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Patient Safety Learning

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  1. Patient Safety Learning
    There has been a rise in the number of young adults in England who report feelings of severe distress, according to a new survey.
    The study found one in five 18 to 24-year-olds said they experienced severe distress at the end of 2022, compared to around one in seven in 2021.
    The research suggested reports of severe distress rose across all age groups, except for those over 65.
    Experts have pointed to the pandemic, cost of living and healthcare crisis.
    Researchers used a point-based score during telephone interviews to assess severe distress for the survey. People had not necessarily sought clinical help or a diagnosis at this point.
    The research team, including academics from King's College London and University College London (UCL), say the rise in reports needs to be urgently addressed.
    Read full story
    Source: BBC News, 7 July 2023
  2. Patient Safety Learning
    An ambulance trust at the centre of an inquiry into alleged cover-ups has shown signs of improvement, according to the Care Quality Commission (CQC).
    North East Ambulance Service Foundation Trust has been accused of withholding information from coroners. An ongoing inquiry chaired by former acute trust chief executive Dame Marianne Griffiths is looking at how it deals with serious incidents, whistleblowers’ concerns and whether the trust complies with the “duty of candour” as well as its processes around inquests. 
    The CQC report suggests it has made progress on many of these areas since inspections last year – which triggered a warning notice – and has raised the rating for its emergency and urgent care division from “inadequate” to “requires improvement”. 
    The inspectors said it was a “mixed picture” but they had seen “the beginnings of a safety culture emerging within the trust”.
    Read full story
    Source: HSJ, 7 July 2023
  3. Patient Safety Learning
    NHS England has issued a ‘tokenistic’ and ‘insulting’ funding settlement for staff mental health and wellbeing hubs this year, which is not enough to provide proper support, HSJ has been told.
    A letter sent by NHSE to its regional directors, and seen by HSJ, confirmed that the hubs have been allocated just £2.3m for 2023-24. NHSE says the funding, which is far below current running costs, must be spent within the financial year.
    It appears to confirm fears that many of the 40 hubs will need to be shut, if they are not funded locally.
    One hub lead said: “Day in, day out, we work with colleagues across the NHS who are struggling with a wide range of mental health issues, from anxiety and depression to burnout and dealing with the impacts of moral injury.
    “Staff are exhausted, overwhelmed by their workload and struggling to give their patients the care they know they deserve.
    “I urge ministers to speak directly to hub leads to find out exactly what the issues are on the ground, and how the hubs are helping staff who are working at their limits, while supporting staff retention.”
    Read full story (paywalled)
    Source: HSJ, 6 July 2023
  4. Patient Safety Learning
    "Dangerous" muscle-building drugs are being sold illegally in shops around the UK, a BBC investigation has found.
    The substances, known as Sarms, can cause erectile dysfunction, mood swings and liver problems, doctors warn.
    Secret filming by the BBC found they were widely available in shops that sell bodybuilding supplements as well as online.
    Responding to the findings, the Royal Pharmaceutical Society (RPS) called for the law to be tightened.
    Sarms - which stands for selective androgen receptor modulators - are body-enhancing drugs that mimic the effects of anabolic steroids, which increase muscle mass and strength.
    Originally developed as an experimental drug to treat muscle-wasting conditions, they have become popular with gym-goers on social media who want to build muscle and lose fat.
    Read full story
    Source: BBC News, 7 July 2023
     
  5. Patient Safety Learning
    The Welsh Government is facing criticism after refusing to appoint an independent Patient Safety Commissioner – a role established in England last year and currently being legislated for in Scotland.
    The moves in England and Scotland follow publication of the Independent Medicines and Medical Devices Safety Review in 2020, which investigated a series of scandals where patients suffered because of negligence and inaction.
    The review recommended the establishment of a Patient Safety Commissioner in England, and last September Dr Henrietta Hughes became the first such commissioner.
    The Scottish Parliament is currently legislating to introduce a Patient Safety Commissioner.
    A Welsh Government spokesman said: “The situation here is different to the other devolved nations. We’ve recently introduced our own legislation and other measures to improve patient safety.
    “We strengthened the powers of the Public Service Ombudsman for Wales to undertake their own investigations and introduced new duties of quality, including safety, and candour for NHS bodies. We have created [the body] Llais to give a stronger voice to people in all parts of Wales on their health and social care services. It has a specific remit to consider patient safety and has the power to make representations to NHS bodies and local authorities and undertake work on a nationwide basis.
    “Our view is that introducing a Patient Safety Commissioner in Wales at this time would create considerable complexity and confusion. Also one of the main roles of the proposed commissioner is in relation to medicines and medical devices, which are not devolved to Wales.”
    Read full story
    Source: Nation Cymru, 6 July 2023
  6. Patient Safety Learning
    GPs should offer all patients presenting with signs of colorectal cancer a faecal immunochemical test (FIT) to reduce the waiting times for a colonoscopy, the National Institute for Health and Care Excellence (NICE) has recommended in draft guidance.
    The current NICE recommendation is to offer FIT to people presenting to primary care with low risk symptoms suggestive of colorectal cancer, while people with high risk symptoms should be immediately referred to the suspected cancer pathway. However, patients often have lengthy waiting times for colonoscopy because of limited capacity.
    NICE estimates that the recommendation should lead to 50% fewer referrals for urgent colonoscopies being made by GPs each year.
    Read full story (paywalled)
    Source: BMJ, 5 July 2023
  7. Patient Safety Learning
    Tens of thousands of children will be treated in “virtual wards” to free hospital beds for more critically ill patients under new NHS plans.
    The Hospital at Home service will be expanded to include paediatric care in every region of England this month, the health service announced.
    As part of the service, clinical teams review patients daily and can provide treatments including blood tests, prescribe medicines or administer fluids through a drip. Ward rounds can include home visits or a video call, and many services use technology such as apps and wearable devices to monitor recovery.
    Professor Simon Kenny, the NHS’s national clinical director for children and young people, said: “The introduction of paediatric virtual wards means children can receive clinical care from home, surrounded by family and an environment they and their parents would rather they be — with nurses and doctors just a call away.” 
    Read full story (paywalled)
    Source: The Times. 5 July 2023
  8. Patient Safety Learning
    The BMA will review the dangers posed by e-cigarettes, after its annual representative meeting passed a motion warning that vaping was a “growing public health epidemic.”
    The motion, which was passed by the meeting in Liverpool on 5 July, called on the BMA’s Board of Science to rereview the dangers of vaping, and discuss restrictions on marketing and cracking down on illegal sales to children. The BMA’s last position paper on vaping was published in 2017.1
    The motion urged the board to consider whether doctors should include history of e-nicotine use as a “regular and essential” part of patient history and examination. 
    Read full story (paywalled)
    Source: BMJ, 5 July 2023
  9. Patient Safety Learning
    Northern Ireland's health system cannot expect its staff to "step up time and time again" to provide patient care and ensure their safety.
    That is according to the head of Northern Ireland's Confederation for Health and Social Care, which is marking the NHS's 75th anniversary.
    A long-term funding plan, political leadership and transformation are all overdue, Michael Bloomfield said.
    "There is a clear vision for what needs to happen, the leaders across the health and social care system know what needs to happen - we just need political leadership to make sure it happens," he told BBC News NI.
    Amid all the celebrations, there are mixed feelings about the current condition and future of health and social care.
    The director of the Royal College of Nursing NI, Rita Devlin, described the idea of not having an NHS as "unthinkable".
    "We need to make sure that the environment that we are asking our nurses to work in is one that values the work that they do and fairly pays and rewards them for what they do," she said.
    Other issues that need addressing, she added, were career pathways, training and ensuring that "when a nurse wants to stay at the bedside, that that is valued equally as the nurses who want to go into management".
    Read full story
    Source: BBC News, 5 July 2023
  10. Patient Safety Learning
    The number of women diagnosed with lung cancer in the UK is expected to overtake men this year for the first time, according to projections that have prompted calls for women to be as vigilant about the disease as they are about breast cancer.
    Lung cancer is the most common cause of cancer death in the UK, accounting for one in five of the total. It has one of the worst cancer survival rates, which is largely attributed to diagnoses at a late stage, when treatment is less likely to be effective.
    Analysis by Cancer Research UK for the Guardian suggests women will overtake men for lung cancer diagnoses in 2022-24. The projections suggest that this year, female cases will eclipse male cases for the first time, with 27,332 and 27,172 cases respectively.
    Cancer experts said the “very stark” figures reflected historical differences in smoking prevalence, specifically that smoking rates peaked much earlier in men than women. Women should now be as alert to potential lung cancer signs as they were about checking for lumps in their breasts, they said.
    Read full story
    Source: The Guardian, 5 July 2023
  11. Patient Safety Learning
    The quality of care that the NHS provides has got worse in many key areas and patients’ long waits to access treatment could become even more common, research has found.
    The coalition government’s austerity programme in the early 2010s led to the heath service no longer being able to meet key waiting time targets, the Nuffield Trust and Health Foundation said.
    Austerity ushered in “really concerning deterioration across the board” in the overall quality of NHS care, as judged by patients’ experience and prevention of ill-health, not just speed of access.
    Analysis by the two thinktanks’ joint Quality Watch programme, which monitors more than 150 indicators of care quality over time, found that in England:
    Fewer people with long-term heath conditions such as cancer, diabetes and depression, are getting enough help to manage their condition. Breast cancer screening rates for women aged 53-74 have fallen. It has become harder for patients to see a named GP. Only 6% of midwives think their maternity unit has enough staff to do its job properly. Read full story
    Source: The Guardian, 5 July 2023
  12. Patient Safety Learning
    The NHS must undergo radical change or it will continue to decline and lose public support, Tony Blair has argued on the service’s 75th anniversary.
    It must embrace a revolution in technology to reshape its relationship with patients and make much more use of private healthcare providers to cut waiting times, the former Labour prime minister says.
    The prevalence of chronic health conditions, long waiting times, the NHS’s stretched workforce and tight public finances in the years ahead mean the service must transform how it operates, he said.
    “The NHS now requires fundamental reform or, eventually, support for it will diminish. As in the 1990s, the NHS must either change or decline,” he writes in the foreword to a new report from his Tony Blair Institute thinktank, which sets out ideas for safeguarding the NHS’s future.
    He adds: “Change is never easy and requires brave political leadership. If we do not act, the NHS will continue down a path of decline, to the detriment of our people and our economy.”
    Read full story
    Source: The Guardian, 5 July 2023
  13. Patient Safety Learning
    Britain’s lead public health body has a staggering lack of control over billions of pounds of spending, and there is no plan for stockpiling vaccines or personal protective equipment (PPE) for a future pandemic, a damning MPs’ report has found.
    The public accounts committee was highly critical of the repeated governance and financial failings at the UK Health Security Agency (UKHSA), which was set up with great fanfare under Boris Johnson.
    Meg Hillier, the committee chair, said it would be “utterly inexcusable” for the government to have failed to make serious preparations for future health emergencies and warned the lack of a plan for stockpiling could leave health workers once again exposed to danger as they were in 2020.
    The committee lambasted the Department of Health and Social Care (DHSC), which oversees UKHSA, for lacking a strategy for reserves of PPE, vaccines and medicines despite its mandate to protect the country’s health security.
    Read full story
    Source: The Guardian, 5 July 2023
  14. Patient Safety Learning
    A Conservative minister has acknowledged the NHS waiting list, which stands at a record high with more than 7.4 million people waiting for treatment in England, will “probably go up” before it goes down.
    Speaking on the 75th anniversary of its creation, the health minister Maria Caulfield claimed the NHS would be “thriving” in 25 years’ time, saying a two-year waiting time had “virtually been eliminated”.
    But experts have called for more investment in the NHS, with Prof Philip Banfield, the British Medical Council’s chair of council, saying the health service is so fragile that it may not survive until its 80th anniversary.
    The shadow health secretary, Wes Streeting, said the NHS would die without “the necessary investment and reform” to change and modernise.
    Read full story
    Source: The Guardian, 5 July 2023
  15. Patient Safety Learning
    NHS England and the government have been criticised for “selective reporting” of statistics by an influential Westminster committee.
    The chair of the Public Accounts Committee Meg Hillier wrote to NHS England CEO Amanda Pritchard requesting “greater realism about the scale of the challenge” on cancer services.
    It follows the government and NHSE claiming in a government response to the committee that they had “implemented” one of its earlier recommendations, to “bring cancer treatment back to an acceptable standard”.
    In their February report on backlogs and waiting times, MPs said cancer delays were “unacceptable” and services should be recovered “as a matter of urgency”. The report also criticised NHSE for “over-optimism” when drawing up cancer and elective recovery plans.
    Read full story (paywalled)
    Source: HSJ,  4 July 2023
  16. Patient Safety Learning
    Maternal mortality rates have doubled in the US over the last two decades - with deaths highest among black mothers, a new study suggests.
    American Indian and Alaska Native women saw the greatest increase, the study in Journal of the American Medical Association (JAMA) said.
    Southern states had the highest maternal death rates across all race and ethnicity groups, the study found.
    In 1999, there were an estimated 12.7 deaths per 100,000 live births and in 2019 that figure rose to 32.2 deaths per 100,000 live births in 2019, according to the research, which did not study data from the pandemic years.
    Unlike other studies, this one examined disparities within states instead of measuring rates at the national level, and it monitored five racial and ethnic groups.
    Dr Allison Bryant, one of the study's authors, said the findings were a call to action "to understand that some of it is about health care and access to health care, but a lot of it is about structural racism".
    She said some current policies and procedures "may keep people from being healthy".
    Read full story
    Source: BBC News, 4 July 2023
  17. Patient Safety Learning
    A "significant" number of doctors are still suffering with the "debilitating effects" of Long Covid, according to a new report.
    Many are left in financial limbo as they have been forced to quit work or reduce their hours, the British Medical Association (BMA) report warns.
    Some 600 doctors with long COVID were quizzed about the impact on their day-to-day lives.
    One in five told the BMA and the Long COVID Doctors for Action group they had been forced to stop work or significantly cut back on their hours.
    Carrying out essential daily activities such as getting dressed, household activities, and childcare have become difficult or not possible for 60% of the medics who took part in the survey.
    Nearly half (49%) said they have experienced loss of earnings as a result of Long Covid symptoms of which include: fatigue, headaches, muscular pain, nerve damage, joint pain, ongoing respiratory problems.
    The BMA has made a series of calls to support doctors with Long Covid, including:
    Financial support for doctors and other health workers with Long Covid. Long Covid to be recognised as an "occupational disease". Better access to physical and mental health services for those affected after the report said that access to NHS long COVID clinics is "patchy". Greater "workplace protection" for staff. More support to help healthcare workers return to work "safely". Read full story
    Source: Medscape, 3 July 2023
  18. Patient Safety Learning
    Thousands of young people are living with post-traumatic stress disorder, with most cases going untreated, a Channel 4 documentary has revealed.
    About 311,000 16- to 24-year-olds in England and Wales have PTSD, with most cases linked to personal assault and violence, according to figures estimated for the show.
    Low awareness of the symptoms and the difficulty of diagnosing PTSD means that 70% of cases go untreated. If the NHS offered more early intervention therapy, it could save £2.4bn in taxpayer money, according to Channel 4’s analysis of research by King’s College London and Office for National Statistics data.
    “When untreated, PTSD – it becomes a chronic condition. It becomes highly disabling. People’s lives can be fundamentally changed,” said Dr Michael Duffy, a psychological trauma specialist at Queen’s University Belfast, who features on the show. He added that it could be more common in areas of high socioeconomic deprivation.
    Read full story
    Source: The Guardian, 4 July 2023
  19. Patient Safety Learning
    Most frontline medics believe ministers are seeking to “destroy the NHS” because they have starved it of cash and mistreated its staff, the leader of Britain’s doctors has said.
    Prof Philip Banfield also warned that the health service, which on Wednesday will mark the 75th anniversary of its creation, is so fragile that it may not survive until its 80th.
    Banfield, the British Medical Association’s chair of council, mounted an unusually strong attack on the government’s handling of the NHS in an interview with the Guardian.
    “This government has to demonstrate that it is not setting out to destroy the NHS, which it is failing to do at this point in time,” he said. “It is a very common comment that I hear, from both doctors and patients, that this government is consciously running the NHS down. [And] if you run it down far enough, it’s going to lead to destruction.
    “You’ll struggle to find someone [among doctors] on the frontline who thinks otherwise, because that’s what it feels like.”
    Read full story
    Source: The Guardian, 4 July 2023
  20. Patient Safety Learning
    The government has rejected calls to set a target and strategy to end ‘appalling’ disparities in maternal deaths.
    In response to a Commons women and equalities committee report, published on Friday, ministers said a “concrete target does not necessarily focus resource and attention through the best mechanisms”.
    The response added: “We do not believe a target and strategy is the best approach towards progress.”
    The government said disparities will be monitored through local maternity and neonatal systems, which are partnerships comprising commissioners, providers and local authorities.
    A recommendation to increase the annual budget for maternity services to up to £350m per year, backed by the now chancellor Jeremy Hunt, and maternity investigator Donna Ockenden, was also rejected.
    Read full story
    Source: HSJ, 3 July 2023
  21. Patient Safety Learning
    Smartwatches might help diagnose Parkinson's disease up to seven years ahead of symptoms, a study suggests.
    The UK Dementia Research Institute team at Cardiff University used artificial intelligence to analyse data from 103,712 smartwatch wearers.
    By tracking their speed of movement over a single week, between 2013 and 2016, they were able to predict which would go on to develop Parkinson's.
    It is hoped this could ultimately be used as a screening tool.
    But more studies, comparing these findings with other data gathered around the world, are needed to check how accurate it will be, the researchers say, in the journal Nature Medicine.
    Read full story
    Source: BBC News, 3 July 2023
  22. Patient Safety Learning
    Premature babies across England will be offered a sight-saving drug, the NHS has announced.
    Retinopathy of prematurity (ROP) is an eye disease that can occur among babies who are born early or those born with a low birth weight.
    The NHS routinely screens these babies for the condition, which affects blood vessels in the retina, creating damaging scar tissue and causing blindness.
    Traditionally the condition is treated with laser eye surgery but some babies are too unwell or fragile to have the treatment.
    Now the NHS is offering new “life-changing” drug ranibizumab to babies with ROP across England who are unable to receive traditional treatment.
    NHS chief executive Amanda Pritchard said: “The impacts of vision loss can be absolutely devastating, particularly for children and young people, so it’s fantastic that this treatment will now give families across the country another life-changing option to help save their child’s precious sight."
    Read full story
    Source: The Independent, 4 July 2023
  23. Patient Safety Learning
    Men who take the epilepsy drug sodium valproate could beat increased risk of having children with disabilities, research has found.
    A study ordered by the European Medicines Agency (EMA) has suggested a link between fathers taking the drug three months before babies are conceived and a small increased likelihood that the children will have neurodevelopmental disorders.
    The drug manufacturer Sanofi has not published the full results, leading to confusion among patients and doctors.
    Sodium valproate, sold in the UK as Epilim, is prescribed to treat epilepsy, bipolar disorder and migraines. It is known to cause deformities in one in ten babies exposed to it in the womb because their mothers are taking the drug. Four in ten babies suffer developmental delays.
    Read full story (paywalled)
    Source: The Times, 2 July 2023
  24. Patient Safety Learning
    Healthcare leaders have called for an urgent plan to tackle the social care crisis, warning Rishi Sunak there is “clear concern” over an ongoing failure to tackle staff shortages.
    The warning from Matthew Taylor, chief executive of NHS Confederation which represents hospitals and community services, comes after the publication of the long-awaited £2.4bn NHS workforce plan, which committed to 300,000 extra nurses and doctors in the coming years.
    Mr Taylor said any benefits to improve NHS staffing will be “limited” without an equivalent strategy for the social care sector, which currently has 165,000 vacant posts.
    Health bosses, represented by NHS Confederation, have now written to the prime minister asking for “urgent intervention” and calling for a clear plan for improving pay and conditions to attract staff.
    Martin Green, chief executive for Care England that represents care homes, warned that the sector “is in the midst of a workforce crisis, which is going to get worse not getting better”.
    He welcomed the NHS Confederation’s letter and said unless similar improvements were made within social care, there would be more “cancelled operations, more people languishing in hospital when they don’t need to and the whole breakdown of the system”.
    Read full story
    Source: The Independent, 2 July 2023
  25. Patient Safety Learning
    Many vulnerable patients are struggling to access covid treatments after commissioning responsibility switched to integrated care boards this week, charities have warned.
    Approximately two million vulnerable patients must now contact local services themselves to access treatments designed to combat covid infections, such as the antivirals Paxlovid and Sotrovimab. Integrated care boards are expected to coordinate and fund “equitable” access.
    Prior to 27 June, identification of patients and the delivery of treatment was coordinated nationally under pandemic arrangements.
    However, a group of 20 patient charities have written to Steve Barclay warning that most ICBs have not drawn up plans to deliver this new responsibility, leaving patients and primary care clinicians unclear on how to access the treatments.
    “Despite continually raising our concerns with those carrying out the planning, implementation, and communication of this [policy], we now find that we are in exactly the position we warned against,” they said. 
    Read full story (paywalled)
    Source: HSJ, 3 July 2023
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