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Found 434 results
  1. Content Article
    In this post, Amber Clour, author of the Diabetes Daily Grind blog, talks about her experience of managing her type 1 diabetes while attending the emergency room for suspected appendicitis. She describes the steps she took to make sure her blood sugar levels were managed safely and with her consent, including communicating clearly with all healthcare professionals, ensuring her continuous glucose monitor (CGM) was not removed and bringing her own supply of glucose tablets to manage hypoglycaemia. Further reading Blog - “I felt lucky to get out alive”: why we must improve hospital safety for people with diabetes
  2. Content Article
    In this blog Patient Safety Learning considers the impact on patient safety of the shortage of hospital beds facing the NHS this winter. It focuses on two specific issues stemming from this, the increasing numbers of patients being cared for in corridors and other non-clinical areas, and current proposals to reduce the number of patients waiting to be discharged.
  3. Content Article
    Young people and expert mental healthcare staff say patients are unlikely to receive in-patient mental health care unless they “have attempted suicide multiple times”, according to a new report published by Look Ahead Care and Support. Launched in the House of Lords, the report – funded by Wates Family Enterprise Trust and produced by experts Care Research – argues Accident and Emergency departments have become an ‘accidental hub’ for children and young people experiencing crisis but are ill-equipped to offer the treatment required.   Based on in-depth interviews with service users, parents and carers, and NHS and social care staff from across England, the findings from the Look Ahead Care and Support report draws on experience of treating depression, anxiety, self-harm, suicidal thoughts and suicide attempts, eating disorders, addiction and psychosis.  
  4. Content Article
    In this letter to Steve Barclay MP, Secretary of State for Health and Social Care, the chair and chief executive of the Patients Association, Sir Robert Francis and Rachel Power, raised their concerns about how the Government is dealing with the growing crisis in health and social care. The letter asked him to declare a national incident in the NHS and to publish solutions to the current crisis, developed with patients and carers. The letter also asked the Minister to publish the long-term workforce plan and includes an offer from the Patients Association to work with the Department for Health and Social Care (DHSC).
  5. Content Article
    In this article, Richard Murray, Chief Executive of The King's Fund, reflects on what 2023 has in store for the health and care system in England. Acknowledging the intense pressure all services are currently under, he highlights that patients aren't currently receiving the care they need meaning that coping with operational challenges is going to dominate the early part of the year for the health and care sector. He warns of the futility of the Government adding new performance management measures to the sector, and expresses hope that Integrated Care Boards (ICBs) could make a difference by bringing together stakeholders to tackle longer-term problems such as integration, population health and inequalities.
  6. Content Article
    In this article for The Guardian, an anonymous hospital consultant describes the situation in many NHS emergency departments in January 2023—patients ready for medical admission waiting in ambulances in the hospital car park, patients receiving IV antibiotics in chairs in the corridor and staff completely overwhelmed by the workload. The author highlights that accident and emergency departments are now being used for a purpose for which they were not designed—looking after patients who need to be admitted to hospital wards. They describe the implications of this on patient safety and staff wellbeing and argue that the NHS and Government need to call the situation what it is—a crisis—or we will come to accept poor quality care and low patient safety standards as the norm.
  7. Content Article
    A prolonged stay in the emergency department before moving on to an in-hospital bed, another facility or departing home, is believed to have a negative effect on clinical outcomes for patients. This international systematic review and meta-analysis in the Journal of Clinical Medicine aimed to investigate the link between emergency department length of stay (EDLOS) and in-hospital mortality. The study's findings suggest two key associations with increased in-hospital mortality: low EDLOS EDLOS exceeding 24 hours The authors suggest that: long stays in the emergency department should not be allowed. special attention should be given to patients admitted after a short stay in the emergency department.
  8. Content Article
    As the NHS crisis has deepened in recent weeks, frontline staff have posted vivid, troubling accounts on social media of what has been happening in their workplaces. Many have described the NHS, and often themselves too, as “broken”. They have related the difficulty of providing proper care, the impact of acute understaffing and their fears for the NHS’s future. In this Guardian article, read some of what doctors, nurses and other NHS staff have been saying.
  9. Content Article
    Crammed wards, burned-out GPs, patients waiting hours for ambulances – the health service is at breaking point. The Guardian journalists, Andrew Gregory and Denis Campbell, take a look at the current NHS situation.
  10. Content Article
    This report provides an overview of the findings of Ireland's Health Information and Quality Authority (HIQA)’s monitoring programme against the national standards in emergency departments in 2022.  Throughout 2022, HIQA commenced a new monitoring programme of inspections in healthcare services against the National Standards for Safer Better Healthcare. As part of the initial phase, HIQA’s core assessment in emergency departments focused on key standards relating to governance, leadership and management, workforce, person-centred care and safe and effective care. The report highlights, HIQA has identified key areas for both immediate and longer-term attention to address safety issues in our emergency departments. 
  11. Content Article
    Writer and commentator Roy Lilley writes a daily email about what's happening on the ground in the NHS, and how this relates to policy decisions and guidance. Roy describes his eLetters as "a combination of opinion, my take on issues of the day and a news digest of things that I think are important or interesting." In this email, Roy shares several recent accounts sent to him by doctors and other healthcare professionals working in NHS hospitals. They describe dangerous staff ratios, overcrowding and medication shortages. The common theme is dangerously long working hours that could impact on patient safety. Sign up to receive Roy Lilley's daily eLetter.
  12. Content Article
    This report by The Patient Experience Library looks at patient experience in urgent and emergency care (UEC), reviewing four years' worth of studies from sources including government bodies, policy think tanks, academic institutions and the local Healthwatch network.
  13. Content Article
    In this opinion piece for the Daily Mail, journalist Tom Utley recounts his recent experience of a seven hour wait at A&E after receiving abnormal blood test results from his GP. He argues that fear of litigation is causing GPs to refer patients on to A&E unecessarily, contributing to the overcrowding happening at emergency departments. He also highlights inefficiencies in the system and states that lack of staff capacity to tell him he didn't require any treatment meant he stayed an additional hour and a half in the waiting room.
  14. News Article
    Further funding cuts to the NHS will unavoidably endanger patient safety, an NHS leader warned last week after the chancellor’s promise of spending cuts of “eye-watering difficulty”. Matthew Taylor, the chief executive of the NHS Confederation, said his members were issuing the “starkest warning” about “the huge and growing gulf between what the NHS is being asked to deliver and the funding and capacity it has available”. The warning came as figures showed that paramedics in England had been unavailable to attend almost one in six incidents in September due to being stuck outside hospitals with patients. Service leaders say wait times for A&E and other care are being exacerbated by an acute lack of nurses, with a record 46,828 nursing roles – more than one in 10 – unfilled across the NHS. "Patients are presenting more unwell," says a GP from South Wales, "Wait times in A&E have become unmanageable, so we’re seeing patients who have waited so long to be seen they’re bouncing back to us. Things we can’t deal with, like injuries and chest pain. We tell them they have to go back to A&E. "Abuse of surgery reception and admin staff began last year and it’s just scaled up from there. We’ve had staff members who have been verbally and physically threatened and we’re struggling to recruit and retain staff – people are hired and quit in a couple days. A lot of people are going off sick with stress." Five healthcare workers describe the pressures they are facing, including ambulance stacking, rising A&E wait times and difficulties discharging patients. Read full story Source: The Guardian, 1 November 2022
  15. News Article
    Scotland's NHS is in "a perilous situation" amid a staffing and funding crisis, according to the chairman of the doctors' union. Dr Iain Kennedy said urgent action was needed to tackle workload pressures ahead of a potentially "terrifying" winter period. It comes after Scotland's health secretary Humza Yousaf admitted NHS Scotland was not performing well. Mr Yousaf told BBC Scotland it would take at least five years to fix. Dr Kennedy, who is chairman of the industry body BMA Scotland, said it was good to hear Mr Yousaf being honest about the scale of the problems, but added that "frankly we cannot wait five years" for things to improve. He told BBC Radio's Good Morning Scotland programme: "The NHS in Scotland is in a perilous situation and we have a particular crisis around the workforce - we simply do not have enough doctors in general practice and in hospitals. "We need more urgent action because the pressures and the workload have really shot up." Dr Kennedy has called on the government to publish a "heat map" showing where NHS vacancies are unfilled across Scotland. He said: "The public need to see transparency on where the vacancies are. We think that there are probably 15% vacancies across hospital consultant posts across Scotland. "Even the government admits to 7% and that we are at least 800 GPs short in Scotland - and I, and others, suspect we are probably well over that figure now." Read full story Source: BBC News, 31 October 2022
  16. News Article
    Steve Barclay is back as England's health secretary, just as the NHS prepares for what its chief executive Amanda Pritchard says could be a "very, very challenging winter". The government has said "intensive work" is under way in the 15 most under-pressure hospital trusts in England, to speed up ambulance delays, free up beds and reduce waiting times in A&E. Emergency departments across the UK are struggling to quickly treat patients. Only 57% of people who turned up at major A&E departments in England last month were seen, admitted or discharged within four hours, well below the 95% national target. The latest figures from Gloucestershire Royal show it performs slightly worse than average, with 55% dealt with in four hours. One medic, speaking anonymously to the BBC, said: "I wouldn't bring a member of my family to this hospital. And winter is going to be worse unless something changes fast." Read full story Source: BBC News, 28 October 2022
  17. News Article
    Senior staff have questioned why a major hospital did not seek support from neighbours when emergency patients were left waiting more than 60 hours to be admitted to a bed. Cambridge University Hospitals Foundation Trust’s emergency department came under severe pressure last week, with patients being bedded down in corridors and facing very long waits to be admitted to a ward. Senior sources told HSJ there were two cases where patients were waiting more than 60 hours last Monday, and the trust declared an internal incident. But the sources felt the trust should have escalated its alert level to “Opel 4”, which prompts calls for external support when trusts are under the most severe levels of operational pressure. This can include diverting ambulances to other hospitals. The trust apologised to patients who had been kept “waiting for a long time” but that the required threshold for Opel 4 had not been reached. Read full story (paywalled) Source: HSJ, 25 October 2022
  18. News Article
    Hospitals “desperate” to free up beds could be putting patients in danger, The Independent has been told. NHS trusts are being forced into “risky behaviours” in the push to free up hospital beds and A&E departments, experts have warned. It comes as new data reveals that waits for ambulance crews outside hospitals hit 26 hours in September, with more than 4,000 patients likely to have experienced severe harm due to delays. In documents leaked to The Independent, hospital leaders in Cornwall warned staff that current pressures in its emergency care system combined with ambulance delays have “tragically resulted in deaths”. Royal Cornwall Hospitals Trust and the Cornwall Partnership NHS Foundation Trust said in the document that ambulance delays and waits in A&E were causing a “risk to life”, and that as a result they were planning to begin discharging patients into the care of the voluntary sector. The document said: “It is likely that the risk of such support not meeting all the patients’ individual requirements is less than the risk to life currently experienced in the community when there are significant handover delays at the hospital front doors.” It comes as North West Ambulance Service launched an investigation after a patient died waiting in the back of an ambulance outside A&E, the Manchester Evening News reported. Read full story Source: The Independent, 24 October 2022
  19. News Article
    A patient flow model which involves moving A&E patients to wards “irrespective” of whether there are beds available, is under review for wider rollout by NHS England and is being endorsed by senior clinicians, despite safety fears, HSJ has learned. The Royal College of Emergency Medicine has said it would be “unethical” for leaders not to at least consider implementing some form of “continuous flow” model for emergency patients. The approach has been been trialled recently by North Bristol Trust and at several London trusts. HSJ understands NHS England is considering the wider implementation of the continuous flow model, although no final decision has yet been made. The calls come despite patient safety concerns about the model being raised by the Nuffield Trust think tank, who said the evidence for the model is “poor” and could spread risk to other parts of the hospital. Read full story (paywalled) Source: HSJ, 21 October 2022
  20. News Article
    Paramedics in England cannot respond to 117,000 urgent 999 calls every month because they are stuck outside hospitals looking after patients, figures show. The amount of time ambulance crews had to wait outside A&E units meant they were unavailable to attend almost one in six incidents. Long delays in handing patients over to A&E staff meant 38,000 people may have been harmed last month alone – one in seven of the 292,000 who had to wait at least 15 minutes. Of those left at risk of harm, 4,100 suffered potential “severe harm”, according to the bosses of England’s ambulance services. Read full story Source: The Guardian, 21 October 2022
  21. News Article
    The NHS is setting up “war rooms” as it prepares for one of the toughest winters in its history, officials have announced. In a letter to staff, health leaders in England set out “winter resilience plans”, which include new system control centres that are expected to be created in every local area. These centres will be expected to manage demand and capacity across the entire country by constantly tracking beds and attendances. They will be operated by clinicians and experts who can make quick decisions about emerging challenges in the health service, NHS England said. The data-driven centres will be able to spot when hospitals are near capacity and could benefit from mutual aid. Where A&Es are especially busy, ambulances will be diverted to nearby hospitals with more space. Meanwhile, NHS England announced plans to expand falls response services so people are treated in their homes, avoiding unnecessary trips to hospital where possible. NHS England’s chief executive, Amanda Pritchard, said: “Winter comes hot on the heels of an extremely busy summer – and with the combined impact of flu, Covid and record NHS staff vacancies – in many ways, we are facing more than the threat of a ‘twindemic’ this year. “So it is right that we prepare as much as possible – the NHS is going further than it ever has before in anticipation of a busy winter, and today we have set out further plans to step up these preparations – building on our existing plans to boost capacity set out in August this year." Read full story Source: The Guardian, 19 October 2022
  22. News Article
    Angry exchanges between paramedics and A&E staff in Liverpool have broken out after new measures were deployed to hold and treat patients in the back of ambulances. Sources said there have been “Mexican standoff” situations at Aintree Hospital in recent days, after hospital staff insisted patients who had been brought inside should be returned to ambulance vehicles. Staff at North West Ambulance Service told HSJ they were informed of a new protocol last week, which said patients should be kept in the back of ambulances if the corridor of the emergency department is full with patients. There have been repeated orders from NHS England and the Care Quality Commission over the past year for hospitals to ensure patients can be offloaded by ambulance crews, even if they fear they do not have adequate staffing or beds to accept them. One senior source at NWAS said: “To see a new protocol like this is absolutely unprecedented. I very much doubt the execs had approved it. “We’ve had Mexican standoff situations over the weekend with crews who have brought patients into ED being told to take them back out to their vehicles, but they’ve refused to do this as it means they cannot cohort. “We completely accept that taking extra patients means the ED and hospital staff have to deal with additional and unacceptable risk, but holding ambulances is not the solution because the risks to patients out in the community are even greater. Despite repeated instructions from NHS England and the CQC this still doesn’t seem to be understood.” Read full story (paywalled) Source: HSJ, 17 October 2022
  23. News Article
    Staff at accident and emergency departments across Scotland have expressed “deep concern” at the daily “excessively long waiting times” that are forcing a record number of patients to wait more than 12 hours, according to a leading NHS consultant. Dr John-Paul Loughrey, vice-chair of the Royal College of Emergency Medicine Scotland national board, warned that while such long waits were once regarded as “never events,” they are now daily occurrences. Amid fears the delays will spike significantly over the winter months, especially with another wave of Covid-19 expected, Dr Loughrey said staff were already “burned out,” “exhausted,” and “overwhelmed with a system facing increasing strain.” The latest weekly data on A&E treatment shows that in the week ending 2 October, the number of patients waiting more than 12 hours had soared by 45% week-on-week. “There is deep concern among staff around the excessively long waiting times,” Dr Loughrey said. “The weekly data that show significant increases in long waits translates to real patients on the ground or in the community who are seeking urgent and emergency care. “The system is failing them. We know that long waiting times are associated with patient harm and even death. Staff face moral injury daily, but they are working incredibly hard and doing all they can to minimise this harm to patients.” Read full story Source: The Scotsman, 16 October 2022
  24. News Article
    Senior doctors have sent a warning over the “shambles” of heart attack care after pressures on the NHS have left patients waiting eight hours for an ambulance. The caution comes as several hospitals in the past week have declared critical incidents over the level of pressure on their emergency care services. Portsmouth Hospital said on Monday: “Demand for an emergency response is far outstripping the capacity available in Portsmouth and South East Hampshire at this time.” Professor Mama Mamas, a consultant cardiologist in Stoke and Professor of Cardiology at Keele University, told The Independent: “I was on call this weekend and I was seeing delays of eight hours. It was several people, three or four this weekend with heart attacks that waited between four and eight hours … it’s a national disgrace that we’re in this situation. “I think that patient care is being compromised. We know that time is muscle and an eight-hour delay getting an ambulance to a patient with a heart attack is impacting on the survival levels.” Read full story Source: The Independent, 13 October 2022
  25. News Article
    Mental health patients are increasingly having to turn to A&E for help, experts have warned, as new research suggests nearly one in four are being forced to wait more than 12 weeks to start treatment. The Royal College of Psychiatrists said its research found 43% of adults with mental illness say the long waits for treatment have led to their mental health getting worse. Almost a quarter (23%) have to wait more than 12 weeks to start treatment, with many so desperate they turn to A&E or dial 999. The college said many people face a “hidden wait time” for starting treatment, with no publicly available data on how long people wait from their initial referral to actually starting treatment. Those surveyed for the research had a range of mental illnesses, including eating disorders, addiction, bipolar disorder, anxiety and depression. Dr Kate Lovett, the college’s presidential lead for recruitment, said: “We cannot sit idly by and watch the most vulnerable people in our society end up in crisis. Not only do spiralling mental health waiting times wreak havoc on patients’ lives, but they also leave NHS services with the impossible task of tackling rising demand.” One female patient, a 45-year-old from south London, told how she ended up in A&E after having to wait seven months to be referred to a community team. “The only other way to get help was to present to A&E, which was a traumatic experience – having to be reassessed and readmitted again and again. Turning up to A&E was the only way I could be seen regularly. No one should have to go through that.” Read full story Source: The Guardian, 10 October 2022
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