Jump to content
 View Profile  See their activity

  • Posts

    11,906

  • Joined

  • Last visited

Patient Safety Learning

Administrators

 Content Type 

News posted by Patient Safety Learning

  1. Patient Safety Learning
    All GP practices in England will be able to book cancer tests directly for their patients from later this month, NHS bosses say.
    The option of GPs booking CT scans, ultrasounds and MRIs has been gradually rolled out in recent years, as community testing centres have opened.
    NHS England chief executive Amanda Pritchard will announce later all GPs will now be able to do this. 
    GPs have previously relied on referring on to specialist hospital doctors. Before referring, they have to identify clear symptoms the patient may have a specific type of cancer.
    But only one out of every five cancer cases is diagnosed through these urgent GP referrals. Patients with less clear symptoms face long waits for check-ups or are diagnosed only after presenting at an accident-and-emergency (A&E) unit or being referred to hospital for something else.
    And Ms Pritchard will tell delegates at the NHS Providers annual conference of health managers, in Liverpool, today, she hopes the new initiative will lead to tens of thousands of cancer cases every year being detected sooner.
    Read full story
    Source: BBC News, 16 November 2022
  2. Patient Safety Learning
    The national director for mental health has said she was shocked to discover how many ward managers do not work at weekends, adding this could contribute to abuse and poor care going undetected.
    Asked at the NHS Providers conference about recent reports into care scandals, NHS England’s director for mental health Claire Murdoch said it was crucial to listen to frontline staff, such as healthcare assistants, who spend most of their time with patients.

    But she added: “[It’s also] making sure your ward managers do work of a night and at the weekend.
    “I’ve been a bit shocked to hear that we’ve moved with agenda for change and quite often ward managers are Monday to Friday people.”
    Her comments come amid a string of high-profile care scandals, such as at the Edenfield Centre in Greater Manchester, as well as an ongoing debate around seven-day working across the NHS.
    It is understood Ms Murdoch is concerned managers are spending too much time on bureaucratic tasks, which typically happen during Monday to Friday shifts, meaning they are then not working night or weekend shifts.
    In September, the national director ordered all trusts to carry out safety reviews, warning in a letter they should leave “no stone unturned” in seeking to eradicate and prevent poor care. She also urged all boards to urgently review safeguarding of care in their organisations, and identify any immediate issues requiring action now.
    Read full story (paywalled)
    Source: HSJ, 15 November 2022
  3. Patient Safety Learning
    Experts have warned that Europe faces a “cancer epidemic” unless urgent action is taken to boost treatment and research, after an estimated 1m diagnoses were missed during the pandemic.
    The impact of Covid-19 and the focus on it has exposed “weaknesses” in cancer health systems and in the cancer research landscape across the continent, which, if not addressed as a matter of urgency, will set back cancer outcomes by almost a decade, leading healthcare and scientific experts say.
    A report, European Groundshot – Addressing Europe’s Cancer Research Challenges: a Lancet Oncology Commission, brought together a wide range of patient, scientific, and healthcare experts with detailed knowledge of cancer across Europe.
    One unintended consequence of the pandemic was the adverse effects that the rapid repurposing of health services and national lockdowns, and their continuing legacy, have had on cancer services, on cancer research, and on patients with cancer, the experts said.
    “To emphasise the scale of this problem, we estimate that about 1m cancer diagnoses might have been missed across Europe during the Covid-19 pandemic,” they wrote in The Lancet Oncology. “There is emerging evidence that a higher proportion of patients are diagnosed with later cancer stages compared with pre-pandemic rates as a result of substantial delays in cancer diagnosis and treatment. This cancer stage shift will continue to stress European cancer systems for years to come.
    “These issues will ultimately compromise survival and contribute to inferior quality of life for many European patients with cancer.”
    Read full story
    Source: The Guardian, 15 November 2022
  4. Patient Safety Learning
    Directors of a major hospital have ordered their accident and emergency staff to continue receiving ambulance patients into their department “in all instances”, following angry exchanges with paramedics.
    Hospital staff and ambulance crews have clashed at the new Royal Liverpool Hospital since its opening last month, after ambulance crews were prevented from bringing patients inside accident and emergency department when it was deemed to be full to capacity.
    The problems were escalated to hospital directors and North West Ambulance Service Trust earlier this month, resulting in new instructions being issued to the emergency department.
    In a letter to managers in A&E and the other divisions, seen by HSJ, the three most senior directors at the Royal Liverpool, wrote: “As you are aware we are currently experiencing long delays in accepting handover of patients from ambulance crews.
    “This phenomenon is not unique to us at the Royal Liverpool, nor is it particularly new, but our recent challenges have undoubtedly been exacerbated due to teams still familiarising themselves with working in a new environment and the patient flow challenges we have been experiencing on site.
    “However, what has changed has been the extent to which we have managed these pressures by continuing to hold patients in the back of ambulances, which we collectively agree is an unacceptable situation. Whilst providing corridor care is not what any of us would aspire to, we have to recognise and respond to the risk of patients awaiting response in the community.
    “We have therefore today met with NWAS colleagues and agreed that, with immediate effect, we will, in all instances, continue to receive crews from NWAS into the hospital building.”
    Read full story (paywalled)
    Source: HSJ, 16 November 2022
  5. Patient Safety Learning
    A large study today from Germany shows that children and adolescents are at the same relative risk of experiencing COVID-19 symptoms 90 days or more after acute infection as adults are, according to findings in PLOS Medicine.
    Though kids and adolescents have far fewer deaths or severe outcomes from COVID-19 infections compared to adults, little is known about Long or post-Covid symptoms in this age-group, or symptoms that persist for more than 12 weeks after acute infection.
    Researchers from the Technical University of Dresden, Germany, used data from half of the German population to determine that kids and adults have the same relative risk of experiencing post-Covid symptoms at 90 days following infection.
    Martin Roessler, the lead author of the study, said there were significant symptom overlap among kids and adults who experienced symptoms 90 days or more after acute infection.
    "We found 5 identical outcomes among the 10 outcomes with the highest relative risk among children/adolescents and adults. These symptoms are cough, fever, headache, malaise/fatigue/exhaustion, throat or chest pain," he told CIDRAP News.
    Other symptoms were more commonly seen in adults, but not kids. Those included a loss of taste or smell, fever, and shortness of breath.
    Daniel Blatt, MD, a pediatric infectious disease physician at the post-COVID clinic at Norton Children's Hospital in Louisville, Kentucky, said he was not surprised by the study's findings.
    "It's unclear if Long Covid is the same in children and adults, in terms of pathophysiology, but it's just as real," he said. Blatt, who was not involved in the study, said his clinic also collects data on children and Long Covid. He said the most common symptoms reported in his patients are fatigue, anxiety, and "brain fog," followed by some shortness of breath or muscle pain.
    "The good news is kids tend to get better, regardless of what intervention is needed," Blatt said. As in adult Long Covid, there's no one-size-fits-all approach for pediatric Long Covid patients. "Some need reassurance; some need a graduated exercise program."
    Read full story
    Source: CIDRAP, 10 November 2022
  6. Patient Safety Learning
    Voices offer lots of information. Turns out, they can even help diagnose an illness — and researchers in the USA are working on an app for that.
    The National Institutes of Health is funding a massive research project to collect voice data and develop an AI that could diagnose people based on their speech.
    Everything from your vocal cord vibrations to breathing patterns when you speak offers potential information about your health, says laryngologist Dr. Yael Bensoussan, the director of the University of South Florida's Health Voice Center and a leader on the study.
    "We asked experts: Well, if you close your eyes when a patient comes in, just by listening to their voice, can you have an idea of the diagnosis they have?" Bensoussan says. "And that's where we got all our information."
    Someone who speaks low and slowly might have Parkinson's disease. Slurring is a sign of a stroke. Scientists could even diagnose depression or cancer. The team will start by collecting the voices of people with conditions in five areas: neurological disorders, voice disorders, mood disorders, respiratory disorders and pediatric disorders like autism and speech delays.
    This isn't the first time researchers have used AI to study human voices, but it's the first time data will be collected on this level — the project is a collaboration between USF, Cornell and 10 other institutions.
    The ultimate goal is an app that could help bridge access to rural or underserved communities, by helping general practitioners refer patients to specialists. Long term, iPhones or Alexa could detect changes in your voice, such as a cough, and advise you to seek medical attention.
    Read full story
    Source: NPR, 10 October 2022
  7. Patient Safety Learning
    GP surgeries across Scotland are at risk of collapsing because of staff shortages and increased demand, a senior doctor has warned.
    Dr Andrew Buist, chairman of the British Medical Association's (BMA) Scottish GP committee, told the BBC many practices were at "tipping point".
    More than a third of surveyed surgeries reported at least one GP vacancy – up from just over a quarter last year.
    About half of the GP surgeries in Scotland took part in the BMA survey.
    It showed 81% of practices said demand was exceeding capacity - with 42% saying demand substantially exceeded capacity.
    Dr Buist told BBC Scotland: "I worry that we're reaching a tipping point for some practices.
    "They lose one or maybe two doctors out of three, and the remaining doctors cannot continue so they return the contract and the practice may cease to exist.
    "That is a real concern in some parts of Scotland that that is happening and it's going to happen increasingly as the situation develops over this winter."
    Read full story
    Source: BBC News, 15 November 2022
  8. Patient Safety Learning
    A Northern Ireland hospital closed its doors to new admissions on Saturday night because conditions had become unsafe, a health chief has said.
    Jennifer Welsh, chief executive at the Northern Health Trust, said the situation in the emergency department (ED) at Antrim Area Hospital on Monday remained “extremely pressured”.
    A major incident was declared at the weekend when a high number of critically ill patients arrived in quick succession at the Co Antrim hospital, prompting the decision to temporarily close the doors to new admissions.
    Ms Welsh said there were 45 patients in the ED on Monday for whom a decision to admit had been made, but for whom no bed is available.
    She told the BBC Good Morning Ulster programme: “That would have been unthinkable about four or five years ago, we would have never seen numbers like that."
    She said: “We had a high number of people arriving. A very high number of patients in the department.
    “At the time we called the incident there were 131 patients and about 66 of them had a decision to admit and no bed available.
    “At that stage our resuscitation unit was already full, it was over full.
    “Then we got the news we had three more standby ambulances coming in. That is critically ill patients who had to be brought into our resuscitation department as quickly as possible and we simply could not cope.
    “The safest thing to do in those circumstances is to call the major incident, to effectively close the door and what that means is that people are conveyed to the next nearest emergency department to ensure they begin the urgent treatment that they need because we were not able to do that.
    “It was the right call to say that it was unsafe. It was unsafe at that time.”
    Read full story
    Source: The Independent, 14 November 2022
  9. Patient Safety Learning
    Whistle-blowers have described neglect, patient-on-patient assault and staff who bully colleagues and sleep on the job at a troubled mental health ward.
    Sources told a BBC investigation that a patient of 25-bed, mixed-gender Hill Crest Ward in Redditch, Worcestershire, suffered a broken jaw during one clash.
    They also claimed three nurses were "forced out" amid bullying behaviour.
    The NHS trust that runs Hill Crest said it believed changes there were having a positive impact.
    Accounts have been corroborated via five independent sources to whom the BBC spoke. They follow reports earlier this year of a fire and an incident in which staff locked themselves in an office when a patient ran around armed with boiling water and sugar.
    Additionally, one patient has provided the BBC with images alleged to show the effects of her battering herself out of desperation - without staff intervening.
    Sources also described staff being bullied, with one saying a nurse who particularly suffered had her resignation letter read out and mocked by tormentors.
    Sources independently complained of the workplace culture, with the BBC aware of explicit images bearing lewd comments about colleagues.
    Read full story
    Source: BBC News, 15 November 2022
  10. Patient Safety Learning
    A policy change to speed up hospital discharge could save the NHS more than £7bn over a decade, according to a government evaluation – but ministers have not funded it.
    A Department of Health and Social Care impact assessment of the Health and Care Act, passed earlier this year, says that wider use of discharge to assess could free up as many as 6,000 hospital beds and save the NHS £7bn by 2031, the equivalent of £800m a year. It adds: “The overall societal benefits of this would likely be higher as beds could be allocated to patients with more urgent health care needs.”
    The “discharge to assess” approach, which has been used on a temporary basis for several years and more widely during the pandemic – with government funding to back it – sees patients discharged more quickly, and provided with support at home while their long-term care needs are assessed. It was credited with significant reductions in the amount of time patients spent in hospital.
    Changes in the Health and Care Act were intended to remove legal obstacles to the approach, by revoking a requirement for an assessments be carried out before discharge, which often leads to delays in the patient leaving hospital.
    Read full story (paywalled)
    Source: 15 November 2022
  11. Patient Safety Learning
    Doctors and nurses are “absolutely frightened and petrified” about how bad this winter will be for the NHS in England, hospital bosses have revealed.
    Staff fear services will not be able to cope with a combination of flu, resurgent Covid, winter and the cost of living crisis damaging people’s health, and also the wave of looming strikes over pay.
    “People are genuinely scared,” said the chief executive of one acute NHS trust in England.
    “I’m talking to senior clinicians and consultants and nurses who are absolutely frightened and petrified about what’s potentially to come,” added the hospital boss, speaking on condition of anonymity. Staff are anxious because of “the potential for the impact of Covid and flu, the impact of industrial action, the impact of cost of living, the impact on people’s health from that, [and] the massive increases in mental health need, and the breakdown in primary care and social care.”
    Chiefs of other NHS trusts in England said they shared that gloomy prognosis. They are bracing themselves for having to curtail and cancel services on days when staff stop work over pay, including outpatient clinics and non-urgent surgery. The NHS will face an “onslaught” this winter, one said.
    Read full story
    Source: The Guardian, 15 November 2022
  12. Patient Safety Learning
    Trust leaders have raised concerns about other major unions striking on the same dates as the Royal College of Nursing in co-ordinated action, which would make avoiding disruption and harm ‘more hairy’.
    The concerns were raised after the Royal College of Nursing confirmed members at various trusts had voted in favour of unprecedented action last week, with Unison and a raft of other unions also balloting members on strike action this month and in December.
    Unison told HSJ co-ordinated action between itself, the RCN and the other health unions was “the best way to ensure industrial action is effective”.
    One senior trust leader said that while the RCN strike days would prove a major challenge, they predicted their trust would be able to cope with the fallout. But they said the challenge would get even “more hairy” if Unison members also walked out on the same dates – a prospect they feared likely.
    HSJ also understands that trust bosses have concerns about what will and won’t be classified as urgent and also about the emergency work to be carried out throughout a strike.
    One senior provider figure used the example of insulin injections, which are at present to be part of the urgent and emergency care activities to continue throughout a strike, and wound treatment services, which, at this stage, are not.
    They said: “If people don’t get those [insulin] injections twice a day, that person, by the end of 24 hours, will be in hospital [but] we are negotiating on [other areas] for example wound care. If you don’t dress people’s wounds at the right time, the worst situation is that a [deteriorating] wound means your leg has to be chopped off. At the moment, doing wound care is not being considered urgent care.”
    Read full story (paywalled)
    Source: HSJ, 15 November 2022
  13. Patient Safety Learning
    Care homes and hospitals will be forced to allow visitors under plans being drawn up by the government.
    Helen Whately, the care minister, said shutting out relatives showed a lack of humanity. Covid-19 rules mean some of the country’s most vulnerable people still cannot have loved ones at their bedside.
    Whately, who has told of her personal grief and frustration at being barred from visiting her critically ill mother, is now developing laws to give residents and patients a right to receive visitors.
    Although official visiting restrictions were dropped in the spring in England, there are still widespread reports of care homes and hospitals refusing to let in relatives or imposing stringent conditions that ministers do not believe are justified by public health guidance.
    Hundreds of care homes still refuse to accept visitors entirely, according to government figures, while others restrict residents to one relative at a time. 
    Campaigners report residents losing weight because their relatives cannot go in to help them at mealtimes amid staff shortages. They also fear residents are being left in bed for long periods because staff know there will be no visitors to check on them. Whately said that she was “determined to fix” the issue, adding: “No one can be in any doubt now how much visits matter”. 
    Read full story (paywalled)
    Source: The Times, 11 November 2022
    Related reading on the hub:
    Visiting restrictions and the impact on patients and their families: a relative's perspective It’s time to rename the ‘visitor’: reflections from a relative
  14. Patient Safety Learning
    One of the country’s most senior doctors has said he is “desperate” to keep his elderly parents out of hospital, which he said are like “lobster traps”.
    Dr Adrian Boyle, president of the Royal College of Emergency Medicine, said hospitals are easy to get into but hard to get out of.
    His comments come after figures showed the number of patients in hospital beds in England who no longer need to be there has reached a new monthly high.
    An average of 13,613 beds per day were occupied by people ready to be discharged from hospital in October. That was up from 13,305 in September and the highest monthly figure since comparable data began in December 2021, according to analysis by the PA news agency.
    In an interview with the Daily Mail, Dr Boyle said: “Hospitals are like lobster traps – they’re easy to get into and hard to get out of.
    “If social care was able to do its job in the way we want it to, these poor people wouldn’t be stranded in hospital.
    “I have elderly parents and I’m desperate to keep them out of hospital.
    “For someone who is frail, hospital is often a bad place for them. They’re being harmed by being in hospital.”
    Read full story
    Source: The Independent, 14 November 2022
  15. Patient Safety Learning
    Patients have been asking to go to other hospitals rather than one where the ageing roof is being held up by more than 2,400 wooden and steel posts.
    The Queen Elizabeth Hospital in King's Lynn has already had to close four of its seven operating theatres because of concerns the ceiling could collapse.
    Alex Stewart, head of Healthwatch Norfolk, said some pregnant women have asked to go to other hospitals.
    The Queen Elizabeth Hospital (QEH) opened in 1980, one of seven hospitals built using a material called reinforced autoclaved aerated concrete (RAAC).
    The material has serious weaknesses and is deteriorating, with uncertainty over its structural integrity leading to more than £100m being spent this financial year on safety measures across the affected sites.
    Mr Stewart told BBC Radio 4's Today programme: "I think people are very frustrated, they're well aware that the hospital staff inspect the hospital on a daily basis, several times a day.
    "That said, we are aware of patients, for example, who are giving birth, who have asked to go to other hospitals because they're scared in case the roof might fall in on them."
    The hospital's interim chief executive, Alice Webster, said while four theatres have had to be closed, "potentially" there could be problems with the ceilings in the others.
    "We continue to monitor it on a daily basis," she said.
    "We're making sure our theatres are functioning longer, we're functioning at weekends and trying to manage the waiting lists that way."
    She added: "If we don't get a new hospital we will have to review all the services that we currently provide, but we won't be able to provide all the services that we currently do."
    Read full story
    Source: BBC News, 13 November 2022
  16. Patient Safety Learning
    Scientists are launching a trial screening programme for type 1 diabetes in the UK to detect the disease earlier and reduce the risk of life-changing complications.
    About 20,000 children aged between 3 and 13 are being invited to take part in the Early Surveillance for Autoimmune Diabetes (Elsa) study, with recruitment opening on Monday.
    The aim is to assess children’s risk of developing type 1 diabetes at the earliest stage possible to ensure a quick and safe diagnosis, and reduce the number being diagnosed when they are already seriously ill.
    Parth Narendran, a professor of diabetes medicine at the University of Birmingham, said: “As general population screening programmes for type 1 diabetes emerge around the world, we need to explore how best to screen children here in the UK.”
    Dr Elizabeth Robertson, the director of research at Diabetes UK, which is co-funding the study with the not-for-profit organisation JDRF, said: “Identifying children at high risk of type 1 diabetes could put them and their families on the front foot, helping ensure a safe and soft landing into an eventual diagnosis, avoiding DKA and reducing the risk of life-altering complications.”
    Read full story
    Source: The Guardian, 14 November 2022
  17. Patient Safety Learning
    A Guardian analysis has found that as many as one in three hospital beds in parts of England are occupied by patients who are well enough to be discharged, with a chronic lack of social care meaning many do not have suitable places to go. 
    Barry Long's 91-year-old mother has Alzheimer’s and was admitted to Worthing hospital on 30 May after a minor fall. She was a bit confused but otherwise unhurt, just a bit shaken. Whilst in hospital, she caught Covid and had to be isolated, which she found distressing, and became increasingly disoriented.
    She was declared medically fit to be discharged but no residential bed could be found for her. Then, in August, she was left unsupervised and fell over trying to get to the toilet and she fractured her hip, which required surgery. 
    Her hip was just about healed when she caught her shin between the side bars and the frame of the bed, cutting her shin so badly that she is being reviewed by a plastic surgeon to see if it needs a skin graft.
    "Since the operation, my mum is pretty much bedbound and lives in a state of confusion and anxiety", says Barry. "Her physical health and mental wellbeing have deteriorated considerably in the almost five months she has spent in the care of the NHS. She spends all day practically trapped in bed, staring into space or with her eyes shut, just rocking to and fro. She has little mental stimulation."
    Read full story
    Source: The Guardian, 13 November 2022
  18. Patient Safety Learning
    A senior doctor is to be removed from the medical register after she was found to have attempted to cover-up the circumstances of a young girl's death.
    Paediatrics consultant Dr Heather Steen was found to be unfit to practise after an investigation into the death of nine-year-old Claire Roberts in 1996.
    A medical tribunal examining the doctor's case ruled that the majority of allegations against her were true.
    Claire's mother said it was "just the start of getting full justice".
    "I am angry at Dr Steen for putting us through 26 years of mental torment," said Jennifer Roberts.
    At the time of Claire's death, her parents were told she had a viral infection that had spread from her stomach to her brain.
    But in 2018 a public inquiry determined that she had died from an overdose of fluids and medication caused by negligent care at the Royal Belfast Hospital for Sick Children.
    The inquiry also concluded there had been "cover up" and the girl's death had not been referred to the coroner immediately to "avoid scrutiny".
    The case was then put to the Medical Practitioners Tribunal Service (MPTS), which rules on doctors' fitness to practise.
    When the case reached the tribunal stage Dr Steen twice applied to be voluntarily removed from the medical register and was twice refused. Had that been successful the tribunal would have been halted as she would no longer have been a doctor.
    However the tribunal continued and examined allegations that between October 1996 and May 2006 Dr Steen "knowingly and dishonestly carried out several actions to conceal the true circumstances" of Claire.
    Read full story
    Source: BBC News, 11 November 2022
  19. Patient Safety Learning
    No formal risk assessment was done on a man who beat a fellow care home resident to death, a review has found.
    Alexander Rawson attacked 93-year-old Eileen Dean with a metal walking stick at a care home in south-east London. Mrs Dean suffered catastrophic injuries to her head and body and died later in hospital.
    A review found Fieldside Care Home in Catford did not provide the specialist mental health services that Rawson - who had a history of violence - needed.
    Rawson, who had a history of mental health problems caused by alcoholism, was 62 when he was placed in the home a few days before Christmas 2020.
    He was put in the room next to Mrs Dean and, in the first week of 2021, he went into her room at night and attacked her.
    In a review published on Friday, the Lewisham Safeguarding Adults Board said Rawson had been moved into the home after being an inpatient at a psychiatric unit run by the South London and Maudsley NHS Foundation Trust.
    The care home was the only place that agreed to take him after his discharge from hospital.
    In the months before he was moved into the care home, Rawson was involved in at least 34 recorded incidents of violence or threats to patients and health staff, including a threat to kill.
    Before he was placed in the home, no attempts were made to find out whether Rawson had come into contact with the criminal justice system over his behaviour, the report found.
    It states that the care home had asked about the risks Rawson posed before they took him and had been reassured by a social worker and medical staff.
    Read full story
    Source: BBC News, 12 November 2022
  20. Patient Safety Learning
    Ambulances called to serious emergencies in the East of England, which encompasses Essex, have the longest waiting times of anywhere in the UK, according to new data. The East of England Ambulance Service, which serves the county of Essex, has the longest wait times for life-threatening injuries of anywhere in the country.
    Ambulances took an average of 11 minutes and 12 seconds to respond to category one calls - those for life threatening injuries - in the Essex region in October. That’s up from 10 minutes 49 seconds in September, and far longer than the 7 minute target set by the NHS.
    This means it’s also the longest category one response time of any ambulance service in England, as compared to the average wait time for ambulances across England as a whole, category one calls were responded to in an average of 9 minutes and 56 seconds.
    A spokesperson for the East of England Ambulance Service said: "Our service is under extreme pressure with many ambulances delayed outside hospitals and high call volumes.
    "To help us respond effectively we have increased our escalation state across the Trust. We urge the public to please support us by using our services wisely and only calling for life-threatening illnesses and injuries."
    Read full story
    Source: Essex Live, 10 November 2022
  21. Patient Safety Learning
    A nurse in the USA who called emergency services in response to staffing issues at Silverdale, Washington-based St. Michael Medical Center spoke out about her decision and the events leading up to the call.
    Kelsay Irby has been an emergency department charge nurse at the hospital for less than a year. On the 8 October, the night Ms Irby called emergency services for help, the ED was operating at less than 50% of its ideal staffing grid. Among the nearly 50 people in the hospital's waiting room were patients with cardiac or respiratory issues and children with high fevers — "all patients that made us very nervous to have in the lobby, unmonitored for extended periods of time," Ms. Irby said. 
    The ED had one first-look nurse on the clock who was trying to keep up with patients checking in and could not supervise those waiting for care. After exhausting all other available options, Ms. Irby said she called emergency services' nonemergent line and asked the dispatcher if any crews were available to help ED staff. Ms. Irby was connected with a local fire chief who sent an emergency services crew to the hospital to monitor patients in the lobby, retake their vitals and do roll calls to ensure the ED team's patient list was accurate. 
    Ms. Irby's actions made national headlines in the US as a dramatic example of the staffing issues hospitals nationwide are facing. 
    "I didn’t recognize the impact of what I was doing that night," Ms. Irby wrote. "I was simply working my way down the list of possible sources of help for my coworkers and ultimately our patients."
    Read full story
    Source: Becker's Hospital Review, 8 November 2022
  22. Patient Safety Learning
    Thirty-three provider groups in the USA penned a joint letter to President Joe Biden this week warning of “gridlocked” hospital emergency departments that are threatening patients’ lives and the well-being of shorthanded healthcare workers.
    “In recent months, hospital emergency departments (EDs) have been brought to a breaking point. Not from a novel problem—rather, from a decades-long, unresolved problem known as patient ‘boarding,’ where admitted patients are held in the ED when there are no inpatient beds available,” provider associations including the American College of Emergency Physicians (ACEP) and the American Medical Association (AMA) wrote. “While the causes of ED boarding are multifactorial, unprecedented and rising staffing shortages throughout the healthcare system have recently brought this issue to a crisis point.”
    The issue of boarding “has become its own public health emergency” for adult and paediatric care alike, the latter of which is being driven by a spike in mental health visits and, more recently, a “triple threat” of flu, COVID-19 and respiratory illnesses that have backed up children’s hospitals.
    “If the system is already this strained during our ‘new normal,’ how will emergency departments be able to cope with a sudden surge of patients from a natural disaster, school shooting, mass casualty traffic event or disease outbreak?” the groups wrote.
    The letter included a handful of firsthand accounts solicited by ACEP from anonymous emergency physicians describing patients deteriorating or dying “during their tenth, eleventh or even twelfth hour of waiting to be seen by a physician.”
    Read full story
    Source: Fierce Healthcare, 10 November 2022
  23. Patient Safety Learning
    The share of referrals waiting more than three months for a diagnostic test — one of the key problems behind long waits for cancer treatment — is worse than at any point since February 2021, during the second national covid lockdown.
    NHS England data released this morning for September shows 12.4% of the 1.6 million awaiting a test had been on the list longer than 13 weeks.
    At the peak of June 2020, 32% waited more than 13 weeks, but the proportion dropped back beneath 1 in 10, in May 2021, as services ramped up activity following the impact of the major winter 2020-21 Covid wave.
    Echocardiography patients and those needing endoscopies had the highest proportion of patients waiting more than six weeks – these specialties jointly comprise about a third of the total national waiting list and had 48 and 38%, respectively, of their lists over six weeks. 
    Katharine Halliday, president of The Royal College of Radiologists, said: ”Today’s cancer waiting times data is alarming. We know the longer patients wait for a diagnosis or treatment, the less their chance of survival.
    “Our members are clinical radiologists and clinical oncologists, and much of their work involves diagnosing and treating cancer. Today’s figures show the NHS in England would have to employ 441 radiology consultants, the equivalent of a 16% increase in the current workforce, in order to clear the six-week wait for CT and MRI scans in one month.”
    Read full story (paywalled)
    Source: HSJ, 10 November 2022
  24. Patient Safety Learning
    At least half of integrated care systems (ICS) lack plans for responding to cyberattacks, at a time of increasing cyber risks, HSJ can reveal.
    The findings also come at a time when the threat posed by cyber attackers is “constantly evolving”, and in the wake of a recent high-profile attack on a supplier to several trusts. 
    In August 2021, NHS England published a framework – What Good Looks Like – to set out what ICSs and member organisations must achieve to be considered digitally mature.
    Requirements included that all ICSs should have a system-wide plan for “maintaining robust cybersecurity” with “centralised capabilities to provide support across all organisations”.
    However, 20 ICSs have told HSJ they do not yet have such a cybersecurity strategy or plan in place. Nine ICSs said they did, while the remaining 13 ICSs did not respond.
    This is despite the NHS being subjected to a growing number of cyber attacks. In 2020-21, NHS Digital reported the health service had been targeted roughly 21 million times on a monthly basis, which marked an increase since before the pandemic. Most of these are malicious emails containing malware and are automatically blocked by cyber defence and monitoring systems. 
    However, in August, a dozen mental health trusts and several NHS 111 and urgent care providers were badly affected by a cyber attack on one of their IT suppliers, Advanced. Several trusts have not yet regained full access to their electronic patient record three months on from the attack.
    Read full story (paywalled)
    Source: HSJ, 11 November 2022
  25. Patient Safety Learning
    The number of falls and bed sores recorded in Scotland's hospitals has increased since the Covid pandemic, new data shows.
    NHS staffing pressures and the deconditioning effect of the Covid lockdown creating more frail patients are being blamed for the rise.
    The Scottish government paused work on a national prevention strategy for falls when the pandemic started. The strategy has now been shelved and experts argue this is a mistake.
    Figures released by NHS Healthcare Improvement Scotland (HIS) show that in 2018-19 - the last full year before the Covid pandemic - a total of 26,489 falls were recorded in hospitals.
    Dawn Skelton, a professor in ageing and health at Glasgow Caledonian University, said there was a "maelstrom" of problems fuelling the increase in hospital falls.
    She said: "You've got staffing issues definitely but you've also got people who are going in to hospital a step change frailer than they were pre-Covid because of what has happened with all the restrictions.
    "The people in these falls figures have got no reserves, blow on them and they will fall over, so they are at more risk when they go in."
    IProf Skelton said it was time to resurrect the Scottish government's falls and fracture prevention strategy as its "value now cannot be underestimated".
    She added: "Falls and frailty are one of the main causes of long hospital stays and demands on social care and without a spotlight on both the management, but also prevention, the financial and staffing demands on NHS and social care will only rise."
    Read full story
    Source: BBC News, 10 November 2022
×
×
  • Create New...