Jump to content
  • articles
    6,946
  • comments
    80
  • views
    5,194,523

Contributors to this article

About this News

Articles in the news

 

USA: What is the healthcare cost of racial health disparities, inequity?

There is a considerable human and healthcare cost that could have been avoided at the onset of COVID-19 had more been done to ameliorate eventual racial health disparities, amounting to thousands of lives lost and billions of dollars spent, according to analysis from Altarum on behalf of Episcopal Health Foundation.

Using figures up until the end of September 2020, the researchers found that had Black and Hispanic people in Texas been hospitalised at the same rate as their White counterparts, the state would have seen 24,000 fewer hospitalisations. That would have amounted to $550 million in healthcare cost savings, the analysis showed.

That is not to mention the human costs associated with racial health disparities during the pandemic. Had Black and Hispanic patients had the same COVID-19 mortality rates as White people, the state of Texas would have seen about 5,000 fewer deaths, cutting the total number of COVID-19 deaths in the state by 30%.

“These numbers are a glaring reminder of how non-medical factors like economic status and living conditions impact health and how COVID-19 is highlighting that in the worst way,” Elena Marks, president and CEO of the Episcopal Health Foundation, said in a statement. “The human and economic costs of health disparities continue to grow during the pandemic and we’re learning why we can’t address them through medicine alone. Something has to change in Texas.”

Read full story

Source: Patient Engagement HIT, 13 January 2021

Read more
 

More than 1,000 patients in one region awaiting urgent cancer surgery

More than 1,000 people needing urgent cancer surgery in London have no date for their treatment, HSJ can reveal.

A document leaked to HSJ showed that, at the end of last week, more than 1,000 of London’s cancer surgery patients without an appointment date were defined as P2 (priority two), meaning they needed to be seen within four weeks or risk their condition worsening.

The report seen by HSJ also showed more than 300 P2 patients had their surgery postponed in the past week, a statistic NHS England London has so far refused to disclose.

Hospitals in the capital are facing their highest-ever COVID-19 occupancy rates, with surgical lists at many trusts being cancelled.

Meanwhile, a separate NHSE London document reported in the press this week revealed: “Most NHS Green sites [those cancer surgery sites intended to be covid-free to avoid risk to very frail patients] are now compromised with only a limited number of cases being undertaken in NHS sites this week”.

The papers also said the current plans to increase indepedent sector capacity usage were “insufficient to offset the NHS shortfall”, and noted there was a two week lead-in time to move patients into private hospitals “based on clinical rotas, theatre bookings, [and] patient isolation”.

Read full story (paywalled)

Source: HSJ, 12 January 2021

Read more
 

Patients need a voice if we are to avoid the medical harm of the past

In July last year, the Independent Medicines and Medical Devices Safety Review – chaired by Baroness Cumberlege— published its landmark report, First Do No Harm. It followed a two-year review of harrowing patient testimony and a large volume of other evidence concerning three medical interventions: Primodos, sodium valproate and pelvic mesh.

Yesterday, in a written statement to Parliament, the Minister for Patient Safety, Suicide Prevention and Mental Health, Nadine Dorries, gave an update on the government’s response to the recommendations of the Cumberlege Review.

In an article in The Times today, Baroness Cumberlege welcomes that the government has now accepted the need for a patient safety commissioner for England and the amendment to the Medicines and Medical Devices Bill, which is being considered in the House of Lords today, which she hopes "will swiftly become law".

However, she also states that "... a full response to the review's is still outstanding 6 months after publication. Action is urgently needed to ensure we help those who have already suffered and reduce the risk of harm to patients in future".

Read full story (paywalled)

Source: The Times, 12 January 2021

Read more

Third of region’s ICUs exceed ‘maximum safe capacity’

More than a third of critical care units in the East of England are either at or have exceeded their maximum surge capacity, information leaked to HSJ reveals, and all but one are above their normal capacity.

Data from the region’s critical care network shows that as of 11 January, seven of the region’s 19 critical care units were either at 100% of, or had exceeded, what is known as ”maximum safe surge” capacity. This represents the limit of safe care, mostly based on available staffing levels. The units have opened more beds, but they require dilution of normal staffing levels.

Across the East of England, 482 of the region’s current 491 intensive care beds, after the opening of surge capacity, were occupied. This included 390 patients in intensive care with confirmed covid-19, six with suspected covid and 86 non-covid patients.

It gives a regional occupancy rate of 91 per cent against total “safe surge” capacity.

Published government figures show the rapid increase in demand for intensive care in the East of England in the last two weeks — the number of patients with covid in mechanical ventilation beds is more than double what it was just after Christmas.

Read full story (paywalled)

Source: HSJ, 11 January 2021

Read more

Thousands of women had abortions while ‘struggling to access contraception during Covid crisis’

Thousands of women have had abortions after falling pregnant while having difficulties accessing contraception during the pandemic, healthcare providers have warned.

Sexual health clinics have been forced to shut or run reduced services while staff are transferred to work with Covid patients or have to self-isolate – with the profound disruption leaving many women unable to access their usual methods of contraception.

Many women are struggling to get the most effective long-acting contraceptive choices of a coil or an implant due to these requiring face-to-face appointments which have largely been suspended as consultations are carried out remotely via phone or video call to curb the spread of COVID-19.

British Pregnancy Advisory Service, the UK's largest abortion provider, told The Independent they provided the progestogen-only contraceptive pill to almost 10,000 women undergoing an abortion between May and October last year.

Katherine O’Brien, a spokesperson for the service, said: “Many of these women will have fallen pregnant after struggling to access contraception, so there really is a huge unmet need for contraceptive services which will only worsen as lockdown and Covid continues.

“We routinely hear from women during the pandemic who simply can’t access their regular method of contraception because of clinics closing or staff being deployed elsewhere or staff self-isolating.”

Read full story

Source: The Independent, 9 January 2021

Read more
 

Covid: Gut bacteria may influence disease severity, study suggests

A coronavirus patient's gut bacteria may influence the length and severity of their infection and their immune response to it, a new study suggests. A team of researchers at The Chinese University of Hong Kong examined whether the variety and quantity of microbiome played a role in COVID-19 infections.

Researchers found that patients with COVID-19 were depleted in gut bacteria known to modify a person's immune response, and that this depletion appeared to persist 30 days after the virus had gone.

Gut bacteria — or gut microbiome — help to digest food. But research increasingly shows that gut bacteria also affect our health.

The study, published in the journal Gut, found that the composition of gut microbiome had changed in COVID-19 patients, compared to those who did not have the infection.

It said that gut microbiome could be involved in the "magnitude of COVID-19 severity possibly via modulating host immune responses".

Read full story

Source: The Independent, 12 January 2021

 

Read more
 

Global health insurance card to replace EHIC under new rules

UK residents can apply for a Global Health Insurance Card (GHIC) to access emergency medical care in the EU when their current EHIC card runs out.

Under a new agreement with the EU, both cards will offer equivalent healthcare protection when people are on holiday, studying or travelling for business. This includes emergency treatment as well as treatment needed for a pre-existing condition.

The new GHIC card is free and can be obtained via the official GHIC website.

Current European Health Insurance Cards (EHIC) are valid as long as they are in date, and can continue to be used when travelling to the EU. 

You don't need to apply for a GHIC until your current EHIC expires. People should apply at least two weeks before they plan to travel to ensure their card arrives on time.

Read full story

Source: BBC News, 11 January 2021

Read more

GP surgeries offered £1,000 to cancel second dose Covid jab appointments in roll-out chaos

GPs are being paid £1,000 to cancel second dose appointments for Covid jabs and given a script to follow to deal with angry patients amid growing chaos in the roll-out of the vaccine programme.

Practices have been offered the payments to cover the workload of postponing hundreds of patients who were set to have their second dose and booking new ones in their place.

NHS sources said the shift has contributed to delays in rolling out the programme. Some GPs have refused to postpone the appointments, with practice managers saying it was "too cruel" to dash the hopes of those who were booked for a second jab.

In December, everyone given a first vaccine by Pfizer was told to come back for their second dose three weeks later. But the strategy was changed 10 days ago in a bid to get a first dose to more of the population more quickly.

Patients are now being told they will have to wait 12 weeks for the second dose, with a reassurance from health officials that the longer gap could strengthen its effectiveness.

By the time the plan was changed, around one million people had already been booked in for their second dose. GPs are now under orders to postpone such appointments and instead give the slots to those awaiting a first dose. 

Read full story

Source: The Telegraph, 8 January 2021

Read more

NHSE orders further dilution of staffing ratios to help double ICU capacity

NHS England has told hospitals in the Midlands to further dilute their staffing ratios so critical care capacity can be doubled, HSJ has learned.

In a letter sent on 9 January to the boards of all trusts in the region, national leaders said they needed to “dilute nursing ratios beyond the current ask of 1:2” to achieve the significant increase in capacity.

In November, all trusts in England were told they could dilute staffing ratios in critical care from the standard one nurse to one patient ratio, to one nurse to two patients. Informal reports from around the country suggest some trusts have already had to move beyond these ratios.

The letter said trusts had already been asked to surge capacity to 150% cent of the normal baseline on 6 January, and were expected to be at 175% today. But it said some units were still not achieving this and the region was “transferring patients to other regions.”

It added: “In addition to this, you need to have well developed plans in place that can be rapidly activated to surge to 200% of baseline, which may need to be enacted in the coming days.

Read full story (paywalled)

Source: HSJ, 11 January 2021

Read more
 

New partnership to improve patient safety in South East London ICS

Guy’s and St Thomas’ NHS Foundation Trust will work with Omnicell to develop a European technology-enabled inventory optimisation and intelligence service which will be initially implemented across South East London Integrated Care System (ICS). This partnership will encompass all six acute hospital sites within the South East London ICS, including Guy’s & St Thomas’, Kings College Hospital NHS Foundation Trust and Lewisham & Greenwich NHS Trust.

The project will have the following goals:

  • Develop analytics and reporting tools with a goal of improving patient safety, achieving increased operational efficiency and cost efficiencies
  • Utilize the analytics and reporting tools with a goal of achieving agreed efficiencies and cost reductions
  • Demonstrate the impact of managing clinical supplies and medicine spend together at scale
  • Build a service model for the ICS which can be scaled up and adopted by other hospital groups in the UK

Read the full article here

Read more
 

Mortality rate for Black babies is cut dramatically when they’re delivered by Black doctors, researchers say

Rachel Hardeman has dedicated her career to fighting racism and the harm it has inflicted on the health of Black Americans. As a reproductive health equity researcher, she has been especially disturbed by the disproportionately high mortality rates for Black babies.

In an effort to find some of the reasons behind the high death rates, Hardeman, an associate professor at the University of Minnesota School of Public Health, and three other researchers combed through the records of 1.8 million Florida hospital births between 1992 and 2015 looking for clues.

They found a tantalising statistic. Although Black newborns are three times as likely to die as White newborns, when Black babies are delivered by Black doctors, their mortality rate is cut in half.

"Strikingly, these effects appear to manifest more strongly in more complicated cases," the researchers wrote, "and when hospitals deliver more Black newborns." They found no similar relationship between White doctors and White births. Nor did they find a difference in maternal death rates when the doctor's race was the same as the patient's.

Read full story

Research paper

Source: The Washington Post, 9 January 2021

Read more

NHS COVID-19 jab letters 'confusing over-80s'

People waiting to receive the COVID-19 vaccine say they are confused by NHS letters inviting them to travel to centres miles away from their homes.

The first 130,000 letters have been sent to people aged 80 or older who live about 30 to 45 minutes' drive away from one of seven new regional centres.

But patients, many of whom are shielding, questioned why they had to travel so far in a pandemic.

Local jabs are available to people if they wait, the NHS said.

The seven centres include Ashton Gate in Bristol, Epsom racecourse in Surrey, London's Nightingale hospital, Newcastle's Centre for Life, the Manchester Tennis and Football Centre, Robertson House in Stevenage and Birmingham's Millennium Point.

Mary McGarry from Leamington Spa in Warwickshire told BBC News that her letter points to an NHS online booking page which suggests she would have to take her husband, who has cancer and a lung disease, 20 miles to Birmingham.

"We're very reluctant to go into Birmingham city centre," she said.

"If we can't get somebody to take us, we'd have to go on the train but we're shielding because my husband's got poor health.... we want to know why we've got to travel that far?"

People will not miss out on their vaccination if they do not use the letters to make an appointment at one of the centres, the NHS said.

Read full story

Source: BBC News, 11 January 2021

Read more
 

Hospital's oxygen supply in 'critical' situation

A hospital's oxygen supply has "reached a critical situation" due to rising numbers of COVID-19 infections.

A document shared with the BBC showed Southend Hospital has had to reduce the amount it uses to treat patients. It said the target range for oxygen levels that should be in patients' blood had been cut from 92% to a baseline of 88-92%.

Hospital managing director, Yvonne Blucher, said it was "working to manage" the situation.

"We are experiencing high demand for oxygen because of rising numbers of inpatients with Covid-19 and we are working to manage this," she said.

Read full story

Source: BBC News, 11 January 2021

Read more
 

US: 10 top patient safety issues for 2021

The Becker's Clinical Leadership & Infection Control editorial team chose the top 10 patient safety issues for healthcare leaders to prioritise in 2021, presented below in no particular order, based on news, study findings and trends reported in the past year.

  1. COVID-19
  2. Healthcare staffing shortages
  3. Missed and delayed diagnoses
  4. Drug and medicine supply shortages
  5. Low vaccination coverage and disease resurgance
  6. Clinical burnout
  7. Health equity
  8. Healthcare-associated infections
  9. Surgical mistakes
  10. Standardising safety efforts.

Read full story

Source: Becker's Healthcare, 30 December 2020

Read more
 

Coronavirus hospital patients still have symptoms six months later, study finds

Three quarters of patients surveyed at Jinyintan Hospital in Wuhan, China had at least one ongoing symptom

The majority of people admitted to hospital with coronavirus still had symptoms six months after getting ill, a new study has revealed.

Over three quarters of Covid patients surveyed at Jinyintan Hospital in Wuhan, China had at least one ongoing symptom – with the most commonly reported being fatigue or muscle weakness. A total of 1,733 patients, with a median age of 57, were examined for the study between 7 January and 29 May last year. At a follow-up, 76% of patients reported at least one ongoing symptom.

Read the full article here

Read more
 

Trust boss warns region faces ‘absolute crisis’ with trusts ‘hanging on by their fingernails’

Hospital chiefs in the South West have warned the region will not avoid the extreme pressures felt by other parts of the NHS amid rapidly rising numbers of COVID-19 inpatients.

The region was the least affected area of England during the pandemic’s first wave, but the medical director of two acute trusts yesterday predicted a “tidal wave” of COVID-19 coming to the West Country.

Adrian Harris, medical director at Royal Devon and Exeter Foundation Trust and Northern Devon Healthcare Trust (NDHT), said the region faced an “absolute crisis” and individual trusts would be “hanging on by their fingernails”.

His comments, made at NDHT’s board meeting, came on the same day HSJ revealed the South West region now has the fastest growth in COVID-19 inpatients. Although the region is England’s least densely populated, it also has the lowest hospital capacity per capita in the country.

Dr Harris said: “We hope and we pray that the lockdown has come in time for Devon. My personal view — and of my colleagues around the country — is that there’s a tidal wave of COVID-19 coming to the West Country."

“We are preparing to be hit as hard as the East of England. If we are hit as hard, we will be hanging on by our fingernails and we are planning accordingly.”

Read full story (paywalled)

Source: HSJ, 8 January 2021

Read more
 

Pfizer vaccine 'works' against key variant mutation, study suggests

The Pfizer/BioNTech vaccine can still target a key mutation that has emerged in two new variants of coronavirus, laboratory studies show. 

However, this is only one of many mutations that are found in the new forms of the virus. So while the study has been welcomed, it is not being seen as definitive scientific evidence about how the vaccine will perform.

New variants have been detected in the UK and South Africa. Both forms of the virus are spreading more quickly and this has raised questions over what level of protection vaccines can offer against them.

The widely held view is that vaccines will still work, but researchers are on the hunt for proof.

Read full story

Source: BBC News, 8 January 2021

Read more
 

Leak reveals urgent care patients face 30-hour waits because of covid pressures

Patients calling NHS 111 in London could face a 30-hour wait before being admitted to a hospital bed, the capital’s ambulance service has warned.

Slides presented by London Ambulance Service Trust at a webinar with NHS London this week showed “category three” patients faced long delays at all stages of the process.

The length of each stage was said to be as follows: having calls answered at 111 centres (20 mins); the “revalidation” of the call before it is passed to 999 (two hours); 10 to 12 hour waits for an ambulance; and similar waits in emergency departments before being admitted to a bed.

Category three calls are considered urgent, but not immediately life-threatening. The calls could involve abdominal pain, uncomplicated diabetic issues and some falls. Category three patients are among those the NHS is encouraging to call first, rather than going straight to accident and emergency, as part of the flagship “111 first” drive designed to produce pressure on emergency care. 

Normally, the pathway from a 111 call being made to a patient being admitted to a bed would take nine hours with a faster response at all stages, the slides suggest. But the pressure across the NHS from covid cases is leading to much longer waits.  

Read full story (paywalled)

Source: HSJ, 8 January 2021

Read more

Moderna becomes third Covid vaccine to be approved for use in UK

The Moderna COVID-19 vaccine has become the third to be approved by the UK.

The US pharmaceutical company’s jab was given the green light by Britain’s regulator and doses will be available in the spring.

The announcement comes as the rollout of the Pfizer and Oxford vaccines is scaled up to meet Boris Johnson’s target of immunising all care-home patients by the end of the month, with 1,000 vaccination centres expected to be operational by Sunday. 

The government has also purchased an additional 10 million doses of the Moderna vaccine on top of its previous order of 7 million, taking the total to 17 million.

Supplies will begin to be delivered to the UK once Moderna expands its production capability, the Department of Health and Social Care said.

The Medicines and Healthcare products Regulatory Agency (MHRA) accepted the recommendation of the Commission on Human Medicines and authorised the Moderna vaccine following months of rigorous clinical trials and extensive analysis of the vaccine’s safety, quality and effectiveness.

The jab is 94% effective in preventing disease, including in the elderly.

Read full story

Source: The Independent, 8 January 2021

Read more
 

Hospital watchdog chief calls for honesty over Covid pandemic’s impact on patient care

The chief inspector of hospitals has called for honesty about the impact of the coronavirus pandemic on patients warning poor care could become normalised.

Professor Ted Baker told The Independent it was vital staff continued to report incidents and revealed the Care Quality Commission had seen a 60% rise in whistleblowing concerns during the last national lockdown in November.

He said staff must report incidents and be free to speak up about any concerns as well as being transparent with families where things have gone wrong.

He emphasised that where a patient was unable to get the care they clinically needed because of the demand on services, this would amount to a notifiable patient safety incident.

Professor Baker’s comments follow multiple anonymous leaks from NHS staff to The Independent in recent weeks, showing how bad the situation has become in some hospitals. Many staff have only spoken out on condition of anonymity.

Many hospitals have declared major incidents, cancelled operations and been forced to stretch staffing ratios to unsafe levels to cope with the increasing numbers of COVID-19 patients.

Read full story

Source: The Independent, 7 January 2021

Read more
 

There are so many Covid patients, younger this time. But my hospital is full

"There can be no debate: this is now much, much worse than the first wave", says a NHS consultant.

"Truly, I never imagined it would be this bad.

Once again Covid has spread out along the hospital, the disease greedily taking over ward after ward. Surgical, paediatric, obstetric, orthopaedic; this virus does not discriminate between specialities. Outbreaks bloom even in our “clean” areas and the disease is even more ferociously infectious. Although our local tests do not differentiate strains, I presume this is the new variant.

The patients are younger this time around too, and there are so many of them. They are sick. We are full."

Read full story

Source: The Guardian, 7 January 2020

Read more
 

Hospital declared it may ‘refuse critical care’ as ‘overwhelmed’ by covid

A hospital in the South East today declared a level of critical care alert meaning that it may be forced into ‘refusal or withdrawal of critical care due to resource limitation’ because it has been ‘overwhelmed’ — but later claimed it was an ”administrative error”.

Data from an internal NHS dashboard for critical care, seen by HSJ, showed today Darent Valley Hospital, near Dartford in Kent, declared it was at “CRITCON level four”. 

CRITCON level four declarations are extremely rare. In guidance they are known as “Triage - emergency” and defined as: “Resources overwhelmed. Possibility of triage by resource (non-clinical refusal or withdrawal of critical care due to resource limitation).”

The definition continues: “This must only be implemented on national directive from [NHS England] and in accordance with national guidance.”

Dartford and Gravesham Trust, which runs the hospital, replied to HSJ more than five hours after it was contacted, and after publication of the story, to say: “This was a purely administrative error which was quickly rectified.” The level has not however been changed so far on the live dashboard, HSJ has confirmed.

Read full story (paywalled)

Source: HSJ, 7 January 2021

Read more
 

Two more life-saving Covid drugs discovered

Two more life-saving drugs have been found that can cut deaths by a quarter in patients who are sickest with Covid.

The anti-inflammatory medications, given via a drip, save an extra life for every 12 treated, say researchers who have carried out a trial in NHS intensive care units.

Supplies are already available across the UK so they can be used immediately to save hundreds of lives, say experts. The UK government is working closely with the manufacturer, to ensure the drugs - tocilizumab and sarilumab - continue to be available to UK patients.

As well as saving more lives, the treatments speed up patients' recovery and reduce the length of time that critically-ill patients need to spend in intensive care by about a week.

Both appear to work equally well and add to the benefit already found with a cheap steroid drug called dexamethasone.

Read full story

Source: BBC News, 7 January 2021

Read more
 

Treasury ‘the barrier’ as full hospitals desperate to discharge patients to social care

The government is being pressed to urgently pay care homes to take on thousands of patients from hospitals, many of which are on course to be overwhelmed by COVID-19 patients.

Hospitals, particularly in London and the surrounding areas, are seeing very high and rapidly growing numbers of covid-19 admissions, and are running out of options to free up beds. Multiple senior NHS leaders said they need to discharge more patients to care homes, but that this had become increasingly difficult.

Beds in many care homes are lying empty, but many care providers are refusing to accept residents where there is a risk of introducing covid-19 and fear of repeating the disaster of the spring in the sector.

Part of the problem is some care providers which would otherwise become covid-designated homes say they are not insured for the risk of doing so.

HSJ understands national officials in the NHS and government are now considering options to try to alleviate the problem, amid urgent requests from local NHS leaders, including paying for the additional insurance cost. However, sources said the Treasury had not yet been willing to foot the bill.

Read full story

Source: HSJ, 7 January 2021

Read more
×
×
  • Create New...