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Patient Safety Learning

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  1. Patient Safety Learning
    A senior coroner has warned that more allergy sufferers will die due to a “lack of national leadership” following the death of a 17-year-old aspiring doctor.
    Heidi Connor said the “tragic” case of Alexandra Briess was “not new territory”, citing three recent cases where people had died from anaphylaxis.
    She has now written to the Government saying lives are at risk without better funding and research into the condition and calling for the appointment of an allergies tsar.
    The Berkshire coroner’s warning comes after an inquest into the death of “bright and well loved” Alexandra, who died from a reaction to a common anaesthetic.
    Read full story (paywalled)
    Source: The Times, 18 April 2023
  2. Patient Safety Learning
    A silent crisis in men’s health is shortening the life spans of fathers, husbands, brothers and sons.
    For years, the conventional wisdom has been that a lack of sex-specific health research mainly hurts women and gender minorities. While those concerns are real, a closer look at longevity data tells a more complicated story.
    Across the life span — from infancy to the teen years, midlife and old age — the risk of death at every age is higher for boys and men than for girls and women:
    Men are at a greater risk of dying from covid-19 than women, a gap that cannot be explained by rates of infection or preexisting conditions.  More men die of diabetes than women.  The cancer mortality rate is higher among men — 189.5 per 100,000 — compared with 135.7 per 100,000 for women.  Men die by suicide nearly four times more often than women, based on 2020 data from the Centers for Disease Control and Prevention.  “Some people think health care is a zero sum gain and one dollar to men’s health is taking something away from women,” said Ronald Henry, president and co-founder of the Men’s Health Network, an advocacy group. “That’s wrong. We are fully supportive of women’s health efforts and improving quality of life for women.”
    "But by viewing men as the privileged default, health experts are ignoring important sex differences that could illuminate health issues across gender and minority groups."
    Read full story (paywalled)
    Source: The Washington Post, 17 April 2023
  3. Patient Safety Learning
    A tribunal which allowed a doctor's voluntary removal from the medical register was an "unlawful corner-cutting exercise", a judge has said.
    Neurologist Michael Watt was at the centre of Northern Ireland's biggest recall of patients.
    The Medical Practitioners Tribunal Service (MPTS) allowed him to voluntarily remove himself in 2021. It meant he would not face a public hearing about any fitness to practice issues.
    More 2,500 patients who were in his care had their cases reviewed - with around one in five having their diagnosis changed.
    Having already quashed the decision to grant removal, Mr Justice McAlinden delivered a scathing assessment of how the application was handled on Monday.
    In Belfast's High Court, he described the process where Dr Watt's request was heard without the necessary jurisdiction as a "fiasco".
    The court also heard how Dr Watt appeared to have a "get out of jail free card" where patients were denied public scrutiny of their medical care.
    Read full story
    Source: BBC News, 17 April 2023
  4. Patient Safety Learning
    Thousands of women are to be called for smear tests after errors in Scotland's cervical screening programme.
    In June 2021 it was discovered that several women had died from cervical cancer after being wrongly excluded from NHS Scotland's screening list.
    Now a further review expects to find 13,000 patients who have had a hysterectomy will need further tests.
    MSPs were told two years ago that a small number had died from cervical cancer after wrongful exclusion from the programme, and that further incorrect exclusions were possible.
    The most common reason for exclusion was after a total hysterectomy, where the entire cervix has been removed, meaning there was no need for cervical screening. But some were recorded as having had this procedure where there was only a sub-total or partial hysterectomy, meaning cervical screening was still needed.
    An urgent audit followed and all affected women were invited for follow-up examination. Now, a wider audit of 150,000 women who have had subtotal hysterectomies has been launched.
    Read full story
    Source: BBC News, 17 April 2023
  5. Patient Safety Learning
    Almost 200,000 hospital appointments and procedures in England were cancelled during last week’s junior doctors’ strikes, it has been revealed.
    There were 20,000 more appointments cancelled in the strikes that ran between 11 and 15 April than in the shorter strike in March, NHS England figures show. A total of 27,361 staff were not at work during the peak of the strikes, though the true figure could be higher as some workforce data was incomplete.
    The NHS’s national medical director, Prof Sir Stephen Powis, said the figures showed the “colossal impact of industrial action on planned care in the NHS”, with nearly half a million appointments rescheduled over the last five months.
    He said every postponed appointment had “an impact on the lives of individuals and their families and creates further pressure on services and on a tired workforce – and this is likely to be an underestimate of the impact as some areas provisionally avoided scheduling appointments for these strike days”.
    Read full story
    Source: The Guardian, 17 April 2023
  6. Patient Safety Learning
    An MPs' report is calling for faster progress to tackle "appalling" higher death rates for black women and those from poorer areas in childbirth.
    The Women and Equalities Committee report says racism has played a key role in creating health disparities.
    But the many complex causes are "still not fully understood" and more funding and maternity staff are also needed.
    The NHS in England said it was committed to making maternity care safer for all women.
    The government said it had invested £165m in the maternity workforce and was promoting careers in midwifery, with an extra 3,650 training places a year.
    Black women are nearly four times more likely than white women to die within six weeks of giving birth, with Asian women 1.8 times more likely, according to UK figures for 2018-20.
    And women from the poorest areas of the country, where a higher proportion of babies belonging to ethnic minorities are born, the report says, are two and a half times more likely to die than those from the richest.
    Caroline Nokes, who chairs the committee, said births on the NHS "are among the safest in the world" but black women's raised risk was "shocking" and improvements in disparities between different groups were too slow.
    "It is frankly shameful that we have known about these disparities for at least 20 years - it cannot take another 20 to resolve," she added.
  7. Patient Safety Learning
    The government is investigating reports that growing numbers of people are developing life-changing allergies to some gel nail products.
    Dermatologists say they are treating people for allergic reactions to acrylic and gel nails "most weeks".
    Dr Deirdre Buckley of the British Association of Dermatologists urged people to cut down on gel nail use and stick to "old-fashioned" polishes.
    Some people have reported nails loosening or falling off, skin rashes or, in rarer cases, breathing difficulties, she said.
    Although most gel polish manicures are safe and result in no problems, the British Association of Dermatologists is warning that the methacrylate chemicals - found in gel and acrylic nails - can cause allergic reactions in some people.
    It often occurs when gels and polishes are applied at home, or by untrained technicians.
    Dr Buckley said: "We're seeing it more and more because more people are buying DIY kits, developing an allergy and then going to a salon, and the allergy gets worse."
    The allergies can leave sufferers unable to have medical treatments like white dental fillings, joint replacement surgery and some diabetes medications. This is because once a person is sensitised, the body will no longer tolerate anything containing acrylates.
    Read full story
    Source: BBC News, 15 April 2023
  8. Patient Safety Learning
    The deaths of 650 patients treated by a breast cancer surgeon who was convicted of maiming hundreds are being investigated, it has been reported.
    Once one of the country’s leading doctors, Ian Paterson carried out thousands of operations before he was jailed for uneccesarily performing hundreds of life-changing surgeries.
    The Sunday Times has now revealed medical experts are sifting through the records of women who were cared for by the disgraced surgeon over more than twenty years.
    He is currently serving a 20-year jail term, having been found guilty of 17 counts of wounding with intent. Many of the procedures, which took place between 1997 and 2011, had “no medically justifiable reason”, a court heard.
    According to The Sunday Times, 27 inquests have been opened in cases where coroners “believe there is evidence to have reason to suspect that some of those deaths may be unnatural”.
    Read full story
    Source: The Independent, 16 April 2023
  9. Patient Safety Learning
    An all-out nurses’ strike over the May bank holiday will present “serious risks and challenges” to the NHS, a health leader has warned.
    Sir Julian Hartley, chief executive of NHS Providers, said the “unprecedented” strike action – which will involve staff in emergency departments, intensive care units and cancer care for the first time – was “extremely worrying”.
    He also said the threat of coordinated industrial action with junior doctors could result in the “most difficult challenge” for the NHS to date.
    Sir Julian told BBC Breakfast: “If this takes place in the way that it’s been described, then it would be the first time that we’ve seen nurses not working in those key areas, which of course would present serious risks and challenges for trusts to manage and mitigate that.”
    Nick Hulme, chief executive of Ipswich and Colchester hospitals, told Radio 4 the latest round of nurses’ strikes will “significantly increase the risk to patients”, adding cancer patients will face greater risks as care could be delayed.
    He said: “If there is a delay to cancer care, some delays won’t cause significant effects, but there are many people who have been waiting far too long for care and this will only exacerbate that risk."
    Read full story
    Source: The Independent, 16 April 2023
  10. Patient Safety Learning
    A father whose baby died at six weeks after his vitamin K jab was missed has urged parents not to be taken in by misinformation spreading across social media.
    Alex Patto, 33, and his wife wanted their newborn son, William, to have the vitamin K jab to protect him against a rare but serious bleeding disorder known as vitamin K deficiency bleeding (VKDB).
    But the Rosie Hospital in Cambridge missed the jab and their firstborn child tragically passed away at six weeks old after suffering a bleed on his brain.
    Cambridge University Hospitals NHS Foundation Trust has completed a serious incident report and an inquest is due to take place in the coming months.
    Having gone through baby loss, Alex said he finds it “hard to understand” why parents would trust unverified information on social media over advice from their healthcare professional to opt into the jab.
    iNews previously revealed an increase in anti-vaccination misinformation on social media discouraging parents from getting the vitamin K jab for their newborn babies. The jab is a vitamin injection, not a vaccine – which are given to protect against infectious diseases – but doctors have reported videos on social media are incorrectly mislabelling it as such.
    Read full story
    Source: iNews, 23 March 2023
  11. Patient Safety Learning
    A company which ran children's homes where residents were systemically abused also failed to prevent adults being harmed, BBC News has learned.
    An investigation found 99 cases of abuse at a Doncaster home for vulnerable adults in 2010. One worker even ordered a Taser to use there.
    The care home company - Hesley - said improvements were made at the time. But children at other Hesley homes were later reported to have been punched, kicked and fed chillies.
    The BBC reported in January how more than 100 reports of appalling abuse and neglect - dating from 2018 to 2021 - were uncovered at sites run by the Hesley Group. They included children being locked outside in freezing temperatures while naked, and having vinegar poured on wounds.
    Now the BBC has obtained confidential reports from within Hesley and the local authority which reveal wider safeguarding failings spanning more than a decade at both children's homes and placements for vulnerable young adults.
    Read full story
    Source: BBC News, 14 April 2023
  12. Patient Safety Learning
    A quarter of a million children in the UK with mental health problems have been denied help by the NHS as it struggles to manage surging case loads against a backdrop of a crisis in child mental health.
    Some NHS trusts are failing to offer treatment to 60% of those referred by GPs, the research based on freedom of information request responses has found.
    The research carried out by the House magazine and shared with the Guardian also revealed a postcode lottery, with spending per child four times higher in some parts of the country than others, while average waits for a first appointment vary by trust from 10 days to three years.
    Olly Parker, head of external affairs at YoungMinds, said the freedom of information findings showed a “system is in total shutdown” with “no clear government plan to rescue it”, after the 10-year mental health plan was scrapped.
    “In the meantime, young people are self-harming and attempting suicide as they wait months and even years for help after being referred by doctors,” he said. “This is not children saying ‘I’m unhappy.’ They are ill, they are desperate and they need urgent help.”
    Read full story
    Source: The Guardian, 16 April 2023
  13. Patient Safety Learning
    Junior doctors have been accused of putting “politics above patient safety” as figures showed excess deaths almost tripled after their strikes.
    Office of National Statistics (ONS) figures showed the number of deaths above average increased significantly in the two weeks during and after the first round of industrial action by the British Medical Association (BMA).
    Junior doctors walked out for 72 hours between March 13 and 15, with more than 175,000 appointments and operations cancelled. Health experts said the walkout around that time could be linked to the rise.
    A government source said: “The militant leaders of the BMA junior doctors committee seem willing to put politics above patient safety. They have adopted increasingly hardline tactics whilst demanding a completely unrealistic 35 per cent pay rise. 
    Read full story (paywalled)
    Source: The Telegraph, 13 April 2023
  14. Patient Safety Learning
    “You’re just unlucky,” the doctor told me. Whichever GP I saw, wherever I was, male or female, I would be asked the same questions. Do you drink alcohol? Are you sexually active? Is your underwear too tight? If I heard another woman being relentlessly quizzed like that today, I’d probably call it victim blaming."
    "... when you’re told, over and over, that it’s just bad luck and that some women suffer more than others, you believe it. You put your trust in the professionals. You don’t advocate for yourself because you don’t understand that there’s anything that needs fighting for."
    Claire Cohen, 39, had spent much of her life since her mid-teens in acute pain, begging for help. Now she’s finally been diagnosed with endometriosis, she looks at how medicine is still failing to treat a condition that can have a devastating effect on one in ten women
    Read full story (paywalled)
    Source: The Times, 13 April 2023
  15. Patient Safety Learning
    Thousands of children with severe developmental disorders have finally been given a diagnosis, in a study that found 60 new diseases.
    Children, and their parents, had their genetic code - or DNA - analysed in the search for answers to their condition.
    There are thousands of different genetic disorders. Having a diagnosis can lead to better care, help parents to decide whether to have more children, or simply provide an explanation for what is happening.
    The Deciphering Developmental Disorders study, conducted over 10 years in the UK and Ireland, was a collaboration between the NHS, universities and the Sanger Institute, which specialises in analysing DNA.
    Among the findings, researchers discovered Turnpenny-Fry syndrome.
    Jessica Fisher's son, Mungo - who took part in the study - was diagnosed with the syndrome.
    Jessica subsequently started an online support group for the syndrome, which is now made up of 36 families from around the world, including America, Brazil, Croatia and Indonesia.
    "It's devastating to learn that your child has a rare genetic disorder, but getting the diagnosis has been key to bringing us together," said Jessica.
    Read full story
    Source: BBC News, 13 April 2023
  16. Patient Safety Learning
    Around 10 per cent of the 1.2 million accident and emergency attendees in February waited 12 hours or more, newly published NHS England data has revealed, laying bare the true extent of the NHS’s emergency care crisis.
    The data – which NHSE has collected for years but has only now started to publish – shows 125,505 patients waited 12 hours or more from their arrival at A&E to be admitted, transferred or discharged.
    This is more than double the highest figure under the existing metric of around 55,000, which only starts the clock from when the patient has received a decision to admit.
    NHSE’s decision to publish the data for 12-hour breaches from time of arrival follows a concerted campaign by the Royal College of Emergency Medicine, which has long raised concerns the measure from decision to admit has significantly masked the true extent of long waits in A&E.
    Read full story (paywalled)
    Source: HSJ, 13 April 2023
  17. Patient Safety Learning
    Ghana is the first country to approve a new malaria vaccine that has been described as a "world-changer" by the scientists who developed it.
    The vaccine - called R21 - appears to be hugely effective, in stark contrast to previous ventures in the same field.
    Ghana's drug regulators have assessed the final trial data on the vaccine's safety and effectiveness, which is not yet public, and have decided to use it.
    The World Health Organization is also considering approving the vaccine.
    Malaria kills about 620,000 people each year, most of them young children.
    It has been a massive, century-long, scientific undertaking to develop a vaccine that protects the body from the malaria parasite.
    But widespread use of the vaccine hinges on the results of a larger trial involving nearly 5,000 children.
    These had been expected to take place at the end of last year, but have still not been formally published. However, they have been shared with some government bodies in Africa, and scientists.
    Read full story
    Source: BBC News, 13 April 2023
  18. Patient Safety Learning
    The UK is experiencing a “rapidly escalating” diabetes crisis, with cases topping five million for the first time and under-40s increasingly affected, a report has revealed.
    About 90% of diabetes patients have type 2, a condition much more likely to develop if people are overweight. About two-thirds of adults in the UK are overweight or obese.
    Statistics published by Diabetes UK reveals an all-time high for type 2 and type 1 combined of 4.3m officially diagnosed cases and another 850,000 people living with one or other of the conditions but still to be diagnosed. Another 2.4 million people are at high risk of developing the type 2 form in the UK.
    “These latest figures show we’re in the grip of a rapidly escalating diabetes crisis, with spiralling numbers of people now living with type 2 diabetes and millions at high risk of developing the condition,” said Chris Askew, the chief executive of Diabetes UK.
    “These latest figures show we’re in the grip of a rapidly escalating diabetes crisis, with spiralling numbers of people now living with type 2 diabetes and millions at high risk of developing the condition,” said Chris Askew, the chief executive of Diabetes UK.
    The stark figures mean millions of Britons are at increased risk of complications including heart attacks, kidney failure, stroke, amputation and blindness.
    As a result, the UK faces a public health emergency unless action is taken, Askew said. “Diabetes is serious, and every diagnosis is life-changing. It’s a relentless condition, and the fear of serious complications is a lifelong reality for millions of people across the UK.
    “But it doesn’t have to be this way. With the right care and support, cases of type 2 diabetes can be prevented or put into remission. What we need to see is the will, grit and determination from government and local health leaders to halt this crisis in its tracks and improve the future health of our nation for generations to come.”
    Read full story
    Source: The Guardian, 13 April 2023
  19. Patient Safety Learning
    England’s pharmacies are on the brink of collapse – struggling with a shortage of staff and medical supplies – combined with increased patient demand and soaring costs, according to an industry survey shared exclusively with this programme.
    Staff say that some patients are so frustrated by the supply problems, they’re getting aggressive.
    The Pharmaceutical Services Negotiating Committee, the industry body which carried out the survey, says the Government and NHS need to step in now, before it’s too late.
    View video
    Source: Channel 4 News, 12 April 2023
  20. Patient Safety Learning
    A top doctor has blamed a "dysfunctional" culture at NHS Highland for a crisis in medical recruitment and retention engulfing its rural hospitals.
    Dr Gordon Caldwell, a consultant physician who was the clinical lead at Lorn and Islands hospital in Oban until he resigned last summer, said there "still seems to be a lot of fear" among staff more than four years on from a bullying scandal that cost the health board nearly £3 million in settlements.
    Dr Caldwell - who joined NHS Highland in 2018 - said an exodus of senior consultants from Oban and Fort William over the past 18 months is down to management "undermining us, bullying us, and blaming us for problems that were due to a lack of leadership".
    The 66-year-old, who is internationally regarded for his expertise in medical education, became so concerned about the impact on junior doctor training in Oban that he whistleblew to NHS Education for Scotland (NES) while on sick leave for stress after finding his own internal complaints rebuffed.
    A resulting inspection report, published in May last year, said NES had "serious concerns about the training environment" at Lorn and Islands hospital, including around the "safety of care".
    Read full story
    Source: The Herald, 1 April 2023
  21. Patient Safety Learning
    Staff in hospital emergency departments in England are struggling to spot when infants are being physically abused by their parents, raising the risk of further harm, an investigation has found.
    Clinicians often do not know what to do if they are concerned that a child’s injuries are not accidental because there is no guidance, according to a report from the Healthcare Safety Investigation Branch (HSIB) that identifies several barriers to child safeguarding in emergency departments.
    Matt Mansbridge, a national investigator, said the report drew on case studies of three children who were abused by their parents, which he said were a “hard read” and a “stark reminder” of the importance of diagnosing non-accidental injuries quickly, since these are the warning sign in nearly a third of child protection cases for infants under the age of one.
    “For staff, these situations are fraught with complexity and exacerbated by the extreme pressure currently felt in emergency departments across the country,” Mansbridge said. He said the clinicians interviewed wanted to “see improvement and feel empowered” to ask difficult questions.
    “The evidence from our investigation echoes what staff and national leads told us – that emergency department staff should have access to all the relevant information about the child, their history and their level of risk, and that safeguarding support needs to be consistent and timely/ Gaps in information and long waits for advice will only create further barriers to care,” he said.
    Read full story
    Source: The Guardian, 13 April 2023
  22. Patient Safety Learning
    Many care home staff worked extra hours without extra pay to prop up the system during the pandemic, a study suggests.
    Public money helped stabilise UK care homes during the first wave of Covid-19 but it was withdrawn too soon and not focused on staff, says the research, led by Warwick Business School.
    The researchers studied the accounts of more than 4,000 UK care home companies, from just before the pandemic and during the first year of the health crisis.
    They found nearly two thirds (60%) of care homes were already financially fragile as the pandemic took hold.
    The report concludes: "The decision by government to end financial support for care home companies after the peak of the pandemic had passed has likely contributed to the current financial and operational difficulties experienced by the sector."
    It states the financial plight of many staff and the immense pressure they were under "means it is not surprising the care home sector has struggled to both recruit and retain staff once lockdown restrictions were removed and the wider economy re-opened".
    Read full story
    Source: BBC News, 12 April 2023
  23. Patient Safety Learning
    More than two million patients each year have to make four or more repeat visits to their GP before they get a referral, a patient watchdog has warned.
    Patient safety campaigners said people faced waits of “weeks, months or even years” before officially joining NHS waiting lists, and that their health and wellbeing was suffering as a result. They warned it would also add to pressure on other services such as A&E departments.
    Research by Healthwatch England revealed what the patient watchdog called a “hidden waiting list”.
    “People wait for a GP appointment; they wait for their GP to tell them they will be referred; they wait for the hospital to confirm that referral; and then they join a hospital waiting list,” it said.
    “NHS statistics monitor only the hospital waiting list, leaving the steps between getting a GP referral and a letter confirming a hospital appointment as a dangerous ‘blind spot’ for the NHS and patients.”
    Read full story (paywalled)
    Source: The Times, 11 April 2023
  24. Patient Safety Learning
    Covid-19 has dropped out of the top five leading causes of death in England and Wales for the first time since the start of the pandemic, figures show.
    Coronavirus was recorded as the main cause of death for 22,454 people in 2022, or 3.9% of all deaths registered, making it the sixth leading cause overall.
    In both 2020 and 2021 Covid-19 was the leading cause of death, with 73,766 deaths (12.1% of the total) and 67,350 (11.5%) respectively.
    By contrast, dementia and Alzheimer’s disease was the leading cause in England and Wales in 2022, with 65,967 deaths registered (11.4% of the total), up from 61,250 (10.4%) in 2021.
    The other causes in the top five were ischaemic heart diseases (59,356 deaths and 10.3% of the total); chronic lower respiratory diseases (29,815 deaths, 5.2%); cerebrovascular diseases such as strokes and aneurysms (29,274 deaths, 5.1%); and trachea, bronchus and lung cancer (28,571 deaths, 5.0%).
    Read full story
    Source: The Independent, 11 April 2023
  25. Patient Safety Learning
    Hospital bosses are worried about keeping patients safe overnight this week because of a shortage of consultants available to cover for striking junior doctors.
    When junior doctors in England staged their first strike in mid-March in their pay dispute with the government, their consultant colleagues covered for them for the three days involved.
    However, fewer consultants are available to do the same during this week’s four-day stoppage because it coincides with Easter, Passover and Ramadan and many are off.
    NHS Providers, which represents health service trusts, highlighted the difficulty hospital bosses are facing in trying to ensure nightshift medical rotas are fully staffed this week. T
    “Getting through today is just the start. Trust leaders are worried about securing adequate cover for the night shifts ahead. This is going to be a very long, difficult week for the NHS,” said Miriam Deakin, the head of policy at NHS Providers. “Keeping patients as safe as possible, trusts’ No 1 priority, will be even harder than in previous strikes so it’s all hands on deck.”
    Other health professionals, including GPs, paramedics and pharmacists, were helping hospitals ensure patients received good care, Deakin added.
    Read full story
    Source: The Guardian, 11 April 2023
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