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Found 203 results
  1. News Article
    Take-up and usage of the NHS App in England has begun to plateau, after covid drove huge growth, figures seen by HSJ suggest. This can be seen in the percentage of GP appointments booked or cancelled using the app; the number of records viewed; and the number of times it has been downloaded. Rapid uptake was driven during covid restrictions, when travel and other activities often required a covid vaccination pass. Government has said it wants the growth to continue. The number of GP appointments booked or cancelled using the app fell for a third consecutive month in March to 212,954, representing a decrease of 15% since January and 28% on October 2022, when usage peaked. The NHS app is central to government’s plan for digital health and care, published last year, billed as the “digital front door” to the NHS which would aid the recovery of services post-pandemic. Read full story (paywalled) Source: HSJ, 19 April 2023
  2. News Article
    Almost 200,000 hospital appointments and procedures in England were cancelled during last week’s junior doctors’ strikes, it has been revealed. There were 20,000 more appointments cancelled in the strikes that ran between 11 and 15 April than in the shorter strike in March, NHS England figures show. A total of 27,361 staff were not at work during the peak of the strikes, though the true figure could be higher as some workforce data was incomplete. The NHS’s national medical director, Prof Sir Stephen Powis, said the figures showed the “colossal impact of industrial action on planned care in the NHS”, with nearly half a million appointments rescheduled over the last five months. He said every postponed appointment had “an impact on the lives of individuals and their families and creates further pressure on services and on a tired workforce – and this is likely to be an underestimate of the impact as some areas provisionally avoided scheduling appointments for these strike days”. Read full story Source: The Guardian, 17 April 2023
  3. News Article
    More than two million patients each year have to make four or more repeat visits to their GP before they get a referral, a patient watchdog has warned. Patient safety campaigners said people faced waits of “weeks, months or even years” before officially joining NHS waiting lists, and that their health and wellbeing was suffering as a result. They warned it would also add to pressure on other services such as A&E departments. Research by Healthwatch England revealed what the patient watchdog called a “hidden waiting list”. “People wait for a GP appointment; they wait for their GP to tell them they will be referred; they wait for the hospital to confirm that referral; and then they join a hospital waiting list,” it said. “NHS statistics monitor only the hospital waiting list, leaving the steps between getting a GP referral and a letter confirming a hospital appointment as a dangerous ‘blind spot’ for the NHS and patients.” Read full story (paywalled) Source: The Times, 11 April 2023
  4. News Article
    NHS England has launched a “very aggressive campaign” to ensure all acute trusts give patients the ability to make appointments and receive messages online. Details of the new “national requirement” which must be met by the end of 2023-24 were sent by NHS England to acute trust chief information officers on Friday. NHSE wants all trust portals to integrate with the NHS App to enable patients to manage outpatient appointments and respond to messages through a single channel. Under NHSE’s requirements, the portals must: Enable patients to view their outpatient appointments; Enable the trust to send a waiting list validation questionnaire to patients; Provide patients with a single point of access to contact the provider, for example to cancel appointments; and Enable patients to access their correspondence from the trust. Read full story (paywalled) Source: HSJ, 31 March 2023
  5. News Article
    It is ‘not right to normalise’ the current workload in general practice as numbers of GPs and practices goes down, the RCGP chair told delegates at Pulse Live this week. Professor Kamila Hawthorne highlighted the pressure GPs are under with general practice appointments increasing most last year, compared to A&E and outpatients. She also said her priority from a new GP contract would be better resourcing for GPs working in deprived areas. Her speech looked at the challenges facing general practice and imagined what the future could look like, including what the college can do to bring about change. Professor Hawthorne said: ‘The workload that we’re facing – it’s not right to normalise it. The sort of work days that we have in general practice, it is not right to normalise this. ‘The number of GPs is going down because they’re leaving the profession faster than they’re entering it. The number of practices in England is going down, and compared with affluent areas, GPs in deprived areas earn less but see more patients with more chronic illness.’ Read full story Source: Pulse, 21 March 2023
  6. News Article
    More than 175,000 patient appointments and surgeries were postponed this week during the three-day junior doctor walk-out, it has emerged. NHS leaders have warned the strikes were the most disruptive yet with more appointments cancelled across three days than across any of the previous nurse strikes. Data published by the NHS showed in total 181,049 patients had their care postponed, this included more than 5,000 mental health and hundreds of community health appointments. The news comes after nursing and ambulance unions accepted a pay offer from the government, for a 5.3 per cent increase in 2023-24, which their members will now vote on. Read full story Source: The Independent, 18 March 2023
  7. Content Article
    A Channel 5 News investigation has found nearly three quarters of people getting help for Long Covid weren't given a face-to-face appointment. It's estimated 2.1 million UK people have the condition. A Long Covid hauler herself, 5 News reporter Ruth Liptrot looks at where we're at with finding a treatment.
  8. Content Article
    This report published by the National Confidential Enquiry into Patient Outcome and Death (NCEPOD) assesses the quality of care provided to adult patients with a pre-existing epilepsy disorder, or who were subsequently diagnosed with epilepsy and presented to hospital following a seizure, between 1 January and 31 December 2020.
  9. Content Article
    Many people who usually go to their GP for ear wax removal have recently been told this service is no longer available on the NHS. As a result, they are now being advised to manage their own ear wax build-up or to seek ear wax removal from private providers. However, advice on self-management is inconsistent and sometimes dangerous, and the cost of private removal can make it unaffordable.  The Royal National Institute for Deaf People (RNID) wants to make sure everyone is offered clear advice on managing excess ear wax safely themselves and has access to professional removal on the NHS if self-management doesn’t work. This campaign page highlights research by RNID and outlines how people can get involved in the campaign by writing to their MP and local healthcare organisations.
  10. Content Article
    This US study in the journal Medical Care aimed to investigate the extent of physician practice adoption of patient engagement strategies nationally. The authors analysed data collected from the National Survey of Healthcare Organizations and Systems (NSHOS) on adoption of patient engagement strategies. They found that there was modest adoption of shared decision-making and motivational interviewing, and low adoption of shared medical appointments.
  11. Content Article
    This study in the journal Health and Social Care Delivery Research aimed to assess the scale, scope and impact of changing the type and number of different healthcare practitioners in general practice in England. The authors undertook an analysis of employment trends, looked at motivations behind employment decisions, examined staff and patient experiences, and assessed how skill mix changes are associated with outcome measures and costs. They found that: employing clinicians who are not GPs did not reduce GPs’ workload or improve their job satisfaction. patients appreciated the longer appointments they had with other clinicians. patients wanted better information about what other practitioners can do, and how to use new booking systems.
  12. Content Article
    This article by Rebecca Rosen and Trisha Greenhalgh in the BMJ looks at the safety of remote GP consultations. It begins by looking at the case of student David Nash, who tragically died in 2020 after four telephone consultations with his GP; he was denied an in-person appointment for a painful ear infection that led to a fatal brain abscess. One coroner has raised concerns that this is not a one-off incident, noting that in five inquest reports they wrote during the pandemic, they question whether deaths could have been prevented by in-person consultations. The authors look at the recommendations of the ongoing 'Remote by Default 2' study, which is exploring how best to embed remote consulting in future GP services. They highlight better triage of appointment requests, active listening, checking back, increasing the use of video consulting and better training for clinicians as factors that could improve the safety of remote consultation.
  13. Content Article
    In July 2022, HSIB launched a national investigation into the safety risk of clinical investigation booking systems failures. Specifically, the investigation explores the use of paper or hybrid booking systems and the production of appointment letters. This interim bulletin highlights a safety risk identified by the investigation and presents a safety observation for the attention of NHS care providers. Some vital NHS services still use paper-based or hybrid systems, which may have been developed over time and could leave unintended gaps where patients can be lost in the system. The reference case for this investigation is the experience of a patient whose magnetic resonance imaging (MRI) scan was not rescheduled following a cancellation, leading to a delay in the diagnosis of cancer. Hybrid systems were in use, which did not assist staff to keep track of patients. Additionally, the hybrid systems in use did not allow appointment letters in non-English languages to be produced.
  14. News Article
    NHS England “forgot the people” when it published controversial guidelines last month which said patients faced being removed from the waiting list if they declined two appointment dates, a senior director has admitted. NHSE elective recovery chief Sir Jim Mackey said the guidance was drafted to address legitimate concerns from trusts, but that the process had been “rushed”. Following Sir Jim’s comments, NHSE told HSJ the guidance, which had sparked widespead criticism including from patient groups, would not be changing. But Sir Jim said NHSE would “spend time” better understanding patients after “reflecting” on the process which had created the controversial guidelines. Speaking at the King’s Fund annual conference, Sir Jim said: “[The guidance] was largely a response to trusts saying to us: ‘We keep offering these patients options and they won’t take them, so what do we do?’ “We rushed through a policy to try and deal with that, and in the process, I think forgot the people…We’ve reflected on that.” Read full story (paywalled) Source: HSJ, 1 November 2022
  15. News Article
    Patients in England are being put at risk because of the unacceptably poor service they receive from GPs, MPs say. The House of Commons' Health Committee blamed the failure to tackle doctor shortages, which had led to a decline in the GP-patient relationship. Seeing a GP should not be like booking an Uber with a driver you are unlikely to see again, the MPs said. The warning comes just weeks after ministers launched a drive to improve access to GP services. But the cross-party group of MPs said more needed to be done. Louise Ansari, from the patient group Healthwatch England, said, "The impacts of poor access can be huge, with people feeling abandoned and suffering in silence and not getting referred to hospitals for more specialised treatment." Read full story Source: BBC News, 20 October 2022
  16. News Article
    NHS trusts may be forced to cancel appointments and limit visiting times in a Covid and flu “twindemic” this winter, health leaders have warned. Fears have been raised the viruses could strip back the workforce and further increase demand for services during an already busy period. It comes amid rising Covid infections in the UK. Around 1.3 million tested positive in late September, according to the latest figures, which was a 25% increase on the week before. The UK is also concerned there could be a bad flu season this year, with lower immunity across the population due to reduced exposure in the Covid pandemic. NHS leaders have warned that this background could make winter even more difficult for the health service. “I make no bones about this: we know it’s going to be a pressurised time for trusts over the next four months if not longer,” Saffron Cordery from NHS Providers, which represents trusts in England, told The Independent. The interim chief executive added: “We’re worried about Covid and we’re worried about flu.” Ms Cordery said these joint pressures – which could increase demand, strip back workforces and introduce the need for greater infection control measures – could have a knock-on effect on services. “We need to anticipate that there may well be cancellations for either outpatient appointments or routine procedures or operations, because there could be staff shortages or rising demand in emergency care – that means that those routine appointments cannot take place as quickly as we’d like,” she said. Read full story Source: The Independent, 8 October 2022
  17. News Article
    Patients with suspected skin and breast cancer have experienced the largest increase in waiting times of everyone urgently referred to a cancer specialist, with 1 in 20 patients now facing the longest waits, analysis of NHS England data shows. Almost 10,000 patients referred by a GP to a cancer specialist had to wait for more than 28 days in July – double the supposed maximum 14-day waiting time. Three-quarters of them were suspected of having skin, breast or lower gastrointestinal cancer, a Guardian analysis has revealed. In total, 53,000 people in England waited more than two weeks to see a cancer specialist. That is 22% of all the patients urgently referred for a cancer appointment by their GPs. Minesh Patel, head of policy at Macmillan Cancer Support, said people were waiting “far too long for diagnosis or vital treatment”. Patients “are worried about the impact of these delays on their prognosis and quality of care”. “The NHS has never worked harder,” said Matt Sample, the policy manager at Cancer Research UK, but patients dealing with long waits “reflects a broader picture of some of the worst waits for tests and treatments on record”. “When just a matter of weeks can be enough for some cancers to progress, this is unacceptable.” Read full story Source: The Guardian, 2 October 2022
  18. News Article
    NHS officials ruled a man who died after his ear infection was not picked up in GP telephone consultations should have been seen face to face, a BBC Newsnight investigation has found. David Nash, 26, had four remote consultations over three weeks during Covid restrictions but was never offered an in-person appointment. His infection led to a fatal abscess on his brainstem. David first spoke to the practice on 14 October 2020, after finding lumps on his neck. He sent a photograph but was never examined. With David worried the lumps might be cancerous, the GP asked a series of questions about his health and reassured him that while she could not rule it out completely, she was not worried about cancer. She suggested he booked a blood test for two to three weeks' time. In those three weeks, David would go on to speak to another GP and two advanced nurse practitioners but never face to face or via video call. He was actually due to be seen in person at the GP surgery that day, for the blood tests booked some 19 days earlier, when he had presented with neck lumps. But - fearing he could have coronavirus, despite a negative PCR test - the nurse cancelled the bloods and asked David to retest for Covid. In its investigation, NHS England found "the overarching benefit [of this decision] was less than the risk with going ahead with blood tests". After five calls to NHS 111, David was taken to hospital in an ambulance that day but died two days later. NHS England, in a finding seen by Newsnight, said: "A face-to-face assessment should have been offered or organised to confirm the diagnosis and initiate definitive management." Read full story Source: BBC News, 29 September 2022
  19. News Article
    The government is promising to improve access to GPs, including same-day appointments for those that need them, as part of a new plan in England. Health Secretary Thérèse Coffey will make the pledge as she unveils her NHS plan for this winter and next. GPs will be able to take on extra staff, including senior nurses, while pharmacists will be asked to take on more work to free up appointments. Ms Coffey is due to announce the plan, which will also cover hospital services, in the House of Commons today. She is expected to say: "I will put a laser-like focus on the needs of patients, making their priorities my priorities and being a champion for them on issues that affect them most." Alongside same-day appointments when needed, Ms Coffey will promise no-one will have to wait more than two weeks for a routine appointment - currently one in five appointments take longer. The promises on waiting times are not official targets, but Ms Coffey said they should be seen as clear expectations of what patients should be entitled to. But GP leaders said the announcement would have a "minimal impact". Read full story Source: BBC News, 22 September 2022
  20. Content Article
    This Healthcare Safety Investigation Branch (HSIB) investigation focuses on the systems used by healthcare providers to book patient appointments for clinical investigations, such as diagnostic tests and scans. ‘Clinical investigation booking systems’ are used throughout the NHS to support the delivery of patient care. Healthcare services use paper-based or fully electronic systems, or a combination of the two (hybrid systems), to communicate to patients the time, date and location of their appointment. These systems also produce information for patients about actions they need to take to prepare for their appointment. Written patient communication is a key output of clinical investigation booking systems. This investigation examines the safety implications of patient communications, produced by booking systems, that do not account for the needs of the patient. In addition, it looks at why patients are ‘lost to follow-up’ after an appointment is cancelled, rescheduled or not attended. Lost to follow-up is the term used to describe a patient who does not return for planned appointments (whether for continued care or evaluations) or is no longer being tracked in the healthcare system when they should be.
  21. Content Article
    GP services are the first point of call for many health issues and the gateway to NHS specialist support.  GP teams are highly skilled and may decide that treatment without specialist care is the best action. But when you need specialist support, such as hospital tests or treatment, you may need a referral from your GP team first. New research from Healthwatch highlights that it can be very hard for some people to get a GP referral to another NHS service. And for 21% of people we spoke to, even when they get referrals, they can be lost, rejected or not followed up on. When services don't process referrals properly, it can cause significant frustration, unnecessary anxiety, and even cause harm to patients.  It can also lead to increased demand for either more GP appointments or help from healthcare teams in other parts of the NHS, putting more pressure on already overstretched services.
  22. News Article
    Five million people were unable to book a GP appointment in October, analysis of NHS data suggests. The Labour party, which studied figures from the GP Patient Survey, warned the struggle to see a doctor will mean many patients will not have serious medical conditions diagnosed until it is “too late”. According to the survey, some 13.8% of patients, or around one in seven, did not get an appointment the last time they tried to book one. With almost 32 million GP appointments reported in England in October, the party said it means that more than 5 million people could have been unable to book a GP appointment when they tried to make one that month. October saw GP surgeries carry out the highest number of appointments since records began in 2017, despite a depleted work force. Labour’s shadow health secretary Wes Streeting told Labour List: “Patients are finding it impossible to get a GP appointment when they need one. I’m really worried that among those millions of patients unable to get an appointment, there could be serious conditions going undiagnosed until it’s too late". Professor Kamila Hawthorne, chair of the Royal College of General Practitioners, said in a statement: “GPs and their teams are working flat out to deliver the care and services our patients need. GPs want our patients to receive timely and appropriate care, and we share their frustrations when this isn’t happening. But difficulties accessing our services isn’t the fault of GP teams, it’s a consequence of an under-resourced, underfunded, and understaffed service working under unsustainable pressures.” Read full story Source: The Independent, 6 December 2022
  23. News Article
    Plans have been drawn up to avoid the NHS being overwhelmed this winter by encouraging patients to “behave in ways they’ve not experienced before” and cut down on in-person GP visits, the Guardian can reveal. An advertising campaign devised by M&C Saatchi, awarded a contract by NHS England worth up to £28.6m, suggested ways people could be encouraged to settle for a virtual appointment or visit a pharmacist instead. To help reduce the mounting pressures facing medics, documents show the agency also advised patients should be told that seeking help via alternative routes instead of rushing to A&E would help the NHS “work better for everyone”. The three-year contract is for the ad campaign “Help Us Help You”, which seeks to change people’s behaviour when accessing healthcare to reduce pressures on the NHS and maintain capacity. Wes Streeting, Labour’s shadow health secretary, said patients were already cutting back on in-person GP appointments – “not because they don’t need them but they’re finding it impossible to get one”. He told the Guardian: “Among those millions of patients who can’t get an appointment when they need it, there will be problems which go undiagnosed until it’s too late". Read full story Source: The Guardian, 30 November 2022
  24. News Article
    GP practices can block abusive patients from gaining automatic access to their records online if they pose a ‘risk of harm’ to staff, the Royal College of General Practice has said. Automatic access to patients’ prospective patient records is due to be switched on by the end of this month, following delays related to concerns about patient safety. But the RCGP’s toolkit on access to records said practices can refuse access to online records for patients that pose a risk of harm to others too. The guidance said access should "be refused where there is a clear risk of serious harm to the safety of the patient or members of the practice team, or to the privacy of a third party". It added: "If potentially harmful information cannot be successfully redacted and the practice remains concerned about the safety of record access for an individual patient – or in extreme cases, remains concerned that the patient may react violently to information in the record – then the practice may refuse to give the patient record access or restrict the level of access. "It may be possible to give them access to a reduced part of the record such as the Summary Care Record or restrict access to appointments and repeat prescriptions." The guidance said that records access should only be refused or restricted "after discussion with the practice leads for GP Online Services and Safeguarding or after seeking further professional advice from a local relevant agency or national medical indemnity organisation". Read full story Source: Pulse, 18 November 2022
  25. News Article
    GPs are struggling to cope with as many as 90 appointments and consultations a day – more than three times a recommended safety limit. General practices in England are carrying out more appointments than before the pandemic but face severe workforce shortages. More than 1.45 million patients waited at least 28 days to see a GP in September, according to the most recent NHS figures. GPs who spoke to the Observer last week say that almost every day they breach the BM) guideline of “not more than 25 contacts per day” to deliver safe care. One doctor said he had more than 90 consultations on one day. A conference of local medical committee representatives in England this week will highlight the growing pressures faced in general practice. Surgeries are being urged to impose stricter caps on the number of patient appointments for each GP. One of the proposed motions submitted to the conference by Kensington and Chelsea local medical committee says “focusing on patient safety” is more appropriate than meeting high patient demand. It says the NHS should focus on “safe capacity”. Such a move would mean longer waits for GP appointments, but doctors say it would help safeguard patient care and the welfare of staff in general practice. Read full story Source: The Guardian, 20 November 2022
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