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Found 190 results
  1. Content Article
    Key recommendations The Department of Health and Social Care and NHS England should: develop specific plan to address gaps in diagnostic workforce, short-term and long-term shortages in key professions and level of investment required to deliver sustainable long-term increases. publish a detailed analysis of the extent of the cancer backlog to support the delivery of the elective care recovery plan. set out an estimate of what level of additional capacity in NHS cancer services will be needed to address the backlog in cancer services and treatment by March 2023. set out an action plan to ensure that NHS cancer services are able to provide this additional capacity above normal levels. The new Office for Health Improvement and Disparities should conduct a rapid review of existing evidence of the impact of demographic factors on cancer outcomes and commits to developing a joint strategy with NHS England to address disparities in outcomes.
  2. News Article
    Public satisfaction with the NHS has dropped to its lowest level for 25 years after a sharp fall during the pandemic, a survey suggests. The British Social Attitudes poll, seen as the gold standard measure of public opinion, found 36% of the 3,100 asked were satisfied in 2021. That is a drop from 53% the year before - the largest fall in a single year. Only once have satisfaction levels been lower since the poll started in 1983. That was in 1997, and shortly after that the Blair government started increasing the budget by record amounts. The public said it was taking too long to get a GP appointment or hospital care, and there was not enough staff. Satisfaction with GP care and hospital services were both at their lowest levels since the survey began. Dan Wellings, senior fellow at the King's Fund, described them as "extraordinary". He said the NHS initially saw a "halo" effect early on in the pandemic, with satisfaction rates being maintained as the NHS battled through the first wave. But he said it was clear that had now gone. "People are often struggling to get the care they need. These issues have been exacerbated by the extraordinary events of the past two years, but have been many years in the making following a decade-long funding squeeze, and a workforce crisis that has been left unaddressed for far too long." Read full story Source: BBC News, 30 March 2022
  3. Content Article
    "Urgent and emergency care is in crisis. While the focus has been on the serious elective backlog, a dangerous situation has been developing in our already pressured emergency care system. Emergency departments are full and struggling to receive ambulance patients, resulting in delays and patient harm. Hospitals are full and are struggling to get beds for the patients needing admission. Patients are stuck in the back of ambulances, on trolleys in ED corridors and increasingly in hospital beds because of the paucity of community support for discharges. We now find ourselves in the completely unacceptable situation where the “solution” to ambulance handover problems is to put up tents or sheds in front of emergency departments... The blindingly obvious problem here, as ever, is staffing. Neither hospitals nor the ambulance service has enough staff to cover another clinical area, let alone a tent. Not only that, but these tents do not have the usual safety features of a hospital and while covid is still circulating extensively pose a risk of cross infection. They are a danger to patients’ health and dignity."
  4. Content Article
    The report highlights the following key findings: The maternity service was offering care to women whose pregnancies represented a high risk, but did not have the necessary systems or staff with the appropriate skills in place to manage such cases. There was a lack of input from consultants at crucial times, and there was an over reliance on junior staff to manage complex and difficult cases with little guidance or support. Consultant obstetricians did not routinely carry out ward rounds when they were responsible for overseeing care in the labour ward and the teamwork between midwives and obstetricians was not as effective as it should have been. Therefore, there was no adequate mechanism in place for staff to discuss concerns that they may have had about the women. There was an excessive reliance on the use of locum and agency staff, who did not always receive the necessary guidance or support. Deficiencies in the management structures also contributed to the poor quality of care the women received, for example midwives were expected to manage a busy delivery suite that was reliant on agency and locum staff, with at times, little professional or managerial support. Around the time of the first deaths the midwives received little professional support from the supervisors of midwives. In the majority of cases the women attended their hospital and GP antenatal appointments and sought help when they felt unwell. Yet despite this, in a number of the cases, clinical staff failed to recognise and respond to the severity of the condition of the women, thereby reducing the chances of survival of the women. In some of the cases there were minor deficiencies in care which, in isolation, may not have had such a dramatic impact, but when occurring together had serious consequences for the health of the women concerned. The anaesthetic staff involved in the care of the women responded well, often in difficult circumstances. The haematology department responded efficiently in providing the necessary, and at times large, volumes of blood and blood products. In two of the cases there was an absence of documentation for surgical procedures that were carried out by the obstetric staff and in one case there was an absence of contemporaneous documentation. Related reading An independent review of serious untoward incidents and clinical governance systems within maternity services at Northwick Park Hospital (16 September 2008)
  5. News Article
    A crisis in cancer care at NHS Tayside could have been averted if the health board had publicly supported doctors who were criticised by an official report, according to a top oncologist. The last remaining breast radiotherapy specialist left at the end of January, with the board unable to replace him. Patients must now travel to Aberdeen, Glasgow or Edinburgh for radiotherapy. The situation has emerged three years after an investigation into chemotherapy treatment at Ninewells Hospital. NHS Tayside apologised to patients in 2019 after an investigation found doctors deviated from national standards on chemotherapy dosages given to breast cancer patients after surgery. A subsequent review found that the lower dosages were highly unlikely to have led to the deaths of any patients. Last year the doctors involved were cleared of any wrongdoing by the General Medical Council (GMC), who also found no fault with the treatment patients received. Some clinicians close to those involved told BBC Scotland the cancer doctors felt they had no choice but to leave because they did not have the backing of the board. Colleagues who support the oncologists say none of this needed to happen. Prof Alastair Munro, emeritus professor of radiation oncology at Dundee University, who previously worked as a cancer doctor in the department, said: "It's a totally avoidable tragedy, this should not have happened. "The first thing the health board need to do is to come clean, and say we got it wrong, we put our hands up, we want to start again with a clean slate and we want to attract good people to come to Tayside to deliver breast cancer services to the patients whose needs we serve." Read full story Source: BBC News, 9 February 2022
  6. Content Article
    "This is a welcome plan, but the NHS will need more staff to make it a reality. ‘The plan brings together a series of initiatives that, if successfully implemented, will improve access to services for the many patients anxiously waiting for care in pain and discomfort. But, as this plan notes, it is important to recognise that the NHS backlog is bigger than the people waiting for planned hospital care – mental health and community services are also facing backlogs of care, and the pressure on general practice is leaving many people struggling to get an appointment. These services must not be overlooked by a national focus on hospital waiting lists. ‘The targets in this plan look ambitious, especially as the disruption caused by Covid-19 makes it hard to predict how many patients will need care in the coming months. Analysis by The King’s Fund shows that people living in disadvantaged areas are waiting longer for treatment, so I welcome the recognition that national targets will need to be implemented in a way that rectifies these inequalities. ’More fundamentally, without enough clinical staff these targets will remain aspirational numbers in a plan rather than real change for patients. For many years the NHS has been hamstrung by chronic staff shortages, and today’s plan is a long way short of providing a comprehensive solution. To tackle the staffing crisis, government must move beyond repeating manifesto pledges and instead come forward with a fully funded workforce strategy."
  7. Content Article
    The plan focuses on four areas of delivery: Increasing health service capacity, through the expansion and separation of elective and diagnostic service capacity. The physical separation of elective from urgent and emergency services ensures the resilience of elective delivery, as well as providing service efficiency. This will include a strengthened relationship with independent sector providers to accelerate recovery. Prioritising diagnosis and treatment, including a return towards delivery of the six-week diagnostic standard and reducing the maximum length of time that patients wait for elective care and treatment. Transforming the way the NHS provides elective care; for example, by reforming the way outpatient appointments are delivered, making it more flexible for patients and driven by a focus on clinical risk and need, and increasing activity through dedicated and protected surgical hubs. Providing better information and support to patients, supported by better data and information to help inform patient decisions, and in time, making greater use of the NHS App to better manage appointments, bookings and the sharing of information. The NHS will ensure patients have choice at the point of referral, and this will be enhanced for long-waiting patients through a national hub model. The plan also sets out the following key ambitions: That waits of longer than a year for elective care will be eliminated by March 2025. Within this, by July 2022, no one will wait longer than two years, the NHS will aim to eliminate waits of over 18 months by April 2023, and of over 65 weeks by March 2024. Long-waiting patients will be offered further choice about their care, and over time, as the NHS brings down the longest waits from over two years to under one year, this will be offered sooner. Diagnostic tests are a key part of many elective care pathways - 95% of patients needing a diagnostic test should receive it within six weeks by March 2025. By March 2024, 75% of patients who have been urgently referred by their GP for suspected cancer are diagnosed or have cancer ruled out within 28 days. This will help contribute to the existing NHS Long Term Plan ambitions on early diagnosis. Local systems have also been asked to return the number of people waiting more than 62 days from an urgent referral back to pre-pandemic levels by March 2023. For patients who need an outpatient appointment, the time they wait can be reduced by transforming the model of care and making greater use of technology. The NHS will work with patient groups and stakeholders to better monitor and improve both waiting times and patients’ experience of waiting for first outpatient appointments over the next three years.
  8. Content Article
    In this report, the Coroner states his concerns as follows: Hospital staff told the inquest that due to the reduction in staff numbers, they did not have enough time to carry out their expected tasks. As one healthcare assistant told the court, it was “impossible” to provide one to one nursing care to Mr Housby with the number of staff working on that shift. The court was told that since Mr Housby’s death, the problem of staffing shortages persists. Clifton hospital is a place to where patients – often elderly and vulnerable – are transferred for a period of rehabilitation, usually from an acute hospital setting. The usual aim is that following such rehabilitation, they can hopefully return to their homes, or perhaps be discharged to a suitable care home. However, the Coroner stated that these patients are being put at risk due to a shortage of staff. The Trust needs more support as they try to remedy this problem. This report was sent to the Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool Clinical Commissioning Group/Fylde & Wyre Clinical Commissioning Group and the Department of Health and Social Care.
  9. News Article
    The number of Covid patients in hospitals in England and Scotland has continued to rise this week, as NHS England reached a deal with private hospitals to free up beds amid the outbreak of Omicron cases. Meanwhile, Covid staff absences in England rose to their highest level since the introduction of the vaccine. The number of NHS workers in England off sick because of Covid was up by 41% in the week to 2 January, according to the latest figures. Five health workers describe some of the challenges they are facing, including understaffing, waiting times and bed-blocking. Read full story Source: The Guardian, 14 January 2022
  10. News Article
    Just under 6 million people in England are now waiting for hospital treatment – a record high – as latest performance figures show how the NHS was struggling even before the Omicron Covid variant emerged. A total of 5,995,156 patients were on the waiting list for an operation in November, of whom more than 2 million had already waited longer than the maximum standard of 18 weeks for routine treatment. Figures published by the NHS underlined its growing inability to provide timely care. They also showed that more than 300,000 people have been waiting more than a year for surgery and that performance against the crucial four-hour A&E target is the worst ever. The figures led to warnings from the Health Foundation thinktank that the NHS was “being stretched to its limits” and from the Liberal Democrat health spokesperson Daisy Cooper that “patients are being catastrophically let down by this government’s woeful neglect of the NHS”. “With the NHS now in the thick of one of the most uniquely challenging periods in its history, unacceptably long waits for hospital care are becoming increasingly commonplace,” said Siva Anandaciva, the chief analyst at the King’s Fund. Read full story Source: The Guardian, 13 January 2022
  11. Content Article
    Key results of this survey include: 66% of homecare providers who responded are now having to refuse new requests for home care. 43% of care home providers are closing to new admissions. 21% of providers of homecare are handing back existing care packages. an 18% vacancy rate and 14% absence rate amongst providers who responded, as a result of the Omicron variant (overall a shortage of around a third of all staff, on average, across the survey).
  12. Content Article
    Key recommendations of the report include: The Department of Health and Social Care should work with NHS England to produce a broader national health and care recovery plan that goes beyond the elective backlog to emergency care, mental health, primary care, community care and social care. This should be completed by April 2022 and must also set out a clear vision for what ‘success’ in tackling the backlog will look like to patients. In setting those metrics for success, the plan must take account of the risk that a reliance on numerical targets alone will deprioritise key services and risk patient safety. Instead, it must embrace a range of indicators to demonstrate that hidden backlogs are also being tackled and compassionate cultures encouraged. Primary care practices should respond to the needs of their local populations and work with patients to establish the most appropriate method for consultations, based on clinical outcomes. It is not appropriate to set a numerical target for the proportion of appointments carried out remotely in general practice. NHS England should publish its evaluation of the role of digital tools in primary care as soon as possible. It should be used as a basis to produce clear and consistent guidance on best practice in reducing bureaucracy and day-to-day IT administration tasks, and the use of remote consultations in general practice. NHS England should look beyond primary care and consider the impact of increased use of digital tools on patients and other parts of the health and care system, especially at the primary care and secondary care interface. NHS England should complete and publish evaluations of NHS 111 call first services as soon as is practicable, including learning from those evaluations and the implications for any future iterations of the service. Before the end of this financial year, NHS England must publish a Long Covid plan covering the period until 2023. The plan must be developed in consultation with a wide range of stakeholders, including patient groups. NHS England should integrate this into its wider health and care recovery plan, as Long Covid is likely to have implications for demand and workforce across a range of services. The NHS must make a commitment to keeping in touch with patients, many of whom currently feel 'abandoned' by services. This would not just benefit individual patients, but also help local systems actively to manage their lists and inform decisions about prioritisation. The national health and care recovery plan must set out a clear vision for what ‘success’ in tackling the backlog will look like, and what patients can expect their care to look like in their local area in the coming years. The plan must include minimum expectations for integrated care boards (ICBs) in managing waiting lists actively and communicating with patients awaiting planned care. The Department of Health and Social Care, NHS England and local ICBs must share responsibility for communicating the ‘offer’ to the wider public, considering the “social backlog” facing many members of the public. The Select Committee asks the Department of Health and Social Care report back to them on how this will be delivered. The Care Quality Commission should include consultation with patient groups and details of patient outcomes in its assessment of integrated care systems.
  13. Content Article
    In this report, the Coroner highlights the following concerns: Mary was referred to the mental health team in November 2019 and was assessed in January 2020, some three weeks later than should have been. There was a delay in Mary receiving psychological therapy. She was still on the waiting list at the time of her death. The evidence was that at the date of inquest, there continued to be a delay in service users receiving psychological therapy. Evidence was heard that balancing capacity and demand, which has increased, remains a challenge. The cases referred are of increasing complexity, as in Mary’s case. Some steps have been taken in an effort to deal with this, such as specific risk assessment training, focusing on intervention treatment plans to aid capacity and throughput, reviewing the skill mix of staff. However, there is the ongoing issue of recruitment and retention of suitably skilled staff by the Trust and the ability to resource this to enable the Trust to function effectively. This report was sent to NHS Norfolk & Waveney Clinical Commissioning Group, the Secretary of State for Health & Social Care, the Child Death Overview Panel and the Local Safeguarding Board.
  14. Content Article
    The report argues that the NHS is failing to capitalise on the skills, knowledge and experience of District Nurses and instead is investing in new specialist teams of staff in the community, which may impact negatively on continuity of care. At the same time, the number of District Nurses has fallen dramatically. It calls on the government of each country in the UK to develop and publish a robust workforce plan for community nursing which reverses the decline in staffing and transforms the workforce to meet current and future healthcare challenges.
  15. News Article
    The trust at the centre of a maternity scandal does not have enough midwifery staff to keep women and babies safe, a Care Quality Commission (CQC)inspection has revealed. East Kent Hospitals University Foundation Trust relied on community midwives to fill slots at its acute unit, with some of them working 20-hour days after being called in to help cover and feeling outside of their competence. The trust had suspended a midwife-led unit and diverted women in labour to other hospitals – and when the CQC raised the understaffing issue at its inspection in July, it suspended its home birth service. But the CQC found that the number of midwives and maternity workers on duty rarely matched planned numbers and managers rarely calculated staffing numbers accurately, with some elements of the workload not being factored in. Lack of staff meant there was a risk to the safe assessment and monitoring of women and babies at the trust’s William Harvey Hospital in Ashford. Unqualified staff were having to deal with telephone queries from women who needed advice and support. Read full story (paywalled) Source: HSJ, 15 October 2021
  16. News Article
    A trust being investigated over maternity care failings was urged six years ago to strengthen its neonatal staffing, HSJ can reveal. An external review into East Kent Hospitals University Foundation Trust — conducted in 2015 and kept under wraps until now — said it had insufficient staffing, and that medical consultants felt a lack of engagement with senior managers. The trust released the review yesterday after its existence became public for the first time earlier this month. Last year, the trust was heavily criticised at the inquest of baby Harry Richford, who died seven days after he was born at the Queen Elizabeth, the Queen Mother, Hospital in Thanet. The Care Quality Commission is taking the trust to court over the case, and is the subject of an external inquiry. Among the recommendations of the review, carried out by the Royal College of Paediatrics and Child Health, were that consultants and junior doctors covering the neonatal intensive care unit “should have responsibilities solely to that specialty”. Such a move would improve the quality and safety of the service, the review suggests. Read full story (paywalled) Source: HSJ, 22 March 2021
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