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Patient Safety Learning

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  1. Patient Safety Learning
    Millions of patients face being left without a dentist as one in five practices are on the brink of collapse this month.
    A sharp loss of income since the government banned all routine dental care during the coronavirus crisis has crippled practices, with many poised to close permanently. Some have already been forced out of business.
    A British Dental Association (BDA) survey of 2,800 practices found 71.5% said they could stay “financially sustainable” for only three months at the most. More than one in five, 20.4%, said they would not survive beyond April. Mick Armstrong, who chairs the association, said: “Practices are weeks from a cliff edge. Without meaningful support, the nation’s dental services face decimation.”
    Read full story (paywalled)
    Source: The Times, 12 Aril 2020
  2. Patient Safety Learning
    In March, while the UK delayed, Ireland acted. For many this may prove to have been the difference between life and death.
    The choices our governments have made in the last month have profoundly shaped what risks we, as citizens, are exposed to during the course of this pandemic. Those choices have, to a large extent, determined how many of us will die.
    At the time of writing, 365 people have died in Ireland of COVID-19 and 11,329 have died in the UK. Adjusted for population, there have been 7.4 deaths in Ireland for every 100,000 people. In the UK, there have been 17 deaths per 100,000. In other words, people are dying of coronavirus in the UK at more than twice the rate they are dying in Ireland.
    In her article, Elaine Doyle explores why this might be.
    Read full story
    Source: The Guardian, 14 April 2020
  3. Patient Safety Learning
    None of the new life-saving mechanical ventilators ordered last month to cope with the increase in coronavirus patients has so far been awarded safety approval.
    Models by manufacturers such as Dyson have yet to get the green light from the Medicines and Healthcare products Regulatory Agency, the Financial Times reported.
    It comes a month after the Government issued a rallying cry to put non-medical manufacturers such as Dyson on a "war footing" to make additional machines.
    The lag is thought to be due in part to changing clinical understanding of how best to manage the virus.
    Read full story (paywalled)
    Source: The Times, 14 April 2020
  4. Patient Safety Learning
    Nurses at a hospital run by a major private healthcare provider have been threatened with disciplinary action after apparently refusing to treat coronavirus patients, according to a leaked email seen by HSJ.
    The email was sent on Sunday by a senior matron at Nuffield Health’s Cheltenham Hospital, which has been made available to the NHS during the COVID-19 outbreak.
    She said: “I’m hoping to get another undisturbed day as I’m going to have to formally take on everyone who won’t help on the C19 side."
    “Unfortunately, it will be a disciplinary matter and referral to the [Nursing and Midwifery Council]. I really don’t want to go down that route but they’re giving me little choice.”
    It is not clear why staff had refused to help with COVID-19 work, but one staff member who spoke with HSJ said nurses had objected to working without personal protective equipment.
    A spokesman for Nuffield Health said: “We can categorically state that we have been provided with a full supply of PPE from the local NHS trust so that all members of the team are protected when they treat COVID-19 patients. The team has also been given the appropriate training to ensure they can carry out their roles safely.”
    Read full story
    Source: HSJ, 14 April 2020
  5. Patient Safety Learning
    All care home residents and staff with COVID-19 symptoms will be tested for coronavirus as laboratory capacity increases, the government has promised.
    Health Secretary Matt Hancock said he was "determined" to ensure everyone who needed a test had access to one. 
    Care providers have been calling for more testing for weeks, with charities saying the virus is "running wild" amid outbreaks at more than 2,000 homes. At the moment only the first five residents who show symptoms in a care home are tested, to determine whether there is an outbreak of the virus.
    Providers have also complained that deaths among residents were being "airbrushed" out of official figures and demanded greater support for the industry.
    Read full story
    Source: BBC News, 15 April 2020
  6. Patient Safety Learning
    GPs are advising patients with respiratory diseases to buy oxygen privately amid shortages of the gas across the NHS.
    Last week hospitals were warned to urgently consider limiting how many patients were given oxygen simultaneously.
    Hospitals usually have a pipeline to pump liquid oxygen from a central store to the wards, but most do not have the capacity to meet the demand from the number of patients they are treating with COVID-19.
    Read full story (paywalled)
    Source: The Times, 12 April 2020
  7. Patient Safety Learning
    The number of measles infections around the world could surge in the wake of coronavirus as countries are forced to suspend vaccination programmes.
    The World Health Organization (WHO) has said it fears more than 117 million children could miss out on being vaccinated against measles, which killed 140,000 people in 2018.
    Officials worry that 37 countries where the deadly virus is a major threat could delay immunisation programmes, with 24 countries already suspending their efforts as attention is focused on containing and preventing the spread of COVID-19.
    Read full story
    Source: The Independent, 14 April 2020
  8. Patient Safety Learning
    One in 10 nurses working in acute hospitals are off work due to coronavirus, according to internal NHS figures seen by HSJ.
    Internal NHS figures from the COVID-19 national operational dashboard state that, on Saturday, English acute trusts reported that 41,038 nurses and midwives were absent . 28,063 (68%) were COVID-19 related. The total nursing and midwifery headcount in acute trusts is about 280,000 — meaning roughly 10% are off on covid-related absence.
    There are ongoing complaints from staff about their access to COVID-19 tests — which, it is hoped, will hope reduce the absence rates from suspected cases — while national officials say these are now being made available.
    Read full story
    Source: HSJ, 14 April 2020
  9. Patient Safety Learning
    Cancer doctors say difficult decisions are having to be made to postpone some patients' care during the coronavirus crisis.
    Some treatments such as chemotherapy can weaken the immune system, and potentially put patients at greater risk from COVID-19. Some of those affected have been expressing concern.
    Roisin Pelan is 38 and lives in Lancashire. She has incurable breast cancer and had been taking chemotherapy tablets every day. Every three months she also visits the hospital to receive the drug intravenously. Last month she was told her chemotherapy treatment would be stopped for 12 weeks.
    "It's terrifying they've stopped treatment that I know is keeping me alive," she says.
    "To have that taken away is just unbearable. How do we know it's only going to be 12 weeks? This pandemic could go on a lot longer."
    NHS England has told trusts that all essential and urgent cancer treatments must continue but specialists should discuss with patients whether it is riskier for them to undergo it or delay.
    Read full story
    Source: BBC News, 13 April 2020
  10. Patient Safety Learning
    Once COVID-19 seeps into care homes, it is a monumentally difficult job to protect the residents, writes Sky's Alex Crawford.
    We will look back at this appalling, tragic episode in our global history, and our children and grandchildren will ask us: "Did that really happen? Did you really leave the most vulnerable of our society - the elderly, the infirm, the defenceless, the muddled, sick and weak - in care homes, shut away from their closest relatives? Did you leave them to be ravaged by a deadly virus, and do very little to help them?"
    Because that is what's happening right now. There are elderly people - many with Alzheimer's, many with dementia, many frail - in thousands of residential homes up and down Britain, and they are very much at risk.
    Read full story
    Source: Sky News, 11 Aril 2020
  11. Patient Safety Learning
    Eight in ten coronavirus patients placed on ventilators in New York City have died, according to officials.
    New York state has recorded more cases than any country other than America itself. The tally rose by 10,000 in 24 hours to 159,937, ahead of Spain and Italy, which at different times have reported the most infections in the world. The US, which now holds the position, had 463,433 confirmed cases yesterday and the national death toll was 16,504.
    Read full story
    Source: The Times. 10 April 2020
  12. Patient Safety Learning
    London trusts have been warned not to expect deliveries of gowns from the national supply chain for at least the next few days, HSJ understands.
    Without central deliveries, providers risk running out of gowns ahead of the Easter weekend. Trusts will have to rely on existing supplies and any new stock they procure independently. 
    Staff performing or assisting aerosol-generating procedures on confirmed or suspected covid-19 patients should wear gowns, according to the latest guidance from Public Health England.
    But supplies have been an issue for weeks, with trust procurement leads raising concerns about dwindling gown stocks last month. It recently emerged that gowns were not included in national pandemic stockpiles, unlike other forms of personal protective equipment like masks and gloves.
    Read full story
    Source: HSJ, 9 April 2020
  13. Patient Safety Learning
    Medical leaders have warned sick patients not to avoid getting help from the NHS after a huge drop in the numbers of people attending A&E departments sparked fears some could die without care.
    In March, the number of people going to their local emergency department fell by 600,000, or 29 per cent, compared to same month last year, the lowest number of attendances since 2010.
    While the NHS has battled for years to reduce the number of people going to A&E for unnecessary reasons, the sudden fall during the coronavirus epidemic has worried officials that the pandemic could be deterring people who have genuine need and who could become sicker or even die as a result of staying away.
    Read full story
    Source: HSJ, 9 April 2020
  14. Patient Safety Learning
    Hospitals are turning to the veterinary workforce to fill staffing gaps on intensive care wards ahead of an expected peak of COVID-19 patients, HSJ can reveal.
    Torbay and South Devon Foundation Trust has recruited 150 vets to enrol as “respiratory assistants”, amid preparations for a 10-fold increase of intensive care patients.
    Another trust, Hampshire Hospitals FT, has asked vets and dentists to become “bedside support workers” as part of its response to COVID-19 pressures.
    Read full story
    Source: HSJ, 9 March 2020
  15. Patient Safety Learning
    A major new model of post-acute care is needed for the discharge and rehabilitation of patients following COVID-19 infection, say Alice Murray, Clare Gerada, and Jackie Morris.
    A comprehensive plan must be made for the 50% of COVID-19 patients who will require some form of ongoing care following admission to intensive care, with the goal of improving their long-term outcomes and freeing-up much-needed acute hospital capacity.
    While the current focus is quite rightly on emergent cases, planning should be set in place to create post-acute care resources and facilities for the surge in numbers of people with the physical, psychological and functional consequences of prolonged ITU stays and or hospital admission following COVID-19 infection.
    One potential solution is to provide mass facilities, on a scale to match the Nightingale Hospitals in so-called “Centres of Excellence”, requisitioned for those who survive but need care and cannot return to their own homes, with both residential and day care units available.
    Read full story
    Source: HSJ, 9 April 2020
  16. Patient Safety Learning
    The UK's organ transplant network could be forced to shut down as a result of the coronavirus outbreak, the body that runs the scheme is warning.
    One factor is the pressure on intensive care beds, according to NHS Blood and Transplant (NHSBT). But there is also the risk to transplant patients, who have their immune systems suppressed so their bodies don't reject new organs.
    This is a dilemma for those like Ana-Rose Thorpe, from Manchester, who is waiting for a liver transplant.
    Now aged 29, Ana-Rose has lived with hepatitis almost her entire life after contracting it as a baby. The disease has taken its toll and now her liver is failing and she is in desperate need of a transplant.
    "Having to go into hospital while there are coronavirus patients there is very worrying," she says.
    "Whilst my body could withstand the transplant, the longer I'm not being monitored, not being seen as often as I was, the longer I leave it, I could just get sicker and sicker.
    "I feel like it's patients that are already on the transplant list, patients waiting for other operations, we have just been swept aside."
    "It's my life - it is a matter of life and death," Ana-Rose says.
    Read full story
    Source: BBC News, 9 April 2020
  17. Patient Safety Learning
    Some Welsh NHS staff with Covid-19 have been given wrong test results and were told they did not have coronavirus, BBC Wales has learned.
    They are among a group of ten who have been given incorrect results - including eight from Aneurin Bevan Health Board and two from elsewhere.
    It is not clear how many of the ten had Covid-19 and were told they did not, or vice versa.
    The Gwent-based heath board said the staff were contacted "immediately".
    It happened when a small number of test samples from a batch of 96 were attributed to the wrong patients.
    Read full story
    Source: BBC Wales, 7 April 2020
  18. Patient Safety Learning
    The designs of a new breathing aid developed by engineers at the Mercedes F1 team, University College London (UCL), and clinicians at UCL Hospital have been made freely available to support the global response to COVID-19. It's the latest development in Formula 1’s Project Pitlane effort to help fight coronavirus.
    The Continuous Positive Airway Pressure (CPAP) devices, which help coronavirus patients with lung infections to breathe more easily, were developed by engineers at the Mercedes team and University College London (UCL), and clinicians at UCL Hospital after a round-the-clock effort to reverse engineer a device that could be manufactured rapidly by the thousands.
    After patient evaluations at UCLH and across sister hospitals in the London area, the device received regulatory approval last week. An order for up to 10,000 has now been placed by the British National Health Service, and the Mercedes AMG High Performance Powertrains technology centre in Brixworth – the facility where the F1 team’s highly successful power units are developed and built – is now building 1,000 devices per day.
    Read full story
    Source: F1, 7 April 2020
  19. Patient Safety Learning
    “Recurrent safety risks” around clinical care at an embattled NHS trust’s maternity service have been identified in a report published on Tuesday.
    The Healthcare Safety Investigation Branch (HSIB) has been investigating East Kent hospitals university NHS foundation trust since July 2018 after a series of baby deaths.
    Among those treated at the trust was Harry Richford, whose death was “wholly avoidable”, seven days after his emergency delivery in November 2017, an inquest found.
    Speaking on Tuesday, Harry’s grandfather Derek Richford said it is clear that sufficient lessons were not learned from his death.
    The independent report, published on Tuesday by the Department of Health and Social Care, discusses 24 maternity investigations undertaken since July 2018, including the deaths of three babies and two mothers.
    It said: “These investigations have enabled HSIB to identify recurrent safety risks around several key themes of clinical care in the trust’s maternity services.”
    Read full story
    Source: The Guardian, 8 April 2020
  20. Patient Safety Learning
    Sending coronavirus patients to hospital can dramatically increase death rates, the experience of two hard-hit Italian regions suggests.
    Veneto and Lombardy are neighbouring regions but have seen sharply differing fatality rates since the contagion broke out in northern Italy in late February. Despite having equally well-equipped hospitals and similar levels of wealth, Lombardy’s death rate is around 17% while that of Veneto is around 5%.
    One reason for the disparity is that Veneto has tested many more people – the more tests that are carried out, the more positive cases are found, and that brings down the overall death rate among those infected.
    But another key factor, experts believe, is that Lombardy admitted more patients to hospital, whereas Veneto urged them to stay at home or treated them in local health clinics.
    Read full story (paywalled)
    Source: The Telegraph, 6 April 2020
  21. Patient Safety Learning
    Nick has terminal bowel cancer. He’s been told he won't receive chemotherapy for three months because it would put him more at risk of the coronavirus.
    He fears having the treatment taken away would shorten his life.
    Current NHS guidelines say cancer specialists should discuss with their patients whether it is riskier for them to undergo or to delay treatment at this time.
    Read full story
    Source: BBC News, 6 April 2020
  22. Patient Safety Learning
    Health apps have grown enormously in popularity, even more so during the COVID-19 Pandemic. Since early March, more than 500 health apps contain coronavirus-related keywords in their description.
    People are taking advice from these apps, often using them to share sensitive information. Yet, in a time of fake reviews, scams and personal data breaches, not all health apps can be trusted. 
    The Organisation for the Review of Care and Health Apps (ORCHA) has launched a health app formulary to help healthcare professionals and consumers know which health apps they can trust. 
    As a free to use resource, the site includes reviews of health apps across a range of health conditions relevant to the COVID-19 pandemic, including reviews of COVID-19 apps launched to date.
    Read full story
    Source: ORCHA, 6 April 2020
  23. Patient Safety Learning
    The NHS is launching a hotline to support and advise healthcare staff during the coronavirus pandemic.
    Volunteers from charities including Hospice UK, the Samaritans and Shout, will listen to concerns and offer psychological support.
    The phone line will be open between 07:00 and 23:00 every day, while the text service will be available around the clock.
    The phone number is 0300 131 7000 or staff can text FRONTLINE to 85258.
    It comes as staff face increasing pressure to care for rising numbers of patients who are seriously ill with the virus.
    Read full story
    Source: BBC News, 8 April 2020
  24. Patient Safety Learning
    Ambulance staff are being put at risk by a lack of protective equipment to guard them against coronavirus, according to a trade union.
    GMB says its members are "scared" about their own safety and their families. The union claims one in five ambulance staff in London are off sick with coronavirus-related sickness.
    The government says hundreds of millions of protective items have been delivered to NHS staff around the country.
    According to the GMB Union, 679 frontline ambulance crew in the London Ambulance Service are off sick due to Covid-19-related sickness.
    Among those at work, some say they feel unprotected either because of a lack of or inadequate personal protective equipment (PPE).
    Read full story
    Source: BBC News, 8 April 2020
  25. Patient Safety Learning
    The Government will look for a refund for millions of coronavirus tests ordered from China after scientists found they were too unreliable to be used by the public.
    Ministers will attempt to recoup taxpayers' money spent on the fingerprick tests after an Oxford University trial found they returned inaccurate results.
    The failure is a significant setback because it had been hoped the antibody tests would show who had already built up immunity, therefore offering a swifter route out of lockdown.
    Read full story
    Source: The Telegraph, 6 April 2020
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