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Two patients die after hospitals ignore key safety warning

Two patients have died as a result of NHS hospitals failing to heed warnings about the use of super-absorbent gel granules, which patients mistakenly eat thinking they are sweets or salt packets.

A national patient safety alert has been issued by NHS bosses to all hospitals, ambulance trusts and care homes instructing them to stop using the granules unless in exceptional circumstances.

An earlier alert in 2017 warned the granules, which are used to prevent liquid being spilled, had caused the death of one patient who choked to death after eating a sachet left in an empty urine bottle in their room. The 2017 alert warned hospitals there had been a total of 15 similar incidents over a six-year period between 2011 and 2017.

The latest warning from NHS England says most hospitals concentrated on “raising awareness” rather than stopping the use of gel granules.

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Source: The Independent, 4 December 2019

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Two out of five NHS staff would not recommend their organisation as a place to work

NHS staff are significantly less likely to recommend their organisations as places to work or believe they employ enough people to deliver effective care, the service’s annual staff survey has revealed.

The 2021 survey results, published today, showed regression across a broad range of questions, including in areas such as motivation, morale, workload pressures and staff health.

One of the biggest drop-offs in survey scores related to the question asking whether there were enough staff in their organisation for respondents to do their job properly.

Only 27.2% of those surveyed said staffing was adequate, a fall of 11% points from the previous year (38.4%).

Only 59.4%nof staff said they would recommend their organisation as a place to work. This represented a 7% point decline from the previous year (66.8%). The rating had steadily improved since 2017 when it was at 59.7%.

While a decline was seen across all sectors, the steepest drop was found among ambulance trusts.

Ambulance trusts performing worse compared to other sectors appeared to be a recurring theme across the survey. 

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Source: 30 March 2022

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Two more NHS maternity units downgraded

Two more NHS maternity units have been downgraded by the care watchdog amid safety concerns. 

The services at Colchester Hospital and Ipswich Hospital were downgraded from good, to 'requires improvement', finding staff shortages at both hospitals.

Moreover, it was also found handovers were not sufficient meaning staff were not sharing the proper information about the women and babies.  

Among the concerns and issues raised, there were problems with team-working, properly recording patient information, and inefficient information systems. 

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Source: The Independent, 16 June 2021

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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.

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Source: BBC News, 7 January 2021

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Two million Britons are taking seven different prescription drugs

Two million pensioners are taking at least seven types of prescription drugs - putting them at risk of potentially lethal side-effects, a major report warns. 

Age UK said the rise of “polypharmacy” was putting lives at risk, with three quarters likely to suffer adverse reactions to at least one of their drugs. The research found that the number of emergency hospital admissions linked to such side-effects has risen by 53 per cent in seven years, with some cases proving fatal.

Experts said GPs were doling out too many drugs because they were too busy to properly consider complex health problems, and the risk of side-effects, and interactions between different drugs. 

Caroline Abrahams, Charity Director at Age UK, said: "We are incredibly fortunate to live at a time when there are so many effective drugs available to treat older people’s health conditions, but it’s a big potential problem if singly or in combination these drugs produce side effects that ultimately do an older person more harm than good.”

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Source: The Telegraph, 22 August 2019

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Two in three UK doctors suffer ‘moral distress’ due to overstretched NHS, study finds

Two in three UK doctors are suffering “moral distress” caused by the enfeebled state of the NHS and the damage the cost of living crisis is inflicting on patients’ health, research has found.

Large numbers are ending up psychologically damaged by feeling they cannot give patients the best possible care because of problems they cannot overcome, such as long waits for treatment or lack of drugs or the fact that poverty or bad housing is making them ill.

A new survey found that 65% of doctors overall, including nearly four in five (78%) GPs and more than half (56%) of hospital doctors, have experienced “moral distress” as a direct result of situations they have encountered working in the NHS.

Seeing patients with malnutrition or hypothermia, or stuck on trolleys in A&E corridors asking for help or forced to choose between heating their home or getting a prescription dispensed are among the events triggering their distress, medics said.

“There’s barely a doctor at work in the NHS today who doesn’t see or experience this distress on a daily basis,” said Prof Philip Banfield, the leader of the British Medical Association.

The NHS is “impossibly overstretched”, has thousands of vacancies for doctors and has a quarter fewer doctors a head of population than Germany, he added.

“In practice that means we can almost never give the standard of care we would want, only ever the care we can manage. That takes its toll, as we see here,” Banfield said.

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Source: The Guardian, 28 December 2023

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Two in five NHS staff feel anxious, NHS England reports

Around 40% of NHS staff reported feeling anxious during the recent coronavirus surge, but results were 10 percentage points worse for minority ethnic workers, according to NHS England’s surveys.

Prerana Issar, NHSE chief people officer, highlighted national data from the health service’s ‘people pulse’ survey during a Commons health and social care committee hearing.

The survey was launched last July to help gauge how the health service’s workforce was coping with the pressures of the pandemic, asking questions such as whether they felt supported, motivated, or anxious and what made the biggest difference to their experience at work. It involves findings from 114 local NHS organisations.

Ms Issar said the percentage of staff who reported they were feeling supported “was at a high of 68% during the first few months and started dipping from November onwards to 62%. It is still at 62%”.

Meanwhile, the share of those “feeling anxious” was at a “low” of 29% during the summer and autumn but has since increased to 40%.

The 40% finding may seem surprisingly low to many, considering the enormous impact of the winter surge of coronavirus demand, the very widespread extra asks of staff, potential health risks, and redeployment of roles.

Ms Issar added: “We have seen ‘feeling supported’ come down a little bit and ‘feeling anxious’ go up, and we used that feedback to then augment our offer and communication.”

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Source: HSJ, 24 February 2021

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Two hospitals see 60 percent of new covid cases caught on the wards

More than 60% of new covid cases diagnosed at two hospitals in the Midlands in recent days were caught at least two weeks after the patient was admitted — suggesting there may be particular problems with the virus spreading on their wards.

Northamptonshire is also still grappling with larger numbers of covid cases in hospital, in contrast to most of England. Its NHS organisations have said they do not know the cause of its ongoing problems.

But the large share of cases diagnosed among patients who have been in hospital for at least 15 days – classed by NHS England as definitely “healthcare associated” – indicate that problems controlling the spread within the hospitals may be playing a significant part, rather than the outbreaks in the community.

There has been major national concern about in-hospital spread of the virus in recent weeks, with the government introducing new mandatory controls on Friday.

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Source: HSJ, 11 June 2020

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Two deaths at “not fit for purpose” unit spark CQC action

The Care Quality Commission (CQC) staged an unannounced inspection after two deaths at a mental health unit which it had condemned as “not fit for purpose.”

Two earlier CQC inspections – in 2017 and 2018 – had also been prompted by deaths on the same unit.

The CQC visited the Abraham Cowley Unit, which is at St Peter’s Hospital in Chertsey and run by Surrey and Borders Partnership Foundation Trust, on 26 June. Two inpatients died in April and May on an inpatient ward for working age men.

The deaths both involved “ligature harm” and have led to the trust reviewing its ligature minimisation strategy, according to board papers.

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Source: HSJ, 8 July 2020

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Two dead and hundreds harmed after being given wrong drugs in North East hospitals

Two people died and hundreds of others were harmed following prescription errors in North East hospitals last year, new figures reveal.

Staff at North East health trusts reported 2,375 prescribing mistakes to an NHS watchdog in 2018, including patients being given the wrong drug, failure to prescribe medicine when needed or given the wrong dosage.

At County Durham And Darlington NHS Foundation Trust, where 359 errors were found, 103 patients were harmed by prescription mistakes while one person died.

City Hospitals Sunderland NHS Foundation Trust was the second worse in the region for patients coming to harm as a result of prescription errors. One person was killed while 56 were harmed.

An NHS spokesperson said: “NHS staff dealt with over a billion patient contacts over the last three years, while serious patient safety incidents are thankfully rare, it is vital that when they do happen organisations learn from what goes wrong - building on the NHS’ reputation as one of the safest health systems in the world."

“As part of the NHS Long Term Plan a medicines safety programme has been established, meaning more than ever before is been done to ensure safe medicine use, and nearly £80 million been invested in new technology to prescription systems.”

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Source: Chronicle Live, 22 December 2019

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Two coronavirus cases confirmed in UK

Two people have tested positive for coronavirus in the UK, the Chief Medical Officer for England has announced.

They are both members of the same family and are receiving specialist NHS care. No more details are being released about their identity or where they are being treated.

At least 213 people in the China have died from the virus, mostly in Hubei, with almost 10,000 cases nationally. There have been 98 cases of the virus in another 18 countries.

Prof Chris Whitty, Chief Medical Officer for England said: "The NHS is extremely well-prepared and used to managing infections and we are already working rapidly to identify any contacts the patients had, to prevent further spread. "We have been preparing for UK cases of novel coronavirus and we have robust infection control measures in place to respond immediately," he added.

Prof Whitty said the UK was working closely with the World Health Organization (WHO) and the international community as the outbreak in China develops "to ensure we are ready for all eventualities".

The new coronavirus was declared a global emergency yesterday by the World Health Organization, as the outbreak continues to spread outside China.

"The main reason for this declaration is not what is happening in China but what is happening in other countries," said WHO Chief Tedros Adhanom Ghebreyesus.

The concern is that it could spread to countries with weaker health systems.

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Source: BBC News, 31 January 2020

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Twin crisis of access and affordability calls for a radical rethink of NHS dentistry

New data indicates the dental crisis shows no signs of slowing, with four in five people (80%) struggling to access timely care during the last COVID-19 lockdown.

Access to NHS dental care continues to be a problem for people across England, with Healthwatch recording a 22% rise in calls and complaints about dentistry between January and March 2021.   

A review of 1,375 people’s experiences shared with Healthwatch found a lack of consistency across the country when it comes to accessing a dental appointment. Whilst some people were asked to wait an unreasonable time of up to three years for an NHS appointment, those able to afford private care could get an appointment within a week. 

Healthwatch are calling for greater ambition and urgency from NHS dental reform plans to create more equitable and affordable dental care. 

Imelda Redmond CBE, National Director of Healthwatch England, said: “The twin crisis of access and affordability hitting NHS dentistry means many people are not able to access timely care – and the poorest are hardest hit. Those human stories show that oral health is a social justice and equity issue."

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Source: Healthwatch, 24 May 2021

 

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Twenty-two junior doctors under investigation after covid outbreak

A trust is investigating after two junior doctors developed covid following an offsite event attended by 22 juniors where social distancing rules were allegedly ignored.

The cases, involving doctors from the Royal Surrey Foundation Trust in Guildford, have been declared an outbreak by Public Health England and police have investigated the incident.

But HSJ understands that contact tracing has concluded no patients needed to be tested because staff had worn appropriate PPE at all times and those involved had swiftly self-isolated once they realised they might have covid or had been at risk of exposure to it.

It is not known whether any of the doctors had returned to work after the event before realising they might have been exposed to covid.

Dr Mark Evans, deputy medical director, said: “Protecting our patients is our priority and we are committed to ensuring that all of our staff follow government guidance. This incident took place outside of work and has been reported appropriately, and there was no disruption to our services for patients.”

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Source: HSJ, 22 October 2020

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Twenty-one ‘wholly preventable’ patient safety incidents reported in private hospitals last year

There were 21 “wholly preventable” patient safety incidents of the most serious category at private hospitals last year, new data has shown, as NHS bosses prepare to invest up to £10bn in the sector.

This is the first time that a comprehensive dataset of 'never events’ within private hospitals has been published in the UK, and comes ahead of plans to outsource both inpatient and outpatient services, routine surgery operations and cancer treatment to private providers.

The audit conducted by the Private Healthcare Information Network (PHIN), established in 2014 to bring greater transparency to the private health sector, showed that 287 out of 595 private hospitals and NHS private patient units (PPUs) provided information on Never Events between 1 January and 31 December 2019.

This group accounts for an estimated 86 per cent of privately-funded admitted patient care, PHIN said. It attributed the “gaps in the data” to NHS PPUs, rather than independent hospitals.

The fact that more than 300 hospitals or PPUs were unable or unwilling to hand over this data highlights the private sector’s continuing lack of transparency, said the Centre for Health and the Public Interest, a social care and health think tank.

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Source: The Independent, 2 September 2020

Private Healthcare Information Network press release

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Twenty-four UK doctors in five years censured over medical record breaches

Twenty-four doctors have been disciplined by the UK medical regulator in the last five years after accessing and using information from patients’ treatment records without good reason.

The General Medical Council (GMC) said it had struck off two of the 24 doctors it had sanctioned after finding that they had undertaken “inappropriate use” of medical records.

Another 10 were suspended, 10 were warned about their future conduct, one had a condition imposed on their licence to practise medicine and the other had to undertake not to repeat their behaviour.

The 24 cases were among 194 incidents of doctors allegedly accessing medical records without a clinical justification that prompted a complaint to the regulator between 2017 and 2022.

Privacy campaigners said it was shocking that almost 200 people had made complaints to the GMC accusing doctors of violating patients’ confidentiality in that way.

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Source: The Guardian, 13 June 2023

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TV doctor Hilary Jones blasts Government over ‘at risk of collapse’ NHS

TV presenter Dr Hilary Jones has blasted the Prime Minister over his handling of the NHS, warning it is at risk of collapse.

Speaking on ITV’s Good Morning Britain, the GP shared the experiences of “heartbroken” frontline doctors and said if the situation “doesn’t change very quickly, the NHS is finished”.

Dr Jones referred to a group chat between 13,000 doctors who work on the front line and in primary care, where members are sharing stories that show patients experiencing very long delays in receiving treatment. He described how staff are in tears at the end of their shift “and when they return to the next shift, the same patient is still waiting to be seen after 24 hours”.

He added: “For Rishi Sunak and the Government to pretend that this is not a crisis when more than a dozen trusts have announced critical incidents is not only delusional, as the BMA say, I would say at the very best it’s ill-informed misjudgment, at the very worst it’s total irresponsibility and incompetence. I have never known anything like this.”

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Source: Independent, 5 January 2023

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Turkey surgery warning as mother-of-four dies after gastric sleeve

A father whose daughter died after travelling to Turkey for weight-loss surgery has urged people to think again before doing the same.

Shannon Meenan Browse from Londonderry was 32 when she died in August.

The mother-of-four travelled for a gastric sleeve operation 18 months ago but, according to her father, got sick almost straight away.

The family were told she died in Altnagelvin Hospital from "malnutrition due to gastric sleeve".

A BBC investigation in March found that seven British patients who travelled to Turkey for weight-loss surgery died after operations there, while others returned home with serious health issues.

One of the UK's leading bariatric surgeons, Prof David Kerrigan said people are taking a "massive risk" by travelling abroad for weight-loss surgery.

In the UK, he said, patients undergo a rigorous preparatory process that includes a psychological assessment and there is "a proper after-care programme".

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Source: BBC News, 6 September 2023

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Tuberculosis warning as cases of disease rise for first time in decades in Europe

Disruption caused by the coronavirus pandemic is being blamed for the first recorded rise in tuberculosis (TB) cases and deaths in Europe for two decades.

Some 27,300 people died from TB in the World Health Organization’s Europe region in 2021, up from 27,000 deaths the previous year, according to a new surveillance report by WHO and European Union’s disease prevention agency.

The rate of new cases and relapses in the region is also estimated to have increased by 1.2 per cent compared to 2020, in a reversal analysts said “reflects the impact of disruption to TB services caused by the Covid-19 pandemic.” The report comes days after the UK Health Security Agency (UKHSA) reported a 7.3 per cent rise in cases in England in 2021, a year that saw new 4,425 cases.

Dr Esther Robinson, head of the UKHSA's TB unit, said, "Tuberculosis remains a risk to some of the most vulnerable people in our society and this data highlights that progress towards elimination has stalled."

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Source: Independent, 3 April 2023

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Trusts’ row over stroke services sparks ‘significant safety’ concerns

A district general hospital has accused a major teaching trust of ‘failing to adhere to arrangements’ made around the provision of acute stroke services, sparking patient safety warnings in a local integrated care board’s (ICB) risk register.

Harrogate and District Foundation Trust’s accusation that its neighbour, Leeds Teaching Hospitals Trust, is failing to comply with protocol around acute stroke pathways was published in West Yorkshire ICB’s risk register.

The ICB’s September risk register also said the “risk to patient safety is significant and probable if the situation remains unresolved”.

The issues centre on the provision of hyper-acute stroke unit beds, which provide the first two to three days of care for patients with newly diagnosed strokes, and what happens to patients requiring acute stroke care following their initial HASU stay.

West Yorkshire ICB said in its September’s performance report that the problem had “grown due to two recent clinical incidents,” but added “there is no quick solution to this problem”.

Harrogate has raised concerns with the ICB in recent months that “a number of patients are not receiving HASU level care at Leeds”.

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Source: HSJ, 3 October 2023

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Trusts with the biggest falls in staff confidence in care provided

Several large teaching hospitals are among those which saw the steepest declines in the proportion of staff who would recommend the care of their organisation, according to the NHS staff survey results.

Norfolk and Norwich University Hospitals Foundation Trust, University Hospitals Birmingham, Liverpool University Hospitals FT and Nottingham University Hospitals Trust saw declines of 12 percentage points or more in 2021 — for the proportion of staff saying they would be happy for a friend or relative to be treated at their organisation. This was double the average drop in the acute sector.

In a message to staff, Sue Musson, chair of Liverpool University Hospitals Trust, said about her trust’s overall results: “On behalf of the trust board, I want to apologise to everyone that the experience of working at the trust is so deeply unsatisfactory for so many colleagues.

“It would be wrong to suggest that there are quick fixes to these issues. The promise I can give you today is a genuine commitment to listen and learn; we particularly need to understand what would make the difference for colleagues across the trust, recognising that there may well be different answers in different parts of the organisation.

“We will seek to learn from the trusts that have demonstrated the best staff experience scores and to implement best practices at pace. We will also be seeking support and input from national and staff side colleagues.”

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Source: HSJ, 11 April 2022

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Trusts warned to check helipad safety after death

Trusts have been told to check the safety of their helipads after an accident in a hospital car park left a pensioner dead.

Jean Langan, 87, was blown over by the “downwash” of air from a helicopter at Derriford Hospital last year. She was walking through a car park at the hospital after an appointment when she fell and hit her head as an HM Coastguard helicopter landed on the hospital’s helipad. Another elderly woman broke her pelvis.

Now the Health and Safety Executive has written to trust chief executives reminding them of their duty to manage health and safety risks around helipads. These risks include downwash from helicopters, the moving parts of helicopters, and the design and location of helipads.

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Source: HSJ, 2 August 2023

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Trusts warned they are being ‘complacent’ on A&E over-crowding

Emergency medics are writing to hospital chief executives warning them that some trusts are being ‘complacent’ about crowding in A&E, they have told HSJ.

The Royal College of Emergency Medicine (RCEM) is sending a letter to trust chiefs today calling on them to urgently plan for how they will stop corridor waits and exit blocking ahead of January and February, typically the busiest months. It says some trusts were not treating emergency department crowding as a “high priority”, despite covid risks and pressures.

It is also calling for overcrowding in the emergency department (ED) to be classed as a “never event” — a set of major safety risks.

RCEM’s concern comes amid apprehension over long ambulance queues at hospitals across the UK, and difficulties enabling social distancing between patients in many EDs.

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Source: HSJ, 3 November 2020

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Trusts warn of continued care delay as IT outage goes on

Mental health trusts continue to suffer much disruption after a cyber attack left them unable to access their electronic patient records.

Several trusts which use Advanced’s CareNotes EPR are grappling with the system being down, although the company said on Friday some progress had been made to restore the EPR.

One source at an affected mental health trust said there had been “not much in the way of improvements”, while another said they feared it could be “months” before they can fully access the EPR.

NHS England’s mental health director Claire Murdoch is regularly raising issue nationally, HSJ was told, as response teams work with Advanced to investigate and restore IT systems, which were taken offline after the company was hit by a cyber attack two weeks ago.

Hereford and Worcestershire Health and Care Trust has told its patients they might have to “provide more detail on your medical history to ensure clinicians have the most up-to-date information”, while Oxford Health Foundation Trust warned the technical issues could cause delays to patient care.

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Source: HSJ, 21 August 2022

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Trusts turn to ‘aggressive accounting’ and large covid cash reserves to balance books

NHS trusts will draw on billions of pounds of cash reserves built up during the pandemic to help fund their costs this year, while using aggressive accounting treatments to stop the spending hitting the bottom line.

HSJ analysis reveals trusts’ balance sheets are in a far stronger position than before the pandemic, with cash levels reaching around £18bn – three times higher than in March 2020.

There have been increasing concerns around the financial outlook for the health service, with funding levels falling in real terms due to spiralling inflation.

NHS England has warned of service cuts being needed to balance the accounts, while local leaders have warned of “impossible choices” after being told to deliver “cost improvement plans” of around 5 per cent.

However, sources said the strong cash position offers significant headroom to avoid service cuts in the short term, by using the cash reserves built up during covid. But to avoid this impacting on the reported bottom line in the NHS accounts, which would risk a budget breach, they will deploy accounting treatments which reduce reported expenditure.

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Source: HSJ, 12 September 2022

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Trusts told: prepare for ‘top quartile productivity’ as covid inpatients rise ‘almost everywhere’

New planning guidance asks local NHS organisations to prepare for a major waiting-list catch-up by seeking “top quartile performance in productivity”, but also to “safely mobilise all… available surge capacity over the coming weeks” as the service battles rising covid levels “in almost all parts of the country”. 

An end-of-year planning letter was issued by NHS England to local NHS chief executives last night.

It warns: “With covid-19 inpatient numbers rising in almost all parts of the country, and the new risk presented by the variant strain of the virus, you should continue to plan on the basis that we will remain in a level 4 incident for at least the rest of this financial year and NHS trusts should continue to safely mobilise all of their available surge capacity over the coming weeks.

“This should include maximising use of the independent sector, providing mutual aid, making use of specialist hospitals and hubs to protect urgent cancer and elective activity and planning for use of funded additional facilities such as the Nightingale hospitals, Seacole services and other community capacity.”

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Source: HSJ, 24 December 2020

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