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Found 322 results
  1. Content Article
    This letter from NHS Confederation to Thérèse Coffey MP, the new Secretary of State for Health and Social Care, sets out what needs to be done to support the delivery of an emergency winter plan for health and social care services. It outlines the views of NHS Confederation members on what will be needed to deliver the ‘ABCD’ highlighted as priorities by the Secretary of State: ambulances, backlogs, care and doctors and dentists.
  2. News Article
    An ambulance trust accused of withholding key evidence from coroners was previously warned its staff needed training to ‘understand the real risk of committing criminal offences’ in relation to inquests into patient deaths. North East Ambulance Service, which has been accused by whistleblowers of withholding details from coroners in more than 90 deaths, was told by its lawyers in 2019 about serious shortcomings in its processes for disclosing information, according to internal documents obtained by a campaigner. According to the documents, the lawyers said trust staff could “pick and choose” documents to release to coroners “regardless of relevance.” The following year, an audit report said the issues had not been addressed. Whistleblowers’ concerns about the trust were first reported by The Sunday Times in the spring, with a review highlighting several cases between 2018 and 2019 where key facts were omitted in disclosures to coroners. But campaigner Minh Alexander has since obtained new details of warnings that were being made to internally, from lawyers and auditors who were advising the trust. Read full story Source: HSJ, 20 September 2022
  3. News Article
    The NHS is trialling a fleet of electric vehicles to help relieve pressure on ambulance services while also helping the NHS cut its carbon footprint. The vehicles are part of a £2.1m investment as the NHS becomes the first health service in the world to commit to reaching net zero by 2040, said NHS England, with eight ambulance trusts trialling 21 zero-emission vehicles of various types. Six of these new green vehicles are "dedicated to mental health response in the community", NHS England said. It emphasised that it hoped this development will "cut emergency response times for people with mental health needs and help reduce demand on traditional double-crewed ambulances". The new dedicated mental health response vehicles differ in design from traditional ambulances by having fewer fluorescent markings and a much less clinical interior, to help put patients at ease. However, they still carry the equipment needed to respond to the most serious life-threatening emergencies. NHS England highlighted that the all-electric vehicles can be deployed as a rapid response vehicle when someone is experiencing a mental health crisis, "providing a safe space for healthcare workers to support patients with mental health needs". Claire Murdoch, national director for mental health, NHS England explained that the mental health response vehicles are an important addition to mental health care, and added: "we have a double win of being able to improve the experience of patients in crisis whilst also caring for the planet". Read full story Source: Medscape, 6 September 2022
  4. News Article
    The NHS needs to do more to support care homes and people who have fallen with alternatives to ambulance calls and hospital admissions, the NHS England chief executive has said. Speaking at the Ambulance Leadership Forum, Amanda Pritchard acknowledged this winter would be a difficult one for the health service, saying: “The scale of the current and potential challenge mean that we do need to continue to look further for what else we can do… We need to pull out all the stops to make sure that they [patients] get that treatment as safely as possible and as quickly as possible.” She added one area of focus should be making sure certain patient groups can access other – more appropriate – forms of care, rather than calling an ambulance by default and often resulting in hospital admission. On care homes, she said: “Can we wrap around even more care for these care homes so they get to the point where they don’t need to call for help at all or, if they do, there are alternatives pathways [to the emergency department]?” She suggested another area where responses could be made more consistent was for patients who had fallen but without serious injuries, which she said made up a “really significant part of activity”. These patients took a long time to reach and, if admitted to hospital, risked long admissions, she said. Some areas were working to find other ways of responding to non-injury falls patients and trying to keep them away from hospital, she said. Read full story (paywalled) Source: HSJ, 6 September 2022
  5. Content Article
    The pandemic has had an enormous impact on health and care services in the UK. In this article, Nuffield Trust fellows Jessica Morris and Sarah Reed take a closer look at access and waiting times before and after the start of the Covid-19 pandemic. They highlight that before the pandemic, pressure on the system was already reducing access to NHS services and making waiting times longer. Covid-19 has made the situation significantly worse due to the need for heightened infection control practices, rising levels of staff sickness and burnout, the cancellation of routine care and redirection of staff. Enabling services to recover will be challenging given these ongoing pressures and real-term budget cuts for the NHS this year. The article examines the impact of the pandemic on waiting times relating to: General practice Elective (planned) care Diagnostic testing Cancer care A&E Ambulance
  6. News Article
    Health secretary Steve Barclay says trust chief executives should be held accountable for ambulance handover delays in a ‘fair’ way that recognises factors outside their control. Mr Barclay made a wide ranging speech at a Policy Exchange event on Thursday. However, the content of the speech was much less radical than earlier press reports in which it was suggested he would tell the NHS to “scrap targets”, “declare war on pointless pen-pushers”, and deprioritise “cancer, maternity and mental health”. Last month, the health secretary summoned the chief executives of six of the NHS trusts which are recording the longest waits for ambulance handovers at their emergency departments. Mr Barclay was asked by HSJ what the consequences would be for leaders who failed to improve the situation. He said: “It’s not about blaming the chief executives, it’s about understanding what are their challenges and how do we then get clarity on that. “Once we’ve agreed on that, then you can have performance management to hold individual chiefs to [account on] the bits that are within their control, distinct from bits that may be the ambulance trust’s or others in the system.” He said the government and NHS England would ask what was “within the chief exec’s control” and how a trust’s performance compared to that of its peers? Trusts would be asked to “comply” with best practice or explain why they were not. The Department of Health and Social Care and NHSE would then be able to decide “what are the things where it [the trust] needs wider support?” Read full story (paywalled) Source: HSJ, 2 September 2022
  7. Content Article
    Life expectancy for people with a mental illness diagnosis is 15–20 years less than those without, mainly because of poor physical health. This article in the Journal of Paramedic Practice highlights the fact that mental ill health affects a significant proportion of paramedics' patients, and argues that practitioners could assess and promote patients' physical health even though contact time is limited.
  8. News Article
    Firefighters have resorted to taking people to hospital in fire engines amid rocketing call-outs to medical emergencies. Fire and rescue services now respond to more “non-fire incidents” than fires in England, including cardiac arrests, suicide attempts and elderly people trapped in their homes after falls. Official statistics show that they attended more than 18,200 medical incidents in 2021-22, an increase of a third from the previous year, and that firefighters rather than ambulances were the “first responder” in almost half of those calls. Chris Lowther, who chairs the National Fire Chiefs’ Council’s operations committee, said the figures showed a “new reality” as firefighters step in to help struggling ambulance services. Read full story Source: The Independent (22 August 2022)
  9. News Article
    On Monday, September 20, 2021, Michael Wysockyj felt unwell and did what any gravely sick person would do: he put his life in the hands of the ambulance service. The 66-year-old from Norfolk was whisked by paramedics to the Queen Elizabeth hospital in King’s Lynn at 6.28pm. Nearly four hours later, he was still trapped inside the vehicle. The hospital was too full to take him. He died at 4.42am. So great were the concerns of the coroner, Jacqueline Lake, that she took the unusual step of issuing a “prevention of future death” notice. “The emergency department was busy at the time and unable to offload ambulances,” she said in her report. “An x-ray cannot be carried out in an ambulance and must wait until the patient is in [the emergency department].” This episode should be an anomaly in the failure of emergency services. It is not. The crisis is “heartbreaking”, according to Dr Ian Higginson, vice-president of the Royal College of Emergency Medicine. “If you call for an ambulance and you’re waiting many hours for one and you have a serious condition, that is going to have an impact on your outcome. It would be reasonable to assume the long delays that patients are subjected to waiting for ambulances at the moment will filter through into excess mortality.” Read full story (paywalled) Source: The Times, 21 August 2022
  10. News Article
    A 90-year-old woman waited 40 hours for an ambulance after a serious fall. Stephen Syms said his mother, from Cornwall, fell on Sunday evening and an ambulance arrived on Tuesday afternoon. She was then in the vehicle for 20 hours at the Royal Cornwall Hospital. It comes as an ambulance trust warns lives are at risk because of delays in patient handovers. It was also reported a man, 87, who fell, was left under a makeshift shelter waiting for an ambulance. South Western Ambulance Service said it was "sorry and upset" at the woman's wait for an ambulance. Mr Syms, from St Stephen, told BBC Radio Cornwall: "We are literally heartbroken to see a 90-year-old woman in such distress, waiting and not knowing if she had broken anything. "The system is totally broken." He said it took nine minutes before his 999 call was answered. "If that was a cardiac arrest, nine minutes is much too long, it's the end of somebody's life," he said. Mr Syms said paramedics were "absolutely incredible people". He added: "The system is not deteriorating, it's totally broken and needs to be urgently reviewed." Read full story Source: BBC News, 19 August 2022
  11. News Article
    Last month saw the highest number of ambulance callouts for life-threatening conditions since records began, NHS England officials say. There were more than 85,000 category one calls, for situations like cardiac arrests and people stopping breathing. The heatwave could have been one reason for increased demand, but experts say hospitals already face immense pressures. Nearly 30,000 patients waited more than 12 hours to be admitted to hospital. The number is up 33% on the previous month and the highest since records began in 2010. Richard Murray, chief executive of The King's Fund said the pressure on hospitals was also being felt right across the health and social care system. He added: "At the end of July, 13,014 people were still in hospital beds despite being medically fit to be discharged, often due to a lack of available social care support. The challenges affecting the NHS cannot be solved without addressing the issues in social care." Read full story Source BBC News, 12 August 2022
  12. News Article
    Armed police are being sent to save the lives of people in cardiac arrest because ambulances “can’t cope” with demand, The Independent has revealed. Officers are spending up to a third of their time on non-policing matters, a watchdog has warned, including responding to mental health crises and transporting patients to A&E as ambulance services face a “chronic crisis situation”. Andy Cooke, HM chief inspector of constabulary, said that firearms officers have been responding to pleas from struggling NHS colleagues to respond to cardiac arrests. He told The Independent that police are becoming the “first, last and only resort” as NHS services buckle under strain, taking them away from tackling crime at a time when recorded offences are at a record high in England and Wales. Mr Cooke, the former chief constable of Merseyside Police, added: “Recently, officers in armed response vehicles (ARVs) were being sent to reports of people who were having cardiac arrests because the ambulance service couldn’t cope with the demand, because they’re trained in first aid and to use defibrillators." “The ambulance service contacted the police to say ‘we’ve got this heart patient and we haven’t got anyone to send’." “Being first, last and only resort, the police will go. It’s right that they did go but that hides the problems we’ve got in the rest of the system.” Read full story Source: The Independent, 8 August 2022
  13. Content Article
    This article published by The Conversation looks at the pressures faced by ambulance services and emergency departments across Australia as a result of Covid-19. There has been an increase in 'ramping', where ambulances queue up outside hospitals. Ramping is a sign that the whole health system is under immense pressure. The article looks at the large amounts of funding Australian local governments are putting into ambulance services and emergency departments (EDs), but highlight that this will not solve the issues face by the health system if issues discharging patients into community and social care remain. It highlights a model developed in Leeds, UK, that has been adopted by the health service in Victoria, Australia, focused on solving more systemic issues. The Leeds model aims to improve patient flow in and out of the hospital and ensure that patients are quickly transferred from ambulances into EDs. Discharge coordinators organise the care patients need in the community after an ED or hospital stay. The authors also look at the role of community paramedics in keeping patients out of hospital and their potential to reduce financial and capacity pressure on health systems worldwide.
  14. News Article
    Private and NHS ambulance services are reviewing safety procedures after the Care Quality Commission identified a series of risks to mental health patients being transported by non-emergency providers. The care watchdog wrote to all providers of non-emergency patient transport earlier in the summer, warning of concerns identified at recent inspections about use of restraints, sexual safety, physical health needs, vehicle and equipment safety standards, and unsafe recruitment practices. The letter, seen by HSJ, stated: “We know there are many independent ambulance providers providing a good standard of care. Unfortunately, our recent inspections suggest that this is not always the case." “We expect providers to deliver on their commitment to provide safe, high-quality care and we will do everything within our powers to ensure this happens.” Read full story (paywalled) Source: HSJ, 4 August 2022
  15. News Article
    A call to NHS 111 was abandoned every 10 seconds between 2020 and 2021, figures show. Millions of callers to the helpline hung up at a time when demand for the NHS was at its highest. In 2020, 2,490,663 calls were abandoned, while in 2021 this figure increased to 3,531,186. And 1,174,159 gave up on the line from January to May this year. Callers in Devon take an average of 11 minutes to get through to the NHS 111 service, according to Liberal Democrat research. Daisy Cooper, Lib Dem spokeswoman for health and social care, said: "Ambulance services are being stretched to breaking point, hospitals are reaching full capacity and now people cannot get through to NHS 111. We have called on this government time and time again to get a grip on this issue by recruiting more NHS 111 call handlers now." "The longer they delay, the longer they are leaving people in pain and distress." Helen Hughes, of the Patient Safety Learning charity, said: "These figures represent a serious safety concern. Each call is a potential missed opportunity for patients to receive timely medical advice that may prevent future harm." "With the ongoing severe pressures faced by ambulance services and hospitals this summer, patients are increasingly being signposted to NHS 111 for advice on non-life threatening conditions." "However, it can only relieve the pressure on other areas of the health service if NHS 111 has the capacity and resources to meet rising demand. The NHS leadership needs to urgently assess the reasons for this high number of abandoned calls." Read full story Source: Express, 31 July 2022
  16. Content Article
    In this letter to the Secretary of State for Health and Social Care, Rachel Power, Chief Executive of the Patients Association, calls on Steve Barclay to ask the Government to develop a long-term workforce strategy for the NHS. She also requests that the government urgently fund social care and calls on Steve Barclay to take action to remedy the threat to patient safety caused by staff shortages.
  17. Content Article
    This video examines the crisis facing NHS ambulance services in the UK and looks at the impact of delays and lack of capacity on patient safety. Paul Brand, UK Editor at ITV News, speaks to ambulance crews, patients and a recently bereaved family about their experiences, and highlights the increased stress levels ambulance staff are reporting. Note: The video contains footage of a 999 call that some viewers might find distressing.
  18. News Article
    The new health and social care secretary has asked officials to hastily organise several “hackathons” to try to address the crisis in ambulance performance. The first, which was instigated just last week, will take place tomorrow (28 July), and a second is planned for August, sources told HSJ. Messages from officials described the work as a “request from our new secretary of state” and explained the short notice by saying he was “pushing… quite strongly for something before the end of the month”. The aim is said to be to examine what is driving poor performance, and the Department of Health and Social Care is “particularly interested in understanding which factors reduce risk to patients”, according to one message seen by HSJ. Hackathons are short, time-limited collaborative design events, typically involving computer programmers and data scientists or analysts, which aim to result in working software or product on the chosen theme by the end. Read full story (paywalled) Source: HSJ, 27 July 2022
  19. News Article
    The NHS has broken its “fundamental promise” to the public that life-saving emergency care will be available when they need it, a top NHS doctor has said, as ambulances continue to lose tens of thousands of hours waiting outside hospitals. Katherine Henderson, the president of the Royal College of Emergency Medicine, said that what she described as the fundamental promise of the NHS to provide an ambulance in a real emergency has been “broken”. Her comments come as the West Midlands Ambulance Service (WMAS) University NHS Trust predicted it would lose 48,000 ambulance hours waiting outside A&E departments in July. This would make it the worst month on record. In papers published on Thursday, WMAS said the impact of handover delays means that patients are waiting longer than needed for an emergency response, including patients in category one, which includes those needing immediate life-saving care. It added: “This means that patients who are immediately time-critical medical emergencies do not get the response they need and may suffer significant harm or death.” Read full story Source: The Independent, 26 July 2022
  20. News Article
    A quarter of Black, Asian and minority ethnic (BAME) non-executive directors of NHS trusts have seen or experienced discrimination in the course of their work, a report reveals. While almost four out of five (79%) of these BAME non-executives said they challenged such behaviour when they encountered it, only half (50%) said that led to a change of policy or behaviour. The other half felt they had been ‘fobbed off’ or subjected to actively hostile behaviour for having spoken up,” says a report commissioned by the Seacole Group, which represents most of the BAME non-executive board members of NHS trusts in England. It adds: “This level of discrimination is unacceptable anywhere and even more so in the boardrooms of NHS organisations. Too many Black, Asian and other ethnic NEDs (non-executive directors) are being subjected to it and left to deal with it on their own.” Read full story Source: The Guardian, 21 July 2022
  21. News Article
    Healthcare systems across Australia are buckling in the wake of COVID waves and the flu season. Pictures of ambulances piling up outside hospitals have become commonplace in the media. Known as “ramping”, it’s the canary in the coalmine of a health system. As a major symptom of a health system under stress, state governments across Australia are investing unprecedented amounts into ambulance services, emergency departments (EDs) and hospitals. South Australia has committed to an increased recruitment of 350 new paramedics. Likewise, New South Wales has committed to 1,850 extra paramedics. Victoria, meanwhile, has committed an additional A$162 million for system-wide solutions to counter paramedic wait times, on top of the A$12 billion already committed to the wider health system. This could begin to alleviate the system pressures that lead to ambulance ramping. But what happens when the paramedics return yet again to ED with another patient? Will they simply end up ramped again? We also need to consider better care in the community – and paramedics could play a role in this too. Read full story Source: The Conversation, 21 July 2022
  22. News Article
    Doctors’ leaders have reacted with incredulity to demands that all hospitals in England take “immediate steps” to find extra space for patients so that no ambulance waits longer than 30 minutes. A letter from NHS England sent to the heads of NHS trusts, integrated care boards, and ambulance trusts acknowledged that this will not be easy “and that it may place additional burden on staff at an already challenging time. The letter was sent on 15 July, in response to the increased pressure on ambulance services over the past year and in light of the current heatwave. It said, “All systems that are currently unable to offload ambulances within 30 minutes should now take further steps to create capacity within acute hospitals to ensure the rapid release of vehicles. This will require risk based decisions to be made about both the use of estate and deployment of clinical workforce.” Vishal Sharma, chair of the consultants committee at the BMA, said, “The government should be ashamed that it has come to this. If hospitals had the space or the staff to allow them to care for these patients, they wouldn’t be waiting in ambulances at the hospital door in the first place. The sad fact is that after decades of underinvestment, our hospitals are under-resourced, under-bedded, and understaffed.” Read full story Source: BMJ, 18 July 2022
  23. News Article
    Serious incidents causing patient harm have increased steeply compared to previous years at an ambulance service whose nursing director still expects will “fail” next month under mounting service pressures. There were 98 patient harm incidents at West Midlands Ambulance Service in June, official data obtained by HSJ suggests, up from 49 in the same month last year. The figures show that from April-June this year, 262 harm incidents have been logged – a 240% on 77 in the same period in 2019 and a 71% on 153 last year. Nursing director Mark Docherty, who previously warned the service was facing a “Titanic moment” and would “all fail” around a specific date of 17 August, said much of the increase can be attributed to worsening hospital handover delays. More than 700 people at one time waited for ambulances “that were not going to turn up” on Monday, according to Mr Docherty, who described the situation as a “really dangerous place to be”. Mr Docherty explained how the harm incidents, including deaths, resulted from growing delays: ”You can’t underplay the risk. If you’ve got 750 patients like we did on Monday waiting, none of those patients have been assessed. “Sadly, amongst them there will have been patients with stroke who won’t be treated because they’ve waited too long." Read full story (paywalled) Source: HSJ, 15 July 2022
  24. News Article
    Ambulance services are under intense pressure, with record numbers of callouts and the most urgent, category-one, calls last month. BBC Two's Newsnight programme spent from 08:00 to 20:00 on Monday at six hospitals with the longest delays handing patients over from paramedics to accident and emergency staff. This should take 15 minutes or less - but crews often wait many hours and sometimes whole 12-hour shifts, with ambulances queuing outside unable to respond to other emergency calls. At Royal Cornwall, 25 ambulances were queuing by the afternoon, three for at least 10-and-a-half hours, at Derriford, in Plymouth, 20 were queuing up to 11 hours in an overflow car park and the longest wait at Heartlands was more than five hours. "We're right on the fringe of collapse right now," a paramedic who has worked in emergency care for more than a decade said. "People are phoning and being told that they're not going to get an ambulance for six or nine hours. And that's happening routinely - that is happening pretty much every shift." "It would be wrong to say that there are times when I haven't shed a tear... for the people we haven't been able to help because it's been too late," the paramedic said. "They may have died anyway but there are definitely cases that I've been to where we should have been to them sooner and less harm would have come to them." Read full story Source: BBC News, 15 July 2022
  25. News Article
    A health minister incorrectly told the Commons yesterday “we have procured a contract” for surge support for ambulance services, despite the contract not having been awarded yet, HSJ has learned. There are also doubts about two other points made by health minister Maria Caulfield in Parliament yesterday in a debate about the current high pressure on ambulance services. She said: “We have procured a contract with a total value of £30m for an auxiliary ambulance service, which will provide national surge capacity if needed to support the ambulance response during periods of increased pressure. That capacity is there, should we need it.” However, NHS England, which advertised the contract in May, confirmed to HSJ today that it “is yet to be awarded”. Ms Caulfield was responding to an urgent question from Labour shadow health and social care secretary Wes Streeting about pressure on ambulance services and the heatwave. HSJ reported on Tuesday that all 10 major ambulance services in England were on the highest level of alert. Read full story (paywalled) Source: 14 July 2022
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