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News Article
Omicron blocks thousands of overseas doctors joining NHS
Patient Safety Learning posted a news article in News
Thousands of overseas-qualified doctors wanting to work in the UK will be delayed after the General Medical Council cancelled exams due to the surge in Covid cases. The regulator said its decision to pause professional and linguistic assessment board tests, scheduled for January and February, was made “in direct response” to the current omicron wave. Up to 54 doctors would have been needed each per day as examiners, it said, alongside a “large number of role players and staff”. It comes as overseas recruitment is seen by government and national officials as a crucial way to boost NHS staffing, including GPs. Director of registration Una Lane said: “We are deeply disappointed to have to cancel exams at this time, but given the pressures on the NHS and the impact on examiner availability, it was the only viable option.” Read full story (paywalled) Source: HSJ, 6 January 2022 -
News Article
A quarter of inpatients at mental health trust have Covid
Patient Safety Learning posted a news article in News
More than one in four inpatients at one of England’s largest mental health trusts were reported as covid-positive this week, according to data seen by HSJ. Around 160 inpatients across South London and Maudsley (SLAM) Foundation Trust’s sites, or 28% of its total open beds, were reported as positive at the beginning of the week. Several other London mental health trusts have seen high rates of covid cases in recent weeks, as there has been enormous spread of the omicron variant in the capital, although rates have not been as high as at SLAM. SLAM told HSJ that infection rates rose and fell in a reflection of community transmission, with covid-positive people being admitted, and there being spread within inpatient units. While no wards have been closed and all of the trust’s services are open, visiting was suspended in mid-December due to what the organisation described on its website as a “high number of [covid] outbreaks”. Several sources in the sector told HSJ there had been widespread omicron outbreaks in mental health units across England. They said the nature of psychiatric wards and use of restraints meant adhering to stringent social distancing measures, in the face of a highly infectious variant, was more difficult than in other settings. Read full story (paywalled) Source: HSJ, 6 January 2022 -
News ArticleA health minister has asked NHS England to look into a stricken ambulance trust that is asking patients to get a lift to A&E. The North East Ambulance Service (NEAS) said staff should “consider asking the patient to be transported by friends or family.” See previous news story. NEAS medical director Dr Mathew Beattie said the service had “no option than to try to work differently” amid Covid staff shortages. However, Health Minister Gillian Keegan said she would ask NHS England to look into the situation. She told Sky News: "That is not what we have put in place at all. We have more ambulance crews in operation than we have ever had." “We also gave £55 million extra just for this period to cover staff and make sure we had increases in staff and staffing levels. "I've actually asked NHS England to look at that particular case because that doesn't sound to me like that's an acceptable approach. “People should be able to get an ambulance if they have a heart attack and that's why we've put that extra funding in place, and why we've been building up our ambulance service over the last couple of years." Read full story Source: Mirror, 5 January 2022
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Content ArticleHealthcare workers (HCWs), particularly those from ethnic minority groups, have been shown to be at disproportionately higher risk of infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) compared to the general population. However, there is insufficient evidence on how demographic and occupational factors influence infection risk among ethnic minority HCWs. Researchers analysed data from 10,772 HCWs who worked during the pandemic to identify demographic and household factors that contributed to infection risk. Results from the UK-REACH study, co-funded by the NIHR and UK Research and Innovation, showed that healthcare workers' risk of catching coronavirus increased in correlation with the level of exposure to COVID-19 patients. Other risk factors included a lack of PPE access and sharing living or working environments with other key workers. Geographical differences were also seen, with healthcare workers in Scotland and South West England at lower risk of infection compared with those in the West Midlands. Intensive care unit staff were also at lower risk than those in other hospital settings.
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News Article
More than 90 care home operators in England declare red alert over staffing
Patient Safety Learning posted a news article in News
Care operators are facing acute staffing shortages caused by Omicron with more than 90 declaring a “red” alert, which means staffing ratios have been breached. Over 11,000 care home workers are off for Covid reasons, according to internal health system staffing data seen by the Guardian. One of the UK’s largest private operators, Barchester, is dealing with outbreaks in 105 of its 250 homes. It said that rules meaning homes with Covid cannot accept hospital discharges will cause backlogs in the already struggling NHS. Across England, 9.4% of care home staff are off work, according to government live data, with close to 3% absent because of Covid. The figures, which may be an underestimate because of the festive break, are drawn from submissions by thousands of care providers. “The spread of Omicron across the country will bring more care homes into outbreak, put huge pressure on the already compromised staff group and mean those who need care do not get it,” said Vic Rayner, chief executive of the National Care Forum. Many care operators said delays in getting PCR test results back were a key frustration, meaning workers who may not be infected were isolating longer than necessary." Stephen Chandler, president of the Association of Directors of Social Services, said councils were braced for calls for help from care operators and said “the care that people experience will be affected”. Read full story Source: The Guardian, 5 January 2022 -
Content ArticleWhen COVID-19 struck, many doctors helped out by willingly changing the way they worked. The BMJ hears some of their stories, including from Michael Farquhar, Paediatric sleep consultant at the Evelina London Children’s Hospital, and Alice Findlay, Retired former emergency medicine consultant at Dartford and Gravesham NHS Trust.
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News ArticleNHS staff absences due to covid have risen by a further 11,000 staff in a week in England, figures seen by HSJ reveal. At a national level, the number of absences for covid-related reasons - including isolation - rose to about 44,200 on 29 December, up from 32,800 on 22 December. The 29 December figure has pushed up overall absence for all reasons to 103,727 - 7.8% of the total reported workforce - the leaked data shows. Numerous senior NHS managers have said their main concern at present is about the level of staff absences, which in some cases is undermining services, with staff having to be redeployed to support others. There is concern about it rising further in the new year. One trust is looking at whether staff who test positive could opt to work on wards dedicated to covid patients. Louise Ashley, the chief executive of Dartford and Gravesham Trust in Kent, tweeted yesterday that some nurses had asked if they could come into work while positive but asymptomatic. Ms Ashley later confirmed to HSJ that the trust had assessed the request and “unfortunately” had to refuse it. The two main reasons for the decision were that staff may have the more dangerous Delta strain and that it be too difficult to keep them isolated from other staff. She added: ”I am amazed at their commitment to their patients and colleagues – very humbling after the two years they have been through. We are seeing high levels of staff absenteeism but we are hurrying through PCR tests to get staff back to work and are managing safe staffing levels currently.” There is also growing concern over NHS staff access to testing, which is required to enable contacts to come to work if they are negative. Read full story (paywalled) Source: HSJ, 31 December 2021
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News Article
NHS given its 10 priorities for 2022
Patient Safety Learning posted a news article in News
NHS England has set out 10 priorities for 2022-23 in its annual planning guidance. NHSE chief executive Amanda Pritchard makes clear in an introduction that many of its goals remain contingent on covid, stating: ”The objectives set out in this document are based on a scenario where covid-19 returns to a low level and we are able to make significant progress in the first part of next year.” The 10 priorities are: Workforce investment, including “strengthening the compassionate and inclusive culture needed to deliver outstanding care”. Responding to COVID-19. Delivering “significantly more elective care to tackle the elective backlog”. Improving “the responsiveness of urgent and emergency care and community care capacity.” Increasing timely access to primary care, “maximising the impact of the investment in primary medical care and primary care networks”. Maintaining “continued growth in mental health investment to transform and expand community health services and improve access”. Using data and analytics to “redesign care pathways and measure outcomes with a focus on improving access and health equity for underserved communities”. Achieving “a core level of digitisation in every service across systems”. Returning to and better “prepandemic levels of productivity”. Establishing integrated care boards and collaborative system working, and “working together with local authorities and other partners across their ICS to develop a five-year strategic plan for their system and places”. Read full story (paywalled) Source: HSJ, 24 December 2021 -
Content ArticleNHS England has set out 10 priorities for the 2022-23 financial year in its annual planning guidance. NHSE chief executive Amanda Pritchard makes clear in the introduction that many of its goals remain contingent on covid, stating: ”The objectives set out in this document are based on a scenario where covid-19 returns to a low level and we are able to make significant progress in the first part of next year.”
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News Article
Lincolnshire hospitals declare 'critical incident' over staff shortages
Patient Safety Learning posted a news article in News
A critical incident has been declared at four Lincolnshire hospitals because of staff shortages due to COVID-19. United Lincolnshire Hospitals NHS Trust said it was taking "additional steps to maintain services" at all its hospitals in Lincoln, Boston and Grantham. The trust's medical director, Dr Colin Farquharson, said there were "significant staffing pressures due to absence related to COVID-19". But he said essential services "remain fully open". According to a leaked email seen by The Sunday Times, the trust declared a critical incident on Saturday night "due to extreme and unprecedented workforce shortages". It issued an "urgent appeal" for clinical and non-clinical staff to offer extra time supporting colleagues "over the next 72 hours". It also asked staff to "consider limiting social contacts with people outside of work". Original tweet on Twitter: Read full story Source: BBC News, 3 January 2022 -
Content ArticleRed eyes, ringing ears, sensitivity to light, trouble hearing: although a loss of taste and smell have become well-known sensory symptoms of COVID, accumulating research suggests that vision and hearing are also frequent targets of SARS-COV-2, the virus that causes the disease.
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News Article
Nightingale surge hubs to be set up in eight hospitals, NHS England says
Patient Safety Learning posted a news article in News
Coronavirus "surge hubs" are to be set up at hospitals across England in preparation for a potential wave of Omicron admissions, the NHS has said. The eight temporary "Nightingale" units will each house about 100 patients, with building starting this week. There are also plans to identify sites for a further 4,000 beds if needed. Record Covid case numbers were reported in the UK on Wednesday and NHS medical director Prof Stephen Powis said the service was on a "war footing". The NHS is often required to deploy extra beds over winter, but hospitalisations in England with Covid have risen above 10,000 for the first time since March. Across the UK 183,037 daily cases were reported in the latest figures, with over 900,000 cases reported over the last seven days - up 41.4% on the week before. Prof Powis said the NHS "cannot wait to find out before we act" given the number of infections and uncertainty about Omicron's severity. Read full story Source: BBC News, 30 December 2021 -
News Article
No. 10 criticised for failing to respond to damning MP report on Covid
Patient Safety Learning posted a news article in News
The government has been criticised for failing to respond to a damning parliamentary report that accused ministers of mishandling the early stages of the pandemic. The report, compiled by the Health and Science and Technology Committees, found the government’s initial response to Covid-19 “amounted in practice” to the pursuit of herd immunity, with the delayed decision to lock down ranking as one of the “most important public health failures the United Kingdom has ever experienced”. More than 50 witnesses contributed to the cross-party report, including ministers, NHS officials, government advisers and leading scientists, with the authors saying it was was “vital” that lessons were learnt from the failings of the past 18 months. The findings from the joint inquiry were published on 12 October and a deadline for an official government response was set for 12 December. However, that date has now passed and the committees have yet to formally hear back from ministers, according to the parliamentary website, which states that a response is now “overdue”. Covid-19 Bereaved Families for Justice said the government’s failure to “meet a very reasonable deadline” called into question the willingness of ministers to engage with the coming independent public inquiry into the UK’s handling of the pandemic. "The government have had months to get a response delivered to the Health and Science and Technology committees following their lessons leant from the pandemic report,” said Jo Goodmand, co-founder of the campaign group. “Unfortunately those of us who have lost loved ones are far too used to this with responses to FOIs late and it taking far too long to announce the inquiry. Read full story Source: 30 December 2021 -
News Article
Lateral flow tests to be ‘constrained’ over next two weeks, warns Sajid Javid
Patient Safety Learning posted a news article in News
The health secretary, Sajid Javid, has warned MPs he may need to “constrain” the Covid testing system over the next fortnight, as demand for lateral flow kits surges. Ministers have repeatedly encouraged members of the public to test themselves using a lateral flow device (LFD) before attending gatherings or meeting vulnerable relatives. However, test kits have repeatedly been unavailable online in recent days, and many pharmacies have complained of being unable to secure them. Labour has accused the government of presiding over a “shambles”, with many members of the public struggling to obtain tests despite ministers putting testing at the centre of efforts to control the spread of Omicron. Demand for the tests has also been boosted by a change in quarantine rules that allows people to emerge from self-isolation after seven days instead of 10, as long as they carry out two negative lateral flow tests. In a letter sent to MPs on Wednesday evening, Javid acknowledged the intense strain being put on the system as cases of the Omicron variant continue to increase, with 183,037 new infections recorded on Wednesday. “In light of the huge demand for LFDs seen over the last three weeks, we expect to need to constrain the system at certain points over the next two weeks to manage supply over the course of each day, with new tranches of supply released regularly throughout each day,” he wrote. Read full story Source: The Guardian, 30 November 2021 -
Content ArticleCOVID-19 is known to cause multi-organ dysfunction in acute infection, with prolonged symptoms experienced by some patients, termed Post-Acute Sequelae of SARSCoV-2 (PASC). However, the burden of infection outside the respiratory tract and time to viral clearance is not well characterised, particularly in the brain. Chertow et al. performed complete autopsies on 44 patients with COVID-19 to map and quantify SARS-CoV-2 distribution, replication, and cell-type specificity across the human body, including brain, from acute infection through over seven months following symptom onset. The study showed that SARS-CoV-2 is widely distributed, even among patients who died with asymptomatic to mild COVID-19, and that virus replication is present in multiple pulmonary and extrapulmonary tissues early in infection. The authors detected persistent SARS-CoV-2 RNA in multiple anatomic sites, including regions throughout the brain, for up to 230 days following symptom onset. Despite extensive distribution of SARS-CoV-2 in the body, the authors observed a paucity of inflammation or direct viral cytopathology outside of the lungs. The data prove that SARS-CoV-2 causes systemic infection and can persist in the body months. * Note: This is a pre-print and has not been peer-reviewed yet.
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News Article
Study suggests coronavirus lingers in organs for months
Patient Safety Learning posted a news article in News
Data from a new study suggests that the coronavirus that causes COVID-19 can persist in different parts of the body for months after infection, including the heart and brain. Scientists at the National Institutes of Health (NIH) found the virus can spread widely from the respiratory tract to almost every other organ in the body and linger for months. The researchers described the study as the "most comprehensive analysis to date" of the virus's persistence throughout the body and brain. They performed autopsies on 44 patients who died either from or with COVID-19 to map and quantify virus distribution across the body. Daniel Chertow, principal investigator in the NIH’s emerging pathogens section, said along with his colleagues that RNA from the virus was found in patients up to 230 days after symptom onset. The findings, released in a pre-print manuscript, shed new light on patients who suffer from Long Covid. The study found that the virus had replicated across multiple organ systems even among patients with asymptomatic to mild COVID-19. While the "highest burden" of infection was in the lungs and airway, the study showed the virus can "disseminate early during infection and infect cells throughout the entire body,” including in the brain, as well as in ocular tissue, muscles, skin, peripheral nerves and tissues in the cardiovascular, gastrointestinal, endocrine and lymphatic systems. "Our data support an early viremic phase, which seeds the virus throughout the body following pulmonary infection," the researchers wrote. Read full story Source: The Hill, 27 December 2021 -
News Article
NHS pressures having ‘devastating’ impact on dying patients
Patient Safety Learning posted a news article in News
Patients are dying in hospital without their families because of pressure on NHS services, hospices have told The Independent. A major care provider has warned that it has seen a “huge shift” in the number of patients referred too late to its services. The warning comes as NHS England begins a new £32m contract with hospices to help hospitals discharge as many patients as possible this winter. NHS chief executive Amanda Pritchard said the health service was preparing for an Omicron-driven Covid wave that could be as disruptive as, or even worse than, last winter’s crisis. Hospices are already dealing with a “huge volume of death and patients needing support”, according to the head of policy at Hospice UK, Dominic Carter. He told The Independent that hospices had seen a huge shift in the number of patients referred to their services too late, when they are in a “very serious” state of health. He added: “We don’t really know what kind of support is actually out there for those people, while hospitals have difficulties and deal with challenges around backlogs and Covid. There are lots of people that have been in the community, where hospices are trying to reach them but aren’t always able to identify who needs that care and support. “They’re really important, those five or six final days, for the individual and their families. Yet this is spent in crisis rather than being helped as much as possible in a comfortable environment by the hospice ... [instead] an ambulance is called, and they’re having to be cast into hospital.” Read full story Source: The Independent, 26 December 2021 -
News Article
Give FFP3 masks to NHS staff during Omicron, doctors say
Patient Safety Learning posted a news article in News
NHS staff treating Covid patients should be given much more protective facewear than thin surgical masks to help them avoid getting infected during the Omicron rise, doctors say. The British Medical Association (BMA), Hospital Consultants and Specialists Association (HCSA) and Doctors’ Association UK are calling for frontline personnel to be given FFP3 masks. Making the much higher-quality face masks standard issue would save the lives of health workers who fall ill as a result of treating Covid patients, the BMA said. “At this critical point in the pandemic this is extremely urgent – a matter of life and death,” said Prof Raymond Agius, the acting chair of the doctors’ union’s occupational health committee. FFP3 masks, also known as filtering facepiece respirators, have been shown in a trial in Addenbrooke’s hospital in Cambridge to reduce the number of healthcare staff who become infected. However, the Department of Health and Social Care’s (DHSC) guidance on personal protective equipment, updated last week, only recommends their use in limited circumstances. “With a high transmissible new strain now circulating, and clear evidence that Covid-19 spreads in small airborne particles, healthcare workers must be given the best possible protection against the virus. Surgical masks don’t give the necessary protection against airborne transmission of Covid,” Agius said. The BMA has written to every hospital trust in England demanding that any health professional treating patients who are or may be Covid-positive should be routinely issued with FFP3s, which are much more expensive than the surgical masks usually provided. Surgical masks are “unsuitable” given the threat Covid poses, the BMA believes. Read full story Source: The Guardian, 27 December 2021 -
News Article
Mass rapid tests in Liverpool cut hospital stays by a third
Patient Safety Learning posted a news article in News
Mass lateral flow testing cut the number of people needing hospital treatment for Covid by 32% and relieved significant pressure on the NHS when the measures were piloted last year, a study has shown. Liverpool conducted the first city-wide testing scheme using rapid antigen tests in November last year, amid debate about whether or not lateral flow tests (LFTs) were accurate enough to detect the virus in asymptomatic carriers. It expanded the project to cover the whole of the Liverpool region, offering people LFTs whether or not they had symptoms. Key workers did daily tests before going to work to show they were not infectious. Now an analysis has shown that it was more successful than Liverpool’s scientists and public health teams had anticipated, after they compared Covid cases and outcomes in the region with other parts of England. Professor Iain Buchan, dean of the Institute of Population Health, who led the evaluation, said: “This time last year, as the Alpha variant was surging, we found that Liverpool city region’s early rollout of community rapid testing was associated with a 32% fall in Covid-19 hospital admissions after careful matching to other parts of the country in a similar position to Liverpool but without rapid testing. “We also found that daily lateral flow testing as an alternative to quarantine for people who had been in close contact with a known infected person enabled emergency services to keep key teams such as fire crews in work, underpinning public safety.” Read full story Source: The Guardian, 19 December 2021 -
Content ArticleWhen the pandemic began, many nations’ emergency stockpiles came into the spotlight—and were found wanting. Twenty months later, Jane Feinmann asks what happened, and if procurement has got any better.
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Content ArticleThis report, published by the Agency for Healthcare Research and Quality (AHRQ) in the United States, presents findings from a review of 5,500 patient safety records in which the Covid-19 public health emergency was included as part of the description of the event or unsafe condition. It forms part of a series of Network of Patient Safety Databases Data Spotlight reports.
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Content ArticleThis leaflet by the Royal College of Midwives provides information for patients on how to prepare for a home visit from a midwife. It covers steps that patients should take to reduce the risk of spreading Covid-19 including handwashing, wearing a face mask and reducing the number of people in the room.
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News ArticleNearly two years into the pandemic, people like me are still out of action. We need better support and more funding, writes Joanna Herman, consultant in infectious diseases in London. Joanna caught Covid in March 2020, and was by definition a “mild” case: not admitted to hospital and no risk factors for severe disease, but how it has affected her and her family is anything but mild. Having been fit and active, Joanna now finds that on bad days that she still struggle with everyday chores, and her usually quick-firing brain "remains in slo-mo ('brain fog')". For many months, it has felt as though long Covid has not been on the political agenda, but many people are still struggling with their everyday lives, and struggling to get the help they need. Why is long Covid not included in the daily statistics, or as one of the main incentives to avoid Omicron, and to get a vaccine and booster jab? It’s never mentioned, and it often feels as if sufferers don’t exist. Even if the new variant results in milder disease than previous ones, could more people still end up like Joanna? And how will an already stretched NHS cope if there are new cases of long Covid after this current viral surge? There’s a lot we still don’t know about Omicron; a fuller picture will become evident over the coming weeks and months... Read full story Source: The Guardian, 22 December 2021
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Content Article
COVID Nursing and PTSD (December 2021)
Patient Safety Learning posted an article in Blogs
In an article for the Patient Safety Journal, Cassandra Alexander, a nurse, shares what it is like on the front lines and the toll it has taken on her mental health—a deeply personal and painful story, yet a traumatic experience shared by many nurses around the United States. -
News Article
Immensa lab closed one month after ‘unusual’ Covid results first detected
Patient Safety Learning posted a news article in News
Authorities were aware of discrepancies in Covid test results across England one month before the lab responsible was ordered to shut down its operations, legal papers show. An estimated 43,000 incorrect false negative tests were processed for the NHS by the Immensa laboratory in Wolverhampton between 8 September and 12 October. UK Health Security Agency became aware of an “unusual spike” in suspicious test results on 14 September, with large numbers of people testing positive on lateral flow devices but negative via PCR. It took a month before the UKHSA determined that the “likely cause was a technical issue at the Immensa laboratory”, according to court papers filed by the government in response to a lawsuit. The Independent also revealed in October how machines at the Wolverhampton lab were poorly maintained, concerns over quality control dismissed and untrained staff regularly “left to their own devices”. Samples at the site were wrongly processed or cross-contaminated, leading to incorrect test results, while faulty air conditioning and fluctuating humidity levels within the lab also led to spoiled tests, whistleblowers said. Read full story Source: The Independent, 22 December 2021
