Patient safety 5 – The impact of healthcare inequality on patient safety
02/07/24 • 60 min
Health inequalities are widening in paediatrics. Those that are more disadvantaged experience more safety issues whilst in health care. If we can make our healthcare systems more equitable for the children and young people we can for, they will be safer in our care.
In episode 5 of our series on paediatric patient safety, we speak with Dr Helen Stewart, Dr Cian Wade and Dr Mimi Malhotra to explore how patient safety and health inequalities are inextricably linked. Tackling healthcare inequalities can improve safety and vice versa.
Dr Stewart shares her knowledge and experience as the RCPCH Officer for Health Improvement as to how our children are impacted by health inequalities. Dr Wade and Dr Malhotra discuss their BMJ paper, Action on patient safety can reduce health inequalities, and explore some of the improvement avenues that are available to clinicians and service providers.
Thank you for listening.
Dr Natalie Wyatt, RCPCH Clinical Fellow and Jonathan Bamber, RCPCH Head of Quality Improvement | Produced by 18Sixty
Please be advised that this podcast series contains stories relating to child death and harm. All views, thoughts and opinions expressed belong to the guests and not necessarily to their employer, linked organisations or RCPCH.
About the Patient Safety series
As doctors we ‘first, do no harm’. However, the systems in which we work are rife with safety issues and resultant harm. In thinking about how to improve this, we have brought together leaders in the field to discuss challenging and thought-provoking issues around keeping our children safe in healthcare settings.
We hope you will be entertained, educated and energised to make strides in improving the safety of the children that you care for.
The RCPCH Patient Safety Portal has lots of resources, including a wealth of learning about paediatric patient safety. The RCPCH health inequalities programme of work can be found on our key topics pages.
It is imperative to turn this knowledge into action through improvement activities.
About the speakers
- Dr Helen Stewart is a Consultant in Paediatric Emergency Medicine at Sheffield Children’s Hospital. She also has an interest in public health and health inequalities, which has led to her becoming the Officer for Health Improvement at RCPCH.
- Dr Cian Wade completed a National Medical Director Clinical Fellowship with NHS England. He is a Fulbright Scholar who recently completed a Master of Public Health at Harvard University and now consults for health systems and healthcare providers.
- Dr Mimi Malhotra completed a National Medical Director Clinical Fellowship with the Health Foundation. Dr Malhotra continues to work as a respiratory trainee in London with ab honorary clinical lectureship at UCL.
Topics/organisations/papers referenced in this episode
- Wade, C, Malhotra, A.M., et al (2022). Action of patient safety can reduce health inequalities. BMJ
- North West & North Wales critical care transport service
- Michael Marmot
- Royal College of Emergency Medicine (RCEM)
- RCPCH Health Improvement Committee
- National Medical Directors Fellowship
- The Health Foundation
- RCPCH Child health inequalities driven by child poverty in the UK - position statement
- Increased risk of perioperative pulmonary embolism and sepsis in black patients (Urban Institute)
- Increase risk of adverse drug events in black people (Medical Care)
- MBRRACE study: A comparison of the care...
Health inequalities are widening in paediatrics. Those that are more disadvantaged experience more safety issues whilst in health care. If we can make our healthcare systems more equitable for the children and young people we can for, they will be safer in our care.
In episode 5 of our series on paediatric patient safety, we speak with Dr Helen Stewart, Dr Cian Wade and Dr Mimi Malhotra to explore how patient safety and health inequalities are inextricably linked. Tackling healthcare inequalities can improve safety and vice versa.
Dr Stewart shares her knowledge and experience as the RCPCH Officer for Health Improvement as to how our children are impacted by health inequalities. Dr Wade and Dr Malhotra discuss their BMJ paper, Action on patient safety can reduce health inequalities, and explore some of the improvement avenues that are available to clinicians and service providers.
Thank you for listening.
Dr Natalie Wyatt, RCPCH Clinical Fellow and Jonathan Bamber, RCPCH Head of Quality Improvement | Produced by 18Sixty
Please be advised that this podcast series contains stories relating to child death and harm. All views, thoughts and opinions expressed belong to the guests and not necessarily to their employer, linked organisations or RCPCH.
About the Patient Safety series
As doctors we ‘first, do no harm’. However, the systems in which we work are rife with safety issues and resultant harm. In thinking about how to improve this, we have brought together leaders in the field to discuss challenging and thought-provoking issues around keeping our children safe in healthcare settings.
We hope you will be entertained, educated and energised to make strides in improving the safety of the children that you care for.
The RCPCH Patient Safety Portal has lots of resources, including a wealth of learning about paediatric patient safety. The RCPCH health inequalities programme of work can be found on our key topics pages.
It is imperative to turn this knowledge into action through improvement activities.
About the speakers
- Dr Helen Stewart is a Consultant in Paediatric Emergency Medicine at Sheffield Children’s Hospital. She also has an interest in public health and health inequalities, which has led to her becoming the Officer for Health Improvement at RCPCH.
- Dr Cian Wade completed a National Medical Director Clinical Fellowship with NHS England. He is a Fulbright Scholar who recently completed a Master of Public Health at Harvard University and now consults for health systems and healthcare providers.
- Dr Mimi Malhotra completed a National Medical Director Clinical Fellowship with the Health Foundation. Dr Malhotra continues to work as a respiratory trainee in London with ab honorary clinical lectureship at UCL.
Topics/organisations/papers referenced in this episode
- Wade, C, Malhotra, A.M., et al (2022). Action of patient safety can reduce health inequalities. BMJ
- North West & North Wales critical care transport service
- Michael Marmot
- Royal College of Emergency Medicine (RCEM)
- RCPCH Health Improvement Committee
- National Medical Directors Fellowship
- The Health Foundation
- RCPCH Child health inequalities driven by child poverty in the UK - position statement
- Increased risk of perioperative pulmonary embolism and sepsis in black patients (Urban Institute)
- Increase risk of adverse drug events in black people (Medical Care)
- MBRRACE study: A comparison of the care...
Previous Episode
Patient safety 4 - Involving children, young people and their families in making healthcare safer
It is imperative that children and young people are central to the co-design and co-production of our patient safety improvement interventions.
In this episode, we speak with Dr Jane Runnacles, consultant paediatrician at St. George's Hospital, and Dr Victoria Dublon, paediatric diabetes consultant at the Royal Free Hospital. Both are champions of improvement work that puts the young person and their needs first.
As Jane and Victoria describe, involving children, young people and their families in improvement work improves the experience and outcome for all involved. There are fantastic examples of co-creating and co-producing safety improvements in healthcare.
We discuss the practicalities of how to do this and who to involve in your healthcare setting, and we hear about some of Jane and Victoria’s successes.
Thank you for listening.
Dr Natalie Wyatt, RCPCH Clinical Fellow and Jonathan Bamber RCPCH Head of Quality Improvement Produced by 18Sixty
Please be advised that this podcast series contains stories relating to child death and harm. All views, thoughts and opinions expressed belong to the guests and not necessarily to their employer, linked organisations or RCPCH.
About the patient safety series
As doctors we ‘first, do no harm’. However, the systems in which we work are rife with safety issues and resultant harm. In thinking about how to improve this, we have brought together leaders in the field to discuss challenging and thought-provoking issues around keeping our children safe in healthcare settings.
We hope you will be entertained, educated and energised to make strides in improving the safety of the children that you care for.
The RCPCH Patient Safety Portal has lots of resources. And our engaging children and young people web pages can help you get started on your engagement journey to effectively work with children and young people to improve their healthcare.
Dr Victoria Dublon is based at the Royal Free Hospital and part of the Trust-wide diabetes team. She has been a paediatric diabetes consultant for eight years, working primarily at the Royal Free Hospital as well as running clinics at Barnet Hospital and Chase Farm Hospital. As a registrar, she trained in adolescent health as well as endocrinology and diabetes and this continues to be a big part of her work. Victoria is involved in improvement work within the department as well as being a champion of ‘Me First’, striving to put the young person and their needs first.
Dr Jane Runnacles is a consultant in ambulatory paediatrics at St George's hospital NHS Foundation Trust, London and clinical governance lead for her department. She has an interest in acute paediatrics, simulation and quality improvement. During her postgraduate training in London, she was awarded distinction in her MA in clinical education and spent a year as a Darzi clinical leadership fellow at Great Ormond Street Hospital. Jane is a Training Programme Director for the London School of Paediatrics and leads their leadership and QI education programmes.
Topics/organisations/papers referenced in this episode
- Great Ormond Street Hospital
- Royal Free Hospital
- Darzi Fellowship
- Peter Lachman
- RCPCH SAFE Collaborative
- RCPCH QI Central
- Don Berwick
- Whiteboard communication project (on QI Central)
- Yincent Tse
- NHS blog - Asking "What Matters To You?"
- NHS - Co-production
- Paediatric Early Warning System (PEWS)
- St George's Hospital
Next Episode
Child health and climate change: Uganda
Less predictable weather in the past several years in this east African country have made it increasingly difficult to grow crops, leading to food shortages and skyrocketing prices. There are broader consequences for children's health, too, as Eva Odongpiny, a pharmacist in Uganda, discusses with us. These include an increased vulnerability to diseases like HIV and cholera, air pollution and water scarcity.
This is the first episode in our three-part series on the impacts of climate change on children's health around the word. Host, Dr Bernadette O’Hare, chair of the international workstream of the RCPCH climate change working group, speaks with Eva who has firsthand experience of the environmental challenges children - and health services - face.
Eva explains how the imbalance between supply and demand of food has resulted in widespread hunger and malnutrition. She talks too about how forced migrations due to flooding interrupts normal life routines. And that can impact adherence to medicines, such as antiretrovirals. And, Eva and Bernie explore the mental health toll on children, as the environmental challenges contribute to rising levels of eco-anxiety.
Drawing from our recently published survey, this series aims to deepen our understanding of the risks posed by climate change, particularly for the world’s most vulnerable population: children. We hope to inspire action to tackle climate change to protect children in Uganda and around the globe. So, tune in to learn more about how we can all contribute to creating a safer, healthier future for children everywhere.
Resources:
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