Harrogate hospital has “learned lessons” following the death of a woman who became disconnected from her ventilator when she was left alone in a room with the door closed.

Karen Smith was 44 when, in October 2020, she was admitted to the hospital with covid.

She was put on a temporary intensive care ward that had been set up by Harrogate and District NHS Foundation Trust to deal with the high demand of the pandemic.

An inquest heard this week Ms Smith died on the ward after her oxygen mask became disconnected.

The continuous positive airway pressure (CPAP) oxygen machines used on the ward were not connected to the nurses’ station in the way they were on the established ICU.

When Ms Smith’s mask came off and the tube became disconnected around 5am on Saturday, October 24, although the machine’s alarm sounded, there was no way of it sending a signal to the nurses’ station for a rapid response.

The previous day, the hospital’s infection control team had visited the ward and recommended that the doors to each bay, which had been open, should be closed to help reduce the spread of covid.

Dr David Earl, a consultant in anaesthesia and critical care, told the inquest:

“The doors were closed on that Friday and I don’t think enough work was done to recognise the implications of how that might make nursing quite difficult, because you can’t hear behind the doors.

“This is when things start to go a bit wrong, I think, on that Friday.”

On the Saturday evening, a nurse who was covering a meal break had left Miss Smith’s bay to go to the toilet urgently. She had no way of contacting another nurse to cover for her, but believed the original nurse was about to return from her break.

The inquest heard that, during the pandemic, staff were required to remove extensive personal protective equipment (PPE) and go to a bathroom nearby, rather than the one on the ward, which took much longer than usual.

When the nurse she was covering for returned, the disconnection was noticed and Ms Smith’s mask had been completely removed.

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Dr Earl told the inquest many patients find CPAP masks uncomfortable and can attempt to remove them when slightly disorientated, such as when waking up.

The machine’s log indicated Ms Smith had been without hers for around four-and-a-half minutes. A new mask was immediately brought from the store cupboard nearby.

Staff said they hoped the short time of disconnection meant that Ms Smith would not have been affected by the lack of oxygen supply.

The inquest heard that, although her blood oxygen levels quickly rose again, it became apparent to the team on the next shift that she was more sleepy and less responsive than usual.

That night, as her condition further deteriorated, staff called her mother, but she was not allowed to come into the hospital because of covid restrictions.

Addressing Ms Smith’s mother Audrey and brother John, who were at the inquest, Dr Earl said:

“At the time, we were following national guidelines about visiting.

“As someone who worked through all of this, not having visitors all the time was terrible. On intensive care, we spend a lot of time with families getting to know them. To suddenly not have families there was absolutely awful for us, but we know it was even worse for families like yourselves.

“It we could go back, we would get you straight in when we knew [she was dying]. Now, that’s the national guidelines.”

Ms Smith said her daughter had been well enough the day before to be messaging her friends. However, Dr Earl said given the number of days she had been reliant on the CPAP without any sign of improvement, his experience with covid patients suggested she was more likely than not to have succumbed to the virus in the end.

Walkie-talkies introduced

Dr Earl said the hospital had “learned lessons” from Ms Smith’s death and a number of changes had been implemented to prevent the same situation arising again, including changes to nurse rostering and the introduction of walkie-talkies to allow nurses to communicate with each other even when in separate rooms.

He added:

“We realise we can’t make everything perfect, but we try to list all the things where we think there’s a potential danger there and try to minimise them.

“In this new area, we had one of those risk registers and recognised it was constantly evolving, but in these circumstances, it was the best we could do.”

Delivering a narrative conclusion, senior coroner for North Yorkshire Jonathan Heath said Ms Smith, who lived in Wetherby, had died from a hypoxic brain injury caused by becoming disconnected from her oxygen machine. A secondary cause of death was her high body mass index.

Mr Heath said there was no evidence of how Ms Smith’s mask came to be removed and the tube disconnected, so he did not want to make any assumption.

Mr Heath said:

“I am satisfied that a ‘prevention of future deaths’ report is not required.

“Whatever I would be saying to the hospital appears to have been addressed already.”

North Yorkshire County Council has put town centres at the heart of its plans to revitalise culture in the county.

The council has begun to roll out its new cultural framework after two years of consultations across the county.

A report for the framework found that the pandemic had a large impact on town centre visitor numbers.

Along with the growth of online shopping, it argued that high streets needed new ways of staying relevant, with cultural attractions seen as key.

The report states that:

“Town centres traditionally serve their rural hinterland’s needs for retail and civic amenities but as shopping and banking move online culture can help in animating spaces through activity or art, driving footfall and creating a buzz and amplifying sense of identity.”

Ideas on how to do this include promoting different towns’ heritages, installing public art and working with local stakeholders.

Over the last year, more cultural events have returned to the district’s towns as organisers recognise the important role they play in attracting visitors.

In July, Harrogate staged its first carnival since 2019, which saw street theatre, international street food and music performances. In September, the Ripon Civic Society is organising Heritage Open Days across the town and the city is also hosting a four day Poetry Festival which is growing in popularity.

A possible redevelopment of the Royal Pump Rooms Museum in Harrogate was also reported to be in the planning stage.

The 2022 Harrogate Carnival

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The consultation on the state of culture in North Yorkshire began in March 2020, before the first Covid lockdown.

The framework also recognises the impact that the lockdowns had on people’s wellbeing. It found:

“During the Covid pandemic issues of social isolation and loneliness have been exacerbated. A key factor in reducing loneliness is the social interaction experienced while participating in cultural activity.”

Other aspects of the framework concern regeneration, developing and supporting cultural industries, improving health and wellbeing, and supporting community development.

The plans are to be discussed at the county council’s area committees, including the one for the Skipton and Ripon constituency next week.

The framework was developed in partnership between the district and county councils, including Harrogate Borough Council.

Four Harrogate friends are to team up and cycle 1,573km on stationary bikes to raise money for charity after the death of two close friends.

Henry Bartle, Ollie Ward, Joe Braham and Jeremy Butterfield will collectively cycle the distance of Harrogate to Monaco within 24 hours in time for the Grand Prix.

The money will be raised in memory of James Hindmarsh and David Brown, who both passed away last year.

All four of the group will cycle at the same time on May 27 and will aim to complete 16km every hour, then will rest the remaining time of the hour.

Jeremy Butterfield, a close friend of James and David, said:

“Both James and Dave loved F1 so it was only right we all ‘travelled’ to the Monaco Grand Prix this year.

“James and Dave never gave up in their fights and we will continue their legacies to help others fight the challenges they are facing.

“Every cycle of the bike they will be with us (probably with a smile and a Peroni in hand). Forever in our hearts James & Dave, we love you and we will make it to Monaco together.”

James Hindmarsh (left) and David Brown (Right)

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James passed away from a rare form of cancer in 2021, whilst David lost his battle with covid last December.

Half of the funds raised from the bike ride will be donated to Leeds Hospitals Charity, who will allocate it to Leeds Cancer Centre.

Jeremy said:

“This was a centre that was very close to James’ heart. The money raised will go towards support and help for others fighting the same fight our best mate did so bravely.”

The other half of the funds will be donated to The David Brown Foundation.

Jeremy added:

“Dave was the most thoughtful, caring, gentle and humble human who did so much for children and teenagers across the district. We will follow on in Dave’s footsteps and support children’s education across the UK.”

Last year, the four friends took part in three marathons in three days, a ski tour and climbed the three peaks. They initially tried to raise the money for James’ treatment, but as he died they decided to donate the £33,275 to the Sarcoma charity.

The cycle will take place in the window of Rocca, Harrogate. You can donate to the #DOIT4JAMES&DAVID page here. 

Artizan café, which opened on Cambridge Road late last year, is set to expand to an upper floor.

The floor was initially used for offices and storage space. Due to increased demand, it will now be opened up to the public as an extended café area.

Artizan International was founded by Suzie Hart MBE in 2013.

Ms. Hart will be behind the design of the second floor, which will include the same tiles, mosaics and artisan textures on the ground floor.

The café was introduced to help people with disabilities learn hospitality skills and get into the job market.

Anna Maria Wilson, part-time manager at Artizan café, said:

“It was always in the plan. We are definitely doing it sooner than was anticipated because there was that increased demand.

“We have been so busy, that we needed the extra space. It is beautiful up there, and we aim for it to be more of a tranquil and relaxed area for people to enjoy.”

Although the official date is not yet known, the second floor should be open in a couple of weeks for customers to enjoy.

Specsavers Harrogate to join CUES scheme

Specsavers Harrogate is joining the Covid-19 Urgent Eye Service (CUES) scheme

Specsavers Harrogate has announced that it will be joining the NHS Covid-19 Urgent Eye Service programme.

Those with urgent eye health issues can visit the store for treatment under the CUES scheme.

The service was launched to reduce pressure on the NHS during the coronavirus pandemic.

Patients with urgent eye issues and in need of treatment will now be able to visit Specsavers Harrogate to have vision checks, which will be covered free-of-charge by the NHS.

Robert May, optometrist director at Specsavers Harrogate, said:

“The Cues scheme has been set up as we have the expertise and equipment in-store to deal with a range of eye-related emergencies.

“We’re seeing around one hundred customers every week through the scheme, which is definitely taking the pressure off the NHS’ services and waiting times.”

You can find out more about the CUES scheme here.

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The recent rapid decline of the Harrogate district’s covid rate of infection appears to have halted, with the rate beginning to nudge up again.

A total of 226 cases were confirmed in today’s government figures, taking the seven-day infection rate to 1,073 per 100,000 people.

This is slightly up on yesterday’s figure of 1,059 and remains above both the county and England averages of 974 and 992 respectively.

Central Harrogate is worst affected, with 127 infections in the last seven days. Harrogate East has had 123 cases while Harrogate West and Pannal has had 120,

It was also revealed today that a total of 106.735 booster or third jabs have been administered in the district.

From Thursday, venues and events will no longer be required by law to use the NHS covid pass and face coverings will no longer be required by law in any setting.

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The vaccination centres at the Great Yorkshire Showground in Harrogate and Ripon Races reopen today for the first time since Christmas.

The two sites are run by Yorkshire Health Network, which represents the 17 GP practices in the Harrogate district.

The Yorkshire Event Centre at the showground will open for booked appointments from 11am until 8pm. Appointments are still available.

The site will also accept walk-ins from 11.30am today but people choosing this option may have to wait because bookings take priority.

The showground will be open at the weekend from 8.30am to 5pm for booked appointments and from 9am to 4pm for walk-ins.

All the clinics are for first, second or booster jabs for over-18s. Special clinics for 12 to 17-year-olds are put on separately.

Ripon Races will be open tomorrow and on Saturday at the usual times of 8:30am to 5pm for booked appointments and 9am to 4pm for walk-ins.

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Staff and volunteers at the Yorkshire Event Centre are due to relocate to another building at the showground on Thursday and Friday, ready for the Saturday clinic.

The new site is currently contracted for use until March. A decision on fourth vaccinations has yet to be taken.

A total of 404 infections have been recorded in the Harrogate district today — down on yesterday’s daily record figure of 493.

However, the district’s seven-day average rate of infection has risen from 1,139 and now stands at 1,329 per 100,000 people.

North Yorkshire’s rate is 1,269 and the England rate is 1,508.

Harrogate West and Pannal Ash remains the worst hit area, with 163 cases in the last seven days.

The number of people who have received a third or booster vaccine in the district stands at 101.983. A total of 364,100 vaccines have been administered.

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The daily record for covid cases in the Harrogate district has been obliterated, with 493 new infections recorded today.

Yesterday’s decline from the previous record of 330 to 279 had suggested numbers could have peaked. But today’s surge has dashed hopes.

The seven-day rate has also set a new record, now standing at 1,139 per 100,000. The North Yorkshire average is 1,140 and the England rate is 1,456.

The growth rate has jumped to 2.2. Harrogate West and Pannal Ash remains the worst hit area, with 156 cases in the last seven days.

Covid has been recorded on the death certificates of 366 people in the district, including one in the last week.

A total of 101,823 booster or third jabs have now been administered in the district.

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The covid rate increased significantly in the Harrogate district today in another sign that the Omicron variant is beginning to have an impact.

The seven-day rate leapt from 419 per 100,000 people to 476. It was 383 two days ago. It comes after another 144 daily infections were reported by NHS England.

The rate remains considerably lower than the England average of 783 but slightly above the North Yorkshire average of 444.

Harrogate West and Pannal Ash, which has had 57 confirmed cases in the last seven days, is the district’s current covid hotspot.

A total of 91,569 people in the district have received either booster or third doses of the covid vaccine.

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The Great Yorkshire Showground in Harrogate will accept walk-in patients and booked patients for booster jabs tomorrow this week.

Children aged 12 to 17 will also be able to turn-up for walk-in boosters at the showground from 1.30pm to 4.30pm tomorrow and from 9am to 12.30pm on Tuesday.

Ripon racecourse, which was not open today. is due to administer more jabs tomorrow.

The first suspected cases of the omicron covid variant have been found in the Harrogate district.

Data from the UK Health Security Agency shows there have been five possible cases so far.

in the week to December 6, one covid sample in the district failed an S-gene test, which is a sign that a sample may be omicron.

Four failed in the previous week.

The UKHSA estimates that if omicron continues to grow at the present rate, the variant will become the dominant strain, accounting for more than 50% of all covid infections in the UK by mid-December.

Dr Mary Ramsay, head of immunisation at UKHSA, said:

“These early estimates should be treated with caution but they indicate that a few months after the second jab, there is a greater risk of catching the omicron variant compared to delta strain.

“The data suggests this risk is significantly reduced following a booster vaccine, so I urge everyone to take up their booster when eligible.”

The Great Yorkshire Showground vaccine site in Harrogate is asking people to turn up for walk-in boosters between 1.30pm and 4pm today as it was busy with booked appointments this morning.

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