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Found 203 results
  1. News Article
    Patients at trusts with long waiting lists should no longer think ‘they have to go to their local hospital’ for outpatient appointments, but should instead be offered virtual consultations elsewhere in the country where there is greater capacity, Sir Jim Mackey has told HSJ. The NHS England elective chief said recent efforts to abolish two-year waiters by July had meant a “very big” surgical focus. However, the next phase of the elective recovery plan would see a major shift of emphasis onto reducing the wait for outpatient appointments. Sir Jim said: “Providers have been split into tiers again with tier one having national oversight and tier two, regional oversight. Behind that we will be pairing up organisations so that organisations with capacity can help those with the biggest challenges from a virtual outpatient perspective. He added: “There still is a lot to work through [on virtual outpatients], we’re going to be testing the concept… We need to work through how all the wiring and plumbing needs to work. For example, what happens if the patient needs a diagnostic locally, having seen a clinician virtually in another part of the country? “It would be great also to try and stimulate more of a consumer drive on this – encouraging patients to ask about virtual outpatients when the waits locally may be too long, so they don’t just think they have to go to their local hospital. I think this could really help shift the model if we can get it right.” Read full story (paywalled) Source: HSJ, 9 August 2022
  2. News Article
    NHS patients will wait longer for routine checks as part of a national drive to clear record backlogs. Health officials have instructed hospitals to “repurpose” resources to focus on those waiting the longest, who are yet to have their first appointment. Today the NHS claimed it had “virtually eliminated” two year waits, with less than 3,000 people enduring such delays, down from 22,500 at the end of January. Hospitals are being urged to prioritise those waiting 18 months or more, with pledges to get rid of such waits by April next year. NHS chiefs have instructed hospitals to focus on outpatient first appointments, rather than patients who have already had treatment, and are waiting for follow-up checks. Senior officials have said many such appointments are a “a waste of time” saying there should be more use of systems where routine slots are scrapped, and patients instead told to contact their medical team if they have particular concerns. The drive - which health chiefs dubbed “Super September” - will see priority given to tackling the longest waits. Read full story (paywalled) Source: The Telegraph, 9 August 2022
  3. News Article
    The number of patients unable to get a hospital appointment after being referred by their GP is up more than 50% in two years amid the record NHS backlog, official data show. NHS Digital figures show no appointments were immediately available for 2.3 million referrals made in the first six months of this year – up 51% on the same period in 2020. Appointment slot issues occur when a patient is referred by their GP through the NHS e-Referral Service but no appointment is available to book. The referral is then forwarded or deferred to a patient’s chosen provider, but if an appointment is not made within 180 days it will automatically be removed from the system, according to NHS Digital. Patient safety campaigners have said the scale of the problem must be “urgently investigated” by NHS England to ensure the safety of patients is not being compromised while they wait for appointments. Helen Hughes, the chief executive of the Patient Safety Learning charity, said: “We have significant concerns about the safety of patients who are facing increasingly long waits for treatment, particularly those on high priority cancer pathways and urgent referrals.” She said patients needed to be assured that they will “not be lost in a failing, complex system”, adding: “We believe that NHS England needs to urgently investigate, quantify the scale of the problem and take action if we are to prevent these capacity and system issues resulting in avoidable harm for patients.” Some GPs told Patient Safety Learning they had experienced difficulties getting referrals accepted. One GP, based in the North East, said: “There is an ever-creeping transfer of management of complex conditions from secondary to primary care, without adequate training or resources to manage this safely.” Read full story (paywalled) Source: The Telegraph, 7 August 2022 You may also be interested in Patient Safety Learning's blog: Rejected outpatient referrals are putting patients at risk and increasing workload pressure on GPs
  4. News Article
    A 27-year-old man died from complications linked to diabetes after GPs failed to properly investigate his rapidly deteriorating health. Lugano Mwakosya died on 3 October 2020 from diabetic ketoacidosis, a build-up of toxic acids in the blood arising from low insulin levels, two days before he could see a GP in person. His mother, Petronella Mwasandube, believes his death could have been avoided if doctors at Strensham Road Surgery, in Birmingham, had given “adequate consideration” to Lugano’s diabetic history and offered face-to-face appointments following phone consultations on 31 July and 16 and 30 September. An independent review commissioned by NHS England found two doctors who spoke to Lugano did not take into account his diabetes or “enquire in detail and substantiate the actual cause of the patient’s symptoms”. The review raised concern over the “quality and brevity” of the phone assessments and said the surgery should have offered Lugano an in-person appointment sooner. Read full story Source: The Independent, 7 August 2022
  5. News Article
    The decades-old routine of visiting an NHS dentist for a six-month checkup is being scrapped across England and Wales for most adults as part of changes designed to address the dire lack of access to dental care for many people. Wales has announced that most adults now only need to see their dentist once a year, which the government in Cardiff says will free up NHS dentists’ time and allow them to take on more than 100,000 extra patients annually. The Labour-controlled Welsh government also hinted it wanted to recruit disillusioned dentists from England by offering chances to develop skills such as carrying out more complex surgery within their practices. Its announcement came after the UK government wrote to NHS dentists last week saying that under the first changes to the dental contract in 16 years, healthy people will only need a checkup every two years. It said this complied with guidance from the National Institute for Health and Care Excellence (Nice), which says dental teams should see patients for a checkup based on their health risk, which can be once every two years instead of every six months. Both governments claimed the moves would allow more people to find NHS care but dentists’ representatives in England and Wales described the changes as “tinkering” and “marginal tweaks”. Read full story Source: The Guardian, 27 July 2022
  6. News Article
    NHS England will ask GP practices to make ‘reasonable adjustments’ for patients with a learning disability or autism such as giving them ‘priority appointments’. They could also be asked to provide ‘easy-read appointment letters’ to the group, the Department of Health and Social Care (DHSC) said yesterday in a new strategy on strengthening support for autistic people and those with a learning disability. It said the measures aim to support Government plans to reduce reliance on mental health inpatient care, with a target to reduce the number of those with a learning disability or autism in specialist inpatient care by 50% by March 2024 compared with March 2015. The policy paper said: ‘We know that people experience challenges accessing reasonably adjusted support which may prevent them from having their needs met.’ It added: ‘To make it easier for people with a learning disability and autistic people to use health services, there is work underway in NHS England to make sure that staff in health settings know if they need to make reasonable adjustments for people." NHS England is also developing a ‘reasonable adjustments digital flag’ that will signal that a patient may need reasonable adjustments on their health record, it said. It plans to make this flag, which is currently being tested, available across all NHS services, it added. Read full story Source: Pulse 15 July 2022
  7. News Article
    Patients are increasingly avoiding seeing their GP because they find it too difficult to book an appointment, the latest data show. Results from the 2022 GP Patient Survey also show that satisfaction with family doctors in England has dwindled since the previous year. The findings come as the Government and the NHS struggle to retain GPs and boost recruitment to meet rising patient demand and an ageing population. The survey found that overall satisfaction ratings have declined over the past 2 years, although most patients who responded to a questionnaire reported a good overall experience with their GP practice, had confidence and trust in the healthcare professional who saw them, and considered they received good care and treatment. The results also revealed an increase in the barriers patients faced in getting an appointment in the first place, with 55.4% who needed one in the last 12 months saying they had avoided making one – an increase of 13.1% since the last survey. The most common reason given was that they found it too difficult, cited by 26.5% of respondents, and a huge increase on last year's figure of 11.1%. Commenting on the results, Beccy Baird, senior fellow at The King's Fund said: "For many of us, general practice is the front door to the NHS – these results show that patients are finding that door increasingly hard to push open. "GPs are working harder than ever before, yet these findings show a dramatic fall in patients' experience of getting an appointment." She said recruitment of GPs, nurses, and other professionals to meet rising levels of need was proving tough "because in many cases those staff simply don’t exist". Read full story Source: Medscape, 14 July 2022
  8. News Article
    Emma Hardy MP has secured a Westminster debate on gynaecological wait times. Gynaecology waiting lists across the UK have now reached a combined figure of more than 610,000 – a 69% increase on pre-pandemic levels. New analysis by the Royal College of Obstetricians and Gynaecologists (RCOG) shows that in England, gynaecology waiting lists have grown the most by percentage increase of all elective specialties. Emma is co-chair of the All Party Parliamentary Groups (APPGs) for Surgical Mesh and Endometriosis - both come under the heading of ‘gynaecological conditions’ and both are being impacted by increased waiting times. Through her involvement with these APPGs, Emma has heard the testimony of so many women whose lives have been impacted by conditions that can be so painful and debilitating that they impact on every aspect of family, social and work life. Emma will ask the minister to launch an investigation into possible gender bias in the prioritisation of gynaecology services and ensure that elective recovery will address the unequal growth of gynaecology waiting lists compared to other specialties. Emma said: "It is completely unacceptable that 610,000 women are waiting for gynaecological care across the UK. The reality is that many of these women will be in excruciating pain awaiting treatment, unable to go about their day-to-day lives." Read full story Source: Hull Daily Mail, 5 July 2022
  9. News Article
    More than 10,000 people are waiting three months or longer following an urgent referral for suspected cancer, internal NHS data seen by HSJ reveals. Patients with suspected cancer are not supposed to wait more than two months from a referral. However, information shared with HSJ shows that of the 313,000 people on the national cancer waiting list, just over 10,000 had waited 104 days or more. Information about three-month cancer waits is not made public on a regular basis. NHS England publishes data for the total backlog of patients waiting over 62 days, but does not make public the regional or trust-level results, or reveal how many patients are waiting three months or more. One senior figure in cancer policy told HSJ the backlog position was “awful” and “a reflection of a worsening trajectory overwhelming diagnostic capacity in particular”. Breast, skin and lower gastro-intestinal cancers saw the biggest increases in long waiters. Read full story (paywalled) Source: HSJ, 5 July 2022
  10. News Article
    Rapidly falling continuity of care levels pose an “existential threat” to patient safety, Britain’s top family doctor will warn today as research reveals only half of Britons regularly see the same GP. Prof Martin Marshall, chair of the Royal College of GPs (RCGP), will say trusted relationships between family doctors and patients are the most “powerful intervention” for delivering effective, high-quality care as they boost patient satisfaction and health outcomes, and reduce use of hospital services. But in a keynote speech to the college’s annual conference, Marshall will warn that continuity of care is becoming almost impossible to deliver on the NHS amid soaring demand and shrinking numbers of GPs, in what he will describe as the “most worrying crisis in decades”. There are mounting concerns over the ability of the NHS to tackle record waiting lists, with 6.5m patients awaiting care in England alone. Earlier this month Sajid Javid, the health secretary, admitted the current model of GP care “is not working” but insisted there would be no more money for the health service. At the RCGP conference in London, Marshall will tell delegates that because of rising workloads and fewer staff, GPs no longer have the time to properly assess patients, with 65% warning safety is being compromised due to appointments being too short, according to a recent survey commissioned by the college. Only 39% of respondents said they were able to deliver the continuity of care their patients need – down from 60% two years ago. Read full story Source: The Guardian, 29 June 2022
  11. News Article
    England's first women's health ambassador is calling for "one-stop shops" where women can sort out their health needs. Dame Lesley Regan, also a practising doctor, wants to make it easier for women and girls to access care such as contraception and smear tests in the community. Her new role aims to close the "gender health gap". She will also support the upcoming government-led women's-health strategy. "At the moment, we waste a lot of resource in telling girls and women that they cannot have things," she told BBC News. "So you might go off to your doctor or gynaecologist or heart specialist and get told, well, you cannot have a smear here, even if it is due, or you need to go somewhere else for this, that and the other. "We should make it very, very easy for people to access this out in the community - why do you need to go to a secondary or tertiary facility for things that are very easy to provide?" Instead, she wants health hubs where women could "go for half a day and get all these things sorted out" and then get on with their lives. "A one-stop shop is what I want for myself and what I want for my daughters and I'm sure it is what every other girl and woman wants and what every man and boy wants for the women in their lives, to be looked after that way," Dame Lesley said. Read full story Source: BBC News, 17 June 2022
  12. News Article
    Diabetes patients have been warned that non-attendance at eye-test appointments puts them at greater risk of developing unnecessary sight loss. The Royal National Institute for the Blind (RNIB) has described the attendance rates at clinics in Northern Ireland as "alarmingly low" . It said 20% to 40% of patients were not showing up for their appointments on any given day. Prof Tunde Peto, clinical lead for the NI Diabetic Eye Screening Programme, said the most common of many complications caused by diabetes was diabetic eye disease. Diabetes can cause cataracts early on but it can also affect the retina at the back of the eye, "which will eventually lead to sight loss if not treated on time," Prof Peto explained. "Diabetic retinopathy causes no symptoms until it can be just about too late to treat," she said. Ian Catlin from Ballymoney has experienced sight loss due to diabetic retinopathy. He has had Type 1 diabetes since childhood and became aware of problems with his eyesight in his mid-30s. Mr Catlin said he put off asking for medical help because of the fear of what he would be told."I did eventually go, but you're scared and you put your head in the sand," he said.Read full story Source: BBC News, 15 June 2022
  13. News Article
    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
  14. News Article
    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
  15. News Article
    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
  16. News Article
    "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
  17. News Article
    Patients who fail to turn up for surgical day case procedures are costing the health service thousands of pounds. It is a problem across Northern Ireland's five health trusts. Over a 10-month period in the South Eastern area 14,000 patients did not attend or cancelled review appointments on the day they were due to turn up. Assistant Director of Elective Surgery at the South Eastern Trust Christine Allam said it was "frustrating". The South Eastern trust review showed between April 2022 and January 2023, 7,755 people did not attend or cancelled new outpatient appointments on the day. During the same period, 14,003 or 10% of patients didn't show for review appointments. Ms Allam said the situation was "frustrating for those patients who are waiting to be seen". "Those slots where people don't turn up are lost capacity because we haven't been given notice - and this only lengthens the waiting lists," she added. It is a problem that all health trusts are experiencing. Read full story Source: BBC News, 24 May 2023
  18. News Article
    ICBs should ensure there are ‘formal escalation routes’ in place for GPs after 25 daily clinical contacts, the BMA has said in new guidance. From next week (15 May), GP practices are contractually required to offer an ‘appropriate response’ to patients the first time they get in contact, by offering them an appointment or redirection, rather than asking them to call back at a different time. While GP leaders warned this would lead to increased pressure on NHS 111 and A&E, NHS England attempted to clarify in this week’s recovery plan that GPs should only redirect patients in ‘exceptional circumstances’. It also said practices should inform their ICB on each such occasion. However, conflicting BMA guidance has now been published, warning that practices attempting to adhere to the new requirement ‘may do so at the expense of clinician wellbeing and patient safety’. It reiterates the GP Committee for England’s safe working guidance recommending that clinicians have no more than 25 clinical contacts per day because anything beyond this "can lead to decision fatigue, clinical errors and patient harm, and clinician burn out". Read full story Source: Pulse, 11 May 2023
  19. News Article
    Delayed health checks among people with diabetes may have contributed to 7,000 more deaths than usual in England last year, a charity report suggests. The routine checks help cut the risk of serious complications like amputations and heart attacks. Diabetes UK says too many people are still being "left to go it alone" when managing their challenging condition. There are more than five million people in the UK living with diabetes, but around 1.9 million missed out on routine vital checks in 2021-22, Diabetes UK says. Disruption to care during the pandemic is likely to be a factor in the current backlog, which may be leading to higher numbers of deaths than usual in people with diabetes, it says. Between January and March 2023, for example, there were 1,461 excess deaths involving diabetes - three times higher than during the same period last year. "Urgent action is needed to reverse this trend and support everyone living with diabetes to live well with the condition," the report says. Read full story Source: BBC News, 10 May 2023
  20. News Article
    Thousands of NHS-funded talking therapy sessions are still being carried out by unaccredited practitioners every month, despite NHS England trying to stop the practice for at least five years. NHS Digital data for January this year showed 44,170 sessions involved practitioners who were neither in training nor had done an accredited course. The actual figure could be higher as, of the 517,027 sessions in total carried out, data about who was involved was missing for more than half (328,433). Since last June, practitioners delivering NHS-funded “low intensity” talking therapies – previously known as Improving Access to Psychological Therapies – are required to be part of either the British Psychological Society or the British Association for Cognitive and Behavioural Psychotherapies’ registers. The registers, which were set up in 2021, confirm practitioners have completed an accredited course, ensure continuous professional development and provide a framework for striking off. Meanwhile, NHSE’s IAPT manual – first published in 2018 – states all clinicians should have completed an accredited training programme and a “robust and urgent” plan should be in place to train those who have not, including the possibility of those without accreditation being prevented from working alone. Read full story (paywalled) Source: HSJ, 3 May 2023
  21. News Article
    A hospital trust has said its staff have been verbally abused when contacting some patients to postpone their appointments because of next week’s nursing strike. Oxford University Hospitals Foundation Trust posted a statement to its website yesterday, which said: “It is very regrettable that we have to report that our staff have been verbally abused when contacting some patients to postpone their appointments. We fully understand and appreciate how disappointing and frustrating any postponement is, and we only do this if we absolutely have to in order to provide safe care for all our patients. “Our staff are doing their best in challenging circumstances to make sure you are informed as soon as possible. We do not tolerate abuse of our staff and abuse will be noted and further action may be taken.” Read full story (paywalled) Source: HSJ, 27 April 2023
  22. News Article
    Patient safety investigators have issued a warning to the NHS over writing to patients only in English after a Romanian child died following missed cancer scans. The three-year-old, of Romanian ethnicity, had an MRI scan delayed after they were found to have eaten food beforehand. When the appointment for the child’s MRI scan was made by the radiology booking team, a standard letter was produced by the NHS booking system in English asking the child not to eat before the scan, despite the family’s first language being Romanian. Staff at the trust had hand-written on the patient’s MRI request sheet that an interpreter was required. “The family recognised key details in the written information, including the time, date and location of the scan,” the report said. “However, they were not able to understand the instructions about the child not eating or drinking (fasting) for a certain amount of time before the scan.” The Healthcare Safety Investigation Branch (HSIB) has urged NHS England to develop and implement new rules on supplying written appointment information in languages other than English. Read full story Source: The Independent, 27 April 2023
  23. News Article
    “Nobody cares about me. Nobody wants to help me. I don’t want to be here anymore.” Difficult words to hear from a small child, but for Molly Tippetts, aged five with a nasty tooth infection, the outburst was the culmination of two years of pain – all because she couldn’t get an appointment to see a dentist. Molly is just one example of the UK’s dental-health crisis. An increasing number of people cannot access dental care at all; others – including children and expectant mothers – find themselves on years-long waiting lists. Even though the pandemic is over, NHS practitioners admit the country is in a crisis that shows no sign of ending. New research shows one in four people suffering from toothache put off going to the dentist because of the cost. Dentistry is now the number one issue raised with Healthwatch, the independent statutory body representing NHS patients, with four in five people who contacted them saying they found it difficult to access dental care. The Royal College of Paediatrics and Child Health recently warned that even toothbrushes were a “luxury item” for some families, and that children’s dental health was a “national disgrace”. Read full story (paywalled) Source: The Telegraph, 25 April 2023
  24. News Article
    Nearly five million patients each month in England wait more than a fortnight for a GP appointment, NHS figures show, which Labour is calling "unacceptable". The government says it expects all patients needing a GP appointment to be seen within two weeks. The Royal College of GPs says 85% of appointments happen within two weeks and nearly half on the same day. Those taking longer than two weeks may be routine ones for which the wait is therefore appropriate, it says. Prof Kamila Hawthorne, who chairs the Royal College of GPs, said: "GPs and our teams are working tirelessly to deliver safe, timely and appropriate care and to give patients the choice of appointment they want. "We share our patients' frustration when they struggle to access our care. However, this is not down to GPs and their hard-working teams, but due to decades of underfunding and poor resource planning." Read full story Source: BBC News, 21 April 2023
  25. News Article
    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
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