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Found 435 results
  1. News Article
    An investigation into whistleblowing claims which described patients “hanging off trolleys” and “vomiting down corridors” in a crowded emergency department has upheld most of the concerns. It comes after a staff member at Northern Lincolnshire and Goole Foundation Trust wrote to the chief executive and trust’s commissioners after working a weekend shift within the emergency department at Diana, Princess of Wales Hospital in Grimsby. In their original email, sent in January 2020, the anonymous whistleblower said they were writing out of “sheer desperation for the safety of patients”. They added: “I have never in my whole career seen patients hanging off trolleys, vomiting down corridors, having [electrocardiograms] down corridors, patients desperate for the toilet, desperate for a drink. Basic human care is not being given safely or adequately…" “Your hospital is full, your A&E department is over-flowing, you are expecting staff to manage treble the amount of patients in majors and resus than they would do normally, without breaks, this is not safe. They cannot provide that care – which is evident.” Read full story (paywalled) Source: HSJ, 7 November 2021
  2. Content Article
    This report looks at several incidences of pregnant women with Covid-19 symptoms being sent to a maternity unit, when it would have been more appropriate for them to attend A&E. It highlights some confusion amongst health professionals and states that the Coronavirus (Covid-19) Infection in Pregnancy Guidance was updated to make care pathways clearer.
  3. News Article
    The British Red Cross have found that that 367,000 people, which equates to around one percent of the population in England attend A&E up to 346 times a year. These figures accounted for nearly one in three ambulance call outs and over one in six A&E visits. The research analysis found that a fifth of those repeatedly attending A&E lived alone and also often lived in deprived areas of the country. Frequent users also accounted for 29% of all ambulance call outs and 16% of non-minor-injury A&E visits. The data also revealed that people in their twenties were more likely to repeatedly visit A&E than any other age category. Mike Adamson, chief executive of the British Red Cross, said: 'High intensity use of A&E is closely associated with deprivation and inequalities - if you overlay a map of frequent A&E use and a map of deprivation, they're essentially the same.' Read full story Source: National Health Executive, 29 November 2021
  4. Content Article
    Prehospital care is the care received by a patient from an emergency medical service before arriving at a hospital. This systematic review in the International Journal for Quality in Health and Care aimed to identify: how the prevalence and level of harm associated with patient safety incidents (PSIs) in prehospital care are assessed. the frequency of PSIs in prehospital care. the harm associated with PSIs in prehospital care.
  5. Content Article
    This report by the British Red Cross highlights the impact of deprivation and inequality on high intensity use of accident and emergency services (A&E), and the additional cost and strain this puts on these services. It shows that people from the most deprived areas of the UK and people with mental health issues are more likely to be in poor health and are most likely to attend A&E frequently. The report calls for better support for people who frequently attend A&E because they feel they have 'nowhere else to turn'.
  6. News Article
    Thousands of patients a year are dying because of overcrowding in A&E units in Britain, and more fatalities will follow this winter, emergency care doctors claim. An estimated 4,519 people in England died in 2020-21 as a direct result of people receiving less than ideal care while delayed in A&E waiting to start treatment in the hospital. “To say this figure is shocking is an understatement. Quite simply, crowding kills,” said Dr Adrian Boyle, a vice-president of the Royal College of Emergency Medicine (RCEM). There have also been 709 deaths in Wales and 303 in Scotland so far this year for the same reason, according to a report by the college. Another 566 excess deaths caused by overcrowding occurred in Northern Ireland in 2020-21. The 4,519 in England “may be an underestimate”, it adds. The four figures taken together mean the college has identified at least 6,097 deaths across the four home nations that it believes occurred because overcrowding hampered the person’s treatment. “There’s a lot of human misery behind these figures. It’s uncomfortable and unbearable that people are being put through this. It’s impossible not to feel upset and angry about this,” Boyle said. Read full story Source: The Guardian, 18 November 2021
  7. Content Article
    This report was triggered by the Coroner’s report into the death of Evan Nathan Smith in North Middlesex hospital. Evan was a young man with his whole life in front of him. The mistakes made in his treatment leading to his early and avoidable death brought into sharp focus the lack of understanding of sickle cell, the battles patients have to go through to get proper treatment and the terrible consequences which can come about as a result. Following the publication of the Coroner’s report, the All-Party Parliamentary Group (APPG) on Sickle Cell and Thalassaemia held three evidence sessions, hearing from patients, clinicians and politicians. This report is a result of that evidence. The findings in this report reveal a pattern of many years of sub-standard care, stigmatisation and lack of prioritisation which have resulted in sickle cell patients losing trust in the healthcare system that is there to help them, feeling scared to access hospitals, expecting poor treatment from some of those who are supposed to care for them and fearing that it is only a matter of time until they encounter serious care failings.
  8. Content Article
    This document outlines the Royal College of Emergency Medicine’s (RCEM) systemwide plan to improve patient care. The RCEM CARES campaign addresses pressing issues facing emergency departments (EDs) so that staff can deliver safe and timely care for patients. The campaign focuses on five key areas: Crowding, Access, Retention, Experience, and Safety.
  9. News Article
    Family doctors have reopened their bitter dispute with the government by accusing Sajid Javid of misleading MPs and the public by blaming overloaded A&Es on a lack of GP appointments. The Royal College of GPs has told the health secretary in a strongly worded letter that there is no basis for the claim, which he made to MPs last week and which was widely covered by the media. In it Prof Martin Marshall, the college’s chair, said that its 54,000 members “are dismayed and disappointed at the media coverage of your evidence session, which suggested that the lack of face-to-face GP appointments was placing additional strain on accident and emergency departments”. He disputed Javid’s claim that there is evidence which links the issues. He wrote: “You told the [health and social care select] committee you had seen data which showed that more patients were presenting at A&E departments because they were unable to access primary care. I am not aware of any evidence to suggest that this is happening and would welcome sight of any data you have.” Tensions are simmering between GPs and the government since Javid’s edict last month that GPs in England must see any patient who wants an in-person appointment. Read full story Source: The Guardian, 12 November 2021
  10. News Article
    Lives are at risk because patients are facing unacceptably long waits for a 999 response, paramedics across the UK have told a BBC investigation. Average waits for emergency callouts for problems such as heart attacks and strokes are taking more than twice as long as they should in England. Targets are being missed in the rest of UK too, with some seriously-ill waiting up to nine hours for an ambulance. There are numerous investigations ongoing into deaths linked to delays. The problems have forced all ambulance services to be put on their highest levels of alert - meaning patients who can make their own way to hospital are told to do so. A number of services have also brought in the military to support crews. The BBC has received reports of numerous serious incidents across the UK. Margaret Root, 82, waited nearly six hours for an ambulance to come following a stroke, and she then waited for another three hours outside hospital. When she was finally admitted, her family was told it was too late to give her the drugs needed to reverse the effects of the stroke. Her granddaughter Christina White-Smith said her grandmother had been "hugely let down". She said she did not blame the staff because they were "amazing" when they got to her grandmother, but said she is angry the NHS is not getting the help it needs. "I don't think people are aware of the severity of the situation." Read full story Source: BBC News, 11 November 2021
  11. News Article
    Long waiting times in emergency departments are becoming normal, with some patients spending days in A&E wards before they can be moved into other hospital beds, emergency physicians have warned. Leaders of the Royal College of Emergency Medicine (RCEM) and the Society for Acute Medicine (SAM) said that some hospitals had effectively run out of space, meaning patients could not receive the right care until a bed became free. NHS figures for September show that 5,025 patients waited for more than 12 hours to be admitted to hospital in England. That is only 1% of the 506,916 admitted via A&Es, but it is more than 10 times as many as the 458 waiting more than 12 hours in September 2019 and nearly twice as many as the January peak of 2,847. Scientists at the Zoe Covid study said last week that UK cases of coronavirus may have peaked. But the React study at Imperial College found that the R number was between 0.9 and 1.1 with Covid cases at their highest levels. Pressures on hospitals have prompted the Royal College of Nursing to call for a return to compulsory mask-wearing, while Sadiq Khan, the mayor of London, said that ministers should reimpose a legal obligation to wear masks on public transport, allowing police to enforce the law. Read full story Source: The Guardian, 7 November 2021
  12. Content Article
    This review by Healthcare Inspectorate Wales considers the impact of ambulance waits outside emergency departments on the overall experience of patients, which included their safety, care, privacy and dignity. It covers the period between 1 April 2020 and 31 March 2021, during the Covid-19 pandemic. The report highlights that although patients were positive about their experience with ambulance crews, handover delays are having a detrimental impact upon the ability of the healthcare system to provide responsive, safe, effective and dignified care to patients. It makes 20 recommendations for consideration by the Welsh Ambulance Services NHS Trust, health boards and the Welsh Government.
  13. Content Article
    Emergency Department *ED) crowding has potential detrimental consequences for both patient care and staff. Advancing disposition can reduce crowding. This may be achieved by using prediction models for admission. This systematic review from Brink et al. aims to present an overview of prediction models for admission at the ED. Furthermore, we aimed to identify the best prediction tool based on its performance, validation, calibration and clinical usability.
  14. News Article
    A major hospital has declared a “critical incident” after a surge in demand saw more than 100 patients awaiting treatment in A&E and 25 ambulances queueing outside. The Royal Cornwall Hospital Treliske, in Truro said “unprecedented” pressure this week is worse “than at any point during the pandemic.” It urged “families, friends and neighbours” to collect any patients who are able to “to leave hospital sooner.” Managers at Cornwall’s main hospital raised the operating level from OPEL4 — known as a ‘black alert’ — to an ‘internal critical incident’ to allow for greater cooperation to ease the crisis. It comes as the government is under intense pressure to reimpose some COVID-19 measures amid a surge in cases, with many other NHS clinics and hospitals across the country facing similar pressure. Allister Grant, medical director of the RCHT, said: “There is unprecedented demand on health and care services in Cornwall, more so this week than at any point during the pandemic. “As a result, we have escalated our operational level from OPEL4 to an internal critical incident. “Pressure will always be most visible at the Emergency Department where ambulances are waiting, and our priority here is to move people into wards as soon as we can.” Read full story Source: The Independent, 21 October 2021
  15. News Article
    An NHS trust has spent more than two weeks running on emergency measures after skyrocketing demand since mid-September, while others have kept people waiting for more than a dozen hours in the backs of ambulances. The Independent has learnt one patient in the West Midlands spent 13 hours waiting to be handed over to staff at the Shrewsbury and Telford Hospitals Trust. Gloucester Hospitals Trust declared its internal incident on 19 September and only stood it down on 5 October, while London’s Barnet Hospital took similar extraordinary action on Monday due to high demand. And at North Middlesex Hospital staff saw more than 200 patients crowd into the emergency department on Monday afternoon. Declaring an internal incident is designed to activate measures that help hospitals deal with a sudden peak of demand and should only last for a short time. Such pressures are being felt across the country with NHS managers seriously concerned about what the coming months will look like as temperatures dip. One said they had not seen things as bad in more than a decade. Read full story Source: The Independent, 13 October 2021
  16. News Article
    The percentage of patients visiting A&E who are seen within four hours has hit a “terrifying” new low in Scotland, latest figures show, with ministers urged to “get a grip” on the growing crisis. The figure has been declining since the summer amid high demand, staffing shortages and a lack of patient flow through hospitals. In the week to 3 October, just 71.3% of patients were seen within four hours, a five percentage point drop on the previous week, according to a data published by Public Health Scotland. The figure is the lowest since records began in 2015, with the Scottish Government target set at 95%. With 25,000 visits to A&E in that week, it means more than 7,000 patients waited longer than four hours. Some 1,782 people waited more than eight hours, while a record 591 patients waited longer than 12 hours. Last week, Scotland’s Health Secretary, Humza Yousaf, warned that Scotland’s NHS faces an “incredibly difficult winter” despite announcing a £300 million funding boost. But opposition parties have now accused him of “overseeing a scandalous situation” and leaving A&E departments “beyond breaking point”. Read full story Source: The Scotsman, 12 October 2021
  17. Content Article
    This article by Lauren McGIll in The Walrus looks at how design changes to the trauma bay at St Michael's Hospital in Toronto are saving lives. Lack of intentional design in hospitals, new technologies and a culture that celebrates adaptability all contribute to what the author describes as "a piecemeal approach" to emergency medicine workspaces. The outcome of this is ultimately higher mortality rates as staff do not have an optimum working environment. The article describes a research project set up in 2015 by doctors Christopher Hicks and Andrew Petrosoniak, which aimed to identify and remove latent hazards and obstacles that cost trauma staff time in emergency situations. They redesigned the trauma bay at St Michael's hospital as a result of their findings, and early reports are that dramatic rescues have been possible thanks to the new layout. Petrosoniak says, “You cannot remove the stress of someone dying in front of you, but we can remove the stress of not being able to find equipment.” Further reading Trauma Resuscitation Using in situ Simulation Team Training (TRUST) study: latent safety threat evaluation using framework analysis and video review (BMJ Quality & Safety) Study protocol for a framework analysis using video review to identify latent safety threats: trauma resuscitation using in situ simulation team training (TRUST) (BMJ Open) Stress Testing the Resuscitation Room: Latent Threats to Patient Safety Identified During Interprofessional In Situ Simulation in a Canadian Academic Emergency Department (AEM Education and Training) Health professionals' experience of teamwork education in acute hospital settings: a systematic review of qualitative literature (JBI Evidence Synthesis)
  18. News Article
    Between April 2020 and March 2021 there were approximately 185,000 ambulance handovers to emergency departments throughout Wales. However, less than half of them (79,500) occurred within the target time of 15 minutes. During that period there were also 32,699 incidents recorded where handover delays were in excess of 60 minutes, with almost half (16,405) involving patients over the age of 65 who are more likely to be vulnerable and at risk of unnecessary harm. Data published by the Welsh Government highlighted that in December 2020 alone, a total of 11,542 hours were lost by the ambulance service due to handover delays. This figure has been rising sharply and has now reached pre-pandemic levels once again. Inspectors said these delays have consistently led to multiple ambulances waiting outside A&E departments for excessive amounts of time, unable to respond to emergencies within their communities. "These delays have serious implications on the ability of the service to provide timely responses to patients requiring urgent and life-threatening care," the report stated. Read full story Source: Wales Online, 7 October 2021
  19. News Article
    Sick patients have been forced to wait outside a hospital A&E department on chairs and wrapped only in blankets while being treated by nurses in shocking photographs and videos captured by one worried relative. The situation, at Addenbrooke's Hospital in Cambridge, is a regular occurrence, workers have told The Independent. Footage shared with The Independent by a concerned member of the public shows one patient being cannulated, where a needle and intravenous line is inserted into a vein, while another patient has a monitor attached to track their vital signs. Patients waiting outside the A&E were said to be extremely sick, with some vomiting and complaining of worsening symptoms. “It was like something out of a horror movie,” said Maria, who has asked for her surname not to be used. “The system is completely broken from the beginning to the end..." Addenbrooke’s Hospital has been under severe pressure for months with patients queuing out the door earlier this year and patients waiting over 24 hours for a bed. One mental health patient was detained in the back of an ambulance for over 12 hours. It is just one symptom of a nationwide summer crisis in the NHS, with the military called in to support ambulance services that have reported their busiest months ever. A&E units are also witnessing record levels of attendance. Patients are being made to wait so regularly outside Addenbrooke’s A&E that heat lamps have been installed on the walls outside one entrance, used by non-Covid patients. The hospital has also built a marquee as a permanent space for waiting patients. Read full story Source: The Independent, 28 September 2021
  20. News Article
    A patient died from a serious spinal injury after emergency staff incorrectly attributed his physical condition to his mental health issues, an inquest heard. Robert Walaszkowski, who had been detained at a secure mental health unit run by North East London Foundation Trust in October 2019, suffered a serious injury after running into a door on the unit. Staff from London Ambulance Service did not suspect a spinal injury and he was taken to the emergency department at Queen’s Hospital in Romford with a suspected head injury. An inquest heard he did not receive a spinal examination and imaging of the spine, despite this being required due to the nature of his injury and presentation. He was discharged from A&E the following day, and was then placed on the floor of a private patient transport vehicle, to be transported back to the mental health unit, Goodmayes Hospital. He arrived at the hospital unresponsive. He never recovered consciousness and died of his injuries a month later. An inquest jury has recorded a narrative conclusion and found that neglect contributed to Robert’s death. Read full story (paywalled) Source: HSJ, 24 September 2021
  21. News Article
    Scotland's Health Secretary Humza Yousaf says the NHS is facing the "biggest crisis" of its existence. There's a shortage of beds, the demand for ambulances is soaring and waits in accident and emergency departments are getting longer. On top of that, COVID-19 admissions have been rising fast as the number of infections in Scotland spiralled at the end of the summer. BBC News share five charts illustrating the enormous pressures currently being felt by NHS Scotland. Read full story Source: BBC News, 23 September 2021
  22. News Article
    A survey of almost 50,000 patients by the Care Quality Commission (CQC) found people’s experiences of emergency departments improved in 2020, compared to the last time the poll was conducted in 2018. On a scale of one to 10, the regulator found 33% of patients scored their overall experience as 10, compared to 29% in 2018. Eighty-eight per cent of patients scored their care at six or higher, compared to 85% three years ago. However, overall satisfaction levels declined at around 20 providers. Ted Baker, CQC’s chief inspector of hospitals, said: “This year’s survey shows some encouraging improvements with trust and confidence in clinicians, perceptions of cleanliness and overall experience all performing better than in previous years… “However, the scope for further improvement remains. Access to emotional support, help with pain relief and information provided at discharge were all areas where some people surveyed were less positive.” Read full story (paywalled) Source: HSJ, 16 September 2021
  23. Content Article
    Getting It Right First Time (GIRFT) is designed to improve the quality of care within the NHS by reducing unwarranted variations. By tackling variations in the way services are delivered across the NHS, and by sharing best practice between trusts, GIRFT identifies changes that will help improve care and patient outcomes, as well as delivering efficiencies such as the reduction of unnecessary procedures and cost savings.
  24. News Article
    A new snapshot survey by the Royal College of Emergency Medicine has found that in August 2021 half of respondents stated that their Emergency Department had been forced to hold patients outside in ambulances every day, compared to just over a quarter in October 2020 and less than one-fifth in March 2020. The survey, sent out to Emergency Department Clinical Leads across the UK, also found that half of respondents described how their Emergency Department had been forced to provide care for patients in corridors every day, while nearly three-quarters said their department was unable to maintain social distancing every day. One-third said that the longest patient stay they had had in their Emergency Department was between 24 and 48 hours, with 7% reporting the longest stay to be more than 48 hours. Dr Ian Higginson, Vice President of the Royal College of Emergency Medicine, said: “It is shocking to see the extent of the challenges faced by Emergency Departments across the UK. Holding ambulances, corridor care, long stays – these are all unconscionable practices that cause harm to patients. But the scale of the pressures right now leaves doctors and nurses no options. We are doing all we can to maintain flow, maximise infection prevention control measures, and maintain social distancing. Our priority is to keep patients safe, and ensure we deliver effective care quickly and efficiently, but it is extremely difficult right now." Read full story Source: The Royal College of Emergency Medicine, 6 September 2021
  25. News Article
    The family of a senior medic and lifelong NHS campaigner have called for an investigation into his death as it took paramedics more than half an hour to arrive at his home after operators were told he was suffering a cardiac arrest. Professor Kailash Chand, a former British Medical Association deputy chair, had complained of chest pains before one of his neighbours, a consultant anaesthetist at Manchester Royal Infirmary, called 111 for help before telling the call handler within three minutes that he believed his friend was having a cardiac arrest. “I was answering their questions when Kailash’s eyes began rolling and he slipped into unconsciousness. That’s when I said ‘this looks like a cardiac arrest’ and to upgrade the call. They kept asking questions as I started CPR and asked for an urgent ambulance. That was two or two and a half minutes into the call." Evidence seen by i News shows that it took another 30 minutes after the neighbour told the operator about the cardiac arrest for the paramedics to arrive at Professor Chand’s flat in Didsbury, Greater Manchester. National standards for ambulance trusts show that ambulance trusts must respond to category 1 calls – those that are classified as life-threatening and needing immediate intervention and/or resuscitation, such as cardiac or respiratory arrest – in 7 minutes on average, and respond to 90% of Category 1 calls in 15 minutes. Read full story Source: iNews, 3 September 2021
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