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Patient Safety Learning

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  1. Patient Safety Learning
    Paramedics describe a health service in crisis with a lack of investment and increasing demand, of lengthy waits to transfer patients to hospitals and of a social care system facing collapse. So what does a typical ambulance shift look like?
    The area covered by the East of England Ambulance Service's nearly 400 front-line ambulances is vast.
    In 2020-21, the service received nearly 1.2 million 999 calls.
    Ed Wisken has been a paramedic for 13 years.
    An advanced paramedic specialising in urgent care, Mr Wisken says: "It is really sad to see patients who have had to wait such a long time for an ambulance - but this is just the culmination of years of underfunding and of reduced resources peaking now where demand outstrips supply."
    "It is upsetting to see it," he says. "It is not nice to see people who have been waiting hours and hours for an ambulance - but we have really hit crisis point now."
    He says the morale of fellow paramedics and other healthcare workers is currently very low.
    "The key is you just have to do just one job at a time and just take the patients that you see and do the best for them," he says.
    "If you worry about the bigger picture too much you will get frustrated and angry - but that's not going to be beneficial for yourself or your patients."
    Read full story
    Source: BBC News, 21 November 2022
  2. Patient Safety Learning
    NHS leaders in Scotland have discussed abandoning the founding principles of the service by having the wealthy pay for treatment.
    The discussion of a "two-tier" health service is mentioned in draft minutes of a meeting of NHS Scotland health board chief executives in September.
    They also raise the possibility of curtailing some free prescriptions.
    Scotland's Health Secretary Humza Yousaf insisted the NHS would stay publicly owned and publicly operated.
    He added that health services "must always" be based on individual patient need and "any suggestion" that it should be about the ability to pay was "abhorrent".
    The minutes of the meeting seen by BBC News highlight the degree of official concern about the sustainability of Scotland's NHS in its present form.
    They include suggestions that hospitals should change their appetite for risk by aiming to send patients home more quickly, and pause the funding of some new drugs.
    The group were advised that they had been given the "green light to present what boards feel reform may look like" and that "areas which were previously not viable options are now possibilities".
    Describing a "billion pound hole" in the budget, the minutes warn that it "is not possible to continue to run the range of programmes" the NHS currently offers while remaining safe "and doing no harm." And they warn that: "Unscheduled care is going to fall over in the near term before planned care falls over."
    Read full story
    Source: BBC News, 21 November 2022
  3. Patient Safety Learning
    GPs are struggling to cope with as many as 90 appointments and consultations a day – more than three times a recommended safety limit.
    General practices in England are carrying out more appointments than before the pandemic but face severe workforce shortages. More than 1.45 million patients waited at least 28 days to see a GP in September, according to the most recent NHS figures.
    GPs who spoke to the Observer last week say that almost every day they breach the BM) guideline of “not more than 25 contacts per day” to deliver safe care. One doctor said he had more than 90 consultations on one day.
    A conference of local medical committee representatives in England this week will highlight the growing pressures faced in general practice. Surgeries are being urged to impose stricter caps on the number of patient appointments for each GP.
    One of the proposed motions submitted to the conference by Kensington and Chelsea local medical committee says “focusing on patient safety” is more appropriate than meeting high patient demand. It says the NHS should focus on “safe capacity”.
    Such a move would mean longer waits for GP appointments, but doctors say it would help safeguard patient care and the welfare of staff in general practice.
    Read full story
    Source: The Guardian, 20 November 2022
  4. Patient Safety Learning
    The adverts promise beautiful legs, zero risk, and treatment in as little as 15 minutes. But unregulated injections to “eliminate” varicose veins are putting clients at risk of serious health complications, surgeons have warned.
    Vein removal treatments costing as little as £90 a session are being offered by beauticians without medical supervision across the UK, Observer analysis has found.
    Promoted with dramatic before and after photos and billed as a quick fix, microsclerotherapy involves the injection of a chemical irritant to disrupt the vein lining. This causes the vein walls to stick together, making it no longer visible on the skin. When performed correctly on finer veins, known as “thread” or “spider” veins, the procedure is generally considered safe, provided no underlying issues are present.
    But beauticians and other non-healthcare professionals are also offering vein treatments for people with varicose veins, which can signify underlying venous disease, analysis of promotional materials shows. In such cases, treatments should be performed by practitioners in a regulated clinic, where specialists first use ultrasound scans to assess the area.
    Conducting vein removal incorrectly or when there are underlying problems can lead to complications including leg ulcers, nerve damage, blood clots, stroke, allergic reactions and scarring, the Joint Council for Cosmetic Practitioners (JCCP) said. Even in cases where only thread veins are visible, other problems may be present.
    Prof Mark Whiteley, a consultant venous surgeon and chair of the Whiteley chain of clinics, said he had seen cases of women with leg ulcers and permanent scarring after treatment for varicose veins from non-medics. In other cases, people had paid for treatment but saw no effect because the underlying cause was not tackled. “It’s totally disgraceful,” he said.
    Read full story
    Source: The Guardian, 20 November 2022
  5. Patient Safety Learning
    Nearly a fifth of trusts providing maternity care have been red rated for their infant mortality rates in a national audit.
    Twenty-three trusts were flagged for their perinatal mortality in the latest Mothers and Babies: Reducing Risk through Audit and Confidential Enquiries audit for maternity services. Trusts with mortality rates more than 5% higher than an average of peer group providers are given a red rating.
    The report was published last month and looked at data for 2020. Average perinatal mortality rates have been falling across England since 2013, although there is significant variation across England.
    Six trusts in the latest audit were red rated for both stillbirths and neonatal mortality; Buckinghamshire Healthcare; Gloucestershire Hospitals; University Hospitals Dorset; Sandwell and West Birmingham Hospitals; University Hospitals Coventry and Warwickshire; and University Hospitals of Leicester.
    Twenty-three trusts rated red on a combined perinatal mortality indicator (including the six listed above). For 17 of them, their mortality rates were not high enough on one of the stillbirth or neonatal measures to be red rated, but sufficiently high enough on both indicators to tip their overall extended overall perinatal rating into the red.
    Andrew Furlong, medical director of University Hospitals Leicester, said: “Where learnings have been identified from reviews of care, we have developed robust action plans and strengthened care practice to shape and improve future services.”
    These include aiming to improve access to interpreters, provide clearer medical review guidelines, and update ultrasound scanning processes, he added.
    Read full story (paywalled)
    Source: HSJ, 21 November 2022
  6. Patient Safety Learning
    The Government has insisted that plans to build 48 ‘new’ hospitals by 2030 will still go ahead, despite widespread concerns over timelines and increasing construction costs.
    In its 2019 manifesto, the Conservative Party announced the New Hospitals Programme, a pledge to build 48 new hospitals across the country, including eight schemes that had been announced by previous governments.
    However, since then, the number has been seemingly interchangeable, with the Government, in a response to questions from BBH, referring to just 40 developments in total, even though the GM Government website clearly mentions 48.
    And, to date, just two of those projects have been completed, while only five others are under construction.
    The remaining schemes are still in the planning or approval stages, and this, combined with rising inflation and construction costs and a shortage of building materials, has led to concerns that they will not go ahead.
    Read full story
    Source: Building Better Healthcare, 28 November 2022
  7. Patient Safety Learning
    Greg Price died of complications after testicular cancer surgery, but a review of his case found missed faxes, follow-ups and botched data-sharing ultimately cost the vibrant 31-year-old Alberta man his life.
    All the missteps in his case meant it took 407 days from his first complaint for Price — an engineer, pilot, and athlete — to be diagnosed with cancer. He died three months after his doctor said he should see a specialist, and while he was being passed between multiple doctors, his health data often was not.
    Now, his sister, Teri Price, says too little has changed in medical information-sharing in the decade since her brother's death. This, despite a review of his case — the 2013 Alberta Continuity of Patient Care Study — that recommended life-saving changes to the healthcare system to avoid more experiences like his.
    So, she's fighting to improve the system that she says not only failed her brother, but keeps failing to change.
    Price says that Canadians assume that their health information is shared between doctors to keep them safe and studied to improve the system, but often, it's not. And medical front-line staff in Canada say problems persist when it comes to sharing everything from patient information to aggregate medical and staffing data. 
    "Information tends to be broken up between the services that patients attend," said Ewan Affleck, a doctor in the Northwest Territories who has spent his career fighting for better data access, and a member of the expert advisory arm of the Pan-Canadian Health Data Strategy Group.
    "The cohesion and use of health data in Canada is legislated to fail." 
    Read full story
    Source: CBC News, 17 November 2022
  8. Patient Safety Learning
    Health and Human Services (HHS) Secretary Xavier Becerra startled a recent meeting of senior health system leaders by declaring in opening remarks that a plane crash had just killed all 200 passengers. He immediately added that this hadn’t really happened; he’d said it only to illustrate the toll taken by medical error.
    The 14 November meeting at which Becerra spoke signalled a renewed commitment by HHS to preventing patient harm as it launched an “Action Alliance to Advance Patient Safety.” The Alliance aims to recruit the nation’s largest health systems as participants.
    “We’re losing pretty much an airline full of Americans every day to medical error, but we don’t think about it,” said Becerra. (The department’s fiscal 2022-2026 strategic plan actually estimated the death toll at roughly 550 daily, which would be a very large airliner.) “But the worst part about it is that it’s avoidable.”
    Though the meeting rhetoric was rousing and the invitee list impressive, specifics remained scarce. The Alliance is described only in general terms as a partnership among health systems, federal agencies, patients and others to implement Safer Together: A National Action Plan to Advance Patient Safety. 
    Read full story
    Source: Forbes, 17 November 2022
  9. Patient Safety Learning
    GPs are leaving UK practice over workplace incidents rather than due to falling ‘out of love’ with the profession, the General Medical Council (GMC) has warned.
    Speaking to the NHS Providers conference (16 November), chief executive Charlie Massey said that many specialty and associate specialist (SAS) and locally employed (LE) doctors feel their careers are being ‘curtailed’ and that they ‘can’t tolerate the environments’ in which they work.
    He cited new GMC research into doctors’ migration which identified poor workplace conditions and ‘negative experiences with colleagues’ as a ‘far more impactful’ as a trigger compared to poor experiences with patients.
    According to the research, bullying at work, lack of respect from line managers and experiences of favouritism ‘provided the nudge for them to consider making a change and migrating abroad’.
    Mr Massey said: "This is a senseless waste of talent, not least because these issues are preventable. With a focus on compassionate, supportive cultures, they can be put right. This will not only improve doctors’ wellbeing, but also their productivity. Happier workers are better workers, and they deliver better results."
    Read full story
    Source: Healthcare Leader, 16 November 2022
  10. Patient Safety Learning
    The Government is looking to hire a new cyber security chief for the NHS and Department of Health and Social Care (DHSC), at a time of heightened risk of cyber attacks against the health service. 
    The DHSC last month issued a job advert for a “national chief information security officer”, who will sit within the digital policy unit of NHS England’s transformation directorate.
    It comes at a time when the risk of cyber attacks against the NHS is increasing. Earlier this summer, an attack on an NHS electronic patient record supplier impacted several providers, including a dozen mental health trusts, with some trusts still not having recovered their service fully.
    Meanwhile, in February, NHSE wrote to trusts to tell them to strengthen their cyber defences in the wake of Russia’s invasion of Ukraine. 
    Read full story (paywalled)
    Source: HSJ, 18 November 2022
  11. Patient Safety Learning
    More than two million people in the UK say they have symptoms of Long Covid, according to the latest Office for National Statistics (ONS) survey.
    Many long Covid patients now report Omicron was their first infection.
    But almost three years into the pandemic there is still a struggle to be seen by specialist clinics, which are hampered by a lack of resources and research.
    So has the condition changed at all, and have treatments started to progress?
    NICE defines Llong Covid, or post-Covid syndrome, as symptoms during or after infection that continue for more than 12 weeks and are not explained by an alternative diagnosis.
    An estimated 1.2m of those who answered the ONS survey reported at least one such symptom continuing for more than 12 weeks - health issues that they didn't think could be explained by anything else.
    It's easy to assume that new cases of long Covid have significantly decreased, given recent research suggesting the risk of developing long Covid from the Omicron variant is lower. However, the sheer scale of cases over the past year has resulted in more than a third of people with long Covid acquiring it during the Omicron wave, according to the ONS.
    Patients are usually referred to post-Covid assessment clinics after experiencing symptoms for 12 weeks - however, waiting times have not improved much within the past year.
    The latest NHS England figures show 33% of Londoners given an initial assessment had to wait 15 weeks or more from the time of their referral, compared to 39% from a similar period in 2021.
    The British Medical Association (BMA) has called on the government to increase funding for Long Covid clinics to deal with ever-increasing patient numbers. The BMA says that NHS England's 2022 strategy set out in July failed to announce any new funding.
    Read full story
    Source: BBC News, 18 November 2022
  12. Patient Safety Learning
    Ambulance waiting times for stroke and suspected heart attacks have quadrupled in four parts of England since before Covid-19 – whereas others have only grown by half – underlining the severe impact of long accident and emergency handovers.
    Response times have leapt across England over the past two years, particularly for category 2 and 3 incidents, but the data makes clear that the steepest increases are in areas where hospitals have the biggest handover delay problems.
    Of the 10 patches with the largest increases in average category 2 performance between 2018-19 and 2021-22, four are served by major hospitals which make up NHS England’s “cohort one” of trusts selected for the worst handover problems; and four more are on government’s list of 15 which accounted for the most long handover delays last winter. 
    The increase in handover delays – in turn linked to delayed discharge, staffing, lack of community services and social care’s collapse – are the stand-out reason for areas with a steep rise in response times.
    Read full story (paywalled)
    Source: HSJ, 18 November 2022
  13. Patient Safety Learning
    Children say they were “treated like animals” and left traumatised as part of a decade of “systemic abuse” by a group of mental health hospitals, an investigation by The Independent and Sky News has found.
    The Department of Health and Social Care has now launched a probe into the allegations of 22 young women who were patients in units run by The Huntercombe Group, which has run at least six children’s mental health hospitals, between 2012 and this year.
    They say they suffered treatment including the use of “painful” restraints and being held down for hours by male nurses, being stopped from going outside for months and living in wards with blood-stained walls. They also allege they were given so much medication they had become “zombies” and were force-fed.
    Through witness testimony, documents obtained by Freedom of Information request and leaked reports, the investigation has uncovered:
    The CQC has received more than 700 whistleblowing and safeguarding reports, including “incidents of concern” and several “sexual safety” concerns. NHS England was notified of 195 safeguarding reports between 2020 and 2021. A 2018 internal report at Meadow Lodge hospital in Newton Abbot (now closed) found staff members using sexually inappropriate language in front of patients. 160 reports investigated by Staffordshire police about Huntercombe Staffordshire between 2015 and 2022. Between March 2021 and 2022, the CQC gave permission for 29 patients to be admitted to Maidenhead hospital after it was placed in special measures. Read full story
    Source: The Independent, 17 November 2022
  14. Patient Safety Learning
    The NHS will receive an extra £3.3bn in each of the next two years, the chancellor has announced, but experts warn the cash is probably only half of what is needed to keep the health service afloat.
    Jeremy Hunt told the Commons during his autumn statement he had been assured the funding would mean the NHS can hit its “key priorities”. Its chief executive, Amanda Pritchard, later issued a statement welcoming the funding, saying it showed that “the government has been serious about its commitment to prioritise the NHS”.
    However, it was only last month that NHS England, the organisation Pritchard leads, had forecast a £7bn shortfall in its funding next year, which it warned it could not plug with efficiency measures alone.
    “The NHS warned it needed more money to cope with the impact of inflation on its costs,” said Nigel Edwards, the chief executive of the independent thinktank Nuffield Trust. “Today’s autumn statement has provided much-needed extra cash from April over the next two years, but this is only around half of what the NHS had warned last month would likely be needed.”
    Hunt pledged to grow the NHS budget in 2023-24 and 2024-25 by £3.3bn in each year.
    But Edwards warned that would not account for the £2.5bn worth of inflation and other unexpected cost pressures the NHS has faced in the current financial year.
    “The impact of today’s funding announcement is that real terms health spending per head after adjusting for age will increase by less than 1% for the next two years,” Edwards added. “This is compared to the long-term average of 2.6% and comes at a time when the NHS cannot afford to stand still and is desperately trying to increase the work it can do to clear record waiting times.”
    Read full story
    Source: The Guardian, 17 November 2022
  15. Patient Safety Learning
    A US Senate investigation into allegations that unwanted medical procedures were performed on detained female immigrants in Georgia has uncovered “a catastrophic failure by the federal government” to protect the detainees.
    A Senate hearing on Tuesday by the bipartisan permanent subcommittee on investigations (PSI), chaired by the Georgia senator Jon Ossoff, announced its findings on conditions and practices at the Irwin county detention center (ICDC).
    The ICDC, located in Ocilla, Georgia, housed detainees who shared accounts of poor treatment including gynaecological procedures that were “excessive, invasive and often unnecessary”. An account of what was occurring at the ICDC first came to light when Dawn Wooten, a nurse at the facility, acted as a whistleblower.
    Ossoff called the alleged unnecessary and sometimes non-consensual medical treatment and procedures disclosed in the 18-month investigation “nightmarish and disgraceful”.
    Ossoff said: “This is an extraordinarily disturbing finding, and in my view represents a catastrophic failure by the federal government to respect basic human rights.”
    The report detailed the harrowing account of an unnamed woman who was detained in the ICDC in 2020. The detainee describes how Dr Mahendra Amin allegedly removed a portion of her fallopian tube, a result of a dilation and curettage procedure she was not made aware of, and how Amin told her “she would never be able to have children naturally again”.
    Read full story
    Source: The Guardian, 15 November 2022
  16. Patient Safety Learning
    Families whose loved ones’ bodies were sexually abused in a hospital mortuary have yet to receive any compensation, because the Department of Health and Social Care has not signed off a proposed framework.
    A family member involved in the case claimed the delay was due to a “chaotic, splenetic mess of a government… [which] can’t get an arse on a seat long enough to approve it”.
    Former hospital maintenance supervisor David Fuller is serving life sentences for the murder of two women, committed two decades before he went on to commit sexual offences against 101 dead women and girls in hospital mortuaries in Kent.
    He was given a total of 12 years, to run concurrently, for 51 sex offences when he was sentenced last December but recently pleaded guilty to 16 additional charges involving 23 bodies and will be sentenced for these next month.
    But the families of the women and girls involved have waited more than a year to receive any compensation for the emotional distress his actions caused. 
    Read full story (paywalled)
    Source: HSJ, 16 November 2022
  17. Patient Safety Learning
    Women are four times as likely to die after childbirth in Britain as in Scandinavian countries, a study published in the BMJ has found.
    Researchers analysed data on the number of women who die because of complications during pregnancy in eight high-income European countries.
    They found that Britain had the second-highest death rate, with one in 10,000 mothers dying within six weeks of giving birth, only slightly less than in Slovakia, the worst performing.
    The study found that rates of “late” maternal death — when women die between six weeks and a year after giving birth — were nearly twice as high in Britain as in France, the only other country for which data was available. Heart problems and suicide were the main causes of death.
    Professor Andrew Shennan, an obstetrician at King’s College London, said: “Any death relating to pregnancy is devastating. Equally shocking are the avoidable discrepancies in worldwide maternal mortality.
    “Causes of [maternal] death are relatively consistent across the world, and largely avoidable. Most deaths are due to haemorrhage, sepsis and hypertensive disorders of pregnancy.
    “In Europe, non-obstetric causes of death have become proportionately more common than obstetric causes, including deaths from cardiovascular disease (23%) and suicide (13%); these should be prioritised.”
    Read full story (paywalled)
    Source: The Times. 17 November 2022
  18. Patient Safety Learning
    The plan to tackle long waits in hospital treatment and cancer care in England by 2025 is at serious risk, the spending watchdog says.
    The National Audit Office report warned inflation and other pressures on the NHS could undermine the push. These included a lack of staff and hospital beds, which was affecting productivity, the watchdog said.
    But NHS bosses said they could overcome the challenges and the health service was on track to hit its targets.
    NHS England and the government have set a series of targets over the next three years.
    They include:
    returning performance on the 62-day target for cancer treatment to pre-pandemic levels by March 2023 ending waits of over a year and a half for planned treatment, such as knee and hip operations, by April 2023 ending waits of over a year for planned treatment by March 2025 The NAO report comes as the chancellor prepares to set out his tax and spending plans in his Autumn Statement on Thursday. Cuts to public spending are likely but Health Secretary Steve Barclay has strongly hinted the NHS will receive more money.
    Read full story
    Source: BBC News, 17 November 2022
  19. Patient Safety Learning
    The health service’s independent data watchdog has issued a warning to local NHS bodies over concerns confidential patient information is being shared unlawfully with third parties, including for ‘population health’ analysis.
    In a letter to integrated care systems (ICSs), National Data Guardian Nicola Byrne and UK Caldicott Guardian Council chair Arjun Dhillon said they had both “been made aware that within some local record sharing programmes, organisations could be processing confidential patient information without ensuring that the processing does not breach confidentiality”.
    They added among the four areas of concern health and care staff had raised with them was that confidential patient information may be being transferred from local record sharing programmes to third party hosted secure data environments. Secure Data Environments are data storage and access platforms where organisations can apply to access data for planning and research purposes.
    It is not clear what kind of patient data may have been unlawfully shared.
    Read full story (paywalled)
    Source: HSJ, 17 November 2022
  20. Patient Safety Learning
    Doctors have warned of "unsafe" maternity services at a Sussex hospital in emails seen by the BBC.
    In the email chain between senior staff at the Royal Sussex County Hospital in Brighton, consultants wrote of "compromises" to patient care.
    One doctor said during a birth "we were one step away from a potential disaster".
    One senior doctor wrote in the exchange that "increasing workforce issues" had contributed to making the situation in the maternity unit "almost unmanageable at times". They added: "We are making compromises to patient care every day as a result."
    Another wrote that their workload was often "unmanageable, and obviously impacted by the staffing issues".
    A senior member of maternity staff said "we are delivering suboptimal care" and "we are one step away from potential disaster".
    A doctor also said staff were being "stretched", and that there were delays to women's care.
    Another consultant wrote: "We have an unsafe service and we have to strive for better than that."
    Read full story
    Source: BBC News, 16 November 2022
  21. Patient Safety Learning
    Following the blistering verdict last week of the independent review into the General Medical Council's (GMC) handling of the notorious 'laptop' case, which highlighted the "worrying trend" of ethnic minority doctors facing disproportionate regulatory action, the GMC has launched a new resource 'hub' to support doctors facing racism at work. 
    A new dedicated area on the GMC website offers advice on how to address racism in the workplace, and sits alongside its existing dedicated whistleblowing webpage as the latest of 12 areas in an 'ethical hub' that brings together resources on how to apply GMC guidance in practice, focussing on areas doctors often query or find most challenging, and helping to address important ethical issues.
    Announcing the launch, the GMC said: "Tackling discrimination and inequality continues to be an urgent priority for health services."
    It added: "The GMC has committed to working with organisations to drive forward change, setting targets on tackling inequality." Its equality, diversity, and inclusion targets set last year aimed, inter alia, "to eliminate disproportionate complaints from employers about ethnic minority doctors, by 2026, and to eradicate disadvantage and discrimination in medical education and training by 2031". In March this year it published its first progress report, which showed that the gap between employer referral rates for ethnic minority doctors and international medical graduates, compared with white doctors, had "reduced slightly".
    Read full story
    Source: Medscape UK, 15 November 2022
  22. Patient Safety Learning
    An orthodontist whose methods around shaping the jawline have gone viral advised treatment to young children that “carried a risk of harm”, a tribunal has heard. Dr Mike Mew, whose “mewing” techniques have racked up nearly 2 biillion views on TikTok, faces a misconduct hearing at the General Dental Council (GDC).
    Opening the hearing in central London on Monday, Lydia Barnfather, representing the GDC, said comments made by Mew, who claims to help “alter the cranial facial structure” on his YouTube channel, were “pejorative” about orthodontists.
    Barnfather told the professional conduct committee that Mew seeks to treat children with “head and neck gear” and “lower and upper arch expansion appliances” to help align teeth and shape the jawline.
    “The GDC alleges this is not only very protracted, expensive, uncomfortable and highly demanding of the child, but it carries the risk of harm", Barnfather said.
    It was heard that between September 2013 and May 2019, advice and treatment were provided to two children, referred to as Patient A and Patient B.
    Mew was accused of failing to “carry out appropriate monitoring” of their treatment and “ought to have known” this was liable to cause harm.
    Barnfather said: “The GDC allege you are not to have treated patients the way you did.”
    She argued that both children had “perfectly normal cranial facial development for their age” before treatment took place. She added that the treatment was “not clinically indicated” and that Mew “had no adequate objective evidence” it would achieve its aims.
    Read full story
    Source: The Guardian, 14 November 2022
  23. Patient Safety Learning
    Poison control centres in the USA have seen an increase in reports of children ingesting a type of prescription cough medicine, a study published by the Food and Drug Administration (FDA)found.
    From 2010 through 2018, reports of paediatric poisonings involving the drug, benzonatate, increased each year, the study found. Benzonatate, sold under the brand name Tessalon, is prescribed to treat coughs caused by colds or the flu. It is not approved for children younger than 10 years old.
    The findings, published in the journal Pediatrics, were based on more than 4,600 cases reported to poison control centres. 
    The reports included children who were unintentionally exposed to the drug, as well as children who abused or misused it intentionally. 
    The proportion of cases with serious adverse effects was low. However, accidental or inappropriate use of benzonatate, which comes in gel capsules, can lead to serious health problems in children, including convulsions, cardiac arrest and death.
    The findings should galvanise doctors to be more careful when they prescribe these kinds of medications, said study author Dr. Ivone Kim, a pediatrician and senior medical officer at the FDA.
    Cough medications "should be treated like any other medication that can have serious side effects," Ameenuddin said, "which means not giving it to children without specific medical direction."
    Read full story
    Source: NBC News, 15 November 2022
  24. Patient Safety Learning
    Hundreds of mental health patients in England are sent to hospitals miles from home each month because of local bed shortages - more than a year after the NHS aimed to end the practice.
    NHS data shows that 630 patients were in inappropriate out of area placements (OAPs) at the end of August 2022. 
    An inappropriate OAP is when someone is sent to a hospital in a different area because no beds are free locally. Of the 630 patients in inappropriate OAPs in August 2022, more than half were sent away that month.
    In 2019, Kelly was sectioned and - because no local bed was free - sent to a hospital 23 miles from her home.
    "I didn't have anything on me", she says, "I only had my phone and the clothes that I was in."
    With family members too far away to bring her possessions, the hospital provided basics: pyjamas, trousers, a T-shirt, one pair of socks and two pieces of underwear.
    "All I could wear were the pyjamas and the same top and trousers every day for three weeks," says Kelly.
    "It was just awful. When you're stuck in a strange place as it is... It's even more distressing not having your own familiar things to take comfort in."
    Shortly after her discharge, Kelly was sectioned again - this time closer to home. She says this made a "massive difference", adding: "When you're closer to home you've got your friends and your family coming to visit you and take you out for a walk."
    Paul Spencer, the charity Mind's head of health, policy & campaigns, describes OAPs as traumatic, isolating and costly to the NHS. He says that "people are cut off from their support networks right at the very moment they need them most".
    Read full story
    Source: BBC News, 16 November 2022
  25. Patient Safety Learning
    Far too many women were rushed into mesh sling surgery for stress incontinence after birth when pelvic floor physiotherapy could have fixed or eased the problem.
    In France, women are offered pelvic floor physiotherapy after childbirth as standard.
    A recent question to the Secretary of State for Health and Social Care asked what assessment the Department has made of the potential benefits of offering new mothers pelvic floor physiotherapy.
    This question was answered on 15 November 2022:
    "The National Institute for Health and Care Excellence’s guidance recognises that physiotherapy is important for the prevention and treatment of pelvic floor problems relating to pregnancy and birth. The NHS Long Term Plan committed to ensure that women have access to multidisciplinary pelvic health clinics and pathways in England.
    NHS England is deploying perinatal pelvic health services to improve the prevention, identification and access to physiotherapy for pelvic health issues antenatally and postnatally. Two-thirds of local maternity and neonatal systems are expected to establish these services by the end of March 2023, with full deployment in England expected by March 2024."
    Source: Parallel Parliament, 15 November 2022
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