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Found 352 results
  1. News Article
    Public satisfaction with the NHS has slumped to its lowest level ever recorded by the long-running British Social Attitudes survey. Just 29% said they were satisfied with the NHS in 2022, with waiting times and staff shortages the biggest concerns. That is seven percentage points down on last year and a drop from the 2010-high of 70% satisfaction. The poll - the gold standard measure of the public's view of the health service - has been running since 1983. A&E saw the biggest drop in satisfaction, but ratings for all services from GPs and dentistry to general hospital care fell. The fall in overall satisfaction was seen across all ages, income groups, sexes and supporters of different political parties. Read full story Source: BBC News, 29 March 2023
  2. News Article
    Whistleblowers have described the accident and emergency (A&E) department at Hull Royal Infirmary as "incredibly dangerous" and a "death trap". The Care Quality Commission (CSC) found Hull University Teaching Hospitals required improvement overall and its A&E department was rated inadequate. Two clinical staff members, who wished to remain anonymous, described it as a "toxic" place to work. Speaking to the BBC, the two staff members who have worked in Hull's A&E department said they had raised concerns with senior managers and the CQC. They said there were frequently fewer staff than needed and warned inexperienced staff, one whom had never seen a cardiac arrest, were working in areas like resuscitation, which was "incredibly dangerous". "Nurses who aren't even signed off to give oral medication are being put in resuscitation," one said. "It's a death trap, it is terrifying." Despite these concerns, CQC inspectors in December and November did find the service "had enough nursing and support staff to keep patients safe". Read full story Source: BBC News, 28 March 2023
  3. News Article
    Trust executives and senior managers have been criticised by a former national director for their lack of support for an under-pressure A&E. An independent review described York Hospital as “reluctant” to trigger internal escalation processes, and suggested it should be quicker to admit extra patients to inpatient wards during busy periods. Professor Matthew Cooke, a former national clinical director for emergency care who conducted the review, said that during his two-day visit to the department he witnessed a 60-hour delay for a patient to be admitted: “I was surprised not to see any senior managers or executives in the ED, despite such long delays. ED staff reported they rarely saw the executive team.” Professor Cooke also warned of uncertainty over escalation processes, including for reducing pressure in the emergency department by “boarding” patients on wards beyond normal capacity. He said: “On the second morning, there were multiple patients on oxygen in ordinary seats in majors waiting room, cared for by a single nurse. I find it difficult to understand how this is safer than boarding one extra patient on several wards.” “Staff perceived that the organisation was reluctant to move to higher escalation levels and I sensed this meant staff no longer pushed for such actions.” Read full story (paywalled) Source: HSJ, 23 March 2023
  4. News Article
    Self-harm hospital admissions for children aged eight to 17 in the UK jumped 22% in one year. The age group is now the largest for self-harm admissions, with all others seeing a drop, according to NHS data. Charities say early access to support is vital, but high thresholds and long waiting lists mean more young people are ending up in hospital. Emily Nuttal, 29, first struggled with self-harm when she was 12. At 13, she was first admitted to A&E. At that time, she was struggling with changes at school, bullying and troubles at home. Over the years, she said she had had varied experiences in accident and emergency departments. "It's been times where it's been really empathetic and passionate people, understanding, supportive. And there's been times where there's been that stigma and judgement." She said being labelled as "attention-seeking" was really difficult and made it harder to reach out for help again. "I would then only go if I was forced upon by the crisis service, or if somebody else noticed, and they got people involved," she said. Read full story Source: BBC News, 23 March 2023
  5. News Article
    The NHS’s efforts to prop up emergency departments with thousands of additional medical staff has been the wrong approach to solving the crisis in these services, experts have argued. Analysis of NHS staffing data by HSJ shows the emergency care medical workforce has grown by almost two-thirds since 2016, far outstripping the growth in other specialties. Despite this, waiting times in accident and emergency have deteriorated significantly over the same period. John Appleby, chief economist at the Nuffield Trust think tank, said: “Cramming the A&E department with more doctors doesn’t look like it’s having the intended effect over the last four to five years. Waiting times have got worse and we have more staff. “Increasing staffing has helped with waiting times in the past, but maybe we have reached a point where it’s not staffing in A&E which is the issue. The issue is the front door and the backdoor of the A&E.” Read full story (paywalled) Source: HSJ, 17 March 2023
  6. Content Article
    Key insights In 2022, 1.65 million people waited 12 hours or more from their time of arrival (TOA) in an ED. This figure is 4.8 times the number of 12-hour Decision to Admit (DTA) waits reported, demonstrating the metric is misleading. From April 2023, NHS England will routinely publish 12-hour TOA data, a vital first step toward reducing long and unnecessary waiting times in EDs. We must have an accurate picture of these long waiting times, as they can have catastrophic consequences for patient safety and mortality. Using the Standard Mortality Ratio (SMR) and the 12-hour TOA figure, we estimate 23,003 excess patient deaths in 2022 in England were associated with long stays in EDs. While we welcome the Government publishing the data, we seek assurance that this data will be published on a monthly basis at ED level, so that hospitals can use this information to improve quality of care and ensure patient safety.
  7. News Article
    One patient is dying every 23 minutes in England after they endured a long delay in an A&E unit, according to analysis of NHS figures by emergency care doctors. In all, 23,003 people died during 2022 after spending at least 12 hours in an A&E waiting for care or to be admitted to a bed, according to the Royal College of Emergency Medicine (RCEM). That equates to roughly 1 every 23 minutes, 63 every day, 442 a week or 1,917 each month. The college said its findings, while “shocking”, were also “unsurprising” and reflected the fact that emergency departments are often overwhelmed and unable to find patients a bed in the hospital. Rosie Cooper, the Liberal Democrats’ health spokesperson, said “patients are now dying in their droves” due to successive Conservative governments neglecting the NHS, and added that the lives lost due to A&E snarl-ups constituted a “national disaster”. “Long waiting times are associated with serious patient harm and patient deaths,” said Dr Adrian Boyle, RCEM’s president. “The scale shown here is deeply distressing.” Read full story Source: The Guardian, 28 February 2023
  8. News Article
    Hundreds of thousands of older people in England are having to endure chronic pain, anxiety and unmet support needs owing to the worsening shortage of social care staff and care home beds. Age UK has said older people with chronic conditions such as diabetes, high blood pressure and heart failure are increasingly struggling with living in their own homes because of a lack of help with everyday tasks such as getting out of bed, dressing and eating. The decline in the amount of support and care provided to older people is piling pressure on families and carers and leaving the NHS in constant crisis mode, contributing heavily to ambulance queues outside A&E departments, the charity said in a new report It warned that there would be a repeat of the NHS crisis this winter – in which rising numbers of elderly people have been unnecessarily stuck in hospital because of an acute lack of social care – without a shift to preventing unnecessary admissions. Read full story Source: The Guardian, 17 February 2023
  9. Content Article
    Key findings Half (49%) of all the people arriving in A&E by ambulance are over 65. A third (36%) of all the people arriving in A&E by ambulance are over 75. Unplanned hospital admissions have been rising and have become more frequent, particularly for the oldest old. The proportion of older people feeling supported to manage their condition has been falling consistently, almost 20% in relative terms since 2016/17. 2.6 million people over 50 have unmet social care needs increasing to 15% of people in their 70s, and 21% of people in their 80s. In 2022, there were 165,000 vacant posts in social care- an increase of 50% and the highest rate on record. Call for action Integrated Care Systems (ICS) to develop comprehensive strategies for meeting the health and social care needs of older people at home, and in care homes, living in their areas. This must include major efforts to embed prevention in their work so older people can avoid the need for crisis care and maintain their independence. Social care reform and a major and sustained increase in funding. The NHS cannot deliver these improvements alone. The lack of adequate social care for basic daily needs simply stores up problems, leaving older people less able to care for themselves and arriving in hospital with serious health problems that could have been avoided. Multidisciplinary working to become the default method of delivering health and care services to older people. Older people are too often left to fall between the cracks of disjointed services and professionals who don’t communicate well with each other. For ICSs, this means making sure that social care services – and by extension the local authorities that are responsible for them - are central to their leadership and decision-making. A better paid health and social care workforce, with the skills and competencies to properly support older people would make a huge difference to the quality and availability of care. A step change in the recognition of and financial and practical support on offer to unpaid carers, who are holding up many parts of the health and care system.
  10. News Article
    Virtual wards, set up to relieve pressure on A&E departments, could create extra NHS demand as some are only staffed for 12 hours a day, the country’s top emergency doctor has warned. The service allows patients to be monitored remotely from their own homes, freeing up hospital beds and capacity in emergency departments. Patients are given devices to track their vital signs, such as blood pressure and oxygen levels, with readings sent back to doctors via smartphone apps. Dr Boyle, President of the Royal College of Emergency Medicine, said that virtual wards “must not be seen as a silver bullet for all the problems in urgent and emergency care”. “We’re very wary of virtual ward beds being used to say that there are increased beds within hospitals because that’s simply not true,” he said. “The plan for 7,000 or 5,000 extra beds need to be actual beds, with pillows, sheets and staff looking after them.” Source: Telegraph, 11 February 2023 Read full story
  11. News Article
    Nurses in England are preparing to escalate their dispute with the government by involving staff from NHS A&E departments, intensive care and cancer wards in a series of 48-hour strikes. The Royal College of Nursing (RCN) is understood to be planning to announce walk outs for two consecutive days and nights, rather than limiting action from 8am to 8pm as they have done so far. NHS leaders warned the looming strike could be the “biggest impact” on patients yet seen, with the union preparing to end a process where the RCN had agreed to exemptions with hospitals. The RCN told NHS leaders on Friday it is preparing to step up its dispute by asking its members working in emergency departments, intensive care units and oncology to join the strike. But the union, expected to announce the strike this week, will make a very limited set of provisions for the most urgent clinical situations as part of a legal obligation not to endanger life. Saffron Cordery, deputy chief executive at NHS Providers said: “A continuous 48-hour strike that includes staff from emergency departments, intensive care units and cancer care services would likely have the biggest impact on patients we’ve seen.” Read full story Source: The Independent, 12 February 2023
  12. News Article
    Children suffering mental health crises spent more than 900,000 hours in A&E in England last year seeking urgent and potentially life-saving help, NHS figures reveal. Experts said the huge amount of time under-18s with mental health issues were spending in A&E was “simply astounding” and showed that NHS services for that vulnerable age group were inadequate. Children as young as three and four years old are among those ending up in emergency departments because of mental health problems, according to data obtained by Labour. Dr Rosena Allin-Khan, the shadow mental health minister, who is also an A&E doctor, said: “With nowhere to turn, children with a mental illness are left to deteriorate and reach crisis point – at which time A&E is the only place left for them to go. Emergency departments are incredibly unsuitable settings for children in crisis, yet we’re witnessing increasingly younger children having to present to A&E in desperation.” Young people who endured long A&E waits included those with depression, psychosis and eating disorders as well as some who had self-harmed or tried to kill themselves, doctors said. Read full story Source: The Guardian, 9 February 2023
  13. News Article
    Ambulance crews reached emergencies such as heart attacks and strokes one hour quicker in January than December in England, figures show. They took 32 minutes on average, compared with more than 90 the month before. The target is 18 minutes but January's average was the quickest for 19 months. A&E waiting times also improved, with just over a quarter of patients waiting longer than four hours - down from more than a third in December. But Society for Acute Medicine president Dr Tim Cooksley said wait times remained "intolerable". And he highlighted the waits the sickest and most frail were facing for a bed on a ward. Nearly four out of every 10 patients waited over four hours on trolleys and in corridors. "The fundamental problem remains a significant shortage of workforce, leading to woefully inadequate inpatient bed and social-care capacity," Dr Cooksley added. Read full story Source: BBC News, 9 February 2023
  14. Content Article
    University Hospitals Sussex NHS Foundation Trust identified two main solutions: Annualised self-rostering/self-preferencing rotas so staff had more control over their working hours. Introduction of a clinical fellow role with 25% non-clinical time to allow these staff to undertake other projects – for example, teaching medical students. These two solutions were initially started for the A&E departments and then medical juniors whilst implementing the same systems but also allowing for continuity of ward care. The Trust decided to use the HealthRota system, to implement an annualised system for consultants (using a period-of-activity contract), middle grades (using a combination of period-of-activity and hours contract) and junior rotas (using hourly contracts), alongside self-rostering or self-selecting preferences, with staff choosing the amount of clinical work they wish to do. The Trust now benefits from 24/7 A&E consultant cover at Brighton, and cover between 8am and 10.30pm every day of the week at the Princess Royal Hospital. In five years, the Trust went from seven consultants and seven registrars on A&E (for two sites) to 23.8 full-time equivalent consultants and 20 registrars. In addition, the costs of using locum doctors have been massively curtailed. For example, before the annualised rota system was introduced, in A&E alone £1.3M was spent on locums at RSCH and PRH. For 2022-23, the only locum need has been for sickness cover.
  15. News Article
    Staff at the Royal London are proud of their work but don’t know how long they can continue as waiting times grow and patients suffer. Read full story (paywalled) Source: The Times, 6 February 2023
  16. News Article
    A major hospital in the UK has declared a critical incident, warning it is facing “immense pressures” on its services. Wigan’s Royal Albert Edward Infirmary urged people to avoid its A&E unless suffering a “life or limb-threatening emergency”. Wrightington, Wigan and Leigh (WWL) Teaching Hospitals NHS Foundation Trust warned that “unprecedented attendances” meant the emergency department was “full”. It said it is working with partners to discharge patients who are ready to leave hospital. The trust, which previously declared a critical incident in December, said the safety of its patients is the “top priority”. By declaring a critical incident, hospitals are able to take action so that safe services are maintained despite increasing pressures. Read full story Source: The Independent, 1 February 2023
  17. News Article
    Some ambulance trusts are not sending paramedics to up to around a quarter of their most serious calls, according to figures obtained by HSJ. HSJ submitted data requests to all 10 English ambulance trusts after the Care Quality Commission raised concerns about the proportion of category one calls not being attended by a paramedic at South Central Ambulance Service Foundation Trust. The regulator said in a report published in August last year that between November 2021 and April 2022 around 9% of the trust’s category one calls were not attended by a paramedic. Inspectors said this meant some patients “did not receive care or treatment that met their needs because there were not appropriately qualified staff making the decisions and providing treatment.” But data obtained via freedom of information requests reveals other ambulance trusts had far lower proportions of category one calls attended by paramedics than the South Central service last year. Read full story Source: HSJ, 2 February 2023
  18. News Article
    NHS staff are failing to follow guidelines for providing care to sickle cell patients - and some of the advice has been branded as “unfit for purpose”. The NHS Race and Health Observatory commissioned research, undertaken by Public Digital, to explore the lived experience of people undergoing emergency hospital admissions for sickle cell and managing crisis episodes at home. The Sickle cell digital discovery report: Designing better acute painful sickle cell care, found that the existence of service-wide information tailored by the National Institute for Health and Care Excellence has “arguably not been designed for an ambulance, A&E and emergency setting”, and states it has been proven that this guideline is “not being used and adhered to consistently”. Moreover, healthcare professionals have warned that the National Haemoglobinopathy Register (NHR) - a database of patients with red cell disorders - is not being readily accessed, while patients reported being treated in a way that breached prescribed instructions. “We believe that sickle cell crisis guidelines could be improved in terms of their usability in a high-pressure emergency setting, and in terms of promoting access to them,” the report authors concluded, adding that current guidance should be adapted. Read full story Source: The Independent, 31 January 2023
  19. News Article
    The amount of time people over 80 spend in A&E in England has almost doubled in a year, leaving them at increased risk of coming to harm and dying, emergency care doctors are warning. An analysis by the Royal College of Emergency Medicine (RCEM) found that people of that age are spending 16 hours in A&E waiting for care or a bed, a huge rise on the nine hours seen in 2021. The college, which represents the UK’s A&E doctors, warned that long waits, allied to overcrowding in hospitals and older people’s often fragile health, is putting them in danger. Doctors specialising in emergency and elderly care warned that older people forced to spend a long time in A&E are more likely to suffer a fall, develop sepsis, get bed ulcers or become confused. Dr Adrian Boyle, the RCEM’s president, said that it is also likely that some older people are dying as a result of the delays they are facing, combined with their often poor underlying health. The risks older people face while waiting in sometimes chaotic A&E units are so great that they are likely to be disproportionately represented among the 500 people a week who the RCEM estimates are dying as a direct result of delays in accessing urgent medical help. Read full story Source: The Guardian, 31 January 2023
  20. News Article
    The NHS will start publishing “hidden” figures on A&E waiting times following several leaks reported by The Independent. After unveiling its emergency care plan on Monday, NHS England confirmed it would release internal data each month - currently only made public once a year - showing how many people are waiting for longer than 12 hours after arriving at an emergency department. The Independent has published several leaks of this data, which shows that these waiting times can be up to five times higher than publicly available NHS figures. Official monthly figures only count the number of hours patients wait after a decision to admit them has been made, and so mask the true scale of the problem. The move comes after health secretary Steve Barclay said the NHS would, from April, publish this “real” number in a bid for “greater transparency.” Writing in The Telegraph, he said: “Too much of the debate about A&E and ambulance services is based on anecdotal evidence. I want NHS managers and the wider public to have access to the same facts from the front line, starting with publishing the number of 12-hour waits from the time of arrival in A&E from April.” Read full story Source: The Independent, 31 January 2023