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Found 50 results
  1. News Article
    Private hospitals saw record admissions this year after hundreds of thousands of people sought care through their insurance amid rocketing NHS waiting lists, new figures show. Between January and June 443,000 private treatments took place – a 7% rise from 2022, the vast majority of which were claimed through medical insurance policies. According to the Private Hospital Information Network (PHIN), which collects data from hospitals in the sector, there was a 12% increase in the number of people paying for care via insurance with 157,000 people using this route from January to March and 148,000 from April to June this year. The news comes as the NHS’s waiting list continues to grow with almost 7.8 million appointments recorded. Recently published data shows that there is a total of 6.5 million individual people on the waiting list. Read full story Source: The Independent, 7 December 2023
  2. Content Article
    This blog calls for action on the careful review of established pain medication when a patient is admitted to hospital. Richard describes the experience of two elderly patients who suffered pain due to their long term medication being stopped when they were admitted to hospital. Pain control needs must not be ignored or undermined, there needs to be carer and patient involvement and their consent, and alternative pain control must be considered.
  3. News Article
    A high-profile shift to admitting patients from A&E to wards irrespective of bed capacity has ‘turned the dial’ for an acute trust’s emergency care, its chief executive has told HSJ. Since introducing the model in July last year North Bristol Trust has seen a significant improvement in its performance against the national target, with the number of patients seen within four hours rising from 51% to 72% in August 2023 – with a peak of 80% in April 2023. The model attracted interest from NHS England last year, as well as some concern from the Nuffield Trust over patient safety – but NBT CEO Maria Kane said the trust was “happy, on balance” with the system. She said the model “won’t be for everyone and we never claimed it would be” but she added: “Engendering whole hospital conversations about the principles of flow and understanding of [the emergency department] is something we could all do.” Read full story (paywalled) Source: HSJ, 8 November 2023
  4. Content Article
    Urgent funding is required to clear waiting list backlogs and drive Northern Ireland's long-term healthcare transformation, the Northern Ireland Audit Office has said in a new report which outlines the health service's "critical situation" after almost a decade of worsening waiting lists for elective care. The NI Audit Office looked at waiting list data from 2014 to 2023. It found the number of patients waiting for elective care has risen by 452,000 during that nine-year period. The Audit Office also said: "Available information suggests waiting list performance levels are significantly worse in Northern Ireland compared with the other UK regions."
  5. Content Article
    All health overuse implies an unnecessary risk of patients suffering adverse events (AEs). However, this hypothesis has not been corroborated by direct estimates for inappropriate hospital admission (IHA). The objectives of the study were (1) to analyse the association between IHA and the development of subsequent AEs; and (2) to explore the distinct clinical and economic implications of AEs subsequent IHA compared to appropriate admissions. It found that patients with IHA have a higher risk of subsequent occurrence of AE. Due to the multifactorial nature of AEs, IHA is a possible contributing factor. AEs developed after IHA are associated with scheduled admissions, prolonged ICU stays, and resulted in significant cost overruns.
  6. News Article
    A ‘disappointingly slow’ transformation of community services means thousands of mental health patients are still presenting at emergency departments within weeks of being discharged from an inpatient facility. Experts said an NHS England-led community transformation programme, launched in 2019 as part of a £2.3bn investment in mental health services, should have helped reduce readmission rates, but internal data seen by HSJ suggests the rates have actually increased since then. The data reveals for the first time the proportion of patients discharged from inpatient care who then present to accident and emergency within two months. The proportion of adult patients was 11 per cent in 2018-19, when the investment programme was launched, and had increased to 12 per cent by 2022-23, representing around 6,000 adult cases. The situation appears worse for children, with an 18 per cent readmission rate within two months, up from 17 per cent in 2018-19. Read full story Source: HSJ, 8 August 2023
  7. News Article
    New artificial intelligence software being rolled-out in NHS hospitals will be able to predict daily A&E admissions weeks in advance. The software, which launched in 100 hospitals across England on Monday, analyses data, including Covid infections rates, 111 calls and traffic to predict the number of patients that will seek emergency care. It also takes into consideration public holidays, such as New Year’s Eve, when A&E is more likely to be busy. The AI software is being rolled after trials showed an “impressive” ability to forecast admissions up to three weeks in advance. The NHS believes it will help tackle the record waiting list and allow hospitals to more easily manage their patient and bed capacity, prepare for busier days and staff up when needed. Nine trusts were given the software to use during the pandemic which notified them of expected spikes in cases, staff levels and numbers of beds and equipment necessary. However, hospitals receiving the new equipment have also been warned uncertainties within the data mean the system should be used as a “starting point to consider an operational response, not as a definite signal for action.” Read full story Source: The Independent, 28 March 2022
  8. News Article
    The use of temporary treatment areas for patients arriving via ambulance at over-crowded A&Es is ‘borderline immoral’ and ‘a danger to patient safety and dignity’, the Royal College of Emergency Medicine has warned. The college said NHS England had told regional bosses to prepare to errect more of the so-called “tents” outside their major emergency departments as part of plans to get a grip on ambulance handover delays, which have reached record highs in the last two weeks. Senior figures also told HSJ that trusts have been instructed by NHS England to call the overflow facilities “temporary external structures” and not tents – a move also criticised by RCEM president Katherine Henderson. Dr Henderson told HSJ: “Using tents is just wrong on every level… We’ve been down this route before. It doesn’t work. It’s a huge distraction, and I think what upsets me the most about it is it creates the appearance that people are taking action when it’s not the action that will deal with the problem.” In an opinion piece for HSJ, Dr Henderson says: “We 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 – euphemistically being called ‘temporary external structures’. “Trust leaders and NHS England must not be afraid to stand up and make this case – putting patients in tents is a bad, borderline immoral bodge job to treat the symptom rather than cause, and our patients need to see some real leadership to protect them." Read full story (paywalled) Source: HSJ, 25 March 2022
  9. News Article
    Almost 900,000 older people are admitted to hospital every year as an emergency because the NHS is failing to keep them healthy at home, Age UK has warned. A major lack of services outside hospitals means elderly people are also suffering avoidable harm, such as falls and urinary tract infections, the charity said. In a new report it urges NHS bosses to push through huge changes to how the “hospital-oriented” service operates and establish “home first” as the principle of where care is provided. Doing so would reduce the strain on overcrowded hospitals and leave the NHS better set up to respond to the increase in the number of over-65s and especially over-85s, Age UK said. Its report, on the state of health and care of older people in England, concluded that “our health and care system is struggling, and too often failing, to meet the needs of our growing older population.” Read full story Source: The Guardian, 11 July 2023
  10. News Article
    Several trusts have now started reporting thousands of 12-hour waits in their emergency departments, representing a huge difference to the numbers published nationally under a slightly different measure. This year, trusts have started submitting data to NHS England on the number of patients waiting over 12 hours from time of arrival in ED, until discharge, admission or transfer. Many trusts are now reporting these statistics in their public board reports. This is a slightly different measure to the publicly reported “trolley wait” figures, which count waits of over 12 hours from decision to admit until admission. Experts have long argued the trolley wait measure does not capture the true problem of ED overcrowding and delayed care. The new data captures a far higher number of patients and has not been published nationally by NHSE. Read full story (paywalled) Source: HSJ, 2 August 2022
  11. News Article
    Admissions of people to hospital with Covid in England have begun to grow again, new data from the NHS shows, as fears were raised over a new wave. Analysis by John Roberts of the Covid Actuaries group, set up in response to the pandemic, showed hospital admissions had stopped falling after a period of decline. Figures on Tuesday showed weekly admissions increased by 4% across England as of 5 June and were up by 33% in the North East and Yorkshire. When asked if the UK was heading into another wave, Mr Roberts told The Independent: “Yes we could be but...how big that wave and how serious it will be in terms of admissions and deaths is very, very difficult to judge at this stage.” His comments come after experts in Europe warned there will be a new wave driven by the growth of the BA.5 and BA.4 Covid variants. The figures, which cover hospitals in England only, show the weekly average of admissions for patients in hospital with Covid stood at 531 as of 5 June. Read full story Source: The Independent, 9 June 2022
  12. News Article
    NHS 111 sends too many people to accident and emergency departments because its computer algorithm is “too risk averse”, the country’s top emergency doctor has warned. Dr Adrian Boyle, president of the Royal College of Emergency Medicine (RCEM), said that December was the “worst ever” in A&E with 9 in 10 emergency care leaders reporting to the RCEM that patients were waiting more than 24 hours in their departments. Asked what measures could help improve pressures in emergency care, Dr Boyle said more clinical input was needed in NHS 111 calls. “In terms of how we manage people who could be looked after elsewhere, the key thing to do is to improve NHS 111,” Dr Boyle told MPs. “There is a lack of clinical validation and a lack of clinical access within NHS 111 - 50 per cent of calls have some form of clinical input, there’s an awful lot which are just people following an algorithm.” Dr Boyle added where clinical input is lacking “it necessarily becomes risk averse and sends too many people to their GP, ambulance or emergency department”. Read full story (paywalled) Source: The Telegraph, 24 January 2023
  13. News Article
    The new national target to see 76% of A&E patients within four hours by March 2024 has been described as ‘extremely unambitious’ by senior emergency clinicians. Adrian Boyle, president of the Royal College of Emergency Medicine, also told the Commons Health and Social Care Committee that the objective – included in NHS England planning guidance for 2023-24 and agreed with government – could also drive “perverse incentives” for some emergency department managers. The new target to admit, transfer or discharge 76% of patients by the end of 2023-24 is the first time a specific bar has been set against the four-hour standard for several years. In December, just three acute trusts were hitting the new 76% objective. But Dr Boyle told MPs: “The aspiration from NHS England is that we return to a four-hour target performance of 76%. We think that is too unambitious, and we think that is going to create all sorts of perverse incentives, because it’s going to encourage managers and senior clinicians just to focus on people who can be discharged from hospital, without dealing with our problem, which is exit block [people who cannot be admitted as wards are full]. “We think the 76 per cent is an extremely unambitious target. It was 95% – I know that’s going to be a long way to go back to and we haven’t achieved it since 2015, but we would say we need to have a trajectory to a higher target.” Read full story (paywalled) Source: HSJ, 24 January 2023
  14. News Article
    A growing number of patients deemed to require a hospital admission are waiting so long in A&E that they end up being discharged before being admitted to a ward, HSJ has been told. A senior emergency clinician, who has delivered improvement support to multiple emergency departments across the NHS, said such cases have become a regular occurrence – describing it as a “terrible experience” for some patients. The clinician, who asked not to be named, said: “I suspect every ED in the country are having patients who are spending 24 to 48 hours in ED under the care of a specialist, that in a better time they would have gone onto a ward. That’s happening every day in every department. “If you have been seen by the ED crew and referred to the medics who say ‘you need to be admitted to hospital’, the chances are that they are sick enough that they really do need that bed. “It’s a terrible experience [for the patients]. EDs are busy, noisy and crowded. This is not the place where, if you were feeling ill, to get better in a calm, relaxing area. This idea that somehow it’s OK because these people are not that sick, it’s pretty poor. “It feels very much like battlefield medicine – slap a patch on and try and get them back into battle as quickly as possible. It shouldn’t be the way with civilian healthcare.” Read full story (paywalled) Source: HSJ, 23 January 2023
  15. News Article
    There were more than 3,700 patients a day in hospital with flu last week - up from 520 a day the month before, the latest data from NHS England shows. Of these, 267 people needed specialised care in critical care beds last week. NHS England warns pressures on the health service continue to grow as viruses like flu re-circulate after a hiatus during the pandemic. Prof Sir Stephen Powis, NHS national medical director, said: "Sadly, these latest flu numbers show our fears of a 'twindemic' have been realised, with cases up seven-fold in just a month and the continued impact of Covid hitting staff hard, with related absences up almost 50% on the end of November." He warned this was "no time to be complacent" with the risk of serious illness being "very real" and encouraged those eligible to take up their flu and Covid jabs as soon as possible. Admissions among children under 5 have been high this flu season, as well as among older people. Read full story Source: BBC News, 30 December 2022
  16. News Article
    The antiviral, molnupiravir, does not reduce coronavirus hospital admissions or deaths in vaccinated people at high risk, new research suggests. But the treatment was associated with a shorter recovery time, by four days, and reduced viral load. People who received molnupiravir reported feeling better compared to those who received usual care, the study found. Researchers suggest that while the drug could have some benefits in terms of symptom reduction, the cost of the drug may mean it is not the best choice for the general population, given the study findings. But it may be useful in reducing the pressure on UK health systems, they added. Chris Butler, professor of primary care in the Nuffield Department of Primary Care Health Sciences and co-chief investigator of Panoramic, said: “Finding effective, safe and scalable early treatments for Covid-19 in the community is the next major frontier in our research response to the ongoing worldwide pandemic. “It is in the community where treatments could have a massive reach and impact. “But decisions about who to treat should always be based on evidence from rigorous clinical trials that involve people who would most likely be prescribed the drugs.” Read full story Source: The Independent, 23 December 2022
  17. News Article
    A reduction in the number of GP referrals to hospitals could be creating a "hidden backlog" of patients needing help, according to a new report. The study by the Institute for Government (IFG) and Public First says that not enough data is published about the "advice and guidance" referral system. Family doctors have been told to reduce the number of people they refer for hospital care by using the 'advice and guidance' route – whereby a GP will call or email a hospital doctor to ask for advice on whether or not a referral is required. The method has been used since 2015 but NHS England introduced a target for GPs to have 12 "advice and guidance" patients for every 100 outpatient appointments in October 2021 in an attempt to reduce the backlog of hospital care. This has now increased to 16 but it has been reported that as many as 22 out of 100 potential hospital appointments are being handled this way. The IFG and Public First report states: "There is a risk that GPs making fewer referrals – in part to address hospital capacity concerns – is creating a 'hidden backlog' by allowing treatable conditions to deteriorate and possibly leading to more unplanned admissions." Read full story Source: Medscape, 14 June 2023
  18. 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
  19. Content Article
    The safety, effectiveness, and cost-effectiveness of molnupiravir, an oral antiviral medication for SARS-CoV-2, has not been established in vaccinated patients in the community at increased risk of morbidity and mortality from COVID-19. In this study, Butler et al. aimed to establish whether the addition of molnupiravir to usual care reduced hospital admissions and deaths associated with COVID-19 in this population. The authors conclude that molnupiravir did not reduce the frequency of COVID-19-associated hospitalisations or death among high-risk vaccinated adults in the community.
  20. Content Article
    The waiting list in England stood at more than seven million in September 2022, up by 1.2 million since September 2021 and 2.6 million since 2019. This analysis by the King's Fund outlines what different patients on the waiting list are waiting for, breaking this figure down into: different medical and surgical specialties whether patients are waiting for admission, diagnostics or decisions It highlights that many on the waiting list are awaiting further diagnostics or decisions before treatment can commence, and others are waiting for treatment that does not require admission to hospital.
  21. Content Article
    This video by the NHS England National Patient Safety Team provides tips for patients on keeping safe during a hospital stay. It highlights simple things you can do as a patient to help keep yourself safe during a hospital stay, such as asking for help when needed, protecting yourself from slips and falls and helping to prevent blood clots. A British Sign Language (BSL) version of the video is also available, as well as a leaflet translated into these languages: English Arabic Cantonese French Gujarati Mandarin Polish Portuguese Punjabi Romanian Spanish Urdu
  22. News Article
    NHS England has ordered the collection of identifiable patient data from hospitals by US data firm Palantir, for a pilot scheme aimed at accelerating recovery of elective waiting lists. The regulator has instructed NHS Digital, with which it will merge in January, to use Palantir’s Foundry platform to collect data about patients’ admission, inpatient, discharge and outpatient activity at acute hospitals. Identifiable data such as patients’ NHS numbers, date of birth, and postcode will be collected through Palantir’s software. Patients cannot opt out of having their data collected. But NHS Digital’s Caldicott Guardian – who is meant to safeguard use of data – has identified “risks” in the pilot and said it needs additional work before it can meet confidentiality requirements. The data collected will be “anonymised in accordance with the ICO’s (Information Commissioner’s) Anonymisation Code of Practice”. However, privacy campaigners Medconfidential claimed this code is not fit for purpose and warned that NHS chiefs were making the same mistakes as previous failed efforts to use patient data appropriately. Read full story (paywalled) Source: HSJ, 1 November 2022
  23. News Article
    The Care Quality Commission (CQC) has urged system leaders to move away from “quick fixes” to the “enormous gap in resources and capacity” in urgent and emergency care. A report by the CQC and a large group of emergency clinicians and other health and care leaders calls for a ”move away from reactive ‘quick fixes’ such as tents in the car park or corridor care to proactive long-term solutions and to address the enormous gap in resources and capacity”. The use of tents and treating more patients in corridors have been increasingly adopted by hospitals in recent months, sometimes encouraged by NHS England, particularly when they are under pressure to reduce handover delays from ambulances. The report, 'People First: a response from health and care leaders to the urgent and emergency care system crisis', suggests: expanding use of urgent community response teams to attend minor injuries 999/111 calls, giving acute and social care providers direct access to GP and community service booking systems, and providing “rapid access” to support packages to help people avoid hospital admission. Read full story (paywalled) Source: HSJ, 22 September 2022
  24. News Article
    The most common reasons why people with type 2 diabetes (T2DM) are admitted to hospital with greater frequency than the general population are changing, with hospitalisation for traditional diabetes complications now being accompanied by admissions for a diverse range of lesser-known complications including infections (i.e., pneumonia, sepsis), mental health disorders, and gastrointestinal conditions, according to an analysis of national data from Australia spanning seven years. The findings, being presented at this year's European Association for the Study of Diabetes (EASD) Annual Meeting in Stockholm, Sweden (19-23 Sept), reveal that just four traditional diabetes complications (cellulitis, heart failure, urinary tract infections, and skin abscesses) were ranked in the top ten leading causes of hospitalisation in men and women with T2DM. "Although traditional complications such as heart failure and cellulitis remain a substantial burden for people with T2DM, infections less commonly linked with diabetes and mental health disorders are emerging as leading causes of hospital admissions, and have substantial burdens that sometimes exceed the top-ranked well-known complications," says lead author Dr. Dee Tomic from the Baker Heart and Diabetes Institute, Melbourne, Australia. She adds, "The emergence of non-traditional diabetes complications reflects improvements in diabetes management and people with diabetes living longer, making them susceptible to a broader range of complications. Increasing hospitalizations for mental health disorders as well as infections like sepsis and pneumonia will place extra burden on healthcare systems and may need to be reflected in changes to diabetes management to better prevent and treat these conditions." Read full story Source: MedicalXpress, 1 September 2022
  25. Content Article
    Physicians raised a concern to the Quality Department about patients who were diagnosed in the emergency department (ED) with a urinary tract infection (UTI) but who later were clinically reviewed and found to be without disease. These patients were often admitted and treated with potentially unnecessary antibiotics.
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