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News Article
Review finds 418 ‘unnatural, unexpected deaths’ linked to troubled trust
Patient Safety Learning posted a news article in News
A troubled mental health trust’s internal mortality review has concluded 418 of an estimated 12,503 patient deaths over a four-and-a-half year period were “unexpected and unnatural”. Norfolk and Suffolk Foundation Trust’s leaders said the findings showed there had been a “much, much smaller” number of avoidable deaths than had been implied by previous reviews and reported by the media in the past. But the review’s findings were swiftly dismissed by campaigners, who said they had “no confidence” in the new figures, accused the trust of “corporate gaslighting” and renewed calls for a statutory public inquiry. The review was initiated after a similar exercise by Grant Thornton last June concluded it was not possible to work out how many avoidable deaths there had been because of the trust’s poor data. A month later, BBC Newsnight reported evidence it had watered down criticism in the Grant Thorton report, with allegations of “weak” and “inadequate” governance in earlier versions of the report removed from the final version. The trust and auditor said the changes were due to “fact checking”. Read full story (paywalled) Source: HSJ, 18 July 2024 -
Content Article
Listening to the voices of workers is essential for a safe and effective healthcare for workers, patients and the public. Freedom to Speak Up Guardians provide an opportunity for organisations to learn from these voices which may not otherwise be heard. Freedom to Speak Up Guardians are required to report non-identifiable information on the cases they receive both locally to their boards and senior leadership and to the National Guardian’s Office. This report summarises the data shared by Guardians about the speaking up cases they received between 1 April 2023 and 31 March 2024. -
News Article
Third of services rated ‘red’ for baby deaths
Patient Safety Learning posted a news article in News
The proportion of trusts with maternity services “red rated” for neonatal mortality rose from around a quarter in 2021 to a third in 2022, according to the latest national audit. The latest Mothers and Babies: Reducing Risk Through Audit and Confidential Enquiries report, published on Friday, classifies trusts from red to green, according to how far above or below they are their peer group providers. Nationally, there were increases in the neonatal mortality rate per 1,000 live births in 2022 compared with 2021, rising from 1.65 to 1.69 per 1,000 total births. Neonatal death is when a baby dies in the first 28 days of life. Of 121 trusts, 41 (34%) were rated “red” for neonatal mortality in 2022, as their rates were over 5% higher than their peer group average. This compares with 32 trusts (26% of 123 trusts) rated “red” for neonatal mortality in 2021. There were, however, also some areas of improvement year-on-year. The number of trusts rated “green” — with neonatal death rates more than 15% lower than the average in their peer group — increased from three in 2021 to eight in 2022, marking a significant improvement from 2020 and 2021. Read full story (paywalled) Source: HSJ, 17 July 2024 -
Content ArticleThis is the tenth MBRRACE-UK Perinatal Mortality Surveillance Report. The report is divided into five sections: perinatal mortality rates in the UK; mortality rates for Trusts and Health Boards; mortality rates by gestational age; mortality rates by ethnicity and socio-economic deprivation; and a description of the causes of perinatal death. This report focuses on births from 24 completed weeks’ gestational age, with the exception of the section on mortality rates by gestational age, which also includes information on births at 22 to 23 completed weeks’ gestational age. This avoids the influence of the wide disparity in the classification of babies born before 24 completed weeks’ gestational age as a neonatal death or a late fetal loss. Terminations of pregnancy have been excluded from the mortality rates reported. Additional supporting materials to accompany this report include: a set of reference tables a data viewer with interactive mapping, which presents mortality rates for individual organisations, including Trusts and Health Boards a technical manual containing full details of the MBRRACE-UK methodology, including definitions, case ascertainment and statistical methods.
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Content Article
Safety is a core dimension of health care quality, and measurement of patient safety culture in Organisation for Economic Co-operation and Development (OECD) countries is increasingly conducted as part of efforts to monitor patient safety and to contribute to health system performance assessment. This Health Working Paper looks at the findings of the second OECD pilot on patient safety culture. This occurred in 2022-2023 and in total took data from 648,209 health care providers from 14 countries. -
Content ArticleThe NHS wasn’t the only health system that experienced severe disruption of care during the pandemic, but how quickly have waiting times in England recovered in comparison to other nations? Sarah Reed and Theo Georghiou look at how waiting times have changed in England and in other countries since the peak of the Covid-19 crisis.
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News Article
Hip and knee replacements on NHS four times longer than in Italy
Patient Safety Learning posted a news article in News
Waiting times for hip and knee replacements are four times longer in England than Italy post-lockdown, analysis has revealed. Patients in England are waiting an average of 128 days for hip replacements and 141 days for a new knee on the NHS, which are both up by around 50 per cent since before the pandemic. It leaves England lagging behind other European countries, with waits that are four times longer than Italy, where hip replacements are completed in 33 days and knees within 30 days, according to analysis by the Nuffield Trust. Sarah Reed, senior fellow at Nuffield Trust and author of the report, said countries around the world were “dealing with the effects of the Covid-19 pandemic, with many still struggling to bring down waiting times”. “However, it’s striking that in England our pace of recovery has been much slower for major surgeries like hip and knee replacements, but for some minor procedures we appear to have improved more quickly than nearly everywhere else,” she said. Read full story (paywalled) Source: The Telegraph, 11 July 2024 -
Content Article
NHS Confederation: The state of NHS finances 2024/25
Patient Safety Learning posted an article in Data and insight
This report examines the financial challenge facing NHS organisations in 2024/25. -
Content ArticlePatient safety challenges are exacerbated by healthcare workforce challenges. However, a workplace culture focused on measuring what goes wrong and making changes to address root causes – powered by reporting and analytics technology and encouraged by the example set by top leadership – can address these significant forces impacting care delivery. Today’s healthcare environment demands effective digital tools and a commitment to cultural change, according to Heidi Raines, founder and CEO of Performance Health Partners, a healthcare safety software vendor. Healthcare IT News spoke with Raines about near-miss reporting, and how better analytics and a culture of data-driven leadership can improve patient safety.
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Content ArticleThe Pennsylvania Patient Safety Reporting System (PA-PSRS) is the largest database of patient safety event reports in the United States. This study in Patient Safety analysed more than 23,970 healthcare association infection (HAI) reports submitted by long term care facilities in Pennsylvania in 2023. The results showed an increase in the number of reports of HAIs submitted.The overall infection rate increased by 11.4%, from 0.88 in 2022 to 0.98 in 2023, and all six regions of the state had an increase in infection rate. The Northeast region had the highest rate, with 1.28 reports per 1,000 resident days, and the Southeast region had the lowest rate, at 0.72. The overall rate increase was driven by rates of urinary tract infection (UTI) and skin and soft tissue infection (SSTI), which increased by 20.1% and 17.4%, respectively. Within the UTI infection type, symptomatic urinary tract infection (SUTI) rates increased by 21.1% and catheter-associated urinary tract infection (CAUTI) rates increased by 11.8%.
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Content ArticleTrauma remains a leading cause of global mortality and morbidity, necessitating effective trauma care. Despite progress, adverse events during trauma resuscitation persist, impacting patient outcomes and the healthcare system. This study in the American Journal of Surgery aimed to investigate adverse events in trauma resuscitation, evaluate contributing factors, and assess methods, such as trauma video review (TVR), to mitigate adverse events. The authors concluded that trauma video review (TVR) shows promise for identifying adverse events. They identified challenges including ensuring reporting consistency and integrating approaches into existing protocols. They call for future research to prioritise linking trauma team performance to patient outcomes and develop sustainable TVR programs to enhance patient safety.
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Content Article
PRSB: Transfer of care toolkit
Patient Safety Learning posted an article in Transfers of care
High volumes of patients are transferred every day between health and care settings. Whilst efforts have have been made over several years to improve this process through the implementation of standards and the sharing of digital information, there is more to be done. Whole system improvements are required and significant further progress can be made to improve the quality and consistency of data shared between organisations. The Professional Standards Record Body (PRSB) has published a number of standards that support the transfer of care of patients between settings. This toolkit concentrates on the PRSB eDischarge Summary Standard, which specifies the data to be shared between secondary and primary care to support the discharge of a patient from hospitals across the UK. This toolkit does not propose a one-size-fits-all approach and recognises that health and care services are organised in different ways across the UK. -
Content ArticlePolypharmacy is a term used to describe when a patient is taking a number of medicines at the same time. This study in the British Journal of Clinical Pharmacology aimed to measure how common polypharmacy is and describe the prescribing of selected medications known for overuse in older people with polypharmacy in primary care. It was a multinational retrospective cohort study that used data from patients with a mean age of 75-76 years from six countries: Belgium, France, Germany, Italy, Spain and the UK. The results revealed a high prevalence of polypharmacy with more than half of the older population being prescribed at least five drugs in four of the six countries. Whilst polypharmacy may be appropriate in many patients, the authors found worryingly high usage of PPIs and benzodiazepines. The study's results support current efforts to improve polypharmacy management across Europe.
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News Article
Hacked UK trove includes data on newborns, cancer patients...
Patient Safety Learning posted a news article in News
Hackers behind a London hospital attack recently published records that include personal information about pregnant women, newborns, cancer patients, people suffering from schizophrenia and thousands of others across the UK and Ireland, revealing the breach was far more widespread than authorities have previously indicated. An analysis of the data trove by Bloomberg News found that it contains tens of thousands of medical records on patients from more than 400 public and private hospitals and clinics. Among the records are some 40,000 highly sensitive documents sent by doctors requesting biopsies and blood tests for individual patients in all regions of the UK and some hospitals in Ireland. A breach of the kind faced by Synnovis was inevitable, according to Saif Abed, a former NHS doctor and expert in cybersecurity and public health. “The NHS has some of best patient safety and cybersecurity standards in the world,” Abed said. “They are just immensely poorly enforced.” Abed said that there was a lack of mandatory cybersecurity audits on any contractors providing services to the NHS, which meant those contractors could have substandard cybersecurity practices that could in turn leave the NHS vulnerable. Read full story Source: Bloomberg UK, 26 June 2024 -
Content ArticleThe healthcare systems of nearly every country are straining to keep up with the demands placed on them by advances in both treatment and technology. In this article, Timothy Ferris explores ways in which technology can reduce the burden on already under-resourced healthcare workforces. Acknowledging the complexity of healthcare compared to other industries, and the highly professional nature of the workforce, he uses the concept of 'unit cost' to look at how the financial and time burden associated with healthcare interactions can be reduced.
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Content ArticleAlthough diagnostic errors are estimated to affect about 12 million Americans each year in ambulatory care settings alone, the conceptual and pragmatic scientific foundations for their measurement are under-developed. Further progress towards reducing diagnostic errors will rely on our ability to overcome measurement-related challenges. This article in BMJ Quality & Safety outlines a multifaceted framework to advance the science of measuring diagnostic errors (The Safer Dx framework). The authors describe how Safer DX serves as a conceptual foundation for system-wide safety measurement, monitoring and improvement of diagnostic error. They believe it lays robust groundwork for measurement and monitoring techniques to ensure diagnostic safety.
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News Article
NHS confirms patient data stolen in cyber attack
Patient Safety Learning posted a news article in News
NHS England has confirmed its patient data managed by blood test management organisation Synnovis was stolen in a ransomware attack on 3 June. Qilin, a Russian cyber-criminal group, shared almost 400GB of private information on their darknet site on Thursday night, something they threatened to do in order to extort money from Synnovis. In a statement, NHS England said there is "no evidence" that test results have been published, but that "investigations are ongoing". More than 3,000 hospital and GP appointments were disrupted by the attack. "Patients should continue to attend their appointments unless they have been told otherwise and should access urgent care as they usually would," NHS England said. A sample of the stolen data seen by the BBC includes patient names, dates of birth, NHS numbers and descriptions of blood tests, something cyber security expert Ciaran Martin told the BBC was "one of the most significant and harmful cyber attacks ever in the UK." Read full story Source: BBC News, 24 June 2024 -
Content Article
Welsh Health Equity Solutions Platform
Patient-Safety-Learning posted an article in Health inequalities
The Welsh Health Equity Solutions Platform is part of the Welsh Health Equity Status Report initiative (WHESRi), which supports a healthier, more equal and prosperous Wales. The platform is a gateway to data, evidence, health economics and modelling, policies, good practice, innovative tools and practical solutions to help improve population wellbeing and reduce the health equity gap in Wales and beyond. It is structured around an innovative WHO framework of ‘Five Essential Conditions’ for healthy prosperous lives for all. The platform will link with and feed into a WHO health equity gateway, providing an example and inspiration for countries to learn and follow, as well as to contribute and share. -
Content ArticleDavid Stockwell is Chief Medical Officer at Johns Hopkins Children’s Center and Associate Professor of Pediatrics and Anesthesiology and Critical Care Medicine at Johns Hopkins University School of Medicine. He is also Chief Clinical Officer at Pascal Metrics, a federally listed Patient Safety Organisation working with the Betsy Lehman Center on a pilot to test the impact of automated safety event monitoring in a diverse set of six-to-eight acute care hospitals in Massachusetts. Stockwell talked with Patient Safety Beat about Pascal’s approach to using electronic data to transform safety.
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News Article
Hacked London NHS hospitals data allegedly published online
Patient Safety Learning posted a news article in News
Data from a ransomware attack has allegedly been published online weeks after the attack halted operations and tests in major London hospitals, NHS England has said. A Russian group is believed to have carried out the cyber-attack on Synnovis, a private pathology firm that analyses blood tests for Guy’s and St Thomas’ NHS foundation trust (GSTT) and King’s College trust, on 3 June, forcing hospitals in the capital to cancel almost 1,600 operations and outpatient appointments. NHS England said on Friday it had “been made aware that the cyber-criminal group published data last night which they are claiming belongs to Synnovis and was stolen as part of this attack. We know how worrying this development may be for many people. We are taking it very seriously.” In the attack, it is understood hackers from the Russian-based ransomware criminal group Qilin infiltrated Synnovis’s IT system and locked the computer system by encrypting its files to extort a payment for restoring access. The trusts have contracts with Synnovis totalling just under £1.1bn for services that are vital to the smooth running of the NHS. NHS England said an analysis of the data was under way involving the National Cyber Security Centre and other partners to confirm whether the data was taken from Synnovis’s systems and what information it contained. Read full story Source: The Guardian, 21 June 2024 -
News Article
C2-Ai launches Maternal and Neonatal Observatory
Clive Flashman posted a news article in News
C2.AI has formally launched its Maternity and Neonatal Observatory at the NHS ConfedExpo in Manchester (Government and Public Sector Journal). The observatory is intended to give hospitals and clinicians a detailed picture of the performance of maternity units and the health trajectories of individual women, so areas of concern can be identified and acted on. The system works by calculating and comparing observed outcomes for women and babies with expected outcomes for these individuals. To do this, it uses AI and machine learning to assess clinical factors, case-mix, and the social determinants of health. Early adopters within the NHS, where maternity services are under intense scrutiny, are expected soon. -
Content ArticleCurrent adverse effects of medical treatment (AEMT) incidence estimates rely on limited record reviews and underreporting surveillance systems. This study evaluated global and national longitudinal patterns in AEMT incidence from 1990 to 2019 using the Global Burden of Disease (GBD) framework. It found that although the global population increased 44.6% from 1990 to 2019, AEMT incidents rose faster by 59.3%. The net drift in the global incidence rate was 0.631% per year. The proportion of all cases accounted for by older adults and the incidence rate among older adults increased globally. The high SDI region had much higher and increasing incidence rates versus declining rates in lower SDI regions. The age effects showed that in the high SDI region, the incidence rate is higher among older adults. Globally, the period effect showed a rising incidence of risk after 2002. Lower SDI regions exhibited a significant increase in incidence risk after 2012. Globally, the cohort effect showed a continually increasing incidence risk across sequential birth cohorts from 1900 to 1950. As the global population ageing intensifies alongside the increasing quantity of healthcare services provided, measures need to be taken to address the continuously rising burden of AEMT among the older population.
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Content ArticleThe Patient Safety Authority's 2023 Annual Report.
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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 ArticleThe NHS is the world’s largest publicly funded health service. It is also the world’s largest repository of healthcare data, but these data are fragmented and underutilised. Making them accessible in one place would improve health and deliver wealth for the nation. This report by the Tony Blair Institute for Global Change proposes the creation of a National Data Trust (NDT)—an organisation which would be majority-owned and controlled by the government and the NHS, together with investment from industry partners. It would aim to connect NHS data, attract private investment in new medical discoveries and bring the economic benefits of health innovation to citizens. The authors believe the NDT would accelerate the NHS’s development of cutting-edge innovations, provide quicker access to these advancements at reduced costs and generate a new funding source for the healthcare system.
