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Patient Safety Learning

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  1. Patient Safety Learning
    Nurses in England, Wales and Northern Ireland have started a nationwide strike in the largest action of its kind in NHS history.
    Staff will continue to provide "life-preserving" and some urgent care but routine surgery and other planned treatment is likely to be disrupted.
    The Royal College of Nursing said staff had been given no choice after ministers refused to reopen pay talks.
    RCN general secretary Pat Cullen has called on the government to "do the decent thing" and resolve the dispute before the year ends.
    Ms Cullen told BBC Breakfast the strike marked "a tragic day in nursing".
    "We need to stand up for our health service, we need to find a way of addressing those over seven million people that are sitting on waiting lists, and how are we going to do that? By making sure we have got the nurses to look after our patients, not with 50,000 vacant posts, and with it increasing day by day," she said.
    Health Minister Maria Caulfield, a former nurse, accepted "it is difficult" living on a nurse's wage, but said that a 19% pay rise "is an unrealistic ask".
    Under trade union laws, the RCN has to ensure life-preserving care continues during the 12-hour strike.
    Chemotherapy and kidney dialysis should run as normal, along with intensive and critical care, children's accident and emergency and hospital neonatal units, which look after newborn babies.
    Read full story
    Source: BBC News, 15 December 2022
  2. Patient Safety Learning
    Orthopaedic patients in NHS Highland face a wait of up to seven years for surgery, new research has found.
    A University of Aberdeen study said the worst case estimate would apply if surgical rates did not increase for those listed in July this year.
    Researchers also discovered the average wait across Scotland's 14 health boards could be as long as two years and three months.
    The Scottish government said it was working to maximise NHS capacity.
    Luke Farrow, clinical research fellow, warned that the significance of the delays could not be underestimated.
    He said: "Prolonged waits for certain orthopaedic procedures can have a major negative impact on patient health.
    "This occurs both in terms of deterioration in quality of life whilst awaiting surgery, as well as potential negative connotations for post-operative recovery and longer-term health in addition to reduced independence and increased social care needs."
    Read full story
    Source: BBC News, 14 December 2022
  3. Patient Safety Learning
    Rare genetic disorders will be diagnosed and treated in babies thanks to a project to sequence the complete DNA of 100,000 newborns.
    It should spare hundreds of families in England months, or years, of anguish waiting to find out why their children are ill.
    The project is the first time that whole genome sequencing (WGS) has been offered to healthy babies in the NHS. It will screen for around 200 disorders, all of them treatable.
    The Newborn Genomes Programme, to begin next year, is thought to be the biggest study of its kind in the world. If successful, it could be rolled out across the country.
    Owen, 9, has an extremely rare genetic condition which affects his growth and development. Called THRA-related congenital hypothyroidism, it is one of the disorders which will be included in the new genetic test.
    Father, Rob Everitt, told the BBC: "I think of all the hours we spent in hospital waiting rooms, getting referred around different departments, all the tests - some of which were quite invasive - that drew a blank every time. I lost count of how many doctors and consultants we went to see and how many tests they did on him."
    Mother, Sarah Everitt, says getting the diagnosis was life-changing: "It was like winning the lottery….because we knew there was a treatment pathway; we knew we could get him support and he could attend a mainstream school."
    Read full story
    Source: BBC News, 13 December 2022
  4. Patient Safety Learning
    NHS leaders fear patients will come to harm as cancer services are “hit hard” by upcoming nurses’ strikes.
    The NHS’s four chief nurses wrote to the Royal College of Nursing (RCN) general secretary Pat Cullen warning patients’ lives are at risk due to life-saving services not being protected when nurses walk out on Thursday.
    And a separate letter from Dame Cally Palmer, the national cancer director for NHS England, urged Ms Cullen to protect urgent cancer operations from strike action “to ensure a consistent and compassionate approach for patients across the country”.
    The RCN has since agreed that staff will cover emergency cancer and mental health crisis services on strike days but has maintained only night-level staffing for inpatient services.
    But trust executives told The Independent that they were concerned they won’t be able to fill any gaps with agency staff due to RCN rules, which will worsen existing shortages.
    One senior NHS source claimed cancer services weren’t being prioritised by unions despite national agreements to protect chemotherapy treatments.
    They said: “I fear that someone is going to get hurt as the system is so pressured and fragile right now, whether strike-related or not, public sympathy will shift considerably if this were to happen.”
    Read full story
    Source: The Independent, 14 December 2022
  5. Patient Safety Learning
    All new hospitals built in England must have only single patient rooms, health infrastructure chiefs have confirmed, requiring an overhaul of many trusts’ current proposals.
    Leaders of the New Hospitals Programme said the NHS needed to be “brave”, with the move marking an end for multi-bed bay wards and representing a major change in hospital design.
    Previously, NHS trusts were expected to consider a minimum of 50% single rooms when refurbishing or building new facilities, but HSJ revealed in September that officials were considering a 100 per cent requirement.
    Natalie Forrest, senior responsible officer for NHP, said England was “behind the times” on single patient rooms.
    She said: “If we really want to look for evidence of why patients should have the ability to sleep in privacy and choose to socialise in social areas… we need not look very far. Scotland, Wales, Ireland, Europe, the US – where they wouldn’t dream of building a hospital that didn’t provide single bedroom occupancy.”
    Ms Forrest, who is also a nurse, acknowledged an “anxiety” among NHS staff that they can’t care for patients in single rooms as well, and stressed the need to combine them with “digital technology”.
    “I have said we need to be brave and take on new challenges, and this is one of those brave decisions the NHS needs to stand up and move forward with.”
    Read full story (paywalled)
    Source: HSJ, 13 December 2022
  6. Patient Safety Learning
    Increasing numbers of emotionally troubled children have been taken into care while waiting long periods for NHS treatment because their condition deteriorated to the point where their parents could no longer cope with their behaviour, child protection bosses have revealed.
    Association of Directors of Children’s Services (ADCS) president Steve Crocker said that since the pandemic, youngsters with complex emotional needs had become a significant factor in rising child protection referrals.
    “We are seeing children in the social care system because they have not been supported in the [NHS] mental health system,” he said.
    Crocker urged ministers to “do better” for children facing “unacceptable” delays in NHS mental health treatment, adding that it was not uncommon for waiting lists to involve waits of over a year.
    Councils were “filling gaps” in NHS provision but struggling to find placements for children with severe behavioural problems, and when they did, typically paid “untenable” fees of tens of thousands of pounds a week.
    He accused private children’s residential care providers and their “rapacious” hedge fund backers of “profiteering” from the care crisis, and urged the government to intervene to cap typical profit margins that were currently about 20%. “We do not see how this can be allowed to continue,” he said.
    Read full story
    Source: The Guardian, 13 December 2022
  7. Patient Safety Learning
    Medics and nurses have been urgently called upon to support London Ambulance Service during next week’s strike action, as it will otherwise have to rely on staff only able to provide ‘first aid’.
    The North East London primary care team has sent out a request for clinical staff working for integrated care boards to be released from duties ahead of industrial action on 21 December.
    Unison members are preparing to walk out, alongside thousands of other staff at nine other ambulance trusts across the country, in a dispute over pay.
    The letter, seen by HSJ, was sent yesterday afternoon. It said: “LAS are keen to have experienced medics and nurses, who have current urgent and emergency clinical exposure, have knowledge of how to navigate the system and can operate as a senior clinical decision maker. Medical Practitioners would ideally be from general practice and emergency medicine.
    “Advanced Paramedics and Advanced Care Practitioners with urgent care or IUC CAS experience are also required. A knowledge of ambulance services is preferred as it removes the need to learn very quickly the significant differences in ambulance services and LAS control rooms."
    Read full story (paywalled)
    Source: HSJ, 13 December 2022
  8. Patient Safety Learning
    The family of a boy who died of an invasive form of strep A have said they sought medical help three times before he was admitted to hospital.
    Jax Albert Jefferys, who attended Morelands Primary School in Waterlooville, Hampshire, died on 1 December, aged five.
    His family said they were initially told he had flu.
    Since September, UK Health Security Agency figures show 15 UK children have died after invasive strep A infections.
    Paying tribute to their "darling son", Jax's family said they had sought medical advice on three occasions during the four days leading up to his death and were told that he was suffering with influenza A.
    "We then followed the recommended course of action: to administer a proprietary paracetamol-based medication in the prescribed dosage," they said in a statement.
    However, they said on the fourth day Jax's condition "deteriorated so much" they "rushed him to hospital" and he later died.
    "Only after his death was it confirmed that the cause was [strep A]," the family said.
    Read full story
    Source: BBC News, 14 December 2022
  9. Patient Safety Learning
    All ambulance services have declared the highest level of alert due to ‘extreme pressures’ facing the urgent and emergency care system.
    One senior ambulance chief told HSJ that ambulance response times have dropped dramatically in the last few days, while A&E handover delays have surged. They said: “The wheels are falling off [the emergency care system] now, we’re in a really awful situation.”
    They said ambulance leaders have major concerns about the planned strike action by nurses on Thursday, fearing this will exacerbate discharge delays and have a knock-on effect on ambulance handover problems.
    It also comes ahead of strike action planned by ambulance staff for next week.
    HSJ has seen internal communications which confirm all ten ambulance trusts in England are now in level four of their “resource escalation action plan”, which means they can seek assistance from other nearby trusts or services. However, this is more difficult when an entire sector is under pressure, as is the case currently. 
    Read full story (paywalled)
    Source: HSJ, 13 December 2022
  10. Patient Safety Learning
    Autistic people in England who do not also have a learning disability are approximately 51% more likely to die in a single year compared to the general population, according to a leaked document which estimates the mortality rate for the first time.
    According to an internal NHS England document, seen by HSJ, the standardised mortality rate between April 2020 and March 2021 was 16.6 deaths per 10,000 for people with autism and no learning disability compared to 11 deaths per 10,000 for the general population. 
    NHSE also determined life expectancy for this group to be 75 years – 5.4 years less than the general population.
    Dominic Slowie, former national clinical director for learning disability, told HSJ that because of the different ways autism presents itself, it can be difficult to pinpoint causes of premature mortality. 
    “In some cases, people with autism who are severely disabled and can’t communicate their needs in a conventional way are going to have premature mortality for the same reasons that people with a learning disability do, because people do not really understand the level of their need or do not investigate their need in a reasonably adjusted way,” he said.
    “While, if someone is presenting atypically in their communication, we mustn’t make presumptions – we must make reasonable adjustments to ensure they are investigated and diagnosed in the same way.”
    Read full story (paywalled)
    Source: HSJ, 13 December 2022
  11. Patient Safety Learning
    Lucy Letby used a plunger to force milk and air into one of the babies she is accused of attempting to murder, a medical expert has told a court.
    The alleged attack caused the infant’s stomach to distend to such a degree that she then projectile vomited a “massive” amount of milk so violently that the material left her cot and splashed over a chair several feet away.
    Staff at the Countess of Chester Hospital managed to save Baby G’s life but the incident was so catastrophic that it caused the child severe brain damage. Seven years later she still suffers from quadriplegic cerebral palsy.
    Dr Dewi Evans, a consultant paediatrician called in by the prosecution, said the use of a plunger on the end of a syringe was the only explanation for the baby’s sudden collapse in the early hours of 7 September 7 2015.
    Letby, 32, of Hereford, is accused of murdering seven children in the neonatal unit of the hospital in Cheshire, and of ten attempted murders, between June 2015 and June 2016. She denies all the charges.
    Read full story (paywalled)
    Source: The Times, 13 December 2022
  12. Patient Safety Learning
    The number of operations cancelled by the NHS in England because of staff shortages may have doubled in three years, with an estimated 30,000 not proceeding because no staff were available to perform them.
    At least a third of cancelled operations were those that were deemed urgent, according to the analysis by Labour. It suggested at least 2,500 cancelled operations for cancer patients and 8,000 on children.
    It found staff shortages were the most common reason given for cancellations by hospitals, accounting for one in five of all operations cancelled for non-clinical reasons last year.
    The Department of Health and Social Care said it was “misleading” to extrapolate that figure from the data in the FOIs. “Thousands of elective appointments and procedures had to be cancelled during the pandemic to protect the NHS, and since then we’ve been focused on delivering the biggest catch-up programme in health history - virtually eliminating the longest 2-year waits for treatment,” a spokesman said.
    In total, 158,000 operations were cancelled for issues including equipment failures, a shortage of beds, and 5,700 because of equipment failure, administrative errors, and theatre lists overrunning. Labour cited one case that involved a 72-year-old woman who had two operations to remove a brain tumour cancelled in September, blamed on a lack of available beds.
    About 9,500 operations were cancelled because an emergency case took priority, and 250 due to adverse weather.
    Separate figures from the NHS show record numbers of operations cancelled at the last minute are not rearranged to take place within a month, with one in five patients waiting longer.
    Read full story
    Source: The Guardian, 12 December 2022
  13. Patient Safety Learning
    Bosses at the North West Ambulance Service issued an urgent warning to members of the public on 999 calls and apologised for delays last night.
    At 5pm on Monday (December 12), more than 600 patients were waiting for an ambulance across the North West, the service said. Another 100 emergency vehicles were parked outside of hospitals waiting to handover patients.
    'Severe weather and hospital handover delays' had an impact on the service last night, as well as 'significant demand'. Ambulance chiefs said they had to 'maximise resources' by putting all clinically-trained staff on the frontline and increasing use of private providers.
    In an urgent message issued on Monday night, medical director Dr Chris Grant said: "This is an urgent message for the public across the whole of the North West. Tonight, across both our 111 and 999 services, we're seeing a really significant demand and I apologise for the delay in getting care to you but I do need your help.
    "We've called in all our operational and clinical resources to make sure we prioritise those who have the most life-threatening conditions. We need to keep our phone lines free so please only call us back if you no longer need our help or if your own condition has got significantly worse. Thanks for your support."
    Ged Blezard, director of operations at NWAS said: "Please only call 999 if someone has a serious illness or injury, you think their life is at risk, and you cannot get them to hospital by any other means. We know there are patients waiting for our help and we are sorry that we are unable to respond as quickly as we would like.
    Read full story
    Source: Manchester Evening News, 13 December 2022
  14. Patient Safety Learning
    A “decade of neglect” by successive Conservative administrations has weakened the NHS to the point that it will not be able to tackle the 7 million-strong backlog of care, a government-commissioned report has concluded.
    The paper by the King’s Fund says years of denying funding to the health service and failing to address its growing workforce crisis have left it with too few staff, too little equipment and too many outdated buildings to perform the amount of surgery needed.
    The UK’s poor public finances, health service staff suffering from exhaustion, and a wave of NHS strikes this winter will also lead to ministers being unable to deliver key pledges on eradicating routinely long waits, the thinktank says.
    “Though Covid certainly exacerbated the crisis in the NHS and social care, we are ultimately paying the price for a decade of neglect,” said the King’s Fund chief executive, Richard Murray.
    “The sporadic injections of cash during the austerity years after 2010 were at best meant to cover [the service’s] day-to-day running costs. This dearth of long-term investment has led to a health and care system hamstrung by a lack of staff and equipment and crumbling buildings. These critical challenges have been obvious for years.
    “The NHS in 2022 faces many of the same challenges it faced in 2000: unacceptably long waiting times and a service hobbled by staff shortages. To that is now added a cost of living crisis, industrial action by staff and a backdrop of a weak economy and weak public finances.”
    Read full story
    Source: The Guardian, 12 December 2022
  15. Patient Safety Learning
    A man who had broken his hip was taken to hospital strapped to a plank in the back of a van after his granddaughter was told no ambulances were available.
    Nicole Lea found Melvyn Ryan behind the door of his home after he pressed an emergency call button around his neck.
    When she got there she discovered the 89-year-old also had a broken shoulder.
    She said she went to grandfather-of-eight Mr Ryan's home, in Cwmbran, Torfaen, after being contacted just after midnight on Friday.
    She said: "I didn't waste any time in calling 999 and gave them my details. And they turned around and said they were unable to send anyone, there wasn't any help to send and that I'd have to find a way of getting him there myself."
    The call handler advised her to call the out-of-hours GP before saying she had to go to deal with other calls.
    She did not call the GP as she thought it would be a waste of time.
    "With my partner and my mum's help we managed to come up with the idea of getting him onto a plank of wood and into the back of my partner's van to get him up to hospital," Ms Lea said. 
    "Mr Ryan has had what sounds like the most appalling of experience," said Dr Iona Collins, chairwoman of the British Medical Association (BMA) Cymru.
    "How must the ambulance service feel when they are getting calls like this? Obvious its an emergency and they need help and they are unable to help," she told Radio Wales Breakfast.
    Read full story
    Source: BBC News, 12 December 2022
     
     
  16. Patient Safety Learning
    English hospitals have increased emergency fuel supplies and put staff on standby to postpone operations and switch off X-ray scanners amid heightened concerns over energy provision this winter.
    NHS hospital trusts across England have put their power plans under the microscope as they look to protect patients from potential outages for lifesaving equipment.
    Responses to freedom of information requests to 63 NHS trusts revealed that 41 are re-examining their plans for a loss of power for this winter. A further 10 trusts said they conducted routine reviews of their business continuity plans this year, while 12 had not revised their strategies.
    National Grid warned in October that, in extreme circumstances, it would be forced to enact planned three-hour power cuts with a days’ notice.
    Major hospitals are exempt from this system, called rota disconnection, however businesses and the government have studied their plans for a complete power failure on the network.
    Despite the pressure on the NHS budgets, the responses show that most hospitals have up-to-date plans and backup generators to ensure lives are not lost due to lack of power.
    A quarter of hospital trusts said they were able to run indefinitely on backup diesel generator power, providing they had access to fuel supplies. Just over 10% said they could run on backup power for 10 days.
    Read full story
    Source: The Guardian, 12 December 2022
  17. Patient Safety Learning
    A new survey of more than 1,000 surgeons across the USA reiterates concerns that impending cuts to surgical care, set to take effect on 1 January 1 2023, will lead to a decrease in Medicare patient intake, increased delays to care, and longer wait times for patients in surgical practices. These survey results support the efforts of the over one million physician and non-physician healthcare providers joining together in urging congressional leadership to stop the full cut to Medicare payments through a Week of Action.
    "Our survey results confirm that the impending cuts to Medicare payments will be disastrous for patients and their access to life-saving and life-altering care," said Patricia L. Turner, American College of Surgeons Executive Director and Chief Executive Officer. "As our population continues to age, more and more seniors depend on Medicare to receive the care they need. Congressional leadership must protect patients by stopping the full cut to Medicare payments so healthcare providers can focus on delivering high-quality care to patients."
    The survey, conducted for the American College of Surgeons, a founding member of the Surgical Care Coalition, found:
    Around two-thirds of members expect patients will be faced with delays to care (68%) or longer wait times (65%). These are up from 56% and 57%, respectively, in 2021. One-in-three (33%) members say there will be a change in their Medicare patient intake if the cuts were to go into effect, up from 25% in 2021. 20% say they expect to take on fewer new Medicare patients, but that they will keep all existing Medicare patients. While members report feeling the impact from supply chain issues and inflation, surgeons are also sounding the siren around healthcare worker shortages. Over nine-in-ten (93%) report healthcare worker shortages impacting their ability to provide high quality care over the last year. Over three-quarters (77%) report "a great deal of impact" from these shortages. Read full story
    Source: CISION PR Newswire, 9 December 2022
  18. Patient Safety Learning
    Dilapidated mental health facilities across the country are in need of £677m worth of repairs to fix sewerage issues, collapsing roofs and wards that deprive patients of their dignity, The Independent has been told.
    An NHS analysis of the government’s flagship programme to build 40 hospitals, seen by The Independent, shows ministers have failed in their promise of “parity” for mental health services as issues are not addressed.
    NHS trust and psychiatry leaders warned that the out-of-date buildings are putting patients at risk and urged the government to include six mental health hospitals within its next round of improvements.
    Data analysis by the Royal College of Psychiatrists, shared with The Independent, found that the cost of fixing “high and significant” risks in mental health and learning disability hospitals has rocketed from £92m in 2019-20 to £186m in 2021-22 – far higher than the 16 per cent increase in costs seen in acute hospitals. These are risks that must be fixed to avoid “catastrophic” failure or safety problems that could result in serious injury.
    Saffron Cordery, interim chief executive at NHS Providers, said patients and staff are at risk because so many buildings aren’t fit for purpose, and warned that things will get worse until mental health trusts get the capital funding they need.
    Read full story
    Source: The Independent, 11 December 2022
  19. Patient Safety Learning
    Strep A home-testing kits have sold out online as parents rush to find ways to diagnose their children’s rashes and high temperatures.
    The panic-buying follows the deaths of at least 16 children from invasive strep A infections in the UK.
    As infections and deaths from strep A have risen over the past few weeks, parents have turned to tests that involve a long cotton swab that is lightly passed over the back of the throat. Solutions and a strip test are then used to display results.
    These tests are now being sold online for more than £100, while some retailers have reported selling out after demand soared over the past few days. Other suppliers have warned customers that they will not be able to get hold of a test until after Christmas. One online retailer told customers that they would not be able to get the products until mid-January. Others said they were awaiting deliveries but “there may be delays beyond our control”.
    Strep A tests are not sold in England through the NHS because the National Institute for Health and Care Excellence (NICE) – which approves and advises on clinical care – has said their accuracy is uncertain and likely to be “highly variable”. Scotland has not approved them either, though in Wales people can buy them over the counter for £7.50.
    “We’re not advising using those [tests] for the time being,” Professor Kamila Hawthorne, chair of the Royal College of GPs, said on Friday. “It is a clinical diagnosis. It is not too difficult to make. So long as the parent watches their child and brings their child in, then we are more than happy to see them.”
    Read full story
    Source: The Guardian, 11 December 2022
  20. Patient Safety Learning
    Medicine shortages are an “increasing problem” for Australia and antibiotics are among the commonly prescribed drugs currently in short supply, the peak body for general practitioners says.
    The drugs regulator, the Therapeutic Goods Administration (TGA),  said the three most commonly prescribed antibiotics – amoxicillin, cefalexin and metronidazole – are scarce. They are used to treat a range of bacterial infections, including pneumonia and other chest infections, skin infections and urinary tract infections.
    To see patients through the shortage, the TGA has authorised pharmacists to provide alternative antibiotics without approval from the prescribing doctor.
    “Importantly, many of these medicines have alternatives available,” the TGA said. “Your pharmacist may be able to give you a different brand, or your doctor can prescribe a different strength or medicine with similar spectrum of activity.”
    A TGA spokesperson said “most of the antibiotic shortages are caused by manufacturing issues or an unexpected increase in demand”.
    Dr Nicole Higgins, the president of the Royal Australian College of General Practitioners, said the shortage of certain medicines was “becoming an increasing problem in Australia”.
    Read full story
    Source: The Guardian, 12 December 2022
  21. Patient Safety Learning
    Six NHS staff workers are typically reported every week in England for sexually harassing a patient or colleague, the Telegraph can reveal.
    Nearly a fifth of English trusts have recorded a rise in reports of sexual harassment within their services since 2017, while millions have been spent by the NHS on legal claims specific to sexual abuse over the same time period, according to newly obtained data.
    Health secretary Steve Barclay described the findings as “worrying” and urged NHS leaders to take “robust action in response to any such incidents in their organisation”.
    Patient Safety Learning said the Telegraph's “deeply troubling” revelations demonstrated an abuse of the “significant power imbalance” that exists between vulnerable patients and their care providers.
    “Healthcare professionals need to recognise the power they hold over patients,” said chief executive Helen Hughes. “Inappropriate behaviours undermine trust in healthcare system and the ability to deliver safe care.”
    “Clinicians, managers and healthcare leaders have both a professional and moral responsibility to patients to ensure that there is a safe culture in healthcare settings and that misconduct is not tolerated," said Ms Hughes.
    As part of its investigation into sexual harassment within the NHS, the Telegraph uncovered the case of a mentally incapacitated patient who was raped by her healthcare worker and subsequently fell pregnant. The healthcare worker, who is in his 30s, was recently jailed for eight months after pleading guilty to sexual activity with a mentally disordered female. 
    Joe Matchett, an expert lawyer at Irwin Mitchell who has secured settlements for survivors of abuse, said his firm continues to “represent a number of patients subjected to terrible abuse at the hands of hospital staff who have betrayed their position of trust in the worst imaginable way”.
    Read full story (paywalled)
    Source: The Telegraph, 11 December 2022
  22. Patient Safety Learning
    Hospitals in England have paid out as much as £5,200 for a shift by a doctor through an agency, according to figures obtained by Labour through Freedom of Information requests.
    That is the latest in an intensifying debate over workforce shortages in the NHS in England.
    Labour blamed the high agency fees on Conservatives, arguing they had failed to train enough doctors and nurses. A Conservative spokesperson said "record numbers" had been recruited.
    The most expensive reported shift was £5,234 - paid by a trust in northern England. This covers the agency fee and other employer costs as well as the money going to the doctor.
    The NHS Confederation said the "staffing crisis" was so "desperate" that NHS trusts were being forced to pay large fees to make sure rotas were "staffed safely".
    Matthew Taylor, chief executive of the NHS Confederation, said: "Trusts are having to breach the caps on how much they pay for agency doctors because of the extremely high levels of demand they are facing for their services.
    "The staffing crisis is so desperate that they either pay these fees or find that their rotas cannot be staffed safely, leading to reduced services for patients. This is particularly true in parts of the country where the NHS can struggle to recruit new staff."
    Read full story
    Source: BBC News, 12 December 2022
  23. Patient Safety Learning
    More than 1000 investigations have been launched in Scotland over the past decade into adverse events affecting women and infants' healthcare.
    Figures obtained by the Herald show that at least 1,032 Significant Adverse Event Reviews (Saers) have been initiated by health boards since 2012 following "near misses" or instances of unexpected harm or death in relation to obstetrics, maternity, gynaecology or neonatal services.
    The true figure will be higher as two health boards - Grampian and Orkney - have yet to respond to the freedom of information request, and a number of health boards reported the totals per year as "less than five" to protect patient confidentiality.
    Saers are internal health board investigations which are carried out following events that could have, or did, result in major harm or death for a patient.
    Major harm is generally classified as long-term disability or where medical intervention was required to save the patient's life. They are intended as learning exercises to establish what went wrong and whether it could have been avoided. Not all Saers find fault with the patient's care, but the objective is to improve safety.
    NHS Lanarkshire was only able to provide data from April 2015 onwards, but this revealed a total of 194 Saers - of which 102 related to neonatal or maternity services, and 80 for obstetrics.
    A Fatal Accident Inquiry involving NHS Lanarkshire has already been ordered into the deaths of three infants - Leo Lamont and Ellie McCormick in 2019, and Mirabelle Bosch in 2021 - because they had died in "circumstances giving rise to serious public concern".
    Read full story (paywalled)
    Source: The Herald, 10 December 2022
  24. Patient Safety Learning
    A hospital trust has apologised to a woman for failing to admit a surgeon had been responsible for a massive haemorrhage that almost killed her after a Caesarean section.
    For seven years, East Kent Hospitals Trust maintained the size of Louise Dempster's baby was to blame.
    "It was just continuous lies," the 34-year-old told BBC News.
    East Kent Hospitals chief executive Tracy Fletcher promised "to ensure lessons are learned".
    Louise Dempster gave birth in May 2015 but the surgeon's error only emerged during an inquiry into poor maternity care at East Kent Hospitals Trust which reported this year.
    Read full story
    Source: BBC News, 9 December 2022
  25. Patient Safety Learning
    Three “major” reviews are being launched into a struggling teaching trust in response to growing concerns over bullying and poor workplace culture.
    Birmingham and Solihull integrated care board has begun a series of investigations into University Hospitals Birmingham, whose chief executive announced he was standing down last month.
    The first review will get under way immediately and will focus on specific allegations made recently on BBC Newsnight. These include patient safety concerns, the “bullying” of clinicians and the issues raised by a review of 12 patient deaths undertaken by former consultant Dr Manos Nikolousis in 2017.
    It will be led by an “experienced senior independent clinician” from outside the local health system who is expected to report by the end of January. 
    The second and third investigations will review the trust’s leadership and broader cultural issues respectively. The probes will be carried out with UHB and NHS England. Both are expected to report in the first half of 2023. 
    Read full story (paywalled)
    Source: HSJ, 9 December 2022
     
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