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Found 90 results
  1. News Article
    A ‘leading’ cancer service has reported a series of safety incidents which contributed to patients being severely harmed or dying, HSJ has reported. An internal report at Liverpool University Hospitals Foundation Trust suggests the incidents within the pancreatic cancer specialty were partly linked to patient pathways being ill-defined following the merger of its two major hospitals. The report lists seven incidents involving severe harm or death, and five involving moderate harm. It is not clear how many of the patients died. The trust was formed in 2019 through the merger of the Royal Liverpool and Aintree acute sites, with the consolidation of clinical services an integral part of the plans. However, there were no formal plans to change the configuration of pancreatic cancer services, which already operated under a “hub and spoke” model. In one finding relevant to all 12 incidents, the report said: “Patient ownership and clinician accountability (local vs specialist) have not been defined following the merger of the legacy trusts and subsequent service reconfigurations. “This has contributed to system failures in the provision of timely quality care, particularly in patients with time-critical clinical uncertainty.” Read full story (paywalled) Source: HSJ, 5 October 2022
  2. News Article
    Multiple failures by the NHS 111 telephone advice service early in the pandemic left Covid patients struggling to get care and led directly to some people dying, an investigation has found. The Healthcare Safety Investigation Branch (HSIB) looked into the help that NHS 111 gave people with Covid in the weeks before and after the UK entered its first lockdown on 23 March 2020. It identified a series of weaknesses with the helpline, including misjudgment of how seriously ill some people with Covid were, a failure to tell some people to seek urgent help, and a lack of capacity to deal with a sudden spike in calls. It also raised concerns that the government’s advice to citizens to “stay at home” to protect NHS services deterred people who needed immediate medical attention from seeking it from GPs and hospitals, sometimes with fatal consequences. Mistakes identified by HSIB included that: The CRS algorithm did not allow for the assessment of any life-threatening illness a caller had – such as obesity, cancer or lung disease – to establish whether they should undergo a clinical assessment. When many callers reached the core 111 service, there was no way to divert them as intended to the CRS, which was operationally independent of 111. Although patients who had Covid-19 symptoms as well as underlying health conditions, such as diabetes, were meant to be assessed when they spoke to the core 111 service, some were not. The number of extra calls to 111 in March 2020 meant that only half were answered. Read full story Source: The Guardian, 29 September 2022
  3. 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.
  4. News Article
    An NHS England director says trusts should use ‘as robust triage as you can possibly do’ when deciding whether to accept referrals from GPs. Ian Eardley, NHSE’s joint national clinical director for elective recovery, was asked during an internal NHSE webinar how trusts can encourage GPs to work more closely with secondary care to make sure they only send appropriate referrals. He said: “There’s got to be as robust triage as you can possibly do, so if you’ve got referrals coming in which haven’t got the relevant or wrong information, then I think you need senior clinicians in a position to go back to the GP and say we need this bit of information or the other… Ultimately, it’s about robust front-end management.” However, he admitted it was a “difficult [issue and] really difficult to do anything centrally”. Read full story (paywalled) Source: HSJ, 23 November 2022
  5. 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
  6. 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
  7. 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
  8. 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
  9. 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
  10. 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
  11. 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
  12. Content Article
    Diabetes UK are calling on government for a recovery plan to tackle 'devastating’ diabetes care delays – before it’s too late   Diabetes is serious and people living with diabetes have been ‘pushed to the back of the queue’ during the coronavirus pandemic and a national recovery plan is needed to support front-line healthcare teams in getting vital services back on track.    Diabetes UK warn that despite the tireless efforts of the NHS through the pandemic, many people living with the condition are still struggling to access the care they need, putting them at risk of serious complications, which can lead to premature death.   This new report published by Diabetes UK as part of our Diabetes Is Serious campaign, shows the scale of the problem and sets out a series of calls to UK Government to tackle it.  
  13. Content Article
    Recovering services from the covid crisis is the big task for NHS leaders for the foreseeable future. HSJ's Recovery Watch newsletter tracks prospects and progress. This week HSJ bureau chief and performance lead James Illman discusses virtual wards and why staffing pressures are ‘likely to be under-estimated’ and are a patient safety risk.
  14. Content Article
    On 8 April 2020 the coroner commenced an investigation into the death of Daniel France, age 17. Danny was 17 years old and was living at a YMCA hostel. He was on medication for depression and had been referred to secondary mental health services. He had made previous suicide attempts. On 3 April 2020 he took his own life. The medical cause of death was asphyxiation by hanging and the conclusion was suicide.  Danny was a vulnerable teenager: he had left home and was living in hostel accommodation; he had changed his GP practice; he was trans, had changed his name and had been referred to the Gender Identity Clinic; he had recently been discharged from secondary mental health services in Suffolk and had been referred to mental health services in Cambridge; he had previously been under CAMHS and was now being referred to adult mental health services; he had diagnoses of anxiety and depression and had been prescribed medication; he had made previous suicide attempts and had long term suicidal thoughts He had been assessed by First Response Service but had been considered as not requiring urgent intervention. Safeguarding referrals about Danny were made to Cambridgeshire County Council in October 2019 and January 2020. Both referrals were closed and it was accepted that the decision to close both referrals was incorrect. In December 2019 Danny’s new GP referred him to Cambridgeshire & Peterborough NHS Foundation Trust (CPFT). He had been seen by the Primary Care Mental Health Services but was still awaiting assessment by the Adult Locality Team at the time of his death. 
  15. 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.
  16. 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.
  17. 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.
  18. Content Article
    Amid climbing covid case numbers and with scarce resources, Tara Vijayan describes what it has been like in the US to triage treatments that aim to prevent patients being hospitalised with COVID-19
  19. Content Article
    Benjamin Lee Stroud died on the 19 March 2021 at home. He lived alone but had a partner who saw him regularly. He had a previous medical history of recreational drugs, including steroids and cannabis; he was recently diagnosed as insulin dependent diabetic and had undergone a kidney transplant. He fell and injured his back at work, and developed a dependence on pain medication, some of which were purchased on the internet. His mental health issues increased as a result of his psychical health problems. A post mortem was undertaken and the cause of death was multiple drug toxicity.
  20. 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.
  21. Community Post
    "There is an aspect of information exchange that has attracted less attention and fewer resources: that patients are experts in their experience and know much more than clinicians about their own health and the needs and goals important to them." From: https://catalyst.nejm.org/information-asymmetry-untapped-patient/ Such an important point to see patients as knowledge hubs on their own care experiences.
  22. 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.
  23. 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,
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