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Patient Safety Learning

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  1. Patient Safety Learning
    Left in agonising pain, with staff ignoring his cries for help, Martin Wild called 999 from his hospital bed, desperate for someone to get him the medication he needed.
    This was just the beginning of the 73-year-old’s “nightmare” experience at the hands of Salford Royal Hospital.
    Over nearly five months, the former car salesman says he was subjected to prolonged periods of neglect, including being left to lie in urine-soaked sheets, pleading for medication.
    He lost so much weight that, according to his wife, he became skin and bone. One staff member involved in his care said they’d never seen a hospital patient neglected to such a serious degree.
    Mr Wild told The Independent that his time at Salford Royal Hospital has shattered his belief in the NHS and that he believes it is not fit for purpose.
    “It was a nightmare in that ward. I didn’t feel like there was much caring going on,” he said.
    “I used to lie there at night; I could hear people shouting and screaming for help. It was like being in the third world.”
    Read full story
    Source: The Independent, 24 February 2024
  2. Patient Safety Learning
    Women are waiting nearly nine years for an endometriosis diagnosis in the UK, according to research that found health professionals often minimise or dismiss symptoms.
    The study by the charity Endometriosis UK suggests waiting times for a diagnosis have significantly deteriorated in the past three years, increasing to an average of eight years and 10 months, up 10 months since 2020. In Scotland, the average diagnosis time has increased by four months.
    The report, based on a survey of 4,371 people who have received a diagnosis, shows that 47% of respondents had visited their GP 10 or more times with symptoms before being diagnosed, and 70% had visited five times or more.
    The chief executive of Endometriosis UK, Emma Cox, said: “Taking almost nine years to get a diagnosis of endometriosis is unacceptable. Our finding that it now takes even longer to get a diagnosis of endometriosis must be a wake-up call to decision-makers to stop minimising or ignoring the significant impact endometriosis can have on both physical and mental health.”
    The report includes examples of patients’ experiences, with many being told that their pain was “normal”.
    One said: “I was constantly dismissed, ignored and belittled by medical professionals telling me that my symptoms were simply due to stress and tiredness. I persevered for over 10 years desperate for help.” Another said she had been told she was “being dramatic” after going to her GP as a teenager with painful periods. Another said: “A&E nurses told me that everyone has period pain so take paracetamol and go home.”
    Read full story
    Source: The Guardian, 4 March 2024
  3. Patient Safety Learning
    The lives of thousands of blind and partially sighted people are being put at risk by delays in vital care that they have a legal right to after being assessed as visually impaired, according to a report.
    More than a quarter of English councils are leaving people who have just been diagnosed as blind waiting more than a year for vision rehabilitation assessments and potentially life-saving support, the report by the RNIB revealed.
    It cited the example of one person who died while waiting for council help. The Guardian can reveal that the case involved a woman from Church Stretton in Shropshire who had been waiting 18 months for an assessment when she tripped on a pothole and died later from head injuries. She had been trying to teach herself how to use a white cane, without any support or training, despite getting a certificate of visual impairment.
    Councils are obliged to provide such help for those coping with a recent visual impairment under the 2014 Care Act. The support involves helping people cope practically and mentally with visual impairment at a critical time after a diagnosis.
    The social care ombudsman recommends that councils should provide these services within 28 days of someone receiving a certificate of visual impairment.
    But the RNIB report, which is based on freedom of information requests to councils in England, found that 86% were missing this 28-day deadline. The report, Out of sight – The hidden scandal of vision rehabilitation warned that the delays uncovered in the figures were dangerous.
    Read full story
    Source: The Guardian, 10 March 2024
  4. Patient Safety Learning
    NHS England is in negotiations with ministers to formally push back the target to eliminate 65-week waiters, HSJ has learned.
    Discussions about the target are on-going as part of negotiations around the delayed 2024-25 planning guidance. It has been clear for months the March deadline to virtually eliminate 65-week waiters would be missed.

    It has emerged some trusts with the largest waiting lists already appear to be working to a September deadline.
    The news follows prime minister Rishi Sunak being forced to finally admit this week that his flagship NHS pledge from last January, that the waiting list would be falling by this year, had failed. This was something NHS bosses have warned of since summer.
    Read full story (paywalled)
    Source: HSJ, 9 February 2024Choose Single File...
  5. Patient Safety Learning
    Long A&E waits have got worse at more than one in five acute trusts, despite an improving trend nationally.
    Around 30 acute trusts have reported an increase in long accident and emergency waits, bucking the national trend.
    According to data covering the nine months to December, the proportion of waits more than 12 hours from time of arrival has improved to 6.3%, down from 8% during the same period in 2022. However, 28 out of 119 acute trusts reported a rise of up to 3 percentage points.
    HSJ’s analysis, which used published and unpublished data, showed 11 of these trusts had worsened despite improving their headline performance against the four-hour target.
    Adrian Boyle, of the Royal College of Emergency Medicine, said the emphasis on the four-hour target “incentivises focus on the people who are being sent home, and takes effort and attention away from the people who are being admitted to hospital”.
    He added: “The harms of long waits are greatest for people being admitted to hospital. We are disappointed by the current lack of focus in the planning guidance to help our most vulnerable patients.”
    Read full story (paywalled)
    Source: HSJ, 27 February 2024
  6. Patient Safety Learning
    Scores of potentially dangerous nurses and midwives could be working in the NHS and putting patients at risk as their cases sit in a growing backlog of misconduct, 
     
    Hundreds of accusations against staff are being progressed without a full investigation, a Nursing and Midwifery Council (NMC) whistleblower has alleged, risking false sanctions or rogue nurses being wrongly cleared if the cases collapse.
    Overall there are more than 1,000 outstanding cases against healthcare staff for a hearing, including 451 that have not even been allocated a lawyer to vet. In 83 of the more serious allegations, the accused staff have been put under restrictions but could still be working with patients.
    The NMC whistleblower has claimed the figures expose a hidden backlog of “under-investigated” allegations, with 451 cases against nurses and midwives still needing to be reviewed by lawyers. These could include nurses who are innocent but are awaiting a hearing, with one “stuck in the void” for eight years, the source added.
    The whistleblower whose allegations prompted The Independent’s investigations has raised repeated concerns to the Professional Standards Authority (PSA), which regulates the NMC, over the hidden backlog, which was only uncovered through a freedom of information request.
    However the PSA has not used its powers to trigger a review. The whistleblower warned the public is being left at risk of harm, while nurses and midwives could face miscarriages of justice.
    “The NMC’s desperation to hide these figures has caused it to make dangerous decisions including creating a surge team of colleagues from across the organisation to review these cases with only minimal training,” the whistleblower said.“It is proposing to mass outsource these reviews to a firm of lawyers who have never undertaken this kind of work before.”
    Read full story
    Source: The Independent, 3 March 2024
  7. Patient Safety Learning
    An investigation published by The BMJ today reveals new details of requests to recall striking junior doctors from picket lines for patient safety reasons. 
    Documents show that while most trusts in England did not make such requests, those that did were rejected by the BMA in most cases. Some of these trusts warned of potential harm to patients from cancelling operations at the last minute and short staffing, reports assistant news editor Gareth Iacobucci.
    However, the BMA said it takes concerns about patient safety “incredibly seriously” and provided The BMJ with summaries of why requests were turned down.
    The union’s chair of council Phil Banfield said, “Throughout industrial action we have engaged thoroughly and in good faith with the derogation process, considering each request carefully to ensure that granting a derogation is necessary and the last and only option.”
    He said that poor planning by some trusts had led to some routine care being inappropriately booked in on strike days. In other instances, he said trusts had failed to make sufficient effort to draft in the necessary cover for strike days.
    Read full story
    Source: BMJ, 28 March 2024
  8. Patient Safety Learning
    The rate at which people are dying early from heart and circulatory diseases has risen to its highest level in more than a decade, figures show.
    Data analysed by the British Heart Foundation (BHF) shows a reverse of previous falling trends when it comes to people dying from heart problems before the age of 75 in England.
    Since 2020, the premature death rate for cardiovascular disease has risen year-on-year, with the latest figures for 2022 showing it reached 80 per 100,000 people in England in 2022 – the highest rate since 2011 when it was 83.
    This is the first time there has been a clear reversal in the trend for almost 60 years.
    Between 2012 and 2019 progress slowed and, from 2020, premature death rates began to clearly rise, the data reveals.
    Dr Sonya Babu-Narayan, associate medical director at the BHF and a consultant cardiologist, said: “We’re in the grip of the worst heart care crisis in living memory.
    “Every part of the system providing heart care is damaged, from prevention, diagnosis, treatment, and recovery; to crucial research that could give us faster and better treatments.
    “This is happening at a time when more people are getting sicker and need the NHS more than ever.
    “I find it tragic that we’ve lost hard-won progress to reduce early death from cardiovascular disease.”
    Read full story
    Source: Medscape, 22 January 2024
  9. Patient Safety Learning
    Doctors "failed to realise" that a first-time mother's pregnancy had become "much higher risk" because crucial warning signs were not properly highlighted in her medical records, an inquiry has heard.
    Nicola McCormick was obese and had experienced repeated episodes of bleeding and reduced foetal movement, but was wrongly downgraded from a high to low risk patient weeks before she went into labour.
    Her daughter, Ellie McCormick, had to be resuscitated after being born "floppy" with "no signs of life" at Wishaw General hospital on March 4 2019 following an emergency caesarean.
    She had suffered severe brain damage and multi-organ failure due to oxygen deprivation, and was just five hours old when her life support was switched off.
    A fatal accident inquiry (FAI) at Glasgow Sheriff Court was told that Ms McCormick, who was 20 and lived with her parents in Uddingston, should have been booked for an induction of labour "no later" than her due date of 26 February.
    Had this occurred, she would have been in hospital for the duration of the birth with Ellie's foetal heartbeat "continuously" monitored.
    In the event, Ms McCormick had been in labour for more than nine hours by the time she was admitted to hospital at 8.29pm on 4 March.
    A midwife raised the alarm after detecting a dangerously low foetal heartbeat, and Ms McCormick was rushed into theatre for an emergency C-section.
    Dr Rhona Hughes, a retired consultant obstetrician who gave evidence as an expert witness, told the FAI that Ellie might have survived had there been different guidelines in place in relation to the dangers of bleeding late in pregnancy, or had her medical history been more obvious in computer records.
    Read full story
    Source: The Herald, 24 January 2024
  10. Patient Safety Learning
    A patient in north Wales suffered "catastrophic" consequences when staff didn't connect their oxygen supply correctly.
    The Betsi Cadwaladr health board, which was caring for the patient at the time, is investigating and says it was one of a small number of recent similar incidents.
    But it refused to say whether the patient died, or to explain what the “catastrophic” consequences were.
    It says it is working to improve staff training to avoid similar incidents happening again.
    On Tuesday, Wales' health minister Eluned Morgan said the health board still had "a lot to do," before it could be taken out of special measures.
    A report to the committee said: “Further patient safety incidents have occurred in the health board related to the preparation and administration of oxygen using portable cylinders.
    “On review, the cylinder had not been prepared correctly, resulting in no flow of oxygen to the patient.
    “One incident had a catastrophic outcome and is under investigation.”
    Read full story
    Source: BBC News, 20 February 2024
  11. Patient Safety Learning
    The number of patients waiting more than 12 hours in A&E hit a record in January of almost 180,000 people.
    Worsening pressures on A&E come as prime minister Rishi Sunak has officially missed his pledge, made in January last year, to cut the NHS waiting list.
    NHS England began publishing previously-hidden data on patients waiting 12 hours or more last year, after reports by The Independent.
    The latest figures for January show 178,000 people were waiting this long to be seen, treated or discharged after arriving from A&E – a record since February 2023 when the data was first published. In that month, 128,580 people waited more than 12 hours, and in December there were 156,000.
    The number waiting at least four hours from the decision to admit to actual admission has also risen, from 148,282 in December to 158,721 last month – the second-highest figure on record.
    Dr Tim Cooksley, past president of the Society for Acute Medicine, warned: “Degrading corridor care and prolonged waits causing significant harm is tragically and increasingly the expected state in urgent and emergency care.”
    Read full story
    Source: The Independent, 8 February 2024
  12. Patient Safety Learning
    Drugs used to treat ADHD are being openly traded in "potentially lethal" doses to UK buyers on encrypted apps, a BBC North West investigation has found.
    Criminals are cashing in on a national shortage to offer the prescription tablets in a secret mail-order service.
    The BBC found an unregulated online market stacked with medication which high street chemists were struggling to stock.
    It is feared patients are turning to the black market in desperation, but one psychiatrist has warned some of the drugs could contain other potentially harmful chemicals.
    Thousands of people with ADHD have been unable to get prescribed medication amid a major supply shortage.
    The BBC has heard how the situation has left children and adults in limbo and with the shortage set to last until December many are believed to be turning to illegitimate traders to help treat the condition.
    The BBC took these findings to Dr Morgan Toerien, associate specialist in mental health at Beyond Clinics in Warrington, who said: "A lot of these drugs are potentially lethal, not just dangerous - particularly if you weren't used to taking them and if you took a higher dose.
    "During my work in illicit drug treatment, we've tested people alleged to have taken a lot of the drugs seen on this channel and they don't actually contain what they say they do."
    He said people could be taking a tablet purporting to be to treat ADHD, but could be "far more dangerous".
    Read full story
    Source: BBC News, 28 February 2024
  13. Patient Safety Learning
    Almost one in three NHS employees have had to take time off work suffering poor mental health in the past year, new research suggests.
    The Unison union said its survey of 12,000 health workers shows the impact of a staffing crisis, with many suffering “burnout”.
    Panic attacks, high blood pressure, chest pains and headaches are among the physical signs of stress reported by nurses, porters, 999 call handlers and other NHS staff who completed the survey.
    The news comes as more than half of the mental health hubs launched for NHS workers after the pandemic have closed since last year, according to the British Psychological Society.
    Unison said workforce pressures are taking a huge toll as staff tackle a waiting list backlog, with many struggling to look after their wellbeing.
    Of those who were off with mental health problems, one in five said they did not tell their employer the real cause of their absence, mainly because they did not feel their manager or employer would be supportive.
    The union said staff feel undervalued and frustrated, with many quitting for less stressful jobs that pay more.
    Read full story
    Source: The Independent, 8 April 2024
  14. Patient Safety Learning
    NHS England has confirmed new financial incentives for trusts to deliver strong performance against the four-hour emergency target this month.
    National leaders are desperate for the NHS to hit the four-hour target in 76% of cases in March, telling trusts earlier this month that it was necessary to restore confidence in the health service.
    They took the unusual step at the start of the month of asking local leaders to sign a commitment to deliver the necessary performance. The recent pressure has come under criticism for encouraging hospitals to prioritise four-hour performance over caring for the sickest patients.
    It was also indicated there would be new financial incentives for those delivering the best performance.
    In a letter, NHSE confirmed a significant expansion to the criteria for trusts to claim a share of a £150m incentive fund, by improving their headline accident and emergency performance.
    Read full story (paywalled)
    Source: HSJ, 12 March 2024
  15. Patient Safety Learning
    England’s largest hospital trust has written to GPs warning their patients face 15-week waits for routine MRIs, ultrasound and CT scans.
    Guy’s and St Thomas’ Foundation Trust in central London said it was prioritising suspected cancer and other “urgent cases”, meaning “unfortunately waiting times for routine patients are now an average of 15-16 weeks for an appointment against a target of six weeks”.
    This is much worse than national averages, which December figures showed were 3.2 weeks, 2.5 weeks and 3.3 weeks for MRI, CT and ultrasound waits respectively.
    It its letter to GPs in Lambeth and Southwark – its main patches – GSTT said: “Current imaging referral demand outstrips capacity, despite these services consistently delivering near 120 per cent levels of activity compared to 2019-20.
    “The radiology service is exploring multiple routes to increase imaging capacity, including increased weekend working, insourcing and outsourcing contracts, but there is still a significant shortfall of slots every week.”
    In particular, it said primary care staff should expect long waits for the reporting of routine MRI scans.
    Read full story (paywalled)
    Source: HSJ, 13 February 2024
  16. Patient Safety Learning
    The menopause is not a disease and is being “over-medicalised”, experts have said.
    High-income countries, including the UK, commonly see menopause as a medical problem or hormone-deficiency disorder with long-term health risks “that are best managed by hormone replacement (therapy)”, they said.
    Yet, around the world, “most women navigate menopause without the need for medical treatments”, the experts, including from the Royal Women’s Hospital in Melbourne, Australia, and King’s College London, said.
    They argued there is a lack of data on whether health problems are caused by menopause or simply by ageing.
    In a first paper in The Lancet Series on the menopause, the experts said: “Although management of symptoms is important, a medicalised view of menopause can be disempowering for women, leading to over-treatment and overlooking potential positive effects, such as better mental health with age and freedom from menstruation, menstrual disorders, and contraception.”
    Series co-author Professor Martha Hickey, from the University of Melbourne and Royal Women’s Hospital, said: “The misconception of menopause as always being a medical issue which consistently heralds a decline in physical and mental health should be challenged across the whole of society.
    “Many women live rewarding lives during and after menopause, contributing to work, family life and the wider society.
    “Changing the narrative to view menopause as part of healthy ageing may better empower women to navigate this life stage and reduce fear and trepidation amongst those who have yet to experience it.”
    Read full story
    Source: The Independent, 5 March 2024
  17. Patient Safety Learning
    William Wragg, the Tory chair of the Public Administration and Constitutional Affairs Committee (PACAC), has belatedly intervened in the growing crisis over the failure of the Prime Minister to appoint a new Parliamentary Ombudsman to replace Rob Behrens who quits the Parliamentary and Health Service Ombudsman on 31 March 2024.
    In a letter published on the committee’s website, Mr Wragg asks Sir Alex Allan, the senior non executive director on the Parliamentary and Heath Services Ombudsman board, what measures will be taken to keep the office going and what is going to happen to people who, via their MP, want to lodge a complaint to the Ombudsman. He also raises whether reports can be published and complaints investigated. 
    The letter discloses that recruitment for a new Ombudsman began last October and a panel chose the winning candidate at the beginning of January. Since then the Cabinet Office and Rishi Sunak, who has to approve the appointment, have not responded. The silence from Whitehall and Downing Street means no motion can be put to Parliament appointing a new Ombudsman, who then appears before the PACAC for a pre appointment hearing. PACAC has only a couple of weeks to set up the hearing.
    Read full story
    Source: Westminster Confidential, 12 March 2024
  18. Patient Safety Learning
    A former consultant at the Southern Health Trust has told an inquiry into urology services that waiting lists are the "greatest source of patient harm".
    The inquiry was established in 2021 and is examining the trust's handling of urology services prior to May 2020.
    Aidan O'Brien became a consultant urologist in Craigavon Area Hospital in July 1992.
    His work is at the centre of the inquiry.
    Giving evidence on Monday, he said waiting list figures highlighted what "myself and my colleagues [have said] for decades" and described it as a "grossly inadequate service".
    "If you look at four-and-a-half years for urgent surgery, it is appalling," he told the inquiry.
    "I don't have a magic solution to the current situation, which is dire."
    Read full story
    Source: BBC News, 8 April 2024
  19. Patient Safety Learning
    The new NHS gender identity clinics for young people are “understaffed” and “nowhere near ready”, it was claimed on Monday as they officially started taking on patients.
    A London hub, alongside a second in the northwest, will begin to see patients this week as they replace the Gender Identity Development Service (Gids) at the Tavistock and Portman NHS Foundation Trust.
    The Gids clinic was ordered to close after a review by Dr Hilary Cass found it was “not a safe or viable long-term option”.
    However, whistleblowers described as senior staff at Gids have expressed concerns about the preparedness and expertise of the new hubs, just as they open.
    One, who spoke to the i newspaper under the condition of anonymity, said: “It’s been shoddy, disorganised, messy and unclear. And at times, it’s felt unsafe.”
    Read full story (paywalled)
    Source: The Times, 1 April 2024
  20. Patient Safety Learning
    Trusts will be told to hit the four-hour A&E target in 78% of cases by next year after NHS England finally made an agreement with government, HSJ understands.
    The new target is just two percentage points higher than the target set for the current year of 76% – and must be hit in March 2025, according to NHS planning guidance.
    NHS England will also aim to maintain “core” general and acute beds at 99,000 on average across 2024-25 after funding was agreed with the government. This would maintain the beds at levels seen over recent months, but it would be a significant increase in the permanent “sustainable” beds available in the health service compared with previous years.
    Most trusts have fallen well short of the 76% target through much of 2023-24, and NHSE has pressed for them to make last-ditch attempts in recent weeks to try and get closer to the target ahead of the March 2024 deadline. This has included offering new capital funding rewards for improvement and telling trusts to focus on non-admitted patients.
    Elective recovery targets are expected to slip, and government has conceded making significant progress on these is almost impossible, with ongoing doctors strikes on top of other capacity problems. 
    Read full story (paywalled)
    Source: HSJ, 27 March 2024
  21. Patient Safety Learning
    NHS England is looking to ditch a key elective target that aimed to deliver large reductions in follow-up appointments, HSJ has learned.
    Senior sources privately admit progress has not been made against the target to cut the volume of the most common type of outpatient follow-up by 25 per cent target.
    This is supported by publicly available data. While this only gives a partial picture, the data suggests the volumes have actually increased compared to pre-covid levels.
    The volume-based target is widely viewed as unrealistic and senior figures told HSJ it had also “masked” some genuine progress trusts have made in reforming outpatient services and reducing less productive appointments.
    Sources familiar with discussions said having a volume-based target to reduce a subset of patients while trying to increase overall activity volumes had been logistically complex.
    NHSE is instead pushing for a new “ratio-based” target which sources said would be a better measure to reduce the least productive types of outpatient follow-ups and be a fairer measure of progress.
    Read full story (paywalled)
    Source: HSJ, 26 February 2024
  22. Patient Safety Learning
    People experiencing Long Covid have measurable memory and cognitive deficits equivalent to a difference of about six IQ points, a study suggests.
    The study, which assessed more than 140,000 people in summer 2022, revealed that Covid-19 may have an impact on cognitive and memory abilities that lasts a year or more after infection. People with unresolved symptoms that had persisted for more than 12 weeks had more significant deficits in performance on tasks involving memory, reasoning and executive function. Scientist said this showed that “brain fog” had a quantifiable impact.
    Prof Adam Hampshire, a cognitive neuroscientist at Imperial College London and first author of the study, said: “It’s not been at all clear what brain fog actually is. As a symptom it’s been reported on quite extensively, but what our study shows is that brain fog can correlate with objectively measurable deficits. That is quite an important finding.”
    Read full story
    Source: The Guardian, 29 February 2024
  23. Patient Safety Learning
    GPs do not ‘face huge amounts of complexity’ and most of their appointments are ‘incredibly straightforward’, according to a former Conservative health minister.
    Speaking to BBC Radio 4 last week, Lord Bethell defended upcoming legislation that will bring physician associates (PAs) under GMC regulation, which could be struck down by the House of Lords this evening.
    Both the Doctors’ Association UK and the BMA had previously complained about the lack of debate in Parliament.
    Discussing the role of PAs on Friday, Lord Bethell said he had not seen ‘any evidence’ of patients being confused about whether they were seeing a doctor or an associate.
    "GPs don’t face huge amounts of complexity. Most interactions are incredibly straightforward. Certainly my own experience over the last 20 years of going to my GP, it really hasn’t required 10 years of training to deal with my small problems," he said.
    Lord Bethell added: ‘When they are complex, they should be escalated. But there’s a much wider group of people who have professional training who should be respected, celebrated – they shouldn’t be denigrated, they shouldn’t be in any way patronised by other professionals.’
    Read full story
    Source: Pulse, 26 February 2024
  24. Patient Safety Learning
    Britain’s hard-pressed carers need all the help they can get. But that should not include using unregulated AI bots, according to researchers who say the AI revolution in social care needs a hard ethical edge.
    A pilot study by academics at the University of Oxford found some care providers had been using generative AI chatbots such as ChatGPT and Bard to create care plans for people receiving care.
    That presents a potential risk to patient confidentiality, according to Dr Caroline Green, an early career research fellow at the Institute for Ethics in AI at Oxford, who surveyed care organisations for the study.
    “If you put any type of personal data into [a generative AI chatbot], that data is used to train the language model,” Green said. “That personal data could be generated and revealed to somebody else.”
    She said carers might act on faulty or biased information and inadvertently cause harm, and an AI-generated care plan might be substandard.
    But there were also potential benefits to AI, Green added. “It could help with this administrative heavy work and allow people to revisit care plans more often. At the moment, I wouldn’t encourage anyone to do that, but there are organisations working on creating apps and websites to do exactly that.”
    Read full story
    Source: The Guardian, 10 March 2024
  25. Patient Safety Learning
    All trusts should pick a “designated lead” for improving how they work with primary care, according to new NHS planning guidance. 
    The guidance for 2024-25 published by NHS England today states: “Every trust should have a designated lead for the primary–secondary care interface.”
    It also asks integrated care boards to “regularly review progress” on how secondary care services are working with primary care.
    NHSE recovery plans include trying to cut the number of patients effectively referred back to GP practices by other services, in order to reduce GP workload.
    The guidance states: “Streamlining the patient pathway by improving the interface between primary and secondary care is an important part of recovery and efficiency across healthcare systems”.
    The planning guidance — published on Wednesday night after months of delays — also said systems should continue to develop integrated neighbourhood teams, including by trying to “improve the alignment of relevant community services” to primary care network footprints. 
    Read full story (paywalled)
    Source: HSJ, 27 March 2024
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