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Found 557 results
  1. News Article
    Several trusts are failing to admit their sickest emergency patients in a timely fashion, despite performing well in official waiting time statistics, HSJ can reveal. The internal NHS England data, obtained via a Freedom of Information request, reveals 12 trusts which have performed above the average against the four-hour accident and emergency target are delivering relatively poor waiting times for patients who require admission, as opposed to those who, for example, can be discharged after being seen. The unpublished provisional data shows an average of just 30% of admitted patients in England spend four hours or less in A&E against the 95% target. But many trusts are falling significantly below this – including those trusts at or around NHSE’s interim target of 76% for four hours performance for all patients by March 2024. Read full story (paywalled) Source: HSJ, 24 November 2023
  2. News Article
    The trusts with the most patients waiting at least a week after they are ‘ready’ to be discharged can be identified for the first time, following publication of new NHS England data. The new collection shows how long patients are spending in hospital after being deemed fit for discharge, with around 3.7% of all patients in England waiting a week or longer in hospital following their “discharge ready” date — although about half trusts have so far failed to report accurate data. However, there is considerable variation across the country, with six trusts recording more than double the national average in terms of the proportion of patients declared medically fit for discharge being delayed by a week or more. Sarah-Jane Marsh, NHSE’s national director for urgent and emergency care, told HSJ in February that NHSE would aim to set a “baseline” for the discharge-ready data. HSJ understands NHSE will revisit the idea of a new target based on how long patients wait for discharge after they are “ready”, using the new collection, when more trusts are publishing data. It is also planning to publish data based on responsible local authority in future, given councils’ major role coordinating social care support for some people awaiting discharge. Read full story (paywalled) Source: HSJ, 23 November 2023
  3. News Article
    The NHS has sparked controversy by handing the US spy tech company Palantir a £330m contract to create a huge new data platform, leading to privacy concerns around patients’ medical details. The move immediately prompted concerns about the security and privacy of patient medical records and the suitability of Palantir to be given access to and oversight of such sensitive material. NHS England has given Palantir and four partners including Accenture a five-year contract to set up and operate the “federated data platform” (FDP). The British Medical Association, which had previously voiced concern about the NHS’s alleged lack of scrutiny of bidders on “ethical” grounds, said Palantir’s winning bid was “deeply worrying”. NHS England sought to allay such concerns. It stressed that none of the companies in the winning consortium would be able to access health and care data without its explicit consent; that it would retain control of all data within the platform; and that it would not include GP data. It said the new software would be protected by the highest possible standards of security through the deployment of “privacy enhancing technology”. Read full story Source: The Guardian, 21 November 2023
  4. Content Article
    The UK’s healthcare systems are experiencing a prolonged period of high pressure, with industrial action, backlogs in elective care persisting, and a shortage of doctors that ongoing high vacancy rates evidence. This report by the GMC analyses trends in the medical workforce across the UK. It uses a variety of sources to provide insights for policymakers and workforce planners, as well as offering deeper analysis on specific themes.
  5. News Article
    The number of child deaths has hit record levels, with hundreds more children dying since the pandemic, shocking new figures show. More than 3,700 children died in England between April 2022 and March 2023, including those who died as a result of abuse and neglect, suicide, perinatal and neonatal events and surgery, new data from the National Child Mortality Database has revealed – with more than a third of the deaths considered avoidable. Children in poorer areas were twice as likely to die as those in the richest, while 15 per cent of those who died were known to social services. The UK’s top children’s doctor, Dr Camilla Kingdon, president of the Royal College of Paediatrics and Child Health, hit out at the government for failing to act to tackle child poverty, which she said was driving the “unforgivable” and “avoidable” deaths. The report said: “Whilst the death rate in the least deprived neighbourhoods decreased slightly from the previous year, the death rate for the most deprived areas continued to rise, demonstrating widening inequalities.” Read full story Source: The Independent, 11 November 2023
  6. Content Article
    The National Child Mortality Database (NCMD) was launched on 1 April 2019 and collates data collected by Child Death Overview Panels (CDOPs) in England from reviews of all children who die at any time after birth and before their 18th birthday. There is a statutory requirement for CDOPs to collect this data and to provide it to NCMD, as outlined in the Child Death Review statutory and operational guidance. The guidance requires all Child Death Review (CDR) Partners to gather information from every agency that has had contact with the child, during their life and after their death, including health and social care services, law enforcement, and education services. This is done using a set of statutory CDR forms and the information is then submitted to NCMD. The data in this report summarise the number of child deaths up to 31 March 2023 and the number of reviews of children whose death was reviewed by a CDOP before 31 March 2023.
  7. News Article
    Black babies in England are almost three times more likely to die than white babies after death rates surged in the last year, according to figures that have led to warnings that racism, poverty and pressure on the NHS must be tackled to prevent future fatalities. The death rate for white infants has stayed steady at about three per 1,000 live births since 2020, but for black and black British babies it has risen from just under six to almost nine per 1,000, according to figures from the National Child Mortality Database, which gathers standardised data on the circumstances of children’s deaths. Infant death rates in the poorest neighbourhood rose to double those in the richest areas, where death rates fell. The mortality for Asian and Asian British babies also rose, by 17%. The annual data shows overall child mortality increased again between 2022 and 2023, with widening inequalities between rich and poor areas and white and black communities. Most deaths of infants under one year of age were due to premature births. Karen Luyt, the programme lead for the database and a professor of neonatal medicine at Bristol University, said many black and minority ethnic women were not registering their pregnancies early enough and the “system needs to reach them in a better way”. “There’s an element of racism and there’s a language barrier,” Luyt said. “Minority women often do not feel welcome. There’s cultural incompetence and our clinical teams do not have the skills to understand different cultures.” Read full story Source: The Guardian, 9 November 2023
  8. News Article
    Long waits in A&E departments may have caused around 30,000 ‘excess deaths’ last year, according to new estimates. Using a methodology backed by experts, HSJ analysis of official data has produced an estimate of 29,145 ‘excess deaths’ related to long accident and emergency delays in 2022-23, up from 22,175 in 2021-22, and 9,783 related deaths in 2020-21. For the first time, the analysis has also produced estimates of excess mortality related to long A&E delays for every acute trust. The data suggests the rate of excess deaths from 2022-23 has so far continued into 2023-24. The analysis followed a methodology used in a peer-reviewed study published in the Emergency Medicine Journal, which found delays to hospital admission for patients of more than five hours from time of arrival at A&E were associated with an increase in all-cause mortality within 30 days. Data scientist Steve Black, one of the authors of the EMJ study, said: “Long waits in A&E should never happen and 12-hour waits should be something like a never event. They should be intolerable anywhere. If we want to fix them it’s helpful to know which trusts have the worst problems with long waits.” Read full story (paywalled) Source: HSJ, 7 November 2023
  9. Content Article
    Structural, economic and social factors can lead to inequalities in the length of time people wait for NHS planned hospital care – such as hip or knee operations – and their experience while they wait. In 2020, after the first wave of the Covid-19 pandemic, NHS England asked NHS trusts and systems to take an inclusive approach to tackling waiting lists by disaggregating waiting times by ethnicity and deprivation to identify inequalities and to take action in response. This was an important change to how NHS organisations were asked to manage waiting lists – embedding work to tackle health inequalities into the process. Between December 2022 and June 2023, the King’s Fund undertook qualitative case studies about the implementation of this policy in three NHS trusts and their main integrated care boards (ICBs), and interviewed a range of other people about using artificial intelligence (AI) to help prioritise care. It also reviewed literature, NHS board papers and national waiting times data. The aim was to understand how the policy was being interpreted and implemented locally, and to extract learning from this. It found work was at an early stage, although there were examples of effective interventions that made appointments easier to attend, and prioritised treatment and support while waiting. Reasons for the lack of progress included a lack of clarity about the case for change, operational challenges such as poor data, cultural issues including different views about a fair approach, and a lack of accountability for the inclusive part of elective recovery. Taking an inclusive approach to tackling waiting lists should be a core part of effective waiting list management and can contribute to a more equitable health system and healthier communities. Tackling inequalities on waiting lists is also an important part of the NHS’s wider ambitions to address persistent health inequalities. But to improve the slow progress to date, NHS England, ICBs and trusts need to work with partners to make the case for change, take action and hold each other to account.
  10. Content Article
    Health at a Glance provides a comprehensive set of indicators on population health and health system performance across OECD members and key emerging economies. These cover health status, risk factors for health, access to and quality of healthcare, and health system resources. Analysis draws from the latest comparable official national statistics and other sources. Alongside indicator-by-indicator analysis, an overview chapter summarises the comparative performance of countries and major trends. This edition also has a special focus on digital health, which measures the digital readiness of OECD countries’ health systems, and outlines what countries need to do accelerate the digital health transformation.
  11. Content Article
    This report documents a meeting held in September 2022 that explored how Consumer Assessment of Healthcare Providers and Systems (CAHPS®) surveys shed light on disparities in patient experience and how improved measurement can advance healthcare equity in the US. Over 600 CAHPS survey users, researchers, healthcare organisation leaders, patient advocates, policymakers, Federal partners and the CAHPS Consortium attended.
  12. Content Article
    The importance of big health data is recognised worldwide. Most UK National Health Service (NHS) care interactions are recorded in electronic health records, resulting in an unmatched potential for population-level datasets. However, policy reviews have highlighted challenges from a complex data-sharing landscape relating to transparency, privacy, and analysis capabilities. In response, authors of this study, published in The Lancet Digital Health, used public information sources to map all electronic patient data flows across England, from providers to more than 460 subsequent academic, commercial, and public data consumers. Although NHS data support a global research ecosystem, they found that multistage data flow chains limit transparency and risk public trust, most data interactions do not fulfil recommended best practices for safe data access, and existing infrastructure produces aggregation of duplicate data assets, thus limiting diversity of data and added value to end users. They provide recommendations to support data infrastructure transformation and have produced a website to promote transparency and showcase NHS data assets.
  13. News Article
    NHS bosses are using misleading figures to hide dangerously poor performance by A&E units in England against the four-hour treatment target, emergency department doctors claim. Some A&Es treat and admit, transfer or discharge as few as one in three patients within four hours, although the NHS constitution says they should deal with 95% of arrivals within that timeframe. How well or poorly A&Es are doing in meeting the 95% target is not in the public domain because the data that NHS England publishes is for NHS trusts overall, not individual hospitals. That means official figures are an aggregate of performance at sometimes two A&Es run by the same trust or include data for any walk-in centres, minor injuries units or urgent treatment centres that a trust also operates. Forty-eight trusts have two A&Es and many also run at least one of the latter. The Royal College of Emergency Medicine (RCEM), which represents A&E doctors, wants that system scrapped. It is urging NHS England to start publishing data that shows the true performance of every individual emergency department against the 95% standard. “The current data is misleading,” Dr Adrian Boyle, the college’s president, told the Guardian. “It’s a good example of a lack of transparency and also of performance incentives. Being open about the long delays in some A&Es would shine a light in some dark places.” Read full story Source: The Guardian. 28 October 2023
  14. Content Article
    The US Department of Health & Human Services was directed in the Patient Safety and Quality Improvement Act of 2005 to create and maintain a Network of Patient Safety Databases (NPSD) to provide an interactive, evidence-based management resource for healthcare providers, Patient Safety Organisations (PSOs) listed by the Agency for Healthcare Research and Quality (AHRQ), and others. AHRQ, the lead agency for patient safety in the USA implements the NPSD. Initially, the NPSD contains non-identifiable data derived from patient safety work product submitted by PSOs from across the country. This rich data source makes it possible to identify and track patient safety concerns for the purpose of learning how to mitigate patient safety risks and reduce harm across healthcare settings nationally. 
  15. Content Article
    New analysis by the Health Foundation shows that, if current trends continue, the waiting list for routine hospital treatment (‘elective care’) in England could rise to over 8 million by next summer, regardless of whether NHS industrial action continues.   The analysis models four different future scenarios to look at the prospects for reducing the waiting list by the end of 2024. It shows that, on current trends, the waiting list could peak at 8 million by August 2024 if there is no further strike action, before starting to fall. If strike action were to continue the waiting list could be 180,000 higher.   The analysis finds that industrial action by consultants and junior doctors has so far lengthened the waiting list by around 210,000, just 3% of the overall size of the list, which totalled 7.75 million at the end of August 2023. The analysis also points out that strikes are also likely to have indirect impacts, by squeezing NHS finances and diverting management attention away from productivity improvement.    The analysis, which features an interactive ‘waiting list calculator’, also includes illustrative better and worse case scenarios.
  16. News Article
    The performance of one of the NHS’s flagship strategies to reduce demand on over-stretched hospitals has collapsed, HSJ can reveal. Internal NHS figures show the number of processed advice and guidance requests (A&G) from GPs to hospital consultants fell by 28% between June and August, alongside a 32% fall in the number of processed cases where patients were diverted away from secondary care. This comes despite the overall number of A&G requests from GPs only falling by 5% in the same period. A&G services allow GPs to contact hospital consultants before making a referral in order to ensure only clinically appropriate patients are referred to secondary care. The model is described by NHS England as a ”a key part of the National Elective Care Recovery and Transformation Programme’s work.” The data showing the fall in processed requests and diversions from secondary care came from NHSE’s specialist advice activity dashboard, which HSJ has seen. Read full story (paywalled) Source: HSJ, 26 October 2023
  17. News Article
    The true picture of A&E waiting times in Wales has been seriously under-reported for a decade, the BBC can reveal. The Royal College of Emergency Medicine (RCEM) has established thousands of hours are missed from monthly figures. Senior A&E doctors have been raising the issue for months. The Welsh government said it would ask health boards for assurances they were following the guidance "to ensure the data is absolutely transparent". The RCEM said it could not measure "how bad" things were because thousands of patients subject to so-called "breach exemptions" were not included in the overall A&E waiting times. The Welsh government initially disputed the RCEM's claim, but after seeing detailed figures - which were obtained through freedom of information (FOI) requests to health boards - it changed its position. Wales' health minister has repeatedly claimed A&E waiting times in Wales have "bettered English performance". But once the missing data is taken into account, it suggests the performance in Wales is worse. Read full story Source: BBC News, 16 October 2023
  18. Content Article
    This bulletin from the Canadian Institute for Health Information (CIHI) describes two new in-hospital infections indicators for Clostridium difficile (C. difficile) and Methicillin-Resistant Staphylococcus aureus (MRSA). It includes a table listing CIHI’s selected patient safety performance indicators and definitions.
  19. Content Article
    This is the tenth MBRRACE-UK annual report and details the care of 572 women who died during pregnancy, or up to one year after pregnancy between 2019 and 2021 in the UK. The report also includes confidential enquiries into the care of women who died between 2019-2021 in the UK and Ireland from haemorrhage, amniotic fluid embolism, anaesthetic causes, sepsis, general medical and surgical disorders, epilepsy and stroke. By global standards, giving birth in the UK is safe, but the data reported this year should be taken as a warning signal concerning the state of maternity services and the consequences of increasing inequalities and social complexities. While Covid-19 is a significant feature of the deaths reported this year, the pandemic must not distract from wider trends. The Government’s ambition in England was to reduce maternal mortality by 50% between 2010-2025. This target is unlikely to be met. Since 2009-11, maternal mortality has increased by 15%. Crucially, the figures detailed in this report are from before the cost-of-living crisis of 2022-23. When the deaths due to Covid-19 are excluded, maternal death rates are very similar to those in 2016. There is concern that we risk losing the gains made in previous decades. Downloads Lay summary Full report Infographics Themed Surveillance Report Themed Maternal Morbidity Report Themed Maternal Mortality Report
  20. Content Article
    This article published by the Betsy Lehman Center looks at the benefits of real-time monitoring of electronic health records (EHRs). Early adopter hospitals have demonstrated dramatic gains in safety by monitoring patients' EHR's in real time for signals of potential safety events, allowing providers to more quickly and effectively address safety gaps and improve outcomes. This monitoring is carried out by automated safety surveillance software that continuously runs in the background of EHR systems and can detect hundreds of categories of adverse events as they occur. Expert analysis then quickly helps organisations gain insight from the data, which can be used to proactively reduce safety risks and reliably measure incidence of harm over time.
  21. Content Article
    The relationship between patients and their data is deeply personal. This report by The Patients Association shows that patients recognise that the potential for data use to improve care is huge, and that there is widespread support for realising this potential if patients’ concerns are acknowledged and addressed. It proposes the development of a data pact to outline the relationship between patients, their data and the health system. This could be a useful first step in informing patients about how data is used in the health and care system and a starting point in improving patient confidence. To do this, the pact needs to acknowledge that the system is not perfect, as one part of building public confidence is acknowledging the reasons why at present, confidence may be low.
  22. Content Article
    In October, the Healthcare Safety Investigation Branch will tweak its name, become independent from NHS England and the UK government, and gain new powers to strengthen investigations. With the announcement of the change in status, Health Secretary, Steven Barclay, reported it would be leading an investigation into inpatient mental health. This follows swiftly on the heels of the Strathdee rapid review into data on mental health inpatient settings, which itself was launched in response to well-documented failures in these settings. The aim of this new investigation into mental health is simple: to improve safety. In this blog, Karen West, Head of Transformation (Mental health) at Oxehealth, and Professor Dan Joyce from the University of Liverpool, discuss the importance of data in patient safety improvement and explain why inpatient mental health data is so difficult to collect and what can be done to improve this.
  23. Content Article
    The report from the International Labour Organization describes the results of a special analysis of data from the Labour Force Surveys (LFS) of 56 countries which provided data about health and social care workers in sufficient detail to distinguish between different occupational groups within the workforce. The report covers analyses for 29 countries in Europe and 27 from other regions of the world. This analysis can help to highlight specific occupation groups and countries which are at heightened risk of decent work deficits and demographic imbalances.
  24. Content Article
    I am passionate about women's health and have worked with campaigners, clinicians and patients for a number of years to look at the barriers that women face in receiving safe care and the challenges clinicians face in delivering it.   We know the medical system has historically been based on the white, male patient which has led to huge gaps in knowledge and understanding around women's health. But we are not just playing catch up to address past racism and patriarchy that is embedded in the system, we are continuing to highlight and fight it where it still exists.   On Saturday I attended the Women's Health Summit, organised by Five X More. It was a powerful event, designed to look at aspects of women's health throughout their life journey. Attended by mums, charity representatives, media, clinicians, patients, leaders and more, united by a desire to change things.   I laughed, I talked and I cried.   One of the final calls to action of the day was to find your skill, find your voice and do more.   So, I start where I am most at home - in writing. 
  25. Content Article
    The Maternal, Newborn and Infant Clinical Outcome Review Programme, which is delivered by MBRRACE-UK, has published a report on UK Perinatal Deaths for Births from January to December 2021. Overall, it found that perinatal mortality rates increased across the UK in 2021, with 3.54 stillbirths per 1,000 total births and 1.65 neonatal deaths per 1,000 live births (3.33 and 1.53 respectively in 2020). However, there was a wide variation in stillbirth and neonatal mortality rates across organisations, though these rates increased in almost all gestational age groups. It was also found that inequalities in mortality rates by deprivation and ethnicity remain, but the most common causes of stillbirth and neonatal death are unchanged (for example, congenital anomalies continue to contribute to a significant proportion of perinatal deaths).
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