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Patient Safety Learning

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  1. Patient Safety Learning
    The Care Quality Commission (CQC) missed multiple opportunities to identify abuse of patients at a privately run hospital and did not act on the concerns of its own members, an independent review has found.
    Bosses at the CQC have been criticised in an independent report by David Noble into why the regulator buried a critical report into Whorlton Hall hospital, in County Durham, in 2015.
    His report published today said the CQC was wrong not to make public concerns from one of its inspection teams in 2015.
    “The decision not to publish was wrong,” his report said, adding: “This was a missed opportunity to record a poorly performing independent mental health institution which CQC as the regulator, with the information available to it, should have identified at that time.”
    Read full story
    Source: The Independent, 22 January 2020
  2. Patient Safety Learning
    The NHS in England faces paying out £4.3 billion in legal fees to settle outstanding claims of clinical negligence, the BBC has learned through a Freedom of Information request. Each year the NHS receives more than 10,000 new claims for compensation. 
    The Department of Health has pledged to tackle "the unsustainable rise in the cost of clinical negligence".
    Estimates published last year put the total cost of outstanding compensation claims at £83 billion. NHS England's total budget in 2018-19 was £129 billion.
    The Association of Personal Injuries Lawyers (APIL) believes the cost is driven by failures in patient safety.
    Doctors represented by the Medical Defence Union (MDU), which supports doctors at risk of litigation, are calling for "a fundamental" reform of the current system.
    Suzanne White, from APIL, said people came to her on a daily basis with no intention of suing the NHS. But she said they often found it difficult to get answers from the medical authorities - and were left with no other option but to sue.
    "What they want to do is find out what went wrong, why they have received these injuries ... and to make sure it doesn't happen to other patients."
    Read full story
    Source: BBC News, 21 January 2020
  3. Patient Safety Learning
    At least seven preventable baby deaths may have occurred at one of the largest groups of hospitals in England since 2016, a BBC investigation has found.
    Significant concerns have been raised about maternity services at the trust.
    East Kent NHS Foundation Trust has apologised, saying it has "not always provided the right standard of care".
    The trust has struggled to improve maternity care for years, despite repeatedly being made aware of the problems.
    In 2015, the medical director asked experts from the Royal College of Obstetricians and Gynaecologists to review maternity care, amid "concerns over the working culture". Their review, seen by the BBC, found poor team working in the unit, a number of consultants operating as they saw fit, a lack of performance management of the consultant body and out of date clinical guidelines.
    It highlights consultants who:
    failed to carry out labour ward rounds, review women, make plans of care or attend out of hours when requested rarely attended CTG training were reported "as doing their own thing rather than follow guidelines". Read full story
    Source: BBC News, 23 January 2020
  4. Patient Safety Learning
    Up to half of all patients who suffer an acute aortic dissection may die before reaching crucial specialist care, according to a new Healthcare Safety Investigation Branch (HSIB) report.
    The report highlights the difficulty which can face hospital staff in recognising acute aortic dissection. The investigation was triggered by the case of Richard, a fit and healthy 54-year old man, who arrived at his local emergency department by ambulance after experiencing chest pain and nausea during exercise. It took four hours before the diagnosis of an acute aortic dissection was made, and he spent a further hour waiting for the results of a CT scan. Although Richard was then transferred urgently by ambulance to the nearest specialist care centre, he sadly died during the journey.
    The report has identified a number of risks in the diagnostic process which might result in the condition being missed. These include aortic dissection not being suspected because patients can initially appear quite well or because symptoms might be attributed to a heart or lung condition.
    It also highlighted that, once the diagnosis is suspected, an urgent CT scan is required to confirm that an acute aortic dissection is present. 
    Gareth Owens, Chair of the national patient association Aortic Dissection Awareness UK & Ireland, welcomed the publication of HSIB’s report, saying: “HSIB’s investigation and report have highlighted that timely, accurate recognition of acute Aortic Dissection is a national patient safety issue. This is exactly what patients and bereaved relatives having been telling the NHS, Government and the Royal College of Emergency Medicine for several years."
    Read full story
    Source: HSIB, 23 January 2020
     
  5. Patient Safety Learning
    One of the country’s smallest trusts recorded 277 serious incidents over a two-year period, HSJ can reveal.
    Delays in treatment, missed diagnoses, adverse media coverage and “suboptimal” care were among the hundreds of serious incidents reported at the struggling Isle of Wight Trust from the start of 2018 and up to November 2019.
    There were also two never events in 2019 — a “wrong site” surgery and an incident in which a patient was mistakenly connected to an air flow meter, rather than an oxygen supply.
    The trust said the level of incidents did not neccessarily reflect poor care, and did not mean patients had come to harm.
    The trust was placed in special measures in April 2017 after it was rated “inadequate” by the Care Quality Commission due to “significant” concerns over patient safety. It was upgraded to “requires improvement” in September 2019, but remains in special measures. 
    Read full story (paywalled)
    Source: HSJ, 22 January 2020
  6. Patient Safety Learning
    Dementia patients are being dumped in hospitals in England because of a lack of community care, a charity says.
    The Alzheimer's Society called for action, highlighting data showing one in 10 dementia patients spends over a month in hospital after being admitted.
    The figures also suggested the overall number of emergency admissions among people with dementia is rising - with some patients yo-yoing back and forth.
    Ministers said they were "determined" to tackle the problems. Central to this, the government said, would be plans for reforming the social care system, which encompasses care home places and support in people's homes.
    Alzheimer's Society Chief Executive Jeremy Hughes said people were falling through the "cracks of our broken social care system".
    "People with dementia are all too often being dumped in hospital and left there. Many are only admitted because there's no social care support to keep them safe at home. They are commonly spending more than twice as long in hospital as needed, confused and scared."
    Read full story
    Source: BBC News, 22 January 2020
  7. Patient Safety Learning
    Herefordshire clinicians injected a patient in the wrong eye after a technical blunder, board papers have revealed.
    The Wye Valley Trust patient was injected with an antivascular endothelial growth factor to treat age-related macular degeneration. They did not come to harm as a result of the incident.
    The mistake occurred after the ophthalmology department deleted a poor quality image of one of the patient’s eyes. This shifted up the other images, which were stored sequentially using software called IMAGEnet6, which led to the mistake. 
    Although initially reported as a “never event,” the incident was downgraded to a “serious incident” after a review by the Herefordshire Clinical Commissioning Group (CCG). 
    The trust, which is still using the software, is updating its standard operating procedure and has installed new technology that can take higher quality images. A spokesman said: “Patient safety is the trust’s priority. While no harm was caused to this patient, the trust has taken this incident seriously.”
    Read full story (paywalled)
    Source: HSJ, 21 January 2020
  8. Patient Safety Learning
    NHS England asked an “inadequate” hospital for people with learning disabilities and autism to admit a patient, despite the service having a “voluntary” ban on admissions in place — and shortly before inspectors decided to impose a legal restriction.
    The provider said it was an “exceptional case”, where the individual “had several failed placements”, and had stayed at the hospital — Jeesal Cawston Park in Norfolk — “in the past”. 
    However, it appears to highlight the shortage of good quality accommodation and placements available and pressure on commissioners to make use of “inadequate” facilities.
    Read full story (paywalled)
    Source: HSJ, 21 January 2020
  9. Patient Safety Learning
    The Care Quality Commission (CQC) has awarded 'Outstanding' ratings to St Giles Hospice in Walsall and Whittington. 
    The CQC, an independent regulator of health and social care services in England, has recently introduced a new regime holding hospices to the same level of scrutiny as hospitals, making this outstanding rating all the more impressive.
    St Giles hospice, founded in 1983, started as a charity caring for local people dying from cancer and now supports people living with incurable illnesses and their families for free.
    Care providers from the hospice work on-site and in patients’ own homes, and their level of care has made them one of only a handful of hospices to ever have been awarded this accolade.
    In the CQC report inspectors complimented the hospice for its “compassionate” range of speciality services. 
    Inspectors added: “People were truly respected and valued as individuals. They were empowered as partners in their care, practically and emotionally, by an exceptional and distinctive service.”
    Read full story
    Source: National Health Executive, 16 January 2020
  10. Patient Safety Learning
    A coroner has today slammed a hospital for a series of serious failings after a mother bled to death when a medic refused to allow her vital clotting products.
    Gabriela Pintilie, 36, from Grays, Essex, gave birth to her healthy baby girl, Stefania, in February last year following a C-section after a long labour. But she suffered a major haemorrhage and died from a cardiac arrest hours later.
    Basildon University Hospital, in Essex, came under fire after it emerged a locum haematologist refused to give Mrs Pintilie the blood after he followed the wrong set of guidelines. The fresh frozen plasma, which could have saved her life, remained outside the theatre after senior staff were not told it was available.
    Essex Coroner Caroline Beasley-Murray today slammed the hospital for a lack of clear leadership and teamwork during the crucial minutes and hours when Mrs Pintilie suffered a massive haemorrhage.
    The court heard how the on-call haematologist Dr Asad Omran, who was at home,  was called but refused to give permission for vital blood-clotting drugs to be issued until further tests were run. 
    An expert witness said she believed the use of clotting drugs in the 'extreme situation' would have 'significantly increased' the chances of a different outcome. Dr Omran did not initially issue blood-clotting drugs because he followed the wrong protocol. He was following protocol for a normal adult, instead of a woman in labour, which was 'completely at odds with clinical guidelines'.
    Read full story
    Source: Mail Online, 20 January 2020
  11. Patient Safety Learning
    The daughter of a man with dementia who died after being pushed by another patient in a care facility, has said her family has been let down by authorities.
    John O'Reilly died a week after sustaining a head injury at a dementia care unit in County Armagh. The 83-year-old was pushed twice by the same patient in the days leading up to the fatal incident. His family were not made aware of this until after his death.
    On 4 December 2018, Mr O'Reilly was pushed by another dementia patient causing him to hit his head off a wall. His family have said he was pushed with such force that it left a dent in the wall. He was admitted to Craigavon Area Hospital with severe head injuries and died a week later.
    Last week, an inquest heard that the dementia patient who pushed Mr O'Reilly had a history of aggressive behaviour linked to dementia.
    The Southern Trust is carrying out as Serious Adverse Incident (SAI) investigation into Mr O'Reilly's death.
    Maureen McGleenon said: "Our experience of the SAI process has been dreadful. In our view it allows the trust to park the fact that something catastrophic has happened to a family. We were told it would be a 12-week process. It's over a year now and we've expended so much energy trying to figure out this process and find things out for ourselves."
    She added: "The system just knocks you down and makes you want to give up."
    "We'll never get over what happened to dad and we can't give up on trying to understand it."
    Read full story
    Source: BBC News, 20 January 2020
  12. Patient Safety Learning
    Hospital bosses have been accused of launching a witch hunt to find a whistleblower who told a widower about blunders in the treatment his wife received.
    The row emerged as an inquest began into the death of Susan Warby who died five weeks after bowel surgery. The 57-year-old died at West Suffolk Hospital in Bury St Edmunds after a series of complications in her treatment.
    Her family received an anonymous letter after her death highlighting errors in her surgery, the inquest in Ipswich heard, and both Suffolk Police and the hospital launched investigations. These investigations confirmed that there had been issues around an arterial line fitted to Ms Warby during surgery, Suffolk’s senior coroner Nigel Parsley said.
    Doctors were reportedly asked for fingerprints as part of the hospital’s investigation, with an official from trade union Unison describing the investigation as a “witch hunt” designed to identify the whistleblower who revealed the blunders.
    Read full story
    Source: The Independent, 17 January 2020
  13. Patient Safety Learning
    One in five deaths around the world is caused by sepsis, also known as blood poisoning, shows the most comprehensive analysis of the condition.
    The report estimates 11 million people a year are dying from sepsis - more than are killed by cancer. The researchers at the University of Washington said the "alarming" figures were double previous estimates. Most cases were in poor and middle income countries, but even wealthier nations are dealing with sepsis.
    There has been a big push within the health service to identify the signs of sepsis more quickly and to begin treatment. The challenge is to get better at identifying patients with sepsis in order to treat them before it is too late. Early treatment with antibiotics or anti-virals to clear an infection can make a massive difference.
    Prof Mohsen Naghavi said: "We are alarmed to find sepsis deaths are much higher than previously estimated, especially as the condition is both preventable and treatable. We need renewed focus on sepsis prevention among newborns and on tackling antimicrobial resistance, an important driver of the condition."
    Read full story
    Source: BBC News, 17 January 2020
  14. Patient Safety Learning
    Almost half of hospitals have a shortage of specialist stroke consultants, new figures suggest. One charity fears "thousands of lives" will be put at risk unless action is taken, with others facing the threat of a lifelong disability.
    In 2016, Alison Brown had what is believed to have been at least one minor stroke, but non-specialist doctors at different hospitals repeatedly told her she did not have a serious health condition. One even described it as an ear infection. 
    Ten months later, aged 34, she had a bilateral artery dissection - a common cause of stroke in young people, where a tear in a blood vessel causes a clot that impedes blood supply to the brain. She was admitted to hospital - but again struggled for a diagnosis. A junior doctor found an issue with blood flow to the brain but she says their comments were dismissed and she was told it was a migraine. It was only when she collapsed again, days later, and admitted herself to a hospital with a dedicated stroke ward that a specialist team was able to give her the care she needed.
    Alison's case highlights the importance of being seen by stroke specialists. However, according to new figures from King's College London's 2018-19 Snapp (Sentinel Stroke National Audit Programme) report, 48% of hospitals in England, Wales and Northern Ireland have had at least one stroke consultant vacancy for the past 12 months or more. This has risen from 40% in 2016 and 26% in 2014.
    The Stroke Association charity - which analysed the data - says the UK is "hurtling its way to a major stroke crisis" unless the issue is addressed.
    Read full story
    Source: BBC News, 17 January 2020
  15. Patient Safety Learning
    Astrophysics and dermatology are colliding through a new research project led by the University of Southampton – with potentially lifesaving consequences.
    The project, dubbed MoleGazer, will take algorithms used for detecting exploding stars in astronomical imaging data and develop them to be used to spot changes in skin moles and, therefore, detect skin cancer.
    MoleGazer, led by Professor Mark Sullivan, Head of the School of Physics and Astronomy at the University, and Postdoctoral Researcher Mathew Smith, has been awarded a Proof of Concept Grant from the European Research Council (ERC). It is the first time the University has won such a grant.
    Currently, patients at high risk of developing skin cancer are photographed at regular intervals and a consultant visually compares images to detect changes. MoleGazer could automate this process, potentially leading to earlier diagnoses and improved survival rates.
    “It’s a really exciting project that came along from nowhere,” added Professor Sullivan. “It also highlights the importance of blue sky science – curiosity-driven scientific research will always have a fundamentally important role to play.”
    Read full story
    Source: University of Southampton, 10 January 2020
  16. Patient Safety Learning
    "Too many" types of hernia mesh implants are being used on NHS patients with little or no clinical evidence, the BBC has been told.
    New data shows more than 100 different types of mesh were purchased by NHS Trusts from 2012 to 2018 in England and Scotland, leading to fears over safety. The meshes can cut into tissue and nerves, leaving some people unable to walk, work or care for children.
    Currently, hernia mesh devices can be approved if they are similar to older products, which themselves may not have been required to undergo any rigorous testing or clinical trials in order to assess their safety or efficacy.
    In England, around 100,000 such operations are performed each year, the majority using mesh. Many go well. But the Victoria Derbyshire programme has heard from nearly 300 people who have experienced complications - including chronic pain, infections and organ perforations. International guidelines estimate one in 10 patients will experience "significant chronic pain" following a mesh repair.
    The director of devices at the Medicines and Healthcare products Regulatory Agency (MHRA), Graeme Tunbridge, told the BBC: "The benefits and risks of using mesh for hernia repair have been considered in detail by clinicians and the professional bodies who represent them. We continue to monitor and review evidence as it becomes available and will take any appropriate action on that basis."
    Mr Tunbridge said he recognised the system "does need strengthening" and said new legislation on medical devices would take effect from May 2020.
    Read full story
    Source: BBC News, 15 January 2020
  17. Patient Safety Learning
    A major NHS hospital is under such pressure that it has decided to discharge people early even though it admits that patients may be harmed and doctors think the policy is unwise.
    The Royal Cornwall Hospitals NHS trust has told staff to help it reduce the severe overcrowding it has been facing in recent weeks by discharging patients despite the risks involved.
    In a memo sent on 8 January, three trust bosses said the Royal Cornwall hospital in Truro, which is also known as Treliske hospital and has the county’s only A&E department, “has been under significant pressure for the last two weeks and it is vital that we are able to see and admit our acutely unwell patients through our emergency department and on to our wards”.
    The memo added: “One of these mitigations was to look at the level of risk that clinicians are taking when discharging patients from Treliske hospital either to home or to community services, recognising that this may be earlier than some clinicians would like and may cause a level of concern.
    “It was agreed, however, that this would be a proportionate risk that we as a health community were prepared to take on the understanding that there is a possibility that some of these patients will be readmitted or possibly come to harm.”
    Read full story
    Source: 14 January 2020
  18. Patient Safety Learning
    Trainee oncologists at a major cancer centre covered clinics and made “critical” decisions without senior supervision, including for cancers they were not trained for, HSJ has revealed.
    A Health Education England (HEE) reviews aid: “The review team was concerned to hear that trainees were still expected to cover clinics where no consultant was present, including clinics relating to tumour sites that they were unfamiliar with.”
    Guy’s and St Thomas’ Foundation Trust’s trainee clinical oncologists felt “they could only approach 50–75% of the consultants for critical decision-making”, the document said.
    The HEE “urgent concern review” report said: “The trainees also reported that there was a continued lack of clear consultant supervision for inpatient areas in clinical oncology, which meant that they were not able to access senior support for decision-making.”
    A trust spokesman said: “We recognise that senior support to the clinical team is a vital part of keeping our patients safe.”
    Read full story (paywalled)
    Source: HSJ, 16 January 2020
  19. Patient Safety Learning
    The inquiry into Britain's worst maternity scandal is now reviewing 900 cases, a health minister has confirmed.
    The Ockenden Review, which was set up to examine baby deaths in the Shrewsbury and Telford Hospital Trust, was initially charged with examining 23 cases, but Nadine Dorries, a health minister, confirmed to the Commons that an additional 877 cases are being reviewed.
    A leaked report in November said a "toxic culture" stretching back 40 years reigned at the hospital trust as babies and mothers suffered avoidable deaths. The review will conclude at the end of the year.
    Jeremy Hunt, the former health secretary, said it was "deeply shocking" to hear of the new details and asked that the inquiry is "resolved as quickly as possible".
    Read full story
    Source: The Telegraph, 16 January 2020
  20. Patient Safety Learning
    Plans to scrap the four-hour A&E target have sparked a furious backlash from doctors and nurses, with some claiming it is driven by ministers’ desire to avoid negative publicity about patients facing increasingly long delays.
    A&E consultants led a chorus of medical opposition to the move. They pointedly urged NHS leaders and ministers to concentrate on delivering the long-established maximum waiting time for emergency care rather than finding “ways around” it.
    Under the target, 95% of people arriving at A&E in England are meant to be treated and then discharged, admitted or transferred within four hours. But performance against the target plunged to a new record low of just 68.6% last month in hospital-based A&E units as a result of staffing problems, the decade-long squeeze on the NHS budget and the dramatic growth in the number of patients seeking care.
    The Royal College of Emergency Medicine (RCEM), which represents A&E doctors, was responding to Wednesday’s apparent confirmation by the health secretary, Matt Hancock, that the target  is set to be axed because it is no longer deemed to be “clinically appropriate”.
    “So far we’ve seen nothing to indicate that a viable replacement for the four-hour target exists and believe that testing [of alternatives to the target] should soon draw to a close,” said Dr Katherine Henderson, the President of the RCEM. “Rather than focus on ways around the target, we need to get back to the business of delivering on it.”
    The Emergency Care Association, to which 8,000 A&E nurses belong, said ministers should exercise “extreme caution” in decisions about the target because “it could cause significant detriment to patient safety within our emergency departments if the four-hour target was abolished”. There are fears that patients thought to have only minor ailments could come to harm by having to wait a lot longer than four hours because they also have a more serious condition.
    Read full story
    Source: The Guardian, 15 January 2020
     
  21. Patient Safety Learning
    Medical examiners are doctors who look at every hospital death with a fresh pair of eyes to make an independent judgement about what took place. It is impossible to overestimate the importance of their role, and it is vital that NHS hospitals now get on with appointing them as a matter of urgency, says Jeremy Hunt, former Foreign Secretary, in an article in the Independent newspaper.
    The big issue is not that bad things happen (sadly in an organisation of 1.4 million people there will inevitably be things that go wrong) but that they take so long to identify and put right. Mid Staffs took four years, Morecambe Bay took nine years and it now looks like the problems at Shrewsbury and Telford could have taken place over 40 years.
    Anyone who has spoken to brave patient-safety campaigners who lost loved ones because of poor care will know that their motivation is never money, simply the desire to stop other families having to go through what they have suffered.
    That is why they and other patient groups all campaign for medical examiners – a process through which every death is examined by a second, independent doctor. It was first recommended following the Shipman inquiry but has taken a long time to implement – inevitably for cost reasons. 
    Where they have been introduced, medical examiners have been transformational. 
    The main pilot sites in Sheffield and Gloucester, which scrutinised over 23,000 deaths, found that “medical examiners have triggered investigations that identified problems with post-operative infections faster than other audit procedures, based on surprisingly few cases”. Doctors also felt confident in raising concerns, as they were protected and supported by the independent medical examiner. Remarkably, pilot studies found that 25% of hospital death certificates were inaccurate and 20% of causes of death were wrong.
    Read full story
    Source: The Independent, 16 January 2020
  22. Patient Safety Learning
    Ten years on from the Mid Staffordshire NHS trust scandal, the man who led the inquiry into one of the worst care disasters in the service’s history has said he remains worried about the safety of patients and a culture that leaves staff too frightened to speak up.
    Sir Robert Francis QC said some safety risks highlighted a decade ago remain unresolved and he threw his weight behind calls for senior managers in the NHS to be regulated.
    The barrister said he believed the NHS was safer now than a decade ago but added he worried whether actions taken since the disaster had made a real difference.
    “What keeps me awake at night is not so much has anyone implemented recommendation 189 or not, but more whether the collectivity of what has happened since has actually resulted in things being better for patients and staff,” he told The Independent.
    Read full story
    Source: The Independent, 15 January 202
  23. Patient Safety Learning
    Public confidence in the health service is being undermined by a lack of transparency from hospitals about patient complaints, the man who led the investigation into one of the NHS’s worst care disasters has warned.
    Sir Robert Francis QC, who chaired the public inquiry into the Mid Staffordshire hospital scandal, has called for a new national organisation with powers to set standards on the handling of patient complaints after research found seven in eight hospital trusts do not follow existing rules.
    The prominent barrister is now chair of Healthwatch England, a statutory body, which analysed 149 hospitals’ handling of complaints. Under current legislation every hospital is required to collect and report on the number of complaints they receive, what they were about and what action has been taken. Healthwatch England found just 12% of NHS trusts were compliant with all the rules. Only 16% published the required complaints reports while just 38% reported any details about learning or actions taken after a grievance.
    Speaking to The Independent, Sir Roberts said better reporting, including the outcome and changes made after a complaint, would create a “collaborative” environment to improving the system with patients and staff alike seeing complaints as a valuable resource.
    One persistent problem remained the gap, he said, between hospitals and the national Parliamentary and Health Service Ombudsman. Sir Robert argued commissioners of NHS services should be more involved.
    Read full story
    Source: The Independent, 15 January 2020
  24. Patient Safety Learning
    Warring between two surgeons at Great Ormond Street Hospital could put patients at risk, a review suggests.
    A board paper released by the leading children's hospital said a "fractured" relationship between two consultants in the paediatric surgical urology team was affecting the service last year.
    The London hospital said steps were being taken to resolve the problems. This has included mediation, mentoring and away days.
    The board paper from a meeting in November set out the findings of a two-day inspection by the Royal College of Surgeons last May. The college was invited in by the trust itself after reports of problems. The summary of the report said there were "significant difficulties" between two surgeons in the team. It described a "lack of trust and respect" which meant they did not work collaboratively and led to significant competition for work.
    If this continued it would have the "potential to affect patient care and safety" as well as longer waits for surgery, it said. The "dysfunction" between the two senior doctors caused problems for the wider team with evidence support staff had also been treated inappropriately.
    Great Ormond Street said it took the issue "extremely seriously" and good progress was being made.
    Read full story
    Source: BBC News, 15 January 2020
  25. Patient Safety Learning
    One in six women who lose a baby in early pregnancy experiences long-term symptoms of post-traumatic stress, a UK study suggests.
    Women need more sensitive and specific care after a miscarriage or ectopic pregnancy, researchers say.
    In the study of 650 women, by Imperial College London and KU Leuven in Belgium, 29% showed symptoms of post-traumatic stress one month after pregnancy loss, declining to 18% after nine months. The study recommends that women who have miscarried are screened to find out who is most at risk of psychological problems.
    "For too long, women have not received the care they need following a miscarriage and this research shows the scale of the problem," says Jane Brewin, Chief Executive of miscarriage and stillbirth charity Tommy's.
    "Miscarriage services need to be changed to ensure they are available to everyone and women are followed up to assess their mental wellbeing with support being offered to those who need it, and advice is routinely given to prepare for a subsequent pregnancy."
    Read full story
    Source: BBC News, 15 January 2020
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