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Found 1,313 results
  1. Content Article
    This is part of our series of Patient Safety Spotlight interviews, where we talk to people working for patient safety about their role and what motivates them. James talks to us about the value of patient feedback in boosting morale and enabling organisations to make real patient safety improvements. He also describes the power of the unique perspective patients have on safety, and asks how we can use this insight to shift culture and provide safer care.
  2. Content Article
    This guide developed by Learn Together and Bradford Teaching Hospitals NHS Foundation Trust has been designed to help patients and families understand what to expect from patient safety investigations and how they can be involved in the process. It includes quotes and advice from patients who have been through patient safety investigations and spaces to record experiences, questions and reflections. The guide provides an outline of the investigation process, broken down into five stages: Understanding you and your needs Agreeing how you work together Giving and getting information Checking and finalising the report Next steps
  3. Content Article
    Even those at the top admit the NHS can’t do what is being asked of it today. But it is far from unsalvageable – we just need serious politicians who will commit to funding it, writes Gavin Francis, who shares his experience as a GP in this Guardian long read.
  4. Content Article
    In this anonymous blog, a patient shares their experience of orthodontic treatment which they undertook to reduce overcrowding of their teeth. However, instead of solving the problem, the treatment caused multiple, complex dental issues that have resulted in severe pain and a high financial cost. The patient talks about how their orthodontist has been unwilling to take any responsibility for the issues caused, threatening legal action if the patient pursues any claims against them. They also discuss the reluctance of other orthodontists to get involved in trying to treat the issues they now face, and call for regulators and governments to look into the issue of negligent orthodontic treatment.
  5. Content Article
    Patients are increasingly describing their healthcare experiences publicly online. This has been facilitated by digital technology, a growing focus on transparency in healthcare and the emergence of a feedback culture in many sectors. The aim of this study was to identify a typology of responses that healthcare staff provide on Care Opinion, a not-for-profit online platform on which patients are able to provide narrative feedback about health and social care in the UK. The authors used framework analysis to qualitatively analyse a sample of 486 stories regarding hospital care and their 475 responses. Five response types were identified: non-responses, generic responses, appreciative responses, offline responses and transparent, conversational responses. The key factors that varied between these response types included the extent to which responses were specific and personal to the patient story, how much responders' embraced the transparent nature of public online discussion and whether or not responders suggested that the feedback had led to learning or impacted subsequent care delivery. Staff provide varying responses to feedback from patients online, with the response types provided being likely to have strong organisational influences. The findings offer valuable insight and have both practical and theoretical implications for those looking to enable meaningful conversations between patients and staff to help inform improvement. The authors suggest that future research should focus on the relationship between response type, organisational culture and the ways in which feedback is used in practice.
  6. News Article
    A trust has had to re-examine the cases of more than 31,000 patients after they were automatically and wrongly discharged from its care because they did not have another appointment within the next six months. Dartford and Gravesham Trust in Kent has revealed that soaring waiting times post-covid meant patients who needed follow-up appointments were not offered them within six months, which before covid was a very unusual occurrence. When they passed six months, they were dropped off waiting lists altogether, due to a feature in the trust’s patient administration system designed to ensure outdated pathways are closed. It is a common feature in many such systems, HSJ was told. The trust has now “validated” more than 31,000 patients who have been in contact with it since 1 September 2021. So far, it said, it had not found evidence of harm, although some people have been recalled for clinical review or investigation, and a small number are still to be seen. Read full story (paywalled) Source: HSJ, 22 August 2023
  7. Content Article
    The aim of this study from Hutchinson et al. was to explore the reasons for and experiences of patients who make an unplanned return visit to the emergency department.
  8. Content Article
    In this blog, Dr Faisal Saeed talks about the patient-provider power imbalance using an AI generated image of two chairs to illustrate his points. 
  9. News Article
    Patients at all general practices across England will soon benefit from new digital phone lines designed to make booking GP appointments easier. Backed by a £240 million investment, more than 1,000 practices have signed up to make the switch from analogue systems - which can leave patients on hold and struggling to book an appointment - to modern, easy-to-use digital telephones designed to make sure people can receive the care they need when they need it. It is expected every practice in the country will have the new system in place by the end of this financial year, helping put an end to the 8am rush - a key pillar of the Prime Minister’s primary care recovery plan to improve patient access to care. Patients will be able to contact their general practice more easily and quickly - and find out exactly how their request will be handled on the day they call, rather than being told to call back later, as the government and NHS England deliver on the promises made in the primary care recovery plan announced in May. If their need is urgent, they will be assessed and given appointments on the same day. If it is not urgent, appointments should be offered within 2 weeks, or patients will be referred to NHS 111 or a local pharmacy. The upgraded system will bring an end to the engaged tone, see care navigators direct calls to the right professional, and the use of online systems will provide more options and help those who prefer to call to get through. Read press release Source: Department of Health and Social Care, 18 August 2023
  10. Content Article
    Many patients struggle to book a GP appointment in England. Once people have been successful in getting a booking to see their doctor, however, how long are they having to wait for their appointment? Charlotte Paddison looks at the latest data to reveal the answer – and argues that quick access to GP appointments is not the only factor to consider.
  11. News Article
    Making data on medical interventions easier to collect and collate would increase the odds of spotting patterns of harm, according to the panel of a recent HSJ webinar When Baroness Julia Cumberlege was asked to review the avoidable harm caused by two medicines and one medical device, she encountered no shortage of data. “We found that the NHS is awash with data, but it’s very fractured,” says Baroness Cumberlege, who chaired the Independent Medicines and Medical Devices Safety Review and now co-chairs the All-Party Parliamentary Group which raises awareness of and support for its findings. And it is that fracturing that can make patterns of harm difficult to spot. The report concluded that many women and children experienced avoidable harm through use of the hormone pregnancy test Primodos, the epilepsy drug sodium valproate, and the medical device pelvic mesh – simply because it hadn’t been possible to connect the dots. “It’s very hard to collect things together and to get an overall picture. And one of the things that we felt very strongly about was that data should be collected once, but used often,” said Baroness Cumberlege at a recent HSJ webinar. Run in association with GS1 UK, the event brought together a panel to consider how better data might help address patient safety challenges such as problems with implants. “But the big problem was they couldn’t identify who had which implants. No doubt somebody somewhere had written this down with a fountain pen and then someone spilt the tea over it and the unique information was lost,” recalled Sir Terence Stephenson , now Nuffield professor of child health at Great Ormond Street Institute of Child Health and chair of the Health Research Authority for England. The review he chaired therefore suggested establishing a concept of person, product place – “for everybody who had something implanted in them, we should have their name, the identifier of what had been put in, and where it had been put in. And one of my panel members said: ‘Well, how are we going to record this? We don’t want the fountain pen and the teacup.’” Ultimately the answer suggested was barcode scanning. By scanning the wristband of a patient, that on the product being implanted, and one for the hospital theatre or department at which it was being implanted, the idea was to create an immediate and easy-to-create record. For those long convinced of the virtues of barcode scanning in health, it is a welcome development Two years later, the then Department of Health launched the Scan4Safety programme, in which six “demonstrator sites” implemented the use of scanning across the patient journey. At these organisations, barcodes produced to GS1 standards – meaning they are globally unique – are present on patient wristbands; on equipment used for care, including implantable medical devices; in locations; and sometimes on staff badges. Link to full article here (paywalled)
  12. News Article
    After generations of inaction and very few novel ideas, researchers and activists are hopeful a new path is being charted in understanding and treating the crippling chronic condition “There’s an excitement at the moment,” says Andrew Horne. After decades of inaction, something is happening in endometriosis. Now, says the professor of gynaecology and reproductive sciences at the University of Edinburgh, “I do think things are changing. There are more people working on it, so it’s bringing in people from different disciplines with new ideas.” In the space of a few months, from gatherings in Edinburgh and Washington DC, labs in Sydney and Japan, there is a sense that new ideas are bubbling to the surface, including a fundamental rethinking of endometriosis not as a disease of the pelvis, but rather, says Horne, “a whole-body disease”. It’s hard to pinpoint the exact moment when despair turned to hope in the research and patient community. There was no single breakthrough. No one person responsible. In March, the largest ever study on the genetics of endometriosis was published in Nature Genetics, which found genetic links to 11 other pain conditions as well as other inflammatory conditions. The study, involving DNA from more than 760,000 women, found ovarian endometriosis is genetically distinct from other types and indicated there may be a genetic predisposition to excessive inflammation in people with the condition. One of the researchers, Dr Nilufer Rahmioglu from the University of Oxford, described the data as a “treasure trove of new information”. Weeks later on the other side of the world, researchers from Sydney’s Royal Hospital for Women attracted international attention after they grew tissue from different types of endometriosis and compared how each responded differently to treatments. Jason Abbott, professor of obstetrics and gynaecology at the hospital, likened the development to those made in the treatment of breast cancer three decades ago. Two weeks on from the Australian discovery, Japanese researchers found a common form of bacteria may be contributing to the growth of endometriosis via inflammation. The frisson was, by then, hard to miss. Read the full article here: https://www.theguardian.com/society/2023/aug/10/its-really-only-the-beginning-are-we-on-the-cusp-of-a-breakthrough-in-endometriosis
  13. News Article
    Teens who have been bullied by their peers, or who have considered or attempted suicide, may be more likely to have more frequent headaches than teens who have not experienced any of these problems, according to a study published in the August 2, 2023, online issue of Neurology®, the medical journal of the American Academy of Neurology. The study does not prove that bullying or thoughts of suicide cause headaches; it only shows an association. “Headaches are a common problem for teenagers, but our study looked beyond the biological factors to also consider the psychological and social factors that are associated with headaches,” said study author Serena L. Orr, MD, MSc, of the University of Calgary in Canada. “Our findings suggest that bullying and attempting or considering suicide may be linked to frequent headaches in teenagers, independent of mood and anxiety disorders.” The study involved more than 2.2 million teens with an average age of 14 years. Read the full article here: https://www.eurekalert.org/news-releases/997216
  14. News Article
    Videos circulating on the social media platform claim that castor oil can help to treat dryness, floaters, cataracts, poor vision and even glaucoma. Doctors have issued a warning not to use castor oil as a way to treat vision problems following claims on TikTok. Castor oil is a type of vegetable oil traditionally used to treat a range of issues like skin infections. It is even a common ingredient in some over-the-counter eye drops. But dozens of TikTok videos have gone one step further, claiming that by rubbing the oil over eyelids, eyelashes and under the eye, it helps to treat dryness, floaters, cataracts, poor vision and even glaucoma. One woman said that after two weeks of use, she doesn't need to wear reading glasses as often, while another said it prevented an eye infection from progressing. Now, doctors in the US have said the oil is "not going to seep in and dissolve or fix anything". They warned that some unsterilised bottles on shop shelves may even cause irritation or infection if put directly into the eye. "Castor oil is not a cure-all. If you have concerns about your eyes, you need to see an optician," Dr Ashley Brissette, a spokesperson for the American Academy of Ophthalmology. She said they cannot make recommendations as studies that look at the effects of eye drops which contain castor oil on dry eyes and blepharitis are of low quality, involving small sample sizes and no control groups. Dr Vicki Chan, a practising optician in Los Angeles added that castor oil has no effect on conditions that affect the inside of the eyeball. These include cataracts - an age-related condition that causes cloudy vision - floaters, and glaucoma, which occurs when fluid accumulates and damages the optic nerve. Dr Brissette added that ignoring early symptoms of glaucoma, or waiting to see it castor oil improves conditions such as cataract, can lead to permanent vision loss or complications with surgery. Instead, eating a healthy balanced diet; removing all make up before bed; wearing sunglasses outdoors and attending regular eye examinations are alternative ways to maintain eye health.
  15. News Article
    Patients in all but one integrated care system found it more difficult to contact their GP practice by phone this year compared to last year. GP patient survey data, published this month, showed the proportion of patients who found it “very” or “fairly easy” to get through by phone had fallen across almost every ICS by as much as seven percentage points. The measure fell nationally from 53 to 50%. The drop in performance comes as NHS England and the government ramp up focus on ease and speed of access to GPs as part of the primary care recovery plan, published in May. An NHSE spokesperson said: ”Despite GP teams experiencing record demand for their services, with half a million more appointments delivered every week compared to before the pandemic, the GP survey found that the majority of patients have a good overall experience at their GP practice. “However, the NHS recognises more action is needed to improve access for patients, which is why it published a recovery plan in May.” Read full story (paywalled) Source: HSJ, 31 July 2023
  16. News Article
    A woman treated in a hospital corridor says the lack of privacy was "wholly inappropriate" after other patients saw her without a top. Isabel Aston was taken to Princess Royal Hospital in Shropshire with pneumonia and sepsis and said she spent seven hours on a bed in a corridor. She said she felt exposed when other patients saw her changing her clothes. She explained: "People were walking in both directions [and] there aren't screens around your bed so people wanting the toilet who couldn't get out of bed were faced with the thought of using a bed pan in full view." She added that on feeling hot at one point, she wanted to change her t-shirt, but the process proved lengthy due to cannulas in her arms. "I did not have anything on underneath," she said. "I'm 64 years of age, I've probably reached an age where I'm not so self-conscious perhaps, but that could have been a much younger patient. "That could have been a patient for whom perhaps culturally they couldn't have change their t-shirt... or somebody who had mastectomy scars [and] were very self conscious. "It is wholly inappropriate for patients to be so exposed when they are so ill." The hospital trust said it aimed to maintain patients' dignity despite being under operational pressures. Read full story Source: BBC News, 28 July 2023
  17. Content Article
    This blog tells the story of a patient, a relation of Patient Safety Learning's Chief Digital Officer. It explains how the patient was failed by the system, seemingly a system designed to fail when its users need it most. Some of the issues described here are technology-based in nature, but the concepts are easy to grasp. A phrase that another person commented when hearing about this story was "when common sense and compassion are lost, there is no hope left for the NHS". I think we have now entered that territory (sadly). Do feel free to comment or add your own stories below....
  18. News Article
    Most NHS staff think they have too little time to help patients and the quality of care the service provides is falling, a survey reveals. Medical and nursing groups said the “very worrying” findings showed that hard-pressed staff cannot give patients as much attention as they would like because they are so busy. In polling YouGov carried out for the Guardian, 71% of NHS staff who have direct contact with patients said they did not have the amount of time they would like to have to help them. A third (34%) felt they had “somewhat less than enough time” and 37% “far less than enough time” than they wanted. Almost a quarter (23%) felt they had the right amount of time while just 3% said they had “more time” than they wanted. The survey presents a worrying picture of the intense pressures being felt at the NHS frontline. Those same personnel were asked if they thought the quality of care the service is able to offer has got better or worse over the last five years. Three-quarters (75%) said “worse”, including a third (34%) who answered “much worse”, while 17% said “about the same” and only 6% replied “better”. Read full story Source: The Guardian, 24 July 2023
  19. Content Article
    Successful day surgery requires a day surgery team with the correct knowledge and skills to enable safe, early recovery and discharge but there is an absence of national guidance on supporting competencies. Applying in-patient competency criteria is inappropriate as this pathway is not aimed at promoting early discharge. This joint publication between AfPP and BADS (the British Association Of Day Surgery) provides recommendations for core competencies for adult day surgery through (1) admission, (2) anaesthetic room, (3) theatres, (4) first-stage recovery and (5) second-stage recovery and discharge. They are relevant for staff new to or after a long absence from day surgery and acknowledge some members of the day surgery team may include non-registered practitioners. All can be used as a reference for workbook competency documents in place or in development.
  20. Content Article
    As reported recently, the Scottish Healthcare Workers Coalition called upon the Scottish Government to reinstate 'universal masking' in health and social care settings.  In this statement written in support of their campaign, an occupational safety and health practitioner, David Osborn, explains the legal requirements for risk assessments that the Government ought to have undertaken before reaching such a decision that exposes healthcare staff to the life-changing consequences associated with repeat Covid-19 infections.  He also explains the legal duty of the Government to consult with workers before implementing changes that may affect their health and safety. Neither duty (risk assessment nor prior consultation with workers) appears to have been well met, putting the Scottish Government and Health Boards in breach of UK-wide health and safety law. 
  21. News Article
    More than 250,000 dementia patients could miss out on new treatments for the disease because they do not have a formal diagnosis, according to government figures. NHS data published for the first time shows the prevalence of different types of dementia with which people in England have been diagnosed. Dementia is an umbrella term for many different conditions, affecting more than 55 million people worldwide. This week, health regulators were urged to approve two new game-changing dementia drugs, after a landmark study confirmed that donanemab slowed cognitive decline in Alzheimer’s patients by 35%, while last year, a second drug, lecanemab, was found to reduce the rate by 27%. The NHS primary care dementia figures estimate that there are about 708,000 people over 65 with dementia in England, but only about 450,000 have a recorded diagnosis. That means that more than 250,000 are missing out on these potential new treatments. Read full story Source: The Guardian, 20 July 2023
  22. Content Article
    Whole-body bathing or showering with a skin antiseptic to prevent surgical site infections (SSI) is a usual practice before surgery in settings where it is affordable. The aim is to make the skin as clean as possible by removing transient flora and some resident flora. Several organisations have issued recommendations regarding preoperative bathing. The care bundles proposed by the United Kingdom (UK) High impact intervention initiative and Health Protection Scotland recommend bathing with soap prior to surgery. The Royal College of Surgeons of Ireland recommends bathing on the day of surgery or before the procedure with soap . The USA Institute of Healthcare Improvement bundle for hip and knee arthroplasty recommends preoperative bathing with CHG soap. Finally, the UK-based National Institute for Health and Care Excellence (NICE) guidelines recommend bathing to reduce the microbial load, but not necessarily SSI. In addition, NICE states that the use of antiseptics is inconclusive in preventing SSI and that soap should be used. The purpose of this systematic review is to assess the effectiveness of preoperative bathing or showering with antiseptic compared to plain soap and to determine if these agents should be recommended for surgical patients to prevent SSI.
  23. Content Article
    A casually centred proposal identifying how Fire and Rescue Services can improve pre-hospital care and quality of life outcomes for burn survivors.  David Wales and Kristina Stiles have released this report looking at the burn survivor experience in the pre-hospital environment. The work makes ten operational recommendations and also two 'lessons learned' recommendations exploring strategic partnership working and the resulting fragmented services.
  24. Content Article
    'The Family Oops and Burns First Aid' is a free children's book written by Kristina Stiles, beautifully illustrated by Jill Latter, created to support children and their families learning about burns prevention and first aid principles together. The book describes an accident prone family who are not burns aware, who have to go to school to learn about burn safety and first aid principles within the home. The book is aimed at KS1 children and their families, and is available as hard copy book by request from Children's Burns Trust and also as an audio/video book via YouTube.
  25. Content Article
    AHRQ's TeamSTEPPS - Team Strategies and Tools to Enhance Performance and Patient Safety - is an evidence-based set of teamwork tools, aimed at optimising patient outcomes by improving communication and teamwork skills among healthcare teams, including patients and family caregivers.
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