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Content Article
PRSB: Transfer of care toolkit
Patient Safety Learning posted an article in Transfers of care
High volumes of patients are transferred every day between health and care settings. Whilst efforts have have been made over several years to improve this process through the implementation of standards and the sharing of digital information, there is more to be done. Whole system improvements are required and significant further progress can be made to improve the quality and consistency of data shared between organisations. The Professional Standards Record Body (PRSB) has published a number of standards that support the transfer of care of patients between settings. This toolkit concentrates on the PRSB eDischarge Summary Standard, which specifies the data to be shared between secondary and primary care to support the discharge of a patient from hospitals across the UK. This toolkit does not propose a one-size-fits-all approach and recognises that health and care services are organised in different ways across the UK. -
Content ArticlePolypharmacy is a term used to describe when a patient is taking a number of medicines at the same time. This study in the British Journal of Clinical Pharmacology aimed to measure how common polypharmacy is and describe the prescribing of selected medications known for overuse in older people with polypharmacy in primary care. It was a multinational retrospective cohort study that used data from patients with a mean age of 75-76 years from six countries: Belgium, France, Germany, Italy, Spain and the UK. The results revealed a high prevalence of polypharmacy with more than half of the older population being prescribed at least five drugs in four of the six countries. Whilst polypharmacy may be appropriate in many patients, the authors found worryingly high usage of PPIs and benzodiazepines. The study's results support current efforts to improve polypharmacy management across Europe.
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News Article
Hacked UK trove includes data on newborns, cancer patients...
Patient Safety Learning posted a news article in News
Hackers behind a London hospital attack recently published records that include personal information about pregnant women, newborns, cancer patients, people suffering from schizophrenia and thousands of others across the UK and Ireland, revealing the breach was far more widespread than authorities have previously indicated. An analysis of the data trove by Bloomberg News found that it contains tens of thousands of medical records on patients from more than 400 public and private hospitals and clinics. Among the records are some 40,000 highly sensitive documents sent by doctors requesting biopsies and blood tests for individual patients in all regions of the UK and some hospitals in Ireland. A breach of the kind faced by Synnovis was inevitable, according to Saif Abed, a former NHS doctor and expert in cybersecurity and public health. “The NHS has some of best patient safety and cybersecurity standards in the world,” Abed said. “They are just immensely poorly enforced.” Abed said that there was a lack of mandatory cybersecurity audits on any contractors providing services to the NHS, which meant those contractors could have substandard cybersecurity practices that could in turn leave the NHS vulnerable. Read full story Source: Bloomberg UK, 26 June 2024 -
Content ArticleThe healthcare systems of nearly every country are straining to keep up with the demands placed on them by advances in both treatment and technology. In this article, Timothy Ferris explores ways in which technology can reduce the burden on already under-resourced healthcare workforces. Acknowledging the complexity of healthcare compared to other industries, and the highly professional nature of the workforce, he uses the concept of 'unit cost' to look at how the financial and time burden associated with healthcare interactions can be reduced.
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Content ArticleAlthough diagnostic errors are estimated to affect about 12 million Americans each year in ambulatory care settings alone, the conceptual and pragmatic scientific foundations for their measurement are under-developed. Further progress towards reducing diagnostic errors will rely on our ability to overcome measurement-related challenges. This article in BMJ Quality & Safety outlines a multifaceted framework to advance the science of measuring diagnostic errors (The Safer Dx framework). The authors describe how Safer DX serves as a conceptual foundation for system-wide safety measurement, monitoring and improvement of diagnostic error. They believe it lays robust groundwork for measurement and monitoring techniques to ensure diagnostic safety.
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News Article
NHS confirms patient data stolen in cyber attack
Patient Safety Learning posted a news article in News
NHS England has confirmed its patient data managed by blood test management organisation Synnovis was stolen in a ransomware attack on 3 June. Qilin, a Russian cyber-criminal group, shared almost 400GB of private information on their darknet site on Thursday night, something they threatened to do in order to extort money from Synnovis. In a statement, NHS England said there is "no evidence" that test results have been published, but that "investigations are ongoing". More than 3,000 hospital and GP appointments were disrupted by the attack. "Patients should continue to attend their appointments unless they have been told otherwise and should access urgent care as they usually would," NHS England said. A sample of the stolen data seen by the BBC includes patient names, dates of birth, NHS numbers and descriptions of blood tests, something cyber security expert Ciaran Martin told the BBC was "one of the most significant and harmful cyber attacks ever in the UK." Read full story Source: BBC News, 24 June 2024 -
Content Article
Welsh Health Equity Solutions Platform
Patient-Safety-Learning posted an article in Health inequalities
The Welsh Health Equity Solutions Platform is part of the Welsh Health Equity Status Report initiative (WHESRi), which supports a healthier, more equal and prosperous Wales. The platform is a gateway to data, evidence, health economics and modelling, policies, good practice, innovative tools and practical solutions to help improve population wellbeing and reduce the health equity gap in Wales and beyond. It is structured around an innovative WHO framework of ‘Five Essential Conditions’ for healthy prosperous lives for all. The platform will link with and feed into a WHO health equity gateway, providing an example and inspiration for countries to learn and follow, as well as to contribute and share. -
Content ArticleDavid Stockwell is Chief Medical Officer at Johns Hopkins Children’s Center and Associate Professor of Pediatrics and Anesthesiology and Critical Care Medicine at Johns Hopkins University School of Medicine. He is also Chief Clinical Officer at Pascal Metrics, a federally listed Patient Safety Organisation working with the Betsy Lehman Center on a pilot to test the impact of automated safety event monitoring in a diverse set of six-to-eight acute care hospitals in Massachusetts. Stockwell talked with Patient Safety Beat about Pascal’s approach to using electronic data to transform safety.
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News Article
Hacked London NHS hospitals data allegedly published online
Patient Safety Learning posted a news article in News
Data from a ransomware attack has allegedly been published online weeks after the attack halted operations and tests in major London hospitals, NHS England has said. A Russian group is believed to have carried out the cyber-attack on Synnovis, a private pathology firm that analyses blood tests for Guy’s and St Thomas’ NHS foundation trust (GSTT) and King’s College trust, on 3 June, forcing hospitals in the capital to cancel almost 1,600 operations and outpatient appointments. NHS England said on Friday it had “been made aware that the cyber-criminal group published data last night which they are claiming belongs to Synnovis and was stolen as part of this attack. We know how worrying this development may be for many people. We are taking it very seriously.” In the attack, it is understood hackers from the Russian-based ransomware criminal group Qilin infiltrated Synnovis’s IT system and locked the computer system by encrypting its files to extort a payment for restoring access. The trusts have contracts with Synnovis totalling just under £1.1bn for services that are vital to the smooth running of the NHS. NHS England said an analysis of the data was under way involving the National Cyber Security Centre and other partners to confirm whether the data was taken from Synnovis’s systems and what information it contained. Read full story Source: The Guardian, 21 June 2024 -
News Article
C2-Ai launches Maternal and Neonatal Observatory
Clive Flashman posted a news article in News
C2.AI has formally launched its Maternity and Neonatal Observatory at the NHS ConfedExpo in Manchester (Government and Public Sector Journal). The observatory is intended to give hospitals and clinicians a detailed picture of the performance of maternity units and the health trajectories of individual women, so areas of concern can be identified and acted on. The system works by calculating and comparing observed outcomes for women and babies with expected outcomes for these individuals. To do this, it uses AI and machine learning to assess clinical factors, case-mix, and the social determinants of health. Early adopters within the NHS, where maternity services are under intense scrutiny, are expected soon. -
Content ArticleCurrent adverse effects of medical treatment (AEMT) incidence estimates rely on limited record reviews and underreporting surveillance systems. This study evaluated global and national longitudinal patterns in AEMT incidence from 1990 to 2019 using the Global Burden of Disease (GBD) framework. It found that although the global population increased 44.6% from 1990 to 2019, AEMT incidents rose faster by 59.3%. The net drift in the global incidence rate was 0.631% per year. The proportion of all cases accounted for by older adults and the incidence rate among older adults increased globally. The high SDI region had much higher and increasing incidence rates versus declining rates in lower SDI regions. The age effects showed that in the high SDI region, the incidence rate is higher among older adults. Globally, the period effect showed a rising incidence of risk after 2002. Lower SDI regions exhibited a significant increase in incidence risk after 2012. Globally, the cohort effect showed a continually increasing incidence risk across sequential birth cohorts from 1900 to 1950. As the global population ageing intensifies alongside the increasing quantity of healthcare services provided, measures need to be taken to address the continuously rising burden of AEMT among the older population.
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Content ArticleThe Patient Safety Authority's 2023 Annual Report.
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Content ArticleThe relentless increase in administrative responsibilities, amplified by electronic health record (EHR) systems, has diverted clinician attention from direct patient care, fuelling burnout. In response, large language models (LLMs) are being adopted to streamline clinical and administrative tasks. Notably, Epic is currently leveraging OpenAI's ChatGPT models, including GPT-4, for electronic messaging via online portals. The volume of patient portal messaging has escalated in the past 5–10 years, and general-purpose LLMs are being deployed to manage this burden. Their use in drafting responses to patient messages is one of the earliest applications of LLMs in EHRs. Previous works have evaluated the quality of LLMs responses to biomedical and clinical knowledge questions; however, the ability of LLMs to improve efficiency and reduce cognitive burden has not been established, and the effect of LLMs on clinical decision making is unknown. To begin to bridge this knowledge gap, the authors of this study, published in the Lancet, carried out a proof-of-concept end-user study assessing the effect and safety of LLM-assisted patient messaging.
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Content ArticleThe NHS is the world’s largest publicly funded health service. It is also the world’s largest repository of healthcare data, but these data are fragmented and underutilised. Making them accessible in one place would improve health and deliver wealth for the nation. This report by the Tony Blair Institute for Global Change proposes the creation of a National Data Trust (NDT)—an organisation which would be majority-owned and controlled by the government and the NHS, together with investment from industry partners. It would aim to connect NHS data, attract private investment in new medical discoveries and bring the economic benefits of health innovation to citizens. The authors believe the NDT would accelerate the NHS’s development of cutting-edge innovations, provide quicker access to these advancements at reduced costs and generate a new funding source for the healthcare system.
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News Article
Patient violence against staff falls to five-year low
Patient-Safety-Learning posted a news article in News
The proportion of NHS staff who have experienced physical violence from patients has fallen to its lowest levels in five years, according to the latest survey data. New figures showed the percentage of staff reporting at least one incident of physical violence from patients or the public, within the last 12 months, had declined from 15.1 per cent in 2019, down to 13.7 per cent in 2023. That is also almost one percentage point lower than 14.6 per cent in 2022, which is the biggest year-on-year percentage point fall in the five years. The 2023 NHS staff survey, first published in early March, was updated recently to include the questions on physical violence. NHS England said earlier this week it had received a “higher than expected rate of missing data” for the questions, which meant they were not originally reported, but these issues had now been resolved. However, ambulance workers remain disproportionately affected by physical violence compared to other roles, with 27.6 per cent saying they had experienced at least one instance of physical violence from patients or the public in the past year. This is down from 32.5 per cent five years ago in 2019. Acute and community staff were the next highest (13.7 per cent), followed by mental health (13.5 per cent), community (7 per cent), and then acute specialist (5.3 per cent). Read full story (paywalled) Source: HSJ, 5 June 2024 -
Content ArticleThe maternity disadvantage assessment tool (MatDAT) is a standardised tool for assessing social complexity during maternity care based on women and birthing people’s broad social needs. Developed by the Royal College of Midwives (RCM), it provides a guide for midwives to identify the woman’s care level (Level 1–4) and develop a personalised care and support plan (PCSP), as well as facilitating smooth communication with the multidisciplinary team. The tool and the MatDAT Planning Guide also support maternity services to plan and allocate resources to level of care pathways.
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Content ArticleSecure and immediate access to health and care data helps to prevent avoidable delays in diagnosis and unnecessary repeat tests and examinations that can slow down the speed at which patients are able to begin treatment. In an emergency situation, the right information at the right time can be life saving. This NHS England webage looks improving individual care and patient safety, within the context of the Data Saves Lives: Reshaping health and social care with data strategy. Content includes: Video: Why do shared care records matter? Video: Why does data matter to adult social care? Case studies
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Content Article
Data Saves Lives
Patient_Safety_Learning posted an article in Data and insight
Data Saves Lives is a multi-stakeholder initiative with the aim of raising wider patient and public awareness about the importance of health data, improving understanding of how it is used and establishing a trusted environment for multi-stakeholder dialogue about responsible use and good practices across Europe. Read more on the Data Saves Lives website Read more on the European Patients forum website -
News ArticleHealthcare providers are failing to protect the privacy of people living with HIV, the UK’s data watchdog has warned. The Information Commissioner’s Office said it has been forced to hand fines worth thousands to organisations which have released the details of those living with HIV. Speaking with The Independent, Information Commissioner John Edwards, said: “It is a huge problem [within healthcare] and it’s a disproportionate amount of our business. “That’s partly because of the seriousness and the sensitivity of health information, the huge scale of the health sector and very many moving parts, with many opportunities for information to slip out as it moves from one place to another, and frankly, they’re just not doing well enough.” In a warning on Tuesday the watchdog highlighted specific concerns over HIV patients’ data being breached through the use of bulk emails in which staff have not used the blind copy function. The Information Commissioner said: “People living with HIV are being failed across the board when it comes to their privacy and urgent improvements are needed across the UK. We have seen repeated basic failures to keep their personal information safe - mistakes that are clear and easy to avoid." Read full story Source: Independent, 30 April 2024
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Content ArticleThe debate about fairness of artificial intelligence (AI) in health care is gaining momentum. At present, the focus of the debate is on identifying unfair outcomes resulting from biased algorithmic decision making. This article in The Lancet Digital Health looks at the ethical principles guiding outcome fairness in AI algorithms.
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Content ArticleThis Office for National Statistics (ONS) report provides in-depth analysis of Winter Coronavirus Infection Study (Winter CIS) data looking at trends in self-reported symptoms of Covid-19 including ongoing symptoms and associated risk factors. Winter CIS was a joint study with the UK Health Security Agency (UKHSA), carried out between November 2023 and March 2024 for England and Scotland. The study was structured as a longitudinal panel survey, with each participant sent a questionnaire and asked to take a lateral flow device test every four weeks for the detection of Covid-19.
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Content ArticleSheffield Health and Social Care NHS Foundation Trust's (SHSCFT's) Patient and Carer Race Equality Framework (PCREF) aims to help the Trust's staff and communities understand how to have sensitive conversations with patients and carers and to get better information from them. This will mean the Trust is more culturally aware and able to offer culturally appropriate care by understanding the barriers ethnic minority communities face in getting healthcare services for diagnosis and treatment. This video was produced by SHSCFT to guide staff in having conversations about collecting information on ethnicity from patients and carers.
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Content ArticlePublic confidence in the NHS is at an all time low and even when people can access the service, national surveys tell us that their experiences of NHS services are deteriorating. The authors of this blog—Patients Association Trustee Alf Collins and Health Consultant Richard Sloggett—make a simple plea: that all aspects of patient experience is taken seriously. They argue that the care backlogs and levels of unmet need require a radical re-orientation of the relationship between the Government, the health system and the public, and that this needs to involve a complete step-change in how patients are engaged in their care.
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Content ArticleIncident reports of medication errors are valuable learning resources for improving patient safety. However, key information is often contained within unstructured free text, which prevents automated analysis and limits the usefulness of these data. Natural language processing can be used to structure this free text automatically and retrieve relevant past incidents and learning materials, but this requires a large, fully annotated and validated set of incident reports. This study in Nature used a set of 58,658 machine-annotated incident reports of medication errors to test a natural language processing model. The authors provide access to the validation datasets and machine annotator for labelling future incident reports of medication errors.
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News Article
Data regulator issues new guidance for healthcare sector on transparency
Patient Safety Learning posted a news article in News
The UK’s data protection regulator has published new guidance for health and social care organisations it says will help them be more transparent about how personal information is being used. The Information Commissioner’s Office (ICO) said the new guidance would provide regulatory certainty to organisations on how they should keep people properly informed as technology is increasingly used to deliver care and carry out research. The regulator said focus on the issue was needed as the health and social care sector routinely handles sensitive information about the most intimate aspects of peoples’ health, and that under data protection law, people have a right to know what is happening to their personal information. Being transparent is essential to building public trust in health and social care services Anne Russell, head of regulatory policy projects at the ICO, said the ever-increasing use of technology meant personal data was more important than ever, and so therefore was more transparency. “Being transparent is essential to building public trust in health and social care services,” she said. “If people clearly understand how and why their personal information is being used, they are likely to feel empowered to share their health information to both access care and support initiatives such as medical research. “As new technologies are developed and deployed in the health sector, our personal information is becoming more important than ever to boost the efficiency and public benefit of these systems. “With this bespoke guidance, we want to support health and social care organisations by improving their understanding of effective transparency, ensuring that they are clear, open and honest with everyone whose personal information is being used.” Read full story Source: The Independent, 15 April 2024
