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Found 203 results
  1. News Article
    The NHS in England is facing mounting pressure amid a surge in patients attending A&E departments with minor ailments, health bosses have said. Emergency departments, which are designed for serious injuries and life-threatening emergencies only, are seeing an increase in people attending with sore throats, insomnia, coughs and earache. Data analysed by the Press Association news agency also shows more people going to A&E with complaints such as hiccups, nasal congestion, backache and nausea. Cases where sore throat was the chief complaint rose by 77% between 2021-22 and 2022-23, from 191,900 cases to 340,441. Patients going to A&E with coughs rose by 47%, from 219,388 to 322,500, while attendances for nosebleeds rose by a fifth, from 47,285 cases to 56,546. Miriam Deakin, the director of policy and strategy at NHS Providers, said: “The rise in A&E admissions is piling even more pressure on to an already stretched NHS. Persistent strain on primary care services, including GPs and dentists, means patients often resort to A&E when they cannot access timely care elsewhere. “Minor ailments such as coughs, earache, fever, nausea and hiccups can and should be managed through more appropriate services such as pharmacies and NHS 111 online. This could ease pressure on emergency departments, whose priority is to deliver urgent care for those most in need. Boosting capacity of staff, beds and equipment in these settings would also significantly help. However, this requires proper funding and support from the government.” Read full story Source: The Guardian, 10 October 2023
  2. Content Article
    Patient initiated follow up and remote clinical reviews show promise in alleviating capacity issues and ensuring timely care, with positive patient feedback and early intervention benefits Media interest regularly reports on the three headline performance measures of the NHS; 18-week target, cancer wait targets, and four hour waits in emergency departments. There is, however, another large group of patients that we do not have any targets for and receive no media attention, who Peter Towers, NHS service manager, has termed the “fourth group”. These are the patients who have started their treatment but cannot be discharged back to primary care as they require continued secondary outpatient care.
  3. Content Article
    Urgent funding is required to clear waiting list backlogs and drive Northern Ireland's long-term healthcare transformation, the Northern Ireland Audit Office has said in a new report which outlines the health service's "critical situation" after almost a decade of worsening waiting lists for elective care. The NI Audit Office looked at waiting list data from 2014 to 2023. It found the number of patients waiting for elective care has risen by 452,000 during that nine-year period. The Audit Office also said: "Available information suggests waiting list performance levels are significantly worse in Northern Ireland compared with the other UK regions."
  4. Content Article
    The adoption of virtual consultations, catalysed by the COVID-19 pandemic, has transformed the delivery of primary care services. Owing to their rapid global proliferation, there is a need to comprehensively evaluate the impact of virtual consultations on all aspects of care quality. This study aims to evaluate the impact of virtual consultations on the quality of primary care. It found that virtual consultations may be as effective as face-to-face care and have a potentially positive impact on the efficiency and timeliness of care; however, there is a considerable lack of evidence on the impacts on patient safety, equity, and patient-centeredness, highlighting areas where future research efforts should be devoted. Capitalising on real-world data, as well as clinical trials, is crucial to ensure that the use of virtual consultations is tailored according to patient needs and is inclusive of the intended end users. Data collection methods that are bespoke to the primary care context and account for patient characteristics are necessary to generate a stronger evidence base to inform future virtual care policies.
  5. Content Article
    In February 2022, NHS England published its Delivery Plan for Tackling the Covid-19 Backlog of Elective Care, aiming for an unprecedented 30% rise in elective activity by 2024-25. In an effort to cut waiting times and the number of people waiting for first appointments, the plan set an improbably ambitious target of reducing follow-up outpatient visits by 25% by March 2023 from 2019-20, to leave more capacity for first appointments. All first appointment waits of over 52 weeks were to be abolished by 2025. In this BMJ opinion piece, David Oliver looks at why the targets are unlikely to be met.
  6. News Article
    A big rise in GP referrals being deferred because no appointment slots are available, in the wake of the covid pandemic, has sparked concerns that patients are going undiagnosed and missing out on the correct treatment. Outpatient referrals are typically classed as having an “appointment slot issue” when no booking slot is available within a timeframe specified by the provider, under the NHS e-referral system. The latest NHS Digital figures, analysed by HSJ, show the number of ASIs was 52% higher in March 2022 than February 2020 — up from 245,582 to 374,209. The statistics suggests appointment slot issue accounted for 77% of all bookings in March 2022, 26% of all referrals and 19% of bookings and referrals combined. In February 2020, this was 32%, 17% and 11% respectively. The Royal College of GPs told HSJ there was a risk of patients “simply disappearing” off lists if the issue was not properly managed, while charity Patient Safety Learning said the issue was a “growing problem” which NHS England must “urgently investigate”. Patient Safety Learning chief executive Helen Hughes said: “NHS England needs to urgently investigate, quantify the scale of the problem and take action if we are to prevent these capacity problems resulting in avoidable harm for patients. “Patients who cannot access outpatient services may deteriorate further while they wait for care, and it is not clear that in these cases there is the appropriate support available for them. There is also the potential for patients to be misdiagnosed and receive inappropriate treatment without specialist involvement, and the potential of a postcode lottery of care emerging for some conditions.” Read full story (paywalled) Source: HSJ, 6 May 2022 Read Patient Safety Learning's blog: Rejected outpatient referrals are putting patients at risk and increasing workload pressure on GPs
  7. News Article
    A 94-year-old man has said his GP refuses to see him “unless it’s life or death”. Dennis Baker, from North Hampshire, said he felt “put off” by his doctor's surgery, which is a three-minute walk from his house. The pensioner, who lives with his wife who has advanced dementia and is bed-bound, said he found it “quite difficult to carry on a conversation with a doctor” and cannot get one to visit him at home. “The chances are [the receptionist] will say… ‘you're not dying, a doctor will phone you at some stage today’, that’s the usual response,” he told BBC Radio 4’s World at One. It comes as the president of the Royal College of GPs (RCGP) said family doctors should start “saying no” to extra work to tackle the crisis in primary care. Speaking at Pulse Live last week, Professor Dame Clare Gerada said the workload crisis was not the fault of GPs and they “cannot innovate [their] way out”. “When you’re in debates and people are saying to you 'you’ve got to work harder and smarter' - no, the rest of the system has to adapt,” she told the conference. “You have to start saying no.” Read full story (paywalled) Source: The Telegraph, 3 May 2022
  8. News Article
    Thousands of lives are being put at risk due to delays and disruption in diabetes care, according to a damning report that warns patients have been “pushed to the back of the queue” during the Covid-19 pandemic. There are 4.9 million people living with diabetes in the UK, and almost half had difficulties managing their condition last year, according to a survey of 10,000 patients by the charity Diabetes UK. More than 60% of them attributed this partly to a lack of access to healthcare, which can prevent serious illness and early mortality from the cardiovascular complications of diabetes, rising to 71% in the most deprived areas of the country. One in three had no contact with healthcare professionals about their diabetes in 2021, while one in six have still not had contact since before the pandemic, the report by the charity said. Diabetes UK said that while ministers have focused on tackling the elective surgery backlog, diabetes patients have lost out as a result, and there is now an urgent need to get services back on track before lives are “needlessly lost”. Chris Askew, the chief executive of Diabetes UK, called for a national diabetes recovery plan. “Diabetes is serious and living with it can be relentless,” he said. “If people with diabetes cannot receive the care they need, they can risk devastating, life-altering complications and, sadly, early death. “We know the NHS has worked tirelessly to keep us safe throughout the pandemic, but the impacts on care for people living with diabetes have been vast. While the UK government has been focused on cutting waiting lists for operations and other planned care, people with diabetes have been pushed to the back of the queue.” Read full story Source: The Guardian, 20 April 2022
  9. News Article
    A phone first system adopted by most GP surgeries at the start of the pandemic is "here to stay", the Royal College of GPs (RCGPs) in Northern Ireland has said. However, the RCGP has also accepted patient access needs to improve. The system was introduced in spring 2020. According to GPs, the move, which came without either consultation or prior information, was necessary to minimise the risk of infection of Covid-19. Two years on, there is concern among some members of the public that the system is not working. Speaking to BBC News NI, Dr Ursula Mason accepted that the system wasn't working but said there were not enough GPs to see people. She added that the telephone system, which was being "refined" and "improved" was the best way to manage "growing demand" and to "prioritise the sickest patients to be seen first". "The telephone system allows us to see many more patients, to deal with demand in a better way so I think the telephone system is here to stay," added Dr Mason. "There will be some changes to upgrade it, but it will form a significant part of how we manage demand."
  10. News Article
    Just 1 in 10 patients preferred face-to-face GP appointments during the Covid pandemic, with most requesting telephone consultations instead, according to research carried out on behalf of NHS England. The Improvement Analytics Unit (IAU) – a partnership between NHS England and think-tank the Health Foundation – looked at data from 146 England GP practices using the askmyGP online consultation system between March 2019 and September 2021, examining over 7.5 million patient-initiated consultation requests. During the pandemic, GPs suffered a backlash from the media, Government and NHS England over accusations that general practice was closed and GPs were not seeing patients face-to-face. GP leaders suggested that NHS England needed to take the research into account and allow practices to decide their own way of working. The research found that: Before the pandemic, 30% of patients requests specified a face-to-face consultation, dropping to less than 4% at the beginning of the pandemic. But by the end of the study period in September 2021, only 10% of patients requests were for face-to-face GP appointments. Telephone consultations were the most popular option, making up over half (55%) of patient requests in 2020/21. However, less than 1% of patients preferred a video consultation, according to the data. IAU head at the Health Foundation Arne Wolters said: ‘Our analysis shows that patients often choose remote over face-to-face consultations and that GP practices can mitigate the risk of digital exclusion via a blended approach.’ He said that ‘traditional routes to accessing and delivering care’ had been ‘offered alongside an online option and, in planning care, practices were able to take account of factors such as patients’ age, frequency of use, clinical needs and preferences’, at the studied practices." And he added: ‘With patient demand at an all-time high due to the care backlog Read full story Source: Pulse, 18 March 2022
  11. News Article
    The two-week wait cancer target should be scrapped and replaced with a different measure, as part of an overhaul of cancer standards, NHS England has said. After piloting a new measure which aims to see 75% of patients given the all-clear or a diagnosis within 28 days of referral, NHS England has recommended .The new “faster diagnosis target” would replace the current ‘two-week wait’ target, which is for 93% to have seen a specialist within two weeks, but not necessarily had a diagnosis. This proposal, and other changes to the way cancer waiting time targets are organised, will be consulted on until 6 April. The nine current cancer targets were created in 2000. The current headline measure along with the two-week wait — a two-month wait from urgent GP referral to first treatment — has not been hit since December 2015. The document containing the proposals said the current two-week standard saw some patients given an appointment at which no test was taken, purely to hit the target. For some suspected cancers, “many trusts… offer outpatient appointments to ensure they hit the target”, without improving diagnosis. The move to scrap the two-week wait was welcomed – with significant caveats — by Cancer Research UK Cancer Research UK chief executive Michelle Mitchell said: “The new Faster Diagnosis Standard is a more meaningful target than the current two-week wait that will hopefully improve early diagnosis. If all trusts met the 75 per cent target, it would be an improvement to where we are now. However, in the long-term to improve cancer survival, we’d like to see a 95 per cent target originally proposed in the 2015 cancer strategy in Sajid Javid’s upcoming 10-year plan for cancer. “We recognise the target was set lower because of a shortage of cancer specialists, critical to diagnosing cancer across the NHS. The government must provide the extra investment they have promised to grow the NHS workforce. Every moment of delay risks more people waiting for diagnosis and treatment.” Read full story (paywalled) Source: HSJ, 10 March 2022
  12. News Article
    GP surgeries must open for routine appointments between 9am and 5pm on Saturdays and during weekday evenings, NHS bosses have said. From October, patients will be able to book weekend and evening slots with “the full multi-disciplinary team” in a local practice, including for services such as screening, vaccinations and health checks. The British Medical Association said it was “bitterly disappointed” by the changes, which had been imposed without its agreement. A letter tells GPs the appointments must be made available at least two weeks in advance. Same-day online booking should be possible “up until as close to the time slot as possible”. Any unused slots should be available for NHS111 to allocate to callers. Some may be remote appointments, but networks are told to “ensure a reasonable number” of appointments are face-to-face consultations. Rachel Power, chief executive of the Patients Association, said: “There’s a great deal in this letter that patients will welcome, given the struggles they have had since the start of the pandemic to see their GPs face-to-face or even get through to their surgeries.” Read full story (paywalled) Source: The Times, 2 March 2022
  13. News Article
    NHS England’s plan to make the 111 service a ‘primary route’ into emergency departments has fallen ‘far short of aspiration’, with only a small fraction of attendances being booked through it. NHSE began recording the numbers of ED appointments booked via 111 in August 2020, as it aimed to reduce unnecessary attendances and demand on emergency services, via the programme known as “111 First”. Planning guidance for 2021-22 told local systems to “promote the use of NHS 111 as a primary route into all urgent care services”. It added that at least 70% of patients referred to ED by 111 services should receive a booked time slot to attend. Pilots experimented with making it harder for people who had not called 111 to attend A&E, although proposals to direct those people away were rejected. Data published by NHSE shows the number of ED attendances that were booked through 111, but not those referred to ED without a booking. Jacob Lant, head of policy and research at Healthwatch England, said: “Sadly, it’s clear from these figures that implementation across the country is lagging behind where we would have hoped. “Obviously this has to be seen in the context of the massive pressures on A&E departments at the moment as a result of the pandemic, but there is also a need for the NHS to really step up efforts to tell people about this new way of accessing care.” Read full story (paywalled) Source: 25 February 2022
  14. News Article
    Face-to-face GP appointments have continued to fall, despite a rallying cry for doctors to restore normal services. The proportion of GP appointments held in person fell for the third month in a row to 60.3% in January, latest data show. Data published by NHS Digital on Thursday show about 25.6 million appointments were carried out in January. Of these, some 15.4 million were face-to-face. The last time it fell below this level was August 2021, when just 57.6% of appointments were face-to-face. Pre-pandemic, the proportion of GP appointments held in person was about 80%. Dr Nikki Kanani, NHS England’s medical director of primary care, told doctors last month to “restore routine service” following the successful rollout of the booster jab campaign. Writing to GPs, she said: “It is now important that all services across the NHS, including in primary care, are able to restore routine services where these were paused in line with the Prime Minister’s request to focus all available resource on the omicron national mission.” But patient groups say the “situation hasn’t improved” and patients are still struggling to see their doctor in person. Dennis Reed, from patient group Silver Voices, said the figures were “worrying” but not surprising. “I'm still getting complaints on a daily basis that people are struggling to see their GP,” he said. Read full story Source: The Telegraph, 24 February 2022
  15. News Article
    Thousands of men are being urged to check their risk of prostate cancer amid warnings that more than 14,000 have missed a diagnosis during the pandemic. New figures show that the disease accounts for a third of those not treated for cancer during the pandemic, making it the cancer most likely to have been missed and putting lives at risk. Experts said many men had held off visiting their GP which meant they could now be missing out on vital treatment. NHS figures suggest nearly 50,000 fewer cancer diagnoses across the UK in the Covid crisis, including 34,000 in England. Experts said prostate cancer made up the largest group of missed cases, followed by breast cancer, of which around 8,000 cases have gone undiagnosed. Prostate Cancer UK and NHS officials are urging men to use an online tool to assess their risk, with those found to be at high risk urged to then visit their GP. Read full story (paywalled) Source: The Telegraph, 17 February 2022
  16. News Article
    The cost of living squeeze is a significant factor in some stillbirths, according to case reviews carried out in one of England’s most deprived areas. The review was undertaken in Bradford last year, and concluded: ”the current financial crisis is impacting on the ability of some women to attend essential antenatal appointments”. Missing these appointments was a factor in a range of maternity safety events, including stillbirths, it said. The researchers are now calling for new national funding to help ensure expectant parents do not miss important appointments because they cannot afford to attend. The research findings include: ‘Did not attend’ rates increased due to lack of funds for transport to antenatal appointments; “Lack of credit on phones prevented communication between women and maternity services, for example, making [them] unable to rearrange scans or appointments”; Wide spread incidence of “digital poverty, [for example] a lady with type 1 [diabetes] was unable to monitor her glycaemic control over night due to only having one phone charger in the house”; and “Families with babies on a neonatal unit going without food in order to finance transport to and from the unit.” Read full story (paywalled) Source: HSJ, 25 August 2023
  17. News Article
    A trust has had to re-examine the cases of more than 31,000 patients after they were automatically and wrongly discharged from its care because they did not have another appointment within the next six months. Dartford and Gravesham Trust in Kent has revealed that soaring waiting times post-covid meant patients who needed follow-up appointments were not offered them within six months, which before covid was a very unusual occurrence. When they passed six months, they were dropped off waiting lists altogether, due to a feature in the trust’s patient administration system designed to ensure outdated pathways are closed. It is a common feature in many such systems, HSJ was told. The trust has now “validated” more than 31,000 patients who have been in contact with it since 1 September 2021. So far, it said, it had not found evidence of harm, although some people have been recalled for clinical review or investigation, and a small number are still to be seen. Read full story (paywalled) Source: HSJ, 22 August 2023
  18. News Article
    Patients at all general practices across England will soon benefit from new digital phone lines designed to make booking GP appointments easier. Backed by a £240 million investment, more than 1,000 practices have signed up to make the switch from analogue systems - which can leave patients on hold and struggling to book an appointment - to modern, easy-to-use digital telephones designed to make sure people can receive the care they need when they need it. It is expected every practice in the country will have the new system in place by the end of this financial year, helping put an end to the 8am rush - a key pillar of the Prime Minister’s primary care recovery plan to improve patient access to care. Patients will be able to contact their general practice more easily and quickly - and find out exactly how their request will be handled on the day they call, rather than being told to call back later, as the government and NHS England deliver on the promises made in the primary care recovery plan announced in May. If their need is urgent, they will be assessed and given appointments on the same day. If it is not urgent, appointments should be offered within 2 weeks, or patients will be referred to NHS 111 or a local pharmacy. The upgraded system will bring an end to the engaged tone, see care navigators direct calls to the right professional, and the use of online systems will provide more options and help those who prefer to call to get through. Read press release Source: Department of Health and Social Care, 18 August 2023
  19. News Article
    Patients in all but one integrated care system found it more difficult to contact their GP practice by phone this year compared to last year. GP patient survey data, published this month, showed the proportion of patients who found it “very” or “fairly easy” to get through by phone had fallen across almost every ICS by as much as seven percentage points. The measure fell nationally from 53 to 50%. The drop in performance comes as NHS England and the government ramp up focus on ease and speed of access to GPs as part of the primary care recovery plan, published in May. An NHSE spokesperson said: ”Despite GP teams experiencing record demand for their services, with half a million more appointments delivered every week compared to before the pandemic, the GP survey found that the majority of patients have a good overall experience at their GP practice. “However, the NHS recognises more action is needed to improve access for patients, which is why it published a recovery plan in May.” Read full story (paywalled) Source: HSJ, 31 July 2023
  20. News Article
    NHS trusts across England are scrambling to trace thousands of children for urgent hearing tests amid fears that cases of infant deafness may have been missed for years. An internal NHS report has exposed poor-quality testing within paediatric audiology departments at five hospitals and warned of systemic failings. At another NHS trust, almost 1,500 children were found to have missed out on appointments dating back to 2012. Vital quality inspections of departments checking infants for hearing loss were stopped ten years ago. Whistleblowers who previously worked for the NHS’s newborn hearing screening programme have revealed that concerns were raised shortly before they were told to stop carrying out checks. They say that thousands of children may have been mistreated for deafness and hearing loss in the past decade. Read full story (paywalled) Source: The Times, 25 June 2023
  21. News Article
    GPs have warned of a ‘tsunami of demand’ this winter as patient contacts surged 200% during the pandemic. One of the largest GP providers in the UK, Modality Partnership, told The Independent it received 4.8 million calls from patients in one year alone with around a quarter going unanswered every day. The provider, which covers 500,000 patients across the country, said its practices were now working above “safe levels” with 50 appointments a day per GP, far higher than the 35 advised by the British Medical Association. Speaking with The Independent, Vincent Sai, chief executive and partner at Modality said the new health secretary Therese Coffey must “not point fingers” and “not find a scapegoat” as “every part of the system is under pressure. Every player in the health system is under the cosh.” Dr Sai said: “We believe patient contacts have increased 200 per cent, over the last few years. The expectation is that GP practices have maybe four to five patient contacts per year, but if you just look at just the number of phone calls alone, it’s showing that it’s much more now. “So something is broken somewhere...there’s more work, there are fewer people. People say I can’t get access to my GP and the hypothesis is they’re just lazy and not working, but it’s not the case.” Read full story Source: The Independent, 7 September 2022
  22. News Article
    Patients will be able to use the NHS app to shop around for hospitals with the shortest waiting lists in a renewed drive to cut backlogs for routine care. Health bosses agreed yesterday to give patients more choice over where they are treated by next April in an effort to use digital league tables to direct people towards hospitals with the shortest waits. Steve Barclay, the health secretary, wants to give patients “real-time data” on their phones to decide whether to travel further to get quicker treatment for hip replacements, cataract removals and other non-urgent procedures. A government source said: “We don’t need a big bureaucracy to funnel patients towards the hospital which NHS managers decide is best, when, armed with a right to choose and the right information on the app, patients will go where waiting times are lowest.” Read full story (paywalled) Source: The Times (31 August 2022)
  23. News Article
    Nearly 38,000 vital follow-up appointments with mental health patients were missed at the time when they were most at risk of suicide, the Royal College of Psychiatrists has said. The medical body has called for “urgent action” to ensure more people are seen for follow-ups within 72 hours of their discharge from inpatient care, to prevent them from falling “through the cracks when they are so vulnerable”. The risk of suicide is highest on the second and third days after leaving a mental health ward, but 37,999 follow-up appointments with patients were not made within this timeframe in England between April 2020 and May 2022. According to NHS data, of the 160,430 instances when patients were eligible for follow-up care within 72 hours after discharge from acute adult mental health care, only three-quarters (76%) took place within that period. The Royal College of Psychiatrists is calling for more trained specialists to check on those perceived to be at risk, which they say requires more staffing and funding. The president of the Royal College of Psychiatrists, Dr Adrian James, said: “We simply can’t afford to let people fall through the cracks at a time when they are so vulnerable. It’s vital that our mental health services are properly staffed and funded to offer proper follow-up care and help prevent suicides. “Staff are working as hard as they can to provide high-quality care, but it’s clear that current resources are not enough to meet these targets. We need urgent action to tackle the workforce crisis and achieve the suicide prevention goals set out in the NHS long-term plan.” Read full story Source: The Guardian, 22 August 2022
  24. News Article
    Britain is in the grip of a new silent health crisis. For 14 of the past 15 weeks, England and Wales have averaged around 1,000 extra deaths each week, none of which are due to Covid. If the current trajectory continues, the number of non-Covid excess deaths will soon outstrip deaths from the virus this year. Experts believe decisions taken by the Government in the earliest stages of the pandemic – policies that kept people indoors, scared them away from hospitals and deprived them of treatment and primary care – are finally taking their toll. Prof Robert Dingwall, of Nottingham Trent University, a former government adviser during the pandemic, said: “The picture seems very consistent with what some of us were suggesting from the beginning. “We are beginning to see the deaths that result from delay and deferment of treatment for other conditions, like cancer and heart disease, and from those associated with poverty and deprivation. “These come through more slowly – if cancer is not treated promptly, patients don't die immediately but do die in greater numbers more quickly than would otherwise be the case.” Read full story (paywalled) Source: The Telegraph, 18 August 2022
  25. News Article
    Half of UK adults with a possible cancer symptom do not contact their GP within six months, despite spotting changes to their body, research suggests. A YouGov poll of 2,468 people for Cancer Research UK found that just 48% of those who had experienced a red flag symptom – including coughing up blood, unexplained weight loss and a new or unusual lump – contacted their GP within half a year. Not telling a doctor about unusual health changes or possible cancer symptoms reduces the chances of an early cancer diagnosis, leading to potentially devastating outcomes. Cancer Research UK’s chief executive Michelle Mitchell said: “Spotting cancer early is vital if more people are to survive, and the first step in that process is getting help for a possible cancer symptom. “It’s really worrying to see such a large gap in accessing services between the UK’s most and least deprived groups. “Earlier this year, the Government announced among its top priorities were improving early diagnosis of cancer and tackling health disparities. “Cancer must remain a top priority and with the upcoming Health Disparities White Paper and 10-Year Plan for England, the new Health and Social Care Secretary has a huge opportunity to transform cancer survival with a clear and strong plan that works for all.” Read full story Source: The Independent, 10 August 2022
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