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Sam

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  1. Sam
    NHS organisations have been told to prepare for redeploying or dismissing thousands of unvaccinated staff without an exit payment, and to raise the alarm about services which may be rendered unsafe.
    NHS England today issued guidance on ‘phase two’ of the government’s “vaccination as a condition of deployment”, which requires all patient-facing staff to have had two covid vaccinations by 1 April. 
    Tens of thousands of staff are believed to still be unvaccinated, and the cut off for having a first dose is 3 February.
    The guidance said efforts should be made to adjust roles or redeploy staff, but added: “From 4 February 2022, staff who remain unvaccinated (excluding those who are exempt) should be invited to a formal meeting chaired by an appropriate manager, in which they are notified that a potential outcome of the meeting may be dismissal.”
    It continued: “Whilst organisations are encouraged to explore deployment, the general principles which apply in a redundancy exercise are not applicable here, and it is important that managers are aware of this.”
    Employers will “not be concerned with finding ‘suitable alternative employment’ and there will be no redundancy entitlements, including payments, whether statutory or contractual, triggered by this process”.
    Trusts also do not have to “collectively consult” with staff being dismissed — as they would with a restructure — although this is “ultimately a decision for each organisation to take”.
    Read full story (paywalled)
    Source: HSJ, 14 January 2022
  2. Sam
    There is a “lack” of NHS services available to people with allergies, a group of MPs has said.
    Despite increasing rates of hospital admissions for severe allergic reactions – also known as anaphylaxis – allergy services “have largely been ignored”, the All Party Parliamentary Group for Allergy said.
    The group warned allergies are “poorly managed” across the health service due to a “lack of training” and only a small number of allergy experts.
    “This mismatch has continued despite millions of patients having significant allergic disease,” it said.
    In its latest report, which is to be delivered to Government on Wednesday, MPs said there are 20 million people in the UK who are living with allergic disease, including five million whose illness is severe enough to need specialist care.
    “Yet our allergy services remain inadequate, often hard to access and are failing those who need them the most,” the report adds.
    The group made a series of recommendations including: devising a “national allergy plan” to address problems; expanding the specialist workforce and ensuring all GPs get training in how to deal with allergies.
    Read full story
    Source: ITV News, 27 October 2021
  3. Sam
    Following the publication of the NHS Patient Safety Strategy this week, which argues that new technologies have the potential to transform improvements in keeping patients from harm, Sarah Scobie, Nuffield Trust's Deputy Director of Research, takes a closer look at what the possibilities are.
    Read blog post
    Source: Nuffield Trust, 2 July 2019
  4. Sam
    Record numbers of children and young people are seeking access to NHS mental health services, figures show, as the devastating toll of the pandemic is revealed in a new analysis.
    In just three months, nearly 200,000 young people have been referred to mental health services – almost double pre-pandemic levels, according to the report by the Royal College of Psychiatrists.
    Experts say the figures show the true scale of the impact of the last 18 months on children and young people across the country.
    “These alarming figures reflect what I and many other frontline psychiatrists are seeing in our clinics on a daily basis,” said Dr Elaine Lockhart, the college’s child and adolescent faculty chair. “The pandemic has had a devastating effect on the nation’s mental health, but it’s becoming increasingly clear that children and young people are suffering terribly.”
    Read full story
    Source: The Guardian, 23 September 2021
  5. Sam
    All NHS hospitals in England have been ordered to create secure areas for coronavirus testing to “avoid a surge in emergency departments”, according to a leaked NHS letter.
    Hospitals have been told to create “coronavirus priority assessment pods”, where people will be checked for the virus, which will need to be decontaminated each time they are used.
    The letter, seen by The Independent and dated 31 January, instructs all chief executives and medical directors to have the pods up and running no later than Friday 7 February.
    It comes as the global death toll from the virus has reached 565 with around 28,000 infected.
    One hospital chief executive told The Independent he believed the requirement was “an overreaction”, adding: “I think we should be sending teams out to swab in patients homes as the advice is to stay at home and self-manage as with any other flu".
    In the letter, Professor Keith Willett, who is leading the NHS’s response to coronavirus, told NHS bosses: “Plans have been developed to avoid a surge in emergency departments due to coronavirus. “Although the risk level in this country remains moderate, and so far there have been only two confirmed cases, the NHS is putting in place appropriate measures to ensure business as usual services remain unaffected by any further cases or tests of coronavirus.”
    Read full story
    Source: 5 February 2020
  6. Sam
    People awaiting a CT or MRI scan will be able to have one on the high street under NHS plans to improve access to diagnostic tests.
    NHS England plans to set up a network of new “one-stop shops” where patients will be able to have scans closer to home rather than having to go hospital. They are intended to reduce the risk of patients getting COVID-19 in hospital and speed up the time it takes to undergo diagnostic testing by having more capacity.
    NHS England’s governing board approved a plan on Thursday by Prof Sir Mike Richards to create “community diagnostic hubs across the country over the next few years”.
    It is part of a planned “radical overhaul” in the way patients access a range of diagnostic tests, screening appointments and other services.
    The hubs, which would open six days a week, may also perform blood tests, lung function checks and endoscopies, in which a camera is put down the throat.
    The new facilities would be sited in disused shops or in shopping centres. They are part of the NHS’s drive to make it easier for people to be tested without having to go to hospital, amid concern that reluctance to do so is part of the reason fewer people are undergoing cancer screening. It is already undertaking lung cancer tests in 10 mobile centres that are parked at supermarkets and shopping centres.
    Bigger hubs could also offer mammograms, eye health checks, scans for pregnant women, hearing tests and gynaecological services.
    Hospital bosses welcomed the plan, which they said should reduce waiting times. Miriam Deakin, the director of policy and strategy at NHS Providers, which represents NHS trusts, said: “Doing these checks in the community rather than in hospital could support trusts as they grapple with a second wave of Covid-19, winter pressures and tackling backlogs of care.”
    Read full story
    Source: The Guardian, 1 October 2020
  7. Sam
    COVID-19 vaccinations should now be “immediately” rolled out to frontline staff, NHS England has told trust leaders.
    New instructions from the national body follow the approval today of the Oxford/AstraZeneca coronavirus vaccine, which NHS England said will “substantially to accelerate vaccine delivery”. Until now, only limited quantities of the Pfizer/BioNTech vaccine have been available.
    NHS staff are in the second priority category for covid vaccines, behind care home residents and alongside over 80s. But there have been complaints from clinicians around the country that they have been unable to get the jab, as well as uncertainty about how the vaccine deliveries should be divided between the priority groups.
    A letter to local leaders from NHS England says that until now, healthcare workers who have been identified at highest risk of serious illness from covid-19 have been given the vaccine in unfilled appointment slots.
    The letter, from chief executive Sir Simon Stevens and senior officials, now states: “Increased supply means that vaccination can also now immediately be expanded to frontline health and social care workers.”
    Read full story (paywalled)
    Source: HSJ, 31 December 2020
  8. Sam
    The Leapfrog Group, an independent national healthcare watchdog organisation, today released Safety In Numbers: The Leapfrog Group’s Report on High-Risk Surgeries Performed at American Hospitals. The report analyses eight high-risk procedures to determine which hospitals and surgeons perform enough of them to minimise patient harm or death, and whether hospitals actively monitor to assure that each surgery is necessary. Findings on these measures pointed to alarmingly poor performance across the board and red flags for patient safety. The voluntary survey found that the vast majority of participating hospitals do not meet The Leapfrog Group’s minimum hospital or surgeon volume standards for safety. Rural hospitals are particularly challenged in meeting the standards. 
    Read full story
    Source: The Leapfrog Group, 18 July 2019
  9. Sam
    Rotating clinicians and keeping ventilation running are among Public Health England’s (PHE) recommendations for how to avoid spreading covid while looking after patients in the back of ambulances outside emergency departments.
    The suggestions are made in unprecedented new guidance issued by PHE amid sky-high rates of very long ambulance handovers outside hospitals.
    This is because emergency departments (EDs) are struggling with attempts to maintain distancing for infection control, along with high occupancy and severe operational pressures elsewhere in hospitals. It has led over the past two months to large numbers of patients being looked after in ambulances for extended times while they wait for space in ED.
    The PHE guidance, added last week to existing covid guidance for ambulance services, says it should only happen in “exceptional circumstances”.
    But it says staff in this situation should adopt infection prevention and control procedures including:
    if more than one clinician is available, rotating them regularly, so allowing them time to change PPE and have a drink;  keeping ventilation systems running which may require the engine to be kept running; ensuring patients and any essential escorts wear surgical masks, as long as patient care is not compromised; minimising the number of people within the patient compartment and avoiding sitting face-to-face with patients; and decontaminating contact surfaces more frequently and during the delay if possible. Read full story (paywalled)
    Source: HSJ, 25 January 2021
  10. Sam
    An amputee's wife having to "carry him to the toilet" after her husband was sent home from hospital without a care plan was just one of many findings in a report into vascular services at Betsi Cadwaladr University Health Board in north Wales.
    The critical report by the Royal College of Surgeons England makes five urgent recommendations "to address patient safety risks".
    Part one of the report, published last summer, made nine urgent recommendations and raised issues including too many patient transfers to the centralised hub, a lack of vascular beds and frequent delays in transfers.
    The final part of the report, published on 3 February, focussed on the clinical records of 44 patients dating from 2014 - five years before centralisation - to July 2021, two years after the Ysbyty Glan Clwyd hub opened.
    Assessors were "extremely concerned" about the case of a man where a decision was made to "amputate the foot rather than proceed to a below-the-knee amputation as the primary procedure".
    The report adds: "The review team also noted that the patient had been discharged without a care plan and that the patient's wife was having to 'carry him to the toilet'."
    It also highlights an "inappropriate" decision to offer a patient an "unnecessary and futile" amputation when "palliation and conservative therapy should have been considered instead".
    Referring to that case, the report added that the risk from "major amputation was extremely high".
    Read full story
    Source: BBC News, 3 February 2022
  11. Sam
    Wales' Health Minister has rejected a suggestion that the NHS is “harming patients” due to the severe levels of pressure on its services. 
    Eluned Morgan MS acknowledged that the speed at which patients were receiving treatment was being impacted but said she would “not accept for a moment” that the NHS was harming its patients.
    ITV Cymru Wales has spoken to a number of NHS staff and health sector bodies and heard concerns over the sustainability of the health service in its present form.
    Ms Morgan said: “I don’t think the NHS is harming patients, no.
    “I think our ability to get to patients quickly, that is perhaps compromised by the pressures that we’re under at the moment but no, I would not accept for a moment that the NHS is harming patients. 
    “I think the situation is that maybe people have to wait a bit longer for care because of the pressures that have grown as a result of the pandemic and let’s be clear about that, that we’re seeing about 20% more people going to their GPs, we’ve got hugely long waiting lists because, of course, we had to be very careful about who was able to go into hospitals during the height of the pandemic. 
    “We’re trying to reign all that back at the same time as dealing with Covid, because that hasn’t finished yet.”
    Speaking to ITV Cymru Wales for Wales This Week, looking at the challenges facing the NHS, Dr Pete Williams, a consultant in emergency medicine and paediatric medicine at Ysbyty Gwynedd in Bangor, said he felt the current pressures on services were causing harm to patients. 
    He said: “This is not sustainable. We, this department, other departments around the country and the wider NHS, are harming patients because they’re not getting timely care."
    Read full story
    Source: ITV News, 22 November 2021
     
     
  12. Sam
    In June 2019, the Academic Health Science Network (AHSN), established by NHS England in 2013 and re-licensed from April 2018 to operate as the key innovation arm of the NHS, invited comment on its proposed patient safety strategy. The strategy aims to demonstrate the added value that AHSNs and Patient Safety Collaboratives can bring to patient safety by working much more collaboratively.
    Chief Executive of Patient Safety Learning, Helen Hughes, has responded to the strategy. Helen comments: "We see the potential of the AHSNs: the capability and expertise, the desire to make a real difference and a belief in collaboration. We want to see this potential realised, and Patient Safety Learning wants to help."
    See Helen's response in full
    AHSN will launch its strategy at NHS Expo in September.
  13. Sam
    The number of Covid patients in hospitals in England and Scotland has continued to rise this week, as NHS England reached a deal with private hospitals to free up beds amid the outbreak of Omicron cases.
    Meanwhile, Covid staff absences in England rose to their highest level since the introduction of the vaccine. The number of NHS workers in England off sick because of Covid was up by 41% in the week to 2 January, according to the latest figures.
    Five health workers describe some of the challenges they are facing, including understaffing, waiting times and bed-blocking.
    Read full story
    Source: The Guardian, 14 January 2022
  14. Sam
    Doctors in Northern Ireland feel increasingly "vulnerable" to criminal proceedings in the workplace, forcing them to consider abandoning the profession, senior medic, Dr Tom Black, warns. Dr Black, chairperson of the British Medical Association Northern Ireland, says that consultants in Northern Ireland are operating in a "hostile working culture" as a result of the situation. He explains that medics are increasingly fearful of the professional repercussions if they make a medical error amid pressured case loads: "Doctors feel vulnerable to criminal and regulatory proceedings, and this creates a hostile training environment for our medical students, young doctors... This blame and sanction culture creates disrespect and mistrust. This has a price - it encourages risk avoidance behaviours in professionals, inefficient and ineffective management, increased cost for the system and deteriorating services for patients."
    Read full story
    Source: Belfast Telegraph, 25 June 2019
  16. Sam
    One in four doctors in the NHS are so tired that their ability to treat patients has become impaired, according to the first survey to reveal the impact of sleep deprivation on medics during the coronavirus pandemic.
    Growing workloads, longer hours and widespread staff shortages are causing extreme tiredness among medics, leading to memory problems and difficulty concentrating, according to the report by the Medical Defence Union (MDU), which provides legal support to about 200,000 doctors, nurses, dentists and other healthcare workers.
    The survey of more than 500 doctors across the UK, carried out within the past month and seen by the Guardian, uncovered almost 40 near misses as a direct result of exhaustion. In at least seven cases, patients actually sustained harm.
    Despite encouraging signs the Omicron wave may be fading, doctors admitted the constant pressure of the past 22 months spent fighting coronavirus on the frontline was taking a toll on their technical skills and even their ability to make what should be straightforward medical decisions. Medics admitted for the first time sleep deprivation was causing real harm to patients in the NHS.
    Almost six in 10 doctors (59%) reported their sleep patterns had worsened during the pandemic. More than a quarter (26%) of medics admitted being so tired that their ability to treat patients was “impaired”. Of these, one in six (18%) said a patient was harmed or a near miss occurred as a result.
    Read full story
    Source: The Guardian, 17 January 2022
    Read MDU press release
  17. Sam
    Safety and quality, as well as integration and leadership, will be a “core focus” for the Care Quality Commission’s (CQC) ratings of integrated care systems (ICS), health secretary Matt Hancock has indicated.
    In a letter to health and social care committee chair Jeremy Hunt, Mr Hancock said the Department of Health and Social Care is working with the CQC and NHS England to develop “detailed proposals” on how ICSs will be regulated. The CQC is due to be given “new powers” to rate ICSs under the government’s proposed health and social care bill.
    The confirmation that the CQC’s ratings of ICSs will include a focus on safety and quality comes days after former health secretary Mr Hunt warned the NHS could take a “big step back” if ICSs are not rated on these domains.
    In the letter published today, Mr Hancock said: “I see these new powers for the CQC as an excellent opportunity not only to inform the public about the quality of health and care in their area, but also as a way to review progress against our aspirations for delivering better, more joined up care across integrated care systems.
    “I note your recommendation that quality and safety of care should be a core domain of the CQC reviews and would like to assure you that, alongside integration and leadership, quality and safety will be a core focus when rating integrated care systems."
    Read full story (paywalled)
    Source: HSJ, 25 May 2021
  18. Sam
    Antimicrobial resistance poses a significant threat to humanity, health leaders have warned, as a study reveals it has become a leading cause of death worldwide and is killing about 3,500 people every day.
    More than 1.2 million – and potentially millions more – died in 2019 as a direct result of antibiotic-resistant bacterial infections, according to the most comprehensive estimate to date of the global impact of antimicrobial resistance (AMR).

    The stark analysis covering more than 200 countries and territories was published in the Lancet. It says AMR is killing more people than HIV/Aids or malaria. Many hundreds of thousands of deaths are occurring due to common, previously treatable infections, the study says, because bacteria that cause them have become resistant to treatment.
    “These new data reveal the true scale of antimicrobial resistance worldwide, and are a clear signal that we must act now to combat the threat,” said the report’s co-author Prof Chris Murray, of the Institute for Health Metrics and Evaluation at the University of Washington.
    “We need to leverage this data to course-correct action and drive innovation if we want to stay ahead in the race against antimicrobial resistance.”
    Read full story
    Source: The Guardian, 20 January 2022
  19. Sam
    GPs say they are misdiagnosing patients because appointment slots are too short. A survey of family doctors found more than one in three said they had failed to properly diagnose cases because they did not have enough time to fully assess them. Typically, the time slot to see a patient is around 10 minutes. The poll of 200 GPs found that 95 per cent of those surveyed said such slots were too short to do their jobs safely.
    Read full story
    Source: The Telegraph, 25 July 2019
  20. Sam
    Traditionally, as a group, surgeons are not well known for their bedside manner. While poor manners aren't commonly accepted in most professional circles, representations of surgeons in popular culture often link technical prowess with rude behavior, and some surgeons have even argued that insensitivity can be helpful in such an emotionally strenuous profession. However, a study published in JAMA Surgery challenges these ideas. The study, which looked at interactions between surgeons and their teams, found that patients of surgeons who behaved unprofessionally around their colleagues tended to have more complications after surgery. Surgeons who model unprofessional behavior can undermine the performance of their teams, the authors write, potentially threatening patients' safety.
    Read full story
    Source: NPR, 19 June 2019
  21. Sam
    Hospitals are having to cancel operations and cancer scans are going unread for weeks because consultant doctors have suddenly begun working to rule in a standoff over NHS pensions. Doctors say the dispute is escalating so quickly that it will send NHS services “into meltdown” and is so serious that it poses “an existential threat” to the health service’s survival.
    Read full story
    Source: The Guardian, 8 July 2019
  22. Sam
    The health service has been promised “whatever it needs” to deal with the coronavirus pandemic, but government spending choices reveal possible long-term changes to funding and policy. 
    Having initially promised the health service “whatever it needs, whatever it costs” on 11th March, the government made this official when Matt Hancock issued a ministerial direction allowing the Department of Health to “spend in excess of formal Departmental Expenditure Limits”—effectively providing a blank cheque.
    But while the government’s actions are designed for the immediate crisis, they may be difficult to reverse once the peak of coronavirus has passed. Indeed, they could yet change how the health service operates on a permanent basis.
    Read full story
    Source: Prospect, 7 April 2020
     
  23. Sam
    The MP leading an investigation into coronavirus fears Long Covid will be one of the biggest issues facing the UK for the next decade, after emerging research revealed most sufferers are still unable to work six months in.
    Layla Moran branded the scale of the problem ‘enormous’, as various experts warned that even healthy young adults have been left struggling to function for months on end.
    With hundreds of thousands of Brits now believed to have Long Covid, medics fear its impact on the world of work could herald another ‘massive economic crisis’. Workers in their 20s and 30s have told of a host of debilitating symptoms keeping them out of the office for much of last year and making simple tasks like walking to the toilet seem ‘like climbing a mountain’.  
    Speaking exclusively to Metro.co.uk, Ms Moran – who chairs the All Party Parliamentary Group (APPG) on coronavirus – said: "The scale of this, in terms of the future prosperity of our country, is enormous. It is going to be, I think, one of the main issues that we are going to deal with not just in ten years but beyond."
    Read full story
    Source: Metro, 4 February 2021
  24. Sam
    Growing numbers of women and men in England with eating disorders are being denied support because they are not considered to be thin enough to warrant it, a leading psychiatrist and other experts have warned in a briefing shared with ministers.
    Against the backdrop of a fourfold rise in people admitted to hospital with eating disorders during the Covid pandemic, doctors said body mass index (BMI) was too often used as a blunt measure to decide whether someone should get treatment.
    In some cases, women have not received an eating disorder diagnosis despite their periods stopping due to overexercising or restrictive eating.
    BMI uses height and weight to calculate a healthy weight score. A normal body weight is considered to be between 18.5 and 24.9, and some doctors consider anything below this a signifier of an eating disorder.
    Dr Agnes Ayton, the chair of the Royal College of Psychiatrists eating disorders faculty, and the mental health campaigner Hope Virgo shared a briefing paper with the Department of Health and Social Care (DHSC) urging funding to meet demand and “as a direct result of an increase in the number and severity” of patients during the pandemic. The paper, seen by the Guardian, said there had been a significant increase in eating disorders among ethnic minorities and men.
    Concern has been raised about “a state of emergency” for eating disorders, the briefing paper said. Hospital admissions have seen a fourfold increase in the last year without extra investment in specialist eating disorder inpatient services during this time, it added.
    Read full story
    Source: The Guardian, 5 April 2021
  25. Sam
    A shortage of contraception is causing chaos and risks unplanned pregnancies and abortions, doctors are warning.
    Leading sexual health experts have written to ministers warning that the supply shortage of contraceptives is beginning to lead to serious problems across the UK.
    A number of daily pills and a long-acting injectable contraceptive are thought to be affected, including Noriday, Norimin and Synphase. The problem follows a shortage of hormone replacement therapy for menopausal women last year.
    It is unclear how many women use these types of contraception - overall around three million women take daily pills, and more than 500,000 use long-acting contraception, such as coils, implants and injections.
    The Royal College of GPs said its members were doing their best to help women find alternatives - there are many different types of daily pill available.
    Faculty president Dr Asha Kasliwal said; "We are aware that women are sent away with prescriptions for unavailable products and end up lost in a system. This is causing utter chaos."
    The faculty has teamed up with the Royal College of Obstetricians and Gynaecologists and the British Menopause Society to write to ministers, asking them to set up a working group to address the problems. The letter warns women are becoming distressed by having to find alternative products that might not necessarily suit them or go without contraception altogether.
    It said this was affecting the "physical and mental wellbeing of girls and women" and could lead to a "rise in unplanned pregnancies and abortions".
    Read full story
    Source: BBC News, 7 February 2020
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