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Patient Safety Learning

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  1. Content Article Comment
    Thanks Alex for your comment. We'd love to hear from and publish other view points to our posts. If anyone would like to write a blog to go alongside any of the hub posts please get in touch content@pslhub.org
  2. News Article
    The government is under pressure to go further on measures to relax rules on powerful painkillers such as morphine to prevent patients suffering “unnecessary pain and distress in the last days of their lives”. On Tuesday the health secretary, Matt Hancock, announced staff in care homes and hospices would be allowed to “re-use” controlled drugs such as morphine and midazolam, with medication prescribed for one patient used for another where there is an immediate need. But the Home Office today confirmed to The Independent that it had no plans to extend the rules to the care of patients in their own homes – a restriction experts and charities have warned could leave people suffering at the end of their lives. The government announced the changes following concerns over the supply of drugs. The Royal College of GPs (RCGP) welcomed the changes announced by Mr Hancock, calling them “a significant step forward”, but added: “This only applies to patients living in care home and hospice settings, so there is still work to be done to ensure patients living in their own homes have appropriate access to necessary medication in a timely way.” Last week the RCGP wrote to home secretary Priti Patel warning that people were suffering unnecessarily due to problems accessing drugs. Read full story Source: The Independent, 30 April 2020
  3. News Article
    NHS staff from black, Asian and minority ethnic (BAME) backgrounds should be “risk-assessed” and possibly moved away from patient-facing roles during the coronavirus crisis, according to official guidance. A letter from NHS England acknowledges UK data showing these workers are being “disproportionately affected by Covid-19” and urges health trusts to make “appropriate arrangements”. Public Health England has been asked to look into the issue by the Department of Health, the letter from NHS chief executive Sir Simon Stevens and chief operating officer Amanda Pritchard said. “In advance of their report and guidance, on a precautionary basis we recommend employers should risk assess staff at a potentially greater risk and make appropriate arrangements accordingly,” he added. This could mean BAME health workers being relocated away from patient-facing roles or ensuring they are adequately fitted with personal protective equipment (PPE). Read full story Source: The Independent, 30 April 2020
  4. News Article
    There is growing concern that standard personal protective equipment (PPE), which often has a unisex design, doesn't always fit women properly. The Department of Health said the kit is designed to protect "both genders". However, healthcare workers are saying that even the smallest sizes are too big for some women - who make up 77% of the NHS workforce, according to NHS Digital figures from 2018. If it is too big it can be less effective in providing a complete barrier to the virus. "PPE is designed to be unisex and offer protection for both genders, although some products are available in different sizes to enable fit to both small and larger frames," said the Department of Health, in a statement. But the Royal College of Nursing has described "one-size-fits-all" personal protective equipment as "problematic" and "restrictive" when it can be worn for up to 12 hours during shifts. PPE includes gloves, masks, gowns and face shields. "Nurses can find it very difficult to treat patients if this equipment is so uncomfortable it makes them hot and unwell," said Rose Gallagher, professional lead for infection prevention and control. Read full story Source: BBC News, 29 April 2020
  5. News Article
    People needing hospital treatment for coronavirus are as likely to die as those with Ebola, claim UK researchers. The warning comes as the largest study in Europe showed at least a third of hospital patients with COVID-19 die. The disease is mild for most and can be treated at home, but scientists said people needed to realise how dangerous the infection could be. Obesity, ageing and being male greatly increase the risk of death, according to the data from 166 British hospitals. Medical details on nearly 17,000 coronavirus patients in England, Wales and Scotland have been analysed and it shows that 49% survived and were discharged, 33% have died and 17% were still being treated. "Some people persist in believing that Covid-19 is no worse than a bad dose of flu - they are gravely mistaken," said Calum Semple, the Chief Investigator on the trial, and a Professor in Child Health and Outbreak Medicine at the University of Liverpool. "The crude case fatality rate for people who are admitted to hospital with severe Covid-19 is 35% to 40%, which is similar to that for people admitted to hospital with Ebola. People need to hear this and get it into their heads... this is an incredibly dangerous disease." Read full story Source: BBC News, 29 April 2020
  6. Content Article
    The lack of funding in social care doesn’t only mean that services are unable to meet demand – there is also under-investment in data and analytics. Laura Schlepper explains why social care data matters and what would help to increase its potential.
  7. Content Article
    Ben Burke is a Critical Care Paramedic for South East Coast Ambulance Service. He shares with the hub his practical tips when transferring critical care patients via ambulance.
  8. Event
    until
    In this episode, the Royal Society of Medicine (RSM) will bring together a panel of health experts to answer the most popular questions received so far throughout the RSM COVID-19 webinar series. Further information
  9. News Article
    The rising death toll from coronavirus is never far from the headlines, but hidden behind the daily figures is what public health experts refer to as the "parallel epidemic". This is the wider impact on people's health that is the result of dealing with a pandemic. UK chief medical adviser Prof Chris Witty has been referring to this with increasing frequency during the daily briefings, speaking about the "indirect" costs of coronavirus. But what is it, and how significant could it be? Routine treatments, such as hip and knee replacements, were cancelled across the UK. This alone will have a significant impact on people's lives, though it is unlikely to kill anyone. However, the pandemic has also had a knock-on effect on emergency care. Data collected by Public Health England from a sample of A&E departments in England shows attendances have halved since the pandemic started. The trend has prompted NHS leaders to urge patients to come forward for treatment. Cancer screening has been suspended in Wales, Scotland and Northern Ireland and drastically cut back in England. But it is not only an issue for cancer patients, people with chronic conditions like diabetes or kidney disease may face trying to manage their conditions remotely without the regular face-to-face contact they would have with health professionals. The pandemic is also the 'perfect storm' for mental health. The full impact could take years to unravel. Read full story Source: BBC News, 29 April 2020
  10. News Article
    An overflow system has been added to NHS 111 to help deal with the “huge increase” in calls during the coronavirus pandemic. People displaying coronavirus symptoms who are contacting 111 either via telephone or online are now being diverted to the overspill system, freeing up space for non-covid related enquiries. The tool has been developed by software company Advanced — alongside NHSX, NHS England and NHS Improvement — for its patient management system Adastra, which is used by 80% of NHS 111 providers in England. The overspill add on, which started being rolled out earlier this month, can be accessed by clinicians who are working from home, including those who have been redeployed in the NHS, as well as those in 111 call centres. Ric Thompson, managing director of health and care at Advanced, said the new queuing extension was developed to handle the “huge increase in the number of calls to 111 but also the need to bring back many thousands of retired clinicians”. Read full story Source: HSJ, 29 April 2020
  11. News Article
    Intensive care capacity in London must be doubled on a permanent basis following the coronavirus pandemic, according to the chief executive of the city’s temporary Nightingale hospital. Speaking to an online webinar hosted by the Royal Society of Medicine, Professor Charles Knight said London had around 800 critical care beds under normal operations but “there’s a clear plan to double intensive care unit capacity on a permanent basis”. He added: “We must have a system of healthcare in this country that means, if this ever happened again, that we wouldn’t have to do this, that we wouldn’t have to build an intensive care unit in a conference centre because we had enough capacity under usual operating so that we could cope with surge.” It would also mean the NHS would no longer be in a position “where lots of patients, as we all know, get cancelled every year for lack of an ITU bed,” he said. Read full story Source: HSJ, 28 April 2020
  12. News Article
    The coronavirus pandemic could lead to almost 18,000 more deaths from cancer in England over the next year and there could also be a 20% spike in fatalities of newly diagnosed cancer patients, according to research by University College London (UCL) and DATA-CAN, the Health Data Research Hub for Cancer. The figures stem from real-time hospital data for urgent cancer referrals and chemotherapy attendances, which have experienced a 76% and 60% fall, respectively. Professor Peter Johnson, the NHS Clinical Director for Cancer, has urged people to not hesitate in seeking help or being checked after worrying research showed nearly half of the public have concerns about seeking help. Moreover, the poll by Portland revealed 1 in 10 people would not contact their GP even if they discovered a lump or a new mole that remained for a week or more. Read full story Source: BBC News, 28 April 2020
  13. Content Article
    Martin Bromiley, Clinical Human Factors Group, talks to Claire Cox, Critical Care Outreach Nurse and Associate Director at Patient Safety Learning.  In this podcast, Claire talks about the importance of simulation for all, using different scenarios to help raise confidence. She further describes some techniques her team are using to improve performance and safety when treating COVID-19 patients.  Claire has recently written a blog on Human factors and the ad hoc team during the pandemic for the hub.
  14. Content Article
    The Health and Care Professions Council highlight the work health and care colleagues are doing during the coronavirus pandemic through a series of blogs on their website. The first two are from Stewart Mears, a locum operating department practitioner currently working at University Hospitals Coventry and Warwickshire NHS Trust, and Rachael Moses, Chief Allied Health Professional Lead at NHS Nightingale London.
  15. News Article
    GPs will now be able to access records for patients registered at other practices during the coronavirus epidemic in a major relaxation of current rules. The move will allow appointments to be shared across practices, and NHS 111 staff will also have access to records to let them book direct appointments for patients at any GP practice or specialist centre. The change in policy has been initiated by NHS Digital and NHSX to enable swift and secure sharing of patient records across primary care during the covid-19 pandemic. It means that the GP Connect1 system, currently used by some practices to share records on a voluntary basis, will be switched on at all practices until the pandemic is over. In addition, extra information including significant medical history, reason for medication, and immunisations will be added to patients’ summary care records and made available to a wider group of healthcare professionals. Usually, individuals must opt in but following the changes only people who have opted out will be excluded. Read full story Source: The BMJ, 27 April 2020
  16. News Article
    The government has announced that the “restoration of other NHS services” will start today on a “hospital-by-hospital” basis. Health and social care secretary Matt Hancock in his daily ministerial coronavirus briefing announced the resumption of healthcare which has been suspended due to coronavirus will begin today. He said the initial focus would be on the most urgent services, citing cancer and mental health as examples. They will be reintroduced on a locally decided basis, depending on the level the virus is currently impacting different areas and trusts, which varies widely, and how easily they can reintroduce the work, he said. Mr Hancock, asked about the plan by HSJ during the briefing, indicated that a large-scale return would be enabled because the government is setting out to avoid a so-called second peak of the virus spreading, so the NHS will not need to keep tens of thousands of extra beds free in readiness. Experts and governments around the globe are concerned about the prospect of further peaks of the virus spread as they move to release distancing measures. Further NHS England guidance on the plan is expected later this week. Read full story Source: HSJ, 27 April 2020
  17. Content Article
    The national Patient Safety Improvement Programmes (SIPs) collectively form the largest safety initiative in the history of the NHS. They are delivered by 15 Patient Safety Collaboratives (PSCs), each hosted by an Academic Health Science Network (AHSN). However, while they have done some work in out-of-hospital settings in the five years since PSCs launched, there is massive potential to explore improving patient safety outside of acute hospital trusts and expanding into more community settings. Natasha Swinscoe, patient safety national lead for the AHSN Network, looks at the importance of safer care in community settings, such as care homes.
  18. News Article
    A government campaign has been launched to encourage people who are seriously ill with non-coronavirus conditions such as heart attacks to seek help amid concerns some are avoiding hospitals. The campaign, which will be rolled out this week, aims to encourage people to use vital services – such as cancer screening and care, maternity appointments and mental health support – as they usually would. The NHS chief executive, Sir Simon Stevens, said delays in getting treatment posed a long-term risk to people’s health. He stressed that the NHS was still there for patients without coronavirus who needed urgent and emergency services for stroke, heart attack, and other often fatal conditions. Read full story Source: 25 April 2020,
  19. News Article
    Intensive care units across the country are running out of essentials, including anaesthetics and drugs for anxiety and blood pressure, after a “tripling of demand” sparked by the coronavirus pandemic. Six senior NHS doctors working on the front line, and drugs industry sources, say that the health service is running out of at least eight crucial drugs. Hospitals in London, Birmingham and the northwest of England have been especially badly hit. Doctors said they were being forced to use alternatives to their “drug of choice”, affecting the quality of care being provided to COVID-19 patients. They also warned that some second-choice drugs might be triggering dangerous side effects such as minor heart attacks. Ron Daniels, an intensive care consultant in the West Midlands, said the shortages had become “acute” already. “We don’t know what we’re going to run out of next week,” he said. “Safety isn’t so much the issue — it’s quality. It may be that we’re subjecting people to longer periods of ventilation than we would normally because the drugs take longer to wear off.” Daniels added that some of the “second-line drugs” being used might be challenging to a patient’s heart: “We might be causing small heart attacks or subclinical heart attacks.” Ravi Mahajan, president of the Royal College of Anaesthetists, said work was being carried out to “preserve” key drugs for those most in need. Read full story (paywalled) Source: The Times, 26 April 2020
  20. Content Article
    This National Patient Safety Agency (NPSA) booklet presents information concerning how better design can be used to make the dispensing process safer in community pharmacies, dispensing doctor practices and hospital pharmacies. There are a number of new factors that will impact on the dispensing process, such as: electronic prescription services; auto-id and automation technologies; more responsibilities for pharmacy technicians; and enhanced pharmacy services. These factors have been incorporated into these safer design recommendations Organisations, managers and healthcare workers involved in dispensing medicines should use this booklet as a resource to help introduce new initiatives to further minimise harms from medicines.
  21. News Article
    Four in ten people are not seeking help from their GP because they are afraid to be a burden on the NHS during the pandemic, polling by NHS England reveals. The findings – from a survey of 1,000 people – are the latest in a wave of evidence that fewer people are seeking care for illnesses other than those related to coronavirus during the pandemic. GP online reported on 20 April that data collected by the RCGP showed a 25% reduction in routine clinical activity in general practice, and figures from Public Health England (PHE) and the British Heart Foundation show that A&E attendances overall and patients going to hospital for heart attacks are down 50%. Warnings that patients' reluctance to come forward could put them at risk come as leading charities warned that suspension of some routine GP services during the pandemic could also lead to a 'future crisis' if control of conditions such as asthma and COPD deteriorate. Professor Carrie MacEwen, chair of the Academy of Medical Royal Colleges, said: 'We are very concerned that patients may not be accessing the NHS for care because they either don’t want to be a burden or because they are fearful about catching the virus. 'Everyone should know that the NHS is still open for business and it is vitally important that if people have serious conditions or concerns they seek help. This campaign is an important step in ensuring that people are encouraged to get the care they need when they need it.' Read full story Source: GP online, 25 April 2020
  22. Content Article
    As the coronavirus pandemic continues to spread around the world, the global shortage of personal protective equipment (PPE) becomes more acute. With a 3D printer, however, it is possible—while supplies last—for ordinary citizens to manufacture PPE and make them available to hospitals and clinics in their communities. Columbia University shows you how.
  23. News Article
    We don’t yet know the number of NHS staff who have lost their lives in the battle against COVID-19. On Wednesday, Dominic Raab put the figure at 69, but the true figure is considered to be far greater. These deaths are not “natural” casualties of the coronavirus pandemic. In fact, they may be the result of a failure in the government’s duty to care for NHS staff, which is why it is vital it is properly investigated under the law. Since the pandemic reached the UK, we have heard countless reports of doctors and nurses raising the alarm over the lack of personal protective equipment (PPE) when treating COVID-19 patients. How many of these deaths could have been prevented had sufficient PPE been provided to NHS workers? And if there is a lack of PPE, how did this happen? The health secretary, Matt Hancock, says the biggest challenge is “one of distribution rather than one of supply”. Should more have been done to meet this challenge, and if so what? Does the government have a legal duty to do more to protect the lives of healthcare workers? There must be investigations into the individual deaths of NHS workers, out of respect to them, and also so that future deaths can be prevented. The evidence appears to be that the government has failed to protect them from risk to their lives, and if that is the case then an investigation will be required by law. Read full story Source: The Guardian, 25 April 2020
  24. News Article
    A coronavirus patient’s terrifying hospital experience inspired an NHS doctor to create a flashcard system to improve communication with medical staff wearing face masks. Anaesthetist Rachael Grimaldi founded CARDMEDIC while on maternity leave after reading about a COVID-19 patient who was unable to understand healthcare workers through their personal protective equipment (PPE). Her system enables medical staff to ask critically ill or deaf coronavirus patients important questions and share vital information on digital flashcards displayed on a phone, tablet or computer. The idea went from concept to launch on 1 April in just 72 hours and is now being used by NHS trusts and hospitals in 50 countries across the world. Read full story Source: The Guardian, 25 April 2020 Read the 'Story behind CARDMEDIC', written by Rachael for the hub
  25. News Article
    A serious coronavirus-related syndrome may be emerging in the UK, according to an “urgent alert” issued to doctors, following a rise in cases in the last two to three weeks, HSJ has learned. An alert to GPs and seen by HSJ says that in the “last three weeks, there has been an apparent rise in the number of children of all ages presenting with a multisystem inflammatory state requiring intensive care across London and also in other regions of the UK”. It adds: “There is a growing concern that a [covid-19] related inflammatory syndrome is emerging in children in the UK, or that there may be another, as yet unidentified, infectious pathogen associated with these cases.” Little is known so far about the issue, nor how widespread it has been, but the absolute number of children affected is thought to be very small, according to paediatrics sources. The syndrome has the characteristics of serious COVID-19, but there have otherwise been relatively few cases of serious effects or deaths from coronavirus in children. Some of the children have tested positive for COVID-19, and some appear to have had the virus in the past, but some have not. Read full story Source: HSJ, 27 April 2020 Do you work in paediatrics? Have you seen similar trends emerging? What are your thoughts on the concerns raised? Join the conversation in the hub community area:
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