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Patient Safety Learning

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  1. Patient Safety Learning
    Healthcare organisations including regulators, royal colleges and faculties have issued a set of principles to help protect patient safety and welfare when accessing potentially-harmful medication online or over the phone.
    The jointly-agreed High level principles for good practice in remote consultations and prescribing set out the good practice expected of healthcare professionals when prescribing medication online.
    The ten principles, underpinned by existing standards and guidance, include that healthcare professionals are expected to:
    Understand how to identify vulnerable patients and take appropriate steps to protect them Carry out clinical assessments and medical record checks to ensure medication is safe and appropriate Raise concerns when adequate patient safeguards aren’t in place. Charlie Massey, Chief Executive of the General Medical Council (GMC), said:
    ‘The flexibility of accessing healthcare online can benefit patients, but it is imperative these services do not impact on their safety, especially when doctors are prescribing high-risk medicines."
    Read full story
    Source: General Medical Council, 8 November 2019
  2. Patient Safety Learning
    Inspectors have demanded action over patients facing long waits on trolleys at Wrexham Maelor Hospital's A&E unit.
    Healthcare Inspectorate Wales (HIW) said officials found some people waiting eight hours during an unannounced visit in August. It wants Betsi Cadwaladr University Health Board (BCUHB) to make rapid improvements.
    In a statement, it said some of HIW's recommendations had already been addressed.
    In its report, HIW acknowledged efforts made by emergency department staff to look after those in need, the Local Democracy Reporting Service reported.
    "It was identified that patients who were waiting on trolleys in the corridor were not receiving appropriate and timely care," said HIW. "We had to alert the nurse responsible for the patients in the emergency department corridor to a patient who was experiencing increased chest pain."
    "During the inspection, we found that there were no pressure relieving mattresses available for any patients who were waiting on trolleys within the emergency department."
    "We considered the above practices to be unsafe and increased the risk of harm to patients."
    Read full story
    Source: BBC News, 9 November 2019
  3. Patient Safety Learning
    NHS staff are being told to report whether hospital mistakes have been caused by Brexit.
    Staff at a London trust must now record whether a safety incident was “caused or contributed to by leaving the European Union”. All patient-related mishaps – anything from a patient falling over, to a medicine being missed – must be recorded on a national database.
    But in the last few weeks, staff at Barts Health NHS Trust have been told they must stipulate whether or not Brexit was a contributing factor, according to documents seen by The Independent. The patient safety reporting system now poses the yes-or-no question: “Is there reason to believe it was caused or contributed to by the EU exit transition [Brexit]?”
    Read full story
    Source: The Independent, 9 November 2019
  4. Patient Safety Learning
    More than 550 objects have been unintentionally left in Canadian medical and surgery patients between 2016 and 2018, and the problem appears to be getting worse.
    A new report released by the Canadian Institute for Health Information says 553 foreign items – such as sponges and medical instruments – were left behind over that two-year period. That's a 14%  increase between the most recent data collected in 2017–2018 and statistics collected five years earlier.
    It's also more than two times the average rate of 12 reporting countries, including Sweden, the Netherlands and Norway, which had the next highest rates.
    The information was examined as part of a broad look at how Canada's health-care system compares to other member nations of the Organisation for Economic Co-operation and Development.
    Read full story
    Source: CTV News, 7 November 2019
  5. Patient Safety Learning
    Staff working at Blackpool hospitals raised 32 concerns with their bosses during the last three months as part of a national NHS whistle-blowing scheme.
    Figures presented to the Blackpool Victoria Hospital board show 16 of the complaints related to patient safety, while 14 were in connection with incidents of bullying and harrassment. The overall figure was in line with the average for the hospital trust since the scheme was introduced nationally by the government in 2015, and is down from 37 during the previous three months.
    But it was felt staff were still cautious about pointing the finger with anonymity requested in almost every case.
    Terri Vaselli, Freedom to Speak Up Guardian for the Trust, said: "Within the nursing teams there are fears they will be ostracised. "It doesn't matter how much I reassure them, the fear factor is still there."
    Read full story
    Source: Blackpool Gazette, 8 November 2019
  7. Patient Safety Learning
    The team of healthcare professionals at Doncaster and Bassetlaw Teaching Hospitals (DBTH) discuss their work ‘Sharing How We Care’ after being awarded the Shared Learning Award for their outstanding contributions to improving patient safety.
    The Trust ‘Sharing How We Care’ work was selected as the winners of the Shared Learning Award at the Patient Safety Learning Conference in London last month. The award recognised the work involved in setting up an annual conference as a forum to share examples of exemplary healthcare practice and a monthly newsletter which focuses on aspects of patient’s safety, including patient experience and articles about improvements in clinical areas.
    As a result of the work through Sharing How We Care, the Trust has seen a 40% decrease in the number of serious incidents reported.
    Cindy Storer, Acting Deputy Director of Nursing, Midwifery and Allied Health Professionals at Doncaster and Bassetlaw Teaching Hospitals, said: “We’re so pleased that the work through Sharing How We Care at the Trust has been recognised. We’ve seen real improvements in the quality of the care we provide as a direct result of this shared learning. These results reflect the commitment from all of our staff to support Doncaster and Bassetlaw Teaching Hospitals to become the safest Trust in England.”
    Read full story
    Source: Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust website
  8. Patient Safety Learning
    The 23 winners of the 2019 HSJ Awards have been announced.
    The awards, now in their 39th year, are among the world’s most fiercely contested health service awards, attracting hundreds of entries from the NHS and its partners.
    The winner of the HSJ Patient Safety Award went to the Wessex Academic Health Science Network for their National Polypharmacy Prescribing Comparators.
    Read full list of winners
    Source: HSJ 7 November 2019
  9. Patient Safety Learning
    Tens of thousands of people have have had their operations cancelled because of staff shortages and faulty medical equipment, according to newly revealed NHS figures. 
    The number of procedures called off by hospitals for non-clinical reasons has increased by 32 per cent in the last two years, the statistics obtained via a freedom of information (FOI) request. Almost 4,000 more were scrapped in 2018 than in 2016.    
     They also show that of the 79,000 operations to be cancelled last year, 20 per cent were scrapped because of staffing issues and equipment failures.
    It comes as the staff vacancies continue to put the health service under strain, with the NHS reporting last year it was short of 100,000 staff including, 10,000 doctors and 35,000 nurses.
    Read full story
    Source: The Independent, 5 November 2019
  10. Patient Safety Learning
    Troubled teenagers seeking urgent help from NHS mental health services are being denied treatment or facing months of delays, GPs have said. Three in four family doctors do not believe under-18s they refer to child and adolescent mental health services will end up being treated, research shows.
    In a survey of 1,008 GPs across the UK, 76% said they did not usually feel confident a young person they referred to Child and Adolescent Mental Health Services (CAMHS) would receive treatment for their illness. Only 10% were confident that treatment would follow.
    Emma Thomas, Chief Executive of YoungMinds, said: “As these worrying results show, GPs are on the frontline when it comes to mental health. But too often they don’t believe that there is good enough early support in their community".  She added, "This means many young people either receive support from GPs who have the best of intentions but may not feel equipped to provide the right help, or face long waiting times for specialist services, which may then turn them away because of high thresholds for treatment.”
    Read full story
    Source: Guardian, 7 November 2019
  11. Patient Safety Learning
    A hospital trust has declared a "critical incident" because of the "exceptional" pressure on A&E.
    Nottingham University Hospitals Trust (NUH) runs the Queen's Medical Centre (QMC) and City Hospital and has been on OPEL 4 – previously known as black alert – since Monday morning. On Wednesday it raised the level further.
    Some routine operations have been cancelled as the trust prioritises those who need emergency care. Health bosses do not want to operate on patients who cannot be guaranteed a bed in which to recover.
    Lisa Kelly, NUH Chief Operating Officer, said: "This is following a number of days seeing exceptional pressure across the system, with high numbers of very poorly patients arriving at our emergency department."
    The trust has been on OPEL 4 at least once this year but this is the first time in 2019 the pressure in the emergency department has been escalated to a critical incident.
    Ms Kelly added: "This is not unique to Nottingham, and hospitals across the country are also experiencing similar pressures."
    In the East Midlands, University Hospitals of Leicester and Sherwood Forest Hospitals NHS Foundation Trust were both on OPEL 4 – which means patient safety could be compromised – earlier this week. They have since been scaled down to OPEL 3.
    Read full story
    Source: BBC News, 6 November 2019
  13. Patient Safety Learning
    More mental health hospital beds are needed in England to end the "distressing" sending of patients far from home, analysis suggests. Patients with conditions such as schizophrenia can be sent to hospitals miles away from their home if their nearby units do not have space. 
    The Department of Health aims to end inappropriate far-away placements by 2021. But the Royal College of Psychiatrists report suggested the push had stalled. The number of inappropriate out-of-area placements at any one time has been consistently between 700 and 800 patients in recent months, after dipping below 600 towards the end of 2018.
    Marjorie Wallace, Chief Executive of the charity Sane, said the drive to cut bed numbers had been "relentless" and caused "widespread distress and neglect".
    "Far too many people contacting us are being shunted around the country like unwanted parcels," she said. "We believe this has led to ever more patients left at risk of self-harm and suicide."
    Read full story
    Source: BBC News, 6 November 2019
  14. Patient Safety Learning
    Half of developers are not seeking ethical approval before they start producing new artificial intelligence systems for healthcare, according to a report by NHSX.
    The report, Artificial Intelligence: How to get it right, notes that the “complex governance framework” around AI tech could limit innovation and potentially compromise patient safety.
    It also revealed that there is “an almost 50/50 split” between developers who sought ethical approval before they started the development process for a new AI system and those who did not.
    Read full story (paywalled)
    Source: HSJ, 31 October 2019
  16. Patient Safety Learning
    Every NHS and social care worker in England will have to undergo mandatory training on autism and learning disability following the death of a teenager, the government has said.
    Eighteen-year-old Oliver McGowan, who had autism, died in November 2016 after being given anti-psychotic medication against his own and his parents’ wishes by staff at Bristol’s Southmead Hospital, part of the North Bristol NHS Trust. Oliver’s medical records showed he had an intolerance to anti-psychotic drugs and shortly after he was given the dose he developed severe brain swelling and died.
    His parents Paula and Tom McGowan have been campaigning for improved training for health and care staff and ministers have now backed their calls with new pilots and £1.4m of funding.
    The new training will be named after Oliver and will start next year, with the aim to improve care for people with autism and learning disabilities using case studies and ensuring all staff understand the needs of patients with learning disabilities and autism.
    Read full story
    Source: Independent, 5 November 2019
  17. Patient Safety Learning
    At last week’s meeting in Perth, Australia, the COAG Health Council discussed a number of national health issues, one of which was the Quality Use of Medicines.
    The Council’s resulting communique highlights that medicines are the most common intervention in healthcare and can contribute to significant health gains – but can also be associated with harm.
    “Half of all medication related harm is preventable and a coordinated national approach that identifies and promotes best practice models and measures progress towards reducing medication related harm has the potential to improve the health of Australians and create savings across the health care system,” it notes.
    At the meeting, the Health Ministers agreed to make the Quality Use of Medicines and Medicines Safety the 10th National Health Priority Area
    Read full story
    Source: Australian Journal of Pharmacy, 4 November 2019
  18. Patient Safety Learning
    A common hospital bed used by thousands of patients across New South Wales (NSW), Australia, poses a risk to heavier patients and nurses caring for them, healthcare staff have been warned.
    A safety alert has been issued throughout the state after NSW Health received five reports of Hill-Rom HR900 model beds tilting dangerously as nurses tried to manoeuvre patients. 
    The incidents are the latest pressure point for a healthcare system responsible for the rising overweight and obese patient population.
    No patients involved were harmed, but “there is a potential risk if the beds tip during an episode of patient care", the alert issued last month by the Clinical Excellence Commission reads.
    Read full story
    Source: The Sidney Morning Herald, 4 November 2019
  19. Patient Safety Learning
    The Professional Record Standards Body (PRSB) has published a standard for ambulance handover to ensure that information can be transferred digitally to emergency departments from any ambulance and improve patient care and safety.
    Emergency care needs fast, effective sharing of information. Once implemented, the standard for handover will improve continuity of care, as emergency care professionals will have the information they need available to them on a timely basis. It means that emergency care professionals will know what medications have been administered, diagnostic tests performed and whether the patient has any allergies as well as other important information.
    The standard is published as a draft while PRSB seeks endorsement from relevant members and other organisations.
    Read the Ambulance handover to emergency care standard
    Source: PRSB, 1 November 2019
  20. Patient Safety Learning
    A 7-year-old boy who has spent most of his life being branded naughty and disruptive has won a settlement of more than £30m after it was discovered that he had sustained a brain injury after negligent delays in his delivery at University College Hospital in London.
    The settlement is thought to be one of only a handful of NHS clinical negligence payouts to exceed £30m.
    Read full story (paywalled)
    Source: BMJ, 1 November 2019
  22. Patient Safety Learning
    Elderly patients are being “poisoned” with medication because too little is known about how different drugs interact with each other and correct dosages for older people, experts have said.
    Speaking at the House of Lords’ science and technology committee hearing on healthier living in old age, Sir Munir Pirmohamed, Professor of Molecular and Clinical Pharmacology at Liverpool University, said most of his patients are on more than 10 and often more than 20 drugs.
    “Those drugs are used at conventional doses and those doses have been tested in younger populations who had exclusion criteria for trials – so they have been tested in people who don’t have the multiple diseases,” he said. “So when we use a drug at a dose which is licensed at the moment, we are often ‘poisoning’ the elderly because of the dosing that we are using.”
    Read full story
    Source: Guardian, 29 October 2019
  23. Patient Safety Learning
    England’s top doctor has welcomed new polling showing that patients and the public support NHS proposals focussing on fast treatment for those who need it in A&E.
    A national survey commissioned by Healthwatch England found that an overwhelming majority of people placed a high priority on early initial assessment on arrival at A&E for everyone, allowing staff to prioritise those patients with the greatest need, and ensuring that patients with critical conditions get the right standard of care quickly.
    These priorities are mirrored in new standards now being trialled across the NHS, as part of a review led by NHS National Medical Director, Professor Stephen Powis, supported by leading staff and patient groups. They include a rapid assessment measure for all patients arriving at A&E, coupled with measuring how quickly life-saving treatment – or Critical Time Standards – is delivered for those with the most serious conditions, such as heart attacks, sepsis, stroke and severe asthma attacks.
    Experts believe updating the 15-year old target regime for emergency department teams with these new measures, combined with an average waiting time target to bring down long waits for all patients, may help NHS teams save more lives and prevent long term disability for thousands more people.
    Read full story
    Source: NHS England, 31 October 2019
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