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County Durham and Darlington improves patient safety with AI

County Durham and Darlington NHS Foundation Trust has created and implemented an artificial intelligence (AI) model to protect patients from acute kidney injury (AKI).

The trust’s AI-driven model helps healthcare staff to identify patients who are at risk from AKI and to swiftly respond with treatment. The technology uses risk stratification digital tools that staff are able to access through an app. These are combined with care processes developed at the trust and which involve a new specialist nurse team, preventive specialist intervention, assessment and follow-up.

Its implementation at County Durham and Darlington has led to a reduction in both hospital-acquired and community AKI. Overall, the incidence of AKI within the trust fell from 6.5% between March and May 2020, to 3.8% during the same period in 2021. The most significant reduction was seen in hospital-acquired AKI – which fell by more than 80%.

Jeremy Cundall, medical director for County Durham and Darlington NHS Foundation Trust and executive lead for the project, said: “The partnership has resulted in patients being detected earlier – preventing AKI from occurring or mitigating the worsening of existing AKI. Accordingly, patients have been more effectively triaged to the right pathways of care including referral and transfer to tertiary renal units where appropriate.”

Claire Stocks, early detection, resuscitation and mortality lead nurse for County Durham and Darlington NHS Foundation Trust, said: “This work has been a project very much about using collaborative partnerships to enhance patient safety and quality. An idea that was developed in a ‘cupboard conversation’ is now a fully operational specialist nurse service. Utilising digital innovations supports rapid triage, early detection and treatment to improve outcomes.”

In addition to the improvements in patient safety, the technology has delivered cost savings for the trust too. County Durham and Darlington saved more than £2million in direct costs from reductions in AKI incidence. The improved transfer of patients has also released ICU capacity, vital at a time when the NHS is dealing with a growing national backlog for elective surgery.

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Source: Digital Health, 27 July 2022

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Safety fears as NHS medical negligence claims soar

Almost 75 years since its foundation, the NHS is struggling with delays caused by the coronavirus pandemic and the “greatest workforce crisis” in its history.

A report from MPs on the health committee this week showed 105,000 vacancies for doctors, nurses and midwives, as thousands quit owing to burnout, bullying, pension rules and low pay.

Jeremy Hunt, the committee’s chairman, said that the “persistent understaffing in the NHS poses a serious risk to staff and patient safety”. Lawyers warned that the crisis risked increasing the number of negligence claims.

Spending on claims by NHS Resolution rose to £2.5 billion in 2021-22 compared with £2.3 billion in the previous year, according to its annual report published last week. The bill increased despite initiatives to cut the number of cases going to court and foster greater collaboration with claimant lawyers.

Claimant lawyers welcomed NHS Resolution’s more collaborative approach and desire to resolve cases sooner. They argued, however, that the defensive culture remained and suggested there should be a greater focus on patient safety and learning from mistakes.

John McQuater, president of the Association of Personal Injury Lawyers, said that NHS Resolution’s denials and delays meant that injured patients had to turn to lawyers to find answers. He said that earlier investigation into patient safety incidents and earlier admissions of liability by NHS trusts would speed up the system, cutting costs and human misery.

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Source: The Times, 28 July 2022

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Failing gender service for children to be replaced by local hubs

The NHS’s only gender identity clinic for children has been found to be neither “safe nor viable” and is set to be replaced by regional hubs.

A damning report into gender identity services run by the Tavistock and Portman Foundation Trust has found that the model is putting children at “considerable risk”.

An interim report by Dr Hilary Cass said that children and young people are being subjected to “lengthy” waits for access to gender dysphoria services, and are not receiving support during this time.

The report said a “fundamentally different” service model that can provide timely and appropriate care for children is needed, and recommended that the NHS launch local specialist centres.

Her full report is due to be published next year, but has so far warned that the long waiting lists for gender-questioning children and young people are “unacceptable”.

The review said it was not yet able to provide recommendations on the use of puberty blockers and feminising or masculinising hormones, due to gaps in the evidence.

A report from safety watchdog the Healthcare Safety Investigation Branch in April warned that CAMHS (Children and Adolescent Mental Health Services) had been forced to “hold the risk” while caring for children who are waiting to access specialist gender-dysphoria (GID) services.

It added: “There is a lack of capacity and capability to ensure proactive risk assessment of the health of patients waiting on the GIDS waiting list.”

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Source: The Independent, 28 July 2022

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Patients kept in A&E for ‘up to three weeks’, CQC finds

Patients experiencing a mental health crisis were kept in a ‘short stay area’ of an emergency department for up to three weeks, a Care Quality Commission (CQC) report has revealed.

The patients were in what the CQC described as a “short stay area” of the ED at the Royal Sussex County Hospital in Brighton. It is an area with no natural light, no TV or radio and only a toilet and washbasin, with a shower available on a neighbouring ward, the CQC said. The patients were reviewed daily by a mental health liaison team from another trust while they waited for a mental health bed to be found.

The CQC report said staff reported the longest stay was up to three weeks, while trust data showed the average length of stay was 52 hours.

It said the urgent and emergency services at the hospital – part of University Hospitals Sussex Foundation Trust which is rated “outstanding” overall by the regulator – “did not fully meet the needs of the local population”.

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Source: HSJ, 29 July 2022

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CQC probes bullying allegations at national NHS agency

Bullying and harassment allegations made against leaders of the organisation that supplies blood to the NHS have prompted a Care Quality Commission (CQC) review, with staff claiming poor culture has exacerbated the crisis around low blood stocks.

HSJ has learned whistleblowers at NHS Blood and Transplant raised concerns with the CQC. As a result, the regulator has been carrying out a review of the organisation’s leadership.

Several current and former staff, who wished to remain anonymous, told HSJ there are widespread concerns about the organisation’s culture, which they claim has enabled bullying and harassment from senior employees, including some racist behaviours.

They said the culture has resulted in a significant number of staff being absent due to stress and anxiety, which alongside the latest wave of coronavirus, has contributed to an ongoing staffing crisis.

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Source: HSJ, 28 July 2022

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NHS leaders warn that social care workforce crisis risks patient safety

NHS leaders across England say staffing gaps and a lack of capacity in social care are putting the care and safety of patients in the NHS at risk.

Almost 250 NHS leaders responding to an NHS Confederation survey say that patients are being delayed in hospital much longer than they should, with the knock-on impact resulting in higher demand on A&E departments and longer ambulance response times.

  • More than 9 in 10 NHS leaders warn of a social care workforce crisis in their area which they expect will get worse this winter.
  • Nearly all NHS leaders say the lack of capacity in social care is putting the care and safety of patients at risk.
  • More than four in five warn that the absence of care packages for people to be able to return home or be moved into a care home is the main reason why medically fit patients are stuck in hospital longer than they should be.
  • Almost all NHS leaders say that the most impactful solution would be better pay for social care staff and want the Government to increase investment in social care as a priority.

An acute trust executive director in the South West accused the Government of presiding over a “national scandal.”

“If the social care capacity shortfall was solved then we would not be holding ambulances at all, we would have almost no problems with elective recovery and our emergency departments would not be crowded and unsafe,” they said.

Another acute trust chair in the East of England added: “The result of using nearly 20 per cent of our beds for patients who are medically fit but need packages of care to return home is an overcrowded A&E, twelve-hour trolley waits and much delayed ambulance handover times. The connection is very clear to us…Until we find a solution to social care staffing and funding, the situation can only get worse.”

Commenting on the survey results Lord Victor Adebowale, chair of the NHS Confederation, said:

“Decades of delay and inertia have left social care services chronically underfunded and in desperate need of more support.

“NHS leaders stand alongside their sister services in social care in wanting a rescue package for the sector. They are sounding the alarm and sending a clear message to Government that the social care system has not been ‘fixed’."

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Source: NHS Confederation, 28 July 2022

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Working women need greater menopause rights

Women going through menopause should be given greater rights and protection in the workplace, MPs say.

The Women and Equalities Committee said a lack of support in the UK was pushing women out of work.

The cross-party group wants menopause to become a protected characteristic like pregnancy, to give working women more rights.

Caroline Nokes, who chairs the committee said: "Stigma, shame and dismissive cultures can, and must, be dismantled."

The government, speaking on the issue for England as health issues is devolved to the national governments in Scotland, Wales and Northern Ireland, said the issue was a priority, highlighting it had recently appointed a women's health ambassador and set up a menopause taskforce to look into workplace support.

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Source: BBC News, 28 July 2022

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Jeremy Hunt calls contaminated-blood scandal a huge failing of democracy

Former Health Secretary Jeremy Hunt has told a public inquiry institutions and the state can sometimes "close ranks around a lie".

Giving evidence at the infected-blood inquiry, he said it could be seen as a "huge failing of democracy" that victims had waited so long for justice.

At least 5,000 people contracted HIV or hepatitis C in the 1970s and 80s, after being given contaminated blood products and transfusions on the NHS. More than 2,400 have died as a result.

Jenni Richards QC asked whether a 2012 briefing for new ministers in the health department - "almost certainly" not shown to Mr Hunt at the time - stating, under a heading "Key facts", hepatitis C and HIV (Human Immunodeficiency Virus) infection had been a problem in the 1970s and 80s, "before it was possible to screen donors and make products safer", suggested the contamination had been an "unavoidable problem".

Mr Hunt, health secretary for six years until July 2018, replied: "I mean, that briefing is wrong and it shouldn't say that.

"At the very least, ministers should be aware as politicians that this is contentious and disputed by families - but I'm afraid it tries to suggest the issue is closed when it is not."

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Source: BBC News, 27 July 2022

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NHS told to make better use of hospital passports to support patients

Hospital passports need to be more consistently used across the NHS to better support patients with communication difficulties, a learning disability nurse says.

Support for patients with communication needs and learning disabilities, as well as the nurses caring for them, is often ‘inconsistent’, according to RCN professional lead for learning disabilities Jonathan Beebee.

Coupled with the current system-wide pressure of patient backlogs and high staff vacancy rates it means patients often do not have their communication needs met.

A hospital passport, which contains vital information about a patient’s health condition, learning disability and communication needs, would help address this, Mr Beebee told Nursing Standard. 

"There has got to be better consistency in how we are identifying people with communication needs, how they are getting flagged and how nurses are being pointed to that from the second that someone is admitted to the ward," he said.

Mr Beebee says ensuring a standardised approach would improve patient experience and ultimately nurses’ relationship with patients.

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Source: Nursing Standard, 27 July 2022

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Speaking up ‘still not business as usual’, national guardian warns

Whistleblowing is still not ‘business as usual’ and leaders must take action after an unusual drop in the proportion of staff viewing their organisation as having a positive speak up culture, the national guardian for freedom to speak up has said.

Speaking to HSJ, Jayne Chidgey-Clark highlighted some “really concerning” findings from the National Guardian’s Office’s most recent survey, both about speak up culture and the wellbeing of the freedom to speak up guardians.

The NGO survey found a 10 percentage point drop in freedom to speak up guardians agreeing senior leaders supported workers to speak up, dropping from around 80% to 70% between 2020 and 2021.

She also highlighted an increase in FTSU guardians reporting staff had experienced “detriment” for speaking up within their organisation.

Ms Chidgey-Clark, a nurse by background who took up the role last December, said it was the first time the National Guardian’s Office had seen a drop on this question since the survey began in 2017, and that it also “chimed” with the latest NHS staff survey.

She added: “Workers are saying the same thing, and that’s really concerning. And it will be even more concerning if we see a similar trend next year. It’s almost like an early warning sign to leaders."

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Source: HSJ, 28 July 2022

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Barclay calls urgent ‘hackathons’ over ambulance crisis

The new health and social care secretary has asked officials to hastily organise several “hackathons” to try to address the crisis in ambulance performance.

The first, which was instigated just last week, will take place tomorrow (28 July), and a second is planned for August, sources told HSJ.

Messages from officials described the work as a “request from our new secretary of state” and explained the short notice by saying he was “pushing… quite strongly for something before the end of the month”.

The aim is said to be to examine what is driving poor performance, and the Department of Health and Social Care is “particularly interested in understanding which factors reduce risk to patients”, according to one message seen by HSJ.

Hackathons are short, time-limited collaborative design events, typically involving computer programmers and data scientists or analysts, which aim to result in working software or product on the chosen theme by the end.

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Source: HSJ, 27 July 2022

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Hospital in meltdown over IT issues

A whistleblower has warned a London hospital is "literally in meltdown" after its IT system was knocked out during last week's heatwave.

Operations at Guy's and St Thomas' Hospital in Lambeth were cancelled after its IT servers broke down in 40C (104F) temperatures on 19 July.

A doctor told the BBC "poor planning" and "chronic underfunding" meant issues remained a week later.

A spokesperson for the hospital said IT issues were "having an ongoing impact".

Without a functioning IT system, staff have returned to paper notes, the doctor said.

The anonymous whistleblower, who works as a doctor at Guy's and St Thomas', said this meant "we see very worrying results, but we don't know where the patients are so we spend ages tracking them down".

"We cannot read any historical notes from patients. Names are being misspelt, so scans are not showing up.

"Each morning, someone hand-delivers a stack of test results to the ward. In there, we received several patient results that don't belong to our ward," the doctor said.

"If we don't recover our shared drives, we risk losing months of research data, if not years."

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Source: BBC News, 27 July 2022

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Dental checkups to become less frequent in England and Wales

The decades-old routine of visiting an NHS dentist for a six-month checkup is being scrapped across England and Wales for most adults as part of changes designed to address the dire lack of access to dental care for many people.

Wales has announced that most adults now only need to see their dentist once a year, which the government in Cardiff says will free up NHS dentists’ time and allow them to take on more than 100,000 extra patients annually.

The Labour-controlled Welsh government also hinted it wanted to recruit disillusioned dentists from England by offering chances to develop skills such as carrying out more complex surgery within their practices.

Its announcement came after the UK government wrote to NHS dentists last week saying that under the first changes to the dental contract in 16 years, healthy people will only need a checkup every two years. It said this complied with guidance from the National Institute for Health and Care Excellence (Nice), which says dental teams should see patients for a checkup based on their health risk, which can be once every two years instead of every six months.

Both governments claimed the moves would allow more people to find NHS care but dentists’ representatives in England and Wales described the changes as “tinkering” and “marginal tweaks”.

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Source: The Guardian, 27 July 2022

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Londoners several times more likely to get life-saving treatment

The NHS and the Treasury need to make a renewed commitment to increasing the number of patients who benefit from thrombectomy, the Stroke Association has said, as it revealed the service was dependent on just 106 doctors in England.

New analysis due to be published by the charity later this week – and shared with HSJ  – also found only a quarter of thrombectomy units are open 24 hours, seven days a week, with 42% only operating during office hours and Monday to Friday.

Despite an NHS long-term plan target of treating 10% of strokes with a thrombectomy by this year, only 2.8% were benefitting in December 2021 – a smaller proportion than in the US or some other Western European nations. It means nearly 6,000 people who could benefit from thrombectomy are missing out, the charity has calculated.

The Stroke Association’s report also highlighted large apparent regional variation in the share of stroke patients receiving the treatment — with London patients several times more likely to receive the treatment than elsewhere.

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Source: HSJ, 27 July 2022

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Pre-eclampsia: Test change for pregnant women could save lives

A change in pre-eclampsia testing for pregnant women could help save lives.

The potentially-fatal condition affects around 6% of women, often during the second half of pregnancy.

The National Institute for Clinical Excellence (NICE) had recommended a test that could only rule out the condition, but now recommends more accurate tests that can diagnose cases.

The Welsh government welcomed the new guidance, but said routine screening had not been recommended.

Jeanette Kusel, director for scientific advice at NICE, said: "These tests represent a step change in the management and treatment of pre eclampsia.

"New evidence presented to the committee shows that these tests can help successfully diagnose pre eclampsia, alongside clinical information for decision-making, rather than just rule it out.

"This is extremely valuable to doctors and expectant mothers as now they can have increased confidence in their treatment plans and preparing for a safe birth"

Eleri Wyn Foxhall, 32, from Penygroes in Gwynedd had pre-eclampsia in 2020.

She welcomes the move, but called for women to be tested routinely.

She believes there is a general "lack of information" about pre-eclampsia, and wants more work to be done on early detection.

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Source: BBC News, 26 July 2022

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Likely cause of mystery child hepatitis outbreak found

UK experts believe they have identified the cause of the recent spate of mysterious liver problems affecting young children around the world.

Investigations suggest two common viruses made a comeback after pandemic lockdowns ended - and triggered the rare but very serious hepatitis cases.

More than 1,000 children - many under the age of five - in 35 countries are thought to have been affected. Some, including 12 in the UK, have needed a lifesaving liver transplant.

The two teams of researchers, from London and Glasgow, say infants exposed later than normal - because of Covid restrictions - missed out on some early immunity to an adenovirus, which normally causes colds and stomach upsets, and adeno-associated virus 2.

Noah, three, who lives in Chelmsford, Essex, needed an urgent liver transplant after becoming dangerously ill with hepatitis. His mother, Rebecca Cameron-McIntosh, says the experience has been devastating.

"He'd previously had nothing wrong with him," she says. "And for it to suddenly go so quickly. I think that's what kind of took us by surprise.

"We've just assumed it was one little problem that will get easily sorted out - but actually it just kept on snowballing."

Noah's recovery has been good - but he will need to take immunosuppressant drugs fo life, to stop his body rejecting the new liver he received.

Rebecca says: "There is something really heartbreaking about that because you go along following the rules, do what you are supposed to do to protect people that are vulnerable and then, in some horrible roundabout way, your own child has become more vulnerable because you did what you were supposed to do."

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Source: BBC News, 26 July 2022

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‘Arrogance and bullying’ persist from ‘less understanding’ regulators, say trusts

NHS England and the Care Quality Commission are becoming less understanding of the pressures on trusts, their leaders report, with one CEO complaining “the arrogance and bullying continues to get worse”. 

This is the finding of a new survey of trust chiefs, chairs and directors by NHS Providers, shared with HSJ and published in a new report on regulation today.

It found two-thirds of trust leaders felt NHSE had a good understanding of “the pressures that NHS providers are facing” — down from 74% cent in a similar NHSP regulation survey in 2019, and 75% in 2018.

NHSP found: “Leaders from the acute sector were much more likely to say regulators understood the pressure they were under than those from the mental health or community sectors.”

One combined acute/community CEO said: “Not only have the number of requests increased but now they are coming from multiple levels, [integrated care system], regional and national.”

Meanwhile, most respondents welcomed regulators’ proposed changes to their approach – for example, by the CQC to a “risk based” approach, and NHSE towards collaboration – but many indicated they did not feel these were being put into practice.

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Source: HSJ, 26 July 2022

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UK doctors ‘less likely’ to resuscitate the most seriously ill patients since Covid

Doctors are less likely to resuscitate the most seriously ill patients in the wake of the pandemic, a survey suggests.

Covid-19 may have changed doctors’ decision-making regarding end of life, making them more willing not to resuscitate very sick or frail patients and raising the threshold for referral to intensive care, according to the results of the research published in the Journal of Medical Ethics.

However, the pandemic has not changed their views on euthanasia and doctor-assisted dying, with about a third of respondents still strongly opposed to these policies, the survey responses reveal.

The Covid-19 pandemic transformed many aspects of clinical medicine, including end-of-life care, prompted by millions more patients than usual requiring it around the world, say the researchers.

In respect of DNACPR, the decision not to attempt to restart a patient’s heart when it or breathing stops, more than half the respondents were more willing to do this than they had been previously.

Asked about the contributory factors, the most frequently cited were: “likely futility of CPR” (88% pre-pandemic, 91% now); coexisting conditions (89% both pre-pandemic and now); and patient wishes (83.5% pre-pandemic, 80.5% now). Advance care plans and “quality of life” after resuscitation were also commonly cited.

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Source: The Guardian, 25 July 2022

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NHS has ‘broken’ its promise to the public over the ambulance service

The NHS has broken its “fundamental promise” to the public that life-saving emergency care will be available when they need it, a top NHS doctor has said, as ambulances continue to lose tens of thousands of hours waiting outside hospitals.

Katherine Henderson, the president of the Royal College of Emergency Medicine, said that what she described as the fundamental promise of the NHS to provide an ambulance in a real emergency has been “broken”.

Her comments come as the West Midlands Ambulance Service (WMAS) University NHS Trust predicted it would lose 48,000 ambulance hours waiting outside A&E departments in July. This would make it the worst month on record.

In papers published on Thursday, WMAS said the impact of handover delays means that patients are waiting longer than needed for an emergency response, including patients in category one, which includes those needing immediate life-saving care.

It added: “This means that patients who are immediately time-critical medical emergencies do not get the response they need and may suffer significant harm or death.”

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Source: The Independent, 26 July 2022

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Covid pandemic births: Mothers 'pitted against midwives'

Women have spoken to the BBC about the "nightmare" of giving birth during the restrictions imposed because of Covid.

The London Assembly was told a de facto maternity ward ban on partners meant new mums often got very little support.

Campaign group Pregnant Then Screwed said elective Caesareans spiked, as women tried to find a way to have their partner by their side.

Patient care also suffered as maternity units struggled with what a midwifery group said was a 40% staff absence.

A London Assembly health committee review of Covid pandemic pregnancy care has heard that more than three-quarters of the some 110,000 women who gave birth in the capital in 2020 were believed to have done so without their partner's support.

Joeli Brearley, director of Pregnant then Screwed, said elective Caesarean rates increased from 15% to 24%: "Women were requesting severe surgery simply so their partner could be there."

Suzanne Tyler, from the Royal College of Midwives, agreed that London hospitals were badly affected by staff shortages.

"At its worst, staffing was 40% down," she said. "The babies didn't stop coming during Covid but services did have to be rationalised."

Dr Tyler, who said the pandemic "ended up pitting midwives against women", criticised "confusing... contradictory" advice from the government and NHS England that "kept changing".

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Source: BBC News, 26 July 2022

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NHS England ‘hasn’t got long’ to develop ‘operating model’ for system working

NHS England and local leaders must urgently develop a coherent ‘operating model’ for the era of integrated care systems (ICS) or see the reforms fail, leading trust chief executives have told HSJ.

Despite ICSs formally launching on 1 July, the chiefs said there was still no clarity about how the service would be supported and held to account as the Health and Care Act reforms are rolled out and the stuttering Covid recovery continues.

The CEOs were speaking at a roundtable to mark the publication of HSJ's annual ranking of the NHS’s “top 50 trust chief executives”.

NHSE has been working on a new operating model since last year. It has confirmed it plans to keep its seven separate regional teams, and has recently indicated national programmes will be curbed as part of reductions to central staffing. 

Caroline Clarke, the chief executive of north London’s Royal Free group of trusts, said: “What’s unclear to me is, what the operating model is for [the] whole NHS? What is NHSE going to do… what’s expected of the regions and the ICSs… is the performance management line [for providers] going to go all the way through the ICS?”

Ms Clarke said she recognised “some kind of regional infrastructure” was needed and that the existing set-up made sense in widely recognised areas such as London and other “urban” conurbations. But she added: “Are [regions] just going to be aggregating features of the NHS, or are they actually going to have a kind of intent to them?”

Ms Clarke said she was “hung up” on getting an effective operating model because, without it, there was an increased chance NHSE staff would “get in the way and stop us making decisions”.

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Source: HSJ, 25 July 2022

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NHS in England facing worst staffing crisis in history, MPs warn

The large number of unfilled NHS job vacancies is posing a serious risk to patient safety, a report by MPs says.

It found England is now short of 12,000 hospital doctors and more than 50,000 nurses and midwives, calling this the worst workforce crisis in NHS history.

It said a reluctance to decisively plug the staffing gap could threaten plans to tackle the Covid treatment backlog.

The government said the workforce is growing and NHS England is drawing up long-term plans to recruit more staff.

Former Health Secretary Jeremy Hunt, who chairs the Commons health and social care select committee that produced the report, said tackling the shortage must be a "top priority" for the new prime minister when they take over in September.

"Persistent understaffing in the NHS poses a serious risk to staff and patient safety, a situation compounded by the absence of a long-term plan by the government to tackle it," he said.

It said conditions were "regrettably worse" in social care, with 95% of care providers struggling to hire staff and 75% finding it difficult to retain existing workers.

"Without the creation of meaningful professional development structures, and better contracts with improved pay and training, social care will remain a career of limited attraction, even when it is desperately needed," the report said.

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Source: BBC News, 25 July 2022

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Five hospital wards run with one registered nurse each

Five wards at Scotland's largest hospital had to operate with one registered nurse on duty each.

Staff at the Queen Elizabeth University Hospital in Glasgow experienced the shortage on Monday night.

It is an example of the severe pressure affecting health services across the country, which has intensified due to the Covid-19 pandemic.

Greater Glasgow and Clyde health board said nurses were supported by a number of other staff.

Originally reported in the Daily Record, the shortage was described to staff in an email sent on Monday afternoon.

The email said nurse staffing levels across medicine were critical, despite attempts to seek support from bank or agency workers.

It said admin staff had been asked to stay on to offer support including answering phones and door buzzers for the rest of the week.

As well as staffing problems, the pandemic has caused more bed blocking in Scotland's hospitals and longer waits for both emergency and outpatient treatment.

Norman Provan, associate director at the Royal College of Nursing Scotland said the shortage had an impact on patient safety as well as staff wellbeing - concerns that had been raised with the health board and the Scottish government.

He added: "We're in this situation largely because of the failure of Scottish government to address the nursing workforce crisis, which has seen registered nurse vacancies reach a record high.

"Urgent action is needed to protect patient safety, address staff shortages and demonstrate that the nursing workforce is valued as a safety critical profession."

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Source: BBC News, 24 July 2022

 

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‘We are presiding over a failing NHS,’ say leading trust CEOs

A lack of accountability is causing the quality of NHS services to crumble, according to some of the most respected trust chief executives.

They said the problem arose from four factors: the lack of an operating model for how NHS England should oversee the service, confusion over what integrated care systems should be responsible for, the lack of clarity on which standards providers should be seeking to meet, and trust leaders not holding each other to account.

The views were expressed at a roundtable to mark the publication of HSJ’s annual ranking of the NHS’s “top 50 trust chief executives”.

The most strongly worded contribution came from Milton Keynes University Hospital Foundation Trust chief executive Joe Harrison.

He told the roundtable: “I’m really concerned about where we are at as an NHS. I think we’re in danger of all sitting around the campfire singing ‘kumbaya’ as the Titanic sinks.

“We are presiding over a failing NHS. There’s no question about it. And if we carry on like this, people have every right to say, ‘what on earth are we spending £150bn on?’”

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Source: HSJ, 25 July 2022

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Trust declares its cancer waiting list ‘unmanageable’

One of the NHS’s biggest hospital trusts has declared its cancer waiting list is now at an ‘unmanageable size’.

Mid and South Essex Foundation Trust leaders set out the stark judgement in a  paper for its July board meeting, held last week.

The report said: “The 62-day [referral to treatment backlog as of 3 July] has increased for the second consecutive week to 1,055.

“[The cancer patient tracking list] is getting bigger and has reached an unmanageable size. Referral rates have plateaued from March 2021 [but] treatment rates have not increased in line with PTL growth.

“This points to a noisy PTL, where the hospital is extremely busy managing patients who do not have cancer.”

The paper also said NHS England had recognised the trust’s 62-day cancer target needed to be delivered “in more realistic and achievable stages”.

It highlighted particular concerns around a “serious” demand and capacity problem in its dermatology department which contributed to almost half of its 62-day backlog. The trust had 445 62-day RTT cancer breaches in dermatology alone in May, the latest data reported.

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Source: HSJ, 22 July 2022

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