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Content Article
This guide published by NHS England & Improvement describes the validation rules relating to the LFPSE project, specifically around submitting an Adverse Event via the Adverse Event Application Programming Interface (API). It covers several types of validation rules, which have been split into three sections. Bespoke business validation rules which have been implemented based on the dependencies between responses and extensions that cannot be captured by the FHIR resource validation. FHIR validation responses which may be returned from the API when native FHIR validation checks the submission body against the LFPSE FHIR profiles defined for an adverse event. Invalid operations and similar responses which are external to validation of the submission, including responses pertaining to permissions, personal information and any other responses that do not fit into the two categories above. -
Content Article
Eating disorders training for health and care staff
Patient-Safety-Learning posted an article in Eating disorders
This series of training programmes was collaboratively developed by eating disorder charity Beat, Health Education England and NHSE. It was developed in response to the 2017 PHSO investigation into avoidable deaths from eating disorders, as outlined in recommendations from the report Ignoring the Alarms: How NHS Eating Disorder Services Are Failing Patients. It is designed to ensure that healthcare staff are trained to understand, identify and respond appropriately when faced with a patient with a possible eating disorder. It includes sessions relevant for different healthcare professionals and includes: Medical students and foundation doctors programme Nursing workforce sessions GP and Primary care workforce sessions Medical Monitoring in eating disorders Understanding Eating Disorders Webinar resource for dietitians, oral health teams and community pharmacy teams- Posted
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Friends of African Nursing
Patient_Safety_Learning posted an article in International patient safety
Friends of African Nursing (FoAN) was started as an organisation by Lesley and Kate, who had family contacts in Africa and due to their professional nursing backgrounds, had taken an interest in the health systems in African countries which they had visited whilst on holiday. It was apparent to them both separately, that the privilege of the healthcare environment in which they both worked in the UK - which offered continuing education, ready access to journals, speciality (perioperative) education and a professional association (in which they were closely involved, at home) as a ready made network was indeed a huge privilege which should be shared. Their primary interest is in supporting nurses and nursing in Africa. FOAN specialises in supporting nurses who work in Operating Theatres particularly and work with the surgical teams. Surgery is often high risk in Africa and their key interest is to update practice, educate on risk management and patient safety as well as infection prevention measures. They have also delivered programmes for ward leaders and other bespoke courses. Visit the FoAN website to find out more via the link below.- Posted
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The UK government’s long-awaited NHS workforce plan for England outlines a vision to increase the number of nursing staff in England over the next 15 years, with a promise of 170,000 more nurses by 2036/37. This article from the Royal College of Nursing (RCN) outlines how the detail of the plan will affect nurses. It argues that the plan fails to acknowledge the financial investment needed if its objectives are to be fulfilled, and expresses the RCN's concern that it does not address financial support for student nurses.- Posted
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Duty of Candour for Wales
Gethin posted an article in NHS Wales (Gig Cymru)
The Duty of Candour for Wales statutory guidance.- Posted
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National Patient Safety Syllabus
Jon Holt posted a topic in Professionalising patient safety
The Academy of Medical Royal Colleges have published the first National patient safety syllabus that will underpin the development of curricula for all NHS staff as part of the NHS Patient Safety Strategy: https://www.pslhub.org/learn/professionalising-patient-safety/training/staff-clinical/national-patient-safety-syllabus-open-for-comment-r1399/ Via the above link you can access a ‘key points’ document which provides some of the context for the syllabus and answers to some frequently asked questions. AOMRC are inviting key stakeholders to review this iteration of the syllabus (1.0) and provide feedback via completing the online survey or e-mailing Rose Jarvis before 28 February 2020. I would be interested to hear people's thoughts and feedback and any comments which people are happy to share which they've submitted via the online survey -
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Mandatory training
Claire Cox posted a topic in Staff - clinical
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Can any one share? The trust I work in delivers patient safety training as part of the mandatory training. I was wondering if any other trust does this, if so would they mind sharing Thier slides as I'm not sure what it should include. Thanks!- Posted
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How can we encourage students to become active leaders in patient safety?
PatientSafetyLearning Team posted a topic in Leadership for patient safety
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A question posed by a delegate at our Patient Safety Learning Conference 2019: 'As invaluable sources of fresh intelligence, how can we encourage students/learners to become active leaders in patient safety?' What are your thoughts?- Posted
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Using simulation to test processes
Phil Gurnett posted a topic in Process improvement
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Hi I have been working in a presentation we are giving at ASPiH in November around the work we have done using simulation to test systems and processes. we have done this in two ways. Firstly as a by-product of an educational in situ simulation in s clinical environment where a latent threat has been identified. In this case we will work with the area in looking at just what contributes to the threat and ways that may help. The second way (and with my HF head on, more exciting) has been setting out to test a process. We have done this several times now and have had some real successes in demonstrating the work as done v work as imagined theory. has anyone else used simulation in this way? looking forward to your replies. Phil- Posted
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Teaching RCAs to teams: a checklist
lzipperer posted a topic in Investigations, risk management and legal issues
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Root case analysis has its detractors but can still bring value to understanding deep-seated problems that affect the safety of care. Does anyone have a checklist of elements of an effective TRAINING strategy to bring staff on board with the process? Not how to do an RCA, but to bring a team to the skill competencies they need to do RCA? I'd appreciate hearing your experiences. Please tell your tales!- Posted
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I met at a recent conference a newly appointed Patient Safety Manager. She’d been working in a supporting role in another organisation and was delighted with her obviously well deserved promotion to a more senior role of patient safety manager in another Trust. But 6 days in, she’s had no induction, there is no patient safety strategy or plan in the Trust, there isn’t any guidance as how she should do her job other than just ‘get on with doing RCAs. ‘ She doesn’t know who she can turn to for advice or support either in her Trust or elsewhere. Are there networks of PSMs she can turn to? Surely there is a model framework for patient safety that is produced as a guide? How can we help her and other PSMs?- Posted
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Content Article
An independent review of how effectively the test prevents unsuitable staff from being redeployed or re-employed in health and social care settings.- Posted
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NHS Resolution has launched its first eLearning module that focuses on learning from the significant avoidable harm that can occur during antenatal and postnatal care and is seen in the cases notified to its Early Notification Scheme. This free resource is designed to support clinicians working in maternity services. The module uses three illustrative case stories to immerse learners into the antenatal, intrapartum and postnatal care provided to mothers and the neonatal care provided to their babies. It aims to deepen learners' understanding of NHS Resolution’s role within the healthcare system, develop their understanding of the law of negligence as applied to clinical claims and explore how clinical decisions and actions can lead to avoidable harm. The module takes approximately two-and-a-half hours to complete and can be used as evidence of CPD hours undertaken for revalidation. -
Content Article
The Patient Safety Movement Foundation offers a unique educational opportunity for healthcare professionals around the world to expand their knowledge in the theory and practice of patient safety. Please apply to this fellowship programme from the link if you are interested in joining the 2024 cohort of fellows. Application deadline is 1 August 2023.- Posted
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NHS Long Term Workforce Plan (30 June 2023)
Patient Safety Learning posted an article in NHS England
The first comprehensive workforce plan for the NHS, putting staffing on a sustainable footing and improving patient care. It focuses on retaining existing talent and making the best use of new technology alongside the biggest recruitment drive in health service history. -
Content Article
The state of medical education and practice in the UK 2023 is published at a time when the UK health systems face extensive challenges. This report from the General Medical Council (GMC) shares concerning data about the experiences of doctors and the challenges to providing adequate care to patients. In this context, careful and constructive exploration of the practical, evidence-based steps that can be taken to improve the situation is critical – to protect both patients and the doctors who care for them. -
Content Article
Sickle cell disease is the name for a group of inherited red blood cell disorders that affect haemoglobin, which is a protein in red blood cells that carries oxygen through a person’s body. It mainly affects people from African or Caribbean backgrounds, though it can affect anyone. It affects approximately 15,000 people in the UK. In November 2021, the All-Party Parliamentary Group for Sickle Cell and Thalassaemia published a report detailing the issues that people with sickle cell disease experience in relation to their care. The report made 31 recommendations to organisations across the healthcare system to help address these issues. The Healthcare Safety Investigation Branch (HSIB) launched two investigations (see also: Invasive procedures for people with sickle cell disease) to find out what additional learning or knowledge could be added in this area and to provide further insights into the practical challenges patients with sickle cell disease may face when receiving NHS care. HSIB used a real patient safety incident, referred to as ‘the reference event’, to explore how sickle cell crises are managed within hospital settings. In particular, the investigation considered: the knowledge nursing staff may have about the care of patients in sickle cell crisis how patient-controlled analgesia (PCA) – where a patient can use a device to give themself doses of pain relief medication – is considered holistically, such as monitoring the patient and staff workload.- Posted
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In 2022, an illustration of a Black foetus in the womb by Nigerian medical illustrator and medical student Chidiebere Ibe, went viral. The image sparked an important conversation around representation in medical imagery and the impact this has on health outcomes for patients who are Black, Indigenous and people of colour (BIPOC). Research showed that only 5% of medical images show dark skin and only 8% of medical illustrators identified as BIPOC. A collaboration between Chidiebere Ibe, Deloitte and Johnson & Johnson, Illustrate Change aims to build the world's largest library of BIPOC medical illustrations for use in medical education and training. So far, the library contains images relevant to the following specialties: Dermatology Eye disease General health Haematology Maternal health Oncology Orthopaedics -
Content Article
The government has published its mandate to NHS England. This mandate is intended to apply from 15 June 2023 until a new mandate is published. NHS England has a duty to seek to achieve the objectives in the mandate. The Secretary of State keeps progress against the mandate under review, setting out his views in an annual assessment which is laid in Parliament and published. The government will agree with NHS England how it should report on overall progress against the mandate to support the Secretary of State in keeping this under review. This will include reporting at agreed intervals on other delivery expectations listed beneath the objectives.- Posted
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The inpatient diabetes team at University Hospital Southampton NHS Foundation Trust recently launched D1abasics, an initiative that aims to improve inpatient care for people with diabetes. In this blog, Diabetes Consultant Mayank Patel and Inpatient Diabetes Specialist Nurse Paula Johnston outline the approach and explain how it will equip staff across all specialties with the basic knowledge to care safely for people with diabetes in hospital.- Posted
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The National Institute for Health and Care Research (NIHR) Evidence Collections draw together evidence from important NIHR-funded and wider research. They aim to help people in policy and practice understand recent important research in a topic area. The most recent Collection is Maternity services: evidence for improvement. In this blog, one of the Collection's authors, Candace Imison, describes how it was framed by the findings from a recent investigation into failings in East Kent Hospitals’ maternity services. She focuses on some key messages from evidence on how to identify poor performance and provide effective board governance and oversight. -
Content Article
Despite steps towards closing the gap between mental and physical health services, many people still cannot access services and face long waits for treatment. Addressing workforce challenges in mental health services will be crucial to improving this situation. This report, commissioned and supported by NHS Confederation’s Mental Health Network, takes stock of progress across the country in staffing the single largest profession within the mental health workforce: nurses. -
Content Article
D1abasics campaign resources (UHS, May 2023)
Patient-Safety-Learning posted an article in Diabetes
People with diabetes account for one in three hospital inpatients, and this is projected to increase to one in five in the next few years. Often, people are in hospital for reasons other than their diabetes, so it is important that staff across all specialties understand the basics of diabetes care in order to ensure patient safety. D1abasics is an innovative project that aims to equip all healthcare professionals to support the basic diabetes healthcare needs of their patients. Developed by the diabetes team at University Hospital Southampton with funding and support from the charity Diabetes UK, the campaign includes resources such as posters, lanyards and prompt cards. The diabetes team is supporting learning across the hospital by making visits to all wards and specialties to promote D1abasics. You can download the D1abasics poster below.- Posted
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Recently, there has been a concerning increase in the number of deaths of pregnant women, especially from Black, Asian and deprived backgrounds. In addition, there have been several investigations into safety issues in maternity services, such as the Ockenden, East Kent, and Shrewsbury and Telford report. This National Institute for Health and Care Research (NIHR) Collection highlights evidence in priority areas, identified in the East Kent report, to support high-quality care and avoid safety issues in maternity services.- Posted
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- Maternity
- Decision making
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