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Patient Safety Learning

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  1. Patient Safety Learning
    The NHS will face scrutiny over alleged failures to listen to whistleblowers’ warnings about baby killer Lucy Letby after the nurse was convicted of another attempted murder.
    Letby was convicted of trying to murder a “very premature” infant by dislodging her breathing tube in the early hours of 17 February 2016, following a retrial at Manchester Crown Court.
    The 34 year-old’s latest conviction comes after she was found guilty of the murders of seven babies and the attempted murders of six others at the Countess of Chester Hospital’s neo-natal unit between June 2015 and June 2016, following her original trial last August.
    The former nurse was given a rare whole-life order, making her one of Britain’s most prolific child serial killers. She is due to be sentenced for the further offence on Friday.
    Detective superintendent Simon Blackwell, who is strategic lead for Operation Hummingbird, said: “The investigation, which is ongoing, focuses on the indictment period of the charges for Lucy Letby, from June 2015 to June 2016, and is considering areas including senior leadership and decision making to determine whether any criminality has taken place. The investigation is complex and sensitive and specific updates regarding progress will be issued at the appropriate time. At this stage we are not investigating any individuals in relation to gross negligence manslaughter.
    “We recognise that this investigation has a significant impact on a number of different stakeholders including the families in this case and we want to reassure that we are committed to carrying out a thorough investigation. Since Letby’s original convictions in August 2023 it has been a very busy period for the investigation team. This has included a subsequent appeal, the re-trial for one count of attempted murder and the launch of the statutory public inquiry that Cheshire Constabulary is assisting with.”
    Read full story
    Source: The Independent, 2 July 2024
  2. Patient Safety Learning
    Almost half of nursing students in England have considered quitting before they graduate amid the worst workforce crisis in NHS history, according to the largest survey of its kind.
    Applicant numbers have fallen significantly since the end of a grant to support nursing students in 2017. Now a report by the Royal College of Nursing (RCN), seen by the Guardian, suggests that as many as 46% of those enrolled – about 32,000 students – could walk away.
    The cost of living was the top reason for students considering an early exit, with seven in 10 (70%) citing “financial difficulties” as a factor. Nursing students have to pay university fees of more than £9,000 a year.
    “I wasted so much time and put my sweat, blood and tears into something that is burning me out before I start and isn’t even paying enough. It makes me sad for myself that this is the profession I chose.”
    Nearly six in 10 respondents (58%) said witnessing low morale and burnout among qualified nurses had also prompted them to consider ditching their nursing degree.
    Read full story
    Source: The Guardian, 3 July 2024
  3. Patient Safety Learning
    There’s a memory, or more specifically a moment, that came to define Heidi Metcalf’s second birth.
    It wasn’t saying goodbye to her husband and newborn before being wheeled into an operating theatre, or the heart attack she thought she was having as she lay there on the table.
    It was when a male obstetrician “ripped the placenta” out of her body, without word or warning.
    A nurse, Ms Metcalf knows the intervention - while immensely painful - was necessary. She couldn't push it out naturally, which was causing potentially fatal bleeding.
    But she hadn’t “seen or met this man before”, and she can’t get past the fact that her consent, during one of the most traumatic experiences of her life, “meant so little”.
    “It felt like a violation - I needed to feel involved in what was happening to my body, and not just like a bystander.”
    Ms Metcalf is one of thousands of Australian women who have come forward to tell their stories, after the federal government assembled a team of experts to tackle what it calls “medical misogyny”.
    So far, they have uncovered that a staggering two-thirds of females nationwide have encountered gender bias or discrimination in healthcare.
    And many say it is taking place when they're at their most vulnerable, such as during intimate examinations, or like Ms Metcalf, while in labour. Others report having their pain dismissed or dangerously misdiagnosed.
    Read full story
    Source: The Guardian, 2 July 2024
  4. Patient Safety Learning
    The expansion and use of virtual ward beds has stalled so far in 2024 after strong growth in the second half of last year, according to analysis of official figures.
    The number of virtual ward “beds” occupied by patients increased by 38% between July and December 2023. But from the end of 2023 to May 2024, it has increased by less than 1%.
    The slowdown comes as ring-fenced national funding for virtual wards came to an end in March. The services – which involve the use of tech to care for patients in their own home when they would otherwise be in hospital – must now be drawn from wider urgent and emergency care funding. 
    One integrated care board chief executive told HSJ  the national virtual wards programme had become “peripheral” to wider challenges facing the health system, whereas it had previously been treated as a high priority on its own.
    Read full story (paywalled)
    Source: HSJ, 3 July 2024
  5. Patient Safety Learning
    The UK nursing regulator’s new interim chief executive has stepped down just four days into the job after facing widespread staff backlash over her links to a high-profile race discrimination case.
    Multiple staff working at the Nursing and Midwifery Council (NMC) raised concerns to its directors over the appointment of interim CEO Dawn Broderick, who was head of HR at another trust when it was found to have discriminated against a Black employee.
    The Independent can now reveal Ms Broderick resigned from the NMC on Monday evening.
    It is the latest in a succession of controversies to hit the nursing regulator, following reports uncovered by The Independent last year. These include allegations from whistleblowers that racism within the NMC was allowing complaints against nurses to go unchecked.
    Staff have come forward to The Independent, warning they do not have confidence the NMC’s board will take the issue of racism seriously.
    Read full story
    Source: The Independent, 2 July 2024
  6. Patient Safety Learning
    The agonising pains came midway through Dr Rageshri Dhairyawan’s third cycle of IVF, ten years ago. “I felt as if a heavy metal shovel was scraping away at the lining of my abdomen,” she recalls. 
    “It was like nothing I’d ever felt before,” she says. Her fear was ovarian torsion — “when the ovaries become so big from all the follicle stimulation that they twist on their stalk, which is excruciating and needs to be repaired surgically because the ovary becomes starved of oxygen.”
    Her husband rushed her to A&E where she was given morphine, then admitted to a gynaecology ward. As a scan revealed no ovarian torsion, “It was thought the hormones had flared up my endometriosis.” 
    Dhairyawan was in so much pain she couldn’t move, and yet she recalls being treated as though she was an attention-seeker “trying to get strong opioids through dishonest means” and “as a nuisance for pressing my buzzer”. It was as if, she says, “I didn’t have something they thought was very serious so why was I still there? I just remember not wanting to feel like more of a nuisance because I knew what being a nuisance on a ward can look like — I’d been a doctor for ten years.”
    Dhairyawan’s husband demanded pain relief for her. She left hospital shaken. “It massively changed me,” she says. “The experience of not being listened to as a patient, not being taken seriously — it really shocked me. Because I thought, I’m a senior doctor, I know exactly how the NHS works, I know my medical condition, I now what to ask for. And I still can’t speak up and advocate for myself.”
    Read full story (paywalled)
    Source: The Times, 2 July 2024
  7. Patient Safety Learning
    NHS trusts are signing up to deliver efficiency savings of up to 9% of costs, HSJ  has found.
    The Queen Elizabeth Hospital King’s Lynn has a cost improvement programme of nearly £30m in 2024-25, equivalent to 9% of spending, which is three times higher than the amount it delivered last year.
    Trusts and commissioners were last month issued with new financial targets as NHS England attempted to bring down a £3bn forecast deficit for local organisations.
    A spokeswoman told HSJ the trust had already identified three-quarters of the £30m, and said “we believe that there are further efficiencies in our system, which would see us go further than the 3.1% achieved last year.”
    She added: “All cost-saving initiatives go through a robust process to make sure that they will not impact patient safety or clinical care provided by the trust.”
    Read full story (paywalled)
    Source: HSJ, 1 July 2024
  8. Patient Safety Learning
    Doctors are warning the UK medical regulator that wider use of physician associates in the NHS may risk patient safety and lead to greater inequalities in care in deprived areas that struggle to recruit GPs.
    The government’s plan to recruit 10,000 physician associates – healthcare professionals supervised by doctors – has angered many clinicians who consider the roles ill-defined and a potential threat to patient safety.
    The General Medical Council (GMC) is to regulate physician and anaesthesia associates, who also work under doctors’ supervision, from December.
    The doctors’ union, the British Medical Association, last week announced it was seeking a judicial review of the GMC over the “dangerous blurring of lines” between doctors and medical associate professions. It argues physician and anaesthesia associates need regulating, but not by the GMC.
    Other professional membership organisations want clarification of associates’ roles. The Royal College of General Practitioners (RCGP) told the GMC that regulation is a “significant step forward”, but the scope of practice needs to be urgently developed.
    Read full story
    The Guardian, 30 June 2024
  9. Patient Safety Learning
    The latest release of data from the Royal College of Nursing's Last Shift Survey shows the urgent need for investment in the nursing workforce and safety-critical nurse-to-patient ratios enshrined in law. New analysis finds more than 11,000 members reveals just a third of shifts had enough registered nurses.   

    Chronic staff shortages mean individual nurses are often caring for 10, 12, 15 or more patients at a time. The RCN are now calling for safety-critical limits on the maximum number of patients a single nurse can be responsible for.   

    Our survey found that 1 in 3 hospital shifts were missing at least a quarter of the registered nurses they needed. In A&E settings, significant numbers of nurses reported having more than 51 patients to care for. 

    Across all settings, 80% of respondents said there aren't sufficient nurses to meet the needs of patients safely.   

    RCN Acting General Secretary and Chief Executive Professor Nicola Ranger said: “Without safety-critical limits on the maximum number of patients they can care for, nurses are being made responsible for dozens at a time, often with complex needs. It is dangerous to patients and demoralising for nursing staff.   

    “When patients can’t access safe care in the community, conditions worsen, and they end up in hospital where workforce shortages are just as severe. This vicious cycle fails staff and patients – it can’t go on.   

    “We desperately need urgent investment in the nursing workforce but also to see safety-critical nurse-to-patient ratios enshrined in law. That is how we improve care and stop patients coming to harm.”  
    Read full story
    Source: RCN, 1 July 2024
  10. Patient Safety Learning
    Hackers behind a London hospital attack recently published records that include personal information about pregnant women, newborns, cancer patients, people suffering from schizophrenia and thousands of others across the UK and Ireland, revealing the breach was far more widespread than authorities have previously indicated.
    An analysis of the data trove by Bloomberg News found that it contains tens of thousands of medical records on patients from more than 400 public and private hospitals and clinics. Among the records are some 40,000 highly sensitive documents sent by doctors requesting biopsies and blood tests for individual patients in all regions of the UK and some hospitals in Ireland.
    A breach of the kind faced by Synnovis was inevitable, according to Saif Abed, a former NHS doctor and expert in cybersecurity and public health. “The NHS has some of best patient safety and cybersecurity standards in the world,” Abed said. “They are just immensely poorly enforced.”

    Abed said that there was a lack of mandatory cybersecurity audits on any contractors providing services to the NHS, which meant those contractors could have substandard cybersecurity practices that could in turn leave the NHS vulnerable.
    Read full story
    Source: Bloomberg UK, 26 June 2024
  11. Patient Safety Learning
    Many doctors from overseas are left feeling lost, anxious and not ready to care for patients after joining the NHS because they are not properly looked after, research has found.
    Many international medical graduates (IMGs) feel the NHS does not help them prepare for life as a doctor in the UK and the practicalities of moving to a new country, according to a survey.
    Almost six in 10 (58%) of those questioned thought their induction was inadequate, and almost half (48%) felt anxious about starting to perform clinical duties in the UK.
    The Medical Protection Society (MPS), which surveyed 737 IMGs working in England, said the results showed that too many foreign-trained doctors were “still being let down” professionally and personally by the NHS.
    One doctor said: “I was very anxious and worried as working clinically without induction and [a] very brief period of shadowing … I was just lost.”
    Another said: “I asked several times about induction, to be told that I will just learn on the job and ‘it will be fine’.”
    Read full story
    Source: The Guardian, 28 June 2024
  12. Patient Safety Learning
    The NHS Race and Health Observatory has raised fundamental concerns about racism towards maternity patients after several cases have come to light in recent months, including midwives branding patients as “Asian princesses”.
    The watchdog’s intervention follows regulators identifying patterns of racist and discriminatory behaviour at the maternity departments of two large hospital trusts and a smaller general hospital in the last six months.
    The observatory’s CEO Habib Naqvi told HSJ  he was “deeply concerned” by the seriousness of the issues raised.
    He added that “discriminatory behaviours and ways of working… [can] lead to hostile and unsupportive learning environments… impact patient care and safety, and also seriously undermine the NHS’s goal of attracting and retaining its workforce”.
    Examples given included the term “Asian princess” being used by midwives in reference to brown-skinned women requesting pain relief during labour.
    The students also described a “disregard” from some midwives towards black and brown-skinned women, particularly where English was not their first language. 
    It was also reported when Asian women verbalised their pain during labour, some midwives responded with “Oh, they are all like this”, while additional derogatory comments were made towards asylum seekers, that “they are playing the system”, the NHSE team’s report said.
    Read full story (paywalled)
    Source: HSJ, 28 June 2024
  13. Patient Safety Learning
    An NHS England document has confirmed that that it wants to ‘optimise’ GP referrals to secondary care via an enhanced model of advice and guidance.
    GP leaders recently raised concerns that NHS England had encouraged Integrated Care Boards (ICBs) to adopt the ‘advice and refer’ model, effectively replacing traditional GP referrals and adding barriers for patients in accessing secondary care. 
    At the time, NHS England did not address concerns about this specific model, but Pulse has now seen a ‘framework’ document which encouraged local commissioners to ‘strengthen’ specialist advice services in order to ‘optimise’ referrals. 
    The guidance suggested the use of the ‘advice and refer’ model, which means all referrals or advice requests from GPs ‘come in through one route’ and directly bookable appointments are ‘discouraged or removed’.
    Under this service, all referrals are then ‘triaged’, allowing hospitals to reject referrals and send them back to GPs with advice. 
    This mechanism removes the option for GPs to send standard referrals, whereas the usual model of advice and guidance (A&G) allows GPs to seek advice if they wish, but maintains the direct referral route.
    NHS England emphasised its commitment to empowering regions to ‘develop diverse models’ of specialist advice in line with their local needs.
    Read full story
    Source: Pulse, 26 June 2024
  14. Patient Safety Learning
    Kansas is the latest US state to file a lawsuit against Pfizer, accusing the pharmaceutical giant of misleading the public about the safety and effectiveness of its Covid-19 vaccine.
    Kansas Attorney General Kris Kobach claims that Pfizer knew about the risks associated with its vaccine, “including myocarditis and pericarditis, failed pregnancies, and deaths” but failed to disclose this information to the public.
    The 179-page lawsuit also alleges that Pfizer made ‘false and misleading’ statements regarding the vaccine's ability to prevent viral transmission, its waning effectiveness and its ability to protect against new variants of the virus.
    “To keep the public from learning the truth, Pfizer worked to censor speech on social media that questioned Pfizer’s claims about its Covid-19 vaccine,” alleges the lawsuit.
    Read full story
    Source: Maryanne Demasi, 23 June 2024
  15. Patient Safety Learning
    An assistant coroner has warned an east London council more people may die if it does not take action, after a "frail lady who was prone to falls" died of hypothermia at her home.
    Anoush Summers, 77, died in hospital in January after a fall days earlier.
    In a prevention of future deaths report, external, assistant coroner Edwin Buckett said Ms Summers' inquest concluded "the absence of a working wrist alarm prevented her from being found sooner than she was and probably contributed to her death".
    Ms Summers lived alone but received help from two carers from Supreme Care Services, and she was visited twice a day.
    After falling at home on 11 January, she was found the next day at 09:00 GMT wearing her wrist alarm and was taken to hospital.
    She died of hypothermia at Homerton University Hospital on 14 January.
    The assistant coroner said among issues he identified in her case "giving rise to concern" were:
    Her wrist alarm had been reported as broken and not working on 6 January, but "this was not replaced or repaired by the company engaged by the local authority", which meant Ms Summers could not call for help as "it did not work" None of the carers who attended her home after the wrist alarm broke on 6 January "ensured that steps were taken to replace the alarm" or reported the matter to the local authority The last carer to see her, who visited on 11 January, "was not aware that the wrist alarm did not work as she had not read the care notes", and "no clear instruction was given" about the extent to which carers should read these notes "None of the carers had been given any training, instruction or guidance on the testing of wrist alarms to ensure they worked properly when attending"
    There was not a "clear system identified between the company providing carers and the local authority as to the duties and responsibilities of each in the reporting of faults with wrist alarms"
    Read full story
    Source: BBC News, 26 June 2024
  16. Patient Safety Learning
    NHS England has warned trusts corridor care “must not be considered the norm”, adding that the failings exposed by a recent undercover documentary were “not acceptable”.
    In a letter to boards after a Dispatches documentary filmed at Royal Shrewsbury Hospital aired on Monday, NHSE’s chief operating officer, chief nursing officer, national medical director and director of urgent and emergency care warned trusts they must ensure basic standards of care.
    The note, seen by HSJ, described footage filmed at RSH’s emergency department as “stark”, adding that it highlighted the service some patients receive is “not acceptable”.
    The documentary captured many instances of patients being treated in corridors, and the letter said corridor care or that delivered outside a normal cubicle environment “must not be considered the norm”.
    NHSE added: “It should only be in periods of escalation and with board-level oversight at trust and system level… where it is deemed a necessity… it must be provided in the safest and most effective manner possible, for the shortest period of time… with patient dignity and respect being maintained throughout.”
    Read full story (paywalled)
    Source: HSJ, 27 June 2024
    Related reading on the hub:
    A silent safety scandal: A nurse’s first-hand account of a corridor nursing shift
     
  17. Patient Safety Learning
    A cancer patient has told Sky News it's "terrifying" for her health that junior doctors are striking again from Thursday.
    The NHS is expecting "major disruption" during the five-day strike as medics in England walk out over pay amid a yellow health alert heatwave and ongoing disruption to some services because of a ransomware cyber attack earlier this month.
    Major hospitals Guys' and St Thomas' and King's in London are still running at reduced capacity after the incident.
    Cancer survivor Donia Youssef has annual colonoscopies but her last was cancelled because of previous industrial action by junior doctors.
    Donia, from Grays in Essex, said: "It's a worry as a mum with two young children and I was on the list. It got cancelled. First time because of the strikes. And after that I didn't hear from them. So I kept pushing. Nothing. It was just more delays. I was just kept waiting.
    "[They said]: 'There's a backlog. We'll get back to you. There's a backlog, they're getting through. We'll let you know if there's any cancellations.'"
    "It's like months later. Nothing. So eventually, because the symptoms are getting worse, I decided to pay."
    Donia was so scared of her health worsening she paid for private treatment, a cost she could barely afford. And now, as a cancer survivor, every time there's a fresh round of strikes she is filled with dread.
    "I get scared. I can't get [treatment] on the private and a lot of it's really expensive. So, yeah, it's terrifying. So you're constantly aware," she said.
    Read full story
    Source: Sky News, 27 June 2024
  18. Patient Safety Learning
    The Care Quality Commission has admitted it is failing to keep patients “safe” and is losing the confidence of ministers and the NHS, HSJ  has discovered.
    HSJ has seen part of an internal “problem statement” produced by interim chief executive Kate Terroni. It says that “stakeholders and the Department of Health and Social Care are losing confidence in our ability to deliver our purpose”.
    The statement adds: “The way we work is not working and we are not consistently keeping people who use services safe.
    “Our people are not able to effectively identify and manage risk and encourage improvement and innovation.
    “Our organisational structure, flow of decision making, roles, internal and external relationships do not promote a productive and credible way of working.” 
    Read full story (paywalled)
    Source: HSJ, 26 June 2024
  19. Patient Safety Learning
    A patient in a West Midlands A&E was forced to urinate while lying in a corridor as another was left crying in agony for hours in an undercover report highlighting the NHS’ emergency care crisis.
    A Channel 4 Dispatches programme has exposed the “suffering and indignity faced by patients on a daily basis” after an undercover reporter secretly filmed himself working as a trainee healthcare assistant inside the emergency department of the Royal Shrewsbury Hospital for two months. The footage, which aired on Monday night, shows one patient waiting 30 hours in a “fit to sit” area while a suspected stroke sufferer was there for 24 hours, the broadcaster said.
    In one clip, an elderly man was forced to urinate in a trolley on the corridor in full view of staff and other patients, while in another a woman is left crying in agony for hours. Nurses are also seen discussing how one of their patients was forced to wait a staggering 46 hours for care and at one point the footage shows large pools of blood on the floor.
    Experts have said while the scenes were “shocking” and “harrowing” they were not unique to the Royal Shrewsbury Hospital and are occurring in hospitals across England.
    Read full story
    Source: The Independent, 25 June 2024
  20. Patient Safety Learning
    Almost half of long-term antidepressant users could stop taking the medication with GP support and access to internet or telephone helplines, a study suggests.
    Scientists said more than 40% of people involved in the research who were well and not at risk of relapse managed to come off the drugs with advice from their doctors.
    They also discovered that patients who could access online support and psychologists by phone had lower rates of depression, fewer withdrawal symptoms and reported better mental wellbeing.
    Prof Tony Kendrick, of Southampton University, who was the lead author of the research, said the findings were significant because they showed high numbers of patients withdrawing from the drugs without the need for costly intense therapy sessions.
    He said: “This approach could eliminate the risk of serious side-effects for patients using antidepressants for long periods who have concerns about withdrawal.
    “Offering patients internet and psychologist telephone support is also cost-effective for the NHS. Our findings show that support not only improves patient outcomes but also tends to reduce the burden on primary healthcare while people taper off antidepressants.”
    Read full story
    Source: The Guardian, 26 June 2024
  21. Patient Safety Learning
    The NHS is having to provide emergency care to rising numbers of patients suffering serious complications following weight loss surgery and hair transplants abroad amid a “boom” in medical tourism, doctors have warned.
    Medics said they were being left to “pick up the pieces” as more Britons seeking cheap operations overseas return with infections and other issues. In some cases, patients are dying as a result of botched surgeries performed in other countries.
    Hospitals have even had to cancel elective procedures for patients because beds were being taken up by someone who needed an overseas procedure fixed.
    There were also concerns over patients buying weight loss drugs, including Wegovy, abroad without receiving the necessary “wraparound” care, doctors said.
    The British Medical Association’s annual meeting in Belfast heard there had been a “boom” in surgical tourism, which was “leading to a rise in serious post-surgery complications and deaths”.
    Read full story
    Source: The Guardian, 25 June 2024
  22. Patient Safety Learning
    The UK is at a "tipping point", with low uptake of routine vaccinations putting children at risk of catching severe diseases, health officials say.
    Stalling vaccination rates against some diseases, such as whooping cough and measles, means population immunity is no longer high enough to stop outbreaks.
    Latest figures from the UK Health Security Agency (UKHSA), for January-March, show a small increase in some vaccinations, including a 0.3% rise in pre-school booster jabs given to under-fives.
    But targets are still being missed.
    The World Health Organization (WHO) target is for 95% of under-fives to be vaccinated.
    And for the six-in-one jab - against whooping cough, polio and tetanus - and measles, mumps and rubella (MMR) vaccine this was exceeded in Scotland and Wales.
    But for the UK as a whole only 91.5% of under-twos had received the six-in-one jab - and among the whole under-five age group, the proportion was just 84.5%.
    he UK's vaccine committee head, paediatrician Prof Sir Andrew Pollard, is "really worried" by the recent rise in whooping, or "100-day", cough, also known as pertussis, which can be particularly serious for babies and infants.
    "We've already seen some deaths from the most recent outbreak," He told BBC News.
    "We're really at a tipping point, where there's a real risk for more children getting seriously ill or [dying] from diseases we can prevent."
    Read full story
    Source: BBC News, 25 June 2024
  23. Patient Safety Learning
    NHS England has confirmed its patient data managed by blood test management organisation Synnovis was stolen in a ransomware attack on 3 June.
    Qilin, a Russian cyber-criminal group, shared almost 400GB of private information on their darknet site on Thursday night, something they threatened to do in order to extort money from Synnovis.
    In a statement, NHS England said there is "no evidence" that test results have been published, but that "investigations are ongoing".
    More than 3,000 hospital and GP appointments were disrupted by the attack.
    "Patients should continue to attend their appointments unless they have been told otherwise and should access urgent care as they usually would," NHS England said.
    A sample of the stolen data seen by the BBC includes patient names, dates of birth, NHS numbers and descriptions of blood tests, something cyber security expert Ciaran Martin told the BBC was "one of the most significant and harmful cyber attacks ever in the UK."
    Read full story
    Source: BBC News, 24 June 2024
  24. Patient Safety Learning
    Long waiting times at hospitals in the north-west of England are putting patient's lives at risk by holding up ambulance crews, a coroner has warned.
    It comes after the death of Bobilya Mulonge, who called 999 with breathing problems on 24 November 2022.
    She waited 72 minutes for an ambulance - four times longer than North West Ambulance Service's (NWAS) 18-minute target for her category of emergency call - which "probably contributed to her death", coroner Lauren Costello said.
    A NWAS spokesman said the service was "very sorry" an ambulance was unable to attend sooner and the service had made "significant" improvements since.
    A report by Ms Costello has been sent to the health secretary and NWAS and urges the region's health authorities to take action to prevent further deaths.
    She said evidence about ambulance delays revealed during the inquest had given rise to her concerns.
    "In my opinion there is a risk that future deaths could occur unless action is taken," she wrote.
    Dale Ollier, north-west regional organiser for Unison, which represents some ambulance staff, said backlogs in moving patients out of hospitals was having a "knock-on effect" at A&E, leading to a "bottleneck crisis".
    “We have patients that could be safely discharged but there isn’t anywhere to discharge them to because of the lack of capacity in social care."
    Ambulances were working "flat out", he added, but delays had lead to an "unbearable demand" on crews who were sometimes "tied up for several hours" waiting at hospitals.
    Read full story
    Source: BBC News, 20 June 2024
  25. Patient Safety Learning
    A man who has battled the NHS for decades to get his wife mental health support has been told by A&E staff she was not a priority despite being so unwell she was catatonic.
    Steve, a 63-year-old from Hertfordshire, has been supporting his wife, who has schizophrenia, for 30 years and has recalled the “horrific” lack of care she has experienced when at her most ill.
    Despite getting to a state of catatonia and becoming a danger to herself, he has been told on multiple occasions his wife was not a priority in A&E and there were no psychiatric beds available.
    His story comes as a poll of more than 600 people by the charity Rethink Mental Illness revealed two-fifths of mental health patients reported being told they weren’t sick enough to access NHS care.
    The charity, which supports people who suffer from severe mental illness, also found 35% of people reported their condition was considered too severe to be helped.
    Read full story
    Source: The Independent, 25 June 2024
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