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Patient Safety Learning

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  1. Patient Safety Learning
    A record 420,000 patients had to wait more than 12 hours in A&E last year, analysis has shown.
    The latest NHS England figures revealed a 20% increase on 2022 in people facing lengthy delays after a decision to admit them to hospital from the emergency department.
    In 2023, 419,560 people – or one in 15 A&E patients – faced “trolley waits” of 12 hours or more, according to the Liberal Democrats, who compiled the analysis. It marks by far the highest number since records began in 2011, and amounts to an average of 1,150 patients a day.
    Ed Davey, the party leader, criticised the “appalling delays” and accused Rishi Sunak’s government of “ignoring the suffering of patients and driving our health service into the ground”.
    Significant waits in A&E have been linked to excess deaths and increased harm to patients, as their condition could deteriorate before they are admitted or given a bed on a ward.
    Davey said: “Every year A&E delays are getting worse and worse under this Conservative government as hospitals are starved of the resources and staff they need. These appalling delays are leaving often vulnerable and elderly patients waiting for hours on end in overcrowded A&Es."
    Read full story
    Source: The Guardian, 14 January 2024
  2. Patient Safety Learning
    The scale of the crisis in social care is laid bare as figures show that dementia patients occupy a quarter of all beds in the NHS. People living with the disease often go into hospital after falls or infections as well as for acute medical or surgical problems.
    Dementia patients often experience longer hospital stays than the average patient and can be delayed leaving wards due to a shortage of care in the community.
    At any one time in the NHS, one in four hospital beds are occupied by people living with dementia, according to the National Institute for Health and Care Excellence, which says stays on wards can trigger distress, confusion and delirium for patients.
    Doctors must carry out a discharge assessment of patients to ensure they are healthy before they can leave hospital. Medics assess a dementia patient’s care needs outside of hospital and discharge can be delayed if these are deemed not adequate.
    Demand for social care continues to rise as the population grows older but there is a shortage of workers in the sector. Skills for Care estimated that, in 2022/23 an average of 9.9 per cent - or 152,000 - roles in adult social care in England went unfilled.
    This was the equivalent to 152,000 vacancies - down by 11,000 from the previous year, although vacancies remain high compared to the wider UK economy.
    Services are so overstretched that people are left struggling without vital support to carry out everyday tasks in their own homes, and lives are being blighted.
    Read full story
    Source: The Independent, 14 January 2024
  3. Patient Safety Learning
    “Better upfront planning, training and testing” were needed in a tech launch which was tied to patient harm and service disruption, an NHS England review has found. 
    Royal Surrey and Ashford and St Peter’s Hospitals foundation trusts went live with Oracle Cerner’s electronic patient record in May 2022 – under a programme called Surrey Safe Care – but the implementation has since been linked to incidents of patient harm, including one death, and significant disruption to trust services.
    Now, a lessons learned review, carried out by NHSE’s frontline digitisation team and obtained by HSJ via a Freedom of Information request, has identified 24 areas of improvement.
    The key lessons cited by the review are “better upfront planning, roles and responsibilities, training and testing”. 
    It recommended that, in future implementations, trust boards should be supported by others experienced with implementing EPRs within the NHS to “aid board level decisions and ‘what questions to ask when’”, while clearer responsibilities should also be agreed upon for programme leads and EPR suppliers.
    The review also found the content of training must be evaluated thoroughly, while the EPR supplier should provide “upfront and continuous training”. It added the “full end-to-end testing [by] representatives from all end user groups” should be completed before go-live.
    It also said EPR readiness needs to incorporate “data readiness, such as data quality, and mapping how data has originally been captured [which] may impact reporting and organisational readiness”.
    Read full story (paywalled)
    Source: HSJ, 15 January 2024
    Related reading on the hub:
    NHS England warns electronic patient record could pose ‘serious risks to patient safety’: what can we learn?
  4. Patient Safety Learning
    More than 8,500 patients in England were being treated on virtual wards in the run-up to Christmas, figures have revealed, as the NHS moves to ease pressures on hospital capacity.
    However, experts said the so-called hospitals at home are not a “silver bullet to solve the crisis in health and social care”.
    Figures published by NHS Digital revealed some 8,586 patients were treated virtually in December 2023, up from 7,886 in November.
    The snapshot was taken on 21 December 2023, meaning it is likely those patients spent Christmas on a virtual ward rather than an actual hospital.
    Virtual wards allow patients to receive care in their own homes, with clinical staff using apps or wearable technology to monitor them remotely.
    Professor Sir Stephen Powis, NHS national medical director, said the “rapid expansion” of virtual wards beds and patients “is a real NHS success story”.
    He added: “This not only frees up vital hospital beds for those who need them most but ensures patients can recover in the place they are most comfortable with support from families, carers and friends, and while occupancy has been growing rapidly as NHS teams make the most of all bed capacity available, we want to see continued growth right across the country so as many patients as possible can benefit."
    However, Wendy Preston, the head of nursing practice at the Royal College of Nursing (RCN), said “virtual wards aren’t a silver bullet to solve the crisis in health and social care”.
    “Whether they’re in a physical bed or on a virtual ward, patients still need to be able to see a nurse,” she added.
    “But there are over 40,000 nursing vacancies across the NHS, and social care is chronically understaffed. Run effectively, virtual wards can relieve pressure, but on every single shift nursing staff are fighting an uphill battle to care for too many patients.
    “If the UK government wants to turn around the state of the NHS and deliver the ‘hospital level’ care at home that patients expect, nursing staff need to see game-changing investment in the workforce.”
    Read full story
    Source: The Independent, 15 January 2024
  5. Patient Safety Learning
    NHS trusts are sharing intimate details about patients’ medical conditions, appointments and treatments with Facebook without consent and despite promising never to do so.
    An Observer investigation has uncovered a covert tracking tool in the websites of 20 NHS trusts which has for years collected browsing information and shared it with the tech giant in a major breach of privacy.
    The data includes granular details of pages viewed, buttons clicked and keywords searched. It is matched to the user’s IP address – an identifier linked to an individual or household – and in many cases details of their Facebook account.
    Information extracted by Meta Pixel can be used by Facebook’s parent company, Meta, for its own business purposes – including improving its targeted advertising services.
    Records of information sent to the firm by NHS websites reveal it includes data which – when linked to an individual – could reveal personal medical details.
    It was collected from patients who visited hundreds of NHS webpages about HIV, self-harm, gender identity services, sexual health, cancer, children’s treatment and more.
    It also includes details of when web users clicked buttons to book an appointment, order a repeat prescription, request a referral or to complete an online counselling course. Millions of patients are potentially affected.
    Read full story
    Source: The Guardian, 27 May 2023
  6. Patient Safety Learning
    An unprecedented medicines shortage in the NHS is endangering lives, pharmacists have said, as unpublished figures reveal that the number of products in short supply has doubled in two years.
    A treatment for controlling epileptic seizures was the latest to be added on Wednesday to a UK drugs shortage list that includes treatments for conditions ranging from cancer to schizophrenia and type 2 diabetes.
    Causes of the crisis are thought to include the plummeting purchasing value of the pound since the Brexit referendum, which reduces the NHS’s ability to source medicines abroad, and a government policy of taxing manufacturers.
    According to Department of Health and Social Care (DHSC) figures provided to the British Generic Manufacturers Association, there were 111 drugs on a shortages list on 30 October last year and 96 on 18 December, with supply notifications issued for a further 10 treatments to NHS providers in the UK since then.
    It amounts to a 100% increase in shortages compared with January 2022, with pharmacists and health charities claiming the conditions of some patients were deteriorating as a result.
    Delyth Morgan, the chief executive of Breast Cancer Now, said her organisation had been contacted over the past 12 months by several patients unable to source the medicines they needed to control the spread of their disease.
    She said: “Last year many people shared with us, via Breast Cancer Now’s helpline, that they’d been facing difficulties accessing their hormone treatment including letrozole, anastrozole and tamoxifen, causing them huge worry and anxiety. Trying to track down a treatment by travelling to a number of different pharmacies is an added burden for patients at an already difficult time.
    “It may also sometimes be that certain brands of drugs are out of stock and people may have to switch to another brand or different drug. In the worst case someone may have a period of time without the medication, a drug which could help reduce the risk of their breast cancer coming back or spreading.”
    Read full story
    Source: The Guardian, 14 January 2024
  7. Patient Safety Learning
    People who go abroad for weight-loss surgery, and then need urgent medical care back in the UK, cost the NHS more than it costs to carry out the operation itself, according to new research.
    A study featuring five London hospitals recorded the details of 35 people who had suffered complications after travelling abroad for gastric surgery during 2022.
    The data, shared with the BBC's Disclosure programme, shows the patients suffered from a range of symptoms including severe malnutrition, vomiting, sepsis, hernias and haemorrhaging. Five of them needed feeding tubes inserted, while the average stay in hospital was 22 days.
    The interventions at the five hospitals for the 35 patients cost the NHS a total of £560,234, or £16,006 per patient, in 2022.
    The equivalent amount would have covered the cost of about 110 bariatric surgeries in UK hospitals.
    Consultant bariatric surgeon Omar Khan, one of the lead authors of the study, said the paper was intended "to try and quantify" the effect on the NHS of increasing numbers of people going abroad for weight-loss surgery - sometimes known as bariatric tourism.
    "We know that the waiting lists in the NHS are unfortunately long. We also know that there are new units, particularly in Turkey, which have been set up to cater for an international market," he explained.
    "We focused on patients with major complications, patients who were severely ill. They had leaks from the stomach, they had bleeding, they had infections. A significant portion required further surgery and some required revisional surgery."
    Read full story
    Source: BBC News, 15 January 2024
  8. Patient Safety Learning
    Thousands of patients are being readmitted to NHS mental health units in England every year soon after being discharged, raising concerns about poor care, bed shortages and increased risk of suicide.
    Experts say being discharged prematurely can be upsetting, set back the patient’s chances of making a full recovery and be “disastrous” for their health.
    Figures from NHS mental health trusts in England show that last year almost 5,000 people – children and adults – were readmitted to a mental health facility within a month of leaving.
    The Labour MP Dr Rosena Allin-Khan said the “alarming” data, which she obtained under freedom of information laws, showed too many patients were not receiving enough help to recover.
    Allin-Khan said: “With record waiting lists and mental health beds in short supply, it is alarming that many patients are being discharged only to be readmitted within days. Every patient expects to receive full and appropriate mental health support, so it is concerning that in many cases patients are being discharged prematurely.
    “Being discharged too soon can have a disastrous impact, stunting progress towards a full recovery, ultimately causing further damage to a patient’s mental health.”
    Read full story
    Source: The Guardian, 12 January 2024
  9. Patient Safety Learning
    The NHS must treat at least 10% more non-emergency hospital cases a month if it wants to reduce the hefty backlog caused by the pandemic, according to new analysis.
    From February 2020 to October 2022, the waiting list for non-urgent care in England grew by 2.6m cases – a projected 1.8m more than if the pandemic had not hit.
    NHS England’s recovery plan aims to increase capacity by 30% by 2025 compared with pre-pandemic levels, but figures published on Thursday showed that the waiting list in England stood at 7.6m, down just 1.3% from the previous month.
    Researchers at the Universities of Edinburgh and Strathclyde examined the number of referrals awaiting treatment between January 2012 and October 2022.
    They calculated that an estimated 10.2m fewer referrals were made to elective care from the beginning of the pandemic to 31 October 2022. They then modelled how many of these missing patients might return for care to estimate the potential impact on waiting lists.
    NHS trusts would have to treat more than 10% to reverse the increasing trend in waiting lists, the authors conclude. “Even if the ambitious target of 30% increase in capacity is achieved during the next three years, several years (beyond the end of 2025) will be needed for the backlog to clear.”
    The research comes as NHS England monthly data published on Thursday revealed the health service is going backwards on some key targets.
    Read full story
    Source: The Guardian, 11 January 2024
  10. Patient Safety Learning
    Long Covid costs the UK at least an extra £23m in GP and other primary care consultations each year, according to estimates in a new study.
    The University of Birmingham said extra appointments cost between £23m and £60m a year.
    The study examined more than 950,000 electronic healthcare records since the start of the global pandemic.
    People with Long Covid report symptoms including persistent coughs and brain fog. The condition is defined as having symptoms three months after the initial infection, which last for two months or more.
    Factors found to increase primary care costs included being older, female, white, obese or someone with long-term health conditions.
    Co-lead author Dr Shamil Haroon, from the university, said: "We might expect that patients who are older or who have long-term health conditions will need additional primary care support, but we have also seen additional costs associated with being white and female."
    Read full story
    Source: BBC, 11 January 2024
  11. Patient Safety Learning
    The number of women dying during pregnancy or soon after childbirth has reached its highest level in almost 20 years, according to new data. Experts have described the figures as “very worrying”.
    Between 2020 and 2022, 293 women in the UK died during pregnancy or within 42 days of the end of their pregnancy. With 21 deaths classified as coincidental, 272 in 2,028,543 pregnancies resulted in a maternal death rate of 13.41 per 100,000.
    This is a steep rise from the 8.79 deaths per 100,000 pregnancies in 2017 to 2019, the most recent three-year period with complete data. The death rate has increased to levels not seen since 2003 to 2005.
    The data comes from MBRRACE-UK, which conducts surveillance and investigates the causes of maternal deaths, stillbirths and infant deaths as part of the national Maternal, Newborn and Infant Clinical Outcome Review Programme (MNI-CORP).
    Urgent action is needed to bolster the quality of maternal healthcare, ensure it is accessible to all, and repair the damage inflicted by the pandemic on women’s healthcare services more generally.
    Clea Harmer, the chief executive of bereavement charity Sands, said improving maternity safety also needs to be at the top of the UK’s agenda.
    The government said it was committed to ensuring all women received safe and compassionate care from maternity services, regardless of their ethnicity, location or economic status.
    Anneliese Dodds, the shadow women and equalities secretary, said Labour would seek to reverse the “deeply concerning” maternal mortality figures by training thousands more midwives and health visitors and incentivising continuity of care for women during pregnancy.
    Read full story
    Source: The Guardian, 11 January 2024
  12. Patient Safety Learning
    Women who experience depression during pregnancy or in the year after giving birth are at a higher risk of suicide and attempting suicide, researchers have warned.
    The British Medical Journal study warned that women who develop perinatal depression are twice as likely to die compared to those who don’t experience depression.
    Suicide was the leading cause of death for women in the UK in 2022 between six weeks and one year after birth, while deaths from psychiatric causes accounted for almost 40 per cent of maternal deaths overall, according to a Perinatal Mortality Surveillance report.
    Last year an analysis by Labour revealed 30,000 women who were pregnant were on waiting lists for specialist mental health support. The number of women waiting rose by 40 per cent between August 2022 and March 2023.
    The most recent NHS data shows in September 2023, 61,000 women accessed perinatal mental health services. For 2023-24, the health service must hit a target to have 66,000 women accessing care.
    In August 2023, the Royal College of Midwives published a research warning half of anxiety and depression cases among new and expectant mothers were being missed amid NHS staff shortages in maternity care.
    Read full story
    Source: The Independent, 11 January 2024
  13. Patient Safety Learning
    A British mother-of-three has died just days after undergoing a Brazilian bum-lift operation in Turkey.
    Demi Agoglia, 26, of Salford, Greater Manchester, died from a heart attack caused by the operation just hours before she was due to return to Manchester from Istanbul where she had the operation, her family said.
    Ms Agoglia, who had a seven-month-old baby boy, went back to the clinic in Istanbul for a check-up but had a heart attack in a taxi on the way to the hospital as her partner, Bradley Jones, gave her CPR in a desperate bid to save her life.
    Her brother Carl, 37, said Ms Agoglia’s family and partner had tried to convince her not to go through with the bum-lift as they were concerned for her safety.
    Last year, a British surgeon warned of the dangers faced by Brits who fly to countries like Turkey for cheaper cosmetic surgery.
    “Many people fail to do their research and focus too much on money, rather than the quality or safety of the clinic,” Dr Ahmed Alsayed, who is lead surgeon and medical director at plastic surgery specialists Signature Clinic told HullLive.
    “Clinics in the UK have to adhere to the strictest levels of expertise, safety and cleanliness. You just can’t be sure you’ll get that from a cheaper option abroad,” Dr Alsayed said.
    Read full story
    Source: The Independent, 10 January 2023
  14. Patient Safety Learning
    The UK has some of the worst cancer survival rates in the developed world, according to new research.
    Analysis of international data by the Less Survivable Cancers Taskforce found that five-year survival rates for lung, liver, brain, oesophageal, pancreatic and stomach cancers in the UK are worse than in most comparable countries. On average, just 16% of UK patients live for five years with these cancers.
    Out of 33 countries of comparable wealth and income levels, the UK ranks as low as 28th for five-year survival of both stomach and lung cancer, 26th for pancreatic cancer, 25th for brain cancer and 21st and 16th for liver and oesophageal cancers respectively.
    The six cancers account for nearly half of all common cancer deaths in the UK and more than 90,000 people are diagnosed with one of them in Britain every year.
    The taskforce calculated that if people with these cancers in the UK had the same prognosis as patients living in countries with the highest five-year survival rates – Korea, Belgium, the US, Australia and China – then more than 8,000 lives could be saved a year.
    Anna Jewell, the chair of the Less Survivable Cancers Taskforce, said: “People diagnosed with a less survivable cancer are already fighting against the odds for survival. If we could bring the survivability of these cancers on level with the best-performing countries in the world then we could give valuable years to thousands of patients.
    “If we’re going to see positive and meaningful change then all of the UK governments must commit to proactively investing in research and putting processes in place so we can speed up diagnosis and improve treatment options.”
    Read full story
    Source: The Guardian, 11 January 2023
  15. Patient Safety Learning
    The family of an autistic teenager who died from an accidental overdose say they had to investigate the death themselves to find the truth of how he died.
    Will Melbourne, 19, was found dead at his Cheshire home on December 18, 2020 after he mistakenly had taken a strong synthetic opioid 100 times stronger than morphine he bought on the dark web.
    The inquest into Will's death took three years to come back and his family say had to investigate the matter themselves to find out what happened. 
    Sally and John Melbourne said their lives were put on hold during the long wait for the inquest to be completed and the family were told at the pre-inquest hearing that the court were short-staff and had a backlog of 500 cases.   
    Parents and friends of the teenager used a trail of digital "breadcrumbs" to uncover that Will had tried to buy oxycodone, a highly addictive opioid that helps with pain relief and anxiety, which turned out to be a synthetic opioid.
    The blue pills Will had bought on the darknet were found beside his body. 
    The family say the drugs were not tested until they raised it with the coroner's court a year after his death.
    Will's blood sample had also been destroyed after the company storing it went into administration. 
    The family said they were left traumatised by the time the inquest was concluded. 
    Mrs Melbourne said: "We thought the inquest system was there to give us answers. Instead, we felt blocked at every turn. 
    "It was outrageous that we had to take the investigation on ourselves."
    Read full story
    Source: Mail Online, 4 January 2023
  16. Patient Safety Learning
    More NHS managers support regulation of their roles than oppose it, despite many fearing its implementation will be unfair or disproportionate, a survey suggests. 
    The trade union Managers in Partnership surveyed NHS managers working at Agenda for Change band 8a and above throughout the UK late last year, collecting 291 responses.
    Asked whether they “in principle… support professional regulation of NHS managers”, 49% said they supported or strongly supported it. Just 19% said they opposed or strongly opposed, while the remainder were neutral.
    However, respondents – 22% of whom said they were already covered by a professional regulator, and likely to be nurses, doctors or finance or legal professionals – appeared sceptical about the benefits. 
    Asked whether they thought professional regulation of NHS managers would make processes for raising concerns/whistleblowing better or worse, only 26% said it would be better. 20% said these would get worse, and the remainder said it would be “about the same”. 
    Read full story (paywalled)
    Source: HSJ, 9 January 2023
  17. Patient Safety Learning
    The former nursing director at the hospital where Lucy Letby murdered seven babies will be among the 'core participants' of the Thirlwall Inquiry.
    The inquiry, chaired by Lady Justice Thirlwall, will investigate how Letby was able to commit the murders and attempt six others while she worked as a neonatal nurse at Countess of Chester Hospital NHS Foundation Trust in 2015 and 2016.
    This week, Alison Kelly, who was director of nursing and quality at the trust during the time of Letby's crimes, was announced as 1 of 10 core participants in the inquiry.
    Also named were former Countess of Chester chief executive Tony Chambers, former medical director Ian Harvey and former human resources director Sue Hodkinson.
    Ms Kelly and Mr Harvey were among the senior staff at the trust who were accused of failing to act when clinicians first raised concerns about Letby.
    How managers responded to such concerns is one of the areas due to be investigated by the Thirlwall Inquiry.
    A number of organisations are also on the list as core participants, including the Nursing and Midwifery Council (NMC), NHS England, the Royal College of Paediatrics and Child Health, the Department of Health and Social Care and Countess of Chester itself.
    Read full story
    Source: Nursing Times, 3 January 2024
  18. Patient Safety Learning
    The senior midwife tasked by the government and NHS to investigate serious maternity scandals has warned that new mothers are being driven to suicide and backed an MP’s review into birth trauma.
    Donna Ockenden said it was “appalling” that women who should be in the “happiest times of their lives” were taking their own lives, after it was found suicide was the leading direct cause of deaths up to 12 months after giving birth.
    Ockenden, who has exposed poor maternity care across the country, is preparing to give evidence to an inquiry launched by Theo Clarke, the Conservative MP for Stafford, on birth trauma.
    Clarke thought she was going to die after giving birth to her daughter Arabella last year, having suffered a third-degree tear.
    But it was the lack of help available that opened her eyes to the estimated 200,000 women a year who experience birth trauma.
    Ockenden told The Times she had “huge respect” for Clarke’s inquiry and said: “I think that this whole issue of maternal trauma, sometimes long-term psychological trauma for families as well post a difficult maternity experience, is not necessarily given enough air time.”
    Read full story (paywalled)
    Source: The Times, 8 January 2023
  19. Patient Safety Learning
    A former midwife has told the BBC she quit because she could not live with herself if she provided poor care.
    Hannah Williams says staff shortages meant she kept patients safe, but sometimes only "by the skin of her teeth".
    BBC Verify analysis shows that the number of full-time equivalent midwife posts in England has gone up by 7% in the last decade. In comparison, the overall NHS workforce has increased by 34%.
    The country has a shortage of about 2,500 midwives, and maternity units are struggling with safety concerns.
    BBC research has also found that some trusts have more than one in five midwife jobs unfilled.
    The Royal College of Midwives says staffing is the "most important issue" and the gap needs to close.
    Read full story
    Source: BBC News, 9 January 2024
  20. Patient Safety Learning
    A coroner overseeing a teenager's inquest has warned there will be more deaths unless mental health services improve for autistic people at risk of self-harm.
    Morgan-Rose Hart, 18, who had ADHD, autism and a history of mental illness had been a patient at a unit in Harlow, Essex, for three weeks.
    An inquest jury concluded she died by misadventure contributed to by neglect.
    Ms Hart, from Chelmsford, died in hospital six days after she was found unresponsive in the bathroom of her mental health accommodation in the Derwent Centre in Harlow, Essex in July 2022.
    The inquest into her death heard staff observations were falsified and critical observations were missed.
    In her Prevention of Future Deaths report, Ms Hayes said: "There is a significant shortfall of appropriate placements for people with autism who have mental health and self-harm risks in Essex both inpatient and in the community."
    She added: "During the course of the inquest the evidence revealed matters giving rise to concern.
    "In my opinion, there is a risk that future deaths will occur unless action is taken."
    Read full story
    Source: BBC News, 8 January 2024
  21. Patient Safety Learning
    NHS England and government are set to raise their target for four-hour A&E performance, despite most hospitals failing to meet the current ask.
    HSJ understands officials are likely to use 2024-25 planning guidance to raise the “interim” target for four-hour performance from the 76% which trusts were asked to hit in 2023-24.
    A new objective of 80% by March 2025 has been discussed, several sources said, but is not confirmed.
    The 76% target has not been met during any month of 2023-24 so far, and most acute trusts are consistently falling well short of it.
    Well-placed sources told HSJ  the target was likely to be increased despite “some doubts” among senior NHSE officials. One senior NHSE source said: “The target should be increasing incrementally as overall NHS A&E performance improves, [but] it hasn’t really improved this year.”
    Read full story (paywalled)
    Source: HSJ, 5 January 2024
  22. Patient Safety Learning
    Patients' lives are being put at risk because it is too easy to buy prescription-only medicines from online pharmacies, a leading pharmacist says.
    A BBC investigation found 20 online pharmacies selling restricted drugs without checks - such as GP approval. In total, over 1,600 various prescription-only pills were bought during the investigation entering false information without challenge.
    Regulator the General Pharmaceutical Council says extra checks are needed when selling some drugs online.
    The BBC's findings highlight the "wild west" of buying medicines on the web, says Thorrun Govind, a pharmacist, health lawyer and former chair of the Royal Pharmaceutical Society.
    "The current guidance basically tells pharmacies to be robust, but do that in your own way, and we know that under this current system, patients have died," she says.
    The parents of a woman who died in 2020, after accidentally overdosing on medicines she bought online, are among those calling for stricter rules.
    Katie Corrigan, from St Erth in Cornwall, had developed an addiction to painkillers after experiencing neck pain.
    "Katie needed help, she didn't need more medication," says her mum, Christine Taylor.
    Her GP had stopped supplying the drug after realising she had been allowed to request new prescriptions prematurely and been prescribed too much.
    Instead, Katie, 38, was able to buy a painkiller and a drug used to treat anxiety from multiple online pharmacies without notifying her GP.
    The coroner at Katie's inquest confirmed her GP had not been contacted by any of the pharmacies to check the drug was safe for her. In his final report, he said the safety controls were inadequate.
    Read full story
    Source: BBC News, 5 January 2024
  23. Patient Safety Learning
    At least 38 babies died in the space of nine years after serious incidents in the country’s maternity units, it has emerged.
    The total is based on research of both media reports of inquests and settled claims.
    Before Christmas, a review by the  Irish Examiner  revealed 21 hospital baby deaths followed one or more serious incidents, between 2013 and 2021.
    However, further study in the same nine-year period shows the toll to be higher. The worst year was 2018, when not only did at least 10 babies die, but three of them died at the same Dublin hospital over a five-month period.
    In at least 18 of the 38 deaths, issues around foetal heartbeat monitoring (CTG) were raised either at inquest or in the High Court.
    At least 18 of the inquests resulted in a verdict of medical misadventure.
    As well as issues around heart monitoring, the Irish Examiner review shows that in at least seven of the 38 cases, maternity staff missed signs that a woman was in labour, leading to repeated recommendations around training.
    In at least seven cases, mothers’ concerns were ignored.
    Read full story
    Source: Irish Examiner, 29 December 2023
  24. Patient Safety Learning
    The NHS will start recording harm caused to patients during strike action where exemptions have been rejected by the British Medical Association (BMA).
    BMA council chair Phillip Banfield yesterday accused NHS England of the “weaponisation” of the strike “derogation” process, saying trusts had this week submitted more of the requests, which would permit some striking doctors to return to work, and were not providing information needed to determine if they were justified.
    NHS England wrote back to Professor Banfield, insisting it was only trying to prioritise safety, but also saying it would revise its own approach to derogation requests.
    This will include: asking trusts whose requests were rejected by the BMA “to compile a picture” of the impact on services; reinforcing requirements to report patient safety incidents during strikes and after mitigation requests, so “we can evidence harm and near misses which might have been avoided”.
    The letter says: “We have consistently asked local medical and other clinical leaders to consider applying to the BMA for patient safety mitigations where they have significant concerns for patient safety that cannot be mitigated through other options available to them, and where they can make a strong evidential case that the return of a limited number of junior doctors would address these risks.
    “We have done this, in part, because we have received a number of reports over previous periods of action that some teams have been put off seeking patient safety mitigations because of their prior experience of having applications rejected, or not receiving a response in time. We are sure you would agree that this is an unsatisfactory position, and that where patient safety concerns exist, these should always be escalated appropriately.”
    Read full story (paywalled)
    Source: HSJ, 4 January 2024
  25. Patient Safety Learning
    The Welsh Ambulance Service is struggling to cope as many A&E departments are full and some patients have reportedly been waiting to be offloaded from ambulances for as long as 15 hours. The service has issued a plea for the public to "use 999 responsibly" amid severe pressure.
    An employee of the service said: "Nearly every A&E department is at capacity. Patients have been on ambulances for the last 15 hours. The ambulance service is only responding to red [immediately life-threatening] calls."
    The service has received almost 13,000 calls to 999 since Boxing Day and there have been almost 36,000 calls to the NHS 111 Wales service.
    Lee Brooks, the ambulance service’s operations boss, said: “Pent-up demand from the Christmas and New Year period, coupled with the seasonal illnesses we see at this time of year, means there are lots of people across Wales trying to access health services currently. When hospitals are at full capacity, it means ambulances can’t admit their patients, and while they’re tied up at emergency departments, other patients in the community are waiting a long time for our help, especially if their condition isn’t life-threatening.
    “We’re working really hard as a system to deliver the best possible care to patients, but our ask of the public today – and in the coming days – is only to call 999 if they are seriously ill or injured, or where there is an immediate threat to someone’s life. That’s people who’ve stopped breathing, people with chest pain or breathing difficulties, loss of consciousness, choking, severe allergic reactions, catastrophic bleeding or someone who is having a stroke."
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    Source: Wales Online, 3 January 2024
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