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Found 92 results
  1. News Article
    Continuity of care in general practice reduces use of out-of-hours care, acute hospitalisations and mortality, researchers have shown - as GP leaders warned staff shortages and heavy workload means it is becoming harder to deliver in the UK. Long-lasting personal continuity with a GP is 'strongly associated with reduced need for out-of-hours services, acute hospitalisations, and mortality', according to a study by researchers in Norway. An association lasting more than 15 years between a patient and a specific GP reduces the probability of any of these factors by 25-30%, the study published in the British Journal of General Practice found. The researchers said 'promoting stability among GPs' should be a priority for health authorities, and warned that continuity of care was under pressure. The findings come as general practice in the UK faces intense pressure amid a shortage of GPs and intense workload after more than 18 months of the COVID-19 pandemic. Responding to the findings, RCGP chair Professor Martin Marshall said: "Continuity of care is highly valued by patients and GPs and our teams alike. It is what allows us to build relationships with our patients, often over time, and this study builds the strong evidence base of its benefits for patients and the NHS." Read full story Source: GP Online, 4 October 2021
  2. Content Article
    Continuity, usually considered a quality aspect of primary care, is under pressure in Norway, and elsewhere. An association lasting more than 15 years between a patient and a specific GP reduces the probability of any of these factors by 25-30%, a study by Sandvik et al. found. The researchers said 'promoting stability among GPs' should be a priority for health authorities, and warned that continuity of care was under pressure.
  3. Content Article
    This report from Macmillan Cancer Support takes stock of how far the UK’s health and care services still need to go on integration for high-quality, personalised cancer care to be a reality for everyone. The analysis suggests there are four key dimensions to personalised, integrated cancer care that need to be addressed: everyone with cancer can access personalised, joined-up care; people with cancer are supported by health and care professionals consistently working together; people with cancer receive personalised, integrated care across services provided by different parts of the system; and services are designed, commissioned and funded around the goal of personalised, integrated cancer care.
  4. Content Article
    The Royal College of Emergency Medicine has raised a concern to NHS England and Improvement Patient Safety, following several reported incidents noting that organisations may not be using the latest version of The Manchester Triage System clinical risk management triage tool. Old versions of the system have outdated treatment/priority parameters for adult and paediatric sepsis that could affect patient outcome. The updated Manchester Triage System can be accessed from the link below.
  5. News Article
    Long delays for coronavirus patients to get through to NHS 111 call handlers while other seriously ill patients were told to stay at home have prompted a safety watchdog to launch an investigation of the phone triage service. The Healthcare Safety Investigation Branch (HSIB) has launched an inquiry into the handling of coronavirus calls by NHS 111 – the first port of call for patients when they become unwell. During the pandemic the NHS 111 service set up a dedicated COVID-19 Clinical Assessment Service (CCAS) but concerns over the safety of advice given to patients saw nurses and non-medical staff stopped from taking patient calls in August last year. Now concerns from a number of patients and families have led the independent HSIB to launch a review of the service and to identify any learning and improvements. HSIB told The Independent the investigation was at an early stage and it was not yet certain of any direct link to patient harm. It said the number of patient cases could grow but that it had initial family concerns related to difficulties getting through to NHS 111, long delays in getting clinical call backs after an initial triage call and concerns that some patients were told to stay at home when they were seriously ill. Read full story Source: The Independent, 23 March 2021
  6. Content Article
    Ward rounds are the focal point for a hospital’s multidisciplinary teams to undertake assessments and care planning with their patients. Coordination of assessments, plans and communication is essential for effective and efficient care.  However, the delivery of ward rounds is consistently constrained by the competing priorities of clinical staff. A number of factors contribute to this, including workforce gaps, inadequate planning, unwarranted variation in practice and an absence of training in the skills required to deliver complex multidisciplinary team care. This leads to frustration for staff and patients, and can lead to errors in care, longer stays in hospital and readmissions. A new report from UK healthcare professional leaders including the Royal College of Physicians, and developed along with patients, sets out best practice for modern ward rounds.
  7. Event
    until
    One of the great opportunities for ICSs may be around reducing future demand for healthcare by ensuring that people remain healthy or are helped to reduce the chances of deteriorating if they do develop an illness or long-term condition. Prevention and early intervention underlie much of the NHS Long Term Plan, with a recognition that the NHS can no longer simply be an “ill health” service and instead bends to think about prevention and reducing health inequalities. Many ICSs are keen to develop this role and bring together the organisations they represent – across both the NHS and local authorities –to work collaboratively on this. But with resources and time limited, they may need to concentrate their efforts on particular areas. The second wave of covid – and the prospect of widespread vaccination starting within weeks - has added a new dimension to this with an urgent need to reduce the pressure covid places on the NHS and on normal life in general. This webinar will ask: has covid helped focus the NHS’s eyes on prevention? where are the “easy wins” for ICSs where interventions are most likely to have significant results within a reasonable timeframe? what key steps do ICSs need to take to get the maximum benefit from these? How can they build common purpose among their members to ensure these happen? how can public health be made “business as usual” for everyone working in the NHS – including those in hospitals? how can ICSs balance the preventative interventions which deliver short-term benefits with those which take longer to offer a “return on investment”? Register
  8. News Article
    Emergency care leaders are warning it will take up to six more months to determine whether pilots of a radical change to accident and emergency are working, even though it is due to go live nationally next week, HSJ has learned. HSJ understands the new “111 First” system — where walk-in patients not in medical emergencies call 111 to “book” urgent care — is set to “go live” across England from next week following pilots in acute trusts which have been run since the summer. From 1 December, people will be able to call NHS 111 from anywhere in the country and have urgent care “booked” for them if needed, it is understood. NHS England has been pursuing the 111 First model to help reduce overcrowding and the risk of nosocomial infections in A&Es. The service is also intended to be able to book them into GP practice appointments. Well-placed sources confirmed most acute trusts have now implemented some form of 111 First and the model is set to be part of their standard operations when the national system “goes live” next week. A national advertising campaign is expected to promote the approach. But the Royal College of Emergency Care Medicine said there was a “vocal minority” of clinicians who are “vehemently against” 111 First as they believe it will increase demand in emergency departments. Read full story (paywalled) Source: HSJ, 25 November 2020
  9. Content Article
    The Re-Engineered Discharge (Project RED) programme is a nationally recognised best practice centered on delivering a patient-tailored hospital discharge plan demonstrated to reduce all-cause 30-day readmissions and improve safety during care transitions. In this study, Mitchell et al. implemented the RED in 10 hospitals to study the implementation process.
  10. Content Article
    Trusts and frontline staff are working flat out to restore those services which were necessarily interrupted to cope with the first peak of the pandemic. NHS Providers' Restoring services: NHS activity tracker highlights detailed examples of the innovations trusts and their staff developing to improve capacity, and respond to unmet demand despite the constraints created by COVID-19, and the need to prepare for additional winter pressures. 
  11. News Article
    Serious patient safety and wellbeing concerns about the latest hospital discharge guidance have been raised to HSJ by senior clinicians and charities. Senior geriatricians warned that the guidance could prompt an increase in “urgent readmissions”, “permanent disability” and “excess mortality”, while charities said families could be left with “unsustainable caring responsibilities” because of the new rules. The government guidance, Hospital Discharge Service: policy and operating model, published in August, said clinicians should consider discharging patients when they were “medically optimised” rather than “medically fit”. It said 95% of these patients would return straight home with additional social care and rehabilitation support if needed. Many of the concerns raised surround the retention of the “criteria to reside”. This was originally agreed in March when there was a push from NHS England to free up acute beds over fears hospitals would become overwhelmed with covid admissions as the pandemic hit the UK. The criteria has, however, been maintained in the new guidance, despite a significant fall in infections and deaths from the virus. Rachel Power, chief executive of The Patients Association charity, warned: “This guidance makes it clear that the NHS is still having to take drastic emergency action in the face of covid-19, that will continue to take a heavy toll on patients. It is clear that many patients will be rushed home who would normally have had a longer period of hospital care.” Read full story (paywalled) Source: HSJ, 8 September 2020
  12. Content Article
    This document from the Department of Health and Social Care (DHSC) sets out how health and care systems can ensure that people: are discharged safely from hospital to the most appropriate place. continue to receive the care and support they need after they leave hospital. It replaces ‘Coronavirus (COVID-19) hospital discharge service requirements’ published on 19 March 2020.
  13. News Article
    Matt Hancock has extended four national data sharing orders which allow GPs and NHS organisations to share confidential patient information, as part of the ongoing response to the COVID-19 pandemic. The data sharing instructions were initially put in place in March when the pandemic broke out in earnest, and they were due to expire at the end of September. Under the arrangement GPs, NHS providers, NHS Digital, NHS England/Improvement, local authorities and the UK Biobank can share information about patients’ treatment and medical history - if doing so would help their response to COVID-19. The data sharing instructions have now been extended until 31 March next year. According to the Department of Health and Social Care’s update which notified organisations of the extension, NHS entities can share information for reasons such as helping to support the NHS Test and Trace service, identifying further patients at risk of COVID-19, and understanding information about patient access to health and adult social care services. Read full story (paywalled) Source: HSJ, 20 August 2020
  14. News Article
    Policymakers’ failure to tackle chronically underfunded social care has resulted in a “lost decade” and a system now at breaking point, according to a new report. A team led by Jon Glasby, a professor of health and social care at the University of Birmingham, says that without swift government intervention including urgent funding changes England’s adult social care system could quickly become unsustainable. Adult social care includes residential care homes and help with eating, washing, dressing and shopping. The paper says the impact has been particularly felt in services for older people. Those for working-age people have been less affected. It suggests that despite the legitimate needs of other groups “it is hard to interpret this other than as the product of ageist attitudes and assumptions about the role and needs of older people”. Read full story Source: The Guardian, 9 August 2020
  15. Content Article
    Drawing on a 2010 analysis of the reform and costs of adult social care commissioned by Downing Street and the UK Department of Health, this paper from Glasby et al., published in the Journal of Social Policy, sets out projected future costs under different reform scenarios, reviews what happened in practice from 2010-19, explores the impact of the growing gap between need and funding, and explores the relationship between future spending and economic growth. It identifies a ‘lost decade’ in which policy makers failed to act on the warnings which they received in 2010, draws attention to the disproportionate impact of cuts on older people (compared to services for people of working age) and calls for urgent action before the current system becomes unsustainable.
  16. News Article
    The aftercare of COVID-19 patients will have significant financial implications for ‘understaffed’ community services, NHS England has been warned. This month the national commissioner released guidance for the care of patients once they have recovered from an immediate covid infection and been discharged from hospital. It said community health services will need to provide “ongoing health support that rehabilitates [covid patients] both physically and mentally”. The document said this would result in increased demand for home oxygen services, pulmonary rehabilitation, diagnostics and for many therapies such as speech and language, occupational, physio, dieticians and mental health support. One GP heavily involved in community rehab told HSJ: “There is a lot detailed information about what people might experience in recovery, but it doesn’t say what should actually happen. “We have seen people discharged from hospital that don’t know anything about their follow-up and the community [health sector] hasn’t got any instructions of what they should be doing or what services have even reopened. This guidance needs to go a step further and rapidly say what is expected so local commissioners can put that in place.” Read full story Source: HSJ, 10 June 2020
  17. News Article
    The government said it will set up ‘dedicated team’ to look for innovative ways for the NHS to continue treating people for coronavirus, while also providing care for non-covid health issues. In its pandemic recovery strategy published today, the government also said step-down and community care will be “bolstered” to support earlier discharge from acute hospitals. The 60-page document contained little new information about plans for NHS services, but said: “The government will seek innovative operating models for the UK’s health and care settings, to strengthen them for the long term and make them safer for patients and staff in a world where COVID-19 continues to be a risk. “For example, this might include using more telemedicine and remote monitoring to give patients hospital-level care from the comfort and safety of their own homes. Capacity in community care and step-down services will also be bolstered, to help ensure patients can be discharged from acute hospitals at the right time for them". To this end, the government will establish a dedicated team to see how the NHS and health infrastructure can be supported for the COVID-19 recovery process and thereafter. Read full story Source: 12 May 2020
  18. Content Article
    Perioperative care is the Integrated care across the full patient pathway before, during and after surgery. Perioperative care, also referred to as perioperative medicine, is the practice of patient-centered, multidisciplinary, and integrated medical care of patients from the moment of contemplation of surgery until full recovery. The Centre for Perioperative Care has produced a video on what good perioperative care looks like and a number or resources and advice on the perioperative journey.
  19. News Article
    Significant concerns about the NHS’ refusal to share data with councils have emerged in a letter from a leading council chief executive and clinical commissioning group accountable officer. Steven Pleasant, chief executive of Tameside Metropolitan Borough Council and accountable officer of Tameside and Glossop CCG, said the failures are “becoming increasingly exasperating”, in a letter intended for the Ministry of Housing, Communities and Local Government’s shielding sounding board. Steven said he understands NHS Digital has decided the most recent version of the list cannot be shared with councils even though it is being shared with police, fire, voluntary organisations and companies offering logistical support. “I am sure that you will appreciate that this is counterproductive and frustrating given that local authorities are leading and coordinating the response to the most vulnerable in communities,” he wrote. He also raised concerns about how the NHS’ shielded patients team is passing on to councils information about people needing additional support — for instance, if the recipient’s food parcel stock is running low, requiring the council to step in. Welfare concerns and medication information could also need to be passed on. Mr Pleasant said although his council had asked for this information to be provided via email, staff “have been told by the NHS shielding team that they do not have permission to do this and that details can only be provided verbally over the phone”. “We believe this significantly increases the chances of error and presents significant risk… around incorrect information being captured,” he wrote. Read full story Source: HSJ, 21 April 2020
  20. Content Article
    How do we protect individuals during lockdown and ensure their health needs are not exacerbated or overshadowed by COVID-19? Simple Stuff Works has created a webinar series to support those providing care for people with postural care needs (anyone who finds it difficult to change position independently and is reliant on others for their positioning / repositioning needs).
  21. News Article
    The UK's organ transplant network could be forced to shut down as a result of the coronavirus outbreak, the body that runs the scheme is warning. One factor is the pressure on intensive care beds, according to NHS Blood and Transplant (NHSBT). But there is also the risk to transplant patients, who have their immune systems suppressed so their bodies don't reject new organs. This is a dilemma for those like Ana-Rose Thorpe, from Manchester, who is waiting for a liver transplant. Now aged 29, Ana-Rose has lived with hepatitis almost her entire life after contracting it as a baby. The disease has taken its toll and now her liver is failing and she is in desperate need of a transplant. "Having to go into hospital while there are coronavirus patients there is very worrying," she says. "Whilst my body could withstand the transplant, the longer I'm not being monitored, not being seen as often as I was, the longer I leave it, I could just get sicker and sicker. "I feel like it's patients that are already on the transplant list, patients waiting for other operations, we have just been swept aside." "It's my life - it is a matter of life and death," Ana-Rose says. Read full story Source: BBC News, 9 April 2020
  22. News Article
    A mental health charity has branded as “irresponsible” the Government’s coronavirus bill which would grant single doctors the power to detain the mentally ill. The Government wants to relax legal safeguards in the Mental Health Act in order to free up medical staff to deal with the COVID-19 pandemic. If passed, the bill would reduce the number of doctors needed to approve detaining individuals from the current minimum of two, to just one. In addition, it would temporarily allow time limits in the Mental Health Act to be extended or removed altogether. This would mean patients currently detained in mental health facilities could be released into the community early, or be detained for longer. Akiko Hart, Chief of National Survivor User Network (NSUN), a UK mental health charity, said: “Whilst we understand that these are unprecedented times, any legislative change must be proportionate and thought through, and should protect all of us. Minimising some of the safeguards in the Mental Health Act and extending its powers, is a step in the wrong direction.” Read full story Source: The London Economic, 19 March 2020
  23. Content Article
    Dr Joanna Silver describes her role working with adults and children with eating disorders. An important part of her role is to work closely work with the multidisciplinary team and other health professionals to make sure the complexities of treating people with eating disorders and related conditions are understood and to ensure the patient is kept safe.
  24. Content Article
    The National Organization for Rare Disorders (NORD)’s Rare Disease Database provides brief introductions for patients and caregivers to specific rare diseases. 
  25. Content Article
    NHS Pathways is a clinical tool used for assessing, triaging and directing the public to urgent and emergency care services.
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