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Content Article
I Manage My Meds
Patient Safety Learning posted an article in Medicine management
A five part support programme to help you manage you medicines confidently and safely. -
Content ArticleThis cohort study in JAMA Network Open aimed to assess how patients receiving radiation treatment for cancer rated their satisfaction with fully remote management by doctors. It also identified the associated safety events, financial implications and environmental consequences. The authors found that: more than 99% of safety events did not reach patients or caused no harm to patients. 98% of patient ratings of satisfaction with fully remote management were good to very good. out-of-pocket cost savings associated with fully remote management totalled approximately $612 913 ($466 per patient). estimated carbon dioxide emissions decreased by 174 metric tons.
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Content Article
Diabetes tech: Do national aspirations and local practice align?
Anonymous posted an article in Diabetes
In this anonymous blog, a person with type 1 diabetes describes their recent experience upgrading their insulin pump, a medical device used to continuously deliver insulin instead of taking multiple daily injections. They describe how communication issues and gaps in staff knowledge led to a significant delay in accessing the pump, which caused them significant stress. They also ask whether recent announcements about increased access to diabetes technology over the next few years will match up to the reality experienced by people with diabetes accessing care at local healthcare organisations. -
Content Article
Patient safety guide (NHS Northern Care Alliance)
Patient Safety Learning posted an article in Patient-centred care
Do you ever forget what you want to ask when you meet with a healthcare professional? Do you leave your appointment without answers to all your questions? To avoid this, the guide will help you to prepare, by giving you advice on what you might want think about before your consultation. You can also use it as a reminder or prompt and it is handy for making notes after your consultation. The main aim of this guide is to empower you, by taking control of your healthcare (or the healthcare of the person you look after), in partnership with your healthcare professional. Preparing information before your consultation and taking it with you will make sure the time you spend with your doctor, pharmacist or practice nurse is used as effectively as possible. -
Content ArticleThe relentless increase in administrative responsibilities, amplified by electronic health record (EHR) systems, has diverted clinician attention from direct patient care, fuelling burnout. In response, large language models (LLMs) are being adopted to streamline clinical and administrative tasks. Notably, Epic is currently leveraging OpenAI's ChatGPT models, including GPT-4, for electronic messaging via online portals. The volume of patient portal messaging has escalated in the past 5–10 years, and general-purpose LLMs are being deployed to manage this burden. Their use in drafting responses to patient messages is one of the earliest applications of LLMs in EHRs. Previous works have evaluated the quality of LLMs responses to biomedical and clinical knowledge questions; however, the ability of LLMs to improve efficiency and reduce cognitive burden has not been established, and the effect of LLMs on clinical decision making is unknown. To begin to bridge this knowledge gap, the authors of this study, published in the Lancet, carried out a proof-of-concept end-user study assessing the effect and safety of LLM-assisted patient messaging.
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Content ArticleUsing open-text responses from the Bereaved Family Survey (BFS), this study in the American Journal of Surgery sought to explore Veteran family experiences on end-of-life care after surgery. Families that left open text comments often expressed a belief in their loved one's unnecessary pain, expressing distrust in the treatment decisions of the care team. The results also showed that limited communication about the severity of disease or risks of surgery caused conflicting and unresolved narratives about the cause or timing of death. Families also described feelings of disempowerment when they were not involved in decision-making and when their wishes were not respected.
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Content Article
Lessons not learned: A family's lengthy efforts to turn complaints into improvements
Anonymous posted an article in PHSO investigations
A family describe the lengthy efforts they had to take to try to ensure their complaints about their loved one's end of life care would result in improvements at the hospital.- Posted
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Content ArticleAntimicrobial resistance (AMR) remains a global threat, which the Lancet is highlighting in a series of articles. This piece was written by a group of AMR survivors and their caregivers in order to share individual stories and perspectives on the impact of AMR. The authors highlight challenges in raising the profile of AMR, including insufficient funding, research, motivation and knowledge. They also call for meaningful patient engagement in the AMR agenda.
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Content ArticleThis webinar hosted by The Patients Association aimed to highlight the realities of life with a long-term condition. Four people who live with long-term health conditions shared what their day-to-day lives are like.
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Content ArticleWhen GP practices have a patient who is violent or exhibiting behaviour that makes them fear for their safety, the patient should immediately be removed from the practice list. This guidance from the BMA explains how to do this as well as outlining the special allocation scheme (SAS), which provides primary care medical services in a secure environment to patients who meet the criteria. In the SAS, designated GP practices provide services to patients by appointment at specific locations and times as detailed in individually agreed contracts. Patients join the scheme after being immediately removed as a result of an incident that was reported to the police. It aims to protect GPs, practice staff and patients who have the right to be in the practice without fear of intimidating behaviour.
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News Article
Surge in patients sent hundreds of miles for care
Patient-Safety-Learning posted a news article in News
The number of people sent out of their home area for a mental health bed – in some cases hundreds of miles away – has increased to a five-year high, despite national ambitions to eliminate the practice. A 2021 date to stop “inappropriate out of area placements” was initially set by government and NHS England in 2016 but, despite initial reductions, the target was missed, with hundreds of patients still affected each month. Demand and bed pressures in the wake of covid appeared to make it more difficult and numbers have been rising. Analysis of the latest NHS Digital data this month shows 825 active inappropriate placements in February 2024 following a steady rise from December 2023, when there were 700 (see chart). The year on year increase from February last year is 15 per cent, but there has been a 46 per cent rise since a low of 565 just 14 months previously, in December 2022. Being sent out of area can disrupt the patient’s care, make it less likely patients will be visited, harder for them to return home and to community support, and is also often very expensive as places are bought at short notice from independent providers. NHSE acknowledged pressures on OAPs in 2024-25 planning guidance but asked systems to “work towards” eliminating them, saying they are “detrimental to patient safety, experience and outcomes.” National mental health director Claire Murdoch last month told HSJ they represented “poor care at relatively high costs.” Read full story (paywalled) Source: HSJ, 23 May 2024 -
Content ArticleIn this Guardian article. Palliative Care doctor Rachel Clarke examines the debate around legalising assisted dying, focusing on the need to ensure patients do not want to end their lives due to lack of adequate health and social care. She highlights the risk that if assisted dying were legalised, patients might be coerced into choosing death "not by some rightwing politician or avaricious family member, but by the woeful inadequacy of their care." She goes on to look at wider attitudes to the dying in the NHS, pointing out that hospice care is mostly funded by charities, not the NHS, and that last year in England, almost 14,000 people died in A&E while waiting more than 12 hours for a bed.
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News Article
Pharmacists blast government over ‘shameful’ increase to NHS prescription cost
Patient-Safety-Learning posted a news article in News
Leading pharmacists have blasted the government over “shameful” increases in the cost of NHS prescriptions. From 1 May they will increase from £9.65 per item to £9.90. Pharmacists across the country have hit out at the increase, warning it will disadvantage working patients on lower incomes. And the National Pharmacy Association (NPA) said the move will create an “arbitrary barrier” to people’s ability to receive healthcare. According to an NPA survey, patients have already reported not getting regular medication due to the costs. Antibiotics, pain killers, asthma inhalers, blood pressure medication and antidepressants are examples of the most commonly reported medicines which patients have not taken due to cost. Hundreds of pharmacies reported seeing patients decline medicines due to the cost of prescriptions, one to five times a week. Nick Kaye, chair of the NPA, said: “To allow the prescription charge to rise to this level is a shameful neglect of working people on low fixed incomes, who are not exempt. Many people already choose not to collect some or all their prescription medicines because of cost, with potentially dire health consequences. As pharmacists, we understand the healing power of medicines. So naturally we oppose arbitrary barriers to people getting the medicines they need. This is a tax on the working poor that deepens the cost of living crisis for them." Read full story Source: Independent, 1 May 2024 -
News ArticleHealthcare providers are failing to protect the privacy of people living with HIV, the UK’s data watchdog has warned. The Information Commissioner’s Office said it has been forced to hand fines worth thousands to organisations which have released the details of those living with HIV. Speaking with The Independent, Information Commissioner John Edwards, said: “It is a huge problem [within healthcare] and it’s a disproportionate amount of our business. “That’s partly because of the seriousness and the sensitivity of health information, the huge scale of the health sector and very many moving parts, with many opportunities for information to slip out as it moves from one place to another, and frankly, they’re just not doing well enough.” In a warning on Tuesday the watchdog highlighted specific concerns over HIV patients’ data being breached through the use of bulk emails in which staff have not used the blind copy function. The Information Commissioner said: “People living with HIV are being failed across the board when it comes to their privacy and urgent improvements are needed across the UK. We have seen repeated basic failures to keep their personal information safe - mistakes that are clear and easy to avoid." Read full story Source: Independent, 30 April 2024
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Content ArticleTrauma-informed care is an approach that emphasises understanding patients' past trauma to provide better and more effective care. In this article, Greg Goushian, Chief Executive Officer at Recovery Beach, looks at the principles and benefits of trauma-informed care, outlining how patient safety can be advanced through understanding mental health histories.
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Content ArticleDisordered eating can affect anyone, but it can be confusing to understand and recognise it in our own personal experiences. This guide, published by East London NHS Foundation Trust, is a snapshot of how adults in East London have navigated those experiences of uncertainty while seeking support for disordered eating. For many of the contributors, preconceptions about what an eating disorder is (or isn’t) have previously acted as a barrier to seeking or receiving support. It also contains advice on how to seek support for disordered eating.
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Content ArticleThis video provides an introduction to Sheffield Health and Social Care NHS Foundation Trust's (SHSCFT's) Patient and Carer Race Equality Framework (PCREF). The PCREF aims to help the Trust's staff and communities understand how to have sensitive conversations with patients and carers and to get better information from them. This will mean the Trust is more culturally aware and able to offer culturally appropriate care by understanding the barriers ethnic minority communities face in getting healthcare services for diagnosis and treatment.
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Content ArticleThis study in the American Journal of Surgery looked at whether language barriers have the potential to influence acute stroke outcomes. The authors examined postoperative stroke outcomes among non-English primary language speakers and found that there were no differences in length-of-stay or secondary outcomes, but there were higher odds of feeding tube placement.
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Content ArticleThis cohort study in JAMA Network Open aimed to assess whether therapist burnout is associated with reduced effectiveness of guideline-recommended psychotherapies for posttraumatic stress disorder (PTSD). The findings suggest that interventions to reduce therapist burnout might also result in more patients experiencing clinically meaningful improvement in PTSD symptoms from evidence-based psychotherapies.
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Content ArticleThe Nursing & Midwifery Council (NMC) is commissioning independent research into nursing and midwifery students’ practice learning to ensure members of the public can shape this work from the start and throughout. One way people can get involved is by being part of a new Public Advisory Group on practice learning.
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Content Article
The digitalising of patient records — why patients MUST be involved
Anonymous posted an article in Health records and plans
In this blog, Tina* discusses the patient safety issues that can occur with electronic patient records, highlighting how easily errors can occur in a patient's record but how difficult they are to fix, and why patients must be involved in the digitalising of their own records. Tina gives her perspective as a clinician but also her personal perspective as a patient who has had stigmatising material propagated throughout the system while important clinical information was excluded from her record.- Posted
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News Article
One in seven callers could not reach GP in worst-performing ICS
Patient Safety Learning posted a news article in News
People attempting to contact their GP practice are almost three times as likely to report failing to get through in some integrated care systems (ICS) than others, according to NHS England-commissioned data. The survey figures, collected for the first time by the Office for National Statistics (ONS), show 8.5% of people nationally who tried to call their GP between mid-January and mid-February this year said they could not reach the practice. This equates to 1.5 million people across England, according to the ONS. In Northamptonshire – the worst performing ICS – 14.7% of callers did not manage to make contact. That is the equivalent of around one in seven people. By comparison, only 3.9% of callers in Gloucestershire, the best performing ICS, could not get through. The findings are broadly similar when population and age are accounted for. Read full story (paywalled) Source: HSJ, 12 April 2024 -
Content ArticleThis cohort study in JAMA Network Open explored whether the empathy displayed by doctors has an impact on the outcomes of patients with chronic pain. 1470 adults with chronic low back pain were included in the study, in which empathy was more strongly associated with favourable outcomes than nonpharmacological treatments, opioid therapy and lumbar spine surgery. The findings suggest that empathy is an important aspect of the patient-doctor relationship and is associated with better outcomes among patients with chronic pain.
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News Article
Plans for Royal Mail delivery cuts could risk patient safety, NHS leaders warn
Patient Safety Learning posted a news article in News
NHS leaders have warned that Royal Mail’s plans to cut second-class deliveries to two days a week could risk patient safety. The changes are part of wider measures announced by Royal Mail’s parent company, International Distributions Services (IDS), including cuts of up to 9,000 routes, which could take more than two years to implement, saving £300m a year. IDS has assured the Royal Mail workforce that there will be no compulsory redundancies and they will request only 100 voluntary redundancies. In a letter sent to the Telegraph, executives from the NHS, Healthwatch England, the Patients Association and National Voices said the Royal Mail proposals would increase the cost of missed appointments, which already exceeds £1bn. The letter said: “Provisional Healthwatch data suggest that more than 2 million people may have missed medical appointments in 2022-23 due to late delivery of letters, and this will only deteriorate under the proposed new plans.” Sir Julian Hartley, the chief executive of NHS Providers, said the proposed delays were “extremely unhelpful”. “It’s really important that patients be updated at the earliest opportunity on developments in their care and treatment,” he said. “An efficient, punctual postal service remains a key part of that process. At a time when far too many patients already face long delays – the last thing any trust leader wants – anything that adds to that uncertainty, and possibly the worsening of conditions, would be extremely unhelpful.” Jacob Lant, the chief executive of health charity National Voices, said: “The proposals being consulted on risk further delaying vital communications and worsening digital exclusion, therefore unfairly widening health inequalities. NHS mail must remain a priority service.” Read full story Source: The Guardian, 6 April 2024 -
Content ArticleThere is a growing momentum around the world to foster greater opportunities for the involvement of mental health service users in their care and treatment planning. In-principle support for this aim is widespread across mental healthcare professionals. Yet, progress in mental health services towards this objective has lagged in practice. Francis et al. conducted a systematic review of quantitative, qualitative and mixed-method research on interventions to improve opportunities for the involvement of mental healthcare service users in treatment planning, to understand the current research evidence and the barriers to implementation. Overarching barriers to shared and supported decision-making in mental health treatment planning were: (1) Organisational (resource limitations, culture barriers, risk management priorities and structure); (2) Process (lack of knowledge, time constraints, health-related concerns, problems completing and using plans); and (3) Relationship barriers (fear and distrust for both service users and clinicians). On the basis of the barriers identified, recommendations are made to enable the implementation of new policies and programmes, the designing of new tools and for clinicians seeking to practice shared and supported decision-making in the healthcare they offer.
