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Sam

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Everything posted by Sam

  1. News Article
    COVID-19 patients in England's busiest intensive care units (ICUs) in 2020 were 20% more likely to die, University College London research has found. The increased risk was equivalent to gaining a decade in age. By the end of 2020, one in three hospital trusts in England was running at higher than 85% capacity. Eleven trusts were completely full on 30 December, and the total number of people in intensive care with Covid has continued to rise since then. The link between full ICUs and higher death rates was already known, but this study is the first to measure its effect during the pandemic. Tighter lockdown restrictions are needed to prevent hospitals from being overwhelmed, says study author Dr Bilal Mateen. Researchers looked at more than 4,000 patients who were admitted to intensive care units in 114 hospital trusts in England between April and June last year. They found the risk of dying was almost a fifth higher in ICUs where more than 85% of beds were occupied, than in those running at between 45% and 85% capacity. That meant a 60-year-old being treated in one of these units had the same risk of dying as a 70-year-old on a quieter ward. The Royal College of Emergency Medicine sets 85% as the maximum safe level of bed occupancy. However, the team found there was no tipping point after which deaths rose - instead, survival rates fell consistently as bed-occupancy increased. This suggests "a lot of harm is occurring before you get to 85%". Read full story Source: BBC News, 14 January 2021
  2. News Article
    More than 1,000 people needing urgent cancer surgery in London have no date for their treatment, HSJ can reveal. A document leaked to HSJ showed that, at the end of last week, more than 1,000 of London’s cancer surgery patients without an appointment date were defined as P2 (priority two), meaning they needed to be seen within four weeks or risk their condition worsening. The report seen by HSJ also showed more than 300 P2 patients had their surgery postponed in the past week, a statistic NHS England London has so far refused to disclose. Hospitals in the capital are facing their highest-ever COVID-19 occupancy rates, with surgical lists at many trusts being cancelled. Meanwhile, a separate NHSE London document reported in the press this week revealed: “Most NHS Green sites [those cancer surgery sites intended to be covid-free to avoid risk to very frail patients] are now compromised with only a limited number of cases being undertaken in NHS sites this week”. The papers also said the current plans to increase indepedent sector capacity usage were “insufficient to offset the NHS shortfall”, and noted there was a two week lead-in time to move patients into private hospitals “based on clinical rotas, theatre bookings, [and] patient isolation”. Read full story (paywalled) Source: HSJ, 12 January 2021
  3. News Article
    In July last year, the Independent Medicines and Medical Devices Safety Review – chaired by Baroness Cumberlege— published its landmark report, First Do No Harm. It followed a two-year review of harrowing patient testimony and a large volume of other evidence concerning three medical interventions: Primodos, sodium valproate and pelvic mesh. Yesterday, in a written statement to Parliament, the Minister for Patient Safety, Suicide Prevention and Mental Health, Nadine Dorries, gave an update on the government’s response to the recommendations of the Cumberlege Review. In an article in The Times today, Baroness Cumberlege welcomes that the government has now accepted the need for a patient safety commissioner for England and the amendment to the Medicines and Medical Devices Bill, which is being considered in the House of Lords today, which she hopes "will swiftly become law". However, she also states that "... a full response to the review's is still outstanding 6 months after publication. Action is urgently needed to ensure we help those who have already suffered and reduce the risk of harm to patients in future". Read full story (paywalled) Source: The Times, 12 January 2021
  4. News Article
    The Becker's Clinical Leadership & Infection Control editorial team chose the top 10 patient safety issues for healthcare leaders to prioritise in 2021, presented below in no particular order, based on news, study findings and trends reported in the past year. COVID-19 Healthcare staffing shortages Missed and delayed diagnoses Drug and medicine supply shortages Low vaccination coverage and disease resurgance Clinical burnout Health equity Healthcare-associated infections Surgical mistakes Standardising safety efforts. Read full story Source: Becker's Healthcare, 30 December 2020
  5. Content Article
    For a few reasons – especially regulatory requirements – the majority of effort when it comes to safety management concerns abnormal and unwanted outcomes, and the work and processes in the run up to these. We need to learn from incidents – for moral, regulatory and practical reasons. But incidents alone don’t tell us enough about the system as a whole. If we view incidents as the tip of the iceberg in terms of total hours of work or total outcomes, then what lies beneath?  Steven Shorrock explores this in an article for HindSight.
  6. Event
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    The webinar from GovConnect will consider: The impact of SSIs on the NHS and the promise of programmes such as Quality Improvement for Surgical Teams in meeting this challenge – led by Professor Mike Reed, Consultant Trauma and Orthopaedic surgeon, Northumbria Healthcare NHS Foundation Trust The role of collaborative best practice guidelines in reducing surgical site infections post-COVID – led by Lindsay Keeley, Patient Safety & Quality Lead, The Association for Perioperative Practice (AfPP) Lessons from Getting It Right First Time and the value of a collaborative approach to SSI reduction – Anna Thompson, SSI Surveillance Lead, Ashford and St Peter’s NHS Trust Group discussion on what more we can do to minimise the risk of SSIs, and how we can ensure that SSI reduction is prioritised by politicians and policymakers Register
  7. Event
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    More than 1,900 delegates have attended Health and care explained, ranging from chief executives of charities to NHS leaders, students and representatives from government bodies. Returning for its ninth run, The King Fund's conference gives you the opportunity to interact with our policy experts, who will guide you through the latest health and social care data and explain how the system in England really works. You will hear balanced and honest views about the pressures and opportunities facing the system in 2021. Register
  8. Event
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    This free online event from the King's Fund will provide insight into the wider UK health and care landscape in 2021 and will explore how recent trends, the impact of the COVID-19 pandemic and future developments could affect people working in the sector, patients and the wider population. The speakers will discuss some of the big issues that we hope to see progress on in 2021, including health and care staff wellbeing, social care reform, population health and health inequalities, and legislative changes to support the integration agenda. Register
  9. News Article
    Hospital chiefs in the South West have warned the region will not avoid the extreme pressures felt by other parts of the NHS amid rapidly rising numbers of COVID-19 inpatients. The region was the least affected area of England during the pandemic’s first wave, but the medical director of two acute trusts yesterday predicted a “tidal wave” of COVID-19 coming to the West Country. Adrian Harris, medical director at Royal Devon and Exeter Foundation Trust and Northern Devon Healthcare Trust (NDHT), said the region faced an “absolute crisis” and individual trusts would be “hanging on by their fingernails”. His comments, made at NDHT’s board meeting, came on the same day HSJ revealed the South West region now has the fastest growth in COVID-19 inpatients. Although the region is England’s least densely populated, it also has the lowest hospital capacity per capita in the country. Dr Harris said: “We hope and we pray that the lockdown has come in time for Devon. My personal view — and of my colleagues around the country — is that there’s a tidal wave of COVID-19 coming to the West Country." “We are preparing to be hit as hard as the East of England. If we are hit as hard, we will be hanging on by our fingernails and we are planning accordingly.” Read full story (paywalled) Source: HSJ, 8 January 2021
  10. News Article
    The Pfizer/BioNTech vaccine can still target a key mutation that has emerged in two new variants of coronavirus, laboratory studies show. However, this is only one of many mutations that are found in the new forms of the virus. So while the study has been welcomed, it is not being seen as definitive scientific evidence about how the vaccine will perform. New variants have been detected in the UK and South Africa. Both forms of the virus are spreading more quickly and this has raised questions over what level of protection vaccines can offer against them. The widely held view is that vaccines will still work, but researchers are on the hunt for proof. Read full story Source: BBC News, 8 January 2021
  11. News Article
    Patients calling NHS 111 in London could face a 30-hour wait before being admitted to a hospital bed, the capital’s ambulance service has warned. Slides presented by London Ambulance Service Trust at a webinar with NHS London this week showed “category three” patients faced long delays at all stages of the process. The length of each stage was said to be as follows: having calls answered at 111 centres (20 mins); the “revalidation” of the call before it is passed to 999 (two hours); 10 to 12 hour waits for an ambulance; and similar waits in emergency departments before being admitted to a bed. Category three calls are considered urgent, but not immediately life-threatening. The calls could involve abdominal pain, uncomplicated diabetic issues and some falls. Category three patients are among those the NHS is encouraging to call first, rather than going straight to accident and emergency, as part of the flagship “111 first” drive designed to produce pressure on emergency care. Normally, the pathway from a 111 call being made to a patient being admitted to a bed would take nine hours with a faster response at all stages, the slides suggest. But the pressure across the NHS from covid cases is leading to much longer waits. Read full story (paywalled) Source: HSJ, 8 January 2021
  12. News Article
    The Moderna COVID-19 vaccine has become the third to be approved by the UK. The US pharmaceutical company’s jab was given the green light by Britain’s regulator and doses will be available in the spring. The announcement comes as the rollout of the Pfizer and Oxford vaccines is scaled up to meet Boris Johnson’s target of immunising all care-home patients by the end of the month, with 1,000 vaccination centres expected to be operational by Sunday. The government has also purchased an additional 10 million doses of the Moderna vaccine on top of its previous order of 7 million, taking the total to 17 million. Supplies will begin to be delivered to the UK once Moderna expands its production capability, the Department of Health and Social Care said. The Medicines and Healthcare products Regulatory Agency (MHRA) accepted the recommendation of the Commission on Human Medicines and authorised the Moderna vaccine following months of rigorous clinical trials and extensive analysis of the vaccine’s safety, quality and effectiveness. The jab is 94% effective in preventing disease, including in the elderly. Read full story Source: The Independent, 8 January 2021
  13. News Article
    The chief inspector of hospitals has called for honesty about the impact of the coronavirus pandemic on patients warning poor care could become normalised. Professor Ted Baker told The Independent it was vital staff continued to report incidents and revealed the Care Quality Commission had seen a 60% rise in whistleblowing concerns during the last national lockdown in November. He said staff must report incidents and be free to speak up about any concerns as well as being transparent with families where things have gone wrong. He emphasised that where a patient was unable to get the care they clinically needed because of the demand on services, this would amount to a notifiable patient safety incident. Professor Baker’s comments follow multiple anonymous leaks from NHS staff to The Independent in recent weeks, showing how bad the situation has become in some hospitals. Many staff have only spoken out on condition of anonymity. Many hospitals have declared major incidents, cancelled operations and been forced to stretch staffing ratios to unsafe levels to cope with the increasing numbers of COVID-19 patients. Read full story Source: The Independent, 7 January 2021
  14. News Article
    A hospital in the South East today declared a level of critical care alert meaning that it may be forced into ‘refusal or withdrawal of critical care due to resource limitation’ because it has been ‘overwhelmed’ — but later claimed it was an ”administrative error”. Data from an internal NHS dashboard for critical care, seen by HSJ, showed today Darent Valley Hospital, near Dartford in Kent, declared it was at “CRITCON level four”. CRITCON level four declarations are extremely rare. In guidance they are known as “Triage - emergency” and defined as: “Resources overwhelmed. Possibility of triage by resource (non-clinical refusal or withdrawal of critical care due to resource limitation).” The definition continues: “This must only be implemented on national directive from [NHS England] and in accordance with national guidance.” Dartford and Gravesham Trust, which runs the hospital, replied to HSJ more than five hours after it was contacted, and after publication of the story, to say: “This was a purely administrative error which was quickly rectified.” The level has not however been changed so far on the live dashboard, HSJ has confirmed. Read full story (paywalled) Source: HSJ, 7 January 2021
  15. News Article
    "There can be no debate: this is now much, much worse than the first wave", says a NHS consultant. "Truly, I never imagined it would be this bad. Once again Covid has spread out along the hospital, the disease greedily taking over ward after ward. Surgical, paediatric, obstetric, orthopaedic; this virus does not discriminate between specialities. Outbreaks bloom even in our “clean” areas and the disease is even more ferociously infectious. Although our local tests do not differentiate strains, I presume this is the new variant. The patients are younger this time around too, and there are so many of them. They are sick. We are full." Read full story Source: The Guardian, 7 January 2020
  16. News Article
    Two more life-saving drugs have been found that can cut deaths by a quarter in patients who are sickest with Covid. The anti-inflammatory medications, given via a drip, save an extra life for every 12 treated, say researchers who have carried out a trial in NHS intensive care units. Supplies are already available across the UK so they can be used immediately to save hundreds of lives, say experts. The UK government is working closely with the manufacturer, to ensure the drugs - tocilizumab and sarilumab - continue to be available to UK patients. As well as saving more lives, the treatments speed up patients' recovery and reduce the length of time that critically-ill patients need to spend in intensive care by about a week. Both appear to work equally well and add to the benefit already found with a cheap steroid drug called dexamethasone. Read full story Source: BBC News, 7 January 2021
  17. News Article
    In a Letter to the Editor published in The Times yesterday, the All Party Parliamentary Group on First Do No Harm Co-Chair Baroness Julia Cumberlege argues in favour of the work of the Independent Medicines and Medical Devices Safety (IMMDS) Review and its report 'First Do No Harm'. "Inquiries are only as good as the change for the better that results from their work." Read full letter (paywalled) Source: The Times, 5 January 2021
  18. News Article
    An experimental treatment involving stem cells from umbilical cords could significantly reduce deaths and quicken recovery time for patients suffering the most severe form of COVID-19, a study suggests. US researchers reported a 91% survival rate in seriously ill patients given the stem cell infusion, compared to 42% in a second group who did not receive the treatment. Researchers said the treatment also appeared to be safe, with no serious adverse reactions reported. Read full story Source: The Independent, 5 January 2021
  19. News Article
    Hundreds of people a day across London are waiting hours for an emergency ambulance to get to them, as paramedics warn that patients are dying as a result of delays. Patients in emergency calls classified as category two, such as those involving a suspected stroke or chest pains, should be seen by paramedics within an average of 18 minutes but are being forced in some cases to wait up to 10 hours. Even life-threatening calls where patients are in cardiac arrest and should be reached within seven minutes have experienced delays, with data suggesting one such call was waiting 20 minutes on Monday. Internal data shared with The Independent shows that London Ambulance Service is holding hundreds of open 999 calls for hours at a time with the service’s boss acknowledging in an email to staff that the service is struggling to maintain standards. Experts warned that the problems in the capital were reflected in ambulance services across the country. One paramedic told The Independent: “Patients desperately requiring ambulances aren’t getting them and, anecdotally, people are deteriorating and dying whilst waiting. Our poor dispatchers have to stare at screens of held calls, working out who gets the next available resource and who waits, suffers or dies.” Read full story Source: The Independent, 5 January 2021
  20. News Article
    Overseas-trained nurses have been told they can join the temporary coronavirus register without undertaking a formal “clinical assessment” in an attempt to bolster the NHS workforce as the third covid wave surges. The Nursing and Midwifery Council confirmed on Tuesday that it has invited the additional nurses in a bid to “strengthen workforce capacity in the immediate period and coming weeks”. It comes as the number of covid inpatient admissions rises sharply across the country, with London and the South East of England badly hit. At the start of the pandemic last year, the NMC asked former nurses who had left within the last three years to join the emergency covid register as cases grew. Unison union’s national nursing officer Stuart Tuckwood believed the move will help deal with “severe” staffing shortages, but warned they must be “supported and supervised” by fully registered nurses to ensure patient safety. Read full story (paywalled) Source: HSJ, 6 January 2021
  21. News Article
    Potentially life-saving cancer operations have been put on hold at a major London NHS trust because of the number of beds taken by Covid patients. King's College Hospital Trust has cancelled all "Priority 2" operations - those doctors judge need to be carried out within 28 days. Cancer Research UK said such cancellations did not appear to be widespread across the country. And surgery has not been stopped on the same scale as during the first wave. Rebecca Thomas, who has had her bowel cancer surgery at King's College Hospital "cancelled indefinitely", told the BBC she felt like she had been left "in limbo". Until she has surgery her tumour cannot be studied to see how aggressive it is, and so she won't know until then how significant this wait will turn out to be. A spokesperson for the Trust, which mainly serves patients in south London, said: "Due to the large increase in patients being admitted with COVID-19, including those requiring intensive care, we have taken the difficult decision to postpone all elective procedures, with the exception of cases where a delay would cause immediate harm. "A small number of cancer patients due to be operated on this week have had their surgery postponed, with patients being kept under close review by senior doctors." Read full story Source: 5 January 2021
  22. Content Article
    Clinical and nonclinical staff at the Rotterdam Eye Hospital have improved patient care and raised staff morale at a very modest cost: 10 minutes a day and a special deck of cards. At the start of every shift, the team members get together for a brief “team-start.” Each team member rates his or her own mood as green (I’m good), orange (I’m okay but I have a few things I’m concerned about) or red (I’m under stress). The rest of the team doesn’t need to know that you’re under stress because you’re having a dispute with your landlord or you are worried about your ill toddler. How you feel, however, is important because it affects how you should be treated. Next, the team leader asks if there is anything in particular the team needs to know to work more effectively together that shift: For example, “Is there a delay in public transport so we can expect patients to be late for their appointments?,” or “Is there a patient with some kind of special need coming in?” Sharing the answers or results generated by the card questions and activities with the group ensures that the insights stick.
  23. Event
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    Good health is not simply an output of a fair economy. A healthy population is one of the nation’s most important assets: a vital input into a strong economy that improves people’s wellbeing, their productivity and their ability to participate in society. But how do we measure the health of the nation? The ONS has launched an ‘experimental’ version of its health index, which was proposed in 2018 by the then Chief Medical Officer (CMO) Dame Sally Davies, and it is currently open for public consultation before being finalised in 2021. Join this webinar from the Health Foundation where you will hear from Dame Sally Davies and guests to find out more about the index, why it was commissioned, and how it can be used in practice. Register
  24. Content Article

    John's Campaign

    Sam

    Sam posted an article in Dementia

    Dr John Gerrard was a doctor and a business man, and diagnosed with Alzheimers in his mid seventies. It was a slow decline, that sped up when he was ill or upset, for ten years. Then, at the start of February 2014, he went into hospital. He had infected leg ulcers which weren’t responding to antibiotics. The hospital had a norovirus outbreak which meant visitors weren’t allowed at all. He was there for five weeks. John went in strong, mobile, smiling, able to tell stories about his past, to work in his garden and help with things round the house. He was able to feed himself, to keep clean, to have a good kind of daily life. He came out skeletal, immobile, incoherent, requiring 24-hour care and barely knowing those around him. His family are sure that if he had not spent that time alone, without them, he would not have descended into such a state of deep delirium. Having someone with you - someone who you love, who you know, whose face you know (be they your carer, your family, your friend, your lover) - helps keep you tied to reality, to life, to sanity. John died in November 2014. His story, however, is still repeated. Far too many people die cut off from the people who care for them. Far too many places have dangerously over-restrictive policies (both predating and during the present pandemic) preventing people from being with people who need them. In the wake of his death, John’s daughter, Nicci Gerrard, cofounded John’s Campaign with Julia Jones, whose mother, June, also lived well with dementia (both Alzheimer’s and vascular) for many years before her death in 2018. John’s Campaign is June’s Campaign, is Everyone’s Campaign, for none of us should be blocked from our best, most special friends, family or carers.
  25. Event
    This virtual masterclass, facilitated by Mr Perbinder Grewal, will focus on patient safety and how to setup a proactive safety culture. It will look at what patient safety is and how to setup and improve the safety culture. It will look at Human Factors and how to mitigate some of the common errors. Can we have a system with zero patient safety incidents or errors? Further information and book your place or email kate@hc-uk.org.uk hub members receive 10% discount. Email info@pslhub.org for code
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