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News ArticleA surgeon has been suspended on the same day a hospital review concluded harm had been caused in hundreds of cases. A tribunal ruled that Tony Dixon, who used artificial mesh to treat prolapsed bowels at Southmead Hospital, in Bristol, and the Spire Hospital, still posed a risk. The Medical Practitioners Tribunal Service's hearing concluded on Thursday that a six-month suspension was "appropriate". Spire Healthcare has now released its review of Mr Dixon, and found 259 cases where harm had been caused. Health bosses have "apologised sincerely". The majority of harm was in three main areas: the failure to adequately investigate patients prior to offering the procedure; the failure to adequately offer alternative treatments; and poor consent with risks and benefits of the procedure not adequately discussed. The tribunal found Mr Dixon’s fitness to practise is impaired and his suspension would allow him time to "to develop further insight and remediate his misconduct". The General Medical Council brought the case against Mr Dixon, who denies all the allegations and maintains that the procedures were carried out in good faith. His suspension will start immediately. Read full story Source: BBC News, 18 July 2024
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News Article
Patient care in hospital corridors is 'now normal'
Patient Safety Learning posted a news article in News
BBC reporters are at Queens hospital in Romford, east London, and, like many across the capital it is busy. Really busy. When filming, 17 patients from their A&E were being treated on beds in corridors. Growing numbers of attendances have meant that what was once an emergency measure has now become the norm. Ruth Green is the director of nursing for the emergency department and says corridor care has become "customary practice" When the BBC last filmed the corridor treatments here back in January 2023, the department was seeing 1,400 patients arrive each month by ambulance. Now that number has risen to 2,100. The number of ambulances arriving every day has gone up in a year too, from around 90 per day to around 120. Ruth Green, the director of nursing for the emergency department said: "Unfortunately it is now customary practice to have patients treated on our corridors pretty much all of the time, not every day now it’s the summer, but still far too often." They have had to install new plugs in the corridors so they can operate the hospital beds, new nurse call buttons and a new sink. One patient in a bed in the corridor is Louis Vella. He spent 18 hours in A&E after coming in with chest pains and was eventually transferred to a corridor to wait for a bed on a ward. He said: "It’s not ideal, no, but they are working as best they can with what they’ve got and what else can one ask for?" Read full story Source: BBC News, 19 July 2024 Related reading on the hub: A silent safety scandal: A nurse’s first-hand account of a corridor nursing shift Reflections on a clinical shift: "After 20 years of nursing, this is one of the worst shifts I have ever completed" -
Content Article
Forgotten generation: shaping better services for children and young people
Sam posted an article in Paediatrics
A forgotten generation’s life chances are being harmed due to delays accessing care. The NHS is struggling to meet rapidly rising demand and increasingly complex and acute care needs among children and young people, a survey by NHS Providers highlights. There is deep concern among leaders of NHS trusts about the long-term harm caused by delays in services for children and young people (CYP), including a widening health inequalities gap. -
News ArticleThousands of children’s lives are being blighted by shocking delays to NHS care of up to three years, according to a report that warns a “forgotten generation” will suffer long-term harm as a result. The health service is struggling to cope with rapidly rising demand for increasingly complex and acute care needs among children and young people, the research by NHS Providers shows. Health leaders say the crisis in England is so severe that there is now “deep concern” that lifelong, permanent harm is being caused by crippling delays to NHS care. Long waits for basic healthcare are derailing children’s development, educational attainment and mental health, they revealed. One trust reported that waiting times for children’s autism assessments had risen from about 14 months before the Covid-19 pandemic to 38 months today. Children are also being forced to wait too long for essential speech and language therapy, hearing tests, medical treatment and surgery. “Too many young lives are being blighted by delays to accessing vital NHS care,” said Sir Julian Hartley, the chief executive of NHS Providers. “We’re in danger of seeing a forgotten generation of young people.” Read full story Source: The Guardian, 15 July 2024
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News ArticleThe waiting lists for diagnostic tests, including cancer scans, is at a record high in NHS England, with doctors warning of a “staggering shortfall” of clinical radiologists. Figures published on Thursday reveal the diagnostic waiting list stands at 1,658,221 – twice what it was 10 years ago. Nearly 500,000 patients are waiting for CT scans and MRIs. The figures show the scale of the task facing the new health secretary, Wes Streeting, who has ordered a review into the NHS. Labour pledged in its manifesto to double the number of scanners, but doctors warn there is an urgent need for more staff to operate them and read the resulting scans. “The NHS is broken,” a spokesperson for the Department of Health and Social Care said in response to the figures. “Waiting lists are too high and patients have not been able to access the care they desperately need. “The longer patients wait for tests and scans, the worse their outcomes will be. We’ve got to get patients diagnosed much earlier.” Read full story Source: The Guardian, 14 July 2024
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Content ArticleReview report and recommendations from the Independent Review of Audiology Services in NHS Scotland. The Review was announced by the Scottish Government in January 2022 in the context of failings in the standards of care provided in the NHS Lothian Paediatrics Services.
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Content Article
If the health and care sector is to safely and securely use and expand digital services, with clinicians becoming ever more dependent on it for the delivery of care, then we must get the basics of digital service delivery right and enable a digitally safe culture. Rob Ludman, Director of Ludman Consulting Ltd, shares the three priorities he feels is needed to tackle this. -
News Article
Ambulance handover delays still harming tens of thousands each month
Patient Safety Learning posted a news article in News
Tens of thousands of patients are still suffering harm from delays in ambulance handovers to emergency departments despite a concerted effort to tackle the problem, figures seen by HSJ indicate. The data shows more hours have been lost to handover delays lasting more than 15 minutes in most of the first five months of 2024 compared to the same period in 2023. In May, more hours were lost than in May 2022 and May 2023. The Association of Ambulance Chief Executives told HSJ the problem remained severe and the government needed to act to improve it. AACE managing director Anna Parry said it had consistently warned about the ongoing risk of handover delays. She said: “This is why one of our key requests of the new government has been that they proactively support the ambulance sector’s aim to ensure patients universally receive high-quality, timely care and no longer experience unacceptable delays in response or handover of care, for example, at hospital emergency departments. “This problem is not intractable. We have demonstrated that in areas where there is a strong leadership focus and true system-wide support, handovers can be managed effectively, despite the significant pressures and constraints our health and social care system is under. However, it remains vital that we see more demonstrations of excellent leadership to get to that point across the country.” Read full story (paywalled) Source: HSJ, 10 July 2024 -
News Article
Fall after fall - care home accused of neglect
Patient Safety Learning posted a news article in News
The daughter of an elderly care home resident who suffered 32 falls in only 11 months said she had sent social services "a begging email" to warn her mother "was going to die" unless urgent improvements were made. "She suffered neglect in every way - it was devastating to see," said Kylie Gobin, whose mother Winifred Tubb lived at St Luke's in Runcorn, Cheshire. Mrs Gobin spoke to the BBC as part of an in-depth investigation which found nearly one in five care homes across England were rated as either "requiring improvement" or "inadequate". A spokesman for Halton Borough Council, which operates St Luke's, said it had "fully investigated" the complaints and "some lessons have been learnt". BBC England's data journalism team analysed Care Quality Commission (CQC) statistics and found the regulator now regards more than 2,500 care homes across England as "requiring improvement". The number of "inadequate" homes stands at 194 across England, but this figure is down on both 2022 and 2023. Read full story Source: BBC News, 9 July 2024 -
News ArticleThe UK advertising watchdog has had to take down hundreds of adverts for cosmetic surgery clinics abroad and weight-loss jabs as dangerous ads target “mummy makeovers”, The Independent has been told. The Advertising Standards Authourity is also taking down 100 unsafe or misleading adverts a day for prescription-only medicines, with the majority of action taken against promotions for Botox and weight-loss jabs. The authority said it has been forced to take down hundreds of cosmetic surgery adverts since February this year, following a crackdown on clinics abroad attempting to attract UK patients. Jessica Tye, investigations operations manager for ASA told The Independent: “They’re running adverts for cosmetic surgery abroad, mostly for clinics in Turkey, but not exclusively … Instagram and Facebook seem to be a big space for clinics to use, to attract people.” She said the clinics were: “Using claims or images that would exploit people’s body insecurities, things like talking about mummy makeovers, which is like a package of surgery involving, breast surgery and liposuction. “It’s a really serious operation, so it’s really important that ads for these clinics are not encouraging people to rush into a decision.” Last week doctors at the British Medical Association annual general warned the NHS is being left to “pick up the pieces” as a result of complications linked to a rise in surgical tourism. Read full story Source: The Independent, 4 July 2024
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News ArticlePopular weight-loss jabs have been linked to an eye condition that can cause blindness. People with diabetes prescribed semaglutide (brand names Wegovy and Ozempic) were more than four times more likely to be diagnosed with a condition called non-arteritic anterior ischemic optic neuropathy (NAION), according to a new study. Meanwhile, people who were overweight or obese prescribed the drugs were more than seven times as likely to develop the condition as those on other weight-loss medicines. NAION, which is uncommon, occurs from a lack of sufficient blood flow to the optic nerve. People typically suffer sudden vision loss in one eye, without any pain, and patients often notice the issue on waking up. There are no current treatments for NAION and vision often does not improve. The new study, published in JAMA Ophthalmology, was led by Joseph Rizzo, a professor of ophthalmology at Harvard Medical School in the US. He said: “The use of these drugs has exploded throughout industrialised countries and they have provided very significant benefits in many ways, but future discussions between a patient and their physician should include NAION as a potential risk. “It is important to appreciate, however, that the increased risk relates to a disorder that is relatively uncommon.” Read full story Source: The Independent, 5 July 2024
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News Article
Wider use of physician associates will increase inequality, say UK doctors
Patient Safety Learning posted a news article in News
Doctors are warning the UK medical regulator that wider use of physician associates in the NHS may risk patient safety and lead to greater inequalities in care in deprived areas that struggle to recruit GPs. The government’s plan to recruit 10,000 physician associates – healthcare professionals supervised by doctors – has angered many clinicians who consider the roles ill-defined and a potential threat to patient safety. The General Medical Council (GMC) is to regulate physician and anaesthesia associates, who also work under doctors’ supervision, from December. The doctors’ union, the British Medical Association, last week announced it was seeking a judicial review of the GMC over the “dangerous blurring of lines” between doctors and medical associate professions. It argues physician and anaesthesia associates need regulating, but not by the GMC. Other professional membership organisations want clarification of associates’ roles. The Royal College of General Practitioners (RCGP) told the GMC that regulation is a “significant step forward”, but the scope of practice needs to be urgently developed. Read full story The Guardian, 30 June 2024 -
News Article
Corridor care ‘must not be the norm’, NHSE warns trusts
Patient Safety Learning posted a news article in News
NHS England has warned trusts corridor care “must not be considered the norm”, adding that the failings exposed by a recent undercover documentary were “not acceptable”. In a letter to boards after a Dispatches documentary filmed at Royal Shrewsbury Hospital aired on Monday, NHSE’s chief operating officer, chief nursing officer, national medical director and director of urgent and emergency care warned trusts they must ensure basic standards of care. The note, seen by HSJ, described footage filmed at RSH’s emergency department as “stark”, adding that it highlighted the service some patients receive is “not acceptable”. The documentary captured many instances of patients being treated in corridors, and the letter said corridor care or that delivered outside a normal cubicle environment “must not be considered the norm”. NHSE added: “It should only be in periods of escalation and with board-level oversight at trust and system level… where it is deemed a necessity… it must be provided in the safest and most effective manner possible, for the shortest period of time… with patient dignity and respect being maintained throughout.” Read full story (paywalled) Source: HSJ, 27 June 2024 Related reading on the hub: A silent safety scandal: A nurse’s first-hand account of a corridor nursing shift -
EventuntilJoin Patients for Patient Safety US for 3 days of events centred around World Patient Safety Day (WPSD) 2024. PFPS US urges Americans impacted by missed or delayed diagnoses, bias or medical error to convene in Washington, DC for a Summit held September 15-17, 2024. The World Health Organization designates 17 September 17 as World Patient Safety Day, and WPSD 2024’s theme is Improving Diagnosis for Patient Safety. Find the full Summit event list at https://www.pfps.us/wpsd-2024, including: Sunday 15 September: Welcome reception and dinner at Johns Hopkins University Bloomberg Center to launch Project PIVOT, a national project identifying patient-prioritized outcomes and experiences and collaboration with patient organizations, US Department of Health and Human Services, Johns Hopkins University, Harvard Medical School and others. Monday 16 September: Participants visit Capitol Hill to urge Congressional leaders to ACT Now for patient safety, diagnostic safety and health equity solutions. ACT Now is PFPS US’s urgent request to leaders for Accountability, Coordination, and Transparency in health care. Later, PFPS US and AcademyHealth co-host a film premiere of The Pitch: The Next Generation of Patient Safety. From immersive tech to AI machine learning, innovations are finally making waves in medicine with the goal of safer health care. The Pitch gives a unique look at the American health care system’s ongoing challenge to embrace the next generation of patient safety. Tuesday 17 September, World Patient Safety Day: The March for Patient Safety begins at Freedom Plaza and ends with a ceremony on the US Capitol Lawn, where marchers will remember those whose lives have been lost to or impacted by preventable harm. Afterwards, PFPS US and the Bloomberg Center co-host a World Patient Safety Day Leadership Briefing with government leaders. Further information and to sign up
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News Article
NHS having to ‘pick up pieces’ of medical tourism ‘boom’, say doctors
Patient Safety Learning posted a news article in News
The NHS is having to provide emergency care to rising numbers of patients suffering serious complications following weight loss surgery and hair transplants abroad amid a “boom” in medical tourism, doctors have warned. Medics said they were being left to “pick up the pieces” as more Britons seeking cheap operations overseas return with infections and other issues. In some cases, patients are dying as a result of botched surgeries performed in other countries. Hospitals have even had to cancel elective procedures for patients because beds were being taken up by someone who needed an overseas procedure fixed. There were also concerns over patients buying weight loss drugs, including Wegovy, abroad without receiving the necessary “wraparound” care, doctors said. The British Medical Association’s annual meeting in Belfast heard there had been a “boom” in surgical tourism, which was “leading to a rise in serious post-surgery complications and deaths”. Read full story Source: The Guardian, 25 June 2024 -
Content ArticleIn the wake of reports linking IT flaws to deaths of patients and the recent cyber attack on pathology services in south east London, Chris Fleming in an article for Digital Health calls for radical change to make digital safer and more effective
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EventuntilMedication errors are a leading cause of injury and avoidable harm in healthcare, with an estimated 1.3 million people impacted in the U.S. each year. Preventable medication errors cost the nation more than $21 billion annually across all care settings, representing a serious public health concern, as well as an economic burden on our healthcare system. Join AHRQ’s expert panel of speakers to hear how quality improvement approaches and digital healthcare interventions such as clinical decision support tools are reducing medication errors, improving provider effectiveness, and enhancing patient safety in a variety of clinical care settings. At the conclusion of this Webinar, participants should be able to: Discuss how an e-prescribing tool can reduce medication discrepancies and improve patient safety by enhancing communication between pharmacists and providers. Identify how clinical decision support systems can significantly reduce the prescribing of potentially inappropriate medications to older patients at the time of discharge from the emergency department setting. Explain how outcome measures, such as the Wrong-Patient Retract-and-Reorder measure, can be developed and used to detect medication errors in electronic orders. Register
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Content ArticleTopiramate is now contraindicated in pregnancy and in women of childbearing potential unless the conditions of a Pregnancy Prevention Programme are fulfilled. This follows a review by the MHRA which concluded that the use of topiramate during pregnancy is associated with significant harm to the unborn child. Harms included a higher risk of congenital malformation, low birth weight and a potential increased risk of intellectual disability, autistic spectrum disorder and attention deficit hyperactivity disorder in children of mothers taking topiramate during pregnancy.
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News Article
Global alert issued over fake Ozempic drugs
Patient Safety Learning posted a news article in News
A global alert about fake versions of Ozempic - which has become popular as a way of losing weight - has been issued by the World Health Organization (WHO). The drug is sometimes known as a "skinny jab" despite its main purpose being a treatment for type 2 diabetes. The WHO said the fake medicines could pose a danger to health. The organisation advised people to source the drug only through reputable sources, such as a doctor, rather than obscure sites online or through social media. The active ingredient in Ozempic - semaglutide - helps people with type 2 diabetes control the amount of sugar in their blood. However, the weekly injection also signals to the brain that we're full. So the drug helps people lose weight by reducing the urge to eat. People without diabetes have been getting hold of the drug as a weight-loss medication, which has led to shortages for people with type 2 diabetes and created a market for counterfeit drugs. “[We advise] healthcare professionals, regulatory authorities and the public be aware of these falsified batches of medicines,” said Dr Yukiko Nakatani, WHO assistant director general for essential medicines and health products. "These falsified products could have harmful effects to people’s health," WHO said. Read full story Source: BBC News, 20 June 2024 -
Content ArticleThis WHO Medical Product Alert refers to three falsified batches of OZEMPIC (semaglutide). This falsified product has been detected in Brazil (October 2023), the United Kingdom of Great Britain and Northern Ireland (October 2023), and the United States of America (December 2023), and was supplied in the regulated supply chain. OZEMPIC (semaglutide) is from a group of medicines called glucagon-like peptide-1 (GLP-1) inhibitors that are indicated for the treatment of hyperglycemia in type 2 diabetes mellitus in adults, adolescents, and children over 12 years of age. The genuine manufacturer of OZEMPIC has confirmed that the three products referenced in this Alert are falsified: the products misrepresent their identify and source as they were not manufactured by Novo Nordisk: batch number LP6F832 is not recognized. the combination of batch number NAR0074 with serial number 430834149057 does not correspond to genuine manufacturing records. batch number MP5E511 is genuine, but the product is falsified.
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News Article
Young women buying Ozempic to get ‘beach body ready’ end up in A&E
Patient Safety Learning posted a news article in News
Young women are ending up in A&E after buying Ozempic online, with the NHS’s top doctor warning that weight-loss injections should not be abused in an attempt to get “beach body ready”. Doctors in emergency care report that “almost every shift” they see “young, beautiful girls” with potentially deadly complications who took the drug despite being a healthy weight. New weight-loss injections including semaglutide, better known by the brand names Ozempic and Wegovy, are being used on the NHS for people with obesity and type 2 diabetes. Some patients, however, including those with eating disorders, have lied about their weight to get them privately from online pharmacies or beauty clinics — leading to complications including inflammation of the pancreas. The drugs are sold by companies including Boots, Superdrug and Lloyds at between £150 and £200 a month. Doctors are calling for “urgent regulation and control” of their sale to ensure they are prescribed only to obese patients. Professor Stephen Powis, NHS England’s medical director, said the drugs should not be seen as a “quick fix for people trying to get ‘beach body ready’ ”. Read full story (paywalled) Source: The Times, 13 June 2024 -
News Article
USA: Leaked documents reveal patient safety issues at Amazon’s One Medical
Patient Safety Learning posted a news article in News
Patient safety issues have increased since One Medical shifted care to a call centre staffed by contractors, employees say Since Amazon acquired the primary care service One Medical, elderly patients have been routed to a call centre — staffed partly by contractors with limited training — that failed on more than a dozen occasions to seek immediate attention for callers with urgent symptoms, according to internal documents seen by The Washington Post. When one patient reported a “blood clot, pain and swelling,” call centre staff scheduled an appointment rather than escalating the matter for medical evaluation, according to a note in an internal incident tracking spreadsheet dated 19 February. Over the following two days, clinical staffers flagged four more call-centre errors involving elderly patients with urgent complaints, including stomach pain and blood in stool, a spike in blood pressure, an insect bite and sudden rib pain, according to the internal spreadsheet. The call-centre incidents were among dozens flagged by doctors, nurses and assistants at One Medical Seniors between 19 February and 18 March in the documents, a year after Amazon acquired the primary-care service. Read full story (paywalled) Source: The Washington Post, 15 June 2024 -
News Article
Women’s health campaigner honoured for improving patient safety
Patient Safety Learning posted a news article in News
Families affected by hormone pregnancy tests have been “recognised as having suffered an injustice” a leading campaigner has said as she was given an award in the King’s Birthday Honours. Marie Lyon, chairwoman of the Association For Children Damaged by Hormone Pregnancy Tests, has been campaigning for decades for justice for people affected by hormone pregnancy tests, including Primodos. The 77-year-old has been awarded the British Empire Medal (BEM) for “advocating for scientific research and improving patient safety for women”. She said she was accepting the award on behalf of members of the association and that the medal is “recognition of what has happened”. The tests were given to more than a million women from 1958 to 1978, but Ms Lyon said many were never told of the risks and were instructed to take the drug – which is 40 times the strength of an oral contraceptive pill – by their GPs as a way of finding out whether or not they were pregnant. Read full story Source: The Independent, 15 June 2024 Read our Patient Safety Spotlight interview with Marie Lyon -
News Article
Pleas from services crippled by cyber attack rejected due to lack of capacity
Patient Safety Learning posted a news article in News
London pathology providers are “running too hot” to give enough support the large system hit by a cyber attack last week, HSJ has been told. HSJ has learnt that all the capital’s pathology services have now been approached to help Guy’s and St Thomas’ and King’s College Hospital after the IT systems for their provider Synnovis went down, the pressure on the capital’s labs and technical issues limited what help could be given. But one senior manager told HSJ: “Many trusts are keen to help but their hands are tied. The difficulties are that so many medium-sized NHS labs are already running hot and have not got the capacity." HSJ was told there was significant clinical risk in primary care as well. Routine tests that might have picked up something important are not happening and one manager said: “Patients in primary care include those in nursing homes – blood tests and test for infections can be the only way to work out why a frail patient is deteriorating.” Read full story (paywalled) Source: HSJ, 17 June 2024 -
Content ArticleTotal parenteral nutrition (TPN, also known as PN) is a method of providing nutrition directly into the bloodstream to those unable to absorb nutrients from the food they eat. TPN is used in all age groups, but in babies its use is often as part of a temporary planned programme of nutrition to supplement milk feeds in those too immature to suckle or too sick to receive milk feeds as a result of intestinal conditions. TPN consists of both aqueous and lipid components, which are infused separately into the baby via specific administration sets and infusion pumps. The rate at which TPN is administered to a baby is crucial: if infused too fast there is a risk of fluid overload, potentially leading to coagulopathy, liver damage and impaired pulmonary function as a result of fat overload syndrome. In a recent three and a half year period 10 incidents were identified where infusion of the aqueous and/or lipid component of TPN at the incorrect rate resulted in severe harm to babies through pulmonary collapse, intraventricular haemorrhage or organ damage, and where intensive intervention and treatment were needed. Most of these incidents involved too rapid a rate of infusion.
