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Content ArticleThe Covid-19 vaccination programme has been one of the few almost unqualified successes of the UK’s response to the pandemic. System-working, joining up the NHS, local government and the voluntary sector was a hallmark of the vaccine roll-out. Local knowledge and delivery were crucial. Volunteers also played a vital role, not just in acting as stewards at vaccination sites, but also in terms of community outreach, for example with faith communities and others offering sites for vaccination which in turn built trust in the vaccine and in the NHS. The NHS has never used so much data so quickly and so powerfully, supporting the delivery of vaccine doses, recording any adverse reactions and, most importantly, allowing NHS staff to map who had the vaccine. This data in turn supported outreach work to support gaps in service provision and overcome vaccine hesitancy. These factors which helped make the roll out a success should be ‘bottled and re-used’ for other NHS services, from childhood immunisations to screening for cancer, diabetes, high blood pressure and other conditions, improving the service’s ability to reach the harder to reach Based on interviews with a wide range of people involved in the programme, this King's Fund report sets out what the roll-out in England has achieved as well as its trials and tribulations.
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Content ArticleThis study in the BMJ Open examines the links between between adverse childhood events and trust in Covid-19 health information, attitudes towards and compliance with Covid-19 restrictions and vaccine hesitancy. The study found correlations between adverse childhood events and: low trust in NHS Covid-19 information feeling unfairly restricted by government supporting removal of social distancing and ending of mandatory face coverings breaking Covid-19 restrictions vaccine hesitancy. The authors concluded that as adverse childhood events are common across many populations, there is a need to understand how they impact trust in health advice and uptake of medical interventions. This could play a critical role in the continuing response to Covid-19 and approaches to controlling future pandemics. In addition, as individuals with adverse childhood events suffer greater health risks throughout life, better compliance with public health advice is another reason to invest in safe, secure childhoods for all children.
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Content ArticleThe resilience of health systems and cooperation between Member States have become particularly important during the COVID-19 pandemic. On the occasion of the French Presidency of the European Union (FPEU) 2022, the European Observatory on Health Systems and Policies and the General Directorate for HealthCare Services of the French Ministry of Health have worked together to produce this special issue of Eurohealth to better understand how health systems have responded to the health crisis and to draw lessons for improving resilience of health systems. (Available in both English and French.)
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EventThis conference focuses on recognising and responding to the deteriorating patient and ensuring best practice in the use of NEWS2. The conference will include National Developments including the recommendations on NEWS2 and Covid-19, and implementing the recommendations from the Healthcare Safety Investigation Branch Report Investigation into recognising and responding to critically unwell patients. The day will include practical case study based sessions on identifying patients at risk of deterioration, improving practice in patient observations, the role of human factors in responding to the deteriorating patient, improving escalation and understanding success factors in escalation, sepsis and Covid-19, involving patients and families in recognising deterioration, using clinical judgement, and improving the communication and use of NEWS2 in the community, including care homes, and at the interface of care. The Recording of NEWS2 score, escalation time and response time for unplanned critical care admissions is now an NHS CQUIN goal. For further information and to book your place visit https://www.healthcareconferencesuk.co.uk/conferences-masterclasses/deteriorating-patient-summit or email kate@hc-uk.org.uk. hub members receive a 20% discount. Email: info@pslhub.org Follow on Twitter @HCUK_Clare #DeterioratingPatient
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EventThis Westminster conference will discuss the future for Long Covid research, services, and care. It will be an opportunity to assess Long Covid: the NHS plan for improving Long Covid services and how its ambitions for improving access to services, patient experience and outcomes for patients can be achieved. Further sessions examine priorities for research and improving understanding of Long Covid, looking at implementing the latest developments in research to improve services, and the long-term health implications of Long Covid. There will also be discussion on addressing concerns around inequalities, capacity and wait times for Long Covid services, as well as the primary care referral system, and utilisation of investment. Sessions in the agenda include: latest developments: trends - key issues - assessing the NHS plan for improving long COVID services. clinical research: taking forward the understanding of Long Covid - advancing clinical trials - utilising data - funding and investment. improving patient outcomes, prediction and prevention - accelerating the development of effective treatments - areas for focus, such as cardiology. examining the increased risk of long-term health conditions and impacts of reinfection for Long Covid patients. improving specialist Long Covid services: progress made so far and priorities for moving forward. options for increasing capacity - addressing inequalities in provision, access to services and information - applying latest developments from research. children’s Long Covid services: assessing delivery - implications for child development and attainment. primary care: tackling key challenges for diagnosis and referral. the workforce: priorities for education and training - support for long COVID patients in the workforce. Register
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EventuntilChaired by Patient Safety Learning's Helen Hughes, and sponsored by BD, an expert panel will discuss what measures are needed to achieve transformational change in the way infection is detected, monitored, prevented, and managed across the NHS, healthcare systems and broader society. The session will touch on how industry, professional bodies and healthcare experts can work collaboratively to support the creation of a healthcare system which is resilient and mature in dealing with disease outbreak and pandemic preparedness, infection prevention, and rapid treatment of time-critical infection, ultimately delivering antimicrobial stewardship (AMS) and improved sepsis outcomes. What attendees will learn: Understand the current challenges and barriers to effective infection prevention. What the future of infection prevention and management looks like in a post-COVID-19 world. Collaboration between all stakeholders – industry, government and PAGs – will be critical in delivering a holistic solution and pathway to robust infection management. Register
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EventThe COVID-19 pandemic has profoundly impacted nearly all countries’ health systems and diminished their capability to provide safe health care, specifically due to errors, harm and delays in diagnosis, treatment and care management. “Implications of the COVID-19 pandemic for patient safety: a rapid review” emphasises the high risk of avoidable harm to patients, health workers, and the general public, and exposes a range of safety gaps across all core components of health systems at all levels. The disruptive and transformative impacts of the pandemic have confirmed patient safety as a critical health system issue and a global public health concern. The objectives of the WHO event are : provide an overview of implications of the COVID-19 pandemic for patients, health workers, and the general public highlight importance of managing risks and addressing avoidable harm in a pandemic situation discuss implications of the pandemic for patient safety within broader context of preparedness, response and recovery lay the foundation for follow-up work around generating more robust evidence and supporting countries in their efforts to build resilient and safer health care systems. Register
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Content ArticleCarl Heneghan discusses the role of modelling in the Covid-19 pandemic.
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Content ArticleThe Covid-19 pandemic resulted in major disruption to healthcare delivery worldwide causing medical services to adapt their standard practices. Learning how these adaptations result in unintended patient harm is essential to mitigate against future incidents. Incident reporting and learning system data can be used to identify areas to improve patient safety. A classification system is required to make sense of such data to identify learning and priorities for further in-depth investigation. The Patient Safety (PISA) classification system was created for this purpose, but it is not known if classification systems are sufficient to capture novel safety concepts arising from crises like the pandemic. This study from Purchase et al. aimed to review the application of the PISA classification system during the COVID-19 pandemic to appraise whether modifications were required to maintain its meaningful use for the pandemic context. The study found that PISA taxonomy can be successfully applied to patient safety incident reports to support the first stages in deriving learning and identifying areas for further enquiry. No incidents were identified that warranted new codes to be added to the PISA classification system, which may extend to other substantive public health crises, negating the need for additional, specific coding within such classification systems and related frameworks for similar system-wide constraints.
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Content ArticleThe only masking that’s going on is that of the government’s continued failure to get to grips with the virus, writes George Monbiot in this Guardian opinion piece. For some people, going to hospital may now be more dangerous than staying at home untreated. Many clinically vulnerable people fear, sometimes with good reason, that a visit to hospital or the doctors’ surgery could be the end of them. Of course, there have always been dangers where sick people gather. But, until now, health services have sought to minimise them. Astonishingly, this is often no longer the case. Across the UK, over the past two years, the NHS has been standing down even the most basic precautions against Covid-19. For example, staff in many surgeries and hospitals are no longer required to wear face masks in most clinical settings. Reassuring posters have appeared even in cancer wards, where patients might be severely immunocompromised. A notice, photographed and posted on social media last week, tells people that while they are “no longer required to wear a mask in this area”, they should use hand sanitiser “to protect our vulnerable patients, visitors and our staff”. Sanitising is good practice. But Covid-19 is an airborne virus, which spreads further and faster by exhalation than by touch.
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Content ArticleIn April 2023, National Voices held a workshop with members, supported by The Disrupt Foundation, on the unequal impact of the Covid-19 pandemic. It explored how communities and groups were affected differently by both the virus itself and the measures brought in to control it. It painted a grim picture of the ways in which the pandemic response exacerbated existing, deep-rooted inequalities across the UK and compounded the disadvantages experienced by people from minoritised communities, by disabled people and by people living with long term conditions. Just some examples include people who are immunocompromised, who were asked to go into isolation for huge periods of time and still feel completely overlooked as control measures have been lifted. Or the use of DNRs (Do Not Resuscitate orders) which were disproportionately applied to people with learning disabilities. With the Covid-19 Inquiry underway, it is imperative that we capture the lessons learnt from the pandemic, and use them to suggest action for the future.
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Content Article
UK Covid 19 Inquiry Hearings
Patient Safety Learning posted an article in Covid-19 Inquiry
All the public and preliminary hearings from the Covid 19 Inquiry can be found here. -
Content ArticleReport, together with formal minutes relating to the report.
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Content ArticleThere are reports of increasing incidence of paediatric diabetes since the onset of the COVID-19 pandemic. This study by D'Souza et al. compares the incidence rates of paediatric diabetes during and before the COVID-19 pandemic. The study found that incidence rates of type 1 diabetes and diabetic ketoacidosis at diabetes onset in children and adolescents were higher after the start of the COVID-19 pandemic than before the pandemic. Increased resources and support may be needed for the growing number of children and adolescents with diabetes. Future studies are needed to assess whether this trend persists and may help elucidate possible underlying mechanisms to explain temporal changes.
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Content ArticleProfessor Brian Edwards summarises this week's evidence in the Covid-UK inquiry.
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Content ArticleIn February 2023, the government commissioned an independent review to offer recommendations on how to resolve key challenges in conducting commercial clinical trials in the UK and transform the UK commercial clinical trial environment. The review sets out 27 recommendations, including both priority actions to progress in 2023 and longer-term ambitions for UK commercial clinical trials. The review was conducted by Lord James O’Shaughnessy, Senior Partner at consultancy firm Newmarket Strategy, Board Member of Health Data Research UK (HDR UK) and former Health Minister, who was appointed as review Chair. During the review, Lord O’Shaughnessy consulted closely with industry and a wide range of stakeholders across the UK clinical trials sector. The government response welcomes all recommendations from the review, in principle, and makes 5 headline commitments backed by £121 million. An implementation update, setting out progress made against these commitments and a comprehensive response to the remaining recommendations, will be published in the autumn.
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Content ArticleThis podcast series from Julie Taylor aims to raise awareness of Long Covid, provide a platform of support, education and the lived experience. Julie is a registered nurse in the UK and became unwell with Covid in May 2020 while working on the frontline, during the first wave of the pandemic. She now lives with Long Covid and POTS (postural orthostatic tachycardia syndrome). In this podcast series, Julie shares her journey and lived experience, the symptoms and how each impacts daily life, not only the physical issues but also the impact this has had mentally and emotionally.
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Content ArticleThe 'Living with Long Covid' podcast series from Julie Taylor aims to raise awareness of Long Covid, and provide a platform of support, education and the lived experience.
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News Article
England to offer Covid jab to five to 11-year-olds
Patient Safety Learning posted a news article in News
Children aged between five and 11 in England will be offered a low-dose Covid vaccine, the government says. Official scientific advice concludes the move would help protect the "very small" number of children who become seriously ill with Covid. Health Secretary Sajid Javid says the rollout will be "non-urgent", with an emphasis on parental choice. Northern Ireland also said on Wednesday it will be following Wales and Scotland in offering young children the vaccine. Children are at a much lower risk of becoming severely ill from a Covid infection, so the health benefits of vaccinating them are smaller than in other age-groups. Also, many will have some protection from already having caught the virus. So the scientists on the Joint Committee on Vaccination and Immunisation (JCVI), which advises governments across the UK, have been weighing up the evidence for immunising five to 11-year-olds. It concluded vaccination should go ahead to prevent a "very small number of children from serious illness and hospitalisation" in a future wave of Covid. Prof Wei Shen Lim, from the JCVI, said: "We're offering this to five to 11-year-olds now in order to future-proof their defences against a future wave of infection." He suggested parents consider getting their children vaccinated during school holidays to minimise disruption to their education from any flu-like side effects of the jab. Read full story Source: BBC News, 16 February 2022 -
News Article
Is it time to live with COVID-19? Some scientists warn of ‘endemic delusion’
Patient Safety Learning posted a news article in News
As surges of COVID-19 cases driven by the highly infectious Omicron variant recede, parts of the United States, Canada, and Europe are moving swiftly to lift constraints on a pandemic-fatigued public. Sweden, Denmark, and Norway have abolished nearly all COVID-19–related restrictions in recent weeks, and the United Kingdom announced it would do the same this month, dropping even the legal requirement that people quarantine after testing positive for SARS-CoV-2. In the United States, despite persistently high numbers of COVID-19–related deaths and busy hospitals, 10 governors, many known for being cautious in their pandemic response, last week announced immediate or impending ends to their states’ indoor or school mask mandates. Some of those moves came with assertions that it’s time to “live with the disease” and treat the coronavirus as endemic—a stable, enduring figure in the panoply of human pathogens, alongside cold viruses and influenza. That suggestion troubles many scientists, who warn it is eroding governments’ commitment to tracking and responding to the pandemic—which could leave countries flying blind and unprepared for any new variant. “Endemic delusion is probably what captures it the best,” says Kristian Andersen, an infectious disease researcher at Scripps Research who has been especially critical of recent moves by his home country of Denmark, which include an announcement that as of this month COVID-19 would no longer be categorised as a “socially critical disease” even though related death and hospitalisation rates were still climbing there. In the United States, governors cited various metrics to justify recent decisions to lift or let expire indoor mask mandates. California Governor Gavin Newsom noted stable hospitalisation rates and a 65% reduction in cases since Omicron’s peak in announcing the state’s mandate would end this week. But leaders also face political and economic pressures. States’ moves may be driven largely by the public’s impatience with restrictions, says epidemiologist Dustin Duncan of Columbia University. “Even people who recognize the importance of masking, social distancing, all that stuff, may be more amenable to take more risk,” he says. “At the same time, to me, going maskless just seems egregious.” Read full story Source: Science, 15 February 2022 -
News ArticleTwo years of the pandemic have meant drops in essential screening and detection in Australia, while cancer patients undergo treatments alone and isolate to avoid Covid risks. When Claire Simpson turned 50 in early 2020, she received a letter telling her to get a mammogram. Then the pandemic hit, and Victoria went into lockdown. “Like many people, I put it off until we were coming out of that lockdown, but by then it was September and I couldn’t get an appointment until December,” she says. In February 2021 she was diagnosed with breast cancer and had a mastectomy. Tests showed she was positive for the aggressive HER2 receptor, so she began 12 weeks of chemotherapy as well as a treatment called Herceptin, which she received an IV infusion of every three weeks. Simpson says the delay in screening “really, really delayed diagnosis for me, by a good six months”. “I can’t help but feel that [an earlier screening] could have probably saved me from having to have chemotherapy and this Herceptin infusion therapy that I’m having,” she says. Her last Herceptin treatment was last Wednesday. She has been living in self-imposed lockdown, terrified as the Omicron wave built that she would have to isolate due to Covid and disrupt her treatment. That self-imposed isolation will continue until her final surgery, an elective operation scheduled for mid-year. Cancer screening dropped by 10% in Victoria alone in the first year of the pandemic. In 2021, referrals to the Peter MacCallum Cancer Centre, a leading treatment and research facility in Melbourne, were down 40%. “That is certainly going to bounce back at some point,” says Prof Sherene Loi, an oncologist and researcher at Peter MacCallum. “It is potentially going to be a real problem in a few years’ time. At the moment we have a lot of very young cancer diagnoses, a lot of breast cancer … we are just flat chat.” Read full Source: The Guardian, 13 February 2022
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News Article
Lack of hospital beds makes Covid spread 'inevitable'
Patient Safety Learning posted a news article in News
A lack of beds in Welsh hospitals meant it was "inevitable" Covid patients would come into contact with others, a doctor has said. "Seeing patients in bed at the time of admission is becoming a rarity," Dr Nicky Leopold said. Some patients, including those with Covid, have had to spend nights on chairs in A&E due to a lack of beds. The Welsh government said it aimed to deliver 12,000 more staff by 2024-25. Health Minister Eluned Morgan and the chief executive of the Welsh NHS are due to give evidence to the Senedd's health committee on winter pressures.. Dr Leopold, a consultant geriatrician, who is a member of the BMA union in Wales, said there had been recent improvements since the number of NHS staff testing positive for Covid fell, but the flow of patients through hospital was still a problem. She said: "So many patients are stranded in hospital and that's very difficult and frustrating. There just aren't the staff in the community to support the increased level of need." Outpatient appointments had also been affected by shortages, she added. A lot of patients were in "dire need" and staff were "desperately" trying to keep clinics running. Read full story Source: BBC News, 10 February 2022 -
News Article
Government plans to remove all remaining restrictions in England
Patient Safety Learning posted a news article in News
The government plans to end all remaining covid restrictions in England—including the legal obligation to self-isolate—ahead of schedule later this month, the prime minister, Boris Johnson, has said. The current restrictions, including the requirement that anyone who tests positive for Covid-19 must self-isolate for at least five days, are due to expire on 24 March. But Johnson, addressing MPs during prime minister’s questions on 9 February, said that the remaining rules could end early if recent trends in the data continued. In response to the prime minister’s statement healthcare leaders said that they understood the importance of wanting to return to normal but called for a cautious approach. Chris Hopson, chief executive of NHS Providers, said, “It is important to remember that Covid-19 has not gone away. Though cases have fallen significantly in recent weeks and the NHS’s very successful booster campaign has made a massive difference to the numbers of seriously ill patients, the number of people testing positive for Covid-19 remains high by previous standards." “Any steps to de-escalate our precautionary approach—including ending requirements for self-isolation for positive tests—must be proportionate to the risks.” Matthew Taylor, chief executive of the NHS Confederation, said, “Around 40% of NHS staff absences are due to covid currently, and so removing the self-isolation requirements could bolster capacity significantly at a time when the service is committed to tackling its waiting lists—but we have to be mindful that it could also lead to higher rates of transmission, which could then lead to more admissions into hospital alongside more ill health in the community." “The government must take a cautious approach as we move onto the endemic stage of covid, be guided by the evidence, engage the NHS appropriately, and be prepared to review its decision if new threats emerge.” Read full story Source: BMJ, 9 February 2022 -
News Article
Virus almost 'wholly responsible' for spike in dementia deaths
Patient Safety Learning posted a news article in News
People with dementia, particularly care home residents early in the pandemic, were “disproportionately” vulnerable to fatal Covid infections, according to a new report. The analysis, commissioned by the Scottish Government, also found that excess deaths involving dementia during 2020 were “almost wholly” attributable to Covid. Of the 2,154 deaths where both dementia and Covid were listed on the death certificate, 95 per cent had Covid as the main underlying cause. This contradicts previous suggestions that a rise in dementia deaths early in the pandemic may have been linked indirectly to the virus as a result of “lockdown distress” or an increased use of potentially harmful sedation in elderly people confused by restrictions. The report also found that 73% (1,577) of those who died with both Covid and dementia mentioned on their death certificates had passed away in care homes. Henry Simmons, chief executive of Alzheimer’s Scotland, said their loved ones had been “torn apart by grief and loss” and that the report “raises many more questions as to why so many people with dementia living in care homes quickly became victims of Covid-19”. Read full story Source: The Herald, 10 February 2022 -
News ArticleA formal complaint accuses the British Government of facilitating ‘the largest single health and safety disaster to befall the United Kingdom workforce since the introduction of asbestos products’. An expert letter to the UK Government’s Health & Safety Executive (HSE) from one of its own advisors accuses the agency of failing to use its statutory authority to correct “seriously flawed” guidance on infection protection and control (IPC), imperilling “the health and safety of healthcare workers by failing to provide for suitable respiratory protection”. The continued failure to protect healthcare workers by ensuring they are wearing the appropriate form of PPE (personal protective equipment) to minimise the risk of infection from COVID-19 airborne transmission, the letter says, has led to thousands of avoidable deaths. The failures amount both to “gross negligence” and serious “criminal offences”, claims the letter seen by Byline Times. The letter addressed to HSE chief executive Sarah Albon is authored by 27-year chartered health and safety consultant David Osborn, who is a ‘consultee member’ of the HSE’s COSHH (Control of Substances Hazardous to Health) Essentials Working Group, where he has helped HSE to prepare guidance for employers and employees. Written in his own personal capacity, the letter is a formal complaint accusing the members of the Government’s “IPC Cell” – a group of experts behind official guidance on infection protection and control – along with other senior Government officials of committing a “criminal offence… ultimately punishable by fine and/or imprisonment” by breaching Section 36 of the Health and Safety at Work Act. The letter argues that a police investigation is needed. The guidance, Osborn writes in his letter, has failed to ensure that healthcare workers understand that they should wear and have access to respiratory protection equipment (RPE) designed to protect from COVID-19 airborne transmission. “There is sufficient prima-facie evidence to suggest that the offence has led to the potentially avoidable deaths of hundreds of healthcare workers and the debilitating disease known as Long COVID in thousands of other healthcare workers,” the letter says. “I firmly believe that the primary source of infection was the inhalation of aerosols whilst caring for infected patients at close quarter,” says Osborn in his letter. Read full story Source: Byline Times, 10 February 2022
