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Found 1,217 results
  1. Content Article
    When public areas such as train stations breach their capacity, emergency protocols are rolled out and stations are closed. Yet when hospitals become overcrowded, there isn’t the option to stop urgent and emergency care. Instead, staff have to develop workarounds, delivering care in areas not designed – nor safe or effective – for clinical use, a phenomenon commonly known as ‘corridor care’. The increasing frequency of corridor care is alarming – both for patient safety and staff morale, and because it risks normalising substandard care delivery.  Corridor care largely occurs when emergency departments are inundated with patients. 45,000 people visit major hospital A&E departments in England each day, 16% more than 10 years ago. Many of these patients require hospital admission or further care. Limited beds within hospitals, stretched community services and chronically low social care capacity mean that A&E often becomes a bottleneck, with patients unable to ‘flow’ out of the department because there are no free beds elsewhere in the hospital. In this blog, Heather Wilson a Programme and Policy Officer in the Healthy Lives team at the Health Foundation, as well as a registered nurse who continues to work in a central London emergency department discusses the impact of corridor care on staff, patients and families. Further reading on the hub: A silent safety scandal: A nurse’s first-hand account of a corridor nursing shift
  2. Content Article
    This white paper presents a framework for health care organizations to improve health equity in the communities they serve, guidance for measuring health equity, a case study, and a self-assessment tool.
  3. News Article
    Areas across England where the highest proportion of ethnic minorities live have the poorest access to GPs, with experts attributing this disparity to an outdated model being used to determine funding. As of October 2023, there were 34 fully qualified full-time-equivalent GPs per 100,000 patients in the areas with the highest proportion of people from ethnic minority backgrounds, according to a Guardian analysis of NHS Digital and census data. This is 29% lower than the 48 general practitioners per 100,000 people serving neighbourhoods with the highest proportion of white British people. Although ethnic minorities tend to be younger than the white British population, minority ethnic areas still have the lowest number of GPs per person even when factors such as age, sex and health necessities are considered. Prof Miqdad Asaria at the London School of Economics department of health policy said it was “very concerning” that ethnic minorities “have systematically poorer access to primary care which is likely to be a key driver of current and future health inequalities”. “Primary care plays a crucial role in preventing disease, diagnosing and treating illness, and facilitating access to specialist or hospital treatment for people who need it,” he added. Read full story Source: The Guardian,15 February 2024
  4. News Article
    "Cultural and ethnic bias" delayed diagnosing and treating a pregnant black woman before her death in hospital, an investigation found. The probe was launched when the 31-year-old Liverpool Women's Hospital patient died on 16 March, 2023. Investigators from the national body the Maternity and Newborn Safety Investigations (MSNI) were called in after the woman died. A report prepared for the hospital's board said that the MSNI had concluded that "ethnicity and health inequalities impacted on the care provided to the patient, suggesting that an unconscious cultural bias delayed the timing of diagnosis and response to her clinical deterioration". "This was evident in discussions with staff involved in the direct care of the patient". The hospital's response to the report also said: "The approach presented by some staff, and information gathered from staff interviews, gives the impression that cultural bias and stereotyping may sometimes go unchallenged and be perceived as culturally acceptable within the Trust." Liverpool Riverside Labour MP Kim Johnson said it was "deeply troubling" that "the colour of a mother's skin still has a significant impact on her own and her baby's health outcomes". Read full story Source: BBC News, 16 February 2024
  5. Content Article
    This study assessed for disparities in the presentation and management of medullary thyroid cancer (MTC). The authors identified patients with MTC from the National Cancer Database and assessed differences in disease presentation and likelihood of guideline-concordant surgical management by sex and race/ethnicity. The results showed that male and non-White patients with MTC more frequently present with advanced disease, and Black patients are less likely to undergo guideline-concordant surgery.
  6. Content Article
    We all have a right to receive information about our own health in a way we can understand. There is no excuse for poor-quality, inaccessible, information that excludes people. In this blog I will consider how these needs can be met and the implications for patient safety if they are not. I have written about accessible information in the past but in this blog, I will dig deeper into some specifics, namely: Special educational needs, learning difficulties and disabilities. Visual and hearing impairments. Dominant language.  If you’re interested in accessible information, I’d strongly recommend you familiarise yourself with the Accessible Information Standard – this is a standard that the NHS and adult social care have to adhere to by law when it comes to communicating with the general public. This blog will give some tips on how you can make sure you meet this standard. 
  7. Event
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    Women’s Health Professional Care is designed for healthcare professionals and policymakers in primary and secondary care looking to improve health outcomes for women. Bringing together key learnings and new insights on a range of issues and challenges affecting women throughout their lives, Women’s Health Professional Care aims to address gender disparities in healthcare by highlighting areas of women’s health that have traditionally been overlooked. Register
  8. Event
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    Professor Sir Chris Whitty will deliver a live-streamed lecture on health inequalities to launch Talk 200, the University's bicentenary lecture and podcast series. ‘Health inequalities past, present and future’ will consider the main drivers of inequalities and disparities in health, how these have changed over time and why addressing them remains a major public health priority. As a society we face the hard truth that the more socio-economically disadvantaged someone is, the higher their risk of poor health. The world’s greatest killer is not any one individual disease, but the unequal way in which people are born, grow, live, work and age. In Greater Manchester, our unique health and social care ecosystem means we can rapidly drive innovation and translate breakthroughs into real-world solutions – which can be scaled-up and replicated across the globe. Professor Whitty is Chief Medical Officer for England, the UK government’s Chief Medical Adviser, and head of the public health profession. His lecture is the first in our Talk 200 series: a mix of in-person and live-streamed lectures and recorded podcast episodes to be released throughout 2024, our bicentenary year. This event will also include a panel discussion and Q&A, with those joining online able to submit questions using Slido and the code Talk200ChrisWhitty (page not active until 13 February). Watch the lecture live
  9. Content Article
    In my 15 years focusing on developing drink thickening solutions for dysphagia patients, the intersection of dysphagia management and patient safety has become increasingly apparent. Dysphagia, or difficulty swallowing, presents not only as a significant health challenge but also as a critical patient safety issue. The condition's underdiagnosis, particularly in vulnerable populations, heightens the risk of severe complications, including choking, aspiration pneumonia, dehydration and the profound fear of choking that can lead to malnutrition.
  10. Content Article
    This blog by Healthwatch outlines research conducted by the organisation that shows the issues homeless people face accessing the health and social care they need. The research demonstrates that homeless people: have particular problems accessing GPs and other services. experience serious problems accessing NHS dentistry. may forgo care because of the costs of travelling to appointments. often feel judged by healthcare professionals and not well cared for. The blog also discusses the impact that integrated care systems could have in improving accessibility and quality of care for homeless people.
  11. Content Article
    Although disparities in surgical outcomes are well-documented, understanding of how socioecological factors drive these disparities remains limited. This US study’s objective was to develop and assess the acceptability and feasibility of a comprehensive tool to evaluate socioecological determinants of health in patients requiring colorectal surgery. The authors developed an 88-item assessment tool measuring 31 socioecological determinants of health. It was assessed as having high acceptability and feasibility for patients who required colorectal surgery. The authors concluded that this work will help to identify what research is needed to understand and address surgical disparities.
  12. Content Article
    Most research examining the association between blood pressure and cardiovascular disease (CVD) is does not take sex into account. This research study aimed assess sex-specific associations between blood pressure and CVD mortality.by estimating sex-stratified, multivariable-adjusted incidence rate ratios (IRRs) for CVD mortality. The authors found that the association between blood pressure and CVD mortality differed by sex, with increased CVD mortality risk present at lower levels of systolic blood pressure among women, compared with men.
  13. News Article
    The NHS Race and Health Observatory, in partnership with the Institute for Healthcare Improvement and supported by the Health Foundation, has established an innovative 15-month, peer-to-peer Learning and Action Network to address the gaps seen in severe maternal morbidity, perinatal mortality and neonatal morbidity between women of different ethnic groups. Across England, nine NHS Trusts and Integrated Care Systems will participate in this action oriented, fast-paced Learning and Action Network to improve outcomes in maternal and neonatal health. Through the Network, the nine sites will aim to address the gaps seen in severe maternal morbidity, perinatal mortality and neonatal morbidity between women of different ethnic groups. Haemorrhage, preterm birth, post-partum depression and gestational diabetes have been identified as some of the priority areas for the programme. The sites will generate tailored action plans with the aim of identifying interventions and approaches that reduce health inequalities and enhance anti-racism practices and learning from the programme. These will be evaluated and shared across and between healthcare systems. The Network, the first of its kind for the NHS, will combine Quality Improvement methods with explicit anti-racism principles to drive clinical transformation, and aims to enable system-wide change. Over a series of action, learning and coaching sessions, participants will review policies, processes and workforce metrics; share insights and case studies; and engage with mothers, parents, pregnant women and people. The programme will run until June 2025, supported by an advisory group from the NHS Race and Health Observatory, Institute for Healthcare Improvement, and experts in midwifery, maternal and neonatal medicine. Read full story Source: NHS Race and Health Observatory, 24 January 2024
  14. Content Article
    Authors of this editorial, published in BMJ Quality and Safety, conclude by stating that while the use of classification to identify patients who have additional needs and/or are at increased risk of harm has potential benefits, care needs to be taken to avoid possible harm and unintended consequences. They highlight several actions that would help ensure the benefits of classification are maximised, but note that none of these are necessarily easy to achieve in practice, especially in the context of overwhelmed and under-resourced health services. However, ensuring that patients with additional needs and/or risks have these appropriately identified and responded to while receiving healthcare must be a priority. The need for healthcare to be equitable, that is, not vary in quality because of a patient’s personal characteristics, is recognised as an important quality dimension, and this issue has received increased attention in recent years. If used well, classification can be part of the move to ensuring more equitable care for those with additional needs.
  15. News Article
    Worsening health among the under fives in the UK needs to be urgently addressed, experts say. The Academy of Medical Sciences highlights what it says are "major health issues" like infant deaths, obesity and tooth decay. It says society is betraying children and the problems are limiting their future and damaging economic prosperity. The report says: The UK is 30th out of 49 rich countries for infant mortality. One in five children falls short of the expected level of development aged two. One in five is overweight or obese by five. Vaccination targets are being missed for diseases such as measles. One in four is affected by tooth decay by five. One in five women struggles with their mental health during or just after pregnancy. Air pollution is linked to worsening asthma. Rising demand for child mental health services. The report calls for a cross-government vision to be developed to tackle the problems and investment in the child health workforce, including health visitors. Read full story Source: BBC News, 5 February 2024
  16. Content Article
    The Academy of Medical Sciences has released a stark report highlighting wide-ranging evidence of declining health among children under five in the UK and calls on policymakers to take urgent action to address the situation.It warns Government that major health issues like infant mortality, obesity and tooth decay are not only damaging the nation’s youngest citizens and their future, but also its economic prosperity, with the cost of inaction estimated to be at least £16 billion a year. In recent years, progress on child health in the UK has stalled. Infant survival rates are worse than in 60% of similar countries and the number of children living in extreme poverty tripled between 2019 and 2022. Demand for children’s mental health services surge and over a fifth of five-year-old children are overweight or obese, with those living in the most deprived areas twice as likely to be obese than in affluent areas. One-in-four is affected by tooth decay. Vaccination rates have plunged below World Health Organization safety thresholds, threatening outbreaks. Issues such as the COVID-19 pandemic, increased cost of living and climate change compound widespread inequality and are likely to make early years health in the UK even worse. 
  17. News Article
    Deeply ingrained medical misogyny and racial biases are routinely putting people in need of treatment at risk, the government’s patient safety commissioner in England has warned. Dr Henrietta Hughes was appointed in 2022 in response to a series of scandals in women’s health. She outlined a “huge landscape” of biases in need of levelling, citing examples ranging from neonatal assessment tools and pulse oximeters that work less well for darker skin tones to heart valves, mesh implants and replacement hip joints that were not designed with female patients in mind. Hughes said: “I don’t see this as blaming individual healthcare professionals – doctors and nurses – for getting it wrong. It’s pervasive in the systems we have – the training, the experience, the resources. “Anatomy books are very narrow in their focus. Even the resuscitation models are of pale males – we don’t have female resuscitation models, we don’t have them in darker skin tones. This is deeply ingrained in the way that we assess and listen to patients.” She described the realisation that pulse oximeters, used to measure blood oxygen levels, work less well for darker skin tones as a “real shock to the system” when the problem was highlighted during the pandemic. More recently, the NHS Race and Health Observatory highlighted concerns about neonatal assessments. Bilirubinometers, widely used to assess jaundice in newborn babies, are less reliable for darker skin tones and some guidelines for the assessment of cyanosis (caused by a shortage of blood oxygen) refer to “pink”, “blue” or “pale” skin, without reference to skin changes in minority ethnic babies. The Apgar score, a quick test given to newborns that was rolled out in the 1950s, traditionally includes checking whether a baby is “pink all over”. “Even the names of those conditions – jaundice and cyanosis – suggest a colour. The Apgar score includes P for pink all over,” said Hughes. “There are systemic biases in that if you have a darker skin tone those conditions may not be so apparent.” Read full story Source: The Guardian, 4 February 2024
  18. Content Article
    Set up in January 2023, the Times Health Commission was a year-long projected established to consider the future of health and social care in England in the light of the pandemic, the growing pressure on budgets, the A&E crisis, rising waiting lists, health inequalities, obesity and the ageing population. Its recommendations are intended to be pragmatic, practical, deliverable and able to be potentially taken up by any political party or government, present or future. 
  19. News Article
    Deaths from cancer in the UK are set to rise by more than 50% in the next 26 years, stark new estimates suggest. Experts from the International Agency for Research on Cancer (IARC) and the World Health Organization (WHO) have found there were 454,954 new cases of cancer in the UK in 2022 and warned this is expected to rise to 624,582 by 2050. In 2022, 181,807 people died in Britain from cancer, but researchers warned this is expected to rise to 279,004 by 2050 – a 53% increase. The estimates suggest the rising rates of cancer will be driven by the UK’s growing and ageing population. However, researchers have also called for new policies to tackle levels of smoking, unhealthy diets, obesity and alcohol to help lower the expected surge in cases. The study examined cancer data from 115 different countries and estimated global cases would rise by 77 per cent, from 20 million in 2022 to 35 million in 2050. The organisations estimate that cancer deaths around the world will almost double from 9.7 million to 18.5 million in that time. Dr Panagiota Mitrou, director of research, policy and innovation at the World Cancer Research Fund, said the new estimates “show the increased burden that cancer will have in the years to come”. “UK governments’ failure to prioritise prevention and address key cancer risk factors like smoking, unhealthy diets, obesity, alcohol and physical inactivity has in part widened health inequalities,” she added. Read full story Source: The Independent, 1 February 2024
  20. News Article
    Online services for GPs across Surrey leave many patients feeling "helpless and lost", a new report says. Healthwatch Surrey said some patients felt "defeated" by online systems and that issues were worse in certain groups. This included people with English as a second language and those less confident with technology. Online services include booking appointments, requesting repeat prescriptions and viewing test results. Healthwatch Surrey, which gathers the views of local people on health and social care services in the county, said: "Confusion around the appointment booking process and a perception that appointments are hard, or even impossible, to book online is the issue people tell us most about." One Epsom and Ewell resident was asked by their surgery to book a blood test online. They told Healthwatch: "I tried but I couldn't understand how to do it and so I called back. "I'm in my 80s and I try to be as independent as I can, but some of these processes defeat me." Sam Botsford, contract manager at Healthwatch Surrey, said communication was key in ensuring patients knew how to use online services. She said: "People feel they're being pushed online, and that spans a range of different demographics. "It's really important for practices to identify the needs of their patients and how they can best meet those." Read full story Source: BBC News, 2 February 2024
  21. Content Article
    Medicine shortages in the UK have been a regular feature on newspaper front pages in recent years. As a doctor on the frontline, Ammad Butt sees how this instability in our medicine supply chain is playing out on the ground. Ammad works in a large city hospital and is used to meeting disgruntled patients who have had to wait hours in clinic to receive treatment. But just imagine their concern when he has to explain to them that the medication they usually took to treat them with is not available, and that they will have to take an alternative instead or stay in hospital for even longer as a result. In the past year, Ammad has routinely seen patients having to go without medication for common conditions such as attention deficit hyperactivity disorder (ADHD), diabetes and even acne that would otherwise be easily managed, or being forced to take alternatives that are less appropriate. And new EU plans for its members to work together to stockpile key medicines will only worsen shortages in the UK. Patients tell Ammad they feel others are receiving better treatment than they are. And they are right, in some ways. Healthcare professionals are being put in a difficult situation having to explain why they are making compromises in their care. It all adds to the sense among patients and healthcare professionals alike that the health service is not working for the most vulnerable. Have you (or a loved one) ever been prescribed medication that you were then unable to get hold of at the pharmacy?  Have you (or a loved one) ever been prescribed medication that you were then unable to get hold of at the pharmacy or in hospital? To help us understand how these issues impact the lives of patients and families, please share your experience and insights in our hub community thread on the topic here or drop a comment below. You'll need to register with the hub first, its free and easy to do. 
  22. Content Article
    The first UK geriatric oncology service at a tertiary cancer centre was established at the Royal Marsden Hospital in London. Its purpose is to conduct comprehensive geriatric assessments of patients with cancer on order to make referrals to multidisciplinary care. This descriptive study aimed to track its progress. It found that the service made a median of three referrals for each patient, most commonly to physiotherapy and occupational therapy. The frequency of referrals indicates that there is a high level of unmet need in older patients with cancer.
  23. Content Article
    This statement from NHS England outlines how NHS organisations should collect and present data on health inequalities and explains the powers available to them to collect such data. Integrated care boards, trusts and foundation trusts should use the statement to identify key information on health inequalities and set out how they have responded to it in annual reports. The statement has been produced according to NHS England's duty under section 13SA of the National Health Service Act 2006.
  24. News Article
    To help patients with high-risk pregnancies receive care at hospitals that are staffed and equipped to deliver care appropriate to their needs, the Department of Public Health will require licensed birthing hospitals to use a system called Levels of Maternal Care. The system classifies hospitals based on their capacity to meet the needs of patients with a range of potential complications during childbirth. The impetus is the rising levels of severe maternal morbidity, large racial disparities in outcomes, and concerns that higher-risk patients who deliver in hospitals that over-estimate the level of care they are able to provide are more likely to experience complications. Levels of care describe a hospital’s physical facilities, capabilities and staffing, indicating its ability to serve people giving birth across a range of medical needs. For example, Level 1 is appropriate for low-risk patients with uncomplicated pregnancies, including twins and labor after cesarean delivery. To that group, Level II adds patients with poorly controlled asthma or hypertension and other higher-risk conditions. Subsequent levels include patients at increasingly high risk of complications, up to Level IV, which is appropriate for patients with severe cardiac disease, those who need organ transplant and others. Established by the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine in 2015, the classification system is one tool used by states across the country to improve maternal health and birthing outcomes. Read full story Source: Betsy Lehman Center. 17 January 2024
  25. Content Article
    In this article, Claire Brader summarises the recent findings on the performance of NHS maternity services in England, as well as recent government and NHS policies aimed at improving the quality of maternity care.
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