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News Article
In-person GP appointments save lives and must return
Patient Safety Learning posted a news article in News
Last week a receptionist saved a patient’s life. She put him straight into a face-to-face appointment early in the day. The doctor saw him and sent him to A&E urgently. He was operated on the same day. Receptionists are are given an impossible task, to fit a large number of patients into a small number of slots, and they have to stay calm. When the slots run out – which sometimes happens by 9am – they then have to persuade one of the doctors, already at the end of their tether, to add any patient they are especially worried about to their list. So it’s not surprising that when during the early part of the pandemic demand for appointments dropped by 30%, some very stressed and overworked GPs found their lives were a lot nicer without patients. And now that appointment levels have finally (as of May 2021) gone back to normal levels, some are finding the demand very difficult to cope with. This could explain GPs’ persistence at keeping patients at arms length. Telephone consultations are less intense somehow, less tiring. Some GPs feel they can control the day better by using telephone consultations and only bringing in some patients. But patients are experiencing this persistent distancing as rejection. And these rejections are hurtful. Some people have held on to problems for six months or more and then finally felt free to book an appointment when the restrictions ended in August. Except the restrictions haven’t ended, not in general practice. GPs seem unable to let the remote triage go. GPs say: “We are seeing patients face-to-face. We’ve been seeing them throughout the pandemic,” which is true. But only some patients. Plenty of patients who would have benefitted from a face-to-face appointment or an examination have not been seen. Patients are not idiots. They know telephone consultations are not as good. They know, especially older patients, that proper doctoring involves an examination. They know that the rapport and connection with a doctor can only come from a face-to-face appointments. And they wish to book an appointment with their GP themselves, without facing multiple barriers. Read full story Source: The Independent, 6 November 2021 -
News Article
BMA urges GPs to move to 15-minute consultations and close patient list
Clive Flashman posted a news article in News
The BMA has advised practices to immediately start offering consultations of 15 minutes or more; and apply to close their patient list, as part of the fightback against the Government’s new GP access plan. It set out a range of measures GPs should take to protect their staff and patients and ‘prioritise’ core work amid pressure to return to pre-pandemic ways of working. In an email bulletin sent to GPs on Friday, the BMA’s GP Committee said that practices ‘should not feel pressured to return to a traditional 10-minute treadmill of face-to-face consultations that are neither good for patients nor clinicians’. It said: ‘Instead, they should offer patients consultations that are 15 minutes or more [and] apply to close the practice list to focus on the needs of existing patients.’ Read full article here Original source: Pulse -
News Article
GPs to vote on industrial action over ‘name and shame’ reforms
Patient Safety Learning posted a news article in News
GPs are set to be balloted on industrial action over controversial reforms proposed by health secretary Sajid Javid. The “outraged” doctors in England have voted unanimously to reject the government’s plans at a British Medical Association (BMA) meeting. The government wants to see GP surgeries ranked in league tables to “name and shame” those that do not carry out enough face-to-face appointments with their patients. From early November, GPs will have to have their names and wages published if they earn an NHS salary of more than £150,000. The BMA says that forcing GPs to publish their earnings “provides no benefit to patients or their care, yet will potentially increase acts of aggression towards GPs, will damage morale amongst the profession, and only worsen practices’ ability to recruit and retain GPs”. GP surgeries will not be eligible for new funding if they fail to provide an “appropriate” number of in-person consultations. Patients will also be asked to rate their GPs via text message. Mr Javid has insisted that his plans would improve patients’ access to primary care – but the union representing the GPs says it has been “left with no alternative” but to ballot over whether to take industrial action. Read full story Source: The Independent, 22 October 2021 -
News Article
24 children wait year for first cancer appointment in Northern Ireland
Patient Safety Learning posted a news article in News
Twenty-four children in Northern Ireland with confirmed or suspected cancers had to wait over a year for a first appointment, a review has found. The figure, for April, is in a review of child health waiting lists by the Northern Ireland Commissioner for Children and Young People. More than 17,000 children were waiting more than a year to see a hospital consultant for the first time. The commissioner said the waiting times were "terrifying". The review examined official waiting list data for children's health services not published as part of the Department of Health's statistical bulletins. Koulla Yiasouma said that waiting for any health service treatment can and does have a "profound impact on a child's health outcomes, emotional and mental well-being". She said it was "shocking not only for the child but their families too". "Each and every single one of them is a child and each and every single one of them is a child whose life has almost been put on hold, and a family whose life has been put on hold, because they are not getting the most fundamental right of healthcare that they deserve," she said. Read full story Source: BBC News, 19 October 2021 -
News Article
Plan to boost face-to-face GP consultations
Patient Safety Learning posted a news article in News
GPs in England are being told to see more patients face-to-face as ministers unveil a £250m winter rescue package. The emergency funding is being handed to GPs so they can recruit extra locum staff with an emphasis on providing more same-day appointments. Social distancing rules are also expected to be relaxed so that GPs can bring more people into their buildings. It comes amid mounting criticism about the fall in face-to-face appointments since the start of the pandemic. Only 58% of patients were seen face-to-face in August - the first full month following the ending of restrictions. That compares with 54% in January and more than 80% before the pandemic. Patients have also complained of long waits on phone lines to book an appointment. The £250m funding is part of the extra £5bn Covid fund announced last month to help the NHS through to the end of the year, and comes on top of the £12bn set aside for GP services this year. Read full story Source: BBC News, 14 October 2021 -
News ArticleAcutely ill patients requiring emergency care are being diverted to their GP via the new NHS 111 First call-before-you-walk A&E triage system, Pulse has learned. GPs have reported receiving inappropriate NHS 111 referrals including: an acutely dizzy elderly patient who was later confirmed to have had a posterior circulation stroke; a patient with acute coronary syndrome; and a patient with acute UTI symptoms. Meanwhile, GPs are also warning that patients are using the triage system as a way of ‘jumping the queue’ because the route is likely to get them an appointment quicker than calling their practice. From this month, patients in England are being asked to call 111 before attending A&Es – with 111 triaging them to the most appropriate service, including GP practices. Scottish patients are also being asked to phone ahead of attending A&E; while pilots are ongoing in Northern Ireland; and Wales is in the process of rolling out a ‘contact first’ model following summer pilots. The BMA has said the influx of inappropriate referrals by NHS 111 is likely being ‘compounded’ by the new 111 First system, which is ‘contributing to the immense pressures currently facing primary care’. GPs have raised concerns about several cases in which patients should not have been sent to them by 111 because they required more urgent care. One GP, who asked not to be named, told Pulse: "I had a patient with UTI symptoms – a temperature of 39°C, a heart rate of 140, nausea and abdomen/loin pain. They were told: speak to your GP." Read full story Source: Pulse, 21 December 2020
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News Article
Lockdown patients ‘put off’ GP visits after warnings about restricted care
Patient Safety Learning posted a news article in News
GPs’ warnings about restricted services may have put patients off seeking treatment, delaying diagnoses and worsening existing illnesses, the health and care watchdog has said. The Care Quality Commission (CQC) said that millions of people had struggled to see their doctors during the pandemic, which had magnified inequalities and risked “turning fault lines into chasms”. Between March and August 119.5 million GP appointments were made in England, down from 146.2 million last year, according to NHS Digital. Ian Trenholm, the CQC’s chief executive, said: “The number of lost GP appointments translates into millions of people potentially . . . not getting conditions diagnosed early enough, not getting those referrals on for diagnoses like cancer and other conditions.” Read full story (paywalled) Source: The Times, 16 October 2020 -
News Article
How East Cheshire NHS is tackling a major cancer problem
Patient Safety Learning posted a news article in News
East Cheshire faces a serious issue with head and neck cancer, with missed target times and inefficient practices leading to worsening outcomes for patients. That’s prompted officials from the NHS Cheshire Clinical Commissioning Group (CCG) to come up with a plan of action to tackle the problem — but as Cheshire East councillors heard this week, it’s hit a snag. Since 2014, the East Cheshire NHS Trust and Manchester Foundational Trust (MFT) have co-delivered the head and neck cancer pathway. This means that patients are seen by staff at Macclesfield Hospital for diagnostic tests — and if malignant cells are detected, then the patient will be referred on to Wythenshawe for surgery or, if sadly needed, East Cheshire’s own palliative care team for supportive care. In a presentation to CEC’s health scrutiny committee, the CCG said just 10% of patients in the borough were seen at Macclesfield within the 62-day target time in Q3 of 2019/20 — against a desired level of 85%. Simon Goff, chief operating officer of East Cheshire NHS Trust, told the committee: “There is no one stop service - which is where a patient gets diagnostics all on the same day. Biopsies are not always up to the standards required so patients need to have it again. This is a key weakness in the existing service.” The lack of a ‘one stop service’ means there are no on-site pathology services — so samples are taken off-site for testing, and with biopsies needing to be analysed within 24 hours of collection, it results in 39% of all patients having to undergo the procedure again. So what did East Cheshire do about it? The first step was to launch a consultation, with 64 former patients out of roughly 300 eligible providing feedback to the Trust over the summer. The ‘robust’ consultation, saw patients express their desire to ‘know what is going on as soon as possible’, with the ‘issue of travel being outweighed by [the desire for] a quick diagnosis’. Fortunately for health chiefs in Cheshire, there are ‘outstanding’ hospitals surrounding the county — with the Care Quality Commission giving top marks to hospitals in Salford, St Helens, and The Christie in Didsbury. So with East Cheshire’s patients happy to travel a distance in order to gain a quick and accurate diagnosis, and the existing partnership with Manchester’s trust, officials are proposing moving some patients experiencing positive diagnoses and ‘bad news’ cases to MFT sites, such as The Christie or Wythenshawe Hospital. The idea is that ‘neck lump’ patients will be immediately sent to Wythenshawe, with all other patients undergoing initial tests in Macclesfield first before being either sent home with the all clear, or referred on. Biopsies will be done in Wythenshawe, as will ‘breaking bad news’ appointments — where patients are told of a positive cancer diagnosis. Officials say this solution ‘would start to address some of the clinical and performance concerns’ by cutting the average diagnosis wait time from four weeks down to one, reducing the amount of appointments patients need to attend, and allowing for continuity of care throughout treatment. Read full story Source: Knutsford Guardian, 10 October 2020 -
News ArticleFamous faces, including TV chefs Gordon Ramsay, Nadiya Hussein, and actress Emma Thompson are backing a major new campaign urging anyone concerned about cancer to get checked and to keep routine appointments, as new research found that even now, nearly half (48%) of the public would delay or not seek medical help at all. A fifth (22%) would not want to be a burden on the health service while a similar number said that fear of getting coronavirus or passing it onto others was a major reason for not getting help. More than four in ten people would leave it longer to get health advice than they normally would have before the coronavirus outbreak, however delaying can have serious consequences for some cancers. NHS staff have pulled out all the stops to keep cancer services going throughout the pandemic, with almost one million people referred for checks or starting treatment since the virus took hold. The NHS’s Help Us Help You access campaign will use TV adverts, billboards and social media to urge people to speak to their GP if they are worried about a symptom that could be cancer, and also remind pregnant women to attend check-ups and seek advice if they are worried about their baby. People with mental health issues are also been encouraged to access NHS support. Read full story Source: NHS England, 9 October 2020
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News ArticleMuch has been said about the delays to patient care during the first wave of COVID-19, but the full picture has been hard to pin down as statistics come in different forms and are released gradually. However, one recently-published poll performed by Ipsos Mori, with more than 2,000 UK adults aged between 18-75, revealed two-thirds of people who needed treatment for new or recently changed conditions had their care cancelled or delayed during March and July. The poll also revealed three-quarters of people missed out on routine treatment in the same timeframe. It is believed to be the hitherto largest patient-focused survey exploring the impact of the pandemic on non-COVID-19 care during its first peak. It found that – of the people who needed treatment for a new or changed condition – 23% chose to cancel their treatment while 42% had their treatment cancelled or delayed by their healthcare provider. Within the group of people requiring care for an ongoing problem, 31% of patients delayed or cancelled their treatment. Mark Davies, chief medical officer at IBM – which commissioned the poll – told HSJ the number of people with new or recently changed conditions choosing to cancel or delay their care was “really worrying”. “This survey backs up the anecdotal evidence we hear about people being worried about going into hospital during the pandemic,” he said. “It is striking that the proportion of this group of patients who did not get treatment is roughly similar to the proportion of patients requiring treatment for an ongoing health problem who cancelled or delayed their care." He said he would have expected the former group – those with new or changed conditions – to be more anxious to get treated, and warned of a “backlog of unmet need that is only going to emerge in the next few months”. Read full story (paywalled) Source: HSJ, 6 October 2020
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News ArticleHundreds of people believe the 111 helpline failed their relatives. Now the Guardian reports that they are demanding a full inquiry into the service. When the coronavirus outbreak hit in March, the NHS feared hospitals could be overwhelmed and so patients with suspected symptoms were directed to call the designated 111 helpline. Call volumes were massive and waiting times were often over an hour. The Guardian’s David Conn has spent months talking to bereaved relatives about that difficult time and during his conversations he found many were deeply unhappy about the service they felt had been provided by the 111 helpline. Lena Vincent’s partner Patrick McManus died from the virus in April following a short period in hospital. He had called 111 three times and had not been advised to seek further medical help. Lena tells Anushka she wants to know who is accountable for the service. Listen to the podcast Source: The Guardian, 28 September 2020
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News ArticlePeople requiring A&E will be urged to book an appointment through NHS 111 under a trial in parts of England. The aim is to direct patients to the most clinically-appropriate service and to help reduce pressure on emergency departments as staff battle winter pressures, such as coronavirus and flu. The pilots are live in Cornwall, Portsmouth, Hampshire and Blackpool and have just begun in Warrington. If they are successful, they could be rolled out to all trusts in December. However, people with a life-threatening condition should still call 999. Under the new changes, patients will still be able to seek help at A&E without an appointment, but officials say they are likely to end up waiting longer than those who have gone through 111. More NHS 111 call handlers are being brought in to take on the additional workload, alongside extra clinicians, the Department of Health and Social Care said. A campaign called Help Us Help You will launch later in the year to urge people to use the new service. Read full story Source: BBC News, 17 September 2020
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News ArticleGP practices are being told they must make sure patients can be seen face to face when they need such appointments. NHS England is writing to all practices to make sure they are communicating the fact doctors can be seen in person if necessary, as well as virtually. It's estimated half of the 102 million appointments from March to July were by video or phone call, NHS Digital said. However, the Royal College of GPs said any implication GPs had not been doing their job properly was "an insult". NHS England said research suggested nearly two thirds of the public were happy to have a phone or video call with their doctor - but that, ahead of winter, they wanted to make sure people knew they could see their GP if needed. Nikki Kanani, medical director of primary care for NHS England, said GPs had adapted quickly in recent months to offer remote consultations and "safe face-to-face care when needed". Prof Martin Marshall, chair of the Royal College of GPs, said general practice was "open and has been throughout the pandemic", with a predominantly remote service to help stop the spread of coronavirus. He said: "The college does not want to see general practice become a totally, or even mostly, remote service post-pandemic. However, we are still in the middle of a pandemic. We need to consider infection control and limit footfall in GP surgeries - all in line with NHS England's current guidance." He said most patients had understood the changes and that clinical commissioning groups had been asked to work with GP practices where face-to-face appointments were not possible - for example, if all GPs were at a high risk from coronavirus. "Any implication that they have not been doing their job properly is an insult to GPs and their teams who have worked throughout the pandemic, continued delivering the vast majority of patient care in the NHS and face an incredibly difficult winter ahead," he said. Read full story Source: BBC News, 14 September 2020 Research from the college indicated that routine GP appointments were back to near-normal levels for this time of year, after decreasing at the height of the pandemic. "Each and every day last week an estimated third of a million appointments were delivered face to face by general practices across the country," added Prof Marshall.
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News Article
GPs told to resume booking face-to-face appointments following row over access
Patient Safety Learning posted a news article in News
NHS England has said GP practices must start opening their receptions and allow people to book initial face-to-face appointments — scrapping the controversial ‘total triage’ rule — for the first time since the early days of the coronavirus pandemic. Since last spring, NHSE guidance, supported by the profession, has said that face-to-face appointments must generally only take place after a phone, video or digital consultation. Many GP practice receptions have been closed to people wanting to make routine appointments. This rule was kept in place throughout last summer, despite covid circulation being low, and some health systems made the approach one of the pillars of planned post pandemic transformation. “Embedding total triage” was encouraged in 2021-22 operational rules for the NHS. The shift was seen by some as part of a move to a potentially more effective and efficient way of working. But there have been concerns about access and complaints in the media. Read full story (paywalled) Source: HSJ, 14 May 2021 -
News ArticlePatients are finding it increasingly hard to see their GPs, with warnings that pandemic restrictions have too often “closed the door” on NHS treatment, a report warns. The Patients’ Association survey comes as an investigation reveals that almost 100 GP surgeries closed down or merged with other practices last year. In total, almost 2.5 million patients were forced to switch to a new surgery because of 788 such closures since 2013, the freedom of information disclosures reveal . Rachel Power, chief executive of the Patients’ Association, said the findings from its survey were “worrying” and show “clear dissatisfaction” from the public. The report said: “It is increasingly clear that many patients have found that new methods for arranging appointments do not work for them, or simply that they do not understand how to go about it. GPs are the front door to the NHS, and patients are increasingly perceiving that that door is closed to them.” Roughly half of those who had telephone consultations said the experience was worse than a traditional appointment, with three times as many saying they were unhappy about their experience, compared with those offering praise. The report warns: “The data does not show a ringing endorsement of new or remote methods for accessing NHS care; indeed, in most cases patients rated these methods worse than traditional contact.” Read full story Source: The Telegraph, 30 April 2021
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News ArticleThe NHS should pause the planned roll out of bookable A&E slots until a robust evaluation of the new system has been undertaken, the Royal College of Emergency Medicine president has told HSJ. The proposals were set out in NHS England’s 2021-22 planning guidance last month. The guidance say local systems should “promote the use of NHS 111 as a primary route into all urgent care services”. It instructs local systems to “maximise the use of booked time slots in A&E with an expectation that at least 70% of all patients referred to an emergency department by NHS 111 receive a booked time slot to attend”. Sites only began piloting the model late last year. But by March the new system appeared to be being actively rolled out across the service. Seventy five of England’s 126 acute trusts with a type 1 emergency departments had begun allowing patients to book appointments in A&E by calling 111, according to NHS England data published this month. But RCEM president Katherine Henderson has told HSJ that NHSE has failed to release any data on the effectiveness of the new approach. She said NHSE must pause its plans while a full evaluation of the pilots is carried out to ensure the model was delivering operational and clinical benefits before it is adopted on a widescale basis. She said: “We are very keen to see some data and clinical validation so we can robustly assess how the 111 First model is working, because, at the moment, we haven’t really seen enough to say: ‘this is something that we really need to push on with’. Read full story (paywalled) Source: HSJ, 26 April 2021
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News ArticleMany GPs find telephone appointments with patients frustrating and want to see them in person because they fear they will otherwise miss signs of illness , the leader of Britain’s family doctors has said. Prof Martin Marshall told the Guardian that remote consultations felt like working “in a call centre” and risked damaging the relationship between GPs and their patients. Telephone and video appointments had proved useful during the Covid pandemic, when GP surgeries limited patients’ ability to come in for face-to-face appointments, he said. However, while that helped limit the spread of coronavirus, “this way of working has been frustrating for some GPs, particularly when most consultations were being delivered remotely, who have felt like they’ve been delivering care via a call centre, which isn’t the job they signed up for." “Remote consultations have advantages, particularly in terms of access and convenience for patients. But we know that patients prefer to see their GP face to face." “Remote working has been challenging for many GPs, particularly when delivering care to patients with complex health needs,” said Marshall, who is a GP in London. “It can also make it harder to pick up on soft cues, which can be helpful for making diagnoses.” His remarks come as NHS leaders and doctors groups are discussing how far appointments should return to being in person now the pandemic is receding. Read full story Source: The Guardian, 28 March 2021
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News Article
Has Covid changed hospitals for the better?
Patient Safety Learning posted a news article in News
The pandemic has been a catalyst for innovation in the NHS and some changes will have a lasting effect, says Dr John Wright of Bradford Royal Infirmary. The Covid pandemic has transformed our hospitals. Car parks are empty, once-bustling corridors are quiet, and these days you won't see any staff making fashion statements - we're all in scrubs and masks. Dr Wright says changes made to reduce spread of infection are here to stay and will help us live with future outbreaks of Covid and other infectious diseases. But there is also much to learn from how we have adapted to non-Covid care - with drive-through PCR swabs and blood tests, for example, or the use of oximeters to monitor oxygen levels in the blood of Covid patients in their homes, providing warning if they need to be admitted to hospital. But the biggest change has been in the way hospital consultations are carried out. Before the pandemic nearly all appointments took place face-to-face. Last year probably 90% occurred via telephone or video call, and most of my colleagues at Bradford Royal Infirmary are still running remote clinics today. This is much more convenient for patients. In the past a typical consultation might have involved a half-day of travel, the search for a parking place, and then sitting in a waiting room. However, remote consultations do have their drawbacks. Patients tend to underplay their symptoms on the phone and it is easier to avoid discussing challenging issues. Life-changing diagnoses require sensitive, face-to-face communication. Another problem is that some patients struggle with technology. The main drawback, though, is that clinicians are unable to undertake physical examination remotely. Clinical histories are the yin of the consultation but physical examinations are the yang, and video consultations only provide half the picture. Read full story Source: BBC News, 15 March 2021 -
News Article
Covid: Half with cancer signs didn't contact GP in first wave
Patient Safety Learning posted a news article in News
Almost half of people with potential cancer symptoms did not contact their GP during the first wave of the pandemic, a survey suggests. Symptoms left unchecked included coughing up blood, lumps and changes to the appearance of moles. NHS figures showed a fall in referrals to cancer services last spring. However, this study, of almost 8,000 people, captures the fall in people contacting their GP in the first place. The team that carried out the study, from Cardiff University and Cancer Research UK, said this raised concerns that people could be diagnosed later - and so be less likely to be treated successfully and recover. They surveyed a representative sample of people across the UK and found that of 3,025 people who said they had experienced at least one symptom which could be a warning sign of cancer, 45% did not seek help. They also found that: 31% did not seek help after coughing up blood 41% did not seek help for an unexplained lump or swelling 59% did not seek help after noticing changes to the appearance of a mole. Some of the reasons given by people who did not contact their GP were not wanting to waste doctors' time or put extra strain on the NHS; not wanting to be seen as someone who made a fuss; and fear of catching Covid at appointments. But people who did contact their GP reported feeling "safe" and "secure" when attending face-to-face appointments. Read full story Source: BBC News, 25 February 2021 -
News Article
Concern raised over death of five patients seen remotely by GPs
Patient Safety Learning posted a news article in News
Patients being assessed remotely in general practice, rather than face-to-face, has been raised as a risk in reports on five deaths by a single coroner since the pandemic hit. Senior coroner for Greater Manchester Alison Mutch has written five prevention of future deaths reports highlighting concerns that doctors were missing details in telephone appointments which may have been spotted, had the patient been seen in person. The reports cover a variety of conditions, including covid, a broken femur, and anxiety and depression. In March 2020, NHS England guidance instructed GPs to adopt a “total triage” approach, where face-to-face appointments should generally only follow a phone, video or digital consultation. But, in May, NHSE wrote to GPs to ask them to “ensure they are offering face to face appointments”, adding remote appointments “should be done alongside a clear offer of appointments in person”. There have been growing calls in the media for increased face-to-face appointments, while, in March 2021, a report by Healthwatch concluded: “While telephone appointments are convenient for some, others are worried that their health issues will not be accurately diagnosed.” Maureen Baker, former chair of the Royal College of GPs and Patient Safety Learning trustee told HSJ she was “not aware pre-pandemic of any major concerns with remote consulting”, adding: “It’s not that things don’t go wrong. They do, but things can and do go wrong in face-to-face consultations as well.” “Many practices have been using remote consulting very successfully for many years [but for GPs introducing remote consultations during the pandemic] the concern is that practices will have had to change and implement it very quickly.” Read full story (paywalled) Source: HSJ, 9 September 2021 You may also be interested in a recent blog from Trish Greenhalgh: 'Why remote consultation with a doctor is difficult – and how it can be improved' -
News Article
Covid in Scotland: Can in-person GP appointments ever fully return?
Patient Safety Learning posted a news article in News
Community doctors in Scotland have told the BBC they cannot imagine returning to normal face-to-face service with current levels of demand. Allowing more patients to see their GP in person is a top priority for the government's NHS Recovery Plan. But as the country tries to emerge from the pandemic, surgeries are seeing unprecedented pressure to catch up with patients. The health secretary has confirmed that new guidance should allow practices to see more people in person. But greater use of telephone and video appointments, brought in when the pandemic hit, is going to continue. Dr Begg has been a GP for 25 years. He says they won't go back to business as usual, the way they worked before. "In person consultations are really important, to examine people, to give injections, to remove lesions, all of these. I think a flexible approach is what we need. It's what we were planning to do before the pandemic anyway; a flexible mix of phone call, video and in-person consulting where it is appropriate." Dr Begg says the new ways of working are essential to deal with the huge number of requests they get. "There is a demand, capacity gap and indeed there was before the pandemic. We are seeing at last more students come through medical school and more people finally coming to join general practice training, but this is going to take at least ten years to turn things around." Read full story Source: BBC News, 7 September 2021 -
News Article
Rheumatology care disruptions related to Covid-19
Patient-Safety-Learning posted a news article in News
It has been found that follow-up appointment cancellations have climbed to 60% during the height of the pandemic. People from older, ethnic and poorer backgrounds were the worst hit according to the data. According to the report, the impact was only partially offset by the use of telehealth sessions. Read full story. Source: Healio Rheumatology, June 10 2021 -
News ArticleA woman was subjected to an unnecessary invasive procedure in an NHS outpatient clinic after she was confused for another patient, a safety watchdog has found. The Healthcare Safety Investigation Branch has called for a review of how the NHS can avoid the mishap happening again after investigating the case of a 39-year-old woman who was subjected to an unnecessary cervical examination. HSIB said a better system was needed as the number of outpatient appointments has increased from 54 million to 94 million during the last 10 years with many clinics carrying out more invasive procedures. According to its latest investigation, the female patient was attending a gynaecological outpatient clinic for a fertility treatment assessment. The error happened when she was called through from the waiting room as another patient had a similar sounding name. Read full story Source: The Independent, 2 June 2021
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News Article
Staff at UK GP surgeries facing abuse and ‘tsunami of demand’
Patient Safety Learning posted a news article in News
NHS staff at GP surgeries are facing unprecedented abuse and aggression from patients, while stressed doctors are increasingly suffering from mental illness, because of an appointments system “in meltdown”, family doctors’ leaders have revealed. The scale of the deep crisis in GP surgeries was revealed in an emergency summit of more than 60 NHS doctors, dentists and administrative staff in Salford, which the Guardian attended, triggered by a recent rise in verbal abuse. "Patients are short-tempered and not happy waiting for anything … They want letters. The latest one was a request to speak to a GP because he needs a letter to confirm anxieties that cause him a problem in long queues – because he wants to take his son to [Southport amusement park] Pleasureland and does not want to queue," says Jan Crowshaw, a GP manager It comes after a recent poll by the body representing GP surgery staff across the UK found that 75% of them face abuse every day, including assaults, threats, racism and sexism. Read full story Source: The Guardian, 28 May 2021 -
News Article
GPs should not switch off online consultations, NHSE says
Patient Safety Learning posted a news article in News
GP practices should not switch off their online consultation systems outside of core hours as it will “reduce patient satisfaction”, according to NHS England. It comes in controversial new guidance issued amid a row over GP access. NHSE issued the new “standard operating procedures” this afternoon. HSJ revealed last month that large numbers of overwhelmed GP practices were turning off their online consultation services at weekends after the recent boom in digital appointments uncovered an ‘unmet demand’, leading to large numbers of queries to deal. But the new SOP says: “Patients should be able to make requests in an online system at any time.” Disabling the system outside of core hours, which some practices have done to help manage demand, is “less convenient” for patients and would “reduce satisfaction”, it says. Read full story Source: HSJ, 20 May 2021
