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Found 434 results
  1. Community Post
    About 1000 angry nurses and doctors have rallied outside Perth Children’s Hospital in Australia following the death of seven-year-old Aishwarya Aswath, demanding vital improvements to the state’s struggling health system. The Australian Nurses Federation was joined by the Australian Medical Association for the rally, with staff from hospitals across Perth attending. Many people held signs that read “We care about Aishwarya”, “Listen to frontline staff”, “Report the executive — not us” and “Please don’t throw me under the bus”. Aishwarya developed a fever on Good Friday and was taken to Perth Children’s Hospital the next day, but had to wait about two hours in the emergency department before she received treatment. She died soon after from a bacterial infection. An internal report into the tragedy made 11 recommendations — including improvement to the triage process, a clear way for parents to escalate concerns and a review of cultural awareness for staff — but Aishwarya’s parents said the report raised more questions than it answered. The family wants a broader independent inquiry to look at all 21 near-misses in the past 15 months – not just their daughter’s case. Some people have been referred to medical authorities, while Child and Adolescent Health Service chair Debbie Karasinski resigned after the report.' I am encouraged to see the way healthcare staff reacted to this tragedy. Imagine a similar event in England, would nurses protest outside the hospital and stand up to authority like this? I doubt it very much, which is very sad reflection on the prevailing culture and health leadership in England. What do others think? Source: The Australian. 9 July 2021 Picture: Picture: 9 News
  2. Community Post
    During the COVID pandemic, it was clear that Emergency Departments across the UK needed to adapt and quickly, with my trust not exempt from this. We have increased capacity, increased our nursing and doctors on the shop floor, obviously with nurse in charge being responsible for all areas. We have different admission wards in terms of symptoms that the patient has, but also have a different type of flow, which i am getting my head around to be able to share I have seen departments split into 2 and various other ideas coming out from various trusts. Which got me thinking about patient safety and how well this is managed. So.... How is your department responding to the pandemic? Do you have any patient safety initiatives as a result of the response? Is there a long term plan? The reason why i am asking this, is so we can share practice and identify individual trust responses.
  3. Content Article
    The aim of this study from Hutchinson et al. was to explore the reasons for and experiences of patients who make an unplanned return visit to the emergency department.
  4. Content Article
    Authors conducted a before and after, retrospective, observational study using anonymised, routinely collected, patient-level data from a single English NHS ED between April 2018 and December 2019. The primary outcomes of interest were the proportion of admitted patients, that is, the admission rate, the length of stay in the ED and ambulance handover times. They used interrupted time series models to study and estimate the impact of removing the 4-hour access standard.
  5. Content Article
    NHS services have been under increasing pressure in recent years, particularly since the start of the Covid-19 pandemic. We have previously reported on the NHS’s efforts to tackle the backlogs in elective care and its progress with improving mental health services in England. This report gives an overview of NHS services that may be used when people need rapid access to urgent, emergency or other non-routine health services, and whether such services are meeting the performance standards the NHS has told patients they have a right to expect. It covers: general practice community pharmacy 111 calls ambulance services (including 999 calls) urgent treatment centres accident and emergency (A&E) departments.
  6. Content Article
    Help raise awareness of Aortic Dissection. Download a free poster, leaflet and screensaver from the THINK AORTA campaign and use them in hospital Emergency Departments, Radiology Departments, Ambulance Stations - anywhere healthcare professionals who might see an Aortic Dissection patient can be found.
  7. Content Article
    The results from the 2022 British Social Attitudes survey made for very difficult reading for those of us working in the NHS right now. Overall satisfaction with the NHS is at the lowest level ever recorded and similarly satisfaction with individual services is at record lows across the board, but it was satisfaction with A&E services that saw the sharpest fall in 2022.  Kelly Ameneshoa, an Emergency Medicine Doctor working across South London and Surrey, reflects on the findings.
  8. News Article
    A life-saving campaign is being launched by the NHS to urge people to learn how to spot signs of a heart attack. The survival rate for heart attack sufferers is seven in 10, rising to nine in 10 for those who have early hospital treatment. The most common sign of a heart attack is chest pain, but other symptoms to look out for include chest, arm, jaw, neck, back and stomach pain, lightheadedness or dizziness, sweating, shortness of breath, nausea, vomiting, anxiety, coughing and wheezing. The health service are encouraging anyone experiencing these indicators to call 999. It comes after a poll found found that fewer than half of people knew to dial 999 if they or a loved one experienced the more vague signs of a heart attack. Another priority of the campaign is to teach people how to differentiate between a heart attack and cardiac arrest. According to the health service, there is often no warning and the person quickly loses consciousness when they suffer cardiac arrest. Those experiencing a cardiac arrest will usually die within minutes if they do not receive treatment. It also points out that a heart attack can lead to a cardiac arrest. NHS medical director Professor Stephen Powis said: “Sadly, cardiovascular disease causes a quarter of all deaths across the country and we have identified this as the single biggest area where we can save lives over the next decade. Read full story Source: 13 February 2022
  9. News Article
    The number of 12-hour waits in accident and emergency departments rose by 27% in one month to reach record levels in January amid warnings overcrowding is harming an increasing number of patients. Official monthly performance data prompted the Royal College of Emergency Medicine’s president to warn that the problems facing emergency departments were getting “worse and worse”, while pointing out the real number of 12-hour A&E breaches is likely higher than official data records. The figures also revealed the waiting list had hit a new high of 6.1 million, while the number of two-year breaches also rose a record level. Trusts recorded 16,558 patients last month waited 12 hours or more in an emergency department from decision to admit to being discharged or admitted. This was up from 12,986 in December. RCEM president Katherine Henderson warned on Twitter: “This is [decision to admit] plus 12 – a concept which must be retired as a performance metric. We should have 0-12 hour data. You cannot fix a problem if you [are] unwilling to face up to what it actually is. We estimate reality is 20 x more. This is getting worse and worse.” Read full story (paywalled) Source: HSJ, 10 February 2022
  10. News Article
    A hospital trust has apologised to a mental health patient who reported being sexually assaulted in its A&E department – after it emerged in a safety review that staff wrote ‘this has not happened’ and dismissed her claims of the attack. The victim was admitted to West Suffolk Hospital’s emergency department following an overdose in January last year. While waiting in A&E for a mental health assessment from a specialist team employed by Norfolk and Suffolk Foundation Trust, she reported being sexually assaulted by a male patient who had also been admitted to A&E. Yet a review into the incident, published several months later and shared with HSJ, reveals that after the victim reported the attack to a nurse, the staff member recorded “this has not happened”. They stated that the male suspect in the cubicle next to her had not left his bed and was under constant observation. However, the patient safety review, drawn up after a serious incident probe was launched, adds that this statement was “incorrect, as the [male] patient was not under constant observation”. “There were witnesses to this incident, and CCTV, and yet it was not escalated until I contacted the trust myself to complain,” the victim said. She added that she pursued the complaint, which resulted in a serious incident probe that took several months to conclude, “to prevent others from being failed” in the same way. She said she was left “shocked, confused and furious” to discover staff had dismissed her assault and claimed the male suspect had not been admitted for an assessment on the day of the attack. Read full story (paywalled) Source: HSJ, 7 February 2022
  11. News Article
    Long waits at accident and emergency (A&E) departments in Scotland continue to put patient safety at “serious risk”, the Royal College of Emergency Medicine has warned. New figures from Public Health Scotland show 78 per cent of patients visiting A&E in the week to January 23 were seen and admitted, transferred or discharged within four hours. This is an increase on the previous week, but still below the Scottish Government target of 95% It comes as the number of planned operations across NHS Scotland dropped 13% from November to December, to 17,835. Dr John Thomson, vice-president of the Royal College of Emergency Medicine in Scotland, said the college was concerned poor A&E performance times are becoming the “status quo”. “With fewer attendances performance has plateaued, but be in no doubt that the health service and its staff in Scotland remain under unprecedented pressure and increasing burnout,” he said. Dr Thomson added: “The impact of this continued poor performance is distress and moral injury to staff and serious discomfort and risk to the safety of patients. Read full story Source: The Scotsman, 2 February 2022
  12. News Article
    Bina Patel, aged 56, died after struggling to breathe and waiting almost an hour for an ambulance. Her son Akshay Patel has shared the six phone calls he made to North West Ambulance Service on the night of her death. North West Ambulance say they "can never say sorry enough" for Bina's death. "The amount of time it took for help to arrive is unacceptable and not how we want to care for our patients," a spokesperson said. View video Source: BBC News, 26 January 2022
  13. News Article
    The four-hour standard for A&E waits is the ‘wrong target’, which ‘doesn’t work’ and leads to ‘perverse outcomes’, health and social care secretary Sajid Javid has said. Mr Javid made the claim during an appearance before the Commons health and social care committee yesterday. He also spoke about the requirement that NHS patient-facing staff must be vaccinated against covid and took the opportunity to restate his belief that radical action was needed to tackle “failing trusts”. Mr Javid told the MPs: “Targets work if they are the right targets, and in the NHS I have already noticed there are targets which are the wrong targets and we’ve got to change them. “The four-hour A&E target is the wrong target, it doesn’t work. It leads to really perverse outcomes. “If you look at some NHS trusts, all of sudden when the individual in A&E has got to three hours and 55 minutes, guess what? They just admit it. That’s a poor outcome. “There may have been a good reason to have that target in the past, but you’ve got to keep these targets constantly under review and that’s something I’m doing.” The long-running clinical review of waiting time standards by NHS England had proposed replacing the four-hour target with a suite of other measures but the government has yet to formally respond. Read full story (paywalled) Source: HSJ, 26 January 2022
  14. News Article
    A troubled integrated care system has been told it must provide more help to a severely under-pressure acute trust where patients were treated on the floor and in a storeroom. The Care Quality Commission said Devon ICS must give more “input” to University Hospitals Plymouth Trust, where inspectors warned staff could “not ensure the safety of all patients” arriving at the emergency department. During a visit to the trust’s Derriford Hospital in September, inspectors saw staff treating six patients who “lay on the floor” of the ambulatory assessment unit, while another patient who had been in the department overnight was being “treated/assessed in the ‘storeroom’” – according to the CQC’s report. Inspectors reported: “The department was overcrowded, there was no seating available… Social distancing was not possible.” While the CQC praised senior leaders in the ED and executive chiefs for being “open to challenge” and “understanding the problems” faced by the urgent and emergency care service, inspectors said there was only so much the trust could do alone. Catherine Campbell, head of hospital inspection at CQC, said: “The impact of a high number of patients attending to receive care, combined with reduced staffing levels in the ED, created issues that the trust couldn’t solve alone and further support was needed from the local health and social care system." Read full story (paywalled) Source: HSJ, 19 January 2022
  15. News Article
    Hospitals are not able to cope with current pressures, senior doctors have warned, as a new study links long A&E waits to an increased risk of death. Patients waiting more than five hours within an emergency department are at an increased risk of dying, according to a study published in the Emergency Medicine Journal (EMJ). The study’s findings come as emergency care performance across England continues to deteriorate, and as pressures across hospitals mean that more patients are waiting for more than four hours in A&E departments than ever before. According to the research, death rates for patients waiting between six and eight hours before admission to hospital were 8% higher, and they were 10% higher for those waiting eight to 12 hours. The study was based on data collected prior to the pandemic, and national A&E waiting times have since deteriorated further. In November last year, the Royal College of Emergency Medicine (RCEM) warned that long delays and overcrowding in A&Es may have caused thousands of deaths during the pandemic. Researchers said that although cause and effect could not be established between longer waits and deaths after 30 days of hospital admission, they recognised a statistically significant trend. The paper said: “Long stays in the emergency department are associated with exit block and crowding, which can delay access to vital treatments. And they are associated with an increase in subsequent hospital length of stay, especially for older patients. Read full story Source: The Independent, 19 January 2022
  16. News Article
    An ambulance trust has apologised after a man having a heart attack said he was advised to get a lift to hospital or face a long wait. Graham Reagan said he was on the verge of collapsing when he finally got to York hospital after a lift from his son. Mr Reagan said he was concerned about the impact on patients with potentially life-threatening conditions. Speaking to BBC Yorkshire and Lincolnshire's Politics North programme, Mr Reagan described his experience as "scary". "I'd had indigestion, or so I thought, for a couple of days, and then on 17 December I went to bed early feeling rough," he said. In the early hours, Mr Reagan said the pains in his chest grew worse and he asked his wife to call for an ambulance. "I couldn't take it any more," he said. Mr Reagan, from Malton in North Yorkshire, said his wife was asked "can you get to hospital" as the nearest ambulance was about 20 to 30 miles away. "My wife doesn't drive, but fortunately my son was with us and he drove me to York hospital." On arrival Mr Reagan said they found the entrance to A&E had also been re-routed. "So, we then had to walk out of the hospital grounds and back in - by which time I'm collapsing," he added. He said staff at the hospital were "absolutely brilliant" and arranged for him to be transferred to Hull for treatment after a heart attack was confirmed. However, he said he was faced with a further 35-minute delay while he waited for an ambulance to take him. Mr Reagan said he wanted to share his experience to raise awareness. Read full story Source: BBC News, 16 January 2022
  17. News Article
    A hospital rated inadequate by inspectors two years ago has been praised for making improvements. The Care Quality Commission (CQC) has welcomed changes in urgent and emergency care at Stepping Hill Hospital in Stockport, Greater Manchester. The trust said the report was a "testament" to its staff's hard work. The CQC's unannounced inspection in November was carried out to check improvements had been made since a previous visit in August 2020. Among the concerns highlighted previously were patients left at high risk of harm during periods of heavy demand, staff shortages and staff who were "not competent for their roles". The new report said inspectors found urgent and emergency care had improved from inadequate to good overall and for being safe and well-led. "It has gone from requires improvement to good for being effective and caring. Responsive has gone from inadequate to requires improvement," the report said. Karen Knapton, CQC's head of hospital inspections, said: "We acknowledge the efforts of the emergency care team at Stepping Hill Hospital. We found staff provided good care and treated people with compassion and kindness." "They gave patients, their families and carers help, emotional support and advice when they needed it. Also, the service has been tailored to meet individual needs, including those living with dementia or a learning disability. " Read full story Source: BBC News, 12 January 2022
  18. News Article
    NHS trusts have been unable to get anywhere close to the target for reducing delayed discharges set by NHS England last month ahead of the omicron wave. The latest NHSE data shows that, in the week beginning 27 December, there were on average 9,857 medically fit for discharge adult patients occupying hospital beds. This is just 836 fewer than the average of 10,693 in the week of 13 December. This was when NHSE told trusts to discharge at least half of their medically fit patients to free up beds ahead of a surge in Covid patients. The news follows ministers announcing £300m would be invested into the adult social care workforce to fund community placements to aid discharges. However, in the letter on 13 December, NHSE said “a significant proportion of discharge delays are within the gift of hospitals to solve”. Meanwhile, ambulance handover delays remained a near record high levels last week as the urgent and emergency care system showed clear signs of pressure, including massive demand on NHS 111. Read full story (paywalled) Source: HSJ, 7 January 2022
  19. News Article
    Nearly a quarter of patients brought to hospital in an ambulance are facing dangerous delays getting into hospital in England, NHS data shows. Ambulances are meant to hand over patients within 15 minutes of arriving. But in the past week 23% out of nearly 84,000 patients brought in waited over 30 minutes. Staff are warning patients are being put at risk by the delays - and they think the situation is only going to get worse as Covid infections rise. At seven NHS trusts more than half patients were left waiting over half an hour with nearly two thirds delayed at Gloucestershire Hospitals NHS Trust. Association of Ambulance Chief Executives managing director Martin Flaherty said the situation was a major concern. "The extent of potential harm that is being caused to patients when there are lengthy delays remains a significant and growing problem." He said work was going on to tackle the issue, but around a quarter of hospitals were really struggling. Read full story Source: BBC News, 16 December 2021
  20. News Article
    UK hospitals have cancelled at least 13,000 operations over the last two months as they struggle to cope with record demand for NHS care and people sick with Covid-19. Figures collected by A&E doctors showed that 13,061 planned surgeries had to be called off during October and November because of shortages of beds and staff. However, the cancellations occurred at just 40 of the several hundred NHS hospitals across the four home nations, so those 13,061 are likely to be a major underestimate of the scale of the problem. Dr Adrian Boyle, a vice-president of the Royal College of Emergency Medicine (RCEM), which published the data, said the cancellations represented “a stark warning for the months ahead”. He also warned that A&E units across the NHS are “verging on crisis” because of their growing inability to provide timely care to the increasing numbers of patients seeking help. “Urgent and emergency care is verging on crisis and it is impacting and derailing elective care, meaning surgery for patients with serious conditions is delayed,” he added. Read full story Source: The Guardian, 7 December 2021
  21. 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
  22. 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
  23. 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
  24. 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
  25. 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
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