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News ArticleThe family of a senior medic and lifelong NHS campaigner have called for an investigation into his death as it took paramedics more than half an hour to arrive at his home after operators were told he was suffering a cardiac arrest. Professor Kailash Chand, a former British Medical Association deputy chair, had complained of chest pains before one of his neighbours, a consultant anaesthetist at Manchester Royal Infirmary, called 111 for help before telling the call handler within three minutes that he believed his friend was having a cardiac arrest. “I was answering their questions when Kailash’s eyes began rolling and he slipped into unconsciousness. That’s when I said ‘this looks like a cardiac arrest’ and to upgrade the call. They kept asking questions as I started CPR and asked for an urgent ambulance. That was two or two and a half minutes into the call." Evidence seen by i News shows that it took another 30 minutes after the neighbour told the operator about the cardiac arrest for the paramedics to arrive at Professor Chand’s flat in Didsbury, Greater Manchester. National standards for ambulance trusts show that ambulance trusts must respond to category 1 calls – those that are classified as life-threatening and needing immediate intervention and/or resuscitation, such as cardiac or respiratory arrest – in 7 minutes on average, and respond to 90% of Category 1 calls in 15 minutes. Read full story Source: iNews, 3 September 2021
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Covid Scotland: Patient numbers soar amid 'out of control' A&E crisis
Patient-Safety-Learning posted a news article in News
New data has revealed the number of people in hospital with Covid-19 is climbing rapidly, even before the latest surge in infections. These figures highlight the immense pressure the NHS is currently facing, and according to this data, there are now 585 people in hospital with the virus, up from 312 just eleven days ago, showing it to be the highest figure since early March. Health Secretary Huma Yousaf said the situation in A&E is being closely monitored. "Hospitals are reporting increased levels of people attending A&E who are much sicker and require higher levels of care. Weekly performance is impacted due to a range of challenges including high attendances, staffing pressures due to isolation and annual leave and the continued requirement for infection control precautions that is affecting the time people need to spend in A&E." Read full story. Source: The Herald, 01 September 2021 -
News ArticleAccording to reports, a hospital in the northeast of England is having to turn away non-emergency patients from A&E due to "unrelenting" pressures on the service. This new policy was announced on Tuesday by Hull Teaching Hospitals Trust, warning patients they may need to travel up to 30 miles in order to receive care. Dr Makani Purva, chief medical officer said in a statement on the trust website on Tuesday: “Staff are working incredibly hard to provide care for patients in challenging circumstances but we need people to use the full range of services available. One in four patients who attend A&E in Hull could have been treated more appropriately elsewhere, that’s around 100 patients every day. So from today, after an initial screening process, those arriving at A&E who could safely be cared for elsewhere will be referred on to one of several alternative care centres and providers. Doing so will help us to reduce waiting times for more seriously ill patients and ensure they receive the priority care they need in hospital, while enabling those patients with non-urgent needs to receive care more quickly from a suitably skilled health professional elsewhere.” Read full story. Source: The Independent, 24 August 2021
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Moving A&E patients to other departments has ‘high mishap rate’
Patient-Safety-Learning posted a news article in News
The authors of a new study in Australia, published in the Emergency Medicine Journal, have said moving emergency care patients to other hospital departments by wheelchair or trolley is prone to a high rate of mishaps, with nearly 40% leading to incidents. The study, which took place at Austin Hospital, a teaching hospital in the Melbourne suburb of Heidelberg, also found endotracheal tubes, ventilator hoses, and arterial lines were also associated with high mishap rates. “Risk events are common and some result in harm. Risk factors include a high equipment number, transport to a ward and some abnormal vital signs. As many risk events are likely preventable, our identified predisposing factors may inform preventative strategies that may benefit other emergency departments.” The authors have said. Read full story. Source: Nursing Times, 24 August 2021 -
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Big surge in the most serious ambulance calls
Patient-Safety-Learning posted a news article in News
Performance data published by NHS England has revealed a big surge in the number of immediately life-threatening incidents ambulance services have responded to. The data also showed average response times have increased and a large number of patients are attending emergency departments. So far, the reason for the increase remains unclear, however, a potential factor could be the return of respiratory illnesses, particularly in children, as the lockdown has eased. In a statement Association of Ambulance Chief Executives said, ”The reasons for the demand increases are complex and will include some patients who have not accessed care as early as they might have done normally and therefore present to the ambulance service as a high acuity patient and many patients who are contacting us for lower acuity issues which in some cases could have been managed by accessing other parts of the UEC system. We continue to work closely with NHS England to mitigate the demand as much as possible and encourage sign-posting of patients to other parts of the UEC system when that is a safe and more appropriate solution to their problem.” Read full story (paywalled). Source: HSJ, 12 August 2021- Posted
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Record 1 million 999 calls made to NHS in July
Patient-Safety-Learning posted a news article in News
Latest data has revealed more than one million 999 calls were placed in July, showing paramedics were sent out to 82,000 emergencies last month and 8,000 more than the record set in June. This comes after A&E departments became overwhelmed with an influx of new patients over the summer, with many hospitals having to cancel operations due to being dangerously understaffed. Dr Katherine Henderson, president of the Royal College of Emergency Medicine has said, "The NHS has been running hot for months now and these figures show we are nearly at boiling point. We are worried that the public think things are getting back to normal on the virtual eve of a further reduction in restrictions, and messages from the centre that say things are OK are disingenuous – the reality is that the health service is really struggling." Read full story. Source: The Independent, 12 August 2021- Posted
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Ambulance services seek regional commissioning
Patient-Safety-Learning posted a news article in News
A report published today has revealed the creation of single regional boards to commission ambulance services is under discussion with NHS England and Improvement. According to the report titled Rapid response: the role of the ambulance sector in transforming services and coping with the long-term impact of covid-19, ambulance trusts are to be involved in regional, integrated care system and place-level decision-making to maximise their contribution to more integrated services has also been called for. NHS Providers chief executive Chris Hopson and Association of Ambulance Chief Executives chair Daren Mochrie said: “As well as providing mobile treatment services, ambulance trusts have the potential to be an absolutely crucial co-ordinator on the urgent and emergency care pathway. We think there is a real opportunity there that is being missed." Read full story (paywalled). Source: HSJ, 12 August 2021 -
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A&E queues mean Wales' ambulances 'can't take 999 calls'
Patient-Safety-Learning posted a news article in News
A new BBC report has found ambulance crews are unable to respond to calls quickly due to the pressure on hospitals to find free beds. Some paramedics are even spending most of their 12 hour shift waiting in the back of their ambulance, waiting to be called. "We know there are people in the community that are screaming out for an ambulance, but as you can see, a lot of ambulances are waiting here. It never ever used to be like this. We used to bring poorly patients in, and we were out on the road again in 15 minutes. We could do 10 jobs a shift, today we've done two. It's so demoralising" Paramedic Osian Roberts has said. Read full story. Source: BBC News, 11 August 2021 -
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NHS’ promotion of 111 First ‘not strong enough’, watchdog warns
Patient-Safety-Learning posted a news article in News
Not enough people know about the NHS 111 First A&E booking service as the messaging hasn't been strong enough, says Healthwatch England. The service can be used for patient who need urgent care but are not in an emergency situation, and patients can call 111 to "book" into urgent care. However, not enough people know about it, or what it's used for. “There’s a real gap in high quality communication to the public,” she said. “They [the NHS leadership] expect the public just to catch up with the changes they have made. 111 First [or] online booking services come along and we’re all supposed just to know how to use it. That’s caused a lot of frustration for people. Our evidence shows that when people understand and use [111 First], they like it. But not enough people know about it and the comms have not been strong enough.” Says Imelda Redmond, the outgoing national director for Healthwatch England. Read full story (paywalled). Source: HSJ, 2 August 2021 -
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Paramedics left in tears from ‘unsustainable demand’, warns union
Patient-Safety-Learning posted a news article in News
In a letter seen by The Independent to ambulance trust chief executives, union officials have warned the health of paramedics is being put at risk due to "unsustainable demand". Union bosses have also warned paramedics are being left in tears at the end of their 12 hour shifts and often working overtime in order to meet demand, warning this increased amount of pressure is taking its toll on the health of ambulance workers. “Ambulance workers have faced exceptional pressures over the past 17 months. It’s not surprising many have reached burnout. They cannot be left to just carry on doing excessive hours without proper breaks and rest between shifts. Employers must act swiftly by doing all they can to limit the unprecedented pressures on staff. Additional welfare support is needed, and the government should make this a top priority.” Says Deputy head of health Helga Pile. Read full story. Source: The Independent, 02 August 2021- Posted
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Woman died in Cardiff home after waiting 'hours' for ambulance
Patient-Safety-Learning posted a news article in News
Maria Whale, 67, has died after waiting more than two hours for an ambulance after her husband dialled 999 when she began experiencing "severe abdominal" pain. Mr Whale has said the family have questioned whether she would have lived if the ambulance had arrived sooner, saying they had waited "four to five hours" for it to come. However, the Welsh ambulance service has said its records showed the call was placed at 02:10 BST before a paramedic arrived at 04:22 BST, with the ambulance following shortly thereafter at 04:35 BST - two hours and 25 minutes after the first call. "We are deeply sorry to hear about the passing of Mrs Whale and would like to extend our thoughts and deepest sympathies to her loved ones. An investigation to determine what happened started earlier this month and given this is underway we are unable to comment further at this time." Says Welsh Ambulance operations director, Lee Brooks. Read full story. Source: BBC News, 28 July 2021- Posted
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Paramedics abused and assaulted while on duty, survey reveals
Patient-Safety-Learning posted a news article in News
New data has revealed hundreds of paramedics experience physical assault and verbal abuse whilst serving the public. According to NHS, there has been a 32 per cent rise in assault against paramedics over the past 5 years, with more than 1,600 saying they had been threatened while on duty or feared for their own lives. Now, ambulance trusts are aiming to fit paramedics with body cameras while the West Midlands have CCTV inside their ambulances. "After years of lobbying, the legislation is now in place to ensure that the worst offenders are severely and appropriately dealt with. The problem is that the law is not being used to full effect and sentences are still far too lenient. We are calling today on the courts to step up and impose the harshest penalties available to them." Said Tracy Nicholls, chief executive of the College of Paramedics. Read full story. Source: The Independent, 28 July 2021- Posted
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Hospitals experiencing "perfect storm"
Patient-Safety-Learning posted a news article in News
NHS bosses have warned as Covid-19 infections rise, the demand for A&E ha surged, colliding with holiday season. According to reports, hospitals are being told to brace themselves as admissions to hospital for patients with Covid have risen by more than 30 per cent over the past week. Newcastle upon Tyne Hospitals, chief executive Dame Jackie Daniel has said, “We are going through the ‘perfect storm’ of high numbers of Covid patients in hospital, high Covid infections in the community, which is affecting staff and our families, unprecedented levels of urgent and emergency demand and peak holiday season, all of which comes after 18 months of exhausting work.” Read full story. Source: The Independent, 25 July 2021 -
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Patients waiting 10 minutes for 999 calls to be answered
Patient-Safety-Learning posted a news article in News
Some people calling 999 are having to wait up to 10 minutes before their call is answered. Staff have warned patients may be coming to harm, and may be even dying as a result of the delays and with paramedics also reporting it's taking as long as 24 hours for some ambulances to reach patients. One paramedic has told The Independent, “We are stacking over 500 jobs, with patients waiting hours for an ambulance response. That includes elderly vulnerable people who have fallen but only merit a category three, so their calls are routinely pushed further and further down the queue. In the last few days, I've been to patients waiting 11 or 13 hours. And just to be clear: this is not the hospitals’ fault. The system is profoundly broken.” Read full story. Source: The Independent, 22 July 2021- Posted
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London Ambulance Service declares incident as 999 calls surge
Patient-Safety-Learning posted a news article in News
The London Ambulance service declared a 'business continuity incident' on Monday after a surge in 999 calls. Paramedics were told the ambulance service was under extreme demand after the calls threatened to overwhelm the service. The announcement was made after more than 400 calls were made in a single hour during Monday afternoon. “Yesterday we saw high levels of demand for our services and used tested processes to care for our patients – this allowed some people with the least urgent care needs to be treated through alternative routes" said a London Ambulance Service spokesperson. Read full story. Source: The Independent, 20 July 2021- Posted
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Greater Manchester hospitals ‘forced to provide extra critical care beds’
Patient-Safety-Learning posted a news article in News
Hospital waiting lists across the country could hit 13 million in the months to come. Reports have found Manchester Hospitals are having to provide extra beds for critical care patients as the number of people coming in has surged. Hospitals are struggling to cope due to increase in patients attending hospitals in the city a reports the Manchester Evening News. The “number of people attending emergency departments across Greater Manchester has seen a significant increase in recent weeks” and that assistance from hospitals in other parts of the country was “part of our usual processes”, a spokesperson for the Greater Manchester Health and Social Care Partnership has said. Read full story. Source: The Independent, 15 July 2021- Posted
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Ambulance trusts on 'black alert'
Patient-Safety-Learning posted a news article in News
999 calls soar as patients experience record waiting times in the back of ambulances. The Independent has seen a leaked brief from the West Midlands Ambulance Service and has found patients have been waiting for hours outside hospitals, meaning ambulances could not respond to any emergency 999 calls. Ambulance staff have also faced hours of delays resulting in at least four hours or more at the end of their 12 hour shift. The briefing in June said "“This current situation is unacceptable and leads to fatigue, poor morale, has impacts on patient safety and potentially non-compliance with the Working Time Directive.” Read full story. Source: The Independent, 9 July 2021- Posted
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Manchester Royal Infirmary under major pressures
Patient-Safety-Learning posted a news article in News
Staff at Manchester's Royal Infirmary have said they are facing mounting pressures amid staff shortages and increasingly long waiting lists in A&E. Doctors and nurses have said they were told a 'major incident' was declared, however, it was then reduced to an internal incident in an attempt to avoid 'bad press'. A clinician has said A&E patients are now regularly waiting over 8 to 10 hours overnight due to an increasing influx of patients and a surge in children attending A&E. Read full story. Source: The Independent, 26 June 2021 -
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Young children in A&E with mild winter viruses
Patient-Safety-Learning posted a news article in News
It has been reported Accident and Emergency are seeing record numbers of young children being brought in with mild winter viruses, overwhelming the department. Experts have said it is unlikely to be serious and that people should seek to speak with their GP, pharmacist or NHS 111 as the first port of call, but that A&E is an option if parents are worried it could be an emergency. It has emerged that most of the children are under the age of five and it may be that as lockdown has been easing and people are mixing, winter viruses are reappearing. Read full story. Source: BBC News, 25 June 2021- Posted
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"Black alert" declared by Barnsley Hospital
Patient-Safety-Learning posted a news article in News
Barnsley Hospital declares 'black alert' as their A&E becomes overwhelmed with patients. The hospital has seen more than 300 patients in one day, putting pressure on staff to free up beds. It has been understood that the surge in numbers is due to other illnesses and not Covid-19 related. Read full story. Source: The Independent, 22 June 2021 -
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Patient safety threat: A&E swapped by record high numbers
Patient-Safety-Learning posted a news article in News
Hospitals around the UK are facing record numbers of patients coming into A&E, overwhelming the service. New records have been set, surpassing that of the worst days in the winter of 2019. Concerns over patient safety have been raised amid fears lives may be lost. It has been revealed by doctors working in A&E that patients are waiting to be seen as long as nine hours and the increased influx of people needing urgent treatment is putting more pressure on hospital beds. There are also reports of growing levels of violence towards medical staff from frustrated public. Dr Adrian Boyle has said "there is no quick fix" and that the increased pressure and violence from members of the public have created a "toxic work environment". Read full story. Source: The Independent, 20 June 2021 -
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NHS England gives green light to scrap four-hour A&E target
Patient Safety Learning posted a news article in News
NHS England is pushing ahead with plans to replace the NHS’s four-hour emergency target with a new set of 10 metrics, it has announced today. The announcement follows a consultation launched in December on its latest proposals, although any final plans will still require government signoff (see box below for the 10 new metrics). NHSE/I said in a press release: “In an NHS consultation four out of five respondents said they would welcome a bundle of measures. The specific proposals were endorsed by two thirds, 67%, of respondents and opposed by just 13%.” However, NHSE/I said in a report on the proposals that it had not yet been established how the new basket of metrics would be used as a performance measure and that the proposals still needed government sign-off. Read full story (paywalled) Source: HSJ, 26 May 2021 -
News ArticleResearch has found that people who go to A&E following self-harm receive varying quality of care and this has a significant impact on what they experience subsequently. The study in BMJ Open, which was codesigned and co-authored with people who have lived experience of self-harm and mental health services, found negative experiences were common, and revealed stigmatising comments about injuries from some hospital staff. Some participants reported being refused medical care or an anaesthetic because they had harmed themselves. This had a direct impact on their risk of repeat self-harm and suicide risk, as well as their general mental health. According to the research, the participants who received supportive assessments with healthcare staff reported feeling better, less suicidal and were less likely to repeat self- harm. "This research highlights the importance of learning from the experiences of individuals to help improve care for people who have harmed themselves. We involved patients and carers throughout the entire process and this enabled us to gain a greater insight into what patients want after they present to hospital having harmed themselves", said Dr Leah Quinlivan. Read full story Source: University of Manchester, 25 May 2021
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Social care cuts mean thousands with dementia taken to A&E, charity says
Patient Safety Learning posted a news article in News
Tens of thousands of people with dementia are taken to hospital each year for emergency admission because inadequate social care has left them unprotected from infections, falls and dehydration, an investigation has found. There has been a 27% increase over a four-year period in avoidable illnesses and injuries caused by failures in care for those living with dementia, according to the Alzheimer’s Society. “This news comes just under a week after the Queen’s speech frustratingly made only a brief mention of the prime minister’s promise nearly two years ago to deliver a clear plan for social care reform, a devastating blow for the 850,000 people living with dementia, worst hit by coronavirus,” said Kate Lee, chief executive officer at Alzheimer’s Society. The charity found that nearly two-thirds of dementia emergency admissions could have been avoided. It blames cuts in social care budgets and warned that worse is to come. Launched to mark Dementia Action Week, the charity’s investigation also found that nearly three-quarters of family carers said loved ones with dementia had experienced preventable medical issues because of lack of support. One in nine had been taken to hospital. Read full story Source: The Guardian, 17 May 2021- Posted
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Ambulance crews in England to use iPads to assess accident and stroke victims
Patient Safety Learning posted a news article in News
Ambulance crews will start using iPads to send photographs of accident and stroke victims to specialist hospital doctors so that they can make rapid diagnoses and save some patients a trip to A&E. NHS England is giving 30,000 iPads to regional ambulance services to help paramedics decide what care to give and whether to take someone to hospital or treat them at the scene. The tablet computers will be a vital link between ambulance crews and hospital consultants, whose digital interaction will make treatment faster and better, NHS England said. For example, the devices will let paramedics show an A&E department how badly injured patients have been in a road traffic crash, so that they can prepare for their arrival. They will also allow crews access to patients’ medical records to help them build a better picture of their health. “Ambulance crews have been at the forefront of the pandemic, routinely dealing with life-and-death situations and often first on scene to treat and diagnose critically ill patients,” said Sir Simon Stevens, NHS England’s chief executive. “These devices are another tool for our highly skilled paramedics and ambulance technicians as they continue to respond to the country’s most critically ill and injured patients.” Read full story Source: The Guardian, 18 May 2021- Posted
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