NEWS
Calls to protect HCWs from litigation over COVID care
The upcoming review of the Coronavirus Act offers a vital opportunity for the Government to introduce emergency legislation to protect healthcare professionals following the difficult clinical decisions they have, and continue to make, during the pandemic – the Medical Protection Society (MPS) has asserted.
In its submission to the All-Party
Parliamentary Group on Coronavirus, MPS said the Government was quick to confirm indemnity arrangements for those facing clinical negligence claims but no progress had been made in providing healthcare professionals with reassurance that they will not face unfair investigations by their employer, regulator or – in the most extreme of cases – by the criminal justice system. From the start of the pandemic, MPS has called for the introduction of emergency laws to protect healthcare professionals from such investigations and it is now urging the Government to use the six-month review and vote on the Coronavirus Act to ensure the issue is addressed swiftly. Dr. Rob Hendry, medical director at MPS, said: “Healthcare professionals have been treating patients with a new disease of which we have a growing but still very limited understanding. Many have been working with stretched resources, outside of their normal area of expertise and sometimes without adequate PPE. Others have made the selfless decision to join the workforce early or to return from retirement to support the NHS. “These doctors tell us they are concerned that they will face investigation for clinical decisions made in good faith. The
RCN calls for lessons to be learnt from pandemic
response Speaking at the All-Party Parliamentary Group (APPG) on Coronavirus, RCN director of nursing, policy and public affairs, Susan Masters, called for an inquiry to investigate how the UK prepared for and responded to the pandemic. At the meeting, she told MPs: “Lessons from the previous wave and supply chain issues need to be identified and learned.”
suspension of routine investigations and outpatient appointments, and the resulting backlog of referrals, will also give rise to medicolegal disputes and investigations. “It could be some time before such investigations are handled and at this point memories of this difficult time and challenging circumstances may have faded. Now more than ever, healthcare professionals need to know they are supported. “The six-month review point and vote on the provisions set out in the Coronavirus Act, as required under Section 98 of the Act, offers an opportunity for the Government to make a bold show of its support by introducing emergency laws for healthcare professionals who have been treating patients and making decisions in good faith during this crisis. Such legal protections should be temporary, applicable only over the duration of the pandemic, and of course not apply to wilful or intentional criminal harm or reckless misconduct.”
Throughout the pandemic, nursing staff highlighted that the sufficient supply of PPE was a major safety issue. An RCN survey in April discovered half of nursing staff, including those working in the most high-risk environments, felt pressure to carry out their work without the levels of protection set out in official guidance. “The change in PPE guidance
halfway through the pandemic meant members felt unsure that they were adequately protected,” she commented. “Going forward, we need to see the UK Government and employers ensure that all nursing staff working in all settings have access to adequate supplies of high-quality PPE.” Masters further pointed out that health and care workers still face considerable barriers when accessing testing, with some staff being told to drive vast distances for a testing appointment. She also highlighted key issues around mental wellbeing, staffing levels and pay.
Safety warning on foreign body aspiration during intubation
A National Patient Safety Alert has been issued on the risk of foreign body aspiration during intubation, advanced airway management or ventilation. Foreign body aspiration can occur if loose items are unintentionally introduced into the airway during these procedures, which can lead to partial or complete airway blockage or obstruction. If the cause is not suspected, it can prove fatal.
Over a six-year period, the NHS England and NHS Improvement patient safety team identified five incidents where a foreign body (FB) was aspirated, and a further four incidents where the FB was identified during intubation and removed.
The most common types of FB identified
in incident reports were transparent backing plastic from electrocardiogram (ECG) electrodes and plastic caps of unclear origin. This is likely to be an under-estimate of the true number of incidents as many may go unrecognised.
During an investigation it was also identified that: l Some breathing circuit components with untethered caps are still available to purchase.
l Airway trays for routine or planned procedures are frequently prepared in advance, but left uncovered and, as a result, loose FBs may become attached to breathing system devices.
l The ends of breathing system hoses are 10 l
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not routinely closed between patient cases, allowing the potential for loose plastic objects to enter the breathing hose system.
The alert asks providers to reduce the risks by purchasing safer alternative equipment without loose and transparent parts. Providers are also asked to develop or amend local protocols to ensure pre- prepared intubation and advanced airway management devices are covered or protected until use; and that the ends of reusable breathing system hoses are closed between patient cases. Failure to take the actions required under the National Patient Safety Alert may lead to CQC taking regulatory action.
OCTOBER 2020
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