University Hospitals Birmingham NHS Foundation Trust

Noted (AI summary) Response from Deputy CEO and Chief Medical Officer, University Hospitals Birmingham NHS Foundation Trust, with no specific actions mentioned.

Noted (AI summary) The DHSC acknowledges concerns about insufficient radiologists at Good Hope Hospital and refers to the responsibility of individual NHS Trusts to determine staffing levels and the upcoming 10 Year Workforce Plan, deferring to the Trust for specific responses. The Trust reconfigured out-of-hours radiology reporting, separating ED and inpatient reporting across hospital sites starting September 1, 2024, and delivered an educational session around aortic dissection, though they maintain that the abnormality was very subtle and difficult to identify.

Noted (AI summary) The Trust will appoint a consultant haematologist with oversight over the stem cell lab and investigations and work up of patients, and are entering discussions with NHSBT to create a joint post. They are also identifying funding at UHB by job planning review across the department. The DHSC expects NHS Trusts to review their staffing levels and notes existing regulations regarding staffing. They also note that they expect a response from the named Trust and Integrated Care Service.

Noted (AI summary) The Trust will display laminated posters of joint guidance in acute surgical areas, publish and disseminate a new trust policy, update the online requesting system, engage with the West Midlands Postgraduate School of Surgery to inform trainees, and report the incident to CORESS, with completion expected by 31st October 2023. The Department of Health and Social Care acknowledges the concerns about capacity at Birmingham Heartlands Hospital and outlines national plans to improve A&E waiting times, increase hospital capacity, and support timely discharge from hospital, but doesn't detail specific actions beyond those already in place.

Noted (AI summary) NHS England notes that the Trust has responded adequately at a local level and that the matters of concern have been dealt with, and has shared the Regulation 28 Report and both responses with the Regional NHSE/I teams. Immediately following the inquest, the hospital sourced 10 zimmer frames and made them available in the ED; a process for procurement, storage, labeling and auditing of walking frames was fully implemented in early July.

Noted (AI summary) The trust has developed a Cardiac Implantable Electronic Device Lead Infection Microbiology Hospital Guideline to aid in detection and treatment of Subacute Bacterial Endocarditis (SBE) related to cardiac rhythm devices and will link it to existing guidance for Pyrexia of Unknown Origin (PUO). The learning board has been shared and will be further supported at the Trust-wide Quality Summit and in a monthly 'Patient Safety Brief' newsletter. The practice discussed the case and reviewed the patient's medical record, concluding that the diagnosis was difficult to make in primary care due to the unusual nature of the infection and non-specific symptoms. They now recognise this as a possible cause of malaise in similar future scenarios. The Trust is undertaking a programme of education for acute physicians via grand rounds and a 'Lesson of the Month' email to raise awareness of pacemaker related endocarditis. They will also update patient information leaflets to include additional instructions regarding fever and device related endocarditis, aiming to complete this by November 2019.