When Jess and Patrick discovered they were expecting their first baby in the new year, they looked forward to an early glimpse of their unborn child via an ultrasound scan.
But the couple, who live in the north-west of England, were soon told that Patrick would not be able to attend any antenatal appointments, including routine scans at 12 and 20 weeks. When their baby begins its journey into the world, Patrick will be permitted to join Jess only when labour is fully established, and he must leave an hour after delivery. He will not be able to visit his new family in hospital again.
“It’s taken the shine off the pregnancy,” said Jess, a junior doctor. “Patrick hasn’t been able to come to a single appointment. It’s making me very anxious and stressed – I’ve had actual nightmares about things going wrong and Patrick not being with me. He’s had to wait at home when I’ve gone for appointments, worrying and waiting for me to call to say everything’s OK.”
The hospital where Jess will give birth is among 43% of NHS trusts that – despite official guidance – have not eased restrictions imposed during lockdown on partners attending antenatal appointments, being present throughout labour, and staying with new mothers and babies after the birth. And as Covid transmissions rise across the UK, almost a quarter of NHS trusts have said they expect to reimpose such restrictions.
Read full story
Source: The Guardian, 24 October 2020
"I still have nightmares most nights about being completely out of my depth."
Gemma, a ward nurse in Northern Ireland, was redeployed to a critical care unit at the end of March when the first wave of coronavirus struck.
"I had never looked after a critically ill intensive care patient in my life," she says.
"I just thought, I'm coming in here and I'm going to die. I'm going to catch Covid and I'm going to be one of those patients in the beds."
As the second wave of the pandemic takes deep root across parts of the UK, thousands of NHS workers are struggling to recover from what they have already been through.
"We were all in PPE all the time," recalls Nathan, a senior intensive care nurse at a hospital in the Midlands. "All you can see is people's eyes, you can't see anything else."
He describes trying to help junior members of staff survive long and difficult days.
"And I'd see these eyes as big as saucers saying help me, do something. Make this right. Fix this."
"The pressure was insane, and the anxiety just got me," he says. "I couldn't sleep, and I couldn't eat, I was sick before work, I was shaking before I got into my car in the morning."
Nathan ended up having time off with severe anxiety, but he is now back at the hospital, waiting for the beds to fill up again.
The BBC has spoken to a number of nurses and doctors across the UK who are deeply apprehensive about what lies ahead this winter.
Read full story
Source: BBC News, 24 October 2020
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.”
Read full story
Source: HSJ, 22 October 2020
Mass cancellations of routine operations in England are inevitable this autumn and winter despite an NHS edict that hospitals must not again disrupt normal care, doctors’ leaders have said.
Organisations representing frontline doctors, including the British Medical Association (BMA), also criticised NHS England for ordering hospitals to provide “near normal” levels of non-Covid care in the second wave of the pandemic, and demanded that fines for failing to meet targets be scrapped.
"Things are very, very difficult at the moment, very challenging at the moment. It feels like a juggling act every day,” said one official in the South Yorkshire NHS. “The problem is both the growing numbers of patients coming into hospital with Covid and the numbers of staff we have off sick due to Covid, either because they are ill themselves or because someone in their household has symptoms, so they are isolating.”
Read full story
Source: The Guardian, 23 October 2020
Parents and professionals have been devastated by the impact of the pandemic on some of the UK’s most vulnerable patients
Kelly Stoor gave birth to her daughter, Kaia, 14 weeks early. On 12 March, the midwife held her up for Kelly to see before whisking Kaia off to the neonatal unit for critical care. Kaia became seriously ill and was transferred to a hospital in Southampton, 50 miles away from home, for specialist treatment just before lockdown was imposed on 23 March. While there, she teetered on the edge of life and death for weeks and underwent life-saving surgery twice.
The impact on Kelly, her husband, Max, and their other three children has been enormous. Hospital restrictions in April dictated that only one parent was allowed to visit. Both parents were not able not hold their daughter for the first time until 88 days after she was born.
“It was extremely difficult,” says Kelly. “I wasn’t allowed to hold her because of Covid. I had to wear gloves if I was going to touch her. We didn’t know if she was going to make it, and Max and I weren’t allowed in together to be with her. There was one time I was with her for three hours and I couldn’t cope any more. I wanted to break.”
Kelly is not alone. In the UK, at least 25,000 children are living with conditions that require palliative care support and their lives, along with those of their families, have been upended by the coronavirus pandemic and accompanying restrictions.
A report by Rainbow Trust found that lockdown was a distressing experience for many; 80% of those surveyed by the charity in April said their situation was worse or much worse than before lockdown. Nearly 60% of parents, meanwhile, say that their mental health is worse than before the pandemic.
Families have had to take on the strain of caring full-time for a child with a life-limiting illness, such as cancer or neurological conditions, with little to no support. There has been no respite, explains Dr Jon Rabbs, a consultant paediatrician and trustee for Rainbow Trust. When lockdown was announced, many community healthcare services had to stop face to face contact and special schools which supported children were also closed. “One of my families is at breaking point, they are so exhausted and worried,” he says.
In child healthcare there have been delays, he says. Urgent treatment is always available but follow-up care has been cancelled or delayed in some places. “In my practice we have not missed any significant relapses,” he adds. “But imagine the worry not knowing whether things were going to be OK or not.”
Read full story
Source: The Guardian, 22 October 2020
The most comprehensive picture so far of how covid’s second wave has hit the NHS in the north of England is revealed in new figures obtained by HSJ.
The latest data confirms that parts of the North West region now have more coronavirus patients in hospital beds than they did in the spring. It comes amid intense public debate about the best way to fight covid, and whether or not it is close to swamping the NHS.
Collected from local NHS sources in a joint HSJ and Independent investigation, the information shows for example that:
Lancashire and South Cumbria had 544 confirmed covid hospital patients yesterday (around 15-18% of the bed base), about 20 more than during the April peak.
Liverpool University Hospitals – which remains the most severely affected trust – had 408 confirmed covid patients yesterday (20-25% of bed base), whereas it never topped 400 in the spring.
The data is sent routinely by trusts to NHS England but most of it is not published – something some politicians are now calling for.
As of yesterday, there were nearly 6,100 confirmed-covid patients across England, about 650 of whom were in critical care, and 560 receiving mechanical ventilation, according to information shared with HSJ.
The number of “unoccupied” hospital beds is much lower now than in the spring, when they were cleared out in anticipation of a major hit. In the North West, up to 5,500 acute beds were reported as “unoccupied” in the spring, whereas the figure now is about 2,500 (around 14-18% of the bed base).
However, critical care is the major pinch point in the most affected areas, with nearly half of the mechanical ventilation beds open at Liverpool’s hospitals (29 of 62) occupied by confirmed covid patients; and a third of those across the North West (178 of 556).
However, hospitals in the area have opened very few extra critical care “surge” beds so far. The total numbers of mechanical ventilation (a subset of critical care) beds open in LUH and the rest of the region has not increased much in recent weeks, and falls well short of what they have declared they could open as potential surge capacity, if they cancelled large amounts of non-urgent care and reorganised staffing and wards.
Read full story
Source: HSJ, 23 October 2020
London-based HealthUnlocked has been acquired by worldwide leader Corrona.
HealthUnlocked is a social network of 1.3 million patients across hundreds of condition-specific communities. Moderated by over 500 patient advocacy groups, it captures insights to better understand what matters most to these patients.
Corrona, based in Massachusetts, US, describes itself as a built-for-purpose source of gold-standard real-world evidence.
“By combining with HealthUnlocked, we are expanding our broad set of capabilities–ranging from highly granular and longitudinal structured data across our eight registries, to broader patient insights from HealthUnlocked,” said Abbe Steel, Chief Patient Officer of Corrona.
“The HealthUnlocked communities provide access to engaged patients across the globe, allowing us to better understand the patient experience and what matters most to patients."
Read full story
Source: Business Cloud, 22 October 2020
The Care Quality Commission (CQC) has called for ‘ministerial ownership’ to end the ‘inhumane’ care of patients with learning difficulties and autism in hospital – after finding some cases where people had been held in long-term segregation for more than 10 years.
Following its second review into the uses of restraint and segregation on people with a learning difficulty, autism and mental health problems, the CQC has warned it “cannot be confident that their human rights are upheld, let alone be confident that they are supported to live fulfilling lives”.
The review was ordered by health and social care secretary Matt Hancock in late 2018 in response to mounting concerns about the quality of care in these areas.
According to the report, published today, inspectors found examples people being in long-term segregation for at least 13 years, and in hospital for up to 25 years. It also found evidence showing the proportion of children from a black or black British background subjected to prolonged seclusion on child and adolescent mental health wards was almost four times that of other ethnicities.
Looking at care received in hospital the CQC found many care plans were “generic” and “meaningless” and patients did not have access to any therapeutic care.
Reviewers also found people’s physical healthcare needs were overlooked. One women was left in pain for several months due to her provider failing to get medical treatment.
The regulator also reviewed the use of restrictive practices within community settings. While it found higher quality care, and the use of restrictive practices was less common, it said there was no national reporting system for this sector.
Read full story (paywalled)
Source: HSJ, 22 October 2020
With so many operations put on hold when the pandemic started in March, surgeon Douglas Hartley and a team of medical veterans got to work pioneering new types of protective equipment.
When the coronavirus pandemic first hit the UK, thousands of surgical procedures were put on hold. For surgeons like Douglas, who performs operations on deaf children to restore their hearing, this created a significant moral dilemma – he wanted to get back into surgery to provide this vital care, but didn’t want to inadvertently catch or pass on COVID-19 in the process.
Douglas regularly carries out cochlear implant surgery, a process in which a surgeon embeds an electronic device which stimulates the hearing nerve in the ear. The scientific evidence is clear that this surgery needs to be performed at the earliest opportunity so that these children can benefit from being able to hear at a vital stage in their development.
But performing the surgery as normal would have put both children and surgical teams in danger. They needed to come up with another way of doing things. The team in Nottingham had to combine creativity and science to develop a novel and safe way to restart cochlear implant surgery in a matter of just a few weeks.
The team used a systematic evidence-based approach to evaluate a variety of PPE for its usability and effectiveness. During simulated cochlear implant surgery, they evaluated each type of PPE across several parameters, including its effect on a surgeon’s ability to communicate, their field of vision, and their comfort.
Many of the PPE options were found to substantially restrict the surgeon’s vision during operating. That rendered them unsafe for performing this sort of surgery. Instead, they found that the combination of “spoggles” and a half-face respirator mask had consistently superior performance across all aspects of clinical usability compared with all other options.
During their studies, Douglas and his team also worked with a surgical product manufacturer to develop a novel drape, basically a tent, that was designed to be suspended from a microscope covering the patient’s head and torso to provide a physical barrier between the site of drilling and the rest of the team.
They found that the operating tent significantly contained the droplets and prevented them from spreading around the theatre environment. They are the first – and are currently only – group in the world to develop an operating tent design that is marked for medical use. After completing our studies, we now had appropriate PPE and a protective operating tent to permit the safe restarting of cochlear implant surgery during the pandemic.
These recommendations were rapidly disseminated internationally via webinars and journal publications and quickly adopted as standard patient care by Nottingham University NHS Foundation Trust and, subsequently, embraced in other departments in the UK and across the world.
Read full story
Source: The Independent, 22 October 2020
The staff-side committee of a major hospital trust has stopped working with its leadership, with its chair alleging an ‘endemic’ culture of ‘racism, discrimination and bullying’.
Irene Pilia, staff-side committee chair at King’s College Hospital Foundation Trust, told colleagues that the decision was taken “in the interests of staff”, especially black, Asian and minority ethnic workers, and expressed concerns about the organisation’s disciplinary procedures. She said the decision had the backing of staff committee officers and delegates.
Ms Pilia, who is also the senior KCHFT Unite representative, said she was open to resuming partnership working again, but told trust executives: “I have lost trust and confidence in the ability of [KCHFT] to conduct fair, impartial and no-blame investigations.
“Until there is tangible and credible evidence that racist behaviour at all levels is proactively eliminated, such that perpetrators face real consequences (including to the detriment of their careers) for their actions and are no longer allowed to behave in racist ways with impunity, I take a stand for the hundreds, possibly thousands of KCHFT staff whose voices are not being heard."
Read full story (paywalled)
Source: HSJ, 22 October 2020
Old age and having a wide range of initial symptoms increase the risk of "long Covid", say scientists.
The study estimates one in 20 people are sick for least eight weeks. The research at King's College London also showed being female, excess weight and asthma raised the risk.
The aim is to develop an early warning signal that can identify patients who need extra care or who might benefit from early treatment.
The findings come from an analysis of people entering their symptoms and test results into the COVID Symptom Study app.
Scientists scoured the data for patterns that could predict who would get long-lasting illness.
"Having more than five different symptoms in the first week was one of the key risk factors," Dr Claire Steves, from Kings College London, told BBC News.
COVID-19 is more than just a cough - and the virus that causes it can affect organs throughout the body. Somebody who had a cough, fatigue, headache and diarrhoea, and lost their sense of smell, which are all potential symptoms,- would be at higher risk than somebody who had a cough alone. The risk also rises with age, particularly over 50, as did being female.
Dr Steves said: "We've seen from the early data coming out that men were at much more risk of very severe disease and sadly of dying from Covid, it appears that women are more at risk of long Covid."
No previous medical conditions were linked to long Covid except asthma and lung disease.
Read full story
Source: BBC News, 21 October 2020
An independent review found that commissioners’ investigation of a young boy’s death was ‘mismanaged’, and heard allegations that the person who coordinated it was bullied over the contents.
The independent review, commissioned by NHS England, has published its final report following an investigation into Bristol, North Somerset and South Gloucestershire clinical commissioning group’s LeDer review into the death of Oliver McGowan.
Chaired by Fiona Ritchie, the independent review was commissioned last year after evidence emerged that the CCG had rewritten earlier findings of the review, removing suggestions his death at North Bristol Trust in 2016 was avoidable.
Oliver died in November 2016 after being given anti-psychotic medication against his own and his parents’ wishes and despite medical records showing he had an intolerance to anti-psychotics. He developed severe brain swelling because of the drugs and died.A local LeDer review — part of a programme aimed at improving care based on deaths among people with learning disabilities — was launched in 2017, seven months after his death, by the CCG (then operating as three separate organisations), then published in 2018.
In 2018, a coroner concluded Oliver’s care prior to his death was “appropriate” and made no recommendations. His death is also currently the subject of a police investigation.
The lead reviewer (Ms A) stated in her panel interview that during the time she was undertaking this LeDeR she had felt bullied, overworked and overly stressed by the demands placed on her by the various correspondences with solicitors and her line management. The fact that Ms A believed she was isolated and unsupported during this review illustrates evident failures in the CCG assurance and management processes at the time.
In a final report by the subsequent independent review, published today, the panel led by Ms Ritchie “unanimously” agreed Oliver’s death was “potentially avoidable”.
Read full story (paywalled)
Source HSJ, 20 October 2020
More than 200 people who went through hotel quarantine in Victoria, Australia, must be screened for HIV amid fears of cross-contamination from incorrect usage of blood glucose test devices.
Several such devices were used on multiple people in quarantine between 29 March and 20 August, necessitating screenings for blood-borne diseases such as hepatitis B and C and HIV.
These monitors, which take a small sample of blood from a fingertip, are intended for repeated use by only one person. While the needle is changed between usages, microscopic traces of blood can remain within the body of the machine, creating a low clinical risk of cross-contamination and infection.
Safer Care Victoria, the state’s healthcare quality and safety agency, has assured the public there is no risk of COVID-19 spread as the disease is not transmitted by blood.
These devices have since been taken out of circulation.
In a statement, a spokesman for the agency said they have identified 243 people who had been tested by one of the shared machines during the timeframe in question, and will be contacted for screening. Everyone “who had conditions or episodes that may have required the test will also be contacted as a precaution”.
The Victorian premier, Daniel Andrews, labelled the incident a “clinical error that was made some time ago”.
“Safer Care Victoria have made some announcements in relation to a clinical error that was made some time ago, very low risk, but you can’t take any risks with these things. You have to follow them up properly and that’s exactly what has happened,” he said at a press conference on Tuesday.
Read full story
Source: The Guardian, 20 October 2020
Ministers have denied care home inspectors access to weekly testing for coronavirus – despite fears they could contribute to the spread of COVID-19 as cases rise across the country, The Independent can reveal.
The Care Quality Commission (CQC) was told by the Department of Health and Social Care last month it could not have access to regular testing for inspection teams as the watchdog prepares for 500 inspections of care homes during the next six weeks.
Officials said the teams, who are assessing care conditions for the vulnerable and elderly, did not get close enough to people to present a risk.
During the first wave of the virus, after Public Health England initially said there was no risk to care homes, an estimated 16,000 residents died from the virus. At the height of the crisis up to 25,000 NHS patients were discharged to care homes by the NHS, with many not having been tested for the virus.
Labour MP Barbara Keeley said: “The refusal of the Department of Health and Social Care to treat CQC inspectors in the same way as other staff going into care homes puts lives at risk.”
Read full story
Source: The Independent, 20 October 2020
COVID-19 became a pandemic in March 2020, but the after-effects of it are becoming more apparent as many people are suffering from a wide variety of symptoms months after contracting the disease.
Long COVID – as it is being called – has been affecting some of the earliest COVID-19 sufferers since the first few months of 2020, but little is known about it and the huge variety of symptoms is making research very difficult.
Sky News looks at what the symptoms of long COVID are, how it has affected people's lives, how many are suffering, what treatments there are and how it could affect the economy.
Read full story
Source: Sky News, 19 October 2020
Following a damning report by the Care Quality Commission (CQC), the East of England Ambulance Service NHS Trust (EEAST) has been placed into special measures.
It comes after inspectors uncovered a culture of bullying and sexual harassment at the trust. As a result of the decision, EEAST will receive enhanced support to improve its services.
A statement from NHS England and NHS Improvement outlined that the Trust would be supported with the appointment of an improvement director, the facilitation of a tailored ‘Freedom to Speak Up’ support package, the arrangement of an external ‘buddying’ with fellow ambulance services and Board development sessions.
This follows a CQC recommendation to place the trust in special measures due to challenges around patient and staff safety concerns, workforce processes, complaints and learning, private ambulance service (PAS) oversight and monitoring, and the need for improvement in the trust’s overarching culture to tackle inappropriate behaviours and encourage people to speak up.
Ann Radmore, East of England Regional Director said, “While the East of England Ambulance Service NHS Trust has been working through its many challenges, there are long-standing concerns around culture, leadership and governance, and it is important that the trust supports its staff to deliver the high-quality care that patients deserve."
“We know that the trust welcomes this decision and shares our commitment to reshape its culture and address quality concerns for the benefit of staff, patients and the wider community.”
Read full story
Source: Bedford Independent, 19 October 2020
Many unpaid carers looking after vulnerable friends or relatives during the coronavirus crisis say they are worried about how they will cope this winter.
Almost 6,000 unpaid carers completed a Carers UK online questionnaire. Eight in 10 said they had been doing more, with fewer breaks, since the pandemic began - and three-quarters said they were exhausted.
The government said it recognised the "vital role" of unpaid carers.
In the Carers UK survey, 58% of carers said they had seen their physical health affected by caring through the pandemic, while 64% said their mental health had worsened.
People also said day centres and reductions in other services meant the help they once got had reduced or disappeared, leaving many feeling worn out and isolated. Carers UK wants such services up and running again as a matter of urgency.
Helen Walker, chief executive of Carers UK, said: "The majority of carers have only known worry and exhaustion throughout this pandemic.
"They continue to provide extraordinary hours of care, without the usual help from family and friends, and with limited or no support from local services."
"It's no surprise that carers' physical and mental health is suffering, badly. I am deeply concerned that so many carers are on the brink and desperately worried about how they will manage during the next wave of the pandemic."
Read full story
Source: BBC News, 20 October 2020
"Long Covid" – the long-lasting impact of coronavirus infection – may be affecting people in four different ways, according to a review, and this could explain why some of those with continuing symptoms are not being believed or treated.
There could be a huge psychological impact on people living with long-term COVID-19, the National Institute for Health Research report says.
They need more support – and healthcare staff require better information.
Most people are told they will recover from mild coronavirus infections within two weeks and from more serious disease within three. But the report says thousands could be living with "ongoing Covid".
Based on interviews with 14 members of a long-Covid support group on Facebook and the most recent published research, the review found recurring symptoms affecting everything from breathing, the brain, the heart and cardiovascular system to the kidneys, the gut, the liver and the skin.
These symptoms may be due to four different syndromes:
permanent organ damage to the lungs and heart
post-intensive-care syndrome
post-viral fatigue syndrome
continuing COVID-19 symptoms
Some of those affected have had a long stay in hospital with severe Covid-19 - but others, who have had a mild infection, have never even been tested or diagnosed.
The review says coming up with a "working diagnosis for ongoing COVID-19" would help people access support.
Read full story
Source: BBC News, 15 October 2020
The parents of a three-year-old boy whose death was part of an alleged NHS cover-up have won a six year battle for the truth about how he died.
Shropshire coroner John Ellery backed the parents of three-year-old Jonnie Meek in a second inquest into his death on Thursday and rejected evidence from nurses about what happened at Stafford Hospital in August 2014.
Jonnie, who was born with rare congenital disability De Grouchy syndrome, died two hours after being admitted to hospital to trial a new feed which was being fed directly into his stomach. His parents, John Meek and April Keeling, from Cannock in Staffordshire, have always maintained their son died after a reaction to the milk feed caused him to vomit and suffocate.
But they have been forced to battle what they believe was an attempt to hide what happened after they discovered attempts to alter their son’s medical history with claims he had experienced several cardiac arrests requiring resuscitation which never happened.
In 2015, healthcare assistant Lauren Tew, who was with Jonnie and his mother when he died, told the HSJ that a statement in her name submitted to a child death overview panel stating Jonnie had died from a sudden cardiac arrest was false and she had never made such a statement.
Another statement said Jonnie had been admitted to hospital for three weeks months before his death which also never happened.
After his parents exposed the false statements an independent inquiry was launched, with three independent experts agreeing with Jonnie’s parents, and in April last year the High Court quashed the original inquest verdict that Jonnie died of natural causes and pneumonia.
Speaking to The Independent Jonnie’s father said: “This does bring us some peace after six years. For the coroner to say he believes April over the nurses after all this time is a big weight lifted off her.
“The hospital definitely decided to try and cover up what happened to Jonnie. We have always said we knew what happened and this has been a massive waste of resources. I am still very concerned about how these things can happen in the first place.”
Read full story
Source: The Independent, 15 October 2020
‘Systemic’ problems within mental health services in Birmingham have caused the number of people waiting for an inpatient bed to reach ‘extremely concerning’ levels, according to documents leaked to HSJ.
There are currently 41 people waiting to be admitted to a bed by Birmingham and Solihull Mental Health Foundation Trust (BSMHFT) , according to internal documents, while 36 people have already had to be sent to private sector facilities up to 150 miles away.
The NHS in the area has indicated to HSJ that it is due to need for “intensive levels of care” now growing because of the impact of the COVID-19 pandemic.
In an email thread, sent to 60 people in the trust including senior executives, one senior clinician wrote in response to the bed figures: “The number of patients with Mental Health Act assessments completed is extremely concerning. This needs to be escalated to commissioners. The problem is systemic.”
It comes after an HSJ investigation earlier this year into the deaths of 12 patients under BSMHFT’s services. It revealed senior medics had repeatedly warned the trust about severe bed shortages and a lack of capacity within home treatment services.
The trust said it was addressing the issues raised, but senior clinicians told HSJ this week the trust is still short of at least 80 adult mental health beds.
Read full story (paywalled)
Source: HSJ, 15 October 2020
Doctors and nurses in areas of northern England with some of the highest Covid infection rates have described being “physically and emotionally” exhausted, as the NHS braces itself for the second wave of the pandemic.
Most of the north has been put into the tier 2 “high risk” category, with Merseyside in the highest – tier 3 – bracket. While politicians debate whether a nationwide circuit breaker would be a more effective instrument to curb spread of the virus, frontline staff – still scarred from the first wave – are under no illusions as to what lies in store.
Carmel O’Boyle, a nurse in Liverpool, who is also chair of the Royal College of Nursing’s Greater Liverpool and Knowsley branch, said members of the public had used A&E and primary care sparingly during the first national lockdown but mixed messages and a lack of trust in the government had led to people throwing caution to the wind and attendances were rising accordingly.
“The nurses across my branch are frightened and exhausted – physically and emotionally,” she said. “They’ve been dealing with this for months and now there are more people in hospitals than there were in March. Although we know a little bit more about how to treat people and the kind of path of the disease process, it’s still frightening. It’s just so demanding and so draining to be nursing people in this manner without any family involvement and with the complications that there are.”
A consultant in Manchester, who did not want to be named, said her hospital coped with the first wave but “the difference this time is that we’re trying to continue all of the elective activity and that’s going to be challenging.
“I do think that we will manage the Covid cases. I just now worry about whether we will be able to continue to keep the normal care for people who need their operations [and] need care for cancer."
Read full story
Source: The Guardian, 15 October 2020
At the age of 49, Sarah Fisher feels her life is on a knife-edge. She had a heart attack during lockdown and has subsequently been diagnosed with heart failure.
In July, she was told she needed to have an implantable cardioverter defibrillator (ICD) fitted, which can shock the heart back into rhythm when it detects a potential cardiac arrest. But 12 weeks on, she is still waiting. "I could have a cardiac arrest at any point," Sarah says.
"It is awful not knowing what is going to happen. "I am on the urgent list – but the infection rates are rising and the clinics are closing."
"I don't know when I will get it.
"There are so many people in my position – we don't have Covid but our lives are at risk too. We are the forgotten victims of this pandemic."
British Heart Foundation analysis of Office for National Statistics data for England and Wales found almost 800 extra deaths from heart disease among under-65s from March to July - 15% more than would be expected.
The rate of death was highest during the full lockdown - but, worryingly, the trend continued afterwards. The charity blames delays in people seeking care, as well as reduced access to routine tests and treatments.
And NHS England figures show a sharp rise in the numbers waiting over six weeks for a whole range of key tests, including echocardiograms for hearts.
Read full story
Source: BBC News, 15 October 2020
An NHS trust has offered an unreserved apology to an elderly patient and his family after they accused hospital staff of restraining him 19 times in order to forcibly administer treatment.
East Kent Hospitals University NHS Foundation Trust admitted that care for the man, who has dementia, “fell far short” of what patients should expect.
The 77-year-old had been admitted to the William Harvey Hospital last November for urinary retention problems, according to a recent BBC investigation.
In February, The Independent revealed that a police investigation had been launched into an alleged assault against an elderly man at the hospital after nurses and carers were filmed by hospital security staff holding the man’s arms, legs and face down while they inserted a catheter.
A whistleblower told The Independent that the incident was being covered up by the trust and staff were told: “Don’t discuss it, don’t refer to it at all.”
On Wednesday, the trust said its investigation had found a failure to alert senior medics to the difficulties being experienced in caring for the patient.
Changes to dementia care including ward reorganisation, training and recruitment are underway, said a spokesperson, who added: “We apologise unreservedly to the patient and his family for the failings in his care, this fell far short of what patients should expect.”
Read full story
Source: The Independent, 14 October 2020
Covid’s second surge has begun disrupting elective care at hospitals outside the north west, HSJ has learned.
At Nottingham University Hospitals Trust, the number of patients with COVID-19 is “rising fast”, causing ward closures and elective care disruption, according to an internal memo seen by HSJ.
The memo, sent by the trust’s divisional director for surgery Simon Parsons, said covid admissions to the trust “are way past 100 and rising fast”.
“There are also outbreaks of covid on certain wards, which have resulted in closures of beds,” Mr Parsons said.
“I am afraid the elective programme is going to be disrupted and we are doing everything we can to preserve as much elective work as possible,” said the memo to staff at the major teaching hospital.
Mr Parsons called on clinicians to concentrate on “getting patients discharged in a timely way” and for them to escalate instances where patients were fit for discharge but not leaving the trust.
“We are not asking you to make unsafe discharges but to keep length of stay as short as possible,” Mr Parsons said.
Read full story (paywalled)
Source: HSJ, 14 October 2020
Increasing staff absence due to COVID-19 will have a ‘significant impact’ on the ability of the NHS to deliver critical care services and routine operations, leading intensive care doctors have said.
The latest NHS England data has shown the number of COVID-19 related absences of staff, either through sickness or self-isolation, has risen from 11,952 on 1 September to 19,493 on 1 October. Staff absence has almost doubled in the North West in this time as well – from 2,664 to 5,142 during the same period.
It peaked at 17,628 in the region on 11 April and means the October total accounts for nearly a third of that amount already (29%).
Alison Pittard, dean of the Faculty of Intensive Care Medicine, confirmed increasing numbers of NHS critical care staff were absent from work. “I suspect this is due to having to be at home with children asked to isolate and therefore the parent needing to isolate, as was the case in the first wave," she told HSJ.
“This will have an impact on our ability to deliver critical care services. We know that staff numbers are inadequate at the best of times, with a significant vacancy rate especially for critical care nurses.”
Royal College of Anaesthetists council member Helgi Johannsson said the rising absence rate was “likely to have a significant impact”, particularly on routine operations.
Dr Johannsson, a consultant anaesthetist at Imperial College Healthcare Trust, said: “In my hospitals, I have been aware of several doctors and nurses having to isolate due to their children being asked to self-isolate. These healthcare staff were otherwise well and would have been at work."
Read full story (paywalled)
Source: HSJ, 14 October 2020
