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Patient Safety Learning

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  1. Patient Safety Learning
    Mike Ramsay has been appointed new Chairman of the Patient Safety Movement Foundation, taking over from Joe Kiani.
    The Patient Safety Movement's goal is to get to ZERO preventable deaths. In their latest newsletter, Mike discusses how he intends to build on the tremendous momentum gained so far. 
    "We are not competing with any organization but strongly support entities with the patient safety goal and hope that we can all pull together and use all our resources to reach zero preventable deaths and zero harm. Zero is our target and we can get there!"
    Read Mike's Letter in the March Patient Safety Movement Foundation newsletter
  2. Patient Safety Learning
    Doctors who look after patients in a vegetative or minimally conscious state must ensure they initiate regular conversations with relatives about what is in the best interests of the person so that they do not get “lost in the system,” says new guidance.
    The Royal College of Physicians has published new and revised guidelines on prolonged disorders of consciousness (PDOC) to take into account changes in the law and developments in assessment and management.
    Read full story (paywalled)
    Source: BMJ, 6 March 2020
  3. Patient Safety Learning
    Regional NHS leaders in England have been ordered to immediately organise a primary care management service to care for covid-19 patients who “do not require immediate admission” to hospital.
    In a letter sent on 8 March, seen by The BMJ, NHS England and NHS Improvement’s strategic incident director for coronavirus, Keith Willett, has ordered regional primary care and public health directors to set up a 24 hour, seven day a week service to manage patients in the community. This service should be delivered by an out-of-hours provider, and every part of England must be covered by Tuesday 10 March, the letter said.
    The service will be used to manage patients who are deemed well enough to be isolated at home, with active monitoring for people who are at high risk of developing severe illness, and advice to those not deemed high risk on what to do if their illness deteriorates.
    The letter advises that patients “remain in isolation until 5 days after resolution of symptoms, unless [they are a] healthcare worker or work with high risk groups, in which case require one negative sample 5 days after resolution of symptoms before return to work.”
    People with mild illness and not in a high risk group will be told to isolate themselves at home and will be given health advice on how to identify deterioration. All patients managed at home will be given a phone number to call if they feel more unwell.
    The letter said that the community service should be provided by a nurse and GP team and that all clinical information should be recorded and transferred to the patient’s general practice.
    Providers must also provide regular situation reports, including confirmed numbers of patients cared for under the service, numbers of patients who deteriorate, and numbers of patients admitted to and discharged from the service.
    Read full story
    Source: BMJ, 9 March 2020
  4. Patient Safety Learning
    Sir Norman Lamb, chair of South London and Maudsley Foundation Trust and a former Liberal Democrat MP, has suggested the government would lose a legal challenge over its national programme for patients with learning disabilities and said the national Transforming Care programme was at the “very least a partial failure”.
    “I regard this as a human rights issue. We’re locking people up when we don’t need to lock them up. We’re subjecting them to force, when we shouldn’t do so, and this is how I think we need to frame it. If the government were challenged in court on this, I think there’s a very good chance, as an ex-lawyer, that they would lose.”
    Transforming Care was launched in 2011 following the Winterborne View scandal and aimed to discharge patients with learning disabilities and autism out of institutional inpatient units into the community. However, the most recent figures, from NHS Digital, show there were still more than 2,000 patients within inpatient units, ahead of the national programme’s expiration this month.
    Kevin Cleary, deputy chief inspector for hospitals and lead for learning disability and mental health services for the CQC, said: “We have allowed our patients to be placed within places like Whorlton Hall.  I think the NHS provides very few services of this type, it has withdrawn from providing these services, and has become comfortable with providing that service, within the independent sector, several hundred miles away and that’s not right… absolutely not right."
    “We cannot say we are providing patient centred care or say we are placing the patient at the heart of everything we do and have that response from the system. We are all responsible for that.”
    Read full story (paywalled)
    Source: HSJ, 10 March 2020
  5. Patient Safety Learning
    Visitors to a hospital are stealing hand sanitising gel daily – as demand for the product surges amid fears over coronavirus.
    Bottles have been taken from patients' beds and dispensers ripped off walls at Northampton General Hospital. Bosses said the gel was "disappearing every day" and they have had to limit the supply on wards.
    "Nothing like this has ever happened in all the years we've had the gel," said a hospital spokeswoman.
    "Over the past week we've seen stocks on wards disappear from the end of beds every single day," Sally-Anne Watts, associate communications director, told the BBC.
    "Three wall-mounted dispensers have been ripped off and we've even seen people coming in and topping up their own dispensers with our product," she said.
    Since the hospital's supplies have been going missing, Mrs Watts said, bottles were no longer being put at the end of all beds.
    "We don't have an unlimited supply and would ask that visitors to the site respect the fact that we are doing all we can to keep our patients, visitors and staff safe, and we need their support," she added.
    Read full story
    Source: BBC News, 6 March 2020
  6. Patient Safety Learning
    This week is Patient Safety Awareness Week, an annual recognition event intended to encourage everyone to learn more about healthcare safety. During this week, the Institute for Healthcare Improvement (IHI) seeks to advance important discussions locally and globally, and inspire action to improve the safety of the health care system — for patients and the workforce.
    Patient Safety Awareness Week serves as a dedicated time and platform for growing awareness about patient safety and recognising the work already being done.
    Although there has been real progress made in patient safety over the past two decades, current estimates cite medical harm as a leading cause of death worldwide.
    The World Health Organization estimates that 134 million adverse events occur each year due to unsafe care in hospitals in low- and middle-income countries, resulting in some 2.6 million deaths. Additionally, some 40 percent of patients experience harm in ambulatory and primary care settings with an estimated 80 percent of these harms being preventable, according to WHO.
    Some studies suggest that as many as 400,000 deaths occur in the United States each year as a result of errors or preventable harm. Not every case of harm results in death, yet they can cause long-term impact on the patient's physical health, emotional health, financial well-being, or family relationships.
    Preventing harm in healthcare settings is a public health concern. Everyone interacts with the health care system at some point in life. And everyone has a role to play in advancing safe healthcare.
    Learn more about IHI's work to advance patient safety.
  7. Patient Safety Learning
    The Royal College of Nursing (RCN) has issued a warning about insufficient staffing in the NHS in the wake of a mental health trust being downgraded.
    Earlier this week, Tees, Esk and Wear Valleys (TEVW) NHS Foundation Trust being rated as "requiring improvement" by the Care Quality Commission. It had previously been rated as "good" but inspectors said some services had deteriorated. Among the concerns raised were ones over staffing, workload and delays. 
    Glenn Turp, Northern Regional Director of the RCN: "The CQC has rightly highlighted some very serious concerns and failings which call into question whether this trust can provide safe patient care. After the very tragic and sad deaths of two vulnerable patients last year and the findings of the CQC, the trust and NHS commissioners must take immediate action to ensure patient and staff safety."
    "They have a responsibility not to commission and open new beds with insufficient nursing staff to provide safe patient care. Having the right number of nursing staff with the right skills in the right place at the right time is critical to protecting patients. It also protects those staff who too often find themselves struggling to maintain services in the face of nursing vacancies."
    Read full story
    Source: The Northern Echo, 7 March 2020
  8. Patient Safety Learning
    Executives in charge of the health secretary’s crisis-hit local hospital are facing calls to step down after The Sunday Times raised serious questions about attempts to cover up catastrophic medical mistakes.
    West Suffolk Hospital in Bury St Edmunds had placed Dr Patricia Mills, one of its most senior consultants, under disciplinary investigation after she had voiced concerns about blunders that had killed one patient and left another seriously brain-damaged. A number of doctors have claimed that a bullying management culture has led to staff being too afraid to speak up about patient safety concerns at the hospital.
    Executives were accused of being obsessed with maintaining the hospital’s “outstanding” status in annual Care Quality Commission. One of the governors said their were "frustrations and concerns" among his fellow council members that they were being kept in the dark by the hospital's executives.
    Read full story (paywalled)
    Source: The Sunday Times, 8 March 2020
  9. Patient Safety Learning
    More than 20 leading NHS doctors and experts back Baby Lifeline demand for safety training for maternity staff to cut £7m a day negligence costs
    The Independent’s maternity safety campaign goes to Downing Street today as senior figures from across the health service deliver a letter demanding action from prime minister Boris Johnson.
    Charity Baby Lifeline will be joined by bereaved families, Royal Colleges and senior midwives and doctors in Downing Street to hand in a letter calling on the government to reinstate a national fund for maternity safety training.
    Baby Lifeline, which has also launched an online petition today, said the government needed to find £19m to support training of both midwives and doctors to prevent deaths and brain damage, which can cost the NHS millions of pounds for a single case.
    The letter to Mr Johnson has also been signed by Dr Bill Kirkup, who led the investigation into baby deaths at the Morecambe Bay NHS trust and is investigating poor care at the East Kent Hospitals University Trust.
    He said: “There have been real improvements in maternity services, but as recent events in Kent and Shropshire have shown only too clearly, much more remains to be done. The Maternity Safety Training Fund is badly needed.”
    Sir Robert Francis QC, Chairman of the public inquiry into poor care at Stafford Hospital, who also signed, said: “The cost in lost and broken lives, not to mention the unsustainable financial burden and the distress of staff caused by these avoidable mistakes, is indefensible.”
    Other signatories included former health secretary Jeremy Hunt, the Royal College of Midwives, the Royal College of Obstetricians and Gynaecologists and a number of senior maternity figures, charities and clinical associations.
    Read full story
    Source: The Independent, 6 March 2020
  10. Patient Safety Learning
    Just 1 in 4 UK GPs are satisfied with time they are able to spend with patients – appointment times are among the shortest of 11 countries surveyed.
    A report published today by the Health Foundation paints a picture of high stress and low satisfaction with workload among UK GPs. The report is an analysis of an international survey of GPs from 11 high-income countries, including 1,001 UK GPs, undertaken by the Commonwealth Fund in 2019.
    Among 11 high-income countries included in the study, only France has lower levels of overall satisfaction with practising medicine, and only Sweden reported higher levels of stress. Over half of UK GPs (60%) say they find their job 'extremely' or 'very' stressful, and almost half (49%) plan to reduce their weekly hours in the next three years.
    UK GPs also reported significantly shorter appointment lengths than their international colleagues. The average length of a GP appointment in the UK is 11 minutes, compared with a 19 minute average appointment for GP and primary care physicians in the other countries surveyed. 
    Dr Rebecca Fisher, one of the Health Foundation report's authors and a practising GP, says: "These findings illustrate the pressures faced by general practice, and the strain that GPs are under. Right now the health system is in unprecedented territory and mobilising to meet the challenge of Covid-19. This survey shows that over the long term we need concerted action to stabilise general practice. Despite performing strongly in some aspects of care, many GPs consider that appointments are simply too short to fully meet the needs of patients. Too many GPs are highly stressed and overburdened – to the point of wanting to leave the profession altogether."
    Read full story
    Source: The Health Foundation, 5 March 2020
  11. Patient Safety Learning
    An NHS trust at the centre of an inquiry into preventable baby deaths will repay money it received for providing good maternity care.
    In 2018, Shrewsbury and Telford NHS Trust received almost £1m, weeks before its services were rated inadequate. The BBC revealed in December the trust had qualified for the payment under the NHS's Maternity Incentive Scheme.
    The trust said an "incorrect submission" had been made and it had ordered an independent review.
    Shrewsbury and Telford NHS Trust (SaTH) is at the centre of England's largest inquiry into poor maternity care, with more than 900 families contacting a review looking into concerns over preventable deaths and long-term harm.
    Former health secretary Jeremy Hunt wrote to ministers questioning if improvements to the Maternity Incentive Scheme were needed in light of payments made to both Shrewsbury and Telford and East Kent Hospitals, despite both facing serious questions over the safety of maternity services.
    The trust in Shropshire was paid £963,391 after certifying it had met the 10 safety standards demanded by the scheme, which is run by NHS Resolution.
    In the letter, seen by the BBC, Mr Hunt suggested one improvement would be to link payments to CQC maternity and safety ratings.
    "The whole approach is likely to be discredited if trusts can meet all 10 actions and yet still be delivering poor standards of care," the letter said.
    Read full story
    Source: BBC News, 6 March 2020
  12. Patient Safety Learning
    Women are at risk of serious harm and death because hospitals are not always diagnosing ectopic pregnancies quickly enough, an investigation reveals.
    About 12,000 women a year in the UK suffer an ectopic pregnancy – when a fertilised egg grows outside the womb – putting them at risk if a fallopian tube containing the foetus ruptures and causes potentially fatal heavy bleeding.
    An investigation by the Healthcare Safety Investigation Branch (HSIB)  has found flaws in the treatment women receive. It has highlighted late diagnosis and consequent delay in treatment as a major concern, especially as a result of the condition being mistaken for a urinary tract infection.
    NHS patient safety data shows that 30 ectopic pregnancies were missed and led to “serious harm” between April 2017 and August 2018.
    As well as the risk to life, an ectopic pregnancy can also damage a woman’s chances of conceiving again and have serious psychological effects.
    Read full story
    Source: The Guardian, 5 March 2020
  13. Patient Safety Learning
    The health service lacks the beds, staffing and resources to cope with a serious outbreak of the coronavirus, The Independent has been told by senior doctors and nurses.
    NHS staff from across the country warned hospitals are already unable to cope, with patients being looked after in spill-over wards and waiting hours for a bed, with one doctor saying it was already a “one in, one out mentality” for intensive care.
    Other staff reported delays in lab tests, rationing of protective masks and equipment, and a lack of isolation areas for suspected coronavirus patients.
    Suggestions from the Health Secretary Matt Hancock that the NHS would use “home ventilation kits”, and that an extra 5,000 intensive care beds could be created, were labelled “fanciful” by the chair of the British Association of Critical Care Nurses today.
    Nicki Credland said: “If you already have a system running at 100 per cent capacity, the idea you can get a significant amount of additional beds is just not realistic. There simply aren’t enough beds for them. We will need to make difficult decisions about which patients are going to be admitted to intensive care."
    Read full story
    Source: The Independent, 5 March 2020
     
     
  14. Patient Safety Learning
    Hundreds of women have said they’ve undergone “distressing” diagnostic tests at NHS hospitals which were not carried out in line with recommended practice.
    Around 520 women who attended NHS hospitals in England to undergo hysteroscopies — a procedure which uses narrow telescopes to examine the womb to diagnose the cause of heavy or abnormal bleeding — have told a survey their doctors carried on with their procedures even when they were in severe pain.
    This is despite the Royal College of Obstetricians and Gynaecologists advising clinicians should offer to reschedule with the use of general anaesthetic, epidural or sedation if the pain becomes unbearable. 
    The Campaign Against Painful Hysteroscopy patient group has surveyed 860 women who had had the procedure at an English NHS hospital, and shared the results with HSJ. Of them, 750 said they were left distressed, tearful or shaken by the procedure, with around 466 of them saying that feeling remained for longer than a day.
    Many of the women said their painful hysteroscopies damaged their trust in healthcare professionals, had made cervical smears more painful and had a negative impact on sexual relationships.
    Patient Safety Learning have connected with the campaigning group 'Hysteroscopy Action' on this issue. We have seen stories and comments posted on the hub from patients who have suffered similar distressing experiences. We are using this feedback and evidence to help campaign for safer, harm-free care. We welcome others to join in the conversation.
    Read full story (paywalled)
    Source: HSJ, 2 March 2020
  15. Patient Safety Learning
    There is significant variation in ambulance response times to patients with serious conditions such as suspected strokes or heart attacks, which is not fully explained by how rural an area is, an HSJ analysis has revealed.
    The exclusive analysis represents the first time ambulance performance for category two calls, which have an 18-minute response time target, have been broken down to clinical commissioning group level. Category two, known as emergency calls, covers a wide range of conditions, including suspected stroke and heart attacks (except cardiac arrests), major burns and epileptic seizures. They account for well over half of ambulance responses.
    The findings — described as “alarming” by the Stroke Association — lay bare the incredibly long waits which are usually hidden, because average waiting time data is usually published for ambulance trusts, which cover far larger areas than CCGs.
    Mark MacDonald, Deputy Director of Policy at the Stroke Association, said: “It is alarming to hear that in some cases ambulance staff are taking over an hour to reach patients because when it comes to stroke, being assessed quickly and then, if necessary, transferred to hospital, is really important.”
    Read full story (paywalled)
    Source: HSJ, 5 March 2020
  16. Patient Safety Learning
    The parents of a baby who nearly died after a series of failings during his birth said they were "heartbroken" mistakes continued to be made
    East Kent Hospitals told Harry Halligan's parents they would learn lessons from his delivery in 2012. But similar failings recently came to light after the death of Harry Richford in 2017 and the trust is now being probed over up to 15 baby deaths.
    The trust said it made "many changes to the maternity service" after 2012.
    Parents Dan and Alison Halligan, from New Romney, said watching news coverage of an inquest into Harry Richford's death earlier this year, which laid bare the failings, had brought back stressful memories.
    Mr Halligan said the trust "clearly haven't learned from [the] mistakes" made in his son's care, adding that it was "heartbreaking" to see "the same mistakes being repeated".
    Read full story
    Source: BBC News, 5 March 2020
  17. Patient Safety Learning
    The failure to address the mental-health needs of people with HIV could lead to an increase in infections, a cross-party group of MPs suggests.
    People with HIV are twice as likely to experience mental-health difficulties. However, in those with depression, support raises adherence to medication by 83%. But most HIV clinics have no mental-health professionals on staff, which, the MPs say, could be reversing progress made over the past decade toward ending the epidemic in the UK.
    The All-Party Parliamentary Group (APPG) on HIV and AIDS met with patients living with HIV at a range of hospital trusts throughout England, as well as numerous healthcare professionals.
    Unless serious mental-health treatment shortfalls are addressed, the government will fail to achieve its target of zero transmissions by 2030, its report says.
    Read full story
    Source: BBC News, 5 March 2020
  18. Patient Safety Learning
    The Association for Perioperative Practice (AfPP) is calling for action to be taken after a recent report suggests little progress has been made to prevent errors within the perioperative environment.
    The patient safety charity made the call following the release of NHS Improvement’s latest Never Event report; Provisional publication of Never Events reported as occurring between 1 April and 31 December 2019, which revealed an alarming 81% (284) of the never events recorded happened while a patient was on the operating table.
    Lindsay Keeley, patient safety and quality lead at AfPP said: “The survey highlighted that there’s a need to take action now if we are to support the healthcare profession in reducing the occurrence of never events. It has become clear that receptive team culture, a strong leadership team and better support for staff is what will help to reduce the risk of a never event occurring. It’s vital that those in leadership positions begin to understand the contributory factors in the recurrence of never events and the challenges faced by staff."
    She went on to highlight some of the recent initiative taking place: “What is promising is that there are practitioners who are developing new, practical and simple solutions every day that can support other team members and can be used within theatres across the country."
    "One example is Rob Tomlinson’s introduction of the 10,000 Feet initiative – a safety initiative designed to cut through noise and distraction within the theatre environment, particularly at critical points of the patient’s journey. If correctly implemented, initiatives like this can cut through the hierarchies that stop people feeling unable to speak up when they see something that shouldn’t be happening, thus reducing the occurrence of never events"
    “We of course need to be mindful that there will always be challenges within perioperative practice in the form of interruptions and distractions, but the key is how as practitioners we engage with this to recognise and reduce never events.”
    Read full story
    Source: Clinical Services Journal, 25 February 2020
  19. Patient Safety Learning
    Technology and healthcare companies are racing to roll out new tools to test for and eventually treat the coronavirus epidemic spreading around the world. But one sector that is holding back are the makers of artificial-intelligence-enabled diagnostic tools, increasingly championed by companies, healthcare systems and governments as a substitute for routine doctor-office visits.
    In theory, such tools, sometimes called “symptom checkers” or healthcare bots,sound like an obvious short-term fix: they could be used to help assess whether someone has Covid-19, the illness caused by the novel coronavirus, while keeping infected people away from crowded doctor’s offices or emergency rooms where they might spread it.
    These tools vary in sophistication. Some use a relatively simple process, like a decision tree, to provide online advice for basic health issues. Other services say they use more advanced technology, like algorithms based on machine learning, that can diagnose problems more precisely.
    But some digital-health companies that make such tools say they are wary of updating their algorithms to incorporate questions about the new coronavirus strain. Their hesitancy highlights both how little is known about the spread of Covid-19 and the broader limitations of healthcare technologies marketed as AI in the face of novel, fast-spreading illnesses.
    Some companies say they don’t have enough data about the new coronavirus to plug into their existing products. London-based symptom-checking app Your.MD Ltd. recently added a “coronavirus checker” button that leads to a series of questions about symptoms. But it is based on a simple decision tree. The company said it won’t update the more sophisticated technology underpinning its main system, which is based on machine learning.
    “We made a decision not to do it through the AI because we haven’t got the underlying science,” said Maureen Baker, Chief Medical Officer for Your.MD. She said it could take 6 to 12 months before sufficient peer-reviewed scientific literature becomes available to help inform the redesign of algorithms used in today’s more advanced symptom checkers.
    Read full story
    Source: The Wall Street Journal, 29 February 2020
  20. Patient Safety Learning
    Northern Ireland's infant mortality rate remains the highest of any UK region although it has decreased, according to a new report.
    Infant mortality is a measure of deaths of children under one year of age. The report from the Royal College of Paediatrics and Child Health (RCPCH) shows the current rate is 4.2 deaths per 1,000 live births. In 2017, the figure stood at 4.8 deaths.
    Infant mortality rates decreased in Northern Ireland, Scotland and Wales but remained unchanged in England, which has the second highest rate of 3.9 deaths per 1,000.
    The report also highlights an increase in the suicide rate among young people aged 15–24 years.
    Responding to the figures, Health Minister Robin Swann said the physical and mental health of children and young people was a "priority" for the for the Northern Ireland Executive.
    "My department is already investing in a number of programmes and strategies which seek to address child health inequalities and improve the wellbeing of our children."
    Dr Ray Nethercott, RCPCH officer for Ireland acknowledged the current healthcare crisis as well as concerns about waiting lists and standard of care but added that "children's health and wellbeing should not be seen as being in competition with adult services or health provision".
    "Acting early to treat and prevent conditions, and reducing the impact of factors such as poverty, can really improve health outcomes. A healthier population of children and young people will reduce many of the pressures on adult services in the long term."
    Read full story
    Source: BBC News, 4 March 2020
  21. Patient Safety Learning
    Neglect and serious failures by the Home Office and multiple other agencies contributed to the death of a vulnerable man who died from hypothermia, dehydration and malnutrition in an immigration removal centre, an inquest has found.
    Prince Fosu, a 31-year-old Ghanaian national, died in October 2012 when his naked body was found on the concrete floor of his cell in Harmondsworth, a detention centre near Heathrow. He had been experiencing a psychotic episode but he was not referred for a mental health assessment due to “gross failures” by all agencies to recognise the need to provide appropriate care to a person unable to look after himself.
    Four GPs, two nurses, two Home Office contract monitors, three members of the Independent Monitoring Board (IMB) and countless detention custody officers and managers who visited him failed to take any meaningful steps, the inquest found.
    Three doctors have since been referred to the UK’s medical watchdog for their alleged failures relating to the death of Mr Fosu on recommendation of the Prison and Probation Ombudsman (PPO), who said the care he received fell “considerably below acceptable standards”.
    Read full story
    Source: The Independent, 3 March 2020
  22. Patient Safety Learning
    Women in labour are being refused epidurals in breach of official guidelines, a government inquiry has found.
    In findings reported by the Guardian, an investigation by the Department of Health and Social Care also found that women may not be being kept fully informed that if they choose to give birth at home or in a midwife-led unit they may have to be transferred if they want an epidural. Failing to make women aware of that possibility would also be in breach of National Institute for Health and Care Excellence (NICE) guidelines.
    As a result of the inquiry, the Health Minister Nadine Dorries will write to all heads and directors of midwifery and medical directors at NHS trusts this week to remind them of the NICE guidance regarding pain relief during childbirth and to ensure it is being followed.
    Clare Murphy, Director of external affairs at the British Pregnancy Advisory Service, said the “results of the government’s inquiry are sadly not surprising”. She added: “We have spoken with many women who have been so traumatised by their experience of childbirth that they are considering ending what would otherwise be wanted pregnancies. Pain relief is sometimes treated as a ‘nice extra’ rather than an integral part of maternity care, and women and their families can suffer profoundly as a result."
    Read full story
    Source: Guardian, 3 March 2020
  23. Patient Safety Learning
    Every week for nearly a year, Lorraine Shilcock attended an hour-long counselling session paid for by the NHS.
    She needed the therapy, which ended in November, to cope with the terrifying nightmares that would wake her five or six times a night, and the haunting daytime flashbacks. Lorraine, 67, a retired textile worker from Desford, Leicester, has post-traumatic stress disorder (PTSD). Her psychological scars due to a routine NHS medical check, which was supposed to help her, not leave her suffering.
    In October 2018, Lorraine had a hysteroscopy, a common procedure to inspect the womb in women who have heavy or abnormal bleeding. The 30-minute procedure, performed in an outpatient clinic, is considered so routine that many women are told it will be no worse than a smear test and that, if they are worried about the pain, they can take a couple of paracetamol or ibuprofen immediately beforehand.
    Yet for Lorraine, and potentially thousands more women in the UK, that could not be further from the truth.
    Many who have had a hysteroscopy say the pain was the worst they have ever experienced, ahead of childbirth, broken bones, or even a ruptured appendix, commonly regarded as the most agonising medical emergency.
    Yet most had no warning it would be so traumatic, leaving some, like Lorraine, with long-term consequences. But, crucially, it is entirely avoidable.
    Do you have an experience you would like to share? Join our conversation on the hub on painful hysteroscopy. We are using this feedback and evidence to help campaign for safer, harm-free care.
    Read full story
    Source: Mail Online, 3 March 2020
  24. Patient Safety Learning
    A new poll has found only 8 out of the 1,618 respondents believed the health service was ready to deal with an outbreak when asked by The Doctors’ Association UK (DAUK), despite the prime minister’s insistence that the NHS will cope if it is hit by a surge in the number of people falling ill.
    Common concerns included difficulties coping with increased demand, a shortage of beds and poor staffing levels, according to the group who led the poll. 
    Some doctors asked said they were worried that there could be not enough laboratory space to do testing in the case of a pandemic. Others claimed that NHS 111 had been giving out “inappropriate advice” to go to A&E and GP practices, according to DAUK. 
    “The NHS has already been brought to its knees and many frontline doctors fear that our health system simply will not cope in the event of a Coronavirus (Covid-19) outbreak,” Dr Rinesh Parmar, the DAUK chair, said. 
    “Many hoped the threat of Covid-19 would prompt an honest conversation to address the issue of critical care capacity and our ability to look after our sickest patients. By simply saying ‘the NHS is well prepared to deal with coronovirus’ it seems that yet again doctors’ concerns have been brushed under the carpet.”
    The findings come after the number of people infected with the coronavirus which rose to 39 in the UK on Monday. 
    Read full story
    Source: The Independent, 3 March 2020
  25. Patient Safety Learning
    A senior NHS nurse was fired after warning the increased workload on her pressured staff had contributed to a patient’s death.
    Linda Fairhall, 60, had an unblemished record of almost 40 years’ service when she turned whistleblower at North Tees and Hartlepool NHS trust. In 2015 she raised concerns over a new requirement for district nurses to monitor patients’ prescriptions. She said it meant a sudden increase of around 1,000 extra visits a month for her hard-pressed team of 50 nurses with no extra resources.
    Over the next 10 months she reported 13 matters, alleging the health or safety of patients and staff was being or was likely to be put at risk.
    After a patient died in 2016 she claimed it may have been prevented if her concerns had been addressed. She told the trust’s care group director Julie Parks she wished to start the formal whistle-blowing procedure. Soon after she was suspended over allegations of potential gross misconduct relating to her leadership, and then sacked.
    Dr Henrietta Hughes, the UK’s national NHS guardian, said: “Workers who speak up should be thanked for doing so and the organisation should demonstrate they are taking action to address the issues raised.”
    North Tees and Hartlepool NHS Trust said it will appeal the decision.
    Read full story
    Source: The Mirror, 2 March 2020
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