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Patient Safety Learning

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  1. Patient Safety Learning
    A review of the clinical records of 44 patients who died under the care of former neurologist Michael Watt has found "significant failures in their treatment" and "poor communication with families".
    While this review looked at a sample of cases in which people died, potentially thousands more could be affected.
    The review arises from a 2018 recall of 2,500 outpatients who were in Dr Watt's care at the Belfast Health Trust.
    About one in five patients had to have their diagnoses changed.
    This separate review into 44 deaths was conducted by the Royal College of Physicians at the request of the regulator, the Regulation and Quality Improvement Authority (RQIA).
    It highlighted concerns over clinical decision-making, prescribing and diagnostics.
    It reveals a misdiagnosis rate of 45% among this group of patients, twice that for living patients.
    Speaking to BBC News NI, the RQIA's chair, Christine Collins, said the outcome of the review was "shocking and gut-wrenching as so many had experienced unpleasant deaths which they ought not to have done".
    Read full story
    Source: BBC News, 29 November 2022
  2. Patient Safety Learning
    With flu cases rising, UK Covid scientists are turning their attention to finding the best life-saving drugs to fight the winter virus.
    A trial will run across 150 hospitals this year and next, recruiting thousands of patients.
    Flu vaccines help prevent infection but each year some people become very sick.
    And antiviral tablets - given within a couple of days of symptoms developing - are designed to reduce the severity of these bad infections.
    One of the pills the Imperial College London team will be testing is oseltamivir, or Tamiflu. It is recommended to treat severe flu - but whether it saves lives is unclear.
    Funded by the National Institute for Health and Care Research, the Randomised, Embedded, Multi-factorial, Adaptive Platform Trial for Community-Acquired Pneumonia (Remap-Cap) will study how good the treatments are at reducing deaths and intensive care admissions.
    Chief investigator Prof Anthony Gordon told BBC News: "We want to learn at pace what works, just like we did during Covid.
    "We'll test multiple treatments in different combinations. Some are antivirals that stop the virus, others are steroids or other treatments that work on how the body responds to infections.
    "We hope that our trial will help to find urgently needed flu treatments rapidly. Our Covid trial changed clinical practice globally and we hope we can impact flu treatment and reduce winter pressures on the NHS in the same way."
    Read full story
    Source: BBC News, 29 November 2022
  3. Patient Safety Learning
    When Kathleen Yaremchuk, Chair of the department of otorhinolaryngology (ear, nose and throat) at Henry Ford Hospital in Detroit, began getting calls about mysterious cases of respiratory distress, she launched a study to figure out what was going on.
    All these patients, it turned out, had a small device implanted in the top of their spines to relieve pain. The object, used to hold a protein that stimulates bone growth, was cleared for sale by the Food and Drug Administration in 2003 without clinical testing in humans.
    When Yaremchuk and her colleagues reviewed the records of all 260 patients implanted with the device at Henry Ford Hospital between 2004 and 2009, they found that a significant number developed airway obstruction, trouble swallowing and respiratory failure, in some cases leading to death.
    The neck implant is just one of the products associated over the past decade with 1.7 million injuries and more than 80,000 deaths.
    A searing global investigation last year by the International Consortium of Investigative Journalists places much of the blame on significant failings in the FDA’s oversight. The agency’s laissez faire attitude has resulted in artificial hips that cause cobalt poisoning (which can damage the heart and brain); surgical mesh that cuts through flesh and organs, causing infections and haemorrhage; and defibrillators that repeatedly shock patients beyond human endurance.
    Safety problems have led to recalls of devices implanted in hundreds of thousands of people. And the devices can be difficult or impossible to remove if they go bad
    No wonder many patient advocates cheered when the FDA announced in November that it planned to make “transformative” changes in the way more than 80% of medical devices are cleared for sale in the United States. But the promised transformation is mere window dressing. Two key loopholes still exist, allowing most products to be approved for sale without clinical trials in humans.
    Read full story (paywalled)
    Source: The Washington Post, 4 January 2019
  4. Patient Safety Learning
    Poorer women in Britain have some of the highest death rates from cancer in Europe, an in-depth new World Health Organization study has found.
    They are much more likely to die from the disease compared with better-off women in the UK and women in poverty in many other European countries.
    Women in the UK from deprived backgrounds are particularly at risk of dying from cancer of the lungs, liver, bladder and oesophagus (foodpipe), according to the research by the International Agency for Research on Cancer (IARC), the WHO’s specialist cancer body.
    IARC experts led by Dr Salvatore Vaccarella analysed data from 17 European countries, looking for socioeconomic inequalities in mortality rates for 17 different types of cancer between 1990 and 2015.
    Out of the 17 countries studied, Britain had the sixth-worst record for the number of poor women dying of cancer. It had the worst record for oesophageal cancer, fourth worst for lung and liver cancer and seventh worst for breast and kidney cancer.
    However, the UK has a better record on poor men dying of cancer compared with their counterparts in many of the other 16 countries. It ranked fifth overall, second for cancer of the larynx and pharynx, and third for lung, stomach and colon cancer.
    That stark gender divide is most likely because women in the UK began smoking in large numbers some years after men did so, the researchers believe. They pointed to the fact that while cases of lung cancer have fallen among men overall in Britain, they have remained stable or increased among women, and gone up among women from deprived backgrounds.
    Read full story
    Source: The Guardian, 28 November 2022
  5. Patient Safety Learning
    Hospitals may not be able to provide key elements of healthcare such as urgent surgery, chemotherapy and kidney dialysis during the forthcoming strikes by nurses, NHS bosses have said.
    Trusts may also have to stop discharging patients, postpone urgent diagnostic tests and temporarily withdraw services to people undergoing a mental health crisis.
    Executives have been warned that industrial action by nurses in their pay dispute with the government could mean that a range of important, and in some cases time-critical, services to seriously ill patients may have to be scaled back or suspended altogether.
    NHS England bosses have raised that possibility in a letter sent on Monday to hospitals and other care providers ahead of crunch talks with the Royal College of Nursing later this week. At that meeting they will try to agree what areas of care will be hit on Thursday 15 and Tuesday 20 December, and which will continue as normal because they are covered by “derogations” – agreed exemptions to the action.
    The letter sets out a list of 12 areas of care and some non-clinical activity in hospitals, such as food supply, which could be affected if agreement is not reached with the nurses’ union.
    Eight of those involve direct patient care, three involve support services in NHS trusts and the other involves “system leadership and management to oversee safe care” on strike days.
    NHS England’s letter sets out 10 other types of vital care, mainly involving life or death scenarios, headed “derogations not needed”, which they hope to agree with the RCN to go ahead as normal.
    These include A&E care, services in intensive care units and emergency operating theatres as well as maternity services, including the delivery of babies, psychiatric intensive care, time-critical organ transplants and palliative and end of life care.
    Meanwhile, the chief executive of NHS England has insisted patients will not have procedures cancelled at the last minute due to the nurses’ strikes, but warned some care would have to be delayed.
    Read full story
    Source: The Guardian, 28 November 2022
  6. Patient Safety Learning
    NHS England’s chief executive has admitted the service is behind on its commitment to increase elective activity to 130% of pre-covid levels by 2025, saying the recovery would need to be ‘reprofiled’ to catch up after this year.
    Amanda Pritchard told MPs on the Public Accounts Committee that NHS England would need to “re-profile some of the [elective recovery] trajectories”, as progress this year was being hampered by a combination of higher than expected covid rates, flu, workforce challenges and industrial action.
    She later added that the 2025 target could “theoretically” be missed, but stressed “we are a very long way from that” and indicated she believed the NHS could catch up in future years.
    Elective recovery plans agreed between NHSE and government last autumn said activity would recover to 110% of pre-covid levels in 2022-23. Yet published data shows many systems have so far been carrying out fewer procedures than before covid in most months.
    Asked by the committee’s chair Meg Hillier if she was confident the NHS would hit the 2025 activity target, first agreed for the 2021 spending settlement, Ms Pritchard replied: “I think at the moment we are absolutely aiming [to hit the target] at the end of that period of time, but we do recognise that we are going to need to re-profile trajectories to get there.”
    Read full story (paywalled)
    Source: HSJ, 28 November 2022
  7. Patient Safety Learning
    The human rights of vulnerable mental health patients are being violated because of the crisis in care, a regulator has warned.
    Rob Behrens, the health service ombudsman for England, said urgent action was needed over repeated “tragedies” in NHS mental health services.
    His warning comes as the latest NHS figures show there were 9,839 incidents of abuse against mental health patients from April 2021 to March this year – a higher figure than in any other sector.
    It follows an investigation by The Independent last month that revealed allegations of systemic abuse of children within a group of private mental health hospitals run by a provider called The Huntercombe Group.
    Mr Behrens said research carried out by his office showed that vulnerable people being detained in hospitals are “losing their human rights when they were put in difficult situations where they had no control”.
    Mr Behrens told The Independent: “We can’t go on with leaders in the NHS and politicians saying ‘This cannot go on’, because it happens time and time again. It’s the amount of resource and commitment that is put into dealing with issues, which ultimately is going to turn this around".
    When asked if mental health is a particular area of concern, Mr Behrens said: “Yes. It’s about human rights. It’s about vulnerable people exposing themselves to the arm of the state in a way where they have very little control, and where there needs to be accountability and scrutiny. That’s exactly where an ombudsman should be looking, to make sure that people without power are not being traduced by the system.”
    Read full story
    Source: The Independent, 28 November 2022
  8. Patient Safety Learning
    Lack of beds in the NHS and social care sector have been highlighted by the case of an 81-year-old woman discharged home at night, her family said.
    Janice Field attended Colchester Hospital in Essex with a suspected heart attack.
    She was returned to her flat at midnight, despite having no home care at that time of day.
    The hospital trust said it focused on keeping patients safe and was "sorry to hear about the concerns raised".
    Ms Field was checked out at the hospital last week and deemed fit to go home, but her family said she should have stayed in hospital overnight, or be found a community care bed.
    Her daughter-in-law, Sarah Field, a qualified nurse, said: "To discharge an 81-year-old lady and have them having to be transferred in the middle of the night is totally unacceptable.
    "But the nurse we spoke to was emphatic. She was desperate. She said, 'no, we have no beds. This has got to happen. She's clinically fit. She has got to go'.
    "The NHS is broken, under-resourced and not fit for purpose. This is not the fault of those that work in it, but the fault of the system."
    Read full story
    Source: BBC News, 26 November 2022
  9. Patient Safety Learning
    Mothers are being offered water injections by the NHS to relieve pain during childbirth, while in some hospitals midwives are burning herbs to encourage breech babies to turn in the womb.
    Safety campaigners have dubbed the practices dangerous and say that they amount to “pseudoscience” being offered by the health service. They have called on the chief executive of NHS England, Amanda Pritchard, to ban their use in a letter published over the weekend.
    At least three trusts in England offer water injections for pain relief, including Newcastle upon Tyne Hospitals Trust, United Lincolnshire Hospitals Trust and North Tees and Hartlepool Trust.
    Information on the Newcastle trust’s website describes the injections as an “alternative form of pain relief” while in Lincolnshire patients are told the body’s response to the injections “prevents pain signals from reaching the brain.”
    The National Institute for Health and Care Excellence (NICE), which is responsible for setting out which treatments patients should receive, has said the NHS should not use injected water for pain relief.
    Read full story (paywalled)
    Source: The Times, 27 November 2022
  10. Patient Safety Learning
    The NHS faces the threat of coordinated industrial action lasting several months, with results to be announced within days of strike ballots of ambulance crews and about 300,000 health workers.
    Junior doctors, paramedics, midwives, porters, cleaners, pharmacy technicians and physiotherapists are being balloted across the NHS. The government now faces the threat of waves of strikes across the public sector, from nurses and firefighters to civil servants and teachers.
    A ballot of 15,000 ambulance workers in England and Wales closes on Tuesday. The result of the GMB ballot could be announced as early as this week, with the prospect of the first national ambulance strike since the dispute of 1989-90, when police and army vehicles were brought in to transport patients.
    The RCN said on Saturday that the health secretary Steve Barclay had written to the union asking for officials to “come back to the table” before the planned strikes. RCN chief executive Pat Cullen said any talks needed to focus on the pay deal and that the position of her members was “negotiations or nothing”.
    Rachel Harrison, GMB public services national secretary, said: “Health service workers have suffered more than a decade of real-terms pay cuts, been on the frontline of a global pandemic and are now in the midst of the worst cost of living crisis in a generation.
    “This is as much about patient safety as it is about pay. A third of GMB ambulance workers think delays they’ve been involved with have led to the death of a patient.”
    Read full story
    Source: The Observer, 27 November 2022
  11. Patient Safety Learning
    A flagship programme intended to bring down NHS waiting backlogs is to be delayed after becoming mired in bureaucracy.
    The £360 million federated data platform is seen as critical to reducing waiting lists, with a record 7.1 million people now waiting for treatment. 
    When the plans were announced in the spring, health chiefs said that the system would be an “essential enabler to transformational improvements” across the NHS.
    Experts have warned that progress in clearing the lists has been set back by chaotic recording systems. 
    While NHS data was found to be littered with errors, such as duplicate entries and dead patients, many patients in need of follow-up care are not recorded once they have had their first slot. 
    Read full story (paywalled)
    Source: The Telegraph, 25 November 2022
  12. Patient Safety Learning
    People suffering from mental illness are increasingly struggling to access help at every level of the NHS – from record numbers facing “unacceptable” delays in referrals to patients waiting up to eight days in A&E for a hospital bed.
    Figures seen by The Independent show almost four times as many people are waiting more than 12 hours in emergency departments as two years ago.
    In the community, more than 16,000 adults and 20,000 children who should receive NHS care are unable to access vital services each month.
    Nearly 80% of those eligible for counselling on the health service are left waiting more than three months for a second appointment, which is when treatment usually begins.
    Health leaders say they are “deeply concerned” by the lack of resources available to handle the rise in demand – and warned that the cost of living crisis would exacerbate the issue further.
    Monica Smith went to A&E at Lewisham last month after her mental health deteriorated when her medication ran out and she was unable to get more.
    The 32-year-old said: “I was told, ‘We can’t find any beds – there’s no bed in the whole country or the whole region, so we’re going to have a bed on A&E and hopefully you’ll get a bed in the morning.’”
    Monica started hallucinating and was given medication to calm her down, but in the morning there was still no bed. Doctors tried to send her home, she said, but crisis services assessed her three times over the following days and each time decided she was too unwell.
    Instead, Monica stayed in an annex off A&E with other mental health patients. She said: “I was on this, like, mattress, like a mental health mattress on the floor.”
    Read full story
    Source: The Independent, 27 November 2022
  13. Patient Safety Learning
    A woman who struggled to access night-time care for her dying father has told the BBC he "shouldn't have been expected to die in office hours".
    Tracey Bennett said she was "completely lost" when her dad Michael needed help.
    Early in 2021, Mrs Bennett, 54, from Doncaster, moved in with her dad, 76-year-old Michael Woodward, to care for him in the last stages of his cancer.
    One night he had a fall. Mrs Bennett was able to help him back up but turned to the local NHS palliative care phone line for help, only to find it closed.
    Although she did not feel her father should be in a hospital, she called 999 as she felt she had no-one else to turn to. He died in the early hours of the next morning.
    "In his hour of need I feel I let my dad down," she said. "He shouldn't have been expected to die in office hours."
    Almost 70% of the UK does not have a consistent 24-hour help-line for the terminally ill, research suggests.
    And 27% of these areas do not have a designated phone line, the study funded by Marie Curie found.
    Ruth Driscoll, from the charity, said the research painted "a bleak picture of out-of-hours care in many areas of the UK".
    Read full story
    Source: BBC News, 28 November 2022
  14. Patient Safety Learning
    Some of the country’s GP are advising patients requiring urgent hospital care to “get an Uber” or use a relative’s car because of the worst ever delays in the ambulance service in England.
    Patients with breathing difficulties and other potentially serious conditions are being told in some cases that they are likely to be transferred more quickly from a general practice to accident and emergency if they travel by cab or private vehicle.
    NHS England data shows that October’s average ambulance response times for category 1 to 3 emergencies, which cover all urgent conditions, appear to be the highest since the categories were introduced nationally in 2017. Some patients who require emergency treatment may have to wait several hours for an ambulance to arrive.
    Dr Selvaseelan Selvarajah, a GP partner in east London, said: “If somebody is not having a heart attack or a stroke, my default advice is ‘have you got someone who can drive you or do you want to get an Uber?’
    “These are patients who may have breathing difficulty or are suffering severe abdominal pain, but their life is not in immediate danger.” He said such patients would have previously been transferred by ambulance.
    Read full story
    Source: The Guardian, 27 November 2022
  15. Patient Safety Learning
    A report commissioned by Jeremy Hunt before he became Chancellor has highlighted how the pandemic ’stopped progress on patient safety in its tracks’ and called for more accurate data to be published on a range of measures.
    The National State of Patient Safety was funded by Mr Hunt’s Patient Safety Watch charity and produced by Imperial College London’s Institute of Global Health Innovation. 
    It highlights a rise in rates of MRSA and C. difficile since the onset of the pandemic in 2020, as well as an increase in deaths due to venous thromboembolism and hip fractures. The report said the pandemic had also exacerbated issues associated with staff wellbeing, claiming there had been “notable rises” in staff burnout and ill-health.
    The researchers described problems with the breadth and accuracy of available patient safety data and highlighted that only 44% of trusts currently fulfilled the obligation to report their own estimated number of avoidable deaths.
    Although the report added that “data on rates of avoidable deaths are not a panacea”, it described them as a “snapshot of safety and harm and are most usefully used to initiate further work to understand the causes of unwarranted variation”.
    Read full story (paywalled)
    Source: HSJ, 27 November 2022
  16. Patient Safety Learning
    A carer who murdered the elderly woman he was employed to look after had a history of violent crime including actual bodily harm, a report found.
    A safeguarding adults review over the death of a 77-year-old Devon woman in 2021 criticised working practices among organisations involved in her care.
    Devon and Cornwall Police did not disclose information about domestic abuse callouts involving the killer in a DBS check by the care provider.
    He was jailed for life in July 2022.
    The woman had seen her killer as "a grandson" figure, it said.
    The 35-year-old killer attacked his victim after she discovered he had stolen several thousand pounds from her.
    The had no previous employment experience of care before being taken on as her sole carer by Complete Quality Care Ltd, an independent care provider.
    Read full story
    Source: BBC News, 24 November 2022
  17. Patient Safety Learning
    Nicola Sturgeon has been accused of running a two-tier NHS after it emerged that tens of thousands of patients are going private for crucial operations and healthcare.
    Anas Sarwar, the Scottish Labour leader, cited figures that showed more than 39,000 patients underwent private procedures in the past year. These included thousands of hip and knee surgeries, costing an average of £12,500 per patient.
    “Often these are people who are forced to borrow money, turn to family and friends, or even remortgage their home to get healthcare that should be free at the point of need,” Sarwar told MSPs at first minister’s questions.
    He said that almost 2,000 people had gone for private treatment for endoscopies and colonoscopies, more than 7,800 for cataract surgery and 3,500 have had a hip or knee replacement in a private hospital.
    “These figures make clear that under the SNP, healthcare in Scotland is already a two-tier system,” he added.
    Read full story (paywalled)
    Source: The Times, 24 November 2022
  18. Patient Safety Learning
    Bosses at Nottingham's crisis-hit maternity units are set to miss a deadline for clearing a backlog of incomplete "serious incident" investigations.
    Nottingham University Hospitals Trust (NUH) has 53 outstanding maternity incidents yet to be investigated.
    The trust had said it aimed to complete investigations by December 23.
    But director of midwifery Sharon Wallis says they have not progressed as quickly as she had hoped.
    The Local Democracy Reporting Service said the trust has managed to clear a number of those incidents - but it declared another nine in September and October.
    An independent review team, led by senior midwife Donna Ockenden, is examining dozens of baby deaths at the trust.
    Read full story
    Source: BBC News, 25 November 2022
  19. Patient Safety Learning
    NHS England’s national cancer director has said that she is “cautiously optimistic” about reaching cancer waiting time targets by March 2023, but she refused to be drawn on what had happened to the government’s proposed 10 year cancer plan.
    Cally Palmer was speaking to MPs on the Health and Social Care Committee at a special one-off session on the urgent challenges facing cancer services, including workforce shortages, winter pressures, and poor performance.
    Latest figures from September, published on 10 November, show that 60.5% of patients began their first treatment within 62 days of being urgently referred for suspected cancer, against a target of 85%. That target was pushed back to March 2023 from March this year.
    Palmer told the committee on 23 November that the 85% target aimed to reduce the 62-day backlog to pre-pandemic levels.
    Read full story (paywalled)
    Source: BMJ, 24 November 2022
  20. Patient Safety Learning
    There is now an "imminent threat" of measles spreading in every region of the world, the World Health Organisation and the US public health agency has said.
    In a joint report, the health organisations said there had been a fall in vaccines against measles and less surveillance of the disease during the COVID pandemic.
    Measles is one of the most contagious human viruses but is almost entirely preventable through vaccination, though it requires 95% vaccine coverage to prevent outbreaks.
    A record high of nearly 40 million children missed a dose last year because of hurdles created by the pandemic, according to the report by the WHO and the US Centers for Disease Control and Prevention.
    This has left millions of children susceptible to the disease.
    "We are at a crossroads," Patrick O'Connor, the WHO's measles lead, said.
    "It is going to be a very challenging 12-24 months trying to mitigate this."
    Read full story
    Source: Sky News, 24 November 2022
  21. Patient Safety Learning
    The NHS in England is facing a “perfect winter storm” with 10 times more people in hospital with flu than this time last year, and ambulances experiencing deadly delays when arriving at A&E with sick patients.
    There were an average of 344 patients a day in hospitals in England with flu last week, more than 10 times the number at the beginning of last December.
    And as many as 3 in 10 patients arriving at hospitals by ambulance are waiting at least 30 minutes to be handed over to A&E teams. Health chiefs say the crisis is leading to deaths.
    The figures on flu and ambulance delays were published by NHS England on Thursday and offered the first weekly snapshot of how hospitals are performing this season.
    Matthew Taylor, the chief executive of the NHS Confederation, which represents the healthcare system in England, said: “These figures really hammer home just how stretched services already are as we head into a perfect winter storm. Significantly higher numbers of people are in hospital because of flu compared to this time last year, coupled with the fact that Covid-19 has not gone away.”
    He added: “The life-saving safety net that NHS ambulance services provide is being severely compromised by these unnecessary delays, and patients are dying and coming to harm as a result on a daily basis.”
    Read full story
    Source: The Guardian, 24 November 2022
  22. Patient Safety Learning
    Hospital doctors failed to share with child protection services a list of "significant" injuries a five-year-old boy suffered 11 months before he was murdered, a case review has found.
    Logan Mwangi had a broken arm and multiple bruises across his body when he was taken to A&E in August 2020. But a paediatric consultant said these injuries were accidental and did not make a child protection referral.
    Logan, from Bridgend, was murdered by his mother, stepfather and a teenager.
    A Child Practice Review (CPR) has looked at how different agencies were involved with Logan's family in the 17 months before his death.
    Cwm Taf Morgannwg health board said it welcomed the commissioning of an independent review into how it identifies and investigates non-accidental injuries.
    The report said that if the injuries had been shared with social services, appropriate action could have been taken to safeguard Logan.
    Jan Pickles, the independent chair of the review panel, said it was a "a significant missed opportunity".
    She added: "Had further information from health been shared it most likely, though we cannot say for sure because of hindsight bias, would have triggered a child protection assessment in line with the joint agreed guidelines, as the nature of those injuries clearly met the threshold."
    Read full story
    Source: BBC News, 24 November 2022
  23. Patient Safety Learning
    The rate of people from black backgrounds being restrained in mental healthcare has more than doubled in the past six years, widening the gap with other racial groups, according to official NHS data.
    Standardised rates of black and black British people subject to restrictive interventions – including physical, chemical and mechanical restraints – have leapt from 52.1 per 100,000 people in 2016-17 to 106.2 in 2021-22.
    That is compared to a much smaller increase of 30% in the same period for people from white backgrounds, from 15.8 per 100,000 to 20.5.
    NHS race and health observatory director Habib Naqvi told HSJ he was “very concerned” at the rise.
    He said a “range of complex causes are likely to be presented to account for this pattern”, including disparities in care pathways, late presentation and lack of timely diagnosis, and general overuse of restrictive practice on people from minority ethnic backgrounds.
    He added: “It is critical we also focus on ‘causes of the causes’ of these disparities, including the impact of discrimination and bias on access, experience and therefore outcomes of mental health services.”
    Read full story (paywalled)
    Source: HSJ, 24 November 2022
  24. Patient Safety Learning
    Nurses across the UK will go on strike for the first time over two days in the fortnight before Christmas after ministers rejected their pleas for formal talks over NHS pay.
    The Royal College of Nursing (RCN) said its members would stage national strikes – the first in its 106-year history – on 15 and 20 December. Senior sources said the industrial action was expected to last for 12 hours on both days – most likely between 8am and 8pm.
    The unprecedented national industrial action will seriously disrupt care and is likely to be the first in a series of strikes over the winter and into the spring by other NHS staff, including junior doctors and ambulance workers.
    On Friday, RCN general secretary, Pat Cullen, said the UK government had chosen strikes over listening to nursing staff, adding: “If you turn your back on nurses, you turn your back on patients.”
    The RCN said that despite a pay rise of about £1,400 awarded in the summer, experienced nurses were worse off by 20% in real terms due to successive below-inflation awards since 2010. It said the economic argument for paying nursing staff fairly was clear when billions of pounds were being spent on agency staff to plug workforce gaps.
    It added that in the last year, 25,000 nursing staff around the UK had left the Nursing and Midwifery Council register, with poor pay contributing to staff shortages across the country, which it warned were affecting patient safety. There are 47,000 unfilled NHS registered nurse posts in England alone.
    Read full story
    Source: The Guardian, 25 November 2022
  25. Patient Safety Learning
    Nine acute trusts accounted for a third of all ‘hours lost’ to ambulance handover delays last week, according to new data.
    The first NHS England winter sitrep data showed wide variation between providers on ambulance handover performance, with a small number of providers accounting for a huge proportion of delays.
    There were nine trusts where, for each ambulance arrival in the week to 20 November, an average (mean) of more than an hour was lost to handover delays. The providers accounted for around 7,000 hours lost, 33% the national total, despite only accounting for 7% of ambulance arrivals. 
    At University Hospitals Plymouth an average of 2.3 hours were lost.
    The other trusts were; Norfolk and Norwich University Hospitals; East and North Hertfordshire; The Queen Elizabeth Hospital King’s Lynn; Great Western Hospitals; University Hospitals of Leicester; Torbay and South Devon; University Hospitals of North Midlands; and Worcestershire Acute Hospitals.
    Many of the worst performing hospitals were in the South West and East of England regions, which have previously been identified as areas which struggle on handover delays.
    Read full story
    Source: HSJ, 24 November 2022
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