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Sam

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  1. Sam
    HSJ analysis of the NHS England data also found that 19,000 adults with a serious mental illness are waiting for longer than 18 months for a second contact with community mental health services. This is seen as a more meaningful metric for adults than the first contact.
    In total, almost 240,000 children and young people were waiting for treatment from community mental health services in August 2023, as well as more than 192,000 adults.
    The data revealed the median, or typical, waiting time for children and young people from referral to first contact was 178 days. The median wait time for adults from referral to “second contact” was 120 days.
    The NHS long-term plan set out proposals for a four-week waiting time standard for children and adults to access community mental health services. This approach was piloted and a consultation published, but the new standards are yet to be implemented.
    Sean Duggan, chief executive of the mental health network at the NHS Confederation, said leaders would be concerned – although “not surprised” – that patients were waiting so long for community services.
    He added: “We need access and waiting times standards for all mental health services, to help us improve national data and to direct and allocate resources effectively.”
  2. Sam
    An NHS trust has concluded that its former chief executive is not a “fit and proper person” to be on an NHS board, after investigating allegations of sexual harassment and inappropriate behaviour, HSJ has learned.
    HSJ understands The Robert Jones and Agnes Hunt (RJAH) Orthopaedic Hospital Foundation Trust commissioned a specialist external workplace investigation into Mark Brandreth, which considered serious allegations made about his behaviour during his time as trust chief executive between April 2016 and August 2021.
    Mr Brandreth is understood to dispute the allegations as well as the investigation’s findings, and is seeking to challenge RJAH’s handling of the complaints and its process for deciding he did not meet the Fit and Proper Person Test. 
    Sources with knowledge of the situation said almost 30 female RJAH staff members came forward to give information to the investigation, but it focused on 12 employees who were willing to give evidence.
    HSJ has been told that as a result of the investigation, which concluded at the end of last year, the trust’s chair has informed NHSE in writing that it believes Mr Brandreth does not meet the “Fit and Proper Person Test”, implying he should be ruled out of board roles – or roles with equivalent responsibility – at English NHS organisations and adult social care providers.
    However, the trust, in Shropshire, is not planning to publish its ruling and – with no professional regulation in place for health and care managers and/or board members – it is unclear how effective the conclusion will be if it is not made public. A female staff member told HSJ of her concerns that “nothing is being done”.
    Read full story (paywalled)
    Source: HSJ, 21 February 2024
  3. Sam
    Staff fell asleep while on duty at a mental health trust, inspectors found.
    The Care Quality Commission (CQC) said it was "very disappointed" to find patient safety being affected by the same issues it had seen previously.
    It said on acute wards for adults of working age and psychiatric intensive care units, five patients described staff falling asleep at night.
    Despite CCTV being available, managers told the CQC they could not always immediately prove staff had been sleeping as accessing the pictures could take up to a fortnight.
    The CQC report added trust data from June to December 2022 recorded 20 incidents of staff falling asleep while on duty but no action was taken because the video evidence had not been viewed.
    Rob Assall, the CQC's director of operations in London and the East of England, said: "When we inspected the trust, we were very disappointed to find people's safety being affected by many of the same issues we told the trust about at previous inspections.
    "This is because leaders weren't always creating a culture of learning across all levels of the organisation, meaning they didn't ensure people's care was continuously improving or that they were learning from events to ensure they didn't happen again."
    Read full story
    Source: BBC News, 12 July 2023
     
  4. Sam
    Older patients should walk around hospital wards and along corridors to prevent their muscles weakening, research suggests.
    Lying in a hospital bed for several days can cause a sharp deterioration in strength, leaving some elderly patients struggling to walk or live independently when they are discharged.
    New research shows this decline can be prevented if patients are helped to walk for at least 25 minutes a day while in hospital.
    The best effect was observed when patients walked around the hospital for at least 50 minutes a day. The study suggested that a mixture of physical activity, such as 20 minutes working with resistance bands while seated and 20 minutes of walking, also helped.
    The authors said patients who remained active during their stay in hospital were less likely to suffer “adverse events” after they were discharged.
    Read full story (paywalled)
    Source: The Times, 4 August 2023
  5. Sam
    NHS bosses are using misleading figures to hide dangerously poor performance by A&E units in England against the four-hour treatment target, emergency department doctors claim.
    Some A&Es treat and admit, transfer or discharge as few as one in three patients within four hours, although the NHS constitution says they should deal with 95% of arrivals within that timeframe.
    How well or poorly A&Es are doing in meeting the 95% target is not in the public domain because the data that NHS England publishes is for NHS trusts overall, not individual hospitals.
    That means official figures are an aggregate of performance at sometimes two A&Es run by the same trust or include data for any walk-in centres, minor injuries units or urgent treatment centres that a trust also operates. Forty-eight trusts have two A&Es and many also run at least one of the latter.
    The Royal College of Emergency Medicine (RCEM), which represents A&E doctors, wants that system scrapped. It is urging NHS England to start publishing data that shows the true performance of every individual emergency department against the 95% standard.
    “The current data is misleading,” Dr Adrian Boyle, the college’s president, told the Guardian. “It’s a good example of a lack of transparency and also of performance incentives. Being open about the long delays in some A&Es would shine a light in some dark places.”
    Read full story
    Source: The Guardian. 28 October 2023
  6. Sam
    The parents of a baby boy who died at seven weeks old after a hospital did not give him a routine injection have described the failure as “beyond cruel”.
    William Moris-Patto was born in July 2020 at Addenbrooke’s hospital in Cambridge, where it was recorded in error that he had received a vitamin K injection – which is needed for blood clotting. The shot is routinely given to newborns to prevent a deficiency that can lead to bleeding.
    His parents, Naomi and Alexander Moris-Patto, 33-year-old scientists from Chatteris, Cambridgeshire, want to raise awareness about the importance of the vitamin after a coroner concluded William would not have died had the hospital administered the injection. On Friday, the coroner Lorna Skinner KC described the omission as “a gross failure in medical care amounting to neglect”.
    Alexander Moris-Patto, a researcher at the University of Cambridge who recently co-founded William Oak Diagnostics to test for deficiencies in babies, said: “What’s come out of the inquest for me is that the systems they [the trust] put in place to try to prevent this happening again are not satisfactory.”
    He stressed the importance of the vitamin K injection, adding that about 1% of the UK population opt out of it. “We want people to know more about it, to understand how critical it can be, and for hospitals to take seriously the responsibility they have in those first precious hours of a baby’s life,” he said.
    Read full story
    Source: The Guardian, 29 October 2023
  7. Sam
    A private healthcare provider has been ordered to pay more than £1.5m – the largest fine issued for such a case – after pleading guilty in a criminal prosecution brought by the Care Quality Commission (CQC) over the death of a young woman at Cygnet Hospital Ealing in July 2019.
    It is the highest ever fine issued to a mental health service following a prosecution by the CQC. 
    The firm pleaded guilty to one offence of failing to provide safe care and treatment, acknowledging failures to: provide a safe ward environment to reduce the risk of people being able to use a ligature; ensure staff observed people intermittently in line with the company procedures; and train staff to be able to resuscitate patients in an emergency.
    The offences related to the case of a young woman who was admitted to a ward in Cygnet Hospital Ealing in November 2018.
    In July 2019, she took her own life while on the ward. CQC said Cygnet Ealing had been aware the young woman tried to harm herself in an almost identical way four months earlier, but had failed to mitigate the known environmental risk she was exposed to.
    Read full story (paywalled)
    Source: HSJ, 21 September 2023
  8. Sam
    A grandfather who went into hospital with stomach problems needed both of his legs and his left hand amputating after contracting a life-threatening infection.
    Stephen Hughes, from Edmondstown, had been admitted to the Royal Glamorgan Hospital in Llantrisant, in March 2022, with gallstones and aggressive stomach inflammation. This led to pancreatitis corroding a hole in the duodenum which caused a significant bleed into his gut. The 56-year-old's condition deteriorated and he was transferred to the ICU at the University Hospital of Wales as a patient in critical condition.
    Whilst at UHW, his family said that the NHS staff worked tirelessly to stop the internal bleeding he was suffering. His gallbladder was removed on September 8th, 2022, and stents were placed along his arteries. Although these operations were successful, his family claims that Mr Hughes caught sepsis from the feeding tube in his neck on 11 September 2022 whilst recovering.
    Stephen’s body prioritised sending blood to his vital organs which resulted in his outer limbs being deprived of blood and oxygen. Stephen then had to have life-altering operations, which resulted in both of his legs being amputated towards the end of September, and his left hand being amputated at the start of October. He was later discharged on 31 October.
    A spokesperson for Cardiff and Vale University Health Board said: “As a Health Board we are unable to comment on individual patient cases, however we appreciate how life altering operations are particularly distressing for the individual and also their loved ones.
    Read full story
    Source: Wales Online, 9 September 2023
  9. Sam
    Tonjanic Hill was overjoyed in 2017 when she learned she was 14 weeks pregnant. Despite a history of uterine fibroids, she never lost faith that she would someday have a child.

    But, just five weeks after confirming her pregnancy she seemed unable to stop urinating. She didn’t realize her amniotic fluid was leaking. Then came the excruciating pain.
    “I ended up going to the emergency room,” said Hill, now 35. “That’s where I had the most traumatic, horrible experience ever.”
    An ultrasound showed she had lost 90% of her amniotic fluid. Yet, over the angry protestations of her nurse, Hill said, the attending doctor insisted Hill be discharged and see her own OB-GYN the next day. The doctor brushed off her concerns, she said. The next morning, her OB-GYN’s office rushed her back to the hospital. But she lost her baby.
    Black women are less likely than women from other racial groups to carry a pregnancy to term — and in Harris County, where Houston is located, when they do, their infants are about twice as likely to die before their 1st birthday as those from other racial groups. Black fetal and infant deaths are part of a continuum of systemic failures that contribute to disproportionately high Black maternal mortality rates.
    “This is a public health crisis as it relates to Black moms and babies that is completely preventable,” said Barbie Robinson, who took over as executive director of Harris County Public Health in March 2021. “When you look at the breakdown demographically — who’s disproportionately impacted by the lack of access — we have a situation where we can expect these horrible outcomes.”
    Read full story
    Source: KFF Health News, 24 August 2023
  10. Sam
    The chief executive at a trust behind one of the UK’s first ‘virtual hospitals’ has said this model is the ‘new gold standard’ for care provision and the trust is looking at a significant expansion.
    West Hertfordshire Teaching Hospitals Trust boss Matthew Coats said the trust aimed to eventually have “hundreds” of virtual beds for patients to be monitored at home.
    The trust has been at the forefront of NHS England’s programme to significantly expand the use of virtual wards across the NHS. It was also among the first to launch a virtual ward to monitor Covid patients at home during the pandemic.
    Its virtual ward model has since evolved beyond covid, to what the trust calls its “virtual hospital”, providing remote care for patients across several different pathways and specialties, including heart failure, respiratory and frailty patients, who are admitted from either a hospital bed, the emergency department or by GPs.
    Mr Coats told HSJ its virtual hospital is not only supporting better flow through the hospital, but is also leading to better patient experience.
    Read full story (paywalled)
    Source: HSJ, 25 September 2023
  11. Sam
    Healthcare leaders are rolling out new NHS training to help speed up dementia diagnoses among Black and Asian people following criticism about a lack of support for patients from minoritised communities, The Independent has revealed.
    An awareness campaign is being launched in England to help those from ethnic minority communities receive a prompt diagnosis and get the support they need at the earliest opportunity.
    The announcement follows a critical report which found that thousands of south Asian people with dementia are being failed by “outdated health services designed for white British patients”.
    Dr Bola Owolabi, director of the Healthcare Inequalities Improvement programme at NHS England, said: “The pandemic put a greater spotlight on longstanding health inequalities experienced by different groups across the country.
    “While there are many factors involved, the NHS is playing its part in narrowing the gap and ensuring equitable access to services through taking targeted action where needed to improve outcomes."
    Read full story
    Source: The Independent, 21 May 2023
  12. Sam
    Some patients in England are waiting up to two-and-a-half years for important diagnostic tests such as ultrasound, MRI and CT scans, according to figures seen by the Guardian.
    The longest waits were two-and-a-half years for an MRI scan, almost two years for an ultrasound and a year for a CT scan, responses to freedom of information requests by the Liberal Democrats show.
    People with heart problems are among the worst affected. Examples from NHS trusts included a 49-week wait for an echocardiogram and a 475-day wait for an angiography.
    Under the NHS constitution, patients should wait less than six weeks for diagnostic tests. The target is for only 1% to wait more than six weeks, but now 25% of all patients do so, according to research from the House of Commons library, commissioned by the Lib Dems.
    Ed Davey, the leader of the Lib Dems, said: “What this Conservative government has done to the NHS is nothing short of a national scandal. Millions are forced to wait in pain and discomfort, anxiously wondering when they will get a diagnosis, let alone treatment.
    “We cannot fix our economy without fixing our NHS. People can’t get back to work when they’re stuck waiting to see a GP, get a diagnosis or start treatment. The longer they wait, the worse their health gets and the greater the stress for themselves and their loved ones."
    Read full story
    Source: The Guardian, 24 September 2023
  13. Sam
    UK organisations responsible for protecting the public from advertisements of prescription-only drugs are putting patients at risk from the harms of weight loss drugs by not enforcing the law, critics have told The BMJ.
    The UK’s Human Medicines Regulations 2012 prohibit the advertising of prescription drugs to the general public, and companies that break the rules can be sanctioned with fines, orders to issue a corrective statement, or prosecution.
    Legal responsibility for regulating advertisements for medicines in the UK rests with the Medicines and Healthcare Products Regulatory Agency (MHRA) on behalf of health ministers. But there is also a system of self-regulation with a number of organisations operating their own codes of practice, including the Advertising Standards Authority.
    But The BMJ has found that the MHRA has not issued a single sanction for prescription drugs in the past five years. And among 16 cases where the MHRA took action by requesting changes to advertisements for weight loss drugs from June 2022 to July 2023, all were triggered by external complaints, not internal mechanisms, and none resulted in sanctions.
    Read full story
    Source: The BMJ, 13 December 2023
  14. Sam
    “Pointless” bureaucracy is helping hospitals grind to a halt, a leading doctor has warned.
    Dr Gordon Caldwell, who has just retired after 40 years as an NHS hospital consultant, said “horribly inefficient” paperwork around patients moving in and out of wards is fuelling record delays.
    The senior doctor took a photograph of all the forms required for one medical admission to an NHS hospital, laid against his 5ft 10in frame.
    Dr Caldwell said promises by the NHS to “digitise” the health service had simply seen needless bureaucracy transferred on to poor computer systems that were often incompatible with each other.
    The specialist in general medicine and diabetes endocrinology said: “A few years ago there were estimates that nurses were spending around 50 per cent of their time on paperwork;  now I’d say it’s closer to 70 per cent.”
    “It’s bureaucratic and it’s very slow and horribly inefficient,” he said.
    Read full story (paywalled)
    Source: The Times, 21 January 2023
  15. Sam
    The safety of people with learning disabilities in England is being compromised when they are admitted to hospital, a watchdog says.
    The Health Services Safety Investigations Body (HSSIB) reviewed the care people receive and said there were "persistent and widespread" risks.
    It warned staff are not equipped with the skills or support to meet the needs of patients with learning disabilities.
    The watchdog launched its review after receiving a report about a 79-year-old who died following a cardiac arrest two weeks after being admitted to hospital.
    As part of its investigation, HSSIB also looked at the care provided in other places to people with learning disabilities.
    It warned systems in place to share information about them were unreliable, and that there was an inconsistency in the availability of specialist teams - known as learning disability liaison services - that were in place in hospitals to support general staff.
    It also said general staff had insufficient training - although it did note a national mandatory training programme is currently being rolled out.
    Senior investigator Clare Crowley said: "If needs are not met, it can cause distress and confusion for the patient and their families and carers, and raises the risk of poor health outcomes and, in the worst cases, harm."
    Read full story
    Source: BBC News, 2 November 2023
  16. Sam
    The mother of a seriously ill boy said she was "very alarmed" when a doctor at an under-fire children's ward admitted they were "out of their depth".
    In October, Carys's five-year-old son Charlie was discharged from Kettering General, but she returned him the next day in a "sort of lifeless" state.
    She said it seemed "quite chaotic" on Skylark ward before he was transferred to another hospital for further tests.
    Since the BBC's report in February that highlighted the concerns of parents with children who died or became seriously ill at the hospital, dozens more have come forward.
    In April, Care Quality Commission (CQC) inspectors rated the Northamptonshire hospital's children's and young people's services inadequate.
    Among the findings, inspectors said "staff did not always effectively identify and quickly act upon patients at risk of deterioration".
    Read full story
    Source: BBC News, 6 June 2023
  17. Sam
    Two young people facing mental health crises were left on paediatric wards for months while different agencies across a health system struggled to find appropriate placements. 
    The patients – who were both autistic and had learning disabilities, with special educational needs – were admitted to Maidstone and Tunbridge Wells Trust (MTW) last year after attending emergency departments more than 10 times within a two-month period.
    They were left on a paediatric ward – one of the patients for four months – as this was the “only available place of safety as opposed to the optimum setting to meet their needs,” according to Kent and Medway Integrated Care Board’s “learning review” of children and young people with complex needs, which the two cases prompted. 
    The review, which HSJ obtained under a Freedom of Information request, revealed several problems with joint working, despite a multidisciplinary team meeting regularly to discuss the young patients’ needs.
    Since the review, a new escalation process has been introduced, urgent mental health risk assessments in the community have been enhanced and a three-month pilot of a self-harm service has been implemented at Tunbridge Wells Hospital, part of MTW.
    Read full story (paywalled)
    Source: HSJ, 17 November 2023
  18. Sam
    Newborn babies could be at a higher risk of a deadly bacterial infection carried by their mothers than previously thought.
    Group B Strep or GBS is a common bacteria found in the vagina and rectum which is usually harmless. However, it can be passed on from mothers to their newborn babies leading to complications such as meningitis and sepsis.
    NHS England says that GBS rarely causes problems and 1 in 1,750 babies fall ill after contracting the infection.
    However, researchers at the University of Cambridge have found that the likelihood of newborn babies falling ill could be far greater.
    They claim one in 200 newborns are admitted to neonatal units with sepsis caused by GBS. Pregnant women are not routinely screened for GBS in the UK and only usually discover they are carriers if they have other complications or risk factors.
    Jane Plumb, co-founded charity Group B Strep Support with her husband Robert after losing their middle child to the infection in 1996.
    She said: “This important study highlights the extent of the devastating impact group B Strep has on newborn babies, and how important it is to measure accurately the number of these infections.
    “Inadequate data collected on group B Strep is why we recently urged the Government to make group B Strep a notifiable disease, ensuring cases would have to be reported.
    “Without understanding the true number of infections, we may not implement appropriate prevention strategies and are unable to measure their true effectiveness.”
    Read full story
    Source: The Independent, 29 November 2023
    Further reading on the hub:
    Leading for safety: A conversation with Jane Plumb, Founder of Group B Strep Support  
  19. Sam
    The head of NHS England has warned that July's planned strikes in the health service could be the worst yet for patients.
    Amanda Pritchard said industrial action across the NHS had already caused "significant" disruption - and that patients were paying the price.
    This month's consultant strike will bring a "different level of challenge" than previous strikes, she said.
    Junior doctors and consultants will strike for a combined seven days.
    Ms Pritchard told the BBC's Sunday with Laura Kuenssberg programme that the work of consultants - who are striking for the first time in a decade - cannot be covered "in the same way" as junior doctors.
    "The hard truth is that it is patients that are paying the price for the fact that all sides have not yet managed to reach a resolution," she said.
    Read full story
    Source: BBC News, 2 July 2023
  20. Sam
    Record numbers of patients are complaining to the NHS Ombudsman about poor care, exorbitant fees and difficulty getting treatment from NHS dental services in England.
    Mistakes by dentists mean some patients are being left in agony – in some cases unable to eat – while others are being landed with huge bills for work on their teeth.
    “Poor dental care leaves patients frustrated, in pain and out of pocket,” said Rob Behrens, the parliamentary and health service ombudsman.
    The number of complaints he receives every year about NHS dental services has jumped from 1,193 in 2017-18 to 1,982 in 2022-23 – a rise of 66%.
    Behrens also disclosed that the proportion of complaints he upholds about NHS dentistry after an investigation has increased from 42% to 78% over the same period. That 78% figure for upheld complaints about dental services is “significantly more” than for any other area of NHS care, such as GP, hospital or mental health care, where the overall average is 60%, he said.
    Dentistry has become one of the public’s main concerns about the NHS, especially the obstacles many people face when trying to access NHS care. A BBC survey last year found that 90% of surgeries across the UK were not accepting new adult patients and 80% were not taking on children as new patients.
    Read full story
    Source: The Guardian, 30 October 2023
    Related reading on the hub:
    “I’ve been mocked, scolded and gaslighted”: a harmed patient’s experience of orthodontic treatment
    A patient harmed by orthodontic treatment shares their story
    We want to hear from patients with experience of NHS and/or private orthodontists and dentists in any healthcare setting, including community practices and hospitals.
    Did the orthodontist/dentist give you the treatment and support you needed? If you had ongoing problems, how did the orthodontist/dentist and other healthcare professionals respond? Have you tried to make a complaint? Share your experience of orthodontist and dentistry services
     
  21. Sam
    National leaders are looking to greatly reduce the number of direct hospital referrals made by GPs, by insisting that they first discuss cases with hospital consultants. 
    The approach – known as “advice and guidance” or “A&G” – involves GPs sending a patient’s details to a consultant who specialises in their condition before making a referral. The consultant then advises on the best course of action.
    “A&G’ has been voluntarily adopted by many health systems, but HSJ has now learnt that a move to significantly increase its use of it is being discussed as part of a new national strategy for outpatient services, due to be published by December.
    Theresa Barnes, outpatients lead at the Royal College of Physicians, is part of a group of clinicians helping to develop the strategy in partnership with NHS England, and said there is a case for A&G to be used “in preference” to direct referrals in a vast number of cases where it is clinically appropriate.
    She told HSJ: “I think there should be a push to use advice and guidance in preference to direct referrals, so we can maximise that pre-referral interaction and deliver as much care as close to patients’ homes as they can get it and without the delay of potentially waiting for a secondary care appointment.”
    Read full story (paywalled)
    Source: HSJ, 20 September 2023
  22. Sam
    New official guidance on treating menopause will harm women’s health, experts, MPs and campaigners have warned.
    Last month, new draft guidelines to GPs from the National Institute for Health and Care Excellence (NICE) said that women experiencing hot flushes, night sweats, depression and sleep problems could be offered cognitive behavioural therapy (CBT) “alongside or as an alternative to” hormone replacement therapy (HRT) to help reduce their menopause symptoms.
    But critics have castigated the guidance, saying it belittled symptoms through misogynistic language, and women’s health would suffer as a result of failing to emphasise the benefits of HRT on bone and cardiovascular health as opposed to CBT.
    In its response to the guidance, Mumsnet said NICE's recommendations used “patronising” and “offensive” language and would be “detrimental” to women’s health.
    Justine Roberts, the founder and chief executive of Mumsnet, said: “Women already struggle to access the HRT they are entitled to. We hear daily from women in perimenopause and menopause who are battling against a toxic combination of entrenched misogyny, misinformation and lack of knowledge among GPs.
    “Too often they are fobbed off or told they simply need to put up with severe physical and mental symptoms – often with life-changing effects.

    “By emphasising the negative over the positive, failing to include information about the safest forms of HRT and placing CBT on a par with hormone replacement therapy, this guidance will worsen that struggle. It will make doctors more reluctant to prescribe HRT and women more fearful about asking for or accepting it.”
    Carolyn Harris, the MP for Swansea East and the chair of the all-party parliamentary group on menopause, said the new guidance was “antiquated”, “naive” and “ill thought-out”.
    ”Talking can make you feel better, but it’s not going to take away the aches in your joints and it’s not going to change how you live your life,” she said. “Whatever a woman feels is what she needs to support her through the menopause should be readily and immediately available, and that’s not true currently [of HRT or CBT]."
    Read full story
    Source: The Guardian, 11 December 2023
     
  23. Sam
    Dozens more children than initially thought have come to “severe” harm following failings in audiology care, HSJ can reveal.
    Two more trusts have confirmed that, between them, 30 children suffered severe harm – which is defined as ”permanent or long-term harm” – after the failings.
    Northern Lincolnshire and Goole Foundation Trust said an external investigation had revealed 14 such cases, while Worcestershire Acute Hospitals Trust found 16 more after going through the same process.
    A total of 36 confirmed or suspected severe harm cases from paediatric audiology failings across six English trusts are now known about. I
    NHS England wrote to all 42 integrated care boards at the end of August, asking them to ensure the “approximately” 130 paediatric hearing services in England were running safely.
    Sir David Sloman, then-chief operating officer, and Dame Sue Hill, chief science officer, said the NHSE “review of these trusts has identified root causes that have led to poor service delivery and outcomes… [which include] lack of clinical governance and oversight, poor reporting of data, poor interpretation of results, poor retention of diagnostic data, and lack of accreditation.”
    The National Deaf Children’s Society called the speed of the NHS’s response “a scandal”.
    Read full story (paywalled)
    Source: HSJ, 19 September 2023
  24. Sam
    Reductions in the number of long ambulance delays have come at a “huge cost” as hospitals are having to take in more emergency patients than they have space for, NHS England’s urgent care director has said.
    Sarah-Jane Marsh told NHS England’s board meeting on Thursday that emergency departments and hospital wards are now taking more “risk” by taking extra patients in a bid to get ambulances back on the road quicker.
    This year, many fewer hours have been lost to ambulance delays, although the total number of delays of more than 60 minutes is approaching the same as last winter. Emergency department waits in November and December were better than last year, although still much worse than pre-covid and a long way below targets. 
    But Ms Marsh said the improvement was a result of hospitals agreeing to take more patients into EDs and acute wards, even when they did not have space or staff to properly care for them.
    She said: “It’s come at a huge cost. Some of the things we have achieved are because we have moved pressures around in the system.
    “We have moved risk out of people’s houses and from the back of ambulances, and in some cases we’ve moved that into emergency departments [and] wards, that have had to take the pressure of taking additional patients.
    “Next year one of our learnings is that we need to have a really big focus on what is happening inside our hospitals [so] we decongest some very crowded areas.”
    Read full story (paywalled)
    Source: HSJ, 1 February 2024
  25. Sam
    Patients are at risk of having serious health conditions missed because of the lack of continuity of care provided by GPs, the NHS safety watchdog says.
    Investigators highlighted the case of Brian who was seen by eight different GPs before his cancer was spotted as an example of what can go wrong.
    Brian had a history of breast cancer and had been discharged from the breast cancer service. Two years later he began to have back pain. 
    Over the following eight months, he saw two out-of-hours GPs and six GPs based at his local practices as well as a physio and GP nurse, before he was sent for a hospital check-up in late 2020.
    A secondary cancer had developed on Brian's spine, but it was too late to offer him curative treatment and he was given end-of-life care. He has since died.
    The watchdog said the lack of continuity of care resulted in the diagnosis of Brian's cancer being missed.
    One of the key problems was that the different GPs he saw missed the fact he was attending repeatedly for the same issue.
    Senior investigator Neil Alexander said Brian's case was a "stark example" of what can happen when there is a breakdown in continuity of care.
    "He told our team 'when I am gone, no-one else should have to go through what I did'."
    Read full story
    Source: BBC News, 30 November 2023
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