.
    On Sunday, the NHS announced it would launch a network of more than 40 long Covid specialist clinics where doctors, nurses and therapists will assess patients’ physical and psychological symptoms.
    The Coverscan study aims to assess the long-term impact of COVID-19 on organ health in around 500 “low-risk” individuals – those who are relatively young and without any major underlying health complaints – with ongoing Covid symptoms, through a combination of MRI scans, blood tests, physical measurements and online questionnaires.
    Preliminary data from the first 200 patients to undergo screening suggests that almost 70% have impairments in one or more organs, including the heart, lungs, liver and pancreas, four months after their initial illness.
    “The good news is that the impairment is mild, but even with a conservative lens, there is some impairment, and in 25% of people it affects two or more organs,” said Amitava Banerjee, a cardiologist and associate professor of clinical data science at University College London.
    Read full story
    Source: The Guardian, 15 November 2020
  2. Patient Safety Learning
    Lawyers have begun legal action on behalf of 200 UK women against the makers of a sterilisation device, after claims of illness and pain.
    The device, a small coil called Essure, was implanted to prevent pregnancies.
    Manufacturer Bayer has already set aside more than $1.6bn (£1.2bn) to settle claims from almost 40,000 women in the US. It has withdrawn the device from the market for commercial reasons but says it stands by its safety and efficacy.
    The metal coil was inserted into the fallopian tube to cause scarring, blocking the tube and preventing pregnancy. 
    Introduced in 2002, it was promoted as an easy, non-surgical procedure - a new era in sterilisation. But many women who had the device fitted have now either had hysterectomies or are waiting for procedures to remove the device.
    Tracey Pitcher, who lives in Hampshire, felt she had completed her family and did not want any more children.
    Her doctor strongly encouraged her to have an Essure device fitted, she says. But after it had been, she began to feel very unwell.
    "I just started to have heavy periods, migraines, which I had only ever had when I was pregnant so they were hormonal," she says. "My back was so painful I'd wake up crying in the middle of the night with pains in my hips and my back."
    Tracey says she battled to persuade doctors to take her symptoms seriously. But the only information she received was from a Facebook group.
    "... there's nobody there, there's no support apart from people that we've found ourselves, no-one will listen, because it's just 'women's things'."
    Read full story
    Source: BBC News, 15 November 2020
  3. Patient Safety Learning
    Thousands of frontline workers delivering treatments where the risk of transmitting coronavirus is heightened are still being denied personal protective equipment (PPE), according to multiple unions and professional bodies.
    Eleven organisations, including Unison and the British Association of Stroke Physicians, believe numerous procedures have been “wrongly excluded” from the list of 13 “aerosol generating procedures” that require PPE, despite the NHS now having adequate supplies.
    They say their members are “facing illness and even death” while performing procedures such as chest physiotherapy, introducing feeding tubes, and assessing whether a patient can swallow safely.
    The unions have formed an alliance to lobby on the issue, and its chair Dr Barry Jones told HSJ: “We’ve asked ministers and the Department of Health and Social Care again and again to take action and provide PPE to frontline NHS staff carrying out procedures which are not currently listed as AGPs but which the scientific evidence shows should be.
    Read full story
    Source: HSJ, 13 November 2020
  4. Patient Safety Learning
    Black and Asian people are up to twice as likely to be infected with COVID-19 compared to those of white ethnicities, according to a major new report.
    The risk of ending up in intensive care with coronavirus may be twice as high for people with an Asian background compared to white people, data gathered from more than 18 million individuals in 50 studies across the UK and US also suggests.
    The report, published in the EClinicalMedicine by The Lancet, is the first-ever meta-analysis of the effect of ethnicity on patients with COVID-19.
    The scientists behind it said their findings should be of "importance to policymakers" ahead of the possible roll out of a vaccine.
    Read full story
    Source: The Independent, 12 November 2020
  5. Patient Safety Learning
    People with learning disabilities are dying of coronavirus at more than six times the rate of the general population, according to “deeply troubling” figures that have prompted a government review.
    A report from Public Health England (PHE) found that 451 in every 100,000 people registered as having learning disabilities died after contracting Covid-19 in the first wave of the pandemic, when the figures were adjusted for age and sex.
    Because not all Covid deaths among people with learning disabilities are registered as such, the true figure is likely to be 692 in every 100,000, or 6.3 times the UK average, the report estimated.
    Campaigners said the figures showed the government had failed to protect the most vulnerable.
    The report found that Covid deaths among those with learning disabilities were also more widely spread across age groups, with far greater mortality rates among younger adults. Those aged 18-34 were 30 times more likely to die with the virus than their counterparts in the general population.
    The higher death rate is likely to reflect the greater prevalence of health problems such as diabetes and obesity among those with learning disabilities, the report said. It also noted that some learning disabilities, such as Down’s syndrome, can make people more vulnerable to respiratory infections.
    People with learning disabilities are also likely to have difficulty recognising symptoms and following advice on testing, social distancing and infection prevention, the report said. It may also be harder for those caring for them to recognise symptoms if these cannot be communicated, it added.
    Read full story
    Source: The Guardian, 12 November 2020
  6. Patient Safety Learning
    A community trust was told to urgently review prescribing of stimulant medications for children after concern that some were posted to families but never arrived.
    Bridgewater Community Healthcare Foundation Trust was told that sending prescriptions through the post may be a potentially unsafe practice by the Royal College of Paediatrics and Child Health. The warning came in a report from the college after it was invited by the trust to review its community paediatrics service
    The trust was urged to work with primary care and clinical commissioning groups to establish shared care for children who needed these medications. Stimulant medicines are often used for children with attention deficit hyperactivity disorder.
    The review also found there was a “a very significant risk for patient care” with letters, reports and prescriptions being delayed or going missing due to “recurrent issues” with the post in the building used by the team covering St Helen’s.
    It highlighted issues with the safeguarding procedures at the trust, with each locality team having its own processes and handling a small number of cases, and called for urgent work to streamline services.
    Read full story (paywalled)
    Source: HSJ, 11 November 2020
  7. Patient Safety Learning
    A trust in the south east is coming under increasing pressure from a growing number of covid patients, leading to long delays in ambulance handovers.
    HSJ has been told that ambulances have been waiting up to five hours to hand over patients at Medway Foundation Trust, which has around 90 covid patients. 
    The trust is currently continuing with elective work but covid patients are taking up close to 20% of its beds. Sources have told HSJ that bed occupancy at the trust is already very high – with a high proportion of acutely ill patients - and there are issues with discharging patients into nursing homes which is affecting the ability to admit patients swiftly through A&E.
    Read full story (paywalled)
    Source: HSJ, 11 November 2020
  8. Patient Safety Learning
    Lockdown measures in England led to thousands fewer children receiving vital immunisations for a range of diseases include measles, diphtheria and whooping cough, Public Health England (PHE) has warned.
    PHE has warned parents they should continue to get their children immunised regardless of lockdown and restrictions brought on by coronavirus.
    During the first wave of coronavirus the government advised that children should continue to receive vaccinations as scheduled but despite these some appointments were delayed and the numbers of children vaccinated against common diseases fell compared to 2019.
    PHE looked at data from almost 40% of GP surgeries for use of the common 6-in-1 vaccination for diseases including diphtheria, tetanus, whooping cough, and polio as well as uptake of the measles, mumps and rubella (MMR) vaccine to 19 October. 
    In total 167,322 children had the 6-in-1 vaccine, a drop of 6,600 on the same period in 2019, a fall of almost 4%. A total of 167,670 children had the MMR jab, 4,700 fewer than in 2019, a drop of 2.8%.  Although the vaccinations recovered after lockdown the rates are still lower overall than 2019.
    Dr Mary Ramsay, head of immunisations at Public Health England, said: “Vaccines remain the best defence against infection. It’s essential we maintain the highest possible uptake to prevent a resurgence of serious and sometimes life-threatening diseases.
    “Routine vaccinations are still available throughout the pandemic – it’s vital that we continue to make it as easy and safe as possible for parents to take their children to appointments.”
    Read full story
    Source: The Independent, 11 November 2020
  9. Patient Safety Learning
    Patients, including those with the coronavirus, are being kept “head to toe” on trolleys in accident and emergency departments in Manchester, with some forced to wait up to 40 hours for a bed.
    The “dangerous” situation has sparked warnings from the president of the Royal College of Emergency Medicine over the “potentially lethal” crowding of patients in A&Es across the country this winter. 
    Katherine Henderson said she was “absolutely terrified” by what was happening in some departments. She said she had warned NHS England about the dangers of crowding patients in A&E but that not enough action had been taken.
    She told The Independent: “Crowding in A&E is unsafe, but with coronavirus it is potentially lethal. We have said this endlessly to NHS England."
    “Everyone agrees crowding is bad, but what they’re not doing is translating that into action.”
    After hearing of the situation in Manchester, she added: “Exactly what we said should not happen is happening. I am absolutely terrified by this. What more can I do? I have highlighted this risk everywhere I can over the past few months.”
    Read full story
    Source: The Independent, 11 November 2020
  10. Patient Safety Learning
    An acute trust’s record of eight never events in the last six months has raised concerns that quality standards have slipped since it was taken out of special measures.
    The never events occurred at Royal Cornwall Hospitals Trust. They included three wrong site surgeries within the same speciality and an extremely rare incident in which a 30cm (15 inch) wire was left in a cardiology patient.
    Kate Shields, chief executive of the trust, said the incidents have led to a “great deal of soul searching”.
    Prior to the incidents the trust had gone 13 months without recording a never event, and Ms Shield acknowledged that pressure created by the pandemic was likely to have been a contributing factor behind the cluster of never events.
    She stressed that none of the patients affected had suffered physical harm.
    Read full story (paywalled)
    Source: HSJ, 12 November 2020
  11. Patient Safety Learning
    A nurse is due in court charged with eight counts of murder following an investigation into baby deaths at the Countess of Chester hospital neonatal unit in Cheshire.
    Lucy Letby, 30, is due to appear at Warrington magistrates court on Thursday. She was arrested for a third time on Tuesday as part of the investigation into the hospital, which began in 2017.
    A force spokesman said: “The Crown Prosecution Service has authorised Cheshire police to charge a healthcare professional with murder in connection with an ongoing investigation into a number of baby deaths at the Countess of Chester hospital.”
    He said Letby was facing eight charges of murder and 10 charges of attempted murder relating to the period from June 2015 to June 2016.
    On Tuesday, police said parents of all the babies involved were being kept fully updated on developments and were being supported by officers.
    Read full story
    Source: The Guardian, 11 November 2020
  12. Patient Safety Learning
    Early results from trials of a Covid vaccine developed in Russia suggest it could be 92% effective.
    The data is based on 20 cases of COVID-19 from 16,000 volunteers given the Sputnik V vaccine or a dummy injection.
    While some scientists welcomed the news, others said the data had been rushed out too early. It comes after Pfizer and BioNTech said their vaccine could prevent 90% of people getting Covid-19, based on a study of 43,500 people.
    Although the Sputnik data is based on fewer people being vaccinated and fewer cases of Covid developing during the trial, it does confirm promising results from earlier research.
    The Sputnik V vaccine, developed at the National Research Centre for Epidemiology and Microbiology in Moscow, is currently going through phase III clinical trials in Belarus, UAE, Venezuela and India.
    So far there are no safety issues, with Russian researchers saying there were "no unexpected adverse events" 21 days after volunteers received their first of two injections.
    Read full story
    Source: BBC News, 11 November 2020
  13. Patient Safety Learning
    A Tory peer has attacked the Department of Health and Social Care’s ‘woeful’ response to the patient safety review she authored and has revealed she intends to create a cross-party group to force action.
    Baroness Julia Cumberlege - who led the “First Do No Harm” report on device and medicine safety– has said she has “not had a whisper” from the department over the report’s key recommendations since it was published in July.
    She told HSJ’s Patient Safety Congress she is setting up a cross-party parliamentary group to “pressure” the department to adopt the report’s recommendations.
    The report arose from The Independent Medicines and Medical Devices Safety Review, which spoke to more than 700 people, mostly women, who suffered avoidable harm from surgical mesh implants, pregnancy tests and the anti-epileptic drug sodium valproate.
    The report discovered “a culture of dismissive and arrogant attitudes” including the unacceptable labelling of many symptoms as “attributable to ‘women’s problems’”. It concluded that the NHS has “either lost sight of the interests of all those it was set up to serve or does not know how best to do this.”
    Health and social care secretary Matt Hancock and minister Nadine Dorries have apologised to the women who were harmed but the department has so far not responded to the report’s other eight recommendations in detail.
    Baroness Cumberlege said the cross party group would “[try] to open up a firmly shut departmental door. A department that doesn’t seem to get it.” She said: “We have been disappointed [in the department’s response] because we hoped by now we would have some sort of inclination about what’s going on."
    “The response from the department on the other key recommendations has been woeful. The reason they give is ‘there is a terrible amount of work to do’”.
    Read full story (paywalled)
    Source: HSJ, 11 November 2020
  14. Patient Safety Learning
    Planning around what the NHS can deliver this winter must be based on how many nursing staff are available and the workload they can safely take on, the Royal College of Nursing (RCN) has warned.
    Amid widespread nursing shortages, the union has called on the government to “be honest” about nurse vacancies and address what steps need to be taken to keep staff and patients safe.
    “It is essential that learning is applied to planning for this winter, including what service can be delivered safely with the workforce available”
    Last week NHS England moved to its highest level of emergency preparedness. But the RCN warned it still had grave concerns around how services would be safely staffed, claiming it was too late to find the nurses needed to meet the anticipated demands of the incoming winter.
    Despite an increase in the number of nurses registered with the Nursing and Midwifery Council this year, the college said there were still around 40,000 nurse vacancies in the NHS in England alone.
    These shortages, which were felt across all areas of nursing, had been exacerbated because of staff self-isolating or being off sick because of COVID-19, the RCN noted.
    The impacts of workforce shortages meant there was “enormous responsibility” on the nurses working and “intolerable pressure” on senior nursing leaders, it said. Unless local staffing plans prioritised safe and high-quality care, the few nurses in post were at risk of “burn out” this winter, the college added.
    Read full story (paywalled)
    Source: Nursing Times, 9 November 2020
  15. Patient Safety Learning
    A controversial exercise technique used to manage chronic fatigue syndrome is no longer being recommended by National Institute for Health and Care Excellence (Nice).
    The decision to stop recommending graded exercise therapy (GET) – which involves incremental increases in physical activity to gradually build up tolerance – represents a crucial win for patient advocates who have long said the practice causes more harm than good.
    Patient groups have argued that the use of exercise therapy suggests that those with chronic fatigue syndrome (also known as ME) have no underlying physical problem but are suffering symptoms due to inactivity.
    “We have been so widely dismissed and had our suffering at the hands of this condition constantly diminished by the inappropriate and damaging guidance/notion that we can simply exercise or think our way out of a physical illness none of us asked for nor deserve,” said ME patient Glen Buchanan.
    Chronic fatigue syndrome is thought to affect about 250,000 people in the UK and has been estimated to cost the economy billions of pounds annually. One in four are so severely affected they are unable to leave the house and, frequently, even their bed.
    Read full story
    Source: The Guardian, 10 November 2020
  16. Patient Safety Learning
    A new NHS treatment programme targeting young people with eating disorders has been launched amid a rise in numbers needing treatment during the coronavirus pandemic.
    Recent NHS data showed record numbers of children and young people are currently being treated across England for eating disorders while waiting times in some places are dangerously long.
    On Monday, children’s charity NSPCC warned that counselling sessions for eating and body image disorders rose by 32% after lockdown was introduced in March. The new scaling up of intervention services for those with eating disorders such as anorexia and bulimia will mean young people can gain access to rapid specialist NHS treatment across England.
    The service will be rolled out to 18 sites, building on a successful trial model at King's College London, where one patient described the treatment as the “gold standard” of care.
    Nadine Dorries, Minister for Health, said: “Eating disorders can have a devastating impact on individuals and their families – and can very sadly be fatal. I am committed to ensuring young people have access to the services and treatment they need which can ultimately save lives."
    Read full story
    Source: The Independent, 10 November 2020
  17. Patient Safety Learning
    Older women could be less likely to receive ovarian cancer treatment.
    A new report analysed data from more than 17,000 cases of ovarian cancer diagnosed across England between 2016 and 2018. Three in five (60%) of women with ovarian cancer over the age of 79 did not receive either chemotherapy or surgery, while 37% of women over the age of 70 did not receive any treatment.
    The nature of ovarian cancer means surgery is essential in the large majority of cases to remove the tumour.
    The researchers cautioned that with an ageing population it is vital that women of all ages have access to the best possible treatments.
    Researchers also examined the various rates of treatments for ovarian cancer among women in different parts of England.
    They found the probability of receiving any treatment fell below the average in the East Midlands, the East of England, Greater Manchester and Kent and Medway.
    The report was jointly funded by The British Gynaecological Cancer Society, Ovarian Cancer Action, Target Ovarian Cancer and delivered by analysts at the National Cancer Registration and Analysis Service.
    Commenting on the report, Cary Wakefield, chief executive of Ovarian Cancer Action, said: "Neither your age nor location should decide your chance of survival if you are diagnosed with ovarian cancer."
    "Our audit is the first step in addressing the health inequalities women across England face, so we can begin to dismantle them."
    Read full story
    Source: The Independent, 11 November 2020
  18. Patient Safety Learning
    Keyhole surgery can allow complicated procedures to be carried out with just a few access cuts, helping to reduce patient recovery times and potential risk of infection.
    But the remote controlled robots that can perform this type of surgery are often very large, expensive and not widely available.
    Now a new robo-surgeon with a modular design could be about to change that.
    View video
    Source: BBC News, 9 November 2020
  19. Patient Safety Learning
    Several NHS trusts are offering a ‘treatment’ for birth trauma which uses a technique which lies outside national guidelines and which is criticised by specialists as potentially causing ‘more harm than good’.
    The ‘Rewind’ technique is promoted as a fast treatment for post-natal post-traumatic stress disorder (PTSD) – also known as birth trauma - which involves the “reprocessing” of painful memories.
    HSJ has learned of several trusts, including East and North Herts Trust, Chelsea and Westminster Hospital Foundation Trust and James Paget University Hospital FT, where the therapy is being offered. It is thought there are other trusts which are providing it or have explored it. Typically, it is provided by midwives who have undergone training in the technique.
    But Nick Grey, a clinical psychologist who was on the National Institute for Health and Care Excellence panel which looked at PTSD, said it was “absolutely clear cut” that it was bad practice to offer the technique as a branded therapy for PTSD, although he said it could be embedded as part of other treatments.
    He told HSJ: “It should not be offered to mothers with PTSD… they are being done a disservice if they are not given evidence-based treatment. There is no evidence that this [provides] treatment for sub-clinical PTSD or trauma,” he said.
    Read full story (paywalled)
    Source: HSJ, 11 November 2020
  20. Patient Safety Learning
    The mutated strain of coronavirus from Danish mink could have “grave consequences”, Matt Hancock warned today.
    The Health Secretary said the new variant was a “significant development”. And he told MPs the new form of the virus “did not fully respond to Covid-19 antibodies” - hinting it might not respond in the same way to a vaccine.
    The UK banned travel and freight from Denmark on Saturday, going further than the current 14-day quarantine system.
    Those who had already passed from Denmark to Britain in the previous 14 days must isolate for two weeks.
    Updating the House of Commons, Mr Hancock said: “We’ve been monitoring the spread of coronavirus in European mink farms for some time, especially the major countries for mink farming like Denmark, Spain, Poland and the Netherlands.
    “On Thursday evening last I was alerted to a significant development in Denmark of a new evidence that the virus had spread back from mink to humans in a variant form that did not fully respond to Covid-19 antibodies.
    “Although the chance of this variant becoming widespread is low, the consequences should that happen would be grave.”
    Read full story
    Source: The Mirror, 10 November 2020
  21. Patient Safety Learning
    The NHS is ready to start providing the new coronavirus vaccine "as fast as safely possible", Health Secretary Matt Hancock has said.
    Asked whether it could be available by Christmas, he said that was "absolutely a possibility" - but he expected the mass roll-out "in the first part of next year".
    He said vaccination clinics would be open seven days a week, and he was giving GPs an extra £150m.
    On Monday, early results from the world's first effective coronavirus vaccine showed it could prevent more than 90% of people from getting Covid. The vaccine has been developed by pharmaceutical companies Pfizer and BioNTech and is one of 11 vaccines that are currently in the final stages of testing.
    The UK has already ordered 40 million doses - enough to vaccinate up to 20 million people as each person will need two doses for it to work effectively.
    Asked how many people would need to be vaccinated before life can return to normal, Matt Hancock said: "Well the answer to that is we just don't know."
    "So the trials can tell you if a vaccine is clinically safe and if it's effective at protecting an individual from the disease. What we can't know, until we've vaccinated a significant proportion of the population, is how much it stops the transmission of the disease."
    Mr Hancock told BBC Radio 4's Today programme it would be "a mammoth logistical operation" and highlighted some of the challenges, including getting it from Belgium to the UK while not removing from a temperature of -70C more than four times.
    Older care home residents and care home staff are at the top of a list from government scientific advisers of who would get immunised first, followed by health workers. Mr Hancock said NHS staff would go into care homes to vaccinate residents, as well as setting up vaccination venues. Children would not be vaccinated, he said.
    However, Prof Sir John Bell from Oxford University said: "I would worry about not giving this to as wide a percentage of the population as we can."
    "I'm more of the view that we need to vaccinate further into the population and vaccinate younger people as well, partly because we don't really know what the long term effects of this disease are."
    The vaccine will not be released for use until it passes final safety tests and gets the go-ahead from the Medicines and Healthcare products Regulatory Agency.
    Read full story
    Source: BBC News, 10 November 2020
  22. Patient Safety Learning
    In small room in the Royal Derby Hospital, there's a table bearing a laminated sign. "You are not alone," it says. It continues: "Kindness will get you through. Embrace the challenge. Look after each other. You are stronger than you think."
    This is the "wobble room", set aside not for patients but for front-line staff to get them away - briefly - from the intense pressure and strain experienced in the first wave of COVID-19.
    "We made a wobble room because that's what we needed," Kelly-Ann Gurney, an intensive-care nurse, told the BBC. "It's a room where staff could just go and sit and cry if they needed to and get it all out and then come back and 'put their face on' and get back into it again."
    Now the second wave is hitting the hospital, and the need for the room is just as great.
    Concerns are growing about the physical and mental health of front-line NHS staff. There has been no lull since the April peak of the virus as normal treatments and operations, postponed during the crisis, have returned to hospitals.
    Caroline Swan, a senior sister and manager of the intensive care unit at the Royal Derby, says she is ready to face what is ahead but feels very tired. "I am also very concerned. My staff are very tired and stressed out. We have a lot of sickness either due to burnout or they are unwell," she says.
    "A lot of staff have to self-isolate at home - and that puts a lot of strain on staffing here."
    Dr Magnus Harrison, medical director of the University Hospitals of Derby and Burton NHS Trust, says managing rotas is getting harder due to staff sickness and the need for some to self-isolate if family members are infected.
    "It is worth acknowledging what staff did in the first wave. They behaved tremendously and worked incredibly hard, and we're expecting them to do it again in winter - and Covid numbers could be higher than in the first wave. People are tired out."
    Read full story
    Source: BBC News, 10 November 2020
  23. Patient Safety Learning
    One in five COVId-19 patients were diagnosed with a mental illness for the first time within three months of their infection, a study has shown.
    Mental health experts said the findings, which were based on an analysis of the electronic medical records of 69 million people in the US, suggest that coronavirus survivors could have an increased risk of developing psychiatric disorders.
    Of the almost 70 million people whose records were examined in the study, 62,354 individuals had confirmed COVID-19 cases.  
    Researchers at the University of Oxford and the NIHR Oxford Health Biomedical Research Centre found that one in five of these patients went on to receive a first time diagnosis of anxiety, depression or insomnia within 90 days of testing positive for the virus. This was roughly twice as high as the figure for other individuals over the same time frame, according to the researchers.
    People with a history of mental health disorders who contracted the virus were also discovered to be more likely to have new psychiatric diagnoses.
    Paul Harrison, a psychiatry professor at the University of Oxford who led the research, said: "People have been worried that COVID-19 survivors will be at greater risk of mental health problems, and our findings in a large and detailed study show this to be likely.
    Read full story
    Source: The Independent, 10 November 2020
  24. Patient Safety Learning
    The NHS will rollout twice-weekly asymptomatic testing for all patient-facing staff by the end of next week, according to a letter from NHS medical director Stephen Powis.
    Government said only last week that universal asymptomatic staff testing would start in December, but government has now agreed it will bring this forward to this week for a first tranche of 34 trusts; and all others next week.
    The tests at 34 trusts this week will cover “over 250,000 staff,” Professor Powis said. He set out plans for the new testing regime in a letter to Commons health and social care committee chair Jeremy Hunt who has been pressing the government for routine staff testing since the summer.
    “Staff will be asked to test themselves at home twice a week with results available before coming into work,” Professor Powis said. The new testing regime can start following “further scientific validation of the lateral flow testing modality last week, and confirmation over the weekend from Test and Trace that they can now supply the NHS with sufficient test kits”.
    Read full story
    Source: HSJ, 9 November 2020
  25. Patient Safety Learning
    Pfizer and BioNTech have said that their coronavirus vaccine may be more than 90% effective, after the two pharmaceutical firms released interim data from their ongoing large-scale trial.
    Preliminary analysis, conducted by an independent data monitoring board, looked at 94 infections recorded so far in the vaccine’s phase 3 study, which has enrolled nearly 44,000 people in the US and five other countries.
    Of those participants who were infected with COVID-19, it is currently unclear how many had received the vaccine versus those who had been given a placebo. The current efficacy rate, which is much better than most experts expected, implies that no more than eight volunteers will have been inoculated.
    The data have yet to be peer-reviewed, and Pfizer said the initial protection rate might change by the time the study ends. The longevity of the immune response provoked by the mRNA-based vaccine also remains unknown.
    However, the findings are the most promising indication to date that a vaccine will be effective in preventing disease among infected individuals, handing humanity a crucial tool in tackling the pandemic.
    Pfizer and its German partner BioTech will continue with the phase 3 trial until 164 infections have been reported among volunteers - a figure that will give regulatory authorities a clearer idea of the vaccine’s efficacy.
    This number is expected to be reached by early December in light of the rising US infection rates, Pfizer said.
    The two companies said they have so far found no serious safety concerns and expect to seek US emergency use authorisation later this month.
    Read full story
    Source: The Independent, 9 November 2020
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