2024

Noted (AI summary) NHS Bolton expresses condolences and provides clarification on their existing radiology request procedures, stating that radiologists determine the appropriate scan modality based on the Ionising Radiation Regulations and clinical guidelines and that PE exclusion follows a standardized pathway. The RCR highlights a joint RCR/Royal College of Emergency Medicine guideline on diagnosing thoracic aortic dissection, published in January 2024 and currently undergoing a minor review, which aims to provide consensus on CT scanning criteria in emergency departments.

Noted (AI summary) The UKHMA engaged with stakeholders and communicated findings to members, and brought the MAIB report to the PMSC steering group. They also proposed the inclusion of guidance in the GTGP, which is expected to be reviewed around Q3 2024. British Marine helped produce and publish the HSPV code in 2010, revised in 2019, and made its use a requirement of membership for operators carrying out this type of activity. The RYA has delayed review of its "Small High Speed Passenger Vessel Voluntary Code of Practice" awaiting MCA legislation, and envisages releasing a revised edition soon after the MCA Sport and Pleasure Vessel Code is finalized. The British Standards Institution acknowledges the concern regarding BS EN ISO 11591 but clarifies its role as a facilitator for expert committees to develop standards, not to interpret or regulate them; BSI will refer the concerns to the relevant technical committee. The BPA acknowledges the concerns and has corresponded with the MAIB regarding guidance, stating the MCA should lead this. The BPA has offered to promote and amplify guidance, but is not insured to set safety-critical guidelines itself. The Department for Transport states that the MCA is prioritising an updated Sport or Pleasure Vessel Code, currently under public consultation. The MCA has also been tasked to commission an anthropometric assessment of small high-speed passenger craft safety, with results expected in late spring/early summer 2026. Associated British Ports acknowledges the concerns but states that monitoring AIS tracks of vessels and intervening in their operation would be very challenging, require dedicated resources, and may not materially increase the safety of harbour users, also noting the limitations of their powers and resources for policing vessels. The MCA is working on an updated Sport or Pleasure Vessel Code, informed by the MAIB Investigation Report, which is currently undergoing public consultation. They have also begun procurement for an anthropometric assessment of small high-speed passenger craft safety, with a report expected in late spring/early summer 2026 to inform future code revisions and guidance. The UKMPG states it supports information sharing but doesn't develop guidance and believes this should be led by the MCA. They will support actions suggested but this must be led by the MCA with industry input. Red Bay Boats Limited has instructed Scot Seats to test seats to meet HSC 2000 standards; they recommend installation of Scot Seats where possible; they will not accept any commissions in the thrill-seeking market; and feel that sea safari craft should not exceed 25 knots.

Noted (AI summary) The VMD provides guidance on the use and storage of veterinary controlled drugs and is producing an article reminding vets of their responsibilities. The VMD investigates breaches of the Veterinary Medicines Regulations (VMR) and conducts risk-based inspections of vet practices and wholesalers. The RCVS will consider additional core requirements in the Practice Standards Scheme (PSS) requiring practices to have individualized suicide prevention plans, review the legislative requirements for schedule 2 CDs and decide what provisions may be extended to schedule 3 CDs via RCVS guidance, and explore methods of communicating the legal and regulatory requirements relating to lethal medicines to the profession. The RCVS will continue to engage with the Home Office regarding additional safeguards for controlled drugs used for euthanasia.

Noted (AI summary) UHCW and GEH finalized and shared guidelines for managing acutely unwell kidney transplant renal inpatients, discussed them at the Renal Quality Improvement and Patient Safety meeting, agreed to a Service Level Agreement for UHCW renal team to attend GEH, and have changed internal processes to prioritize interhospital transfers. NHS England expresses condolences and acknowledges concerns, referring to existing service specifications and the GIRFT program, while noting local arrangements are for the involved providers to respond to, and that they will consider these in due course. The UKKA and BTS will share recommendations with kidney care and transplant communities, contact patient associations, and share information with the Royal College of Physicians Patient Safety Committee. George Eliot Hospital received management guidelines from UHCW's Renal Team, shared posters for dissemination on 12 December 2024, and included information on the guidelines in daily briefings from 16-20 December 2024, emailing guidelines to all doctors and consultants on 17 December. UHCW will be the primary specialist transfer centre for all renal patients admitted to peripheral hospitals, regardless of their parent specialist unit, following shared guidelines and SLA. GEH confirms switchboard now has master copy of local specialist centre contact details following UKKA/BTS recommendations.

Noted (AI summary) NHS England expresses condolences and describes the Maternal Medicine Networks established across England; they support revision of the Royal College of Pathologists’ guidelines for urgent reporting of LFTs to incorporate different levels for pregnancy. UHBW will await national guidance from the Royal Colleges regarding a recommended reference range for urgent reporting of LFTs in pregnancy, and then set up a task and finish group to implement these across the Trust. If no national guidance is available, UHBW will look to change the reference range locally. The RCOG acknowledges the concerns raised and highlights existing online learning resources and escalation protocols, while suggesting the Royal College of Pathologists review its guidance on urgent reporting levels of LFTs for pregnant women. The Royal College of Pathologists states that its guidance on communicating critical pathology results is advice to pathologists and that individual cut-offs should be agreed locally with clinicians. The need to agree local cut offs with clinicians will be emphasised in the next revision of this document.