Tag: Health Quality

Empty nurses station in a hospital.

The NHS Patient Safety Information Tidal Wave

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By John Tingle

The English National Health Service (NHS) was 75 years of age on 5th July 2023 and there was a lot to celebrate. We are proud of our universal health care system which provides free care at the point of delivery. The NHS is an intrinsic part of our national heritage and culture.

The King’s Fund provide some facts and figures on the NHS. It has one of the world’s largest workforces with around 1.26 million full-time equivalent staff in England, as of November 2022. In terms of patient care and treatment, the King’s Fund states that on an average day in the NHS, more than 1.2 million people attend a general practitioner (GP) appointment, and around 260,000 an outpatient appointment. The NHS faces high demand for finite health care resources. We have a growing elderly population in England presenting often with comorbidities. Staffing levels are also a problem, which is being addressed in the NHS long term workforce plan.

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an ambulance parked at the entrance of an emergency department

Psychiatric Care in Crisis

The Petrie-Flom Center Staff Leave a comment

By Zainab Ahmed

Psychiatric care in the Emergency Department is all-or-nothing and never enough. Often, legal holds are the only intervention available, and they rarely are therapeutic. Upon discharge, our patients are, once again, on their own.

The ED acts as a safety-net for a failing health system, one that places little value on mental health services, either preventative or follow-up. The demand for acute psychiatric care is high; however, EDs have little physical capacity for psychiatric patients.

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Austin, Tx/USA - May 23, 2020: Family members of prisoners held in the state prison system demonstrate at the Governor's Mansion for their release on parole due to the danger of Covid-19 in prisons.

Federal Failures to Protect Incarcerated People During Public Health Crises

The Petrie-Flom Center Staff Leave a comment

By Rachel Kincaid

As the COVID-19 pandemic persists, and as we face the reality that future pandemics are coming (or have already begun), it’s a fitting time for the United States to take stock of how the carceral system has exacerbated the harms of COVID-19, and for policymakers to seriously consider what can and should be done differently going forward.

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Empty hospital bed.

Do No Harm: A Call for Decarceration in Hospitals

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By Zainab Ahmed

In an era of mass suffering, some still suffer more than others. What’s worse, there is nothing natural about it. It is human made.

As an emergency medicine resident at a large academic hospital in Los Angeles, I see how incarcerated patients’ suffering is sanctioned by hospitals and medical professionals, despite their pledge to do no harm.

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scoreboard with home and guests written on it at sunset time.

A Mind Is A Terrible _____ To Waste

The Petrie-Flom Center Staff Leave a comment

By Vincent “Tank” Sherrill

You fill in the blank! I’ve often referred to the mind as a womb, or a laboratory of life, not a “thing,” but rather a place where thoughts and ideas are conceived. However, since COVID-19 has been introduced on the scene, I’ve watched a cold game being played inside two Washington State prisons: the game between “The Progression of the Mind versus The Regression of the Mind.”

I didn’t have a front row seat in the Colosseum to this American tragedy; I was one of the 2.3 million sacrificial bodies. (Some of these bodies were released, back into a society not prepared to receive, due to their own post-COVID health needs.)

Supposedly, under the watchful eye of Lady Justice, prisoners are afforded certain inalienable rights and privileges, like religious and education services, for the redemptive qualities they both provide. However, due to this plague of epic proportion within these walls (some ancient, and some modern), which have made my domicile for 28 years, these basic services that provide the space for the Mind to grow, develop, and reconcile ceased.

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cells with the doors closed at a historic Idaho prison.

The Pandemic Prison

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By Dan Berger

The pandemic prison has utilized several of the worst features of incarceration as a foundational part of how the institution governs “public health” for its captives. And because prisons are never as removed from society as proponents like to think, these protocols redound far beyond the prison system itself.

The scale of COVID-19 in jails, prisons, and detention centers was expected. These institutions are defined by close quarters, poor health care, and, at least initially, little or no personal protective equipment. From the earliest days of the pandemic, anyone paying attention to jails, prisons, and detention centers knew that they would be vectors of community spread.

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2020 San Pedro California April 30: Federal Correctional Institution Terminal Island prison. Half the inmates there were infected with coronavirus.

Carceral Health Care Is Designed to Fail

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By Andrea C. Armstrong

COVID-19 is not the first pandemic within prisons. Modern history is littered with examples of disease outbreaks in carceral spaces, including tuberculosis, influenza, and MRSA. Like these earlier carceral pandemics, the over 620,000 COVID-19 infections and 3,100 related deaths among incarcerated individuals to date simply expose how U.S. health law and policy fails to protect people in custody.

Only incarcerated people have a constitutional right to healthcare in the United States. That right, however, is rendered toothless when supplied through a punitive system that lacks meaningful standards and robust oversight.

Here is what we know — despite the secrecy that shields penal institutions — about carceral health care.

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Making Health Care Safer: What Good Looks Like

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It’s fair to say that patient safety and health quality reports in recent years have tended to focus on what is going wrong in the NHS and what needs to be done to put things right.We have had some dramatic health care systems failures which have resulted in unnecessary deaths of patients.The naming and shaming of errant health care providers has taken place and we have now through the CQC (Care Quality Commission), a much more open, stronger, intelligent and transparent way of regulating health care quality than we have ever had before.

The health care regulatory system does seem to be making a positive difference to NHS care judging from recent CQC reports with some good examples of health quality and safe care practices taking place. Other trusts can learn from these practices.

The CQC have just published a report which includes several case studies illustrating some of the qualities shown by care providers that are rated good or outstanding overall. These hospitals known as hospital trusts in the NHS have been on a journey of improvement some going from special measures to good (CQC inspection ratings). The views of some of the people involved in the care improvement initiatives are stated in the case studies revealing important insights on improvement strategies and the nature of the problems overcome. Read More

Intelligent Transparency and Patient Safety: New UK Government Patient Safety Plans Launched

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By John Tingle

One thing is clear when commentating on patient safety developments in the UK is that there is hardly ever a dull moment or a lapse of activity in patient safety policy development .Something always appears to be happening somewhere and it’s generally a very significant something. Things are happening at a pace with patient safety here.

On the 3rd March 2016 the Secretary of State for Health,The Rt Honourable Jeremy Hunt announced a major change to the patient safety infrastructure in the NHS with the setting  up from the 1st April 2016 of the independent Healthcare Safety Investigation Branch. In a speech in London to the Global Patient Safety Summit on improving standards in healthcare he also reflected on current patient safety initiatives.This new organisation has been modelled on the Air Accident Investigation Branch which has operated successfully in the airline industry. It will undertake, ‘timely, no-blame investigations’.

The Aviation and Health Industries
The airline industry has provided some very useful thinking in patient safety policy development when the literature on patient safety in the UK is considered. The way the airline industry changed its culture regarding accidents is mentioned by the Secretary of State in glowing terms. Pilots attending training programmes with engineers and flight attendants discussing communications and teamwork. There was a dramatic and immediate reduction in aviation fatalities which he wants to see happening now in the NHS. Read More