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Patient Safety Learning

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  1. Patient Safety Learning
    The NHS is failing some parents whose children die unexpectedly, a leading paediatrician has told BBC Panorama.
    About 50 children's deaths in the UK every year are termed as "sudden unexplained death in childhood" (SUDC). Little is known about what causes them.
    Gavin and Jodie's two-year-old son Addy died unexpectedly in November 2022.
    BBC Panorama followed the parents over nine months as they searched for answers to why their son died - and whether it could have been prevented.
    Even after a forensic post-mortem examination, no-one could work out why the little boy went to sleep and never woke up, so his death was categorised as SUDC.
    When a child dies unexpectedly, a review is held to gather information about what happened. The NHS is required to assign a key worker to help bereaved parents to navigate this process, and provide emotional support. The role of key worker can be taken by a range of practitioners and is often a specialist nurse.
    However, even though it is a mandatory requirement, a survey carried out by the Association of Child Death Review Professionals (ACDP) found that more than half of NHS areas in England do not have a specialist nurse to visit parents after an unexpected death.
    "It makes me really angry," says paediatrician Dr Joanna Garstang, the chair of the ACDP, who runs one of the few teams in England that support parents.
    "Bereaved families after the sudden death of a child are the most vulnerable people. And if we don't put in early support… we're setting these parents up for a lifetime of misery."
    Read full story
    Source: BBC News, 5 February 2024
  2. Patient Safety Learning
    Children are being forgotten by the government as they face “disgraceful” waiting times for NHS treatment, Britain’s top paediatric doctor has warned.
    Dr Camilla Kingdon said children are being failed because their care is not being treated as a priority, despite considerable progress having been made in reducing waiting times for adults.
    In her final interview as president of the Royal College of Paediatrics and Child Health, she also issued a stark warning over the impact of poverty on young people’s health, lamenting the rise in the number of children being treated for severe lung disease due to damp and poor ventilation in inadequate housing.
    Many parents cannot afford to be at their dying or sick child’s bedside because of financial pressures – an issue that has grown significantly worse in the past five years, she said.
    She told The Independent: “Children simply need to be made a priority. We cannot afford to be ignoring this problem.”
    The latest NHS figures show that the backlog for children’s hospital care has risen again, increasing from 387,000 in August to 412,000 in January, despite the adult waiting list having fallen since October.
    Read full story
    Source: The Independent, 31 March 2024
  3. Patient Safety Learning
    Maternity departments are raising thousands of safety reports every year about delayed inductions of labour, HSJ can reveal.
    Induction of labour may be used when women are overdue, because their waters have broken, or for other medical reasons to speed up the birth, such as poor growth of the baby.
    Delaying induction therefore may increase risks for both mothers and babies and the National Institute for Health and Care Excellence says trusts should raise a “red flag event” if it is delayed for more than two hours after admission.
    Information collected by HSJ from 50 trusts show 4,945 red flags related to delays in induction of labour in 2022-23. HSJ also found 3,109 reports in 2021-22 and 1,807 in 2020-21 across 47 trusts. 
    Meanwhile, there were 1,997 Datix reports mentioning induction of labour in 2022-23 across 59 trusts able to give HSJ figures, in response to Freedom of Information Act requests, compared with 1,690 in 2021-22 and 1,368 in 2020-21. 
    The Care Quality Commission has also raised concerns in inspections that incidents which should have been treated as “red flags” have not always been reported as such. The watchdog has also raised concerns about a lack of board-level oversight of maternity safety incidents and a need for clearer guidance for staff on reporting processes. 
    Read full story (paywalled)
    Source: HSJ, 2 April 2024
  4. Patient Safety Learning
    Legal costs in Irish medical negligence cases are among the highest in the world, according to a report that says the slow pace of legal actions here is damaging patients and doctors’ mental wellbeing.
    The average cost of a legal claim for medical negligence in Ireland is almost three times higher than in the UK, and cases take over 50 per cent longer to resolve, the industry report says.
    Patients and doctors in Ireland are dragged through what can be a brutal process, for longer than necessary, with patients having to wait longer to receive compensation, the report by the Medical Protection Society (MPS) asserts.
    In the report, the society, which provides indemnity cover for 16,000 doctors and other healthcare professionals in Ireland, compared the length and cost of legal actions here with other jurisdictions in which it operates.
    A medical negligence claim in Ireland takes 1,462 days on average (four years), 14% longer than in South Africa and 56% longer than in Hong Kong, the UK or Singapore, it found.
    Two hundred doctors in Ireland were interviewed for the report: 88% said they were worried about the length of time the litigation process was taking and 91% were worried about their mental wellbeing while it was ongoing. Some said they needed professional help, experienced suicidal thoughts, or quit medicine as a result of the claim.
    “It was horrendous. I had to leave medicine after it,” says one doctor involved in a claim who is quoted in the report. “I developed severe anxiety during the course of the claim and PTSD. I lost my career in medicine and I am devastated about that. I knew I could never go through the same again.”
    Read full story
    Source: The Irish Times, 31 January 2024
  5. Patient Safety Learning
    Jason Watkins, a British actor, has urged A&E units to look again at procedures surrounding infants as he has channels his anger at his young daughter’s death from sepsis into trying to “improve the system”.
    The actor said that his fury at the death of Maude aged two on New Year’s Day 2011 led him to smash up his shower.
    “It wasn’t anger at any individual, it was anger at fate. Why should we deserve this?” he told Andy Coulson’s Crisis What Crisis? podcast.
    “You feel really vulnerable and there’s a sort of rage against that. And there are all these different ways of resolving and wrestling out of this horrible dark pit that you’re in."
    He now campaigns for the UK Sepsis Trust.
    “I was never angry at any individual,” he said. “My anger was fuelled into trying to work out better ways of dealing with sepsis, or even more than that, the way that we look at infants in A&E. Because you know, it’s a funding issue, it’s an organisational issue. It’s another conversation.
    “Because I had identified that there wasn’t an individual at fault in the hospital, it has to be the system. So we’ve got to improve it. My anger is fuelled into that. There’s no bitterness. Nobody made a technical mistake, it’s just nobody really thought of the possibilities of what could be happening.
    “For me the whole of looking at infants arriving at A&E needs to be looked at again. Because if I say that Maude died twelve years ago, and that the ombudsman report about sepsis a couple of months ago said that nothing had changed about sepsis, now, that was like a body-blow, that makes me feel sick even thinking about it now, because we’ve worked so hard over that time.”
    Read full story
    Source: The Times, 1 February 2024
     
  6. Patient Safety Learning
    Deaths from cancer in the UK are set to rise by more than 50% in the next 26 years, stark new estimates suggest.
    Experts from the International Agency for Research on Cancer (IARC) and the World Health Organization (WHO) have found there were 454,954 new cases of cancer in the UK in 2022 and warned this is expected to rise to 624,582 by 2050.
    In 2022, 181,807 people died in Britain from cancer, but researchers warned this is expected to rise to 279,004 by 2050 – a 53% increase.
    The estimates suggest the rising rates of cancer will be driven by the UK’s growing and ageing population. However, researchers have also called for new policies to tackle levels of smoking, unhealthy diets, obesity and alcohol to help lower the expected surge in cases.
    The study examined cancer data from 115 different countries and estimated global cases would rise by 77 per cent, from 20 million in 2022 to 35 million in 2050.
    The organisations estimate that cancer deaths around the world will almost double from 9.7 million to 18.5 million in that time.
    Dr Panagiota Mitrou, director of research, policy and innovation at the World Cancer Research Fund, said the new estimates “show the increased burden that cancer will have in the years to come”.
    “UK governments’ failure to prioritise prevention and address key cancer risk factors like smoking, unhealthy diets, obesity, alcohol and physical inactivity has in part widened health inequalities,” she added.
    Read full story
    Source: The Independent, 1 February 2024
  7. Patient Safety Learning
    Online services for GPs across Surrey leave many patients feeling "helpless and lost", a new report says.
    Healthwatch Surrey said some patients felt "defeated" by online systems and that issues were worse in certain groups.
    This included people with English as a second language and those less confident with technology.
    Online services include booking appointments, requesting repeat prescriptions and viewing test results.
    Healthwatch Surrey, which gathers the views of local people on health and social care services in the county, said: "Confusion around the appointment booking process and a perception that appointments are hard, or even impossible, to book online is the issue people tell us most about."
    One Epsom and Ewell resident was asked by their surgery to book a blood test online.
    They told Healthwatch: "I tried but I couldn't understand how to do it and so I called back.
    "I'm in my 80s and I try to be as independent as I can, but some of these processes defeat me."
    Sam Botsford, contract manager at Healthwatch Surrey, said communication was key in ensuring patients knew how to use online services.
    She said: "People feel they're being pushed online, and that spans a range of different demographics.
    "It's really important for practices to identify the needs of their patients and how they can best meet those."
    Read full story
    Source: BBC News, 2 February 2024
  8. Patient Safety Learning
    In 2023-2024, the US News Best Hospitals ranked hospitals in the USA in 15 adult specialties as well as recognised hospitals by state, metro and regional areas for their work in 21 more widely performed procedures and conditions.
    Of the nearly 5,000 hospitals analyzed and 30,000 physicians surveyed, only 164 hospitals ranked in at least one of the specialties.
    Read full story
    Source: US News
  9. Patient Safety Learning
    People who are severely ill with suspected sepsis should promptly be given life-saving access to antibiotics to prevent unnecessary deaths, according to updated guidance from the National Institute for Health and Care Excellence (NICE.) The guidelines state that the national early warning score should be used to assess people with suspected sepsis aged 16 and over, who are not and have not recently been pregnant, and are in an acute hospital setting or ambulance.
    The updated guidance also recommends that doctors are more considerate as to who is given antibiotics, in order to reduce the risk of antibiotic resistance in people being prescribed them for less severe cases of sepsis.
    With the update, NICE says that more people will be categorised at a lower risk level where a sepsis diagnosis should be confirmed before being given antibiotics.
    Prof Jonathan Benger, Nice’s chief medical officer, said: “This useful and usable guidance will help ensure antibiotics are targeted to those at the greatest risk of severe sepsis, so they get rapid and effective treatment. It also supports clinicians to make informed, balanced decisions when prescribing antibiotics.
    “We know that sepsis can be difficult to diagnose so it is vital there is clear guidance on the updated [national early warning score] so it can be used to identify illness, ensure people receive the right treatment in the right clinical setting and save lives."
    Read full story
    Source: The Guardian, 31 January 2024
  10. Patient Safety Learning
    Unregulated healthcare workers are a risk to the most vulnerable patients, a former victim’s commissioner has warned after The Independent and Sky News uncovered a “horrifying” sexual abuse scandal within NHS mental health services.
    Dame Vera Baird called for a formal framework for healthcare assistants and support workers, who do not have a mandatory professional register like doctors and nurses and can “come in and go out from one hospital to another” without the same thorough checks.
    Dame Vera told The Independent that the setup did not lead to a “very safe way of working” because healthcare assistants are “in an environment where they are responsible for vulnerable people”.
    “If there has been abuse from mental health care assistants who are also agency staff who are coming in and going out from one hospital to another, that needs to be looked at,” she said.
    “This is not a very safe way of working. Some kind of framework around agency staff seems to be very important [to have].”
    She warned that sexual predators may go into mental health services and work in units where patients can be “highly sexualised”, prompting a “dreadful combination”.
    Read full story
    Source: The Independent, 30 January 2024
  11. Patient Safety Learning
    A prostate cancer patient went a year without a check-up because his referral to a consultant was lost.
    An inquest into the death of Thomas Ithell also heard that when the error was spotted it was not recorded because staff at Wrexham Maelor Hospital were too busy.
    The 77-year-old from Wrexham died in November 2022 after being admitted to hospital with shortness of breath.
    Assistant Coroner for North Wales East and Central, Kate Robertson, has submitted a Prevention of Future Deaths report to the health board in relation to Mr Ithell's case.
    As well as concerns over the lack of an investigation, she also questioned how the patient's follow-up appointment was missed.
    "There have been no assurances as to what, if any, changes and learning have been identified other than a tracking system for PSA monitoring," she wrote, referring to a type of blood test that helps diagnose prostate cancer.
    She was also concerned to learn that the hospital's Datix system - used for reporting incidents such as Mr Ithell's - had been described as "not user-friendly".
    Time constraints also sometimes prevented staff from completing these reports, thereby failing to trigger subsequent investigations by the board, the assistant coroner added.
    "I remain incredibly concerned that where matters are not raised in accordance with internal health board processes that assurances given to me in previous Prevention of Future Deaths reports cannot be supported," Ms Robertson added.
    Read full story
    Source: BBC News, 27 January 2024
  12. Patient Safety Learning
    Health service dentistry in Northern Ireland could be caught in a "death spiral" without radical action, more than 700 dentists have warned.
    They say a combination of factors could make the service unsustainable.
    These include a potential ban on dental amalgam metals used in fillings, budget pressures and a "financially unviable contractual framework".
    The dentists have called on the Department of Health (DoH) "to show leadership and take action now".
    A DoH spokesperson said the department "valued the important role" of dentists and was "aware of the ongoing pressures on dental practices".
    In an open letter to Peter May, the top civil servant at the DoH, dentists from the British Dental Association (BDA) Northern Ireland warned that services were under "intolerable pressure".
    The letter said: "Despite clear evidence and repeated warnings issued by the BDA about the death spiral health service dentistry in Northern Ireland appears to be in, we have seen inaction from the authorities."
    The dentists added that a move away from health service dentistry was "well and truly underway" and dentists would "be increasingly driven out of health service dentistry to keep their practices afloat".
    Read full story
    Source: BBC News, 30 January 2024
  13. Patient Safety Learning
    New digital prescriptions mean NHS App users in England can now collect medication from a pharmacy without having to visit a GP or health centre.
    The usual paper slip given by doctors has been replaced by an in-app barcode, which can be scanned at any pharmacy.
    Users can already request repeat prescriptions on the app - and every digital order fulfilled will save the GP three minutes, NHS Digital says.
    It comes after a trial last year, involving more than a million users.
    Patients can use the app to check what medicines they have been prescribed, and when.
    Anyone who has a nominated pharmacy can continue to collect medication without a paper prescription or barcode, as the details are sent to their pharmacy electronically.
    Read full story
    Source: BBC News, 30 January 2024
  14. Patient Safety Learning
    Physician associates have attempted to illegally prescribe drugs at dozens of NHS trusts and missed life-threatening diagnoses, a dossier claims. 
    Doctors working across the country claim patients’ lives have been put at risk by physician associates (PAs) who they say have failed to respond appropriately to medical emergencies – alleging more than 70 instances of patient harm and “near misses”.
    The Telegraph has seen responses from more than 600 doctors to a survey on PAs run by Doctors’ Association UK (DAUK), a campaign group.
    The data suggest that at over half of England’s hospital trusts, doctors are being replaced by PAs on the rota, despite associates only completing a two-year postgraduate course and having no legal right to prescribe.
    A spokesperson from the Department of Health said their role “is to support doctors, not replace them”.
    The Telegraph has interviewed more than a dozen surveyed doctors, as well as other clinicians worried about patient safety.
    At Dudley Group NHS Trust, one junior doctor said a PA had missed an “obvious heart attack” on an ECG, having “just signed it as if it was normal”.
    A clinician in primary care alleged PAs repeatedly misdiagnosed a patient’s metastatic cancer as muscle ache – despite blood results that were “tantamount” to a cancer diagnosis.
    They said: “The patient could have been saved eight months of pain; their life could have been prolonged.”
    Read full story (paywalled)
    Source: The Telegraph, 27 January 2024
  15. Patient Safety Learning
    Serious concerns about maternity services at an NHS trust have been revealed by BBC Panorama.
    Midwives say a poor culture and staff shortages at Gloucestershire Hospitals NHS Trust have led to baby deaths that could have been avoided.
    A newborn baby died after the trust failed to take action against two staff, the BBC has been told.
    The trust says it is sorry for its failings and is determined to learn when things go wrong.
    Concerns about two staff members, both midwives, had been raised by colleagues at the Cheltenham Birth Centre after another baby died 11 months earlier.
    The birth centre allowed women with low-risk pregnancies the choice of giving birth there under the care of midwives - there were no emergency facilities in the centre.
    In the event of complications, women should have been transferred to the Gloucestershire Royal Hospital, which is part of the same trust and about a 30-minute drive away.
    But on both occasions, the two midwives did not get their patients transferred quickly enough.
    The two midwives on duty for both deaths are now being investigated by their regulator, the Nursing and Midwifery Council.
    Read full story
    Source: BBC News, 29 January 2024
  16. Patient Safety Learning
    Tens of thousands of sexual assaults and incidents have been reported in NHS-run mental health hospitals as a “national scandal” of sexual abuse of patients on psychiatric wards can be revealed.
    Almost 20,000 reports of sexual incidents in the last five years have been made in more than half of NHS mental health trusts, according to exclusive data uncovered in a joint investigation and podcast by The Independent and Sky News.
    The shocking findings, triggered by one woman’s dramatic story of escape following a sexual assault in hospital revealed in a podcast, Patient 11, show NHS trusts are failing to report the majority of incidents to the police and are not meeting vital standards designed to protect the UK’s most vulnerable patients from sexual harm.
    Throughout the 18-month investigation, multiple patients and their families spoke to The Independent about their stories of sexual assault and abuse while locked in mental health units.
    Dr Lade Smith, president of the Royal College of Psychiatrists, called the findings “horrendous”, while shadow health secretary Wes Streeting said it was a “wake-up call” for the government.
    Dr Smith told The Independent: “There is no place for sexual violence in society, which has a profound and long-lasting negative impact on people’s lives. Today’s horrendous findings show that there is still much to do to make sure that patients and staff in mental health trusts are protected from sexual harms at all times.
    “It is deeply troubling to see that so many incidents in mental health settings go unreported.”
    Read full story
    Source: The Independent, 29 January 2024
  17. Patient Safety Learning
    Rebecca McLellan, a trainee paramedic, pursuing the job she had dreamed of as a child, took her own life at the age of 24.
    Amid the devastation felt by her loved ones, serious questions have now emerged about the standard of care she received at Norfolk and Suffolk NHS Foundation Trust (NSFT).
    In notes recorded before her death last November, McLellan said that Norfolk and Suffolk NHS Foundation Trust (NSFT) had “abandoned” her in a time of need. An internal investigation has now been launched by the mental health trust, which has been dogged by safety concerns for more than a decade.
    Relatives of McLellan, who lived in Ipswich, Suffolk, and was being treated for bipolar disorder, are among hundreds of bereaved families who believe their loved ones were failed under the care of the trust. Her mother, Natalie McLellan, 48, said it was clear that some of her daughter’s feelings of helplessness in her final months were “shaped by their inadequacy”.
    “She was somebody that had it all,” said Natalie. “She had a supportive family, she had a nice flat, she had a nice car, she was doing exactly what she wanted to do in life. She had a voice, she was able to speak and advocate for herself as a medical professional. If she can’t get help, what the hell hope is there for anybody else?
    Recent months have seen calls for a public inquiry and criminal investigation into NSFT after bosses last year admitted to losing count of the number of patients that had died on its books. Campaigners describe the mismanagement of mortality figures as “the biggest deaths crisis in the history of the NHS”.
    The Times has spoken to trust staff, bereaved relatives and MPs who say that despite repeated promises of improved care the trust’s overstretched services remain unsafe and require urgent reform.
    Read full story (paywalled)
    Source: The Times, 26 January 2024
  18. Patient Safety Learning
    Hospitals in England are being hit with disruptions to patients’ care more than 100 times every week because of fires, leaks and problems created by outdated buildings, NHS figures reveal.
    There have been 27,545 “clinical service incidents” over the past five years – an average of 106 a week – data compiled by the House of Commons library shows.
    They are incidents the NHS says were “caused by estates and infrastructure failure related to critical infrastructure risk” and are linked to the service’s massive backlog of maintenance, the bill for which has soared to £11.6bn. All the incidents led to “clinical services being delayed, cancelled or otherwise interfered with” for at least five patients for a minimum of 30 minutes.
    That means the 27,545 incidents between 2018-19 and 2022-23 disrupted the care of at least 137,725 patients, according to an analysis of NHS data by the Commons library commissioned by Ed Davey, the leader of the Liberal Democrats.
    “These findings are shocking but sadly not surprising, given the dilapidated, and in some cases dangerous, state of so many NHS facilities,” said Saffron Cordery, the deputy chief executive of NHS Providers, which represents health service trusts.
    The “unacceptable impact on patients” should spur ministers into increasing the NHS’s capital budget so trusts can urgently overhaul their estates, she said.
    Read full story
    Source: The Guardian, 26 January 2024
  19. Patient Safety Learning
    Paramedics are "watching their patients die in the back of ambulances because they can't get them into A&E", according to the health union, Unison.
    It was commenting on data showing 2,750 hours were lost by ambulance crews waiting to hand over patients at Hull Royal Infirmary in October 2023.
    One crew was stuck outside A&E for 10 hours and 27 minutes.
    Hull University Teaching Hospitals said it was "confident" a new urgent treatment centre on the hospital site would "improve overall waiting times" and lost ambulance hours had "reduced notably" this month.
    The figures, obtained by the BBC through a freedom of information request, showed on 9 October 2023 ambulance crews lost 144 hours and 18 minutes, the equivalent to one crew being out of action for six full days and nights.
    Megan Ollerhead, Unison's ambulance lead in Yorkshire, said paramedics were "literally watching their patients die in the back of these ambulances because they can't get into A and E."
    "I talk to a lot of the people who receive the 999 calls in the control rooms and they're just listening to people begging for ambulances and they know there are none to send."
    Read full story
    Source: BBC News, 26 January 2024
  20. Patient Safety Learning
    Diabetes patients have told the BBC they are struggling without what they have called a "wonder drug".
    Experts estimate about 400,000 people with Type 2 diabetes could have been affected by a national supply shortage caused by rising demand.
    The new generation of medicines - GLP-1 receptor agonists - mimic a hormone that not only controls blood sugar levels but also suppresses appetite.
    The government said it was trying to help resolve the supply chain issues.
    NHS England has issued a National Patient Safety Alert for the drugs.
    The NHS alerts require action to be taken by healthcare providers to reduce the risk of death or disability.
    The diabetes medicines in short supply are Ozempic, Trulicity, Victoza, Byetta, and Bydureon. They work via injections instead of tablets.
    The group of medicines has been used by the NHS for diabetes for around a decade but in recent years there has been a growth in private clinics prescribing the same drugs for weight loss for people who do not have diabetes, pushing up demand.
    Novo Nordisk, which manufactures Ozempic and Victoza, told the BBC it was experiencing shortages of its medicines for people in the UK with Type 2 diabetes due to "unprecedented levels of demand".
    Read full story
    Source: BBC News, 26 January 2024
    Have you (or a loved one) ever been prescribed medication that you were then unable to get hold of at the pharmacy or in hospital? To help us understand how these issues impact the lives of patients and families, please share your experience and insights in our hub community thread on the topic here or drop a comment below. You'll need to register with the hub first, its free and easy to do.
  21. Patient Safety Learning
    The EU is to stockpile key medicines that will worsen the record drug shortages in the UK, with experts warning that the country could be left “behind in the queue”.
    The EU is seeking to safeguard its supplies by switching to a system in which its 27 members work together to secure reliable supplies of 200 commonly used medications, such as antibiotics, painkillers and vaccines.
    But the bloc’s move to insulate itself from growing drug shortages threatens to exacerbate the increasing scarcity of medicines facing the NHS, posing serious problems for doctors.
    “Europe is securing access to key drugs and vaccines as a single region, with huge influence and buying power. As a result of Brexit the UK is now isolated from this system, so our drug supplies could be at risk in the future,” said Dr Andrew Hill, an expert on the pharmaceutical trade.
    Britain is experiencing a record level of drug shortages, with more than 100 – including treatments for cancer, type 2 diabetes and motor neurone disease – scarce or impossible to obtain.
    Mark Dayan, the Brexit programme lead at the Nuffield Trust health thinktank, said the EU’s decision to act as a buying cartel could seriously disadvantage Britain.
    “There is a real risk that measures in such a large neighbour, which is now a separate market due to Brexit, will leave the UK behind in the queue when shortages strike,” Dayan said.
    It also has an initiative for member states to transfer stocks of medicine to cover shortages in others. These measures could shut UK purchasers out in certain scenarios.
    “This would risk worsening shortages from a starting point where they are already exceptionally severe for the UK and other countries, with a mounting impact in terms of costs and wasted time for the NHS, and in terms of patients struggling to get what their doctors have said they need.”
    Read full story
    Source: The Guardian, 25 January 2024
    Have you (or a loved one) ever been prescribed medication that you were then unable to get hold of at the pharmacy or in hospital? To help us understand how these issues impact the lives of patients and families, please share your experience and insights in our hub community thread on the topic here or drop a comment below. You'll need to register with the hub first, its free and easy to do.
  22. Patient Safety Learning
    NHS England said it had opened a tender worth £16 million to support provider organisations as they seek to improve their digital maturity and get electronic patient records in place by the end of March 2026. 
    NHSE said its frontline digitisation programme is working with NHS secondary care trusts providing acute specialist, community, mental health and ambulance services to help them reach a minimum level of digital capability as defined by the Digital Capabilities Framework. 
    To fulfil this ambition, NHSE is seeking a partner to create an experienced, multi-skilled, rapid response intervention service, also known as a Tiger Teams service, capable of supporting EPR delivery across England.
    This service will be an expansion to an existing comprehensive support offer available to providers, designed to support the national demand for resource, expertise, and information necessary to successfully rollout EPRs. 
    NHSE said: “Often during EPR delivery, there is a requirement for either a planned, or unplanned, specific, time-bound skill set, capable of providing a set of deliverables, problem rectification or other specialist intervention for an element of the EPR Programme.
    “Trusts are finding it increasingly challenging to obtain good quality, skilled short-term resources, both from the recruitment and contingent labour market.” 
    Read full story
    Source: Digital Health, 22 January 2024
  23. Patient Safety Learning
    A "significant deterioration" in leadership at an NHS trust probably had a "knock-on effect" on its standard of services, a watchdog has found.
    Inspectors found staff felt encouraged to "turn a blind eye" to bullying in hospitals run by the Newcastle Hospitals NHS Foundation Trust.
    The Care Quality Commission (CQC) downgraded the trust's overall rating to "requires improvement".
    The trust said it "fully accepts" the report and that recommendations were being worked on "as a matter of urgency".
    Ann Ford, CQC's director of operations in the north, said: "We found a significant deterioration in how well the trust was being led.
    "Our experience tells us that when a trust isn't well led, this has a knock-on effect on the standard of services being provided to people.
    "Some staff told us that bullying was a normal occurrence, and they were encouraged to 'turn a blind eye' and not report this behaviour.
    "This is completely unacceptable."
    Read full story
    Source: BBC News, 25 January 2024
  24. Patient Safety Learning
    The Health and Social Care Committee has launched a new inquiry to examine leadership, performance and patient safety in the NHS.
    Inquiry: NHS leadership, performance and patient safety
    MPs will consider the work of the Messenger review (2022) which examined the state of leadership and management in the NHS and social care, and the Kark review (2019) which assessed how effectively the fit and proper persons test prevents unsuitable staff from being redeployed or re-employed in health and social care settings.
    The Committee’s inquiry will also consider how effectively leadership supports whistleblowers and what is learnt from patient safety issues.
    An ongoing evaluation by the Committee’s Expert Panel on progress by government in meeting recommendations on patient safety will provide further information to the inquiry.
    Health and Social Care Committee Chair Steve Brine MP said:
    “The role of leadership within the NHS is crucial whether that be a driver of productivity that delivers efficient services for patients and in particular when it comes to patient safety.
    Five years ago, Tom Kark QC led a review to ensure that directors in the NHS responsible for quality and safety of care are ‘fit and proper’ to be in their roles. We’ll be questioning what impact that has made.
    We’ll also look at recommendations from the Messenger review to strengthen leadership and management and we will ask whether NHS leadership structures provide enough support to whistleblowers.
    Our Expert Panel has already begun its work to evaluate government progress on accepted recommendations to improve patient safety so this will build on that. We owe it to those who rely on the NHS – and the tax-payers who pay for it – to know whether the service is well led and those who have been failed on patient safety need to find out whether real change has resulted from promises made.”
    Terms of Reference
    The Committee invites written submissions addressing any, or all, of the following points, but please note that the Committee does not investigate individual cases and will not be pursuing matters on behalf of individuals.   Evidence should be submitted by Friday 8 March. Written evidence can be submitted here of no more than 3,000 words.   How effectively does NHS leadership encourage a culture in which staff feel confident raising patient safety concerns, and what more could be done to support this? What has been the impact of the 2019 Kark Review on leadership in the NHS as it relates to patient safety? What progress has been made to date on recommendations from the 2022 Messenger Review? How effectively have leadership recommendations from previous reviews of patient safety crises been implemented? How could better regulation of health service managers and application of agreed professional standards support improvements in patient safety? How effectively do NHS leadership structures provide a supportive and fair approach to whistleblowers, and how could this be improved? How could investigations into whistleblowing complaints be improved? How effectively does the NHS complaints system prevent patient safety incidents from escalating and what would be the impact of proposed measures to improve patient safety, such as Martha’s Rule? What can the NHS learn from the leadership culture in other safety-critical sectors e.g. aviation, nuclear? Read full story
    Source: UK Parliament, 25 January 2024
  25. Patient Safety Learning
    Researchers have found the costs of treating patients in a 40-bed virtual ward were double that of traditional inpatient care.
    The study’s authors said the findings should raise concerns over a flagship NHS England policy, which has driven the establishment of 10,000 virtual ward beds.
    Virtual wards, sometimes described as “hospital at home”, are cited as a safe way to reduce pressure on hospitals, by reducing length of stay and enabling quicker recovery.
    The study at Wrightington Wigan and Leigh Teaching Hospitals, in Greater Manchester, found a clear reduction in length of stay but also found higher rates of readmission.
    The authors said this led to additional costs, with the cost of a bed day in the virtual ward estimated at £1,077, compared to £536 in a general inpatient hospital bed. 
    “This raises concerns [over] the deployment of large-scale virtual wards without the existence of policies and plans for their cost-effective management. This evidence should be taken into consideration by [the] NHS in planning the next large deployment of virtual wards within the UK…
    “Virtual wards must be cost effective if they are to replace traditional inpatient care, the costs must be comparable or lower than the costs of hospital stay to be economically sustainable in the medium to long terms.”
    To break even, the paper said the virtual ward would need to double its throughput, but warned this would risk lowering the standard of care.
    Read full story (paywalled)
    Source: HSJ, 25 January 2024
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