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Found 364 results
  1. News Article
    A growing number of patients deemed to require a hospital admission are waiting so long in A&E that they end up being discharged before being admitted to a ward, HSJ has been told. A senior emergency clinician, who has delivered improvement support to multiple emergency departments across the NHS, said such cases have become a regular occurrence – describing it as a “terrible experience” for some patients. The clinician, who asked not to be named, said: “I suspect every ED in the country are having patients who are spending 24 to 48 hours in ED under the care of a specialist, that in a better time they would have gone onto a ward. That’s happening every day in every department. “If you have been seen by the ED crew and referred to the medics who say ‘you need to be admitted to hospital’, the chances are that they are sick enough that they really do need that bed. “It’s a terrible experience [for the patients]. EDs are busy, noisy and crowded. This is not the place where, if you were feeling ill, to get better in a calm, relaxing area. This idea that somehow it’s OK because these people are not that sick, it’s pretty poor. “It feels very much like battlefield medicine – slap a patch on and try and get them back into battle as quickly as possible. It shouldn’t be the way with civilian healthcare.” Read full story (paywalled) Source: HSJ, 23 January 2023
  2. News Article
    Ask any MP or local Healthwatch what health issue sits at the top of their inbox, and there is a good chance it will be the public’s access to NHS dentists. The launch of a Health and Social Care Committee inquiry into dentistry is therefore welcome news. The inquiry is well timed, coming after a recent BBC investigation showing that 90% of practices across England were not accepting new adult NHS patients. The severe access problems stem from several factors. Longstanding issues relating to the dental contract not offering high enough rates for dentists to provide NHS care, for example, have contributed to a decline in the availability of NHS dentistry. This has led to thousands of people across the country going private or, very concerningly, turning to self-care. Accident and emergency departments are over-flowing with people in severe dental distress, with tooth decay being the most common reason for hospital admission among children aged five to nine in recent years. Read full story (paywalled) Source: HSJ, 19 January 2023
  3. News Article
    Pressures on emergency health services are so bad that the UK government should declare a “national emergency” and call a meeting of the Civil Contingencies Committee (COBRA)—the body summoned periodically to deal with matters of major disruption—peers have said. The cross party House of Lords Public Services Committee said in a report that the government needed to respond with an emergency approach and steps to remedy the situation in the longer term. A recurring theme of the report is the substantial delays highlighted by the media in recent months, which peers said were caused by a “broken” model of primary and community care. This was driving unmet need in directing patients to hospitals where many remained longer than clinically necessary because of inadequate social care. The report recommended that the Department of Health and Social Care should mandate a greater presence of clinical staff in NHS 111 control centres to help boost numbers of clinicians in the 999 and 111 services. This would mean that patients were directed to the right services more quickly thanks to better triaging of calls, which could mean fewer patients being passed to emergency or urgent care services. Another suggestion was for the government to introduce more incentives for faster safe discharges from hospitals, with more capacity in hospitals and social care to help people move through the health system more quickly. Read full story Source: BMJ, 19 January 2023 Further reading on the hub: Patient safety impact of hospital bed shortages – A Patient Safety Learning blog
  4. Content Article
    The report's action plan for emergency health services: An emergency response: Recognising this is a national emergency, the Government should refer the crisis in emergency health services to a COBR Committee. Deliver care at the right place, right time: In the short term, boost the number of clinicians in 999 and 111 services so that patients are being directed to the right services at the right time. Unlock the gridlock: Incentivise faster safe discharges from hospitals and increase capacity in hospitals and social care to make sure people can move through the health system and do not end up stuck in ambulances or at A&E. Understand the problem: Data on A&E waiting times do not accurately reflect the patient experience. Performance data should accurately report the true waiting times experienced by patients so that decision makers have a clear picture of the problem, and so the public can hold them to account. Address unmet need: Boost capacity in hospitals and social care. Make it easier for patients to get care in the community both before they reach crisis point (preventing admissions) and following discharge. A new model for emergency health services: The Government must develop a new model for emergency health services which recognises the current crisis, the type of demand services face and clinical best practice and, for accountability purposes, sets out appropriate performance measures.
  5. News Article
    The fact that the NHS is under enormous pressure is undisputed. Almost everything else is debated, including the question of how many patients are dying as a result of the chaos in hospitals. The proportion of patients who wait more than 12 hours in A&E departments to be admitted to a ward has risen from 2% to 7% over the past year. The Royal College of Emergency Medicine has estimated that delays in A&E are leading to 300-500 additional deaths per week. However, officials at NHS England do not accept this figure. The data suggest that something is very awry. Read full story (paywalled) Source: The Economist, 11 January 2023
  6. News Article
    Young people in the midst of a mental health crisis need to have attempted suicide several times before they get a bed in an inpatient unit in England, a report has revealed. Admission criteria for beds in child and adolescent mental health units are now so tight that even very vulnerable under-18s who pose a clear risk to themselves cannot get one. The practice – caused by the NHS’s lack of mental health beds – leaves young people at risk of further harm, their parents confused, exhausted and worried, and the police and ambulance services potentially having to step in. The high thresholds for admission to a child and adolescent mental health services (Camhs) unit are detailed in a report on NHS mental health care for under-18s in England based on interviews with patients, their parents and specialist staff who look after them. The report says a young person has to “have attempted suicide multiple times to be offered inpatient support”. Olly Parker, the head of external affairs at the charity Young Minds, said: “It is shameful that children and young people are reaching crisis point before they get any support for their mental health. We know from our own research that thousands have waited so long for mental health support or treatment that they have attempted to take their own life. “Those who end up in A&E are often there because they don’t know where else to turn. But A&E can be a crowded and stressful environment, and is usually not the best place to get appropriate help.” Read full story Source: The Guardian, 18 January 2023
  7. Content Article
    Key findings Report commissioned by Look Ahead Care and Support finds increasing demand for children and young people’s crisis mental health services amidst challenges with existing services. Yet researchers heard from professionals, service users and their families and carers found that you “had to have attempted suicide multiple times to be offered inpatient support". Interviewees say A&E departments have become an ‘accidental hub’ for children and young people experiencing crisis but are ill equipped to offer the treatment required. Private sector providers now deliver the majority of support for hospitalised young people with mental health difficulties at “exceptionally high” cost. Report recommends alternative community crisis services, including supported housing away from hospital settings to reduce pressure on A&E and reduce costs by more than 50%
  8. News Article
    An acute trust chief executive has criticised the lack of communication during last month’s nursing strike, warning that he and other accountable officers could face manslaughter charges if patients are put in danger by decisions made by senior colleagues elsewhere in the system. Matthew Hopkins told a board meeting that Worcestershire Royal Hospital’s emergency department was “pushed to the extreme” on 20 December, with 176 people squeezed into a facility originally built for 50. He said that without warning from regional colleagues, an additional 18 people were brought in to the hospital by the ambulance service and ended up in corridors, at which point the trust declared a critical incident. The chief executive officer said he wanted to put on record an apology to staff for the incident, adding that he was “not aware” of the situation until it unfolded. Read full story (paywalled) Source: HSJ, 17 January 2023
  9. News Article
    The intense pressure on the NHS in recent weeks has left hospitals unable to cope, patients at risk and staff in despair, writes an A&E doctor in this Guardian article. "I’ve worked in the NHS for over 10 years and I’ve never known it as bad as it is now. A&Es are swamped and primary care is swamped too. It’s a very sorry of state for all concerned. The last few weeks have been beyond dreadful and it was all predicted by those on the ground months ago". We’re now in a position in our A&E where we are looking after a ward and a half of admitted patients, who take up the bedded spaces, while simultaneously running an emergency department out of the corridor and waiting room. Having to manage the very sick in inappropriate areas is now becoming the norm. An emergency department (ED) is not a safe place. It’s filled with some of the sickest people in a hospital, in a chaotic environment. There are lots of comings and goings, with patients being moved frequently and staff looking after multiple patients. It’s a recipe for things getting missed. If you add in the fact that ED personnel work a shift rota, so new staff come on duty every few hours and they don’t necessarily know the patients, there is more scope for potentially vital information being lost. "As ED doctors, we have always tried to give the dying a place of privacy, where loved ones can be with them in some relative peace. I would hope that same degree of compassion was present in all A&Es, but it’s becoming more challenging to provide." Read full story Source: The Guardian, 12 January 2023
  10. News Article
    A senior doctor has told Scottish ministers to drop “patient-blaming language” over “unnecessary attendances” at emergency departments. Lailah Peel, the deputy chairwoman of the British Medical Association in Scotland, said the phrase suggested that patients were responsible for the problems and showed a misunderstanding of the issues. Patients have waited 30 hours for beds in overcrowded A&E units while ambulances have queued outside hospitals waiting to hand over patients to overstretched staff. Sturgeon, announcing measures to ease the strain, said: “To reduce the pressures in hospital and the knock-on impacts at the front door we need to do more firstly to avoid unnecessary attendances at hospital and second to speed up the discharge of patients from hospital.” Read full story (paywalled) Source: The Times, 12 January 2023
  11. News Article
    An investigation by The Independent has revealed that the number of patients waiting more than 12 hours in A&E for treatment has exceeded 50,000 a week for the first time. Leaked NHS data shows that last month as many as one in eight patients faced a “trolley wait”—the time between attending A&E and being admitted—longer than 12 hours, as the health service comes under ever greater strain. Sources across the country told The Independent that hospitals are having to “squeeze” patients into spaces other than normal wards or A&E, with no direct oxygen lines. Meanwhile patients wait for hours in ambulances outside emergency departments. Read full story Source: The Independent, 11 January 2023
  12. News Article
    Patients have suffered cardiac and respiratory arrests because of errors using oxygen cylinders, NHS England has warned, citing more people being cared for in “areas without access to medical gas pipeline systems” such as corridors and ambulances queuing outside A&E. A patient safety alert issued by NHS England today identifies 120 incidents in the past year related to oxygen cylinder use, including cylinders either being empty at point of use, not switched on, inappropriately transported, or inappropriately secured. Some of the incidents involved “compromised oxygen delivery to the patient, leading to serious deterioration and cardiac or respiratory arrest” the alert said, and at least 43 caused harm. Read full story (paywalled) Source: HSJ, 10 January 2023
  13. News Article
    Nigel Edwards is the Chief Executive of the think tank the Nuffield Trust. In this interview, he outlines the discharge problems currently faced by NHS hospitals, highlighting lack of staff and resources in the social care sector as major causes of hospital capacity issues. Source: Channel 4 News
  14. News Article
    Patient safety is at risk “every single day”, with patients in desperate need of intensive care waiting hours in Accident and Emergency departments across Scotland, the deputy chair of British Medical Association Scotland has said. The harrowing description of the scenes in hospitals came as health secretary Humza Yousaf admitted patients were receiving care he would not want to receive himself as the NHS continues to battle intense winter pressures. Dr Lailah Peel, deputy chair of the Scottish arm of the British Medical Association (BMA), told the BBC’s Sunday Show the crisis was “years in the making”. She blamed a creaking social care system and increased delayed discharges. The comments come after details of a January 2021 briefing from the Royal College of Emergency Medicine (RCEM) and the College of Paramedics to the health secretary warned of an unacceptable situation in Scotland’s hospitals. Reported in the Sunday Times, the briefing also specified the actions needed to avoid a similar situation during the current winter crisis, warning an increase of at least 1,000 new beds was needed as well as more doctors and nurses. Dr Peel said it was the case patients were “absolutely” dying in hospitals in Scotland due to the ongoing crisis in the health service. "There’s no shadow of a doubt that that is happening,” she told the BBC. Read full story Source: The Scotsman, 8 January 2023
  15. News Article
    The extent of the gridlock in hospitals over Christmas has been revealed, with data in England showing record numbers of ambulances delayed dropping off patients at A&E. More than 40% of crews were forced to wait at least half an hour to hand over patients in the week up to 1 January. That is the highest level since records began a decade ago. But there is hope pressures could soon start easing, with flu and Covid admissions dropping last week. But the UK Health Security Agency is warning it is too early to say whether the flu season - the worst in a decade - has peaked, because reporting lags over the festive period may have affected the data. And Matthew Taylor, of the NHS Confederation, which represents hospitals, said wards were still incredibly full, which was creating delays in A&E and for ambulances. He said hospitals were facing "crisis conditions" that were presenting a risk to patients. Read full story Source: BBC News, 5 January 2023
  16. News Article
    Junior doctors have threatened to stage a “full walkout” for three consecutive days in March in which they would not treat A&E patients. The British Medical Association told the government this morning that junior doctors would strike for 72 hours if it is supported in a ballot that opens next week. The association said that “doctors will not provide emergency care during the strike”, which is likely to worsen deadly accident and emergency delays. Hospital bosses said they were “deeply worried” by the BMA’s announcement, urging the government to start negotiating rather than “sitting back and letting more strikes happen”. NHS bosses fear that the BMA will co-ordinate strike action with the nursing and ambulance unions if the dispute is allowed to rumble on. Nurses will strike on January 18 and 19, and ambulance workers are due to walk out on January 11 and 23. Read full story (paywalled) Source: The Times, 6 January 2023
  17. News Article
    A man turned up to an accident and emergency department in the Midlands complaining about ear wax on the day a hospital declared a critical incident, a nurse who works there has said. Lesley Meaney, a sister at University Hospitals of North Midlands (UNHM), said the patient presented to A&E with “no pain, no discomfort, just eat war wax!” Earlier on 30 December officials at the trust declared a critical incident, citing “extremely high demand for all of our services.” The disclosure by Ms Meaney underlines the scale of the challenge facing the NHS and staff working in hospitals across the country. Writing on Twitter, Ms Meaney added: “Seriously what is up with the general population? A major incident declared, ambulances queuing, and you decide to come to the emergency department on New Year’s Eve with ear wax.” Dr Matthew Lewis, medical director at UNHM, said: “The accident & emergency departments at UHNM are some of the busiest in the country so we would urge the public to only come to our Emergency Departments if it’s for serious, life-threatening conditions that need immediate medical attention, such as persistent severe chest pain, loss of consciousness, acute confusion, severe blood loss, serious burns, broken bones, suspected stroke. Read full story Source: The Independent, 4 January 2023
  18. News Article
    The crisis engulfing the NHS will continue until Easter, health leaders have warned, as senior doctors accused ministers of letting patients die needlessly through inaction. More than a dozen trusts and ambulance services have declared critical incidents in recent days, with soaring demand, rising flu and Covid cases and an overstretched workforce piling pressure on the health service. But amid warnings that up to 500 people a week may be dying due to delays in emergency care alone, and of oxygen for seriously ill patients running out in parts of England, NHS leaders warned more chaos was expected until April. “It seems likely that the next three months will be defined by further critical incidents needing to be declared and the quality of care being compromised,” said Matthew Taylor, chief executive of the NHS Confederation, which represents the whole healthcare system in England, Wales and Northern Ireland. Ministers face growing pressure to grip the crisis. The British Medical Association (BMA) said the government’s “deafening” silence and failure to act was a “political choice” that was leading to patients “dying unnecessarily”. The Liberal Democrats urged the government to recall parliament, while Labour blamed government “mismanagement” for creating a sense of “jeopardy” around the NHS. Read full story Source: The Guardian, 2 January 2022
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