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Found 469 results
  1. News Article
    Waiting times for tests and treatment not related to COVID-19 are likely to increase significantly in the second half of 2020 because of the fallout from the pandemic, the head of NHS England has acknowledged. Giving evidence to the Commons health select committee on 30 June, NHS England’s chief executive Simon Stevens said that contrary to some commentary, the NHS’s overall waiting list actually dropped by over half a million people between February and April 2020 because fewer people were coming forward for treatment. But, he added, “As referrals return we expect that will go up significantly over the second half of the year.” Stevens said that there were 725 000 fewer elective admissions to NHS hospitals during March and April, but that number has begun to recover significantly. “As we speak, we think we’re now somewhere north of 55% of pre-covid-19 elective activity levels,” he said. He added that he hoped the NHS would return to around three quarters of normal activity levels by July or August. Stevens told MPs that the NHS would pursue a range of measures to increase capacity over the coming months, including extending the deal with the private sector to use its facilities, and repurposing some of the Nightingale hospitals for diagnostic testing. Read full story Source: BMJ, 1 July 2020
  2. News Article
    Almost half a million people are waiting at least six weeks for tests which could diagnose cancer – up from just 30,000 before lockdown, new analysis shows. Ministers have been urged to urgently bring forward plans to tackle the backlog of patients waiting for care, with calls for weekly testing of staff to keep coronavirus infections off the wards. Cancer charities fear there will be an extra 18,000 deaths a year because those with symptoms are not receiving prompt diagnosis and treatment. Read full story (paywalled) Source: The Telegraph, 23 June 2020
  3. News Article
    A patient almost died after being misdiagnosed and sent home from hospital on the first day of the lockdown as the NHS curtailed many normal services to focus on COVID-19. The NHS trust involved has admitted that its failings led to the man suffering excruciating pain, developing life-threatening blood poisoning, and contracting the flesh-eating bug necrotising fasciitis. He needed eight operations to remedy the damage caused by his misdiagnosis. The man, his wife and his GP spent three weeks after his discharge trying to get him urgent medical care. However, St Mary’s hospital on the Isle of Wight rejected repeated pleas by them for doctors to help him, even though his health was deteriorating sharply. The man, who does not want to be named, said his experience of seeking NHS care for something other than COVID-19 during the pandemic had been “debilitating and exhausting” and that feeling the NHS “was not there” for him had been “very distressing” for him and his wife. Mary Smith, of the solicitors Novum Law, who are representing the man in his complaint against the trust, said his plight highlighted the growing number of cases that were emerging of people whose health had suffered because they could not access normal NHS care in recent months. Read full story Source: The Guardian, 16 June 2020
  4. News Article
    A leading doctor has warned that trusts will struggle to get back to anything like pre-covid levels of endoscopy services and will need to prioritise which patients are diagnosed. Endoscopy procedures are part of the diagnostic and treatment pathway for many conditions, including bowel cancer and stomach ulcers. Most hospitals have not done any non-emergency procedures since the middle of March because they are aerosol generating — meaning a greater covid infection risk and need for major protective equipment. Although some areas are now starting to do more urgent and routine work, capacity is severely limited. Kevin Monahan, a consultant gastroenterologist at St Marks’s Hospital, part of London North West Healthcare Trust, and a member of the medical advisory board for Bowel Cancer UK, said the time taken for droplets to settle in rooms after a procedure can be up to an hour and three quarters, depending on how areas are ventilated. Only then can the room be cleaned and another patient seen. Dr Monahan said his trust had restarted some endoscopy work and was currently doing around 17 per cent of its pre-covid activity. “We can provide a maximum of about 20 per cent of normal activity — and that is using private facilities for NHS patients,” he said. “I am not at all confident we will be able to double what we are doing now, even in three to four months’ time." Read full story Source: HSJ, 12 June 2020
  5. News Article
    As the death toll from the virus soars above 40,000, slowly the horrendous toll on non-Covid patients is emerging. These are patients who are not afflicted by coronavirus, but who have had their treatment or diagnosis for other potentially deadly conditions postponed or cancelled, as hospitals scrambled to make way for an overwhelming burden of COVID-19 patients. Sherwin Hall, a 27-year-old from Leeds, had tried 13 times in one month during the lockdown to get a proper diagnosis for the crippling pain in his groin. He was initially told it might be a sexually transmitted disease. Eventually he was given the all clear of any STD after multiple blood tests and begged for an MRI scan. But he claims he was told no scans would be available because of the COVID-19 emergency. Finally he got a scan which confirmed a 14 cm tumour near his pelvis. He clams his consultant confirmed the delay in diagnosis and therefore cancer treatment may have serious consequences on his chances of survival. He told ITV news "I am very angry at the way I have been treated due to COVID-19 and the delay on my cancer treatment and now I am fighting for my life." His lawyer, Mary Smith, who specialises in medical negligence at Novum Law in Bristol, says she is worried there will be a spike in cases involving delayed diagnosis or treatment coming across her desk. She wants an urgent overhaul of the management of this crisis, now its peak appears to have passed. Read full story Source: ITV News, 9 June 2020
  6. News Article
    About 2.4 million people in the UK are waiting for cancer screening, treatment or tests, as a result of disruption to the NHS during the past 10 weeks, according to Cancer Research UK. It estimates 2.1 million have missed out on screening, while 290,000 people with suspected symptoms have not been referred for hospital tests. More than 23,000 cancers could have gone undiagnosed during lockdown. Chief executive Michelle Mitchell said COVID-19 has placed an "enormous strain on cancer services". "The NHS has had to make very hard decisions to balance risk," she said. "...there have been some difficult discussions with patients about their safety and ability to continue treatment during this time. Prompt diagnosis and treatment remain crucial to give people with cancer the greatest chances of survival and prevent the pandemic taking even more lives." To ensure no-one is put at risk from the virus now that cancer care is returning, Cancer Research UK said "frequent testing of NHS staff and patients, including those without symptoms" was vital. Read full story Source: BBC News, 1 June 2020
  7. News Article
    A Nottingham mum recovering from breast cancer surgery said she 'hates to think' what could have happened, if she had let the cancer go undetected. Claire Knee, 45 of Beeston, was diagnosed with breast cancer in March shortly before lockdown measures were introduced. Having felt slightly off and noticing lumps in her breast, she was encouraged to contact her GP who referred her for tests. After a serious of diagnostic tests at Nottingham City Hospital's Breast Institute, specialists confirmed the presence of a tumour in the early stages. Surgeons successfully removed the tumour from her right breast amid the pandemic and Claire has been recommended some follow up treatment. She now wants to share her experience of seeking help and getting treatment to advise others who may be showing signs of cancer but are too scared to contact their GP. "Looking back I just think that if I hadn’t made the call to my GP I would be walking around with undetected breast cancer, which could still be growing now. I would urge anyone in similar circumstances to contact their GP and get checked - even if it’s just for peace of mind.” Read full story Source: Nottinghamshire Live, 4 May
  8. News Article
    Delays in diagnosing and treating people with cancer could lead to more years of lost life than with COVID-19, according to a leading cancer expert. A drop-off in screening and referrals means roughly 2,700 fewer people are being diagnosed every week, Cancer Research UK says. Cancer screening has paused in Wales, Scotland and Northern Ireland, with few invitations sent out in England. People are still advised to contact their GP with worrying symptoms. But Richard Sullivan, professor of cancer and global health at King's College London, said there was more fear of Covid-19 than of having cancer at the moment. With GPs more difficult to contact than normal, this was resulting in a "dramatic drop-off" in referrals to specialists, he said. "Most modellers in the UK estimate excess of deaths is going to be way greater than we are going to see with Covid-19," he said. Read full story Source: 22 April 2020, BBC News
  9. News Article
    Women are at risk of serious harm and death because hospitals are not always diagnosing ectopic pregnancies quickly enough, an investigation reveals. About 12,000 women a year in the UK suffer an ectopic pregnancy – when a fertilised egg grows outside the womb – putting them at risk if a fallopian tube containing the foetus ruptures and causes potentially fatal heavy bleeding. An investigation by the Healthcare Safety Investigation Branch (HSIB) has found flaws in the treatment women receive. It has highlighted late diagnosis and consequent delay in treatment as a major concern, especially as a result of the condition being mistaken for a urinary tract infection. NHS patient safety data shows that 30 ectopic pregnancies were missed and led to “serious harm” between April 2017 and August 2018. As well as the risk to life, an ectopic pregnancy can also damage a woman’s chances of conceiving again and have serious psychological effects. Read full story Source: The Guardian, 5 March 2020
  10. News Article
    Astrophysics and dermatology are colliding through a new research project led by the University of Southampton – with potentially lifesaving consequences. The project, dubbed MoleGazer, will take algorithms used for detecting exploding stars in astronomical imaging data and develop them to be used to spot changes in skin moles and, therefore, detect skin cancer. MoleGazer, led by Professor Mark Sullivan, Head of the School of Physics and Astronomy at the University, and Postdoctoral Researcher Mathew Smith, has been awarded a Proof of Concept Grant from the European Research Council (ERC). It is the first time the University has won such a grant. Currently, patients at high risk of developing skin cancer are photographed at regular intervals and a consultant visually compares images to detect changes. MoleGazer could automate this process, potentially leading to earlier diagnoses and improved survival rates. “It’s a really exciting project that came along from nowhere,” added Professor Sullivan. “It also highlights the importance of blue sky science – curiosity-driven scientific research will always have a fundamentally important role to play.” Read full story Source: University of Southampton, 10 January 2020
  11. News Article
    Trainee oncologists at a major cancer centre covered clinics and made “critical” decisions without senior supervision, including for cancers they were not trained for, HSJ has revealed. A Health Education England (HEE) reviews aid: “The review team was concerned to hear that trainees were still expected to cover clinics where no consultant was present, including clinics relating to tumour sites that they were unfamiliar with.” Guy’s and St Thomas’ Foundation Trust’s trainee clinical oncologists felt “they could only approach 50–75% of the consultants for critical decision-making”, the document said. The HEE “urgent concern review” report said: “The trainees also reported that there was a continued lack of clear consultant supervision for inpatient areas in clinical oncology, which meant that they were not able to access senior support for decision-making.” A trust spokesman said: “We recognise that senior support to the clinical team is a vital part of keeping our patients safe.” Read full story (paywalled) Source: HSJ, 16 January 2020
  12. News Article
    Women in some parts of the country are half as likely to be diagnosed with ovarian cancer as elsewhere, new analysis of NHS data has revealed. The proportion of women diagnosed at an early stage of the disease, when it is most susceptible to treatment, varied in some areas from 22% to 63%. UK survival rates for cancer have lagged behind other countries and NHS England has set a target to improve early diagnosis with an ambition to have 75% of all cancers diagnosed early by 2028. The ovarian cancer audit data shows the UK is far from achieving this with only 33% of cancers diagnosed at stage one or two while 50% of cancers were detected at stage three and four. Chief Executive of Ovarian Cancer Action, Cary Wakefield, said: “Diagnosing ovarian cancer at the earliest stages is crucial, but sadly as we gather data it is clear that a postcode lottery exists around the country, with some areas diagnosing significantly more patients early than others. We want to see all patients diagnosed early enough to get treatment and survive this disease, no matter where they live.” Read full story Source: The Independent, 9 January 2020
  13. News Article
    Mother Natalie Deviren was concerned when her two-year-old daughter Myla awoke in the night crying with a restlessness and sickness familiar to all parents. Natalie was slightly alarmed, however, because at times her child seemed breathless. She consulted an online NHS symptom checker. Myla had been vomiting. Her lips were not their normal colour. And her breathing was rapid. The symptom checker recommended a hospital visit, but suggested she check first with NHS 111, the helpline for urgent medical help. To her bitter regret, Natalie followed the advice. She spoke for 40 minutes to two advisers, but they and their software failed to recognise a life-threatening situation with “red flag” symptoms, including rapid breathing and possible bile in the vomit. Myla died from an intestinal blockage the next day and could have survived with treatment. The two calls to NHS 111 before the referral to the out-of-hours service were audited. Both failed the required standards, but Natalie was told that the first adviser and the out-of-hours nurse had since been promoted. She discovered at Myla’s inquest that “action plans” to prevent future deaths had not been fully implemented. The coroner recommended that NHS 111 have a paediatric clinician available at all times. In her witness statement at her daughter’s inquest in July, Natalie said: “You’re just left with soul-destroying sadness. It is existing with a never-ending ache in your heart. The pure joy she brought to our family is indescribable.” Read full story Source: The Times, 5 January 2020
  14. Content Article
    Positive defensive medicine describes an approach to healthcare that involves excessive testing, over-diagnosing and overtreatment. Negative defensive medicine, on the contrary, describes an approach where doctors avoid, refer or transfer high risk patients. This article in Patient Safety in Surgery examines how both defensive medicine approaches can contribute to medical errors.
  15. Content Article
    This report by the Health and Social Care Commons Select Committee examines why cancer outcomes in England remain behind other comparable countries. For example, 58.9% of people in England diagnosed with colon cancer will live for five years or more, compared to 66.8% in Canada and 70.8% in Australia. The report identifies key issues in early diagnosis, access to treatment, variation in services and research and innovation, and makes recommendations aimed at improving cancer survival rates in England.
  16. Content Article
    This article in the British Journal of General Practice aimed to develop a safety-netting intervention to reduce delays in cancer diagnosis in primary care. To develop the tool, patient representatives, GPs and nurse practitioners were invited to a series of co-design workshops. These workshops suggested the intervention format and content should incorporate visual and written communication specifying clear timelines for monitoring symptoms and when to present back. Participants also agreed that they needed to be available in paper and electronic forms, be linked to existing computer systems and be able to be delivered within a 10-minute consultation. The output of this process was the Shared Safety Net Action Plan (SSNAP), a safety-netting intervention to assist the timely diagnosis of cancer in primary care.
  17. Content Article
    This study in the Journal of Patient Safety aimed to describe the contributing factors in diagnosis-related and failure-to-monitor malpractice claims in which nurses are named the primary responsible party. It also aimed to identify actions healthcare leaders can take to enhance the role of nurses in diagnosis. The authors found that as nurses are held legally accountable for their role in diagnosis, leaders need to raise awareness across the system of the roles and responsibilities of nurses in this area. They also need to focus on enhancing nurses' diagnostic skills and knowledge.
  18. Content Article
    This investigation by the Healthcare Safety Investigation Branch (HSIB) explores the timely recognition and treatment of suspected pulmonary embolism in emergency departments. Pulmonary embolisms can form when clots from the deep veins of the body, usually originating in the legs, travel through the venous system and become lodged in the lungs. A person suffering from a pulmonary embolism requires urgent treatment to reduce the chance of significant harm or death.
  19. Content Article
    Chloe Lumb was known to have a genetic risk of aortic dissection that was being monitored. When she presented to James Cook University Hospital in Middlesbrough on 4 January 2021 a diagnosis of aortic dissection was not made, despite the prior knowledge about her risk and her clinical symptoms. The next day she contacted the hospital following discharge because of ongoing symptoms but was not asked to return to hospital. In her report, the Coroner states that a diagnosis of aortic dissection and appropriate surgical treatment would have prevented Ms Lumb’s death.
  20. Content Article
    The gender health gap is a long-standing, deeply entrenched problem that stretches back centuries - yet it is only finally starting to get the attention it deserves. In this discussion hosted by The Independent's Women's Correspondent Maya Oppenheim, Dr Jess Taylor, Le’Nise Brothers, Sandra Igwe and Dr Geeta Nargund explore the steps that must be taken to solve the gender health gap, including proper education of health professionals and engaging in open honest conversations.
  21. Content Article
    In this episode of The King's Fund podcast, host Helen McKenna speaks with Professor Dame Lesley Regan and Dr Janine Austin Clayton about women’s health journeys from start to finish. They explore why women can struggle to get medical professionals to listen to them and the impact this has on diagnosis and treatment, as well as the mental and physical effects on women themselves.
  22. Content Article
    Language barriers, reduced self-advocacy, lower health literacy and biased care may hinder the diagnostic process. This US study in BMJ Quality & Safety looks at patient-reported diagnostic errors, what contributes to them and the impact they have, and examines the differences between respondents with limited English-language health literacy or disadvantaged socioeconomic position, and their counterparts. The authors conclude that: interpreter access should be viewed as a diagnostic safety imperative. social determinants affecting care access and affordability should be routinely addressed as part of the diagnostic process. patients and their families should be encouraged to access and update their medical records.
  23. Content Article
    To mark Rare Disease Day 2022, the Department of Health and Social Care has published England’s first Rare Diseases Action Plan.
  24. Content Article
    Waiting is a feature of public healthcare systems but must be managed to avoid adverse impacts on patients. The NHS sets performance standards for waiting times for elective and cancer care. Its performance against these was deteriorating before the COVID-19 pandemic and has worsened since it began. Millions of patients’ care was disrupted, meaning backlogs increased. This report looks in detail at backlogs and waiting times for elective and cancer care in the NHS in England. It explains how the current increased backlogs and waiting times have arisen, including the impact of the COVID-19 pandemic. The report sets out: how waiting times performance for elective and cancer care are tracked in the NHS, and how long patients have been waiting relative to the performance standards; the causes of increasing longer waits before the pandemic and the disruption caused by the pandemic; and the steps the Department and NHSE&I have already taken to address the increasing backlogs and waiting times, and the constraints and challenges the NHS faces in making a full recovery.
  25. Content Article
    This study in the journal Rheumatology looked at the experience and views of rheumatology patients and clinicians regarding telemedicine. The Covid-19 pandemic has forced a rapid transition towards telephone consultations, but there are still many research gaps in understanding the safety and acceptability of telemedicine.
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