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Found 434 results
  1. News Article
    A&E waits are now “apocalyptic” and “worse than ever imagined” leaked NHS data shows, and could be driving 1,000 patient deaths a month, The Independent can reveal. Almost 700,000 people have waited more than 12 hours in A&E in the first seven months of 2022, according to leaked NHS data. The “hidden” monthly trolley waits, not published in national data, have more than doubled this year in comparison to 2019. Dr Katherine Henderson, President of the Royal College of Emergency Medicine, warned data shows trolley waits are “worse than ever imagined” and said it is “scandalous” the real figures are not published despite promises. Dr Henderson warned the deterioration in A&E waiting times is the result of “decades of underfunding” and “unheeded warnings” over staffing and social care. In one message to staff in Nottinghamshire, seen by The Independent, hospital leaders said last week patients were waiting more than 40 hours for beds in A&E, while some areas of the hospital were running on a 1:14 staffing ratios and patients were waiting at home with no care. Read full story Source: The Independent, 1 August 2022
  2. News Article
    A cancer sufferer who says she faced a wait of 31 hours in A&E has compared the emergency department to "a cattle market". Tracy Summerson, who had nausea and a fever, was eventually admitted to Lincoln County Hospital last week. Ms Summerson said there were more than 30 other patients who waited a similar amount of time. The hospital said despite long waits, those who needed immediate care were "able to be seen and looked after". Ms Summerson, from Scopwick near Metheringham, described the scene as "just crammed, you were like cattle in a market". Ms Summerson, who has stage four malignant melanoma, said: "There was people coming with sick bowls being sick next to you. "When you are immune-suppressed you're supposed to go in a side room out of germs way, but they needed all the rooms for consultations." The family of an 83-year-old woman also contacted the BBC to say she waited more than 40 hours in a wheelchair in her nightdress after being taken to the hospital with a suspected brain bleed. The trust added: "We continue to see an increasing demand on our urgent and emergency care services coupled with patients staying much longer in our hospitals than previously experienced." Read full story Source: BBC News, 1 August 2022
  3. News Article
    Patients experiencing a mental health crisis were kept in a ‘short stay area’ of an emergency department for up to three weeks, a Care Quality Commission (CQC) report has revealed. The patients were in what the CQC described as a “short stay area” of the ED at the Royal Sussex County Hospital in Brighton. It is an area with no natural light, no TV or radio and only a toilet and washbasin, with a shower available on a neighbouring ward, the CQC said. The patients were reviewed daily by a mental health liaison team from another trust while they waited for a mental health bed to be found. The CQC report said staff reported the longest stay was up to three weeks, while trust data showed the average length of stay was 52 hours. It said the urgent and emergency services at the hospital – part of University Hospitals Sussex Foundation Trust which is rated “outstanding” overall by the regulator – “did not fully meet the needs of the local population”. Read full story (paywalled) Source: HSJ, 29 July 2022
  4. News Article
    Mental health patients who arrive at emergency departments (ED) in crisis are increasingly facing ‘outrageous’ long waits for an inpatient bed, with some being forced to wait several days. HSJ research suggests ED waits of more than 12 hours have ballooned in 2022, and are now around two-and-a-half times as high as pre-Covid levels. Early intervention for patients in mental health crisis is deemed to be crucial in their care and recovery. The Royal College of Emergency Medicine said the findings are a “massive concern”, while the Royal College of Psychiatrists described them as “unacceptable”. RCEM president Katherine Henderson said the experience of mental health patients in accident and emergency departments “is not what it should be from a caring healthcare system”. She said: “We have massive concern for this patient group. We feel they are getting a really poor deal at the moment. “The bottom line is there are not enough mental health beds. There are not enough community mental health services to support patients and perhaps therefore prevent a crisis and the need for beds in the first place. “Mental health crisis first responder teams work – a mental health practitioner working with the ambulance service can prevent the need for an ED visit.” Read full story (paywalled) Source: HSJ, 19 July 2022
  5. News Article
    Hundreds of children suffering from mental health issues are attending A&E each day, with some waiting up to five days in emergency departments, The Independent can reveal. Internal NHS data leaked to The Independent, shows the number of young patients waiting more than 12 hours from arrival has also more than doubled in the last year. A national survey of senior A&E doctors by the Royal College of Emergency Medicine (RCEM) found in some areas children’s mental health services have worsened in the last three years, while the majority of respondents warned there were no children’s crisis services open after 5pm. One NHS trust chief executive has warned his hospital’s A&Es have seen a “real surge” in both attendances of people with severe mental health issues and a sharp increase in long waits in recent months. One parent, Lee Pickwell, told The Independent his daughter was admitted to paediatric wards several times and stayed days in an emergency “section 136” unit while she waited more than two months for a mental health bed. Dr Mark Buchanan, RCEM’s lead for children’s mental health, told The Independent that despite improvements, children’s mental health services still fall short of what is needed. Dr Buchanan said: “I’ve seen children who have been not seen by Child and Adolescent Mental Health Services (CAMHS), who been refused the referrals, despite the fact that the mum and dad were taking it in turns to sleep outside their bedroom door because they were scared that they’d run away and do some harm.” Read full story Source: The Independent, 13 July 2022
  6. News Article
    A spike in Covid absences and the extended heatwave have left NHS hospitals and ambulance services struggling to cope. The hot weather is also driving more patients to A&E departments, and callers are being urged not to use 999 except in serious emergencies. All 10 ambulance trusts in England are on black alert, the highest level, while health leaders warn that “ill-equipped” hospital buildings are struggling to store medicines correctly amid the abnormally high temperatures. Martin Flaherty, managing director of the Association of Ambulance Chief Executives, said: “The NHS ambulance sector is under intense pressure, with all ambulance services operating at the highest level of four within their local resource escalation action plans, normally only ever reserved for major incidents or short-term periods of unusual demand. “Severe delays in ambulance crews being able to hand over their patients at many hospital emergency departments are having a very significant impact on the ambulance sector’s ability to respond to patients as quickly as we would like to, because our crews and vehicles are stuck outside those hospitals.” Read full story Source: The Independent, 12 July 2022
  7. News Article
    Patients may be turned away at A&E in Portsmouth as the UK’s heatwave drives extreme hospital pressures. Staffing pressures coupled with additional strain from the current heatwave have forced Portsmouth Hospitals University Foundation Trust to declare a critical incident. The trust said it only had space in its emergency department for patients with life-threatening illnesses and critical conditions and so would be forced to redirect other patients elsewhere. In a statement, Portsmouth Hospitals University FT said: “Our emergency department remains full with patients and we have very limited space to treat emergency patients. We are only able to treat patients with life-threatening conditions and injuries, so anyone patients who arrive at ED without a life-threatening condition or injury, will be redirected to alternative services that can help... “Our immediate priority is to ensure there are beds available to admit our most seriously ill patients into and we are focusing on safely discharging as many patients as possible. We ask that families and loved ones support us with this and collect patients as soon as they are ready to be discharged.” Read full story Source: The Independent, 11 July 2022
  8. News Article
    Paramedics have begun looking after patients inside an A&E unit, in an initiative by the health service to stop ambulances queueing outside hospitals and ease the strain on overstretched casualty staff. The scheme has led to patients being handed over much more quickly at a hospital that was one of the worst in England for sick people being stuck, sometimes for many hours, in the back of an ambulance. Queen’s hospital in Romford, in east London, has set up an ambulance receiving centre (ARC) near its main casualty unit in which two London Ambulance Service paramedics are on duty round the clock to help look after patients who would otherwise be trapped outside or in a corridor, waiting to be seen. Patients who end up in the new six-cubicle unit behind the A&E nurses’ station have a better experience while they wait and are more comfortable – and safer – because they can have their relatives with them, eat and drink and use the toilet more easily. Almost 2,000 patients have passed through the ARC since it opened last November, saving nearly 13,000 hours of ambulance crews’ time and enabling them to respond to emergency calls more quickly. However, some A&E doctors regard the scheme as merely “a sticking plaster”, given that queues of ambulances have become common outside many hospitals and that casualty units are treating the lowest percentage of patients within four hours on record. Read full story Source: The Guardian, 3 July 2022
  9. News Article
    Next week’s rail strikes will ’probably end up killing people’ as they will prevent staff working for already struggling ambulance trusts from getting to work, a senior NHS leader has told HSJ. Both London Ambulance Service Trust and South Central Ambulance Service Foundation Trust have moved to ”Reap 4”, This is the highest level of alert, meaning they are under extreme pressure. Ambulance trusts are already experiencing high demand amid soaring temperatures and continuing problems with lengthy handovers at the accident and emergency departments. Fears are now growing that next week’s rail strikes will push services to breaking point as many ambulance staff travel to work by public transport. The three days of rail strikes – on Tuesday, Thursday and Saturday next week – will see many lines with very limited services. Tube services in London will also be hit by a strike on Tuesday and the London Overground and some tube lines will be affected on rail strike days. A senior leader closely involved in southern England’s emergency and urgent care services told HSJ: “Next week’s rail strikes will probably end up killing people because they’ll prevent ambulance trust staff getting to work.” Other ambulance trusts are understood to be monitoring the situation closely. Trusts in REAP 4 (REAP stands for resource escalation action plan) normally take a series of measures including diverting more staff to frontline duties, asking some patients to make their own way to hospital and concentrating on reaching the most serious patients. Read full story (paywalled) Source: HSJ, 16 June 2022
  10. News Article
    Delays unloading ambulances at busy hospitals are causing serious harm to patients, a safety watchdog is warning. The Healthcare Safety Investigation Branch has been investigating how the long waits are delaying 999 emergency response times across England. Kenneth Shadbolt, 94, waited more than five hours for an ambulance after a bad fall - an accident that proved fatal. Logs show that in his final 999 call he asked: "Can you please tell them to hurry up or I shall be dead." Ken Shadbolt had been in good shape for his age. On the night of Wednesday, 23 March 2022, just before 03:00, he got out of bed to go the bathroom and fell, hitting a wardrobe before collapsing on the floor. He had hurt his hip - how badly he didn't know - and couldn't get up. He could reach his mobile on his bedside, though, and dialled 999 for help. The BBC has seen transcripts of the three separate phone calls he made to South Western Ambulance Service that night. The first was short and factual, covering the basic details of his injury. He seemed calm and lucid but made clear he was in pain and needed an ambulance. Internal call logs seen by the BBC show that at this point Ken was triaged as a category two emergency, meaning paramedics should arrive in 18 minutes, on average. About 15 minutes later, Ken called 999 for a second time. An internal ambulance service log seen by the BBC shows that South Western Ambulance Service was indeed busy that night. It talks about "high demand" in the Gloucester area, with more than 60 patients waiting for help, some for more than eight hours. Another hour passed before Ken made his third and final call to 999. It was clear now that he was in serious pain. He felt "terrible sick" and said his "breathing is going too". "I need an ambulance because I'm going to fade away quite quickly," he said. The same reply came back: "The ambulance service is just under a lot of pressure at the moment... we are doing our best." An ambulance finally got to Kenneth Shadbolt's house at 08:10 that morning, four hours after that final call. Ken died at 14:21 that afternoon, with the cause of death given as a "very large subdural haematoma" or bleed on the brain. His son Jerry Shadbolt said: "The doctors were saying his injuries were non-survivable but would they have been non-survivable if he'd arrived at hospital four hours earlier? I'd like an answer to that question. "He was on his own and he knew he was on his own. He must have felt abandoned and alone on his bedroom floor. That's the most troubling part of it for me." Read full story Source: BBC News, 16 June 2022
  11. News Article
    More than 380,000 patients waited more than 12 hours in A&E last year, new figures show, amid claims ‘misleading’ public data masks the true scale of the problem. A Royal College of Emergency Medicine report shows 381,991 people across 74 NHS trusts waited half a day or longer from the time they arrived at hospital in 2021. The figures are 14 times higher than the official numbers published by the NHS – which say 25,553 people waited more than 12 hours during the same period at the same trusts – due to the different ways waiting times are measured. While NHS England publishes data every month, it only shows how long patients have waited after a decision by doctors to admit them. Experts claim this is misleading and have called for the NHS to publish the figures from point of arrival instead. It comes after The Independent revealed leaked data in May, showing that more than 3,000 patients a day were regularly facing 12-hour waits in the first four months of 2022. Dr Adrian Boyle, RCEM vice president, said the new figures were “staggering” and “make clear that measuring 12-hour waits from decision to admit masks the reality facing patients and staff. Read full story Source: The Independent, 14 June 2022
  12. News Article
    The number of calls for an ambulance in England have almost doubled since 2010, with warnings of record pressures on the NHS that are seeing A&E patients stuck in corridors and many paramedics quitting the job. Ambulance calls have risen by 10 times more than the number of ambulance workers, according to a new analysis of NHS data carried out by the GMB union. An increase in people seeking emergency treatment, GPs unable to cope with demand and cuts to preventive care are all being blamed for the figures. While the figures represent all calls for an ambulance, some of which go unanswered and do not lead to a vehicle being sent, they reveal the increasing pressures that have led to claims that patient safety is being put at risk by ambulance waiting times. There has been a significant increase in the number of the most serious safety incidents logged by paramedics in England over the past year. Paul, a paramedic and GMB deputy branch secretary, said he had recently seen a crew waiting almost 10 hours between arriving at hospital and transferring a patient to hospital care. “They arrived at the hospital at 20.31,” he said. “They then cleared from the hospital at 05.48 in the morning. The impact of the lack of resources is affecting the ambulance service. “We are also seeing people become aggressive to the ambulance crew, because they’ve waited hours upon hours in an ambulance." Read full story Source: The Guardian, 12 June 2022
  13. News Article
    A struggling A&E told patients they had no beds in the hospital and would face waits of 13 hours, The Independent has learned. NHS staff at Harlow A&E, run by Princess Alexandra Hospital Trust, warned patients on Monday: “We’ve got 170 patients in the department, there are 90 patients waiting to be seen at the moment…our current wait time for a doctor is seven and half hours I will estimate by the time I go home in the morning at 8 ‘clock some of you will still be waiting because the waits will get up to 13 hours. “There are currently no beds in the trust we’re trying to make space if we can but if people are admitted there’s a chance they’ll stay in A&E overnight." “We will do our best to make you comfortable but please don’t expect you will be going direct to a ward because that might not happen.” The staff member asked relatives to leave as the department was so busy. Speaking with The Independent an emergency department consultant from the Midlands said they were “fed up”. He added: “It’s just so unfair on patients and staff. The best ones are burning out and wanting to leave. The only way to survive seems to be to stop caring/trying It’s just so unfair on patients and staff. The best ones are burning out and wanting to leave. The only way to survive seems to be to stop caring/trying.” Read full story Source: The Independent, 8 June 2022
  14. 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
  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
    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
  17. 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
  18. 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
  19. 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
  20. 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
  21. 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
  22. 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
  23. 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
  24. 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
  25. 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
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