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Found 227 results
  1. Content Article
    In this blog Patient Safety Learning considers the impact on patient safety of the shortage of hospital beds facing the NHS this winter. It focuses on two specific issues stemming from this, the increasing numbers of patients being cared for in corridors and other non-clinical areas, and current proposals to reduce the number of patients waiting to be discharged.
  2. Content Article
    Young people and expert mental healthcare staff say patients are unlikely to receive in-patient mental health care unless they “have attempted suicide multiple times”, according to a new report published by Look Ahead Care and Support. Launched in the House of Lords, the report – funded by Wates Family Enterprise Trust and produced by experts Care Research – argues Accident and Emergency departments have become an ‘accidental hub’ for children and young people experiencing crisis but are ill-equipped to offer the treatment required.   Based on in-depth interviews with service users, parents and carers, and NHS and social care staff from across England, the findings from the Look Ahead Care and Support report draws on experience of treating depression, anxiety, self-harm, suicidal thoughts and suicide attempts, eating disorders, addiction and psychosis.  
  3. Content Article
    The Fracture Liaison Service Database (FLS-DB) collects, measures and reports on the care provided by Fracture Liaison Services (FLSs). This annual report presents the results of secondary fracture prevention care received by patients aged 50 and older following a fragility fracture between January and December 2021. Based on 70,384 patient records in 2021 (compared with 70,614 in 2019), it found that there has been a reduction in both case identification and assessment performance, but an improvement in treatment recommendation, monitoring and follow up, when comparing national data from 2021 with 2019.
  4. Content Article
    This document summarises the current landscape of virtual wards from the perspective of healthcare for older people, and provides advice to those looking to set up such services for older people living with frailty.
  5. Content Article
    This paper from Natalie Offord and colleagues describes a service redesign in which has gained learning and experience in two areas. First, a description of measured improvement by the innovation of redesigning the traditional hospital-based assessment of frail older patients’ home support needs (assess to discharge) into their own home and meeting those needs in real time (discharge to assess). In combination with the formation of a collaborative health and social care community team to deliver this new process, there has been a reduction in the length of stay from completion of acute hospital care to getting home (from 5.5 days to 1.2 days for those patients that require support at home). Second, the methodology through which this has been achieved. The authors describe their translation of a Toyota methodology used for the design of complex cars to use for engaging staff and patients in the design of a healthcare process.
  6. Content Article
    Hospitals are crammed full of patients, the staffing crisis in adult social care continues to escalate, and alarming numbers of junior doctors report that they are planning to quit their NHS posts to work abroad. The multiple problems confronting the UK’s health and care system are interconnected and have been years in the making. While the pandemic exacerbated many of them, hugely increasing pressures on staff, political failures and, above all, a lack of investment are making it impossible for the service to stand still this winter – let alone recover. This Guardian Editorial gives its view on the current state of the NHS.
  7. Content Article
    This study in Plos One used a prospective error analysis method—the Systematic Human Error Reduction and Prediction Approach (SHERPA)—to examine the process of dispensing medication in community pharmacy settings and identify solutions to avoid potential errors. These solutions were categorised as strong, intermediate or weak based on an established patient safety action hierarchy tool. The authors identified 88 potential errors with a total of 35 remedial solutions proposed to avoid these errors in practice. Sixteen (46%) of these remedial measures were categorised as weak, 14 (40%) as intermediate and 5 (14%) as strong according to the Veteran Affairs National Centre for Patient Safety action hierarchy. The authors suggest that future research should examine the effectiveness of the proposed remedial solutions to improve patient safety.
  8. News Article
    Hospitals and care homes have not received a single penny of a £500m emergency fund promised by the government to prevent the NHS becoming overwhelmed this winter, the Guardian has learned. Ministers announced they were injecting the cash into the health and social care system last month, to help get thousands of medically fit patients out of hospital into either their own home or a care home as soon as possible in an effort to better prepare the NHS for the coming months. “At the moment, one of the key challenges is discharging patients from hospital into more appropriate care settings to free up beds and help improve ambulance response times,” Thérèse Coffey, the then health and social care secretary, said on 22 September. “To tackle that, I can announce today that we are launching a £500m adult social care discharge fund for this winter.” However, the Guardian has been told that none of the funding has materialised. Senior health and social care sources described the government’s failure to release the promised cash as “inexplicable” and “outrageous”. More than 13,000 of the 100,000 NHS hospital beds in England currently contain “delayed discharge” patients, which has led to A&E units becoming heavily congested and long delays in ambulance handovers. As a direct result, thousands of 999 patients are suffering potential “severe harm” every month because ambulances are stuck outside hospitals. “Leaders across the NHS and local authorities are yet to see a single penny of this investment or any official detail on how it will be allocated,” said Matthew Taylor, the chief executive of the NHS Confederation. “Currently, only two-fifths of patients in hospital are able to leave when they are ready to do so, including due to problems accessing social care, yet health leaders still do not know how and when the £500m will be released to the system. So close to winter, this is unbelievable. Read full story Source: The Guardian, 31 October 2022
  9. News Article
    The “social prescribing” of gardening, singing and art classes is a waste of NHS money, a study suggests. Experts found that sending patients to community activity groups had “little to no impact” on improving health or reducing demand on GP services. The research calls into question a major drive from the NHS and Department of Health to increase social prescribing as a solution to the shortage of doctors and medical staff. In 2019 the NHS set a target of referring 900,000 patients for such activities via their GP surgeries within five years. Projects receiving government funding include football to support mental health, art for dementia, community gardening and singing classes to help patients to recover from Covid. However, the study, published in the journal BMJ Open, said there was “scant evidence” to support the mass rollout of so-called “social prescribing link workers”. Read full story (paywalled) Source: The Times, 18 October 2022
  10. News Article
    Shortages and rising costs of medicines could result in patients not receiving important prescriptions, community pharmacists have warned. Commonly prescribed drugs used to treat conditions such as osteoporosis, high blood pressure and mental health are among those affected. The Department of Health (DoH) said a support package worth £5.3m for the sector is being finalised. But Community Pharmacy NI said this "falls way short of what is needed". David McCrea from Dundela Pharmacy said the price of some medicines had been raised "fiftyfold". "As a community pharmacist for over 30 years, I have never witnessed the price of medicines rise this sharply," Mr McCrea said. "It is becoming increasingly hard for us to afford to buy the medicines from wholesalers because we are not being paid the full cost of these drugs by the department." Mr McCrea added the current situation was causing "financial stress" and was becoming unsustainable. "The bottom line is that we are now facing the situation where we will not be able to afford to supply our patients with essential medicines, within weeks." Read full story Source: BBC News, 18 October 2022
  11. News Article
    Elderly people who call for help after a fall at home will no longer be left waiting for hours on the floor, the head of the NHS has said, as she bids to keep patients out of hospital and stop the service being overwhelmed this winter. Amanda Pritchard said she would start a new national service within weeks under which community teams would offer immediate help to people who had had an accident but had avoided serious injury. Pritchard, who took over as chief executive of NHS England last year, said a quarter of less severe 999 calls in January involved falls. The new teams could stop 55,000 elderly people a year being taken to hospital, she said. All NHS areas will be told this week to establish the service before a “very, very, very challenging winter” for the health service. Read full story (paywalled) Source: The Times, 16 October 2022
  12. News Article
    NHS England is developing plans for a new universal ‘community recovery service’ with a 24-hour target to provide ‘step down care’ once a patient is deemed ready to leave hospital, HSJ has revealed. Slides presented to an NHS England webinar reveal it is seeking to pilot “one single intermediate care step-down service [organised] at place through one lead commissioner”. It would include a target, or standard, requiring that when patients no longer meet the “criteria to reside in hospital”, they enter the new community recovery service within 24 hours. NHSE’s “vision” is that this 24-hour standard is met for all acute hospital patients within five years, the slides seen by HSJ reveal. The documents do not specify whether they would also be discharged within 24 hours. Delayed discharges have been a problem for many years, but have caused particularly huge difficulties in the past 18 months, leading to emergency department overcrowding and ambulance handover delays. In August, one in seven patients in acute hospitals were medically ready to be discharged, NHSE figures suggest. According to the documents seen by HSJ, key objectives for the new service also include reducing long-term care costs “by decreasing demand and acuity”, and ”increasing people’s functional outcomes” by giving more people better rehab care on discharge. This appears to be a recognition that at present many people discharged receive inadequate rehab, which can exacerbate their condition, requiring more care. Read full story (paywalled) Source: HSJ, 12 October 2022
  13. News Article
    Social care services face an “absolute crisis” over record vacancies as unfilled jobs have risen by more than 50% in a year, a new analysis reveals. New data on social care workers shows at least 165,000 vacancies across adult social care providers at the end of 2021-22. This is the highest on record according to the charity Skills for Care, which has collected the data since 2012. Leading think tanks have warned the figures to point to the “absolute crisis” facing social care with the “system on its knees”. At the same time the demand for care has risen, highlighting that social care is facing a complex challenge with recruitment and retention which will be impacting on the lives of people who need social care. The annual report by Skills for Care predicts social care services will need an extra 480,000 workers by 2035 to meet the demand but could be set to lose 430,000 staff to retirement over the next decade. Simon Bottery, senior fellow at The King’s Fund, said the report was evidence “of the absolute crisis social care faces when trying to recruit staff, a crisis that has profound consequences for people needing care”. He added: “A key reason for that is pay, which continues to lag behind other sectors including retail and hospitality, as well as similar roles in the NHS. Our recent analysis found that nearly 400,000 care workers would be better paid to work in most supermarkets." Read full story Source: The Independent, 11 October 2022
  14. Content Article
    Hospital at Home is a short-term, targeted intervention that provides a level of acute hospital care in an individual’s own home, or homely setting that is equivalent to that provided within a hospital. In mid-2020, the ihub within Healthcare Improvement Scotland began working with a number of NHS boards and health and social care partnerships to support the implementation of Hospital at Home services across Scotland. This toolkit was created as part of that work, providing a range of tools and resources to support areas to implement and expand Hospital at Home services.
  15. Content Article
    This investigation by the Healthcare Safety Investigation Branch (HSIB) aimed to support improvements in the work of community mental health teams (CMHTs). Specifically, the investigation looked at the following four areas: assessing a patient’s risk of self-harm or suicide considering menopause as a risk factor for mental health conditions engaging with families caring for people with a first episode of psychosis. Reference event Ms A was 56 years old when she came into contact with mental health services for the first time in September 2019, following a suicide attempt. Ms A spent a month in hospital, and was then discharged home under the care of a community mental health team (CMHT) with a diagnosis of psychotic depression. At the end of May 2020, Ms A was again admitted to hospital following a second suicide attempt. She again stayed in the hospital for about four weeks before being discharged home under the care of a CMHT. Ms A was seen by CMHT workers regularly throughout July, and had a telephone review with a consultant psychiatrist. At the end of July, Ms A’s family became increasingly concerned about her mental state and were unable to make contact with her. On 2 August, Ms A was found deceased at home having died by suicide.
  16. Content Article
    Smart Pods is the first-ever Royal College of Art (RCA)/ Engineering and Physical Sciences Research Council (EPSRC) multi-disciplinary healthcare project. It has grown out of the College’s chartered commitment to engage with ‘social developments’ through design.
  17. Content Article
    Nuffield Trust’s fifteenth annual Summit took place in March 2023. These videos feature highlights of the speaker sessions: Diagnosing the NHS Priorities in social care Community and rehabilitation services - the key to easing gridlock? Addressing inequalities in general practice - politics, policy and reality Solving the workforce burnout crisis Improving communication between the NHS and the public Changing the centralised culture of the NHS
  18. Content Article
    This infographic explains the role community health services play in the NHS healthcare system.
  19. News Article
    As the pressures of winter and the Covid treatment backlog grow, the NHS is struggling. In Manchester, one organisation is pioneering a new way to care for people that tries to reduce the burden on the health service. It's the first call-out of the day for nurse Manju and pharmacist Kara in north Manchester. They are on their way to see Steven, who has been diagnosed with Parkinson's disease and had a fall the previous night. This might have led to a call-out for an ambulance crew and a visit to A&E. But instead the Manchester Local Care Organisation (LCO) stepped in. Once at Steven's house, Manju makes sure he hasn't been harmed by his fall, while Kara checks his medication. Manju notes that Steven's tablets could have contributed to his fall. Manju asks Steven how he copes going up and down the stairs. "I'm OK, just about," he says. But when he has a go at coming down the stairs, Manju spots he could use an extra grab rail and says she will sort one out. This intervention by the team has not only avoided Steven ending up in A&E, but also ensures he can continue to live independently in his own home. That's a key part of the LCO mission, according to Lana McEwan, one of the team leaders in north Manchester. "We would consider ourselves to be an admission-avoidance service, so we're trying to prevent ambulances being called in the first instance. "When an ambulance has been called, we're taking referrals directly from the ambulance service and responding within a one or two-hour response depending on need, and that's an alternative to A&E." Local neighbourhood teams are made up of nurses, social workers, pharmacists and doctors, all working together to keep people out of hospital. Read full story Source: BBC News, 9 December 2022
  20. News Article
    Lack of beds in the NHS and social care sector have been highlighted by the case of an 81-year-old woman discharged home at night, her family said. Janice Field attended Colchester Hospital in Essex with a suspected heart attack. She was returned to her flat at midnight, despite having no home care at that time of day. The hospital trust said it focused on keeping patients safe and was "sorry to hear about the concerns raised". Ms Field was checked out at the hospital last week and deemed fit to go home, but her family said she should have stayed in hospital overnight, or be found a community care bed. Her daughter-in-law, Sarah Field, a qualified nurse, said: "To discharge an 81-year-old lady and have them having to be transferred in the middle of the night is totally unacceptable. "But the nurse we spoke to was emphatic. She was desperate. She said, 'no, we have no beds. This has got to happen. She's clinically fit. She has got to go'. "The NHS is broken, under-resourced and not fit for purpose. This is not the fault of those that work in it, but the fault of the system." Read full story Source: BBC News, 26 November 2022
  21. News Article
    A woman who struggled to access night-time care for her dying father has told the BBC he "shouldn't have been expected to die in office hours". Tracey Bennett said she was "completely lost" when her dad Michael needed help. Early in 2021, Mrs Bennett, 54, from Doncaster, moved in with her dad, 76-year-old Michael Woodward, to care for him in the last stages of his cancer. One night he had a fall. Mrs Bennett was able to help him back up but turned to the local NHS palliative care phone line for help, only to find it closed. Although she did not feel her father should be in a hospital, she called 999 as she felt she had no-one else to turn to. He died in the early hours of the next morning. "In his hour of need I feel I let my dad down," she said. "He shouldn't have been expected to die in office hours." Almost 70% of the UK does not have a consistent 24-hour help-line for the terminally ill, research suggests. And 27% of these areas do not have a designated phone line, the study funded by Marie Curie found. Ruth Driscoll, from the charity, said the research painted "a bleak picture of out-of-hours care in many areas of the UK". Read full story Source: BBC News, 28 November 2022
  22. News Article
    A carer who murdered the elderly woman he was employed to look after had a history of violent crime including actual bodily harm, a report found. A safeguarding adults review over the death of a 77-year-old Devon woman in 2021 criticised working practices among organisations involved in her care. Devon and Cornwall Police did not disclose information about domestic abuse callouts involving the killer in a DBS check by the care provider. He was jailed for life in July 2022. The woman had seen her killer as "a grandson" figure, it said. The 35-year-old killer attacked his victim after she discovered he had stolen several thousand pounds from her. The had no previous employment experience of care before being taken on as her sole carer by Complete Quality Care Ltd, an independent care provider. Read full story Source: BBC News, 24 November 2022
  23. News Article
    A policy change to speed up hospital discharge could save the NHS more than £7bn over a decade, according to a government evaluation – but ministers have not funded it. A Department of Health and Social Care impact assessment of the Health and Care Act, passed earlier this year, says that wider use of discharge to assess could free up as many as 6,000 hospital beds and save the NHS £7bn by 2031, the equivalent of £800m a year. It adds: “The overall societal benefits of this would likely be higher as beds could be allocated to patients with more urgent health care needs.” The “discharge to assess” approach, which has been used on a temporary basis for several years and more widely during the pandemic – with government funding to back it – sees patients discharged more quickly, and provided with support at home while their long-term care needs are assessed. It was credited with significant reductions in the amount of time patients spent in hospital. Changes in the Health and Care Act were intended to remove legal obstacles to the approach, by revoking a requirement for an assessments be carried out before discharge, which often leads to delays in the patient leaving hospital. Read full story (paywalled) Source: 15 November 2022
  24. News Article
    One of the country’s most senior doctors has said he is “desperate” to keep his elderly parents out of hospital, which he said are like “lobster traps”. Dr Adrian Boyle, president of the Royal College of Emergency Medicine, said hospitals are easy to get into but hard to get out of. His comments come after figures showed the number of patients in hospital beds in England who no longer need to be there has reached a new monthly high. An average of 13,613 beds per day were occupied by people ready to be discharged from hospital in October. That was up from 13,305 in September and the highest monthly figure since comparable data began in December 2021, according to analysis by the PA news agency. In an interview with the Daily Mail, Dr Boyle said: “Hospitals are like lobster traps – they’re easy to get into and hard to get out of. “If social care was able to do its job in the way we want it to, these poor people wouldn’t be stranded in hospital. “I have elderly parents and I’m desperate to keep them out of hospital. “For someone who is frail, hospital is often a bad place for them. They’re being harmed by being in hospital.” Read full story Source: The Independent, 14 November 2022
  25. News Article
    A Guardian analysis has found that as many as one in three hospital beds in parts of England are occupied by patients who are well enough to be discharged, with a chronic lack of social care meaning many do not have suitable places to go. Barry Long's 91-year-old mother has Alzheimer’s and was admitted to Worthing hospital on 30 May after a minor fall. She was a bit confused but otherwise unhurt, just a bit shaken. Whilst in hospital, she caught Covid and had to be isolated, which she found distressing, and became increasingly disoriented. She was declared medically fit to be discharged but no residential bed could be found for her. Then, in August, she was left unsupervised and fell over trying to get to the toilet and she fractured her hip, which required surgery. Her hip was just about healed when she caught her shin between the side bars and the frame of the bed, cutting her shin so badly that she is being reviewed by a plastic surgeon to see if it needs a skin graft. "Since the operation, my mum is pretty much bedbound and lives in a state of confusion and anxiety", says Barry. "Her physical health and mental wellbeing have deteriorated considerably in the almost five months she has spent in the care of the NHS. She spends all day practically trapped in bed, staring into space or with her eyes shut, just rocking to and fro. She has little mental stimulation." Read full story Source: The Guardian, 13 November 2022
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