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Found 90 results
  1. Content Article
    Nicholas Gerasimidis had a history of mental illness manifesting as obsessive compulsive disorder (OCD) and anxiety. In 2022, his condition deteriorated. His GP referred him twice to the Community Mental Health Team but the referrals were rejected with medication being prescribed instead, together with advice to contact Talking Therapies.   He was taken on to CMHT workload after being assessed by the Psychiatric Liaison Team in Royal Cornwall Hospital in November 2022. The preferred course of treatment was psychological treatment in the form of Cognitive Behavioural Therapy with Exposure Response Prevention. There was a waiting list of a year. In May 2023, Mr Gerasimidis became worse. It was felt an informal admission to hospital was required but a bed was not available. He was found hanged at his home address on 3 June 2023.
  2. Content Article
    On 29 December 2022, Shahzadi Khan was detained under section 2 of the Mental Health Act due to her mental state and the risks she presented. She was found to have had a manic episode with psychotic symptoms. Due to a lack of beds, she was placed in a privately-run mental health hospital in Norfolk. She remained there until her discharge to the family home on 26 January 2023. She was commenced on Olanzapine and Zopiclone for her mental health whilst an inpatient.   Her diagnosis on discharge was mania with psychotic symptoms. She was to remain on olanzapine in the community. Her placement out of area contributed to disjointed and inadequate discharge planning to support her in the community and was exacerbated by poor communication between the team managing out of area placements and the local team. As a consequence, the aftercare planning did not take place in accordance with S117 Mental Health Act.   This was exacerbated by a failure by all health professionals involved in her care within the mental health trust to recognise that she needed to be referred on to the Trafford Shared Care pathway. A referral would have ensured she received support and care for at least 12 weeks when she returned to the community. There is no clear reason for this failure. She was seen by the Home-Based Treatment Team (HBTT) on 28 January and 2 February, then discharged back to her GP. Within a week of that discharge from HBTT, which meant she had been left with no mental health support, she had deteriorated significantly. On 9 February her GP sent her to hospital for emergency assessment due to her presentation. She was discharged home to be seen by the Home- Based Treatment Team on 11th February. She was seen by that team on 11, 12, and 13 February. There was still no recognition of the fact that the Trafford policy was not being followed. She had indicated her lack of compliance with olanzapine, suicidal thoughts and her behaviour on 13th February was erratic. On 14 February 2023 she took a fatal overdose of prescribed zopiclone at her home address.
  3. Content Article
    ‘Patient-initiated follow-up’ (or PIFU, for short) is not a new idea and has been referred to in different ways over time, such as open-access appointments, self-managed follow-up, and see-on-symptom appointments. However, this approach has been given renewed attention given rising waiting times and the backlog of care that built up throughout the Covid-19 pandemic.  Moving outpatient attendances to patient-initiated follow-up (PIFU) pathways is considered a key part of plans to reduce outpatient follow-ups. But what exactly is PIFU? In this Nuffield Trust explainer, Sarah Reed and Nadia Crellin describe more about what it is, the problems it could solve, and what is known so far about how well it works.
  4. Content Article
    Millions of people use hospital services as an outpatient, with numbers of appointments rising rapidly over recent years. Patient-initiated follow-up (PIFU) is a relatively new initiative in the English NHS, and the NIHR RSET team has conducted a mixed-methods evaluation as the process develops to understand how it's working and what impact it's having on health care systems and the staff and patients involved.
  5. News Article
    Patients are at risk of having serious health conditions missed because of the lack of continuity of care provided by GPs, the NHS safety watchdog says. Investigators highlighted the case of Brian who was seen by eight different GPs before his cancer was spotted as an example of what can go wrong. Brian had a history of breast cancer and had been discharged from the breast cancer service. Two years later he began to have back pain. Over the following eight months, he saw two out-of-hours GPs and six GPs based at his local practices as well as a physio and GP nurse, before he was sent for a hospital check-up in late 2020. A secondary cancer had developed on Brian's spine, but it was too late to offer him curative treatment and he was given end-of-life care. He has since died. The watchdog said the lack of continuity of care resulted in the diagnosis of Brian's cancer being missed. One of the key problems was that the different GPs he saw missed the fact he was attending repeatedly for the same issue. Senior investigator Neil Alexander said Brian's case was a "stark example" of what can happen when there is a breakdown in continuity of care. "He told our team 'when I am gone, no-one else should have to go through what I did'." Read full story Source: BBC News, 30 November 2023
  6. Content Article
    Patients who visit their GP practice with an ongoing health problem may see several different GPs about the same symptoms. To make sure they receive safe and efficient care, there needs to be a system in place to ensure continuity of care. In the context of this report, continuity of care is where a patient has an ongoing relationship with a specific doctor, or when information is managed in a way that allows any doctor to care for a patient. While some GP practices in England operate a formalised system of continuity of care, many do not. This investigation explored the safety risk associated with the lack of a system of continuity of care within GP practices. The investigation focused on: How GP practices manage continuity of care. This includes how electronic record systems alert GPs to repeat attendances for symptoms that are not resolving and how information is shared across the healthcare system. Workload pressures that affect the ability of GP practices to deliver continuity of care. This investigation’s findings, safety recommendations and safety observations aim to prevent the delayed diagnosis of serious health conditions caused by a lack of continuity of care and to improve care for patients across the NHS.
  7. News Article
    Patients are being left feeling “confused and neglected” by not being told who to contact about their future care when they are discharged from hospital, an NHS watchdog has said. Research by Healthwatch England has found that 51% of people are not being given details when they leave of which services they can turn to for help and advice while they are recovering. The NHS was risking patients having to be readmitted as medical emergencies and hospital beds becoming even more scarce by failing to adhere to its own guidelines on discharge, it said. “While our findings show some positive examples, it’s alarming that guidance on safe discharge from the hospital is routinely not being followed,” said Louise Ansari, the patient champion’s chief executive. Healthwatch asked 583 people and their carers how their discharge had gone. Read full story Source: The Guardian, 19 November 2023
  8. Content Article
    New research from Healthwatch reveals worrying problems with hospital discharge arrangements. Many people told us they are not given the right support or information when being discharged from hospital. Read on about their experiences and Health Watch's calls to action.
  9. News Article
    Two young people facing mental health crises were left on paediatric wards for months while different agencies across a health system struggled to find appropriate placements. The patients – who were both autistic and had learning disabilities, with special educational needs – were admitted to Maidstone and Tunbridge Wells Trust (MTW) last year after attending emergency departments more than 10 times within a two-month period. They were left on a paediatric ward – one of the patients for four months – as this was the “only available place of safety as opposed to the optimum setting to meet their needs,” according to Kent and Medway Integrated Care Board’s “learning review” of children and young people with complex needs, which the two cases prompted. The review, which HSJ obtained under a Freedom of Information request, revealed several problems with joint working, despite a multidisciplinary team meeting regularly to discuss the young patients’ needs. Since the review, a new escalation process has been introduced, urgent mental health risk assessments in the community have been enhanced and a three-month pilot of a self-harm service has been implemented at Tunbridge Wells Hospital, part of MTW. Read full story (paywalled) Source: HSJ, 17 November 2023
  10. News Article
    New data suggests around 700,000 cases on the elective waiting list relate to patients who are on at least four different pathways, and NHS England says personalised care plans must be developed to treat them more efficiently. NHSE has published new data that reveals the overall referral to treatment waiting list, of 7.8 million cases, is made up of 6.5 million individual patients. The difference is due to some patients waiting for more than one treatment. Stella Vig, NHSE’s clinical director for secondary care, told HSJ around 2-3% of the individual patients on the waiting list are on four to five pathways or more. Read full story (paywalled) Source: HSJ, 9 November 2023
  11. Content Article
    The aim of this investigation and report is to help improve the inpatient care of adults with a known learning disability in acute hospital settings. It focuses on people referred urgently for hospital admission from a community setting, such as a person’s home or residential home. In undertaking this investigation, the Health Services Safety Investigations Body (HSSIB) looked to explore the factors affecting: The sharing of information about people with a learning disability and their reasonable adjustment needs following admission to an acute hospital. How ward-base staff are supported to delivery person-centred care to people with a learning disability.
  12. Content Article
    The Alzheimer’s Society Accelerator Programme aims to support the development of products and services to help people living with dementia. There is £100,000 of funding available, together with mentoring, peer-to-peer learning and opportunities for co-creation with people who have the condition. Engineers, designers, developers, innovators, academics, entrepreneurs, or anyone with a good idea can apply. Your idea could be a simple product that makes an everyday task easier for a person living with dementia. You may have an innovative idea for a new product or service. To bring your idea to life, the programme offers a 12-month partnership including: Up to £100K of funding Expert innovation and dementia support for 12 months Peer-to-peer learning with our Innovation Collective Opportunities to learn from people living with dementia through co-creation. Support during the application process. Apply from link below. Closing date 4 October 2023.
  13. Content Article
    The National Wound Care Strategy Programme, the AHSN Network’s Transforming Wound Care programme, and the Patient Experience Network have created a new resource to teach patients how to take a photograph of their wound to empower them to take an active role in their healthcare. Developed for patients by patients, based on experience and medical information, the resource provides hints and tips on best practice with taking wound photographs, including the mechanics of getting the best possible photograph and what photographs should and should not include to assist healthcare providers in providing the best possible care.
  14. Content Article
    A casually centred proposal identifying how Fire and Rescue Services can improve pre-hospital care and quality of life outcomes for burn survivors.  David Wales and Kristina Stiles have released this report looking at the burn survivor experience in the pre-hospital environment. The work makes ten operational recommendations and also two 'lessons learned' recommendations exploring strategic partnership working and the resulting fragmented services.
  15. Content Article
    The health needs of the population are changing, and many people need more co-ordinated care across primary, community, social and hospital services. More co-ordinated care requires organisations and staff to collaborate well across organisational and professional boundaries,
  16. News Article
    A scheme in which ‘category 2’ 999 calls are validated by clinicians will be extended nationally after reducing journeys by 4%in a pilot, with no adverse incidents, NHS England has told HSJ. NHSE also confirmed that one ambulance trust in the scheme, the West Midlands, has begun delaying the dispatch of ambulances for some category 2 calls by up to 23 minutes so that the validation can take place. At three other trusts – London, South Western and the East Midlands – about 40% of category 2 calls receive clinical validation, but an ambulance is dispatched to them as soon it is available, as normal. Officials said they believe the demand benefit could be greater if ambulance trusts are able to devote more clinical capacity to the validation process. About 40% of category 2 calls are judged suitable for validation, but not all of them complete the process before an ambulance arrives. Read full story (paywalled) Source: HSJ, 11 July 2023
  17. Content Article
    Patients often have multiple providers involved in their care. On the one hand, patients are able to receive specialty care to help manage multiple, complex medical conditions. On the other hand, such fragmentation in care may lead to medication errors from inaccurate or incomplete patient medication lists. As stewards of their patients' care, it is essential that primary care providers take steps to review and reconcile each patient's medication list to avoid errors or adverse drug events, and organisational leaders must ensure that systems are in place to support these efforts.  
  18. Content Article
    Analysis, commentary and insight on patient flow from leaders across the healthcare sector. Please note you will need to submit your details to be able to download the report.
  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. Content Article
    Missed checks, disrupted care and health inequalities have been revealed in a new report from Diabetes UK looking at the state of diabetes care in England. The report reveals that less than half (47%) of people living with diabetes in England received all eight of their required checks in 2021-22, meaning 1.9 million people did not receive the care they need.  It is calling for urgent action to address the routine diabetes care backlog and prevent avoidable deaths of people living with diabetes. 
  21. Content Article
    This new report from the British Red Cross describes how asylum seekers struggle to access the internet and lack digital tools. The British Red Cross explained that the report aims to improve understanding of the experiences of digital exclusion among people seeking asylum, and how these experiences may impact access to, and experience of, healthcare. Researchers conducted interviews with 30 people currently seeking asylum across England for the report. The researchers themselves also had lived experience of seeking asylum.
  22. News Article
    Thousands of 999 calls are being transferred to the Welsh Ambulance Service because they are taking more than five minutes to answer in England, HSJ can reveal. More than 50,000 calls – 1.2% of all made – were sent to a different ambulance service than the one intended between October and the middle of February, under a new system of routing unanswered calls was introduced. It automatically diverts calls which have not been answered after five minutes, rerouting them to services with current capacity, while a BT operator remains on the line until the call is answered. The Welsh Ambulance Service explained it records details from the transferred caller, prioritises the response level and provides lifesaving instructions if required, including having access to a national database of defibrillators. However, it is unable to despatch ambulances outside its area and does not provide clinical assessment. Instead the details are transferred electronically into the “home” trust’s computer-aided despatch system. Read full story (paywalled) Source: HSJ, 21 March 2023
  23. News Article
    NHS 111 sends too many people to accident and emergency departments because its computer algorithm is “too risk averse”, the country’s top emergency doctor has warned. Dr Adrian Boyle, president of the Royal College of Emergency Medicine (RCEM), said that December was the “worst ever” in A&E with 9 in 10 emergency care leaders reporting to the RCEM that patients were waiting more than 24 hours in their departments. Asked what measures could help improve pressures in emergency care, Dr Boyle said more clinical input was needed in NHS 111 calls. “In terms of how we manage people who could be looked after elsewhere, the key thing to do is to improve NHS 111,” Dr Boyle told MPs. “There is a lack of clinical validation and a lack of clinical access within NHS 111 - 50 per cent of calls have some form of clinical input, there’s an awful lot which are just people following an algorithm.” Dr Boyle added where clinical input is lacking “it necessarily becomes risk averse and sends too many people to their GP, ambulance or emergency department”. Read full story (paywalled) Source: The Telegraph, 24 January 2023
  24. News Article
    Hospital staff have to complete 50 separate steps on average to discharge a patient, it has emerged, as the NHS grapples with a bed-blocking crisis. On average, around 14,000 patients deemed fit to leave hospital are stuck in beds every day, according to the latest official figures. The congestion is helping to fuel the backlog in accident and emergency (A&E) departments, where more than 55,000 patients waited 12 hours or longer last month. Steve Barclay, Health Secretary, announced an additional £250 million in funding last week to buy up care beds to help discharge thousands of patients. But doctors, social care experts and families have warned discharges are being delayed by NHS “bureaucracy” and excessive form filling. Dr Matt Kneale, co-chair of the Doctors’ Association UK and a junior doctor in Manchester, said patients are held up by “numerous bottlenecks” before being sent home. “While social care shortages are the predominant issue, smaller factors stack up to create a big problem,” he told The Telegraph. Many hospitals have limits on the times their pharmacies are open, he explained, meaning patients can often be stuck on the ward all day, or an extra night, waiting for their medication. Read full story (paywalled) Source: The Telegraph, 15 January 2023
  25. News Article
    Vulnerable patients, including some children, have faced long delays for a suitable bed as organisations argue over whose responsibility it is to fund and deliver their care, HSJ understands. In a letter outlining winter arrangements, NHS England has warned trust leaders and commissioners against delaying emergency mental health admissions – typically needed when a patient is away from home, and understood to be more common over the Christmas period – while determining which area has which responsibility. National mental health director Claire Murdoch wrote: “It is not acceptable to delay an emergency mental health admission while determining which area has clinical and financial responsibility for the care of an individual.” She added such admissions should be arranged “as quickly as possible, and without delay caused by any financial sign-off process”. It comes as HSJ has been told patients can often end up waiting for several days in emergency departments or in “inappropriate” out of area or acute beds when disputes occur over who is responsible for their care. Read full story (paywalled) Source: HSJ, 15 December 2022
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