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Coronavirus: Weakest patients could be denied lifesaving care due to lack of funding for NHS, doctors admit

NHS patients could be denied lifesaving care during a severe coronavirus outbreak in Britain if intensive care units are struggling to cope, senior doctors have warned.

Under a so-called “three wise men” protocol, three senior consultants in each hospital would be forced to make decisions on rationing care such as ventilators and beds, in the event hospitals were overwhelmed with patients.

The medics spoke out amid frustration over what one said was the government’s “dishonest spin” that the health service was well prepared for a major pandemic outbreak.

The doctors, from hospitals across England, said the health service’s existing critical care capacity was already overstretched and “would crumble” under the demands of a pandemic surge in patients who may all need ventilation to help them breathe.

Those denied intensive care beds could be those suffering with coronavirus or other seriously ill patients, with priority given to those most likely to survive and recover.

Doctors said this would lead to “tough decisions” needing to be made about the wholesale cancellation of operations to free-up beds.

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Source: Independent, 28 February 2020

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Coronavirus: Warning thousands could be left with lung damage

Tens of thousands of people will need to be recalled to hospital after a serious OVID-19 infection to check if they have been left with permanent lung damage, doctors have told the BBC.

Experts are concerned a significant proportion could be left with lung scarring, known as pulmonary fibrosis. The condition is irreversible and symptoms can include severe shortness of breath, coughing and fatigue.

Research into the prevalence of lung damage caused by COVID-19 is still at a very early stage. It's thought those with a mild form of the disease are unlikely to suffer permanent damage. But those in hospital, and particularly those in intensive care or with a severe infection, are more vulnerable to complications.

In a study from China, published in March, 66 of 70 patients still had some level of lung damage after being discharged from hospital.

Radiologists in the UK say, based on the early results of follow-up scans, they are concerned about the long term-effects of a serious infection.

Prof Gisli Jenkins, of the National Institute for Health Research, is running assessment clinics for those discharged from hospital with COVID-19. He said: "My real concern is that never before in our lifetime have so many people been subject to the same lung injury at the same time."

NHS England has said it is planning to open a number of specialist COVID-19 rehabilitation centres to help patients recover from long-term effects, including possible lung damage.

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Source: BBC News, 24 June 2020

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Coronavirus: Visitors steal hand sanitiser gel from hospital

Visitors to a hospital are stealing hand sanitising gel daily – as demand for the product surges amid fears over coronavirus.

Bottles have been taken from patients' beds and dispensers ripped off walls at Northampton General Hospital. Bosses said the gel was "disappearing every day" and they have had to limit the supply on wards.

"Nothing like this has ever happened in all the years we've had the gel," said a hospital spokeswoman.

"Over the past week we've seen stocks on wards disappear from the end of beds every single day," Sally-Anne Watts, associate communications director, told the BBC.

"Three wall-mounted dispensers have been ripped off and we've even seen people coming in and topping up their own dispensers with our product," she said.

Since the hospital's supplies have been going missing, Mrs Watts said, bottles were no longer being put at the end of all beds.

"We don't have an unlimited supply and would ask that visitors to the site respect the fact that we are doing all we can to keep our patients, visitors and staff safe, and we need their support," she added.

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Source: BBC News, 6 March 2020

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Coronavirus: Vaccine rollout 'marathon not a sprint'

The coronavirus vaccine is the "beginning of the end" of the epidemic in the UK, Prof Stephen Powis has said, as vaccinations begin on Tuesday.

But the NHS England medical director warned the distribution of the Pfizer/BioNTech vaccine would be a "marathon not a sprint". It will take "many months" to vaccinate everybody who needs it, he said.

Frontline health staff, those over 80, and care home workers will be first to get the COVID-19 vaccine.

In England, 50 hospitals have been initially chosen to serve as hubs for administering the vaccine. Scotland, Wales, and Northern Ireland will also begin their vaccination programmes from hospitals on Tuesday.

Prof Powis was speaking outside Croydon University Hospital in south London, which became one of the first hospitals in the UK to take delivery of the vaccine on Sunday.

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Source: BBC News, 6 December 2020

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Coronavirus: Unprecedented demand for action on NHS workforce shortages

The NHS will be unable to meet the needs of patients unless significant action is taken to tackle staff shortages, an unprecedented coalition of health leaders has warned.

Medical royal colleges, NHS trade unions and bodies representing senior hospital managers and other health organisations have joined together to warn bosses at NHS England and the government that they must act to ensure the health service workforce is supported in the wake of coronavirus.

The organisations said they were united in the belief that meaningful action on long-standing workforce issues would be the best way to repay the efforts of NHS staff during the virus outbreak – calling for a public commitment to boost numbers, increase flexible working, and improve leadership and support for staff.

Professor Carrie MacEwen, chair of the Academy of Medical Royal Colleges, which organised the statement, told The Independent: “Continued staff shortages in the NHS will be hugely damaging for patients. It has long been recognised that there is a serious shortage of doctors and nurses and right now we need to keep the staff we have, who have done a brilliant job during the pandemic, as well as increase the size of the workforce."

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Source: The Independent, 7 July 2020

 

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Coronavirus: Uncertainty over maternity care causing distress

Women say the uncertainty surrounding maternity services during the coronavirus outbreak is "making a stressful situation harder".

The Royal College of Midwives says services may need to be reduced due to COVID-19.

Like many areas in the health sector, staff shortages caused by sickness and workers self-isolating are impacting resources, the college adds.

The BBC asked a group of NHS trusts and boards across the UK about the services they are able to provide during the coronavirus pandemic. Nine trusts in England, five boards in Scotland and one trust in both Wales and Northern Ireland responded.

All 16 bodies said one birth partner could be present during labour, but just over a quarter of those asked are allowing partners on the postnatal ward following the birth. Around a third of trusts and boards that spoke to the BBC are now allowing home births.

In the weeks after a birth, midwives and health visitors are now heavily relying on virtual communication to provide families with postnatal support. Home visits are mostly still happening, but one trust in London said it only allows face-to-face contact when it is "absolutely essential".

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Source: BBC News, 24 April 2020

Read Patient Safety Learning's latest blog: Home births, fears and patient safety amid COVID-19

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Coronavirus: UK patients face 'random' tests to check spread

Tests for coronavirus are being increased to include people displaying flu-like symptoms at 11 hospitals and 100 GP surgeries across the UK.

The tests will provide an "early warning" if the virus is spreading, Public Health England Medical Director Prof Paul Cosford said.

Up to now, people were tested only if they displayed symptoms having recently returned from one of the countries where there has been an outbreak, including China, South Korea and northern Italy. However, Prof Cosford said Public Health England was now working with hospitals and GP surgeries to conduct "random" tests.

These will target some patients with coughs, fevers or shortness of breath, regardless of whether they have travelled to a place where the virus is spreading.

"If we do get to the position of a more widespread infection across the country, then it will give us early warning that's happening," said Prof Cosford.

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Source: BBC News, 26 February 2020

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Coronavirus: UK must prepare for second virus wave says health leaders

Health leaders are calling for an urgent review to determine whether the UK is properly prepared for the "real risk" of a second wave of coronavirus.

In an open letter published in the BMJ, ministers were warned that urgent action would be needed to prevent further loss of life.  The presidents of the Royal Colleges of Surgeons, Nursing, Physicians, and GPs all signed the letter.

It comes after Boris Johnson announced sweeping changes to England's lockdown.

Following the prime minister's announcement, health leaders called for a "rapid and forward-looking assessment" of how prepared the UK would be for a new outbreak of the virus.

"While the future shape of the pandemic in the UK is hard to predict, the available evidence indicates that local flare-ups are increasingly likely and a second wave a real risk," they wrote in the letter.

"Many elements of the infrastructure needed to contain the virus are beginning to be put in place, but substantial challenges remain."

The authors of the letter, also signed by the chair of the British Medical Association, urged ministers to set up a cross-party group with a "constructive, non-partisan, four nations approach", tasked with developing practical recommendations.

"The review should not be about looking back or attributing blame," they said, and instead should focus on "areas of weakness where action is needed urgently to prevent further loss of life and restore the economy as fully and as quickly as possible".

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Source: BBC News, 24 June 2020

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Coronavirus: UK changes course amid death toll fears

Change course or a quarter of a million people will die in a "catastrophic epidemic" of coronavirus – warnings do not come much starker than that.

The message came from researchers modelling how the disease will spread, how the NHS would be overwhelmed and how many would die. The situation has shifted dramatically and as a result we are now facing the most profound changes to our daily lives in peacetime.

This realisation has happened only in the past few days.

However, it is long after other scientists and the World Health Organization had warned of the risks of not going all-out to stop the virus.

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Source: BBC News, 18 March 2020

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Coronavirus: Two healthcare workers in UK test positive for deadly virus as GP surgery closed

The number of British cases of coronavirus has doubled to eight – with two healthcare workers among those testing positive – while a GP surgery in Brighton was closed amid fears of the infection spreading.

Brighton’s County Oak medical centre closed on Monday with a warning notice on its door telling patients it was “closed due to operational difficulties”.

According to reports, one of those infected was a GP, who was at work for one day but did not see any patients. Workers wearing protective suits were pictured cleaning the surgery and pharmacy on Monday afternoon.

The government has since classified the virus, which has infected more than 40,000 people in China and led to the death of more than 1,000, as a “serious and imminent threat” to public health while activating emergency powers that can see it force people to remain in quarantine.

“I will do everything in my power to keep people in this country safe,” Matt Hancock, the Health Secretary, said in a statement. “We are taking every possible step to control the outbreak of coronavirus. NHS staff and others will now be supported with additional legal powers to keep people safe across the country.”

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Source: The Independent, 11 February 2020

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Coronavirus: Trial urges people to call 111 before going to A&E

People requiring A&E will be urged to book an appointment through NHS 111 under a trial in parts of England. The aim is to direct patients to the most clinically-appropriate service and to help reduce pressure on emergency departments as staff battle winter pressures, such as coronavirus and flu.

The pilots are live in Cornwall, Portsmouth, Hampshire and Blackpool and have just begun in Warrington. 

If they are successful, they could be rolled out to all trusts in December. However, people with a life-threatening condition should still call 999.

Under the new changes, patients will still be able to seek help at A&E without an appointment, but officials say they are likely to end up waiting longer than those who have gone through 111.

More NHS 111 call handlers are being brought in to take on the additional workload, alongside extra clinicians, the Department of Health and Social Care said.

A campaign called Help Us Help You will launch later in the year to urge people to use the new service.

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Source: BBC News, 17 September 2020

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Coronavirus: Time running out on track and trace, NHS leaders warn

Time is running out to finalise a track and trace strategy that would avoid a potential second surge in coronavirus cases, NHS leaders have said.

The NHS Confederation warned of "severe" consequences to staff and patients if the right system was not established quickly and that lockdown measures should not be eased until a clear plan was in place.

Contact tracing identifies those who may have come into contact with an infected person, either through an app or by phone and email, so they can avoid potentially passing the disease on.

It follows the Prime Minister's pledge to introduce a "world-beating" contact tracing system in England from June.

Niall Dickson, chief executive of the confederation, which represents health and care leaders, welcomed Boris Johnson's pledge made at Prime Minister's Questions on Wednesday. But in a letter to Health Secretary Matt Hancock, Mr Dickson said without a clear strategy the UK was at greater risk of a second peak of the virus.

He said a strategy should have been in place sooner and if the right system was not instigated rapidly the ramifications for the NHS "could be severe".

Speaking on the Today programme, Mr Dickson said: "We are absolutely clear that contact tracing is the right thing to do, it is absolutely critical, it has got to be in place to prevent any notion of a second surge if the lockdown is being further released."

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Source: 21 May 2020

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Coronavirus: Thousands of health and care staff infected at work, new data shows

At least 6,500 health and care workers may have been infected with coronavirus through their work, including 100 who died, according to data from the Health and Safety Executive (HSE).

The regulator told The Independent it was reviewing each case and could launch investigations under the Health and Safety at Work Act if hospitals or care homes are suspected of not taking adequate steps to protect staff from infection.

This could result in a hospital or care home being prosecuted.

The latest data from the HSE shows between 10 April and 10 August there were a total of 3, 382 healthcare workplace infections, including 50 fatal incidents. In residential care there were 3,168 infections reported to the watchdog with 48 fatal cases.

The results of the review, first revealed earlier this month by The Independent, is being kept secret but where a medical examiner finds a worker may have died as a result of a workplace infection the death will have to be reported to the HSE for possible investigation. Coroners may also hold inquests into deaths.

It will also make it easier for families to claim compensation from the government’s additional death in service payments of £60,000 which was announced by health secretary Matt Hancock in April.

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Source: The Independent, 25 August 2020

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Coronavirus: Thousands of COVID-19 survivors could be diagnosed with sepsis, charity warns

People are being warned to familiarise themselves with the symptoms of sepsis after a study found that as many as 20,000 COVID-19 survivors could be diagnosed with the condition within a year.

One in five people who receive hospital treatment for the coronavirus are at risk, according to the UK Sepsis Trust.

Sepsis is triggered when the body overreacts to an infection, causing the immune system to turn on itself - leading to tissue damage, organ failure and potentially death.

If spotted quickly, it can be treated with antibiotics before it turns into septic shock and damages vital organs.

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Coronavirus: They avoided hospital but they still aren't getting better

Extreme fatigue, nausea, chest tightness, severe headaches, "brain fog" and limb pains are among the recurring symptoms described by some sufferers of COVID-19 for weeks - and even months - after their diagnosis.

They call themselves "long-haulers" and their symptoms persist long after the 14-day period that's officially said to be the average length of the illness.

There are calls for both health professionals and employers to recognise that some people will take a lot longer than two weeks to recover.

"It's the weirdest thing I've ever experienced," Helen Calder, from Liverpool, told BBC health correspondent Dominic Hughes.

Nearly four months after she and her family caught the virus, she still experiences a relapse roughly every two weeks where she is hit by debilitating fatigue, nausea, headaches and limb pain. Her doctors have diagnosed Post Viral Fatigue and she says any small over-exertion while she is feeling well can set her back for days at a time.

Dr Jake Suett, an intensive-care doctor in Norfolk, who was himself ill for several weeks, wrote an open letter calling on the government to push for more research into long-haul symptoms, and also to raise awareness among not only health professionals but also employers, who may see their staff off work for longer than two weeks.

"These patients may require financial help, and their employers need to have a realistic expectation for the time it will take them to recover," he wrote.

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Source: 7 July 2020

Read Jake Suett's blog on the hub

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Coronavirus: The new inventions inspired by a pandemic

A new ventilator, a virus-killing snood and a hands-free door pull are just some of the innovations coming out of Wales to tackle coronavirus.

Since the outbreak, doctors, scientists and designers have been working on ideas to stop the virus spreading.

The ventilator has already successfully treated a Covid-19 patient and has been backed by the Welsh Government.

Mass production of the snood-type mask is under way while a 3D design of the handle has been widely circulated.

Plaid Cymru leader Adam Price, who was part of the impetus to get the ventilator into mass production, said the innovations put Wales "on the front foot" in the battle against the pandemic.

"It shows that Wales, as a small nation, can get things done quickly as we face the biggest challenge of our generation," he said.

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Source: BBC News, 24 March 2020

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Coronavirus: Tens of thousands ‘wrongly given’ all clear by Lighthouse Labs

Tens of thousands of people infected with coronavirus were incorrectly given the all clear by England’s Lighthouse Laboratories, a High Court trial will be told next week.

Court documents seen by The Independent show the labs are accused of unfairly selecting software that was shown in a test to produce significant numbers of errors and false negatives, samples that should have been positive or classed as needing to be re-taken.

The two companies behind the Lighthouse Labs in England – Medicines Discovery Catapult Ltd and UK Biocentre Ltd – are accused of treating British company, Diagnostics.ai unfairly and giving preferential treatment to Belgian company UgenTec, despite the British firm’s software performing better in the test.

The case, first revealed by The Independent in June, also includes a judicial review of the procurement decision against health secretary Matt Hancock – one of the first court hearings over the procurement processes followed by the government since the start of the pandemic.

The Independent understands lawyers for Diagnostics.ai will accuse the laboratories of choosing a software solution that went on to produce tens of thousands of incorrect results which will have led to infected people going about their normal lives while at risk of spreading the virus.

In June, UgenTec chief executive Steven Verhoeven told The Independent the suggestion its software had made errors was “incorrect”.

The Department of Health refused to comment on the legal action but said in June that the UgenTec software had been used for several months and was subject to quality assurance processes, though it did not give any further details.

Mr Justice Fraser will hear opening arguments in the case on Monday at the High Court.

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Source: The Independent, 25 September 2020

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Coronavirus: Survivors 'at risk of PTSD'

People who were seriously ill in hospital with coronavirus need to be urgently screened for post-traumatic stress disorder (PTSD), leading doctors say.

The Covid Trauma Response Working Group, led by University College London and involving experts from south-east England, said those who had been in intensive care were most at risk.

The experts said regular check ups should last at least a year.

More than 100,000 people have been treated in hospital for the virus. The experts say tens of thousands of these would have been seriously ill enough to be at risk of PTSD.

The working group highlighted research which showed 30% of patients who had suffered severe illnesses in infectious disease outbreaks in the past had gone on to develop PTSD, while depression and anxiety problems were also common.

Tracy is just one of many people who has been left with psychological scars from her coronavirus experience. She was admitted to Whittington Hospital in north London in March and spent more than three weeks there - one of which was in intensive care.

"It was like being in hell. I saw people dying, people with the life being sucked from them. The staff all have masks on and all you saw was eyes - it was so lonely and frightening."

Since being discharged in April the 59-year-old has been struggling to sleep because of the thought she will die and she has constantly suffered flashbacks. She is now receiving counselling.

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Source: BBC News, 29 June 2020

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Coronavirus: Survival rate of intensive care patients improving, data suggests

As hospitalisations and intensive care admissions surge around the country, new figures indicate coronavirus patients in critical care have a better survival rate now than when the pandemic first began.

The latest report from The Intensive Care National Audit and Research Centre (ICNARC) into critical care for England, Wales and Northern Ireland looks at patients admitted to intensive care up until 31 August and those admitted from 1 September.

The data shows that on average, 39% of critical care coronavirus patients died up until the end of August while less than 12% have died since September.

The proportion of patients who died after being admitted to critical care fell by almost a quarter from the peak and as much as half in hospitals overall.

However, the Dean of the Faculty of Intensive Care Medicine, Dr Alison Pittard, told the BBC that the difference may be attributed to an insufficient amount of time having passed which impedes an accurate and longterm patient assessment, as some remain in hospital.

Meanwhile, scientific advisors continue to warn that the next few weeks are critical for regulating hospital admissions.

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Source: The Independent, 18 October 2020

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Coronavirus: Study reveals alarming impact of Covid on care home sector

Nursing homes were put under “constant” pressure to accept patients with coronavirus while being regularly refused treatment from hospitals and GPs for residents who became ill at the height of the Covid crisis, a landmark study has found.

The Queen’s Nursing Institute said homes were told hospitals had blanket “no admissions” policies during April and May while GPs and local managers imposed unlawful do not resuscitate orders on residents.

The findings have emerged in a survey by the QNI, the world’s oldest nursing charity, which surveyed 163 care home nurses and managers working across the country.

Carried out between May and June this year, the study establishes an evidence base of the impact on the sector from coronavirus, in addition to the official figures showing care home death rates.

One nurse said they were under “constant pressure to admit people who were Covid positive” while another said: “The acute sector pushed us to take untested admissions. The two weeks of daily deaths during an outbreak were possibly the two worst weeks of my 35-year nursing career.”

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Source: The Independent, 22 August 2020

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Coronavirus: Study into 'Long COVID' finds 3 in 4 patients suffering symptoms months later

Nearly three-quarters of coronavirus patients admitted to hospital suffer ongoing symptoms three months later, new research suggests.

A total of 81 patients out of 110 discharged from Southmead Hospital in Bristol were still experiencing symptoms from the virus, including breathlessness, excessive fatigue and muscle aches, after 12 weeks.

Many were struggling to carry out daily tasks such as washing, dressing or going back to work, the study found.

The majority of patients reported improvements in the initial symptoms of fever, cough and loss of sense of smell, and most had no evidence of lung scarring or reductions in lung function.

The findings are part of North Bristol NHS Trust's Discover project, which is studying the longer-term effects of coronavirus - so-called Long COVID.

An intensive care doctor, Dr Jake Suett, told Sky News in June that he was still suffering COVID-19 symptoms three months after contracting the disease. Dr Jake Suett, 31, had no underlying health conditions but was still suffering chest pain, breathlessness, blurred vision, memory loss, a high temperature, concentration problems.

Dr Rebecca Smith, from North Bristol NHS Trust, said: "There's still so much we don't know about the long-term effects of coronavirus, but this study has given us vital new insight into what challenges patients may face in their recovery and will help us prepare for those needs."

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Source: Sky News, 20 August 2020

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Coronavirus: Special needs parents in 'survival mode'

A father has described the "huge impact" of losing respite care for his young daughter who has complex special needs.

Tim Clarke and his wife Ana look after their six-year-old daughter Molly at home in Worcester. The family normally receives a few hours of outside care and educational help a week, but that ended with the coronavirus pandemic.

Molly has been diagnosed with autism and also has medical issues including a cyst on her brain.

One charity worker from the Pathological Demand Avoidance (PDA) Society, a condition which is on the autism spectrum, described parents of children with special needs as being in "survival mode".

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Source: BBC News, 1 April 2020

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Coronavirus: Special body recovery teams set up for those who die at home

Special body recovery teams have begun work to deal with suspected coronavirus victims who die in their homes.

Small units of police, fire and health service staff will confirm death and the identity of the dead and remove their bodies to a mortuary.

Known as Pandemic Multi-Agency Response Teams, or PMART, they will be dispatched when victims die outside hospitals and there is a high probability they had COVID-19.

The teams have been set up, initially in London, to relieve pressure on hospitals overwhelmed with coronavirus emergency cases.

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Source: Sky News, 1 April 2020

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Coronavirus: Social care concerns revealed in leaked letter

A leaked letter seen by the BBC has revealed an extensive list of concerns about how the social care sector is coping with the coronavirus crisis.

The letter raises fears about funding, testing, personal protective equipment (PPE) and the shielding scheme for vulnerable people.

Written on Saturday, to a senior official at the Department of Health and Social Care by the Association of Directors of Adult Social Services (Adass), it says mixed messages from the government have created "confusion and additional workload".

On protective equipment for care workers, the letter says the national handling has been "shambolic". Early drops of equipment have been "paltry" and more recent deliveries have been "haphazard", with some even being confiscated by border control for the NHS.

And while the rollout of testing for care workers has been generally welcomed, the letter states "testing for care workers appears to be being rolled out without being given thought to who is going to be tested and what we are going to do with the result".

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Source: BBC News, 16 April 2020

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Coronavirus: Severe mental health problems rise amid pandemic

Doctors are seeing a rise in people reporting severe mental health difficulties, a group of NHS leaders says.

It follows a more than 30% drop in referrals to mental health services during the peak of the pandemic.

But there are predictions that the recent rise will mean demand actually outstrips pre-coronavirus levels - perhaps by as much as 20%.

The NHS Confederation said those who needed help should come forward.

But the group, which represents health and care leaders, said in a report that mental services required "intensive support and investment" in order to continue to be able to help those who needed it.

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Source: BBC News, 12 August 2020

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