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Showing results for tags 'Emergency medicine'.
Found 374 results
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News Article
NHSE launches new intervention regime for worst A&E performers
Patient Safety Learning posted a news article in News
NHS England has revealed a new intervention regime, as it seeks to deliver on its new urgent and emergency care recovery plan. Systems will be placed in three “tiers of intervention”, with those systems deemed “off-target on delivery” being given “tier three intensive support” from NHSE, which will include on-the-ground planning, analytical and delivery capacity, “buddying” with leading systems and “targeted executive leadership”. The approach follows that which has been taken over the past year for elective and cancer care recovery. The urgent care plan, published by NHSE and the Department of Health and Social Care today, says: “NHS England will identify and share good practice so that all can learn from the best. For those systems that are struggling, we will offer support to ensure that they have the best opportunities to drive improvement locally.” Read full story (paywalled) Source: HSJ, 30 January 2023 -
News ArticleA coroner has urged the health secretary to take action to prevent needless deaths after a woman died of heart failure following a four-hour wait in the back of an ambulance. Lyn Brind, 61, was taken to the Queen Elizabeth Hospital (QEH) in King’s Lynn, Norfolk, with chest pains and low blood oxygen levels but could not be admitted because the hospital had “no space”. Instead she remained in a queue of ambulances outside A&E without a timely diagnosis or treatment and where warning signs about her condition were missed. It was only after four hours and 25 minutes of waiting that she was transferred to a ward, by which time she was “agitated and short of breath”. She was placed on life support but died 22 minutes later. Brind’s family believe the grandmother of four, a former dinner lady from the town, “might still be alive today” had she been admitted more swiftly. “She wasn’t given a chance,” her partner of 38 years, Richard Bunton, said. After an inquest earlier this month into Brind’s death in May 2022, the senior coroner for Norfolk, Jacqueline Lake, took the unusual step of writing to England’s health secretary, Steve Barclay, to raise concerns about the NHS and social care. She warned that others could die in similar circumstances unless action was taken. “I believe you have the power to take such action,” Lake wrote in a prevention of future deaths report. Read full story Source: The Guardian, 29 January 2023
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Content ArticleThis video shows CCTV footage of Bob being treated for a cardiac arrest on his way to watch a football match at the AMEX stadium in Brighton. The video could be used as a training tool to show how to start cardiopulmonary resuscitation (CPR) and how to use an automated external defibrillator (AED). The video highlights what the AED is analysing and then shocking, showing what happened to the electrical rhythm as it converts ventricular fibrillation (VF) to sinus rhythm. It also features the voice prompts from the cardiac arrest. Bob survived with a completely normal quality of life and was the seventh person (out of seven) at the AMEX stadium to have a cardiac arrest and survive with a normal quality of life. The video shows great team work and human factors interactions between the St John Ambulance volunteers who saved Bob's life, the stewarding team and paramedics.
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News Article
NHS ‘haemorrhaging’ senior emergency department nurses
Patient Safety Learning posted a news article in News
Experienced emergency department nurses are “leaving in droves” because they feel unable to do their jobs properly under the current conditions, a doctor has warned. Giving evidence to the Health and Social Care Select Committee yesterday, Dr Adrian Boyle, president of the Royal College of Emergency Medicine, raised concern about nurse retention and morale in emergency departments. “We are haemorrhaging experienced emergency nurses because they are finding it very frustrating" He said: “What I'm also seeing is that a lot of nurses, particularly the experienced nurses, they're almost like the [non-commissioned officers] of the health service, the sergeants who know how to get things done, are leaving in droves.” Dr Boyle added: “We are haemorrhaging experienced emergency nurses because they are finding it very frustrating. “The problem is not because there's too much work but they're unable to do the work that they're trained to do." Read full story Source: Nursing Times, 25 January 2023 -
Content ArticleThe Royal College of Emergency Medicine (RCEM) ‘Wales' Emergency Medicine Workforce Census 2023’ is an in-depth analysis of the state of the Emergency Medicine workforce, providing an insight into the working patterns of clinicians and allowing a forecast to be made around the future workforce needs of Emergency Departments in Wales.
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Content ArticleThis article in The Times explains why the Times Health Commission was set up, what it aims to achieve and how it will do this. The year-long commission aims to address the most urgent challenges facing health and social care including the growing pressure on budgets, the A&E crisis, rising waiting lists, health inequalities, obesity and the ageing population. Commissioners will draw up recommendations in ten areas to identify problems and find solutions. The Commission will publish its final report in January 2024.
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News Article
NHS: More cancer specialists needed in A&E, doctors say
Patient Safety Learning posted a news article in News
Being placed on immunotherapy to treat Stage 4 cancer was a life-saver for Imogen Llewellyn. Three years on, the 34-year-old is currently cancer-free, but said if it was not for specialist doctors, the side effects could have killed her. The Royal College of Physicians (RCP) claims Wales needs more oncology experts in A&E to recognise and treat emergencies. The Welsh government said all acute hospitals were expected to have an acute oncology service. The RCP report wants investment in emergency cancer care because of the sheer volume of patients who need urgent care during their treatment. With about a fifth of acute hospital beds occupied by people who have a cancer-related problems, they add that about a third of admissions could be avoided if same-day care were more widely available in Wales - which in turn would relieve pressure on hospitals. Dr Hilary Williams, consultant oncologist and Wales Cancer Network lead for acute oncology, said: "Wherever a patient lives in Wales, they should be able to access excellent acute oncology services. "When people think about cancer treatment, they might think about undergoing surgery or receiving chemotherapy, radiotherapy or immunotherapy in an organised way, perhaps during weekday hours in a specialist centre. But what happens when an emergency arises?" Read full story Source: BBC News, 24 January 2023 -
News Article
A&E patients being discharged before they are admitted, warns senior medic
Patient Safety Learning posted a news article in News
A growing number of patients deemed to require a hospital admission are waiting so long in A&E that they end up being discharged before being admitted to a ward, HSJ has been told. A senior emergency clinician, who has delivered improvement support to multiple emergency departments across the NHS, said such cases have become a regular occurrence – describing it as a “terrible experience” for some patients. The clinician, who asked not to be named, said: “I suspect every ED in the country are having patients who are spending 24 to 48 hours in ED under the care of a specialist, that in a better time they would have gone onto a ward. That’s happening every day in every department. “If you have been seen by the ED crew and referred to the medics who say ‘you need to be admitted to hospital’, the chances are that they are sick enough that they really do need that bed. “It’s a terrible experience [for the patients]. EDs are busy, noisy and crowded. This is not the place where, if you were feeling ill, to get better in a calm, relaxing area. This idea that somehow it’s OK because these people are not that sick, it’s pretty poor. “It feels very much like battlefield medicine – slap a patch on and try and get them back into battle as quickly as possible. It shouldn’t be the way with civilian healthcare.” Read full story (paywalled) Source: HSJ, 23 January 2023 -
News Article
Ambulance delays cause ‘severe harm’ to record 6,000 patients a month
Patient Safety Learning posted a news article in News
A record number of patients suffered “severe harm” as a result of ambulance delays in December, soaring by nearly 50 per cent in just one month as the NHS crisis deepened. Almost 6,000 suffered permanent or long-term harm due to long waits to hand over patients outside A&Es – up from just over 4,000 in November. A further 14,000 patients were likely to have suffered “moderate harm”, an analysis by The Independent of NHS ambulance data and estimates of harm by the Association of Ambulance Chief Executives (AACE) found. This includes incidents that resulted in patients needing further treatment or procedures, the cancelling of treatment, or being transferred to another area. Miriam Deakin, director of policy and strategy at NHS Providers, said the figures are a “worrying reminder of the huge pressure the NHS is under”. She said: “Trust leaders are doing everything they can to provide patients with safe, high-quality care but they know patients face lengthy handover delays far too often, contributing to avoidable harm.” Read full story Source: The Independent, 20 January 2023 -
News Article
Government should declare “national emergency” over NHS crisis, say peers
Patient Safety Learning posted a news article in News
Pressures on emergency health services are so bad that the UK government should declare a “national emergency” and call a meeting of the Civil Contingencies Committee (COBRA)—the body summoned periodically to deal with matters of major disruption—peers have said. The cross party House of Lords Public Services Committee said in a report that the government needed to respond with an emergency approach and steps to remedy the situation in the longer term. A recurring theme of the report is the substantial delays highlighted by the media in recent months, which peers said were caused by a “broken” model of primary and community care. This was driving unmet need in directing patients to hospitals where many remained longer than clinically necessary because of inadequate social care. The report recommended that the Department of Health and Social Care should mandate a greater presence of clinical staff in NHS 111 control centres to help boost numbers of clinicians in the 999 and 111 services. This would mean that patients were directed to the right services more quickly thanks to better triaging of calls, which could mean fewer patients being passed to emergency or urgent care services. Another suggestion was for the government to introduce more incentives for faster safe discharges from hospitals, with more capacity in hospitals and social care to help people move through the health system more quickly. Read full story Source: BMJ, 19 January 2023 Further reading on the hub: Patient safety impact of hospital bed shortages – A Patient Safety Learning blog -
Content ArticleEmergency access to healthcare is in crisis. Unmet need in primary and community care and low capacity in hospitals and social care has left the emergency health services gridlocked and overwhelmed, unable to provide safe care. This Cross party House of Lords Public Services Committee report recommends that a COBR Committee be assigned the responsibility to address the crisis in emergency healthcare. In the long-term, it recommends a a substantial overhaul is needed, one which sets out a bold new operating model for the system as a whole, and which is backed by equally bold leadership.
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Content ArticleIn this post, Amber Clour, author of the Diabetes Daily Grind blog, talks about her experience of managing her type 1 diabetes while attending the emergency room for suspected appendicitis. She describes the steps she took to make sure her blood sugar levels were managed safely and with her consent, including communicating clearly with all healthcare professionals, ensuring her continuous glucose monitor (CGM) was not removed and bringing her own supply of glucose tablets to manage hypoglycaemia. Further reading Blog - “I felt lucky to get out alive”: why we must improve hospital safety for people with diabetes
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Content ArticleIn November 2021, 15-year old Alice Tapper nearly died due to a missed diagnoses of a perforated appendix. In this opinion piece, Alice shares her experience of being admitted to hospital with intense abdominal pain and other serious symptoms. In spite of her parents' requests for imaging to rule out appendicitis, doctors diagnosed that Alice had a viral infection and refused to prescribe antibiotics. Alice's condition severely deteriorated, leading her father to call the hospital and beg a gastroenterologist for further investigation. Fortunately, the hospital granted his request and after an x-ray and ultrasound, Alice was found to have a perforated appendix. She was going into hypovolemic shock, when severe blood or other fluid loss makes the heart unable to pump enough blood to the body. Thankfully, emergency surgery and antibiotics saved Alice's life, but she reflects on the fact that without her father's intervention, she would probably have died. She describes how her doctors failed to take the concerns she and her parents repeatedly expressed seriously, and that this lack of responsiveness could have been fatal. She highlights research that shows that appendicitis is missed in up to 15% of paediatric patients, and that missed diagnosis is most common in children under five, and is more common in girls than boys.
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News Article
'My dying husband could not get an ambulance'
Patient-Safety-Learning posted a news article in News
Ambulance bosses have apologised to the family of a man who died after he had a heart attack but no ambulance came. Martin Clark, 68, started suffering with chest pains at his home in East Sussex on 18 November - before any strike action started in the NHS. His family rang three times for an ambulance and after waiting 45 minutes drove him in their car to hospital. When they arrived, the father of five went into cardiac arrest and, despite receiving medical attention, died. Dr Sonya Babu-Narayan of the British Heart Foundation (BHF), said cases such as the Clarks' were "incredibly distressing". "The difference between life and death can be a matter of minutes when someone is having a heart attack or stroke," she said. "Extreme delays to emergency heart and stroke care cannot become a new normal. Healthcare staff are doing all they can—but there aren't enough of them and many will be working in difficult conditions without fit-for-purpose facilities." Read full story Source: BBC News -
News Article
Errors in overflowing EDs causing heart attacks, NHS England warns
Patient-Safety-Learning posted a news article in News
Patients have suffered cardiac and respiratory arrests because of errors using oxygen cylinders, NHS England has warned, citing more people being cared for in “areas without access to medical gas pipeline systems” such as corridors and ambulances queuing outside A&E. A patient safety alert issued by NHS England today identifies 120 incidents in the past year related to oxygen cylinder use, including cylinders either being empty at point of use, not switched on, inappropriately transported, or inappropriately secured. Some of the incidents involved “compromised oxygen delivery to the patient, leading to serious deterioration and cardiac or respiratory arrest” the alert said, and at least 43 caused harm. Read full story (paywalled) Source: HSJ, 10 January 2023 -
Content ArticleIn this article for The Guardian, an anonymous hospital consultant describes the situation in many NHS emergency departments in January 2023—patients ready for medical admission waiting in ambulances in the hospital car park, patients receiving IV antibiotics in chairs in the corridor and staff completely overwhelmed by the workload. The author highlights that accident and emergency departments are now being used for a purpose for which they were not designed—looking after patients who need to be admitted to hospital wards. They describe the implications of this on patient safety and staff wellbeing and argue that the NHS and Government need to call the situation what it is—a crisis—or we will come to accept poor quality care and low patient safety standards as the norm.
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News Article
‘No quick fix’ to NHS struggles, says Nuffield Trust chief exec
Patient-Safety-Learning posted a news article in News
Nigel Edwards is the Chief Executive of the think tank the Nuffield Trust. In this interview, he outlines the discharge problems currently faced by NHS hospitals, highlighting lack of staff and resources in the social care sector as major causes of hospital capacity issues. Source: Channel 4 News -
Content ArticleA prolonged stay in the emergency department before moving on to an in-hospital bed, another facility or departing home, is believed to have a negative effect on clinical outcomes for patients. This international systematic review and meta-analysis in the Journal of Clinical Medicine aimed to investigate the link between emergency department length of stay (EDLOS) and in-hospital mortality. The study's findings suggest two key associations with increased in-hospital mortality: low EDLOS EDLOS exceeding 24 hours The authors suggest that: long stays in the emergency department should not be allowed. special attention should be given to patients admitted after a short stay in the emergency department.
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Content ArticleAs the NHS crisis has deepened in recent weeks, frontline staff have posted vivid, troubling accounts on social media of what has been happening in their workplaces. Many have described the NHS, and often themselves too, as “broken”. They have related the difficulty of providing proper care, the impact of acute understaffing and their fears for the NHS’s future. In this Guardian article, read some of what doctors, nurses and other NHS staff have been saying.
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News Article
Trust that banned corridor care ‘reluctantly’ brings it back
Patient Safety Learning posted a news article in News
An acute trust has announced the ‘reluctant’ return of ‘corridor care’ – having previously eradicated the unsafe practice – due to extreme ambulance handover delays and other emergency pressures. Last year, University Hospitals North Midlands Trust chief executive Tracy Bullock said the trust had been “resisting” placing patients in corridors as it “brought significant patient safety and staff wellbeing issues”. This was despite the trust having large numbers of handover delays, being singled out for criticism by the ambulance service, and ‘corridor care’ being commonplace in many other acute hospitals amid severe bed pressures. The trust had successfully eliminated the practice several years earlier, because of these issues. However, at its board meeting today, the trust confirmed the practice was formally introduced at its Royal Stoke site on the day of the ambulance staff strike (21 December) because it was “holding more ambulances than we deem acceptable”. Read full story (paywalled) Source: HSJ, 4 January 2023 -
News ArticleParamedics will only wait with patients for 45 minutes before leaving them on a trolley in A&E, one ambulance trust has said. One in five ambulances are waiting at least an hour outside accident and emergency departments to hand over patients, the latest data show, despite NHS standards stating it should only be 15 minutes. Now, London Ambulance Service (LAS) leaders have told hospitals their staff will only remain with patients for a maximum of 45 minutes for handover due to “the significant amount of time being lost” waiting in A&E departments. A leaked letter, seen by ITV News, from the LAS said: "From January 3 we are asking that any patients waiting for 45 minutes for handover... are handed over immediately to ED (emergency department) staff allowing the ambulance clinicians to leave and respond to the next patient waiting in the community. "If the patient is clinically stable the ambulance clinicians will ensure the patient is on a hospital trolley or wheelchair/chair and approach the nurse in charge of the emergency department to notify them that the patient is being left in the care of the hospital and handover the patient." The email added that if the patient was not clinically stable, ambulance crews would stay with the patient until handover is achieved but added that the clinical responsibility for the patient lied with the hospital. Read full story (paywalled) Source: The Telegraph, 3 January 2023
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News Article
NHS bosses consider deploying field hospitals in 'call to arms'
Patient Safety Learning posted a news article in News
Managers in an NHS area are considering using "field hospitals" to deal with the surge in patients. Sarah Whiteman, chief medical director of the Bedfordshire, Luton and Milton Keynes Integrated Care Board told colleagues the use of tents was a "real possibility". In an email, she also asked colleagues to sign temporary contracts to work in emergency departments. The board said the use of tents in hospital grounds was not imminent. Dr Whiteman's email, obtained by The Sunday Times and seen by the BBC, began with the statement: "Call to arms". It emphasised how busy the acute units were within her board's operational area, including Bedford, Milton Keynes and Luton and Dunstable Hospitals. In the message, she promised staff would receive training and induction if they stepped forward to support colleagues. Read full story Source: BBC News, 4 January 2023 -
Content ArticleNHS England has published its planning guidance for 2023/2023. The 2023/24 priorities and operational planning guidance reconfirms the ongoing need to recover our core services and improve productivity, making progress in delivering the key NHS Long Term Plan ambitions and continuing to transform the NHS for the future.
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News Article
Government urged to take action over NHS pressures
Patient Safety Learning posted a news article in News
The crisis engulfing the NHS will continue until Easter, health leaders have warned, as senior doctors accused ministers of letting patients die needlessly through inaction. More than a dozen trusts and ambulance services have declared critical incidents in recent days, with soaring demand, rising flu and Covid cases and an overstretched workforce piling pressure on the health service. But amid warnings that up to 500 people a week may be dying due to delays in emergency care alone, and of oxygen for seriously ill patients running out in parts of England, NHS leaders warned more chaos was expected until April. “It seems likely that the next three months will be defined by further critical incidents needing to be declared and the quality of care being compromised,” said Matthew Taylor, chief executive of the NHS Confederation, which represents the whole healthcare system in England, Wales and Northern Ireland. Ministers face growing pressure to grip the crisis. The British Medical Association (BMA) said the government’s “deafening” silence and failure to act was a “political choice” that was leading to patients “dying unnecessarily”. The Liberal Democrats urged the government to recall parliament, while Labour blamed government “mismanagement” for creating a sense of “jeopardy” around the NHS. Read full story Source: The Guardian, 2 January 2022 -
Content ArticleCrammed wards, burned-out GPs, patients waiting hours for ambulances – the health service is at breaking point. The Guardian journalists, Andrew Gregory and Denis Campbell, take a look at the current NHS situation.
