2024

Noted (AI summary) The Department of Health and Social Care outlines the planned phased implementation of Martha's Rule, giving patients the right to request a rapid review of their case by someone outside their immediate care team, and describes NHS England's broader Managing Deterioration Safety Improvement Programme. The response contains no text and cannot be classified.

Noted (AI summary) NHS England outlines actions taken to improve ambulance performance, including implementing the Delivery plan for recovering urgent and emergency care services, engaging with West Yorkshire ICB, and publishing the NHS Long Term Workforce Plan. These actions include joint escalation processes, investment in resources, and workforce enhancements. West Yorkshire ICB describes actions taken to reduce ambulance response times and handover delays, including funding for additional resource in call centres. The ICB also highlights the development of a System Coordination Centre (SCC) to enable a proactive system response to operational pressures. The DHSC acknowledges the concerns regarding ambulance response times and hospital handover delays, notes that West Yorkshire ICB and NHS England will respond directly on specific actions, and highlights national initiatives to improve urgent and emergency care performance.

Noted (AI summary) NHS Sussex confirms that University Hospitals Sussex NHS Foundation Trust (UHSx) and East Sussex Healthcare NHS Trust (ESHT) have implemented policies regarding fluid management and hyponatraemia in labour, developed and delivered training and education, and are auditing compliance with fluid balance charts. A leaflet has been developed advising mothers about fluid intake in early labour and shared learning about hyponatraemia and fluid balance in labour with the Regional Maternity Team at NHS England in 2022. The NMC is carrying out Fitness to Practise investigations, has shared the PFD report with the GMC, and will develop and publish a scenario to inform student midwives and midwives about hyponatraemia for the start of the next academic year. The Royal College of Obstetricians and Gynaecologists expresses condolences and outlines its role in supporting maternity services through educational initiatives and clinical guidance. It refers to existing NICE guidelines and other resources related to fetal monitoring, intrapartum care, and hyponatremia, and suggests the Royal College of Midwives also be informed. The Department of Health and Social Care highlights the publication of an NHS Resolution report on hyponatremia and notes the rollout of the Brain Injury Reduction Programme across maternity units in England.

Noted (AI summary) The Royal College of Emergency Medicine notes the coroner's concerns about delays in VTE risk assessment but states that this is the responsibility of admitting specialties, not emergency medicine doctors, once a patient has been seen by another team. NICE acknowledges that its current VTE guidance does not cover people in the emergency department prior to admission and will ask its prioritisation board to consider if guidance should be developed in this area. NHS England has contacted NICE to suggest updating their guidance on VTE assessments to recommend that they should be undertaken within 14 hours of a 'decision to admit', as opposed to admission, to account for ED wait times. Firmley Health NHS Foundation Trust will revise its VTE policy to require risk assessment within 2 hours of arrival in the Emergency Department, with a clinical review within 12 hours if the patient remains in the ED. They will also add a prompt to their electronic record system and communicate the changes Trust-wide, aiming to complete these steps within 12 weeks. The Royal College of Physicians will produce a Safety Alert for Physicians and liaise with national clinical directors and The Society for Acute Medicine regarding delays in VTE prophylaxis due to hospital admission delays.

Noted (AI summary) Walsall MBC acknowledges the concerns regarding pedestrian safety near a parade of shops, but cites legal and practical difficulties in implementing the suggested measures, including land ownership and the need for third-party consent; they are considering alternative measures but cannot guarantee their adoption.

Noted (AI summary) The response consists of the organisation's name only.

Noted (AI summary) NHS Education for Scotland (NES) states that blood tests to detect a risk of excess bleeding for patients taking clopidogrel were considered during the development of the Management of Dental Patients Taking Anticoagulants or Antiplatelet Drugs guidance, but based on expert clinical opinion and published advice, there is no suitable test. They will review the guidance in 2027 or earlier if there are significant developments.

Noted (AI summary) NICE acknowledges the concerns and explains its guideline on venous thromboembolism risk assessment, noting that it does not recommend a particular risk assessment tool and that clinicians should choose a tool that best fits the patient's clinical circumstances. The Department of Health and Social Care will work with NHS England to consider the VTE risk assessment tool, in light of the concerns raised.

Noted (AI summary) Scape Operations Ltd states that window restrictors were installed in 2018 per the National Code of Standards and are inspected quarterly, with any remedial works immediately undertaken, and therefore they propose no further action.