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Patient Safety Learning

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Everything posted by Patient Safety Learning

  1. News Article
    The NHS in England is facing mounting pressure amid a surge in patients attending A&E departments with minor ailments, health bosses have said. Emergency departments, which are designed for serious injuries and life-threatening emergencies only, are seeing an increase in people attending with sore throats, insomnia, coughs and earache. Data analysed by the Press Association news agency also shows more people going to A&E with complaints such as hiccups, nasal congestion, backache and nausea. Cases where sore throat was the chief complaint rose by 77% between 2021-22 and 2022-23, from 191,900 cases to 340,441. Patients going to A&E with coughs rose by 47%, from 219,388 to 322,500, while attendances for nosebleeds rose by a fifth, from 47,285 cases to 56,546. Miriam Deakin, the director of policy and strategy at NHS Providers, said: “The rise in A&E admissions is piling even more pressure on to an already stretched NHS. Persistent strain on primary care services, including GPs and dentists, means patients often resort to A&E when they cannot access timely care elsewhere. “Minor ailments such as coughs, earache, fever, nausea and hiccups can and should be managed through more appropriate services such as pharmacies and NHS 111 online. This could ease pressure on emergency departments, whose priority is to deliver urgent care for those most in need. Boosting capacity of staff, beds and equipment in these settings would also significantly help. However, this requires proper funding and support from the government.” Read full story Source: The Guardian, 10 October 2023
  2. News Article
    About 17,500 women in Northern Ireland are to have their smear tests re-checked as part of a major review of cervical screening dating back to 2008. Some of these women will be recalled to have new smear tests carried out, BBC News NI can reveal. The Southern Trust said that the women affected should receive letters by post from Tuesday. It follows a highly critical report commissioned by the Royal College of Pathologists (RCPath). It found: Several cytology staff were "significantly underperforming". Mechanisms to check their work were flawed. Action taken by management was inadequate over many years. While a majority of negative results issued by the laboratory were correct, a "significant number" of these would likely have been identified as "potentially abnormal" by other laboratories. Read full story Source: BBC News, 9 October 2023
  3. Content Article
    Urgent funding is required to clear waiting list backlogs and drive Northern Ireland's long-term healthcare transformation, the Northern Ireland Audit Office has said in a new report which outlines the health service's "critical situation" after almost a decade of worsening waiting lists for elective care. The NI Audit Office looked at waiting list data from 2014 to 2023. It found the number of patients waiting for elective care has risen by 452,000 during that nine-year period. The Audit Office also said: "Available information suggests waiting list performance levels are significantly worse in Northern Ireland compared with the other UK regions."
  4. Content Article
    This year, WHO's World Mental Health Day on 10 October will focus on the theme 'Mental health is a universal human right'. To mark World Mental Health Day, we’ve pulled together 10 resources, blogs and reports from the hub that focus on improving patient safety across different aspects of mental health services.
  5. Content Article
    The Restraint Reduction Network's mission is to eliminate the unnecessary use of restrictive practices in health, social care and education. They have a range of resources that people with lived experience, parents and carers may find helpful. As all forms of restrictive practice can result in harm, it is important that people are able to identify restrictive practices and challenge their inappropriate use. The resources are designed to support people to understand what restrictive practices are, when and why they might be used, people’s rights, and how to identify and challenge unacceptable and unethical practices.
  6. News Article
    Mental healthcare in England has become “a national emergency”, with “overwhelmed” services unable to cope with a big post-Covid surge in people needing help, NHS bosses say. Care is so stretched that thousands of people undergoing a mental health crisis are having to be admitted every year to acute hospitals, even though they are not set up to deal with them. Hospital bosses claim mental health in England has been “forgotten” by ministers who are giving priority to tackling the record 7.7m-strong care backlog, access to GPs and ongoing NHS strikes. “Mental health has slipped down the government’s set of priorities and patients and services are being forgotten. This is a national emergency which is now having serious consequences across the board, not least for those patients in crisis,” said Matthew Taylor, the chief executive of the NHS Confederation. Read full story Source: The Guardian, 9 October 2023
  7. News Article
    Staff without medical training who fill gaps in the NHS workforce must tell patients they are “not a doctor” when introducing themselves, under new guidance. The advice has been issued to “physician associates” (PAs), a type of clinical role that requires less training than doctors receive, amid a row over their use in the NHS. PAs complete a two-year postgraduate qualification, but no medical degree, and can diagnose and treat patients. They can work in A&E or GP surgeries. NHS England has set out plans to expand the number of PAs to deal with staff shortages, with a workforce of 10,000 PAs wanted over the next decade. The plan has been met with opposition from doctors’ leaders, who say the growing use of PAs instead of fully qualified doctors is leading to missed diagnoses and deaths. Guidance published by the Faculty of Physician Associates, a part of the Royal College of Physicians, said that PAs must not mislead patients into thinking they are doctors. Read full story (paywalled) Source: The Times, 6 October 2023
  8. Content Article
    Physician associates (PAs) are healthcare professionals who work as part of a multidisciplinary team under the supervision of a named senior doctor (a General Medical Council (GMC)-registered consultant or GP). While they are not medical doctors, PAs can assess, diagnose and treat patients in primary, secondary and community care environments within their scope of practice. PAs are part of NHS England’s medical associate professions (MAPs) workforce grouping. MAPs add to the breadth of skills within multidisciplinary teams, to help meet the needs of patients and enable more care to be delivered in clinical settings. PAs do not fall under the allied health professions (AHPs) or advanced practice groups. The Faculty of Physician Associates has created this guidance to provide clarity around the role of PAs. It provides practical examples of how physician associates should describe their role and is aimed at increasing understanding for patients, employers, other healthcare professionals and the public. It is important that PAs take all reasonable steps to inform patients and staff of their role and to avoid confusion of roles. This includes considering the potential for verbal and written role titles to be misunderstood and taking the time to explain their role in any clinical interaction.
  9. Content Article
    It is essential that the voices of people from diverse communities are heard and acted upon because we will only be effective in improving patient safety for everyone if we include these groups. This blog from the Patient Safety Commissioner Dr Henrietta Hughes outlines the importance of listening to patients and staff from diverse communities to identify and act on patient safety issues – and how to make this happen.
  10. News Article
    The boss of a large acute trust has accused a private provider of ‘overpromising and underdelivering’ after significant problems emerged with a local arrangement which have piled further pressure on its waiting list. Mid and South Essex Foundation Trust recently discovered at least 1,000 cases were being returned to the trust from independent provider Omnes Healthcare following “complications” with a pathway for ear, nose and throat patients. CEO Matthew Hopkins told a board meeting last Thursday: “I think other parts of the country, like us, are seeing independent sector providers in some cases overpromising and underdelivering. The consequence of that is what we’ve seen in the ENT example.” The contract is managed by Mid and South Essex Integrated Care Board, which told HSJ it was “very sorry that some patients may have been waiting longer than they should have been” because of the problems. Read full story (paywalled) Source: HSJ, 6 October 2023
  11. News Article
    Only 60% of patients who have had hospital treatment for food anaphylaxis were prescribed medicine to tackle another reaction, a study has found. The study of some 130,000 NHS records where food allergy was mentioned showed 3,589 patients received "unplanned hospital treatment" for anaphylaxis. Of those, only 2,152 were prescribed adrenaline auto-injectors (AAI) at least once. Two leading allergy specialists have produced guidance to raise awareness. Clinical scientist Dr Paul Turner from the National Heart & Lung Institute at Imperial College London, who carried out the study, and Prof Adam Fox, consultant paediatric allergist at Evelina London Children's Hospital, said they hoped the leaflet they have produced would save lives. It is designed to help patients, parents, families, grandparents, friends and nannies so they feel empowered and more confident when looking after a person with food allergies. Read full story Source: BBC News, 6 October 2023
  12. Content Article
    This issue of Hindsight is on the theme of Just Culture…Revisited. The articles reflect Just Culture at the corporate and judicial levels from the perspectives of personal experience, professional practice, theory, research, regulation, and law. You will find a diverse set of articles from a diverse set of authors in the context of aviation, maritime, rail and healthcare. What is ‘just’? How should we conceptualise Just Culture? How should we design and implement regulations, policies and protocols relating to Just Culture? What gets in the way of Just Culture? In this issue, leading voices from the ground and air share perspectives on these questions.
  13. Content Article
    Full opening statement of the Long Covid groups (Long Covid Support, Long Covid SOS and Long Covid Kids) to Module 2 of the Covid-19 Inquiry as representative organisations for nearly 2 million adults and children who have suffered from Long Covid.
  14. Content Article
    The Association of Ambulance Chief Executives (AACE) and the Office of the Chief Allied Health Professions Officer (CAHPO) have launched three publications aimed at reducing misogyny and improving sexual safety in the ambulance service.
  15. Content Article
    It is more important than ever that Integrated Care Systems (ICS) invest urgently in community mental health. The introduction of the Community Mental Health Framework in 2019 presented a once-in-a-generation opportunity for mental health systems.   With ringfenced transformation funding coming to an end in April 2024 and in a climate of crisis and uncertainty, we need to ensure these changes are embedded.  Rethink Mental Illness have launched their new report, 'Building Community into the Integrated Care System; A practical guide to developing robust community mental health', where they: Summarise the significant challenges facing mental healthcare. Provide a toolkit of practical, workable solutions to common barriers to transformation. Explore the role that the VCSE sector can have in pursuing the four core aims and future goals of ICSs.  
  16. Event
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    The Care Experience Symposium will gather health and care thought leaders, professionals, caregivers, and advocates for a captivating and enlightening symposium programme that will combine contributions from leading experts as well as share living examples of how people’s experiences can catalyse positive change in health and care services. It will show the power of stories to help heal the system: through Schwartz Rounds, co-production with patients, and other ways that stories help us make sense of the world. Participants will also examine how data about patient and staff experiences can inform our understanding of service quality, address novel and important questions, and help put people at the centre of care. The symposium will be chaired by Jocelyn Cornwell, the founder and former CEO of The Point of Care Foundation, renowned for her contributions to patient-centred care and healthcare improvement. Keynote Speaker Panel Angela Coulter: Chair, Picker; Policy researcher with a particular interest in people’s experiences of care. Tessa Richards: Patient, Carer, Doctor; A multifaceted perspective on healthcare experiences. Liz O’Riordan: Patient, Carer, Doctor (via video provocation); A compelling voice advocating for patient-centred care. Register
  17. Content Article
    Allergic reactions vary in severity. People with food allergy tend to have reactions which affect the skin or gut, but around one third of reactions involve the breathing: these more serious allergic reactions are known as anaphylaxis. Very rarely, anaphylaxis can be severe and therefore life-threatening. This leaflet created by Allergy UK and Anaphylaxis UK explains how you can reduce the risk of this happening. Anaphylaxis is unpredictable and can occur in people who have never had this type of reaction before, but most people will recover fully. 
  18. News Article
    Two healthcare workers who exchanged vile texts while needless drugging sick people to ‘keep them quiet’ have been found guilty of ill-treating patients. Senior nurse Catherine Hudson, 54, was found to have regularly tranquillised patients unnecessarily for her own amusement and to have an ‘easy’ shift. While Charlotte Wilmot, 48, an assistant practitioner, wrote vile texts encouraging her to carry out the dangerous acts, with complete disregard for the consequences. Preston Crown Court heard the pair worked on the stroke unit at Blackpool Victoria Hospital and had carried out needless sedations between 2017 and 2018. Restrictions on prescription drugs were so lax in the stroke unit that staff would help themselves and self-medicate or steal drugs to supply to others, the court heard. Drugs such as Zopiclone, a powerful medicine used to treat insomnia, were often stolen and used to drug multiple patients. Police launched an investigation in November 2018 after a student nurse raised concerns about the treatment of patients in the stroke unit. A number of staff members were arrested during the course of the investigation and their mobile devices were seized. Read full story Source: The Independent, 6 October 2023
  19. News Article
    The NHS ombudsman has told a health trust chief to withdraw “not accurate” remarks about him amid an alleged attempt to play down up to 1,000 avoidable patient deaths. Rob Behrens wrote to Stuart Richardson, the head of the Norfolk and Suffolk mental health NHS trust, over remarks he made about him to Norfolk county council’s health scrutiny committee. The councillors on the committee were questioning Richardson over claims reported by the BBC’s Newsnight programme that his trust had “watered down” a report into what are thought to be the avoidable deaths of up to 1,000 patients. The changes between different versions of the document toned down criticism of the trust’s leadership, a move that drew criticism from Behrens and bereaved relatives. For example, the auditors, Grant Thornton, removed references included in the first version to the trust’s governance being “poor, … weak [and] inadequate”, after discussions with trust bosses. The trust and Grant Thornton said the changes were part of a normal factchecking process. Referring to the changes, Behrens had told Newsnight that “the differences in the texts at key points are so huge that this is not just a bureaucratic drafting issue”. Read full story Source: The Guardian, 5 October 2023
  20. News Article
    The ambulance sector has signed up to a consensus statement in a bid to tackle misogyny and improve sexual safety for its staff and patients. The statement – which chief allied health professions officer for England Suzanne Rastrick launched at this week’s Ambulance Leadership Forum – commits the service to a “cultural transformation”. Several ambulance trusts have been criticised for a culture which includes “highly sexualised banter” in recent years, with reports highlighting sexual harassment, often of younger female staff. The statement’s guiding principles include: a focus on protecting staff from misogyny and inappropriate sexual behaviour; removing barriers to speaking up and supporting those affected; and working towards an inclusive culture where staff understand misogyny and come to work feeling “sexually safe”. Read full story (paywalled) Source: HSJ, 5 October 2023
  21. News Article
    People who seek help for mental health issues should be asked about problem gambling in the same way they are asked about drugs, smoking and alcohol, new guidance has suggested. According to the National Institute for Health and Care Excellence (NICE), those who visit an NHS health professional in England for depression, anxiety or thoughts about self-harm or suicide because of a possible addiction, such as alcohol or drugs, could be at a greater risk of harm from gambling. NICE said questions should be asked about patients’ gambling habits to ensure they could cope with their thoughts and urges. In new draft guidance, it suggested patients should be encouraged to assess the severity of their gambling by using a questionnaire available on the NHS website. Those who scored eight or higher should seek support and treatment from gambling services. Read full story Source: The Guardian, 5 October 2023
  22. Content Article
    The protests outside the Scottish Parliament took an alarming turn recently with people wearing hospital gowns spattered with blood. The demonstrators were former patients of neurosurgeon Sam Eljamel, many allegedly harmed by him and still suffering and searching for answers years later. A public inquiry has been announced by the First Minister. As the Patient Safety Commissioner for Scotland Bill makes its way into law, Alan Clamp, chief executive officer of the Professional Standards Authority for Health and Social Care, asks what this means for Scotland and the safety of its patients? See also: Working together to achieve safer care for all: a blog by Alan Clamp
  23. Event
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    The introduction of integrated care systems (ICSs) has placed a renewed focus on how organisations can work together to integrate care to meet the needs of local populations. However, much of the activity to integrate care, improve population health and tackle inequalities will be driven by commissioners and providers collaborating over smaller geographies (often referred to as ‘places’) within ICSs. This King's Fund conference will provide an opportunity to discuss how effectively place-based care is being delivered across the health and care system, how place-based partnerships – collaborative arrangements that typically include the NHS, local government and others such as voluntary, community and social enterprise (VCSE) sector organisations and social care providers with responsibilities for planning and delivering services – are evolving, and whether more needs to be done to involve places and communities in developing local approaches to reducing health inequalities. Conference sessions will also explore how ICSs and mayoral combined authorities are developing approaches to supporting the development of healthy places in their locality. You will hear from local partners from the voluntary, community and social enterprise (VCSE) sector, local government and more widely across the health and care system about their role in developing integrated plans, healthy places and neighbourhoods. Register
  24. Content Article
    This report presents findings from a rapid evidence review into improvement cultures in health and adult social care settings. The review aims to inform CQC’s approach to assessing and encouraging improvement, improvement cultures and improvement capabilities of services, while maintaining and strengthening CQC’s regulatory role. It also identifies gaps in the current evidence base.
  25. News Article
    Women are a third less likely to receive lifesaving treatment for heart attacks due to sexism in medicine, research shows. Research led by the University of Leeds and the British Heart Foundation (BHF) pooled NHS data from previous studies looking at common heart conditions over the past two decades. It investigated how care varied according to age and sex, finding that women were significantly less likely to receive treatment for heart attacks and heart failure. Following the most severe type of heart attack — a Stemi — women were one third less likely to receive a potentially lifesaving diagnostic procedure called a coronary angiogram. Women were significantly more likely to die after being admitted to hospital with a severe heart attack. They were also less likely to be prescribed preventative drugs that can help to protect against future heart attacks, such as statins or beta-blockers. Dr Sonya Babu-Narayan, associate medical director at the BHF and a consultant cardiologist said: “This review adds to existing evidence showing that the odds are stacked against women when it comes to their heart care. Deep-rooted inequalities mean women are underdiagnosed, undertreated, and underserved by today’s healthcare system." “The underrepresentation of women in research could jeopardise the effectiveness of new tests and treatment, posing a threat to women’s health in the long-term,” she added. Read full story (paywalled) Source: The Times, 5 October 2023
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