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Patients to wait longer for routine checks so NHS can clear record backlogs

NHS patients will wait longer for routine checks as part of a national drive to clear record backlogs.

Health officials have instructed hospitals to “repurpose” resources to focus on those waiting the longest, who are yet to have their first appointment. 

Today the NHS claimed it had “virtually eliminated” two year waits, with less than 3,000 people enduring such delays, down from 22,500 at the end of January.

Hospitals are being urged to prioritise those waiting 18 months or more, with pledges to get rid of such waits by April next year.

NHS chiefs have instructed hospitals to focus on outpatient first appointments, rather than patients who have already had treatment, and are waiting for follow-up checks.

Senior officials have said many such appointments are a “a waste of time” saying there should be more use of systems where routine slots are scrapped, and patients instead told to contact their medical team if they have particular concerns. 

The drive - which health chiefs dubbed “Super September” - will see priority given to tackling the longest waits. 

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Source: The Telegraph, 9 August 2022

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One in 25 heart attack deaths in north-east of England ‘preventable in London’

One in 25 people who die of a heart attack in the north-east of England could have survived if the average cardiologist effectiveness was raised to the London level, research shows.

The research, undertaken by the Institute for Fiscal Studies (IFS), looked at the record of over 500,000 NHS patients in the UK, over 13 years. It highlights the stark “postcode lottery” of how people living in some parts of the country have access to lower quality healthcare.

The results found that while cardiologists treating patients in London and the south-east had the best survival rates among heart attack patients, patients being treated in the north-east and east of England had the worst.

Among 100 otherwise identical patients, an additional six patients living in the north-east and east of England would have survived for at least a year if they had instead been treated by a similar doctor in London.

Furthermore, if the effectiveness of doctors treating heart attacks in these areas of the country were just as effective as the cardiologists in London, an additional 80 people a year in each region would survive a heart attack.

The research also revealed a divide between rural and urban areas of England, with patients living in the former typically receiving treatment from less effective doctors compared with those in more urban areas.

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Source: The Guardian, 9 August 2022

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Child deaths expose mental health unit pressures

Deaths, staff shortages and a culture of life-threatening self-harm are exposing deep fears about the quality of mental health care in hospitals for children and young people.

Since 2019, at least 20 patients aged 18 or under have died in NHS or privately-run units, the BBC has found.

A further 26 have died within a year of leaving units, amid claims of a lack of ongoing community support.

The NHS said it had "invested record amounts... to meet record demand".

Child and Adolescent Mental Health Services (CAMHS) units look after about 4,000 patients with many different diagnoses each year. The aim is to help them recover over a period of weeks or months through specialist care. Some patients are in and out of the units for years.

The BBC has also heard serious claims regarding the unsafe discharge of patients sent home from CAMHS hospitals.

Several former patients told the BBC they had serious self-harm incidents or tried to take their own life within days of returning home.

Parents have described being on "suicide watch" 24 hours a day, to ensure their child's safety.

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Source: BBC News, 9 August 2022

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NHS backlog of two-year waits for routine surgery in England shrinks to below 200

The backlog of people waiting more than two years for a routine operation in England has shrunk from 22,500 at the start of the year to fewer than 200.

NHS England figures show the number of patients waiting that length of time has fallen to just 168, excluding more complex cases.

Staff have been praised for carrying out the NHS elective recovery plan, published this year to tackle backlogs built up during the coronavirus pandemic.

At the start of the year, more than 22,500 people had been waiting two years or longer for scans, checks and surgery. A further 51,000 who would have passed the two-year mark by the end of July have also been treated, figures show.

The NHS England chief executive, Amanda Pritchard, said: “It has only been possible because the NHS has continued to reform the way we deliver care, using innovative techniques and adopting pioneering technology like robot surgery, and through building new relationships and mutual aid arrangements across systems to offer patients the opportunity to be transferred elsewhere and get the care they need as quickly as possible.

“The next phase will focus on patients waiting longer than 18 months, building on the fantastic work already done, and, while it is a significant challenge, our remarkable staff have shown that, when we are given the tools and resources we need, the NHS delivers for our patients.”

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Source: The Guardian, 9 August 2022

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Man with diabetes died after GPs ‘failed to spot deteriorating health’

A 27-year-old man died from complications linked to diabetes after GPs failed to properly investigate his rapidly deteriorating health.

Lugano Mwakosya died on 3 October 2020 from diabetic ketoacidosis, a build-up of toxic acids in the blood arising from low insulin levels, two days before he could see a GP in person.

His mother, Petronella Mwasandube, believes his death could have been avoided if doctors at Strensham Road Surgery, in Birmingham, had given “adequate consideration” to Lugano’s diabetic history and offered face-to-face appointments following phone consultations on 31 July and 16 and 30 September.

An independent review commissioned by NHS England found two doctors who spoke to Lugano did not take into account his diabetes or “enquire in detail and substantiate the actual cause of the patient’s symptoms”.

The review raised concern over the “quality and brevity” of the phone assessments and said the surgery should have offered Lugano an in-person appointment sooner.

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Source: The Independent, 7 August 2022

 

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Britain really isn’t working – and the collapsing NHS is to blame

After lockdown raided the savings of hairdresser and gym instructor Lucie Wilby, a lengthy wait for a hip replacement dealt another blow to her family’s finances.

“We’re in a lot of debt because of it and that’s a combination of Covid and obviously surgery [and] waiting times,” the 53-year-old mother from Cornwall says. 

“If I hadn’t had to wait six months, we’d be nowhere near this issue.”

Like many of the 6.6 million people on an NHS waiting list, work had become painful and eventually impossible for Wilby as the backlog in treatment forces people to cut their hours or stop employment altogether. 

“By the time of the operation, I was barely walking and I’m self employed,” she says. 

“It took about three years to get diagnosed. That’s one of the major problems – it’s not just the waiting time for the operation once you’re on the list, it’s the waiting time for diagnosis.”

While tax cuts and even trans issues may have stolen the limelight in the Tory leadership race, the struggle to get a grip of record NHS backlogs post-Covid is having a huge economic, as well as human, cost.

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Source: The Times, 7 August 2022

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Ysbyty Glan Clwyd: Stroke patients would rather go to England

People would rather go to England if they had a stroke than use the A&E at a north Wales hospital, a health watchdog has said.

Inspectors said there was a "clear and significant risk to patient safety" after inspections at the department in Ysbyty Glan Clwyd, Denbighshire.

North Wales Community Health Council's Geoff Ryall-Harvey said it was the "worst situation" they had seen.

The report said inspectors found staff who were "working above and beyond in challenging conditions" during a period of "unrelenting demand". Many staff told them they were unhappy and struggling to cope. They said they did not feel supported by senior managers.

However inspectors said that the health board was not fully compliant with many of the health and care standards, and highlighted significant areas of concern, which could present an immediate risk to the safety of patients, including:

  • Doctors were left to "come across" high-risk patients instead of being alerted to them.
  • Patients were not monitored enough - including a suspected stroke patient and one considered a suicide risk.
  • Children were at serious risk of harm as the public could enter the paediatric area unchallenged.
  • Inspectors found evidence of children leaving unseen or being discharged against medical advice.

Betsi Cadwaladr health board said it was committed to improvements.

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Source: BBC News, 8 August 2022

 

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New IT system harms trust’s cancer performance for six months

A trust which is struggling with a new electronic patient record (EPR) is likely to see cancer performance affected for at least the rest of this year, it has said.

Ashford and St Peter’s Hospitals Foundation Trust has set up eight workstreams to ensure its EPR – supplied by Oracle Cerner – is “functioning safely, efficiently and as effectively as possible” after a host of problems since it went live in May. Cancer areas affected include breast, breast symptomatic two week waits, and dermatology.

“It is expected that the impact of the introduction of SSC [Surrey Safe Care, the name of the project] will be felt in aspects of our cancer performance until at least December 2022,” July’s board meeting was told.

The performance report warned the risk of delays causing harm to cancer patients – currently rated at 12 on the risk register – was being reviewed as a result of the introduction of SSC and was expected to rise. 

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Source: HSJ, 8 August 2022

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Multiple reporting systems undermine patient safety, says watchdog

A single system to report patient safety concerns would “keep people safer”, a newly appointed NHS watchdog has told HSJ.

Henrietta Hughes – who will take up the post of patient safety commissioner in September – said both clinicians and patients faced a bewildering choice when looking to raise a safety concern, and that there was a need for a “report once” system.

She said that when ”exhausted” clinicians “come to the end of a 12-hour shift, they don’t want to have to do a Datix report and a yellow card report, and if they’ve got a safeguarding concern or a concern about an individual condition, [to have to] send that somewhere else”.

Dr Hughes added: ”Wouldn’t it be better if we had one report that you do, and all the information that comes from that report just gets sent to the appropriate authority? That’s the type of change that I think we’d like to see. I know, as a GP myself, that’s what I would rather do as a professional. But also, I think, for all the organisations, we could get so much more richness of information, we would get more reporting, and we’d keep people safer as a result of it.”

She added that if a patient “wanted to report an individual clinician” they often ended getting bounced around the system, like a pinball. They get sent from pillar to post.”

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Source: HSJ, 8 August 2022

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Number unable to get a hospital appointment after GP referral up 50% in two years

The number of patients unable to get a hospital appointment after being referred by their GP is up more than 50% in two years amid the record NHS backlog, official data show.

NHS Digital figures show no appointments were immediately available for 2.3 million referrals made in the first six months of this year – up 51% on the same period in 2020.

Appointment slot issues occur when a patient is referred by their GP through the NHS e-Referral Service but no appointment is available to book. 

The referral is then forwarded or deferred to a patient’s chosen provider, but if an appointment is not made within 180 days it will automatically be removed from the system, according to NHS Digital.

Patient safety campaigners have said the scale of the problem must be “urgently investigated” by NHS England to ensure the safety of patients is not being compromised while they wait for appointments.

Helen Hughes, the chief executive of the Patient Safety Learning charity, said: “We have significant concerns about the safety of patients who are facing increasingly long waits for treatment, particularly those on high priority cancer pathways and urgent referrals.”

She said patients needed to be assured that they will “not be lost in a failing, complex system”, adding: “We believe that NHS England needs to urgently investigate, quantify the scale of the problem and take action if we are to prevent these capacity and system issues resulting in avoidable harm for patients.”

Some GPs told Patient Safety Learning they had experienced difficulties getting referrals accepted. One GP, based in the North East, said: “There is an ever-creeping transfer of management of complex conditions from secondary to primary care, without adequate training or resources to manage this safely.”

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Source: The Telegraph, 7 August 2022

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Full extent of NHS dentistry shortage revealed

Nine in 10 NHS dental practices across the UK are not accepting new adult patients for treatment under the health service, a BBC investigation has found.

BBC's research shows no dentists taking on adult NHS patients could be found in a third of the UK's top-tier councils. And eight in 10 NHS practices are not taking on children.

The Department of Health said it had made an extra £50m available "to help bust the Covid backlogs" and that improving NHS access was a priority.

BBC News contacted nearly 7,000 NHS practices - believed to be almost all those offering general treatment to the public.

The British Dental Association (BDA) called it "the most comprehensive and granular assessment of patient access in the history of the service".

While NHS dental treatment is not free for most adults, it is subsidised.

The BBC heard from people across the UK who could not afford private fees and said the subsidised rates were crucial to getting care.

The lack of NHS appointments has led people to drive hundreds of miles in search of treatment, pull out their own teeth without anaesthesia, resort to making their own improvised dentures and restrict their long-term diets to little more than soup.

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Source: BBC News, 8 August 2022

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Armed police sent to heart attack patients as crisis-hit NHS buckles under surging demand

Armed police are being sent to save the lives of people in cardiac arrest because ambulances “can’t cope” with demand, The Independent has revealed.

Officers are spending up to a third of their time on non-policing matters, a watchdog has warned, including responding to mental health crises and transporting patients to A&E as ambulance services face a “chronic crisis situation”.

Andy Cooke, HM chief inspector of constabulary, said that firearms officers have been responding to pleas from struggling NHS colleagues to respond to cardiac arrests.

He told The Independent that police are becoming the “first, last and only resort” as NHS services buckle under strain, taking them away from tackling crime at a time when recorded offences are at a record high in England and Wales.

Mr Cooke, the former chief constable of Merseyside Police, added: “Recently, officers in armed response vehicles (ARVs) were being sent to reports of people who were having cardiac arrests because the ambulance service couldn’t cope with the demand, because they’re trained in first aid and to use defibrillators."

“The ambulance service contacted the police to say ‘we’ve got this heart patient and we haven’t got anyone to send’."

“Being first, last and only resort, the police will go. It’s right that they did go but that hides the problems we’ve got in the rest of the system.”

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Source: The Independent, 8 August 2022

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Cyber attack triggers 111 ‘total system outage’

Many NHS 111 services are without a crucial IT system for several days, after a cyber attack on a software supplier.

Providers had to move to pen-and-paper yesterday, and have been unable to access patient records.

Adastra – which is used by 85% of NHS 111 providers  – went offline at 7am on Thursday. It was still affected as of Sunday, and staff were told it may not be online for several days.

Advanced, which supplies Adastra, confirmed on Friday evening the incident was caused by a cyberattck, but says it managed to limit the damage to a small number of its servers. It was reported on Saturday that the attack is thought to have been by a criminal group trying to extort money — so-called ransomware — rather than an attack by a group linked to a state/government.

As well as NHS 111, the system is used by some GP out-of-hours services and has also been marketed to urgent care providers. 

NHS 111 services have had to use lists of protocols when answering calls and write details down, rather than the software automatically implementing the protocols.

One briefing note from commissioners in London, seen by HSJ, described the issue as a “total system outage” for NHS 111, and said “likely delays for patients… will continue throughout the weekend and potentially over next week”.

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Source: HSJ, 8 August 2022

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‘Difficult discussions’ as NHS faces shortage of childbirth pain relief

The NHS has been hit by a shortage of epidural kits to give mothers-to-be, a key form of pain relief during childbirth, as well as the drug that women are offered as an alternative.

Supplies of epidural kits and the painkiller Remifentanil are now under such pressure that some hospitals cannot offer pregnant women their usual right to choose which one they want to reduce labour pains.

Anaesthetists have told the Guardian that the simultaneous shortage of both forms of pain management has led to “difficult discussions” with women who had been told during their antenatal care that they would have that choice but were upset to learn that it was not available.

The disruption to supplies of epidural kits is so acute that NHS Supply Chain (NHSSC), the health service body that ensures hospitals in England and Wales receive regular supplies of drugs and equipment, to ration deliveries to just one week’s worth of stock.

Childbirth organisations voiced their concern and warned that the disruption to supplies meant some women in labour were already facing long delays before they received pain relief.

“Offering a choice of options during birth is an integral element of good maternity care, and this includes pain relief. It is concerning that the shortage of epidural kits and Remifentanil could be denying many that right”, said Jo Corfield, the NCT’s head of communications and campaigns.

“We don’t yet fully understand the impact this shortage is having but we have heard of long waiting times to receive pain relief and epidurals.”

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Source: The Guardian, 7 August 2022

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‘A historic wrong’: Government set to announce compensation for victims of contaminated blood scandal

A scheme handing payments to those affected by the contaminated blood scandal will be announced this week, as ministers scramble to help those harmed by the “historic wrong”.

Whitehall sources confirmed that a programme handing interim payments will be confirmed in the coming days, once officials have ironed out issues to ensure that victims are not taxed on the payments or have their benefits affected by them. It is thought that ministers accept recent recommendations that infected people and bereaved partners should get “payments of no less than £100,000”.

More than 4,000 people are in line for the payment. Kit Malthouse, the cabinet office minister, has been prioritising the scheme in the last week to ensure payments are made as soon as possible.

“The infected blood scandal was a tragedy for everyone involved, and the prime minister strongly believes that all those who suffered so terribly as a result of this injustice should receive compensation as quickly as possible,” said a No 10 source. “He has tasked ministers with resolving this issue so that interim payments can be made to all those infected as soon as possible, and we will set out the full details later this week.”

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Source: The Guardian, 6 August 2022

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‘We should be offered compensation’ - Mesh campaigner's plea to Steve Barclay

Pelvic mesh campaigner Kath Sansom has met with the health secretary Steve Barclay to discuss financial redress for those suffering complications from the procedure.

The UK government decided last year not to provide compensation to women whose lives had been affected by vaginal mesh implants.

But Kath Sansom, a Cambridgeshire mum and former journalist for this news outlet, has continued campaigning and says she will put pressure on the health secretary to revisit the issue.

It also comes as the government revealed victims of the 1970s and 1980s blood scandal will receive compensation for the impact it has had on their lives.

Ahead of her meeting with the Secretary of State for Health, she said: “We [mesh injured] deserve to be compensated based on the fact we are suffering lifelong damage from a health treatment that caused avoidable harm.

“It is not our fault this happened to us and the State should take responsibility.”

Former Health Secretary Matt Hancock issued a public apology when a public inquiry in 2020 revealed a shocking extent of patient failings and lack of regulation for mesh victims.

“The State has apologised for the suffering of the mesh community, which is an acknowledgement of responsibility,” Kath added.

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Source: Cambs Times, 5 August 2022

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Economically inactive Britons with Long Covid have ‘doubled’ in a year

One in twenty people in the UK who are neither employed nor seeking paid work are suffering from Long Covid, with the figure more than doubling in the past year, official data has revealed.

The proportion is far higher than for the 1 in 29 people who are unemployed but seeking work who have long Covid symptoms, or the one in 30 employed people who are sufferers, data released by the Office for National Statistics (ONS) shows.

Individuals who are not employed and are not looking for paid work are classified as being economically inactive.

The data suggests the long-term impacts of the virus could be driving people into this category, or into retirement.

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Source: The Guardian, 4 August 2022

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'Bolder government action' needed to address inequalities in dementia risk

"Bolder government action" is needed to address inequalities in dementia risk, the charity Alzheimer's Research UK has warned this week. The comments come in response to findings from four new studies presented at the Alzheimer's Association International Conference (AAIC) which link socio-economic deprivation with increased risk of dementia and cognitive decline.

Dr Susan Mitchell, head of policy at Alzheimer’s Research UK, said: "These findings are a stark reminder of the health gap between the most and least deprived in society, with the most deprived at a higher risk of developing dementia.

"Ultimately, these inequalities are profoundly unfair, but they are also avoidable. The Government has a key role in addressing inequalities through a range of measures to improve poverty, employment, housing and education."

She added: "We urge Government to make dementia prevention a key priority in its aim to level up healthcare across the country, and hope the forthcoming health disparities white paper lays the foundation for a fairer, healthier nation."

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Source: Medscape, 5 August 2022

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Private provider says its ‘robust nursing pipeline’ can benefit NHS

A large private provider says it is finding it harder than ever to fill its staffing vacancies, but is optimistic that its investment in nursing apprenticeships and overseas recruitment can help expand NHS-commissioned capacity.

In an interview with HSJ, Shelley Thomas, group HR director for Spire Healthcare, said the company is facing the same staffing difficulties as NHS providers.

She said: “We’re all feeling the same things at the moment… high sickness absence, high holidays, teams that are worn out. We’re all… experiencing the same from a workforce perspective.”

However, she said Spire is “working harder than ever” to fill vacancies, and now has a “really robust pipeline” of apprentices and oversees recruits.

Despite the waiting list backlogs which have ballooned since the pandemic began, and a £10bn framework in place for the NHS to utilise private sector capacity, analysis suggests NHS activity undertaken by private hospitals has been below pre-covid levels in almost all specialities.

Ms Thomas suggested the staffing difficulties had been a factor in that, but acknowledged there were more conversations to be had locally about how the private sector could undertake more activity.

She said the pandemic was a “huge catalyst for stronger working partnerships” between the NHS and the private sector and that relationships are “stronger than they’ve ever been”.

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Source: HSJ, 4 August 2022

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Covid-19: One in eight adults develops long covid symptoms, study suggests

One in eight Covid-19 patients (12.7%) is likely to experience long term symptoms, a study from the Netherlands has reported.

Using digital questionnaires, researchers collected data on the frequency of 23 symptoms commonly associated with Covid in an uninfected population and in people who had had a Covid diagnosis.

The findings, published in the Lancet, found that 21.4% of adults who had had Covid experienced at least one new or severely increased symptom three to five months after infection when compared with before. This compared with only 8.7% of uninfected people followed over the same period.

The core Long Covid symptoms highlighted by the researchers include chest pain, difficulties breathing, pain when breathing, painful muscles, loss of taste and smell, tingling extremities, lump in throat, feeling hot and cold, heavy arms or legs, and general tiredness.

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Source: BMJ, 4 August 2022

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Use of antipsychotic drugs among dementia patients increasing, study suggests

Prescribing potentially harmful antipsychotic drugs to people with dementia has increased by more than 50% on average in care homes during the pandemic, new research suggests.

It found that the number of people with dementia receiving these prescriptions had soared from 18% to 28% since 2018 – with prescription rates of over 50% in a third of care homes.

Professor Clive Ballard, who was part of a national campaign in 2009 to reduce antipsychotic prescribing by half, said: “Covid-19 put tremendous pressure on care homes, and the majority of them must be applauded for maintaining relatively low antipsychotic prescribing levels amid incredibly difficult circumstances."

“However, there were very significant rises in antipsychotic prescribing in one third of care homes and we urgently need to find ways to prioritise support to prevent people with dementia being exposed to significant harms.”

Antipsychotic drugs are used to treat some of the more distressing behavioural and psychological symptoms of dementia, such as agitation and psychotic episodes. They have only very limited, short-term benefits in treating psychiatric symptoms in people with dementia – but significantly increase the risk of serious side effects, including stroke, accelerated decline and death.

Dr Richard Oakley, from the Alzheimer’s Society, added: “This study shows the shocking and dangerous scale of the use of antipsychotic drugs to treat people with dementia in care homes.

“Alzheimer’s Society has been campaigning for a move away from the model of ‘medicate first’ and funded research into alternatives to antipsychotic prescriptions, focused on putting people living with dementia at the centre of their own care.

“This drug-free, tailored care can help avoid the loss of lives associated with the harmful side effects of antipsychotic medications.”

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Source: The Independent, 4 August 2022

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LGBT groups demand more action on monkeypox

Sexual health charities and LGBT groups are calling for the government to step up efforts to control the monkeypox outbreak in the UK.

In an open letter to Health Secretary Steven Barclay, they say that without a quicker and wider vaccine rollout, the virus could become "endemic".

There have been more than 2,600 cases of monkeypox in the UK so far, mostly among men who have sex with men.

The Department of Health & Social Care (DHSC) says it is working "rapidly" to vaccinate those at risk.

The Terrence Higgins Trust, which co-wrote the letter, says the rollout needs to be speeded up across the UK to help combat "fear and anxiety" within the LGBT community.

Trust head of policy Ceri Smith told BBC News: "We need to see far better co-ordination, increased vaccine procurement, improved delivery and a cash injection to sexual health services to treat monkeypox."

The letter reads: "Without urgent action, we risk monkeypox becoming endemic in the UK. This poses a serious risk to health and will exacerbate the health inequalities already experienced by gay and bisexual men and other men who have sex with men.

"Vaccinating those most at risk of monkeypox must be a priority if we are to stand a chance of preventing the virus from becoming endemic in the UK."

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Source: BBC News, 5 August 2022

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NHS too reliant on overseas recruits, says union

The NHS in England is increasingly reliant on doctors and nurses recruited from outside the UK and EU, analysis has found.

Some 34% of doctors joining the health service last year came from overseas, a rise from 18% in 2014.

The government said overseas recruitment had always been part of its strategy, but unions have warned it is an unsustainable way of recruiting in the long-term.

Patricia Marquis, Royal College of Nursing (RCN) director for England, said ministers must do more to reduce the "disproportionate reliance" on international recruits.

The government is funding an additional 1,500 undergraduate medical school places each year for domestic students in England - a 25% increase over three years.

However, last week a report by MPs concluded the large number of unfilled NHS job vacancies, about 110,000 in total, was posing a serious risk to patient safety.

Danny Mortimer, chief executive of NHS Employers, said it was "high time for the government to commit to a fully-funded, long-term workforce plan for the NHS" to tackle "chronic workforce shortages".

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Source: BBC News, 5 August 2022

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Hospitals test evacuations due to roof collapse fears

NHS England has called for a “deep dive” into local evacuation and shelter arrangements, amid ongoing concerns about outdated and unsafe estate.

NHS England’s director of emergency preparedness, resilience and response Stephen Groves wrote to trusts: “Following the publication of the updated evacuation and shelter guidance for the NHS in England, and recent work driven by the heightened risk associated with reinforced autoclaved aerated concrete (RAAC), the 2022-23 EPRR annual deep dive will focus on local evacuation and shelter arrangements.”

The letter, sent at the end of last week, comes amid growing concerns about NHS estate, including RAAC planks which were used in constructing public sector buildings in the 1960s, 70s and 80s. 

Areas to be examined in the deep dive vary by type of organisation. However, according to a self-assessment tool referenced in the letter, questions for providers include: whether they have “a process in place to triage patients in the event of an incident requiring evacuation and/or shelter of patients”; whether there are “effective arrangements in place to support partners in a community evacuation, where the population of a large area may need to be displaced”; and whether “evacuation and shelter arrangements include resilient mechanisms to communicate with staff, patients, their families and the public, pre, peri and post evacuation”. 

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Source: HSJ, 5 August 2022

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Man died after doctors missed opportunities to identify abnormalities on his X-ray

A 65-year-old man died after doctors failed to notice serious abnormalities on his X-ray, an investigation by the Parliamentary and Health Service Ombudsman (PHSO) has revealed.  

The investigation comes a year after a landmark report by the Ombudsman highlighted failings in how X-rays and scans are reported and followed up in the NHS.  

Mr B, who was admitted to University Hospitals Birmingham NHS Foundation Trust in May 2019, had been unwell for several days. He was admitted to hospital suffering from abdominal pain and vomiting. An X-ray of his abdomen was taken, which two doctors said did not show any apparent abnormalities.

The following day the man’s condition deteriorated. He suffered a heart attack and died. A PHSO investigation found the Trust failed to notice a blockage in his intestine on the X-ray. Because of this failure, Mr B did not receive treatment that could have saved his life. 

Speaking on this case Ombudsman Rob Behrens said:  

“The case of Mr B highlights the devastating impact mistakes like this can have. If the Trust had picked up the abnormalities on his X-ray sooner, Mr B could still be with his family today. 

“As the NHS faces the challenge of rebuilding after the pandemic, it must not lose momentum in improving the way X-rays and scans are handled during a patient’s care.”  

Progress has been made by the NHS in implementing recommendations made by the Ombudsman in the report; however, Rob Behrens has said more needs to be done to protect patients from serious harm. 

“Attention and buy-in from the NHS’s senior leaders is crucial if we want to see sustained and meaningful change in how X-rays and scans are managed during a patient’s care. We need more collaboration across clinical specialties, looking at the whole patient journey once a scan has been carried out.

"I want to see the NHS treating complaints as a source of insight to drive improvements in patient care. Not learning from mistakes will mean missed opportunities to diagnose patients earlier. In the most serious cases, like that of Mr B, it will mean a death which should never have happened.”

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Source: PHSO, 20 July 2022

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