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Showing results for tags 'Appointment'.
Found 203 results
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News Article
Child health checks failed to recover after covid, figures show
Patient Safety Learning posted a news article in News
Inadequate health visiting provision has led to gaps in care for children and heaped pressure on acute services, senior clinicians have told HSJ. Government data suggests that a fifth of infants are not receiving one or more of their five mandatory health visiting reviews across the first two years of life, with rates still substantially below pre-covid levels. Meanwhile, nationally about 1 in 10 children are still being seen virtually, contrary to the government’s delivery model and despite clinicians saying in-person contact is vital to spotting problems. Senior figures in children’s services told HSJ that in some areas a much higher rate was still being carried out with no in-person contact. Clinicians said the reasons were ongoing funding and staffing constraints, and that the problems were leading to parents turning to emergency departments and GPs instead. Read full story (paywalled) Source: HSJ, 20 April 2023 -
News Article
National ambitions for use of NHS App undermined by plateauing performance
Patient Safety Learning posted a news article in News
Take-up and usage of the NHS App in England has begun to plateau, after covid drove huge growth, figures seen by HSJ suggest. This can be seen in the percentage of GP appointments booked or cancelled using the app; the number of records viewed; and the number of times it has been downloaded. Rapid uptake was driven during covid restrictions, when travel and other activities often required a covid vaccination pass. Government has said it wants the growth to continue. The number of GP appointments booked or cancelled using the app fell for a third consecutive month in March to 212,954, representing a decrease of 15% since January and 28% on October 2022, when usage peaked. The NHS app is central to government’s plan for digital health and care, published last year, billed as the “digital front door” to the NHS which would aid the recovery of services post-pandemic. Read full story (paywalled) Source: HSJ, 19 April 2023 -
News Article
Junior doctors’ April strike led to 195,000 NHS hospital cancellations
Patient Safety Learning posted a news article in News
Almost 200,000 hospital appointments and procedures in England were cancelled during last week’s junior doctors’ strikes, it has been revealed. There were 20,000 more appointments cancelled in the strikes that ran between 11 and 15 April than in the shorter strike in March, NHS England figures show. A total of 27,361 staff were not at work during the peak of the strikes, though the true figure could be higher as some workforce data was incomplete. The NHS’s national medical director, Prof Sir Stephen Powis, said the figures showed the “colossal impact of industrial action on planned care in the NHS”, with nearly half a million appointments rescheduled over the last five months. He said every postponed appointment had “an impact on the lives of individuals and their families and creates further pressure on services and on a tired workforce – and this is likely to be an underestimate of the impact as some areas provisionally avoided scheduling appointments for these strike days”. Read full story Source: The Guardian, 17 April 2023 -
News Article
Over two million patients have to visit GP four times for referral
Patient Safety Learning posted a news article in News
More than two million patients each year have to make four or more repeat visits to their GP before they get a referral, a patient watchdog has warned. Patient safety campaigners said people faced waits of “weeks, months or even years” before officially joining NHS waiting lists, and that their health and wellbeing was suffering as a result. They warned it would also add to pressure on other services such as A&E departments. Research by Healthwatch England revealed what the patient watchdog called a “hidden waiting list”. “People wait for a GP appointment; they wait for their GP to tell them they will be referred; they wait for the hospital to confirm that referral; and then they join a hospital waiting list,” it said. “NHS statistics monitor only the hospital waiting list, leaving the steps between getting a GP referral and a letter confirming a hospital appointment as a dangerous ‘blind spot’ for the NHS and patients.” Read full story (paywalled) Source: The Times, 11 April 2023 -
News ArticleNHS England has launched a “very aggressive campaign” to ensure all acute trusts give patients the ability to make appointments and receive messages online. Details of the new “national requirement” which must be met by the end of 2023-24 were sent by NHS England to acute trust chief information officers on Friday. NHSE wants all trust portals to integrate with the NHS App to enable patients to manage outpatient appointments and respond to messages through a single channel. Under NHSE’s requirements, the portals must: Enable patients to view their outpatient appointments; Enable the trust to send a waiting list validation questionnaire to patients; Provide patients with a single point of access to contact the provider, for example to cancel appointments; and Enable patients to access their correspondence from the trust. Read full story (paywalled) Source: HSJ, 31 March 2023
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News Article
‘It is not right to normalise the current GP workload’, says RCGP chair
Patient Safety Learning posted a news article in News
It is ‘not right to normalise’ the current workload in general practice as numbers of GPs and practices goes down, the RCGP chair told delegates at Pulse Live this week. Professor Kamila Hawthorne highlighted the pressure GPs are under with general practice appointments increasing most last year, compared to A&E and outpatients. She also said her priority from a new GP contract would be better resourcing for GPs working in deprived areas. Her speech looked at the challenges facing general practice and imagined what the future could look like, including what the college can do to bring about change. Professor Hawthorne said: ‘The workload that we’re facing – it’s not right to normalise it. The sort of work days that we have in general practice, it is not right to normalise this. ‘The number of GPs is going down because they’re leaving the profession faster than they’re entering it. The number of practices in England is going down, and compared with affluent areas, GPs in deprived areas earn less but see more patients with more chronic illness.’ Read full story Source: Pulse, 21 March 2023 -
News Article
More than 175,000 appointments cancelled over three day junior doctors’ walk out
Patient Safety Learning posted a news article in News
More than 175,000 patient appointments and surgeries were postponed this week during the three-day junior doctor walk-out, it has emerged. NHS leaders have warned the strikes were the most disruptive yet with more appointments cancelled across three days than across any of the previous nurse strikes. Data published by the NHS showed in total 181,049 patients had their care postponed, this included more than 5,000 mental health and hundreds of community health appointments. The news comes after nursing and ambulance unions accepted a pay offer from the government, for a 5.3 per cent increase in 2023-24, which their members will now vote on. Read full story Source: The Independent, 18 March 2023 -
News Article
Surge in patients paying for GP appointments as pressure on NHS grows
Patient Safety Learning posted a news article in News
Demand for private GPs has soared as patients seek out face-to-face appointments with doctors at short notice. Spire Healthcare, one of the UK’s largest private healthcare providers, saw 32,000 GP appointments booked with it last year – up from 23,000 in 2021. The hospital company, which runs 125 GPs, said revenues from its private doctor appointments rose by 46% in 2022. It said demand was soaring as patients look for “fast access to longer face-to-face appointments with a GP”. On the surge in demand, Spire Healthcare boss Justin Ash told The Telegraph: “Clearly there is a well known problem of GPs being under pressure, the 8am scramble [for appointments] is a thing. People want to be able to book online and they want to be able to book at short notice.” Read full story Source: The Independent, 4 March 2023 -
Content ArticleGP services are the first point of call for many health issues and the gateway to NHS specialist support. GP teams are highly skilled and may decide that treatment without specialist care is the best action. But when you need specialist support, such as hospital tests or treatment, you may need a referral from your GP team first. New research from Healthwatch highlights that it can be very hard for some people to get a GP referral to another NHS service. And for 21% of people we spoke to, even when they get referrals, they can be lost, rejected or not followed up on. When services don't process referrals properly, it can cause significant frustration, unnecessary anxiety, and even cause harm to patients. It can also lead to increased demand for either more GP appointments or help from healthcare teams in other parts of the NHS, putting more pressure on already overstretched services.
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News Article
‘Very high’ Do Not Attend rates caused by IT failures, trust discovers
Patient Safety Learning posted a news article in News
An acute trust has discovered an IT issue which appears to have led to ‘very high’ numbers of patients not turning up for their appointments. Bedfordshire Hospitals Foundation Trust discovered appointment letters were being lost, and not sent to patients, during intermittent server failures, its board was told yesterday. The trust’s “did not attend“ rate has been between 10% and 12% over the last year, compared to the national average of 7%, according to its board papers. The issue relates to patients with appointments booked at Luton and Dunstable Hospital. It is not yet clear how many patients were affected. The trust is now planning to ensure every patient with an appointment booked this year receives a new appointment letter, and an apology if they did not previously receive one. Read full story (paywalled) Source: HSJ, 2 February 2023 -
News Article
Coroner says student might be alive if GP had seen him
Patient Safety Learning posted a news article in News
A law student who died after four remote GP consultations might have lived had he been given a face-to-face appointment, a coroner ruled. David Nash, 26, died in November 2020 from a bone infection behind his ear that caused an abscess on the brain. Over a 19-day period leading up to his death, he had four phone consultations with his GP. The coroner, Abigail Combes, said the failure to see him meant he underwent surgery ten hours later than it could have been. Andrew and Anne Nash fought for more than two years to find out whether their son would have lived if he had been seen in person by clinical staff at Burley Park Medical Centre in Leeds. Yesterday they said they were “both saddened and vindicated by the findings that the simple and obvious, necessary step of seeing him in person would have saved his life” and wanted to make sure “others don’t die as David did”. Read full story (paywalled) Source: The Times, 21 January 2023 -
News Article
Smear tests: GP waiting times putting women off cervical screening
Patient Safety Learning posted a news article in News
"I got my cervical screening letter in November and I've been putting it off because I don't want to do it - I don't think any girl really wants it done to them." Elena Coley Perez is 26 and due to have her first cervical screening - or smear test - that examines the opening to your womb from your vagina. NHS records show 4.6 million women - or 30% of those who are eligible - have never been screened for cervical cancer or are not up to date with their tests. Women are sometimes too embarrassed to come forward or put it off because they are anxious, surveys have found. Struggling to book their tests due to GP backlogs will not help the situation, say charities. Elena has told the BBC she was already worried about having a smear test, and the difficulty she experienced in booking one put her off even more. "I got another letter in December so I went to book online because with my local GP you have to go through this long-winded form," she said. "I typed in cervical screening and nothing was coming up, so I ended up waiting 35 minutes on the phone to be told they had no appointments for the rest of the year and to phone back in the new year." Elena then tried again in January and was told there was no availability. "At this point I was like, 'what's the point?' - you're trying to do something that can hopefully prevent you from getting cancer and you get to the doctor's surgery and you just get a 'no' - it's really off-putting," she says. Read full story Source: BBC News, 25 January 2023 Further resources on the hub: For patients: Having a smear test. What is it about? (Jo's Cervical Cancer Trust) Cervical cancer symptoms (Jo's Cervical Cancer Trust) For staff: RCN guidance: Human papillomavirus (HPV), cervical screening and cervical cancer -
Content ArticleA Channel 5 News investigation has found nearly three quarters of people getting help for Long Covid weren't given a face-to-face appointment. It's estimated 2.1 million UK people have the condition. A Long Covid hauler herself, 5 News reporter Ruth Liptrot looks at where we're at with finding a treatment.
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Content ArticleThis report published by the National Confidential Enquiry into Patient Outcome and Death (NCEPOD) assesses the quality of care provided to adult patients with a pre-existing epilepsy disorder, or who were subsequently diagnosed with epilepsy and presented to hospital following a seizure, between 1 January and 31 December 2020.
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Content Article
RNID - Our ear wax removal campaign (2022)
Patient-Safety-Learning posted an article in GP and primary care
Many people who usually go to their GP for ear wax removal have recently been told this service is no longer available on the NHS. As a result, they are now being advised to manage their own ear wax build-up or to seek ear wax removal from private providers. However, advice on self-management is inconsistent and sometimes dangerous, and the cost of private removal can make it unaffordable. The Royal National Institute for Deaf People (RNID) wants to make sure everyone is offered clear advice on managing excess ear wax safely themselves and has access to professional removal on the NHS if self-management doesn’t work. This campaign page highlights research by RNID and outlines how people can get involved in the campaign by writing to their MP and local healthcare organisations. -
Content ArticleThis US study in the journal Medical Care aimed to investigate the extent of physician practice adoption of patient engagement strategies nationally. The authors analysed data collected from the National Survey of Healthcare Organizations and Systems (NSHOS) on adoption of patient engagement strategies. They found that there was modest adoption of shared decision-making and motivational interviewing, and low adoption of shared medical appointments.
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News Article
Five million missed out on GP appointments in one month, says Labour
Patient Safety Learning posted a news article in News
Five million people were unable to book a GP appointment in October, analysis of NHS data suggests. The Labour party, which studied figures from the GP Patient Survey, warned the struggle to see a doctor will mean many patients will not have serious medical conditions diagnosed until it is “too late”. According to the survey, some 13.8% of patients, or around one in seven, did not get an appointment the last time they tried to book one. With almost 32 million GP appointments reported in England in October, the party said it means that more than 5 million people could have been unable to book a GP appointment when they tried to make one that month. October saw GP surgeries carry out the highest number of appointments since records began in 2017, despite a depleted work force. Labour’s shadow health secretary Wes Streeting told Labour List: “Patients are finding it impossible to get a GP appointment when they need one. I’m really worried that among those millions of patients unable to get an appointment, there could be serious conditions going undiagnosed until it’s too late". Professor Kamila Hawthorne, chair of the Royal College of General Practitioners, said in a statement: “GPs and their teams are working flat out to deliver the care and services our patients need. GPs want our patients to receive timely and appropriate care, and we share their frustrations when this isn’t happening. But difficulties accessing our services isn’t the fault of GP teams, it’s a consequence of an under-resourced, underfunded, and understaffed service working under unsustainable pressures.” Read full story Source: The Independent, 6 December 2022 -
Content ArticleThis article by Rebecca Rosen and Trisha Greenhalgh in the BMJ looks at the safety of remote GP consultations. It begins by looking at the case of student David Nash, who tragically died in 2020 after four telephone consultations with his GP; he was denied an in-person appointment for a painful ear infection that led to a fatal brain abscess. One coroner has raised concerns that this is not a one-off incident, noting that in five inquest reports they wrote during the pandemic, they question whether deaths could have been prevented by in-person consultations. The authors look at the recommendations of the ongoing 'Remote by Default 2' study, which is exploring how best to embed remote consulting in future GP services. They highlight better triage of appointment requests, active listening, checking back, increasing the use of video consulting and better training for clinicians as factors that could improve the safety of remote consultation.
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News Article
NHS England ad campaign hopes to change behaviours and relieve service
Patient Safety Learning posted a news article in News
Plans have been drawn up to avoid the NHS being overwhelmed this winter by encouraging patients to “behave in ways they’ve not experienced before” and cut down on in-person GP visits, the Guardian can reveal. An advertising campaign devised by M&C Saatchi, awarded a contract by NHS England worth up to £28.6m, suggested ways people could be encouraged to settle for a virtual appointment or visit a pharmacist instead. To help reduce the mounting pressures facing medics, documents show the agency also advised patients should be told that seeking help via alternative routes instead of rushing to A&E would help the NHS “work better for everyone”. The three-year contract is for the ad campaign “Help Us Help You”, which seeks to change people’s behaviour when accessing healthcare to reduce pressures on the NHS and maintain capacity. Wes Streeting, Labour’s shadow health secretary, said patients were already cutting back on in-person GP appointments – “not because they don’t need them but they’re finding it impossible to get one”. He told the Guardian: “Among those millions of patients who can’t get an appointment when they need it, there will be problems which go undiagnosed until it’s too late". Read full story Source: The Guardian, 30 November 2022 -
Content ArticleThis study in the journal Health and Social Care Delivery Research aimed to assess the scale, scope and impact of changing the type and number of different healthcare practitioners in general practice in England. The authors undertook an analysis of employment trends, looked at motivations behind employment decisions, examined staff and patient experiences, and assessed how skill mix changes are associated with outcome measures and costs. They found that: employing clinicians who are not GPs did not reduce GPs’ workload or improve their job satisfaction. patients appreciated the longer appointments they had with other clinicians. patients wanted better information about what other practitioners can do, and how to use new booking systems.
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Content ArticleIn July 2022, HSIB launched a national investigation into the safety risk of clinical investigation booking systems failures. Specifically, the investigation explores the use of paper or hybrid booking systems and the production of appointment letters. This interim bulletin highlights a safety risk identified by the investigation and presents a safety observation for the attention of NHS care providers. Some vital NHS services still use paper-based or hybrid systems, which may have been developed over time and could leave unintended gaps where patients can be lost in the system. The reference case for this investigation is the experience of a patient whose magnetic resonance imaging (MRI) scan was not rescheduled following a cancellation, leading to a delay in the diagnosis of cancer. Hybrid systems were in use, which did not assist staff to keep track of patients. Additionally, the hybrid systems in use did not allow appointment letters in non-English languages to be produced.
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News ArticleGP practices can block abusive patients from gaining automatic access to their records online if they pose a ‘risk of harm’ to staff, the Royal College of General Practice has said. Automatic access to patients’ prospective patient records is due to be switched on by the end of this month, following delays related to concerns about patient safety. But the RCGP’s toolkit on access to records said practices can refuse access to online records for patients that pose a risk of harm to others too. The guidance said access should "be refused where there is a clear risk of serious harm to the safety of the patient or members of the practice team, or to the privacy of a third party". It added: "If potentially harmful information cannot be successfully redacted and the practice remains concerned about the safety of record access for an individual patient – or in extreme cases, remains concerned that the patient may react violently to information in the record – then the practice may refuse to give the patient record access or restrict the level of access. "It may be possible to give them access to a reduced part of the record such as the Summary Care Record or restrict access to appointments and repeat prescriptions." The guidance said that records access should only be refused or restricted "after discussion with the practice leads for GP Online Services and Safeguarding or after seeking further professional advice from a local relevant agency or national medical indemnity organisation". Read full story Source: Pulse, 18 November 2022
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Content ArticleFor many patients, online access to their GP’s services is a normal part of their everyday interaction with the NHS. The majority of patients in England use at least one GP Online Service to request prescriptions, book appointments or access their electronic health record. It is part of modern, responsive primary care services for patients, their families and carers. It is convenient and reliable for patients and useful for practices. It can foster a person-centred approach to care, especially for patients with long term conditions or complex multi-morbidity. The Royal College of General Practitioners (RCGP), in collaboration with NHS England, have developed the guidance and resources in this Toolkit to help practices provide GP online services effectively, efficiently, safely and securely. The Toolkit includes clinical exemplars which demonstrate how GP online services can empower patients to take greater control of the management of their health conditions. It does not cover online consultations.
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News Article
GPs in England treat up to three times more patients than safety limit demands
Patient Safety Learning posted a news article in News
GPs are struggling to cope with as many as 90 appointments and consultations a day – more than three times a recommended safety limit. General practices in England are carrying out more appointments than before the pandemic but face severe workforce shortages. More than 1.45 million patients waited at least 28 days to see a GP in September, according to the most recent NHS figures. GPs who spoke to the Observer last week say that almost every day they breach the BM) guideline of “not more than 25 contacts per day” to deliver safe care. One doctor said he had more than 90 consultations on one day. A conference of local medical committee representatives in England this week will highlight the growing pressures faced in general practice. Surgeries are being urged to impose stricter caps on the number of patient appointments for each GP. One of the proposed motions submitted to the conference by Kensington and Chelsea local medical committee says “focusing on patient safety” is more appropriate than meeting high patient demand. It says the NHS should focus on “safe capacity”. Such a move would mean longer waits for GP appointments, but doctors say it would help safeguard patient care and the welfare of staff in general practice. Read full story Source: The Guardian, 20 November 2022 -
News ArticleNHS England “forgot the people” when it published controversial guidelines last month which said patients faced being removed from the waiting list if they declined two appointment dates, a senior director has admitted. NHSE elective recovery chief Sir Jim Mackey said the guidance was drafted to address legitimate concerns from trusts, but that the process had been “rushed”. Following Sir Jim’s comments, NHSE told HSJ the guidance, which had sparked widespead criticism including from patient groups, would not be changing. But Sir Jim said NHSE would “spend time” better understanding patients after “reflecting” on the process which had created the controversial guidelines. Speaking at the King’s Fund annual conference, Sir Jim said: “[The guidance] was largely a response to trusts saying to us: ‘We keep offering these patients options and they won’t take them, so what do we do?’ “We rushed through a policy to try and deal with that, and in the process, I think forgot the people…We’ve reflected on that.” Read full story (paywalled) Source: HSJ, 1 November 2022
