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News Article
Virtual outpatient drive at heart of effort to end 78-week waits, says Mackey
Patient Safety Learning posted a news article in News
Patients at trusts with long waiting lists should no longer think ‘they have to go to their local hospital’ for outpatient appointments, but should instead be offered virtual consultations elsewhere in the country where there is greater capacity, Sir Jim Mackey has told HSJ. The NHS England elective chief said recent efforts to abolish two-year waiters by July had meant a “very big” surgical focus. However, the next phase of the elective recovery plan would see a major shift of emphasis onto reducing the wait for outpatient appointments. Sir Jim said: “Providers have been split into tiers again with tier one having national oversight and tier two, regional oversight. Behind that we will be pairing up organisations so that organisations with capacity can help those with the biggest challenges from a virtual outpatient perspective. He added: “There still is a lot to work through [on virtual outpatients], we’re going to be testing the concept… We need to work through how all the wiring and plumbing needs to work. For example, what happens if the patient needs a diagnostic locally, having seen a clinician virtually in another part of the country? “It would be great also to try and stimulate more of a consumer drive on this – encouraging patients to ask about virtual outpatients when the waits locally may be too long, so they don’t just think they have to go to their local hospital. I think this could really help shift the model if we can get it right.” Read full story (paywalled) Source: HSJ, 9 August 2022- Posted
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NHS Wales: App helping keep heart patients out of hospital
Patient Safety Learning posted a news article in News
Mobile apps to track patients' health are keeping them out of hospital and could cut waiting times, experts have said. It follows a trial of a new app which heart patients are using through their mobile phones. The trial allows clinicians to change treatments quickly and uses video consultations, avoiding unnecessary hospital visits. Rhodri Griffiths is the innovation adoption director at Life Sciences Hub Wales, and is looking for more ways to introduce similar technology. He believes the pandemic accelerated the use and acceptance of digital solutions in healthcare, by patients and clinicians. "We really are looking at a big digital revolution within healthcare and there are an amazing myriad of things coming through," he said. He explained data collected by smartphones and watches can help predict who is likely to have a heart attack. "We can avoid that happening. So prevention is key but it's also looking at how some of this can impact on waiting lists," he said. "So, looking at how theatres are used, which patients can be prioritised? "In social care it's looking at how pain is managed by face recognition." Mr Griffiths said he believed the data collected could also identify wider problems: "It's combining these digital solutions with our genetic information - bringing big data together on a population level we can start spotting trends". Read full story Source: BBC News, 4 August 2022- Posted
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News ArticleNHS England patients with Type 1 diabetes will now be eligible for life-changing continuous glucose monitors after the health service secured a new cut-price deal. The wearable arm gadget sends information to a mobile app and allows diabetes patients to keep track of their glucose levels at all times without having to scan or take a finger prick test. Traditionally, continuous glucose monitors are more expensive than their flash monitor counterparts – which record glucose levels by scanning a sensor – but thanks to the NHS agreeing on a new cost-effective deal with manufacturers DEXCOM, they will now be available for NHS patients on prescription at a similar price. The monitor, called Dexcom ONE Real Time-Continuous Glucose Monitoring, uses a sensor no bigger than a bottle cap that attaches to the arm for up to 10 days and measures glucose levels from just under the skin. Patients will receive their starter pack – which will include information on the product and usage, a sensor and transmitter – from the hospital or GP surgery once prescribed, after which they can go to the pharmacy for their repeat prescription. Dr Partha Kar, national speciality advisor for diabetes and obesity said: “This is a huge step forward for Type 1 diabetes care and these monitors will be life-changing for anyone with the illness – giving them more choice to manage their condition in the most convenient way possible – as well as the best chance at living healthier lives, reducing their risk of hospitalisation and illnesses associated with diabetes, which in turn reduces pressure on wider NHS services. “The new deal also delivers on our commitment to get patients the latest cutting-edge medical technology at the best value for taxpayer money – saving the NHS millions over the coming years”. Read full story Source: NHS England, 2 August 2022 You may also be interested in: “I felt lucky to get out alive”: why we must improve hospital safety for people with diabetes Peer support makes a big difference to living with type 1 diabetes Improving safety for diabetic inpatients: 4 key steps - Interview with Dr Partha Kar
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Home menopause tests are waste of time and money, say doctors
Patient Safety Learning posted a news article in News
Women are wasting their time and money buying do-at-home menopause testing kits, doctors have warned. The urine tests are not predictive enough to tell whether a woman is going through the phase when her periods will stop, doctors have told the BBC. The tests, which give a result within minutes, accurately measure levels of follicle-stimulating hormone (FSH), which helps manage the menstrual cycle. But experts say it is not a reliable marker of the menopause or perimenopause. Dr Annice Mukherjee, a leading menopause and hormone doctor from the Society of Endocrinology, told the BBC the FSH urine tests were “another example of exploitation of midlife women by the commercial menopause industry, who have financial conflicts of interest”. “It’s not helpful for women to access [FSH] directly,” she said. “It is not a reliable marker of perimenopause and can cause more confusion among women taking the test. At worst, misinterpretation of results can cause harm.” The Royal College of Obstetricians and Gynaecologists (RCOG), along with other leading experts in women’s health, said the tests could be unhelpful and potentially misleading. Read full story Source: The Guardian, 10 June 2022- Posted
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Royal Surrey County Hospital to launch virtual ward to free up beds
Patient Safety Learning posted a news article in News
The Royal Surrey County Hospital is preparing to open its first virtual ward. From this summer 15 patients will receive treatment at home using apps and wearable technology, as an alternative to a stay in hospital. The ward will be overseen by a consultant, working with therapists, nursing staff and pharmacists. The hospital, in Guildford, plans to extend the ward to 52 patients by April 2024. Health providers across England have been asked to deliver virtual wards at a rate of 40 to 50 beds per 100,000 people by December 2023. It is hoped they will free up beds more quickly, speeding up admissions from A&E and for elective surgery. Read full story Source: BBC News, 7 June 2022- Posted
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More than 100,000 treated on ‘virtual wards’
Patient Safety Learning posted a news article in News
More than 100,000 patients, including children, have been treated in so-called virtual wards over the last year, NHS officials have said. Leading medics said that the use of the system to monitor patients at home has been a “real game changer”. Officials say virtual wards can help patients avoid unnecessary hospital trips altogether, or enable them to be sent home from hospital sooner. Using various equipment and technology, clinicians can monitor vital signs such as a patients’ heart rate, oxygen levels and temperature remotely. NHS England’s national medical director, Professor Sir Stephen Powis, said: “The advantages of virtual wards for both staff and patients have been a real game-changer for the way hospital care is delivered and so it is a huge achievement that more than 100,000 patients have been able to benefit in the last year alone, with the number of beds up by nearly two thirds in less than a year. “With up to a fifth of emergency hospital admissions estimated to be avoided through better supporting vulnerable patients at home and in the community, these world-leading programmes are making a real difference not just to the people they directly benefit but also in reducing pressure on wider services.” Read full story Source: The Independent. 11 March 2023- Posted
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England’s worsening care shortages leave older people struggling
Patient Safety Learning posted a news article in News
Hundreds of thousands of older people in England are having to endure chronic pain, anxiety and unmet support needs owing to the worsening shortage of social care staff and care home beds. Age UK has said older people with chronic conditions such as diabetes, high blood pressure and heart failure are increasingly struggling with living in their own homes because of a lack of help with everyday tasks such as getting out of bed, dressing and eating. The decline in the amount of support and care provided to older people is piling pressure on families and carers and leaving the NHS in constant crisis mode, contributing heavily to ambulance queues outside A&E departments, the charity said in a new report It warned that there would be a repeat of the NHS crisis this winter – in which rising numbers of elderly people have been unnecessarily stuck in hospital because of an acute lack of social care – without a shift to preventing unnecessary admissions. Read full story Source: The Guardian, 17 February 2023- Posted
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Somerset care training to help support loved ones at home for longer
Patient Safety Learning posted a news article in News
A training programme is providing people with the skills to care for loved ones suffering from serious conditions at home in their final days. Sarah Bow's partner Gary White, from Somerset, was 55 when he was diagnosed with motor neurone disease in 2021. A team from NHS Somerset provided personalised training to Ms Bow which allowed the couple to spend the final 13 months of his life together at home. The Somerset NHS Foundation Trust social care training team made visits to the couple's home as Mr White's condition progressed, to provide advice and guidance to Ms Bow. The service was set up in November 2021 to provide free NHS standardised training and competency assessments in clinical skills to people involved in social care. Ms Bow said the scheme had helped them spend more time together doing the things Mr White enjoyed. "Being able to care for him meant we could have so many precious moments before he died," she said. The training in a variety of skills including like catheters and injections, aims to reduce hospital admissions and improve patient discharge times. Read full story Source: BBC News, 17 February 2023 -
News Article
'I'm well enough to leave hospital - but I can't'
Patient Safety Learning posted a news article in News
"It would be much better if I was out there than in here," said Roger. The 69-year-old looked wistfully across Newport from the window next to his bed at the Royal Gwent Hospital in Wales. He has been here for three weeks after being admitted with an infection and although he is now well enough to leave, and desperate to do so, he can't. Roger has cerebral palsy and the impact of his recent illness means he needs extra care to be arranged before he can safely go home. Roger is not alone. "At least a quarter of patients in our care of the elderly beds are in a similar position," explained Helen Price, a senior nurse at the hospital. "It is very much a waiting game for that care to be available," she said. Hospitals in Wales are fuller than ever, according to the latest statistics. In the final week of January more than 95% of all acute beds in the Welsh NHS were occupied, which is the highest figure ever recorded. Paul Underwood, who manages urgent care in Aneurin Bevan University Health Board, said there are well over 350 patients medically fit enough to leave hospital. "Roughly a third of patients do not need to be accommodated on those sites and that's extremely difficult," he said. Read full story Source: BBC News, 16 February 2023- Posted
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‘Hospitals at home’ plan to save NHS
Patient Safety Learning posted a news article in News
More than half a million patients a year will be treated in “hospitals at home” in an attempt to relieve pressure on A&E departments. Under the plans, elderly and frail patients who fall will be treated by video link, with ministers saying that a fifth of emergency admissions could be avoided with the right care. Health officials said the “virtual wards” would be backed up by £14 billion in extra spending on health and care services over the next two years, as the NHS tackles record backlogs, with seven million people on waiting lists. Rishi Sunak said the Urgent & Emergency Care Recovery Plan showed that the NHS was one of his “top priorities”. Read full story (paywalled) Source: The Telegraph, 29 January 2023- Posted
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Paramedics say people are getting ill because their homes are so cold
Patient Safety Learning posted a news article in News
Ambulance crews say they are treating a growing number of patients who are falling ill because they are unable to afford to heat their homes. The soaring cost of gas and electricity has forced many people to switch off their heating in the winter months. Scottish Ambulance Service crews say they are seeing people who are unwell because their homes are so cold or they cannot afford to eat properly. Charities have warned many people are dealing with a "toxic cocktail" of increasing energy bills, growing inflation and higher interest rates this winter. Glasgow ambulance workers Tanya Hoffman and Will Green say that most weeks they see patients who are facing the stark choice between eating and heating. They have been in homes which feel ice cold, where the patients are clearly struggling to cope. "It is sad to see people are living like that," said Tanya. "There's been quite a few patients I have been out to who can't afford to buy food. They have to choose one or other, heating or food. "So they'll sit quietly at home and it's usually a relative or a friend who will phone for them as they don't want to bother anybody. "They're sitting there [and] you can't get a temperature off them because they're so cold. "So you take them into hospital because they are not managing. You know if you leave that person at home they are probably going to die through the fact they are so cold." Read full story Source: BBC News, 24 January 2023- Posted
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NHS Wales: Patients can be sent home without care package
Patient Safety Learning posted a news article in News
Senior NHS staff have been advised by the Welsh government to discharge people who are well enough to leave, even without a package of care. But one GP called the announcement "terrifying" and warned that patients could deteriorate and end up back in hospital. The seven health boards in Wales have nearly 1,800 patients medically well enough to leave hospital. The Welsh government has called the NHS situation "unprecedented". The message comes after one health leader said the NHS was on a "knife-edge" in terms of its ability to cope. The letter from the chief nursing officer and the deputy chief medical officer to the health boards offered "support and advice to ensure patients are kept as safe as possible, and services are kept as effective as possible over the next period". Read full story Source; BBC News, 4 January 2023 -
News Article
Council providing three-minute care visits to vulnerable, finds ombudsman
Patient Safety Learning posted a news article in News
Care workers are taking as little as three minutes to help vulnerable people in their own homes, the social care ombudsman has found, after discovering a council was allocating extremely short visits to hundreds of people. Amid chronic staff shortages and rising unmet care needs nationwide, a homecare worker commissioned by Warrington borough council sometimes stayed for just three minutes, despite the family paying for the full visit. The council was found to have allocated 15-minute care calls to more than 300 people in the region, despite national guidance stressing these were “not usually appropriate”. The Homecare Association, which represents care providers, said the number of short calls being commissioned was increasing more widely and said “15-minute visits are inappropriately short”, result in inadequate care and are stressful for workers placed under “unfair pressure”. The case that triggered the investigation involved a woman with dementia who was paying the full costs of her care under a plan devised by the council. In 15 minutes two agency care workers were expected to wake her, prepare a meal and a drink, ensure she ate and drank, administer her medication, change her incontinence pad, administer any personal care and tidy the kitchen. Electronic monitoring showed they regularly stayed less than 15 minutes and the ombudsman said it was probable her care needs were not met and her care was not dignified. Read full story Source: The Guardian, 5 January 2023- Posted
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People urged to wear masks and stay at home if unwell as pressure on NHS mounts
Patient Safety Learning posted a news article in News
People have been urged to wear face coverings and remain at home if feeling unwell, as an already crisis-stricken NHS faces down multiple waves of winter illnesses. With children returning to school at a time when high levels of flu, Covid-19 and scarlet fever are all being reported, the UK Health Security Agency (UKHSA) has issued fresh guidance in a bid to minimise the diseases’ spread. Parents have been urged to keep children at home if they are unwell and have a fever, with adults told to only go out if necessary and wear face coverings if they are ill and avoid visiting vulnerable people. While transport secretary Mark Harper said the advice was “very sensible”, Downing Street insisted that such guidance was “pretty longstanding”, stressing that it was “not mandatory” and remained a far cry from ministers “telling people what to do” at the height of the pandemic. The government has also reintroduced travel bans for those testing positive for Covid-19 in China from 5 January amid a mass outbreak there. It comes as pressure on the NHS continues to grow, but Rishi Sunak said he was “confident” the NHS has the funding it needs despite accusations from senior doctors his government is in denial about the scale of the crisis in the health service. Read full story Source: The Independent, 3 January 2023- Posted
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News ArticleFlu and Covid are on the rise in England, with experts stressing the importance of vaccination and warning that people who feel unwell should stay at home rather than mingling with others during the festive season. The figures come as cases of scarlet fever and strep A infections continue to rise. The UK Health Security Agency (UKHSA) added that while invasive strep A infections remain rare there have now been a total of 94 deaths in England, including 21 children. Dr Colin Brown, the deputy director at UKHSA, sought to reassure parents. “I understand how this large rise in scarlet fever and ‘strep throat’ may be concerning to parents, however the condition can be easily treated with antibiotics and it is very rare that a child will go on to become more seriously ill,” he said, adding that parents should visit NHS.UK, contact 111 online or their GP surgery if their child has symptoms so they can be assessed for treatment. Dr Mary Ramsay, the director of public health programmes at UKHSA, noted a link between indoor mixing and the rise in cases and hospital admissions for flu and Covid. “Both Covid and flu can cause severe illness or even death for those most vulnerable in our communities, and so it is also important to avoid contact with other people if you are unwell in order to help stop infections spreading over the Christmas and new year period,” she said. Read full story Source: The Guardian, 23 December 2022
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Take car in emergency during 999 strike, says cabinet minister
Patient Safety Learning posted a news article in News
Patients should “make their own way to hospital” if they can do so during Wednesday’s strike by ambulance workers, a cabinet minister said yesterday, as the government warned that the industrial action would put lives at risk. Senior government figures said that ambulance unions had still not agreed national criteria for what conditions would be considered life threatening and responded to during the strike. Steve Barclay, the health secretary, is understood to be writing to all striking unions, including nurses, seeking discussions on patient safety. Yesterday Oliver Dowden, the Cabinet Office minister, said people should still call 999 in an emergency but might in less serious cases have to make their own way to hospital. “We are working to ensure that if you have a serious injury, in particular a life-threatening injury, you can continue to rely on the ambulance service, and we would urge people in those circumstances to dial 999,” he told Sunday with Laura Kuenssberg on BBC1. “If it is the case that you have less serious injuries, you should be in touch with 111, and you should seek to make your way to hospital on your own if you are able to do so.” Read full story (paywalled) Source: The Times, 19 December 2022- Posted
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Two-thirds of GPs refuse to register homeless patients
Patient Safety Learning posted a news article in News
Two-thirds of GP practices from a sample of 100 in London declined to register a patient without an address, contrary to national rules which are meant to ensure homeless and excluded people can get healthcare, HSJ has found. NHS England guidance states anyone can register with a GP without proof of address, and that people without a permanent address “can still register using a temporary address or the address of the GP surgery”. Practices normally need to record an address, but the exception rule is meant to ensure people who are homeless, or living in unstable or short-term accommodation, are still able to access primary care or referrals for secondary services. Despite this, when HSJ called 100 randomly selected practices in London (about 9 per cent of the total), 64 refused to register the caller. Read full story (paywalled) Source: HSJ, 19 June 2023 -
News ArticleParamedics are being told to take a police escort to more than 1,200 addresses for fear of attack, The Times has revealed. The College of Paramedics said the figure was outrageous and called on courts to implement tougher sentences for assaults on paramedics. Ambulance services have marked hundreds of addresses after violence towards crew. Notes on addresses include “patient keeps axe under pillow — serrated knife hidden round the house and is known to be a risk”, “shoots/throws acid”, and “patient is anti-ambulance”. Read full story (paywalled) Source: The Times, 4 June 2023
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Hepatitis C home test kits available to most-at-risk in England
Patient Safety Learning posted a news article in News
Home test kits for a virus which attacks the liver are now available to order online in England, as the NHS tries to reach those needing treatment. Hepatitis C tends to affect current or past drug users and people who have had contact with infected blood through a tattoo or medical procedure abroad. It can lead to liver disease and cancer, but symptoms often go unnoticed for many years. The NHS website says it can usually be cured by taking a course of tablets. More than 70,000 people are thought to be living with the virus in England. Some may not know they have it, so would be unlikely to go to their GP for a test. Read full story Source: BBC News, 13 May 2023- Posted
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What the NHS is learning from Brazil
Patient Safety Learning posted a news article in News
Knocking on doors to check on people's health and catch problems before they escalate is common practice across Brazil. But could that approach work in the UK? Comfort and Nahima are two out of four door-knockers on round Churchill Gardens, a council estate in the Pimlico neighbourhood of London, visiting residents as part of a proactive community healthcare pilot. They can help with anything from housing issues which impact health, such as overcrowding, or pick up the early signs of diabetes by chatting informally to residents about their lifestyle. These community health workers are partly funded by the local authority and partly by the NHS so they can co-ordinate between the local GP surgery and other social services. Local GP Dr Connie Junghans-Minton says the proactive approach had led to fewer requests for appointments The National Institute for Health Research helped crunch the data from the pilot. Households which had been visited regularly were 47% more likely to have received immunisations and 82% more likely to have taken up cancer screening, compared to other areas. The idea to import this model to the UK came from Dr Matthew Harris, a public health expert at Imperial College London who worked as a GP in Brazil for four years. There, community health workers have been credited with achieving a drop of 34% in cardiovascular deaths. "In Brazil they have scaled this role to such degree that they have 270,000 community health workers across the whole country, each of which looks after 150 households, visiting them at least once a month," Dr Harris said. "They've seen extraordinary outcomes in terms of population health in the last two or three decades. We think we've got a lot to learn from that." Read full story Source: BBC News, 9 May 2023- Posted
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'Care homes are being deprived of dental services'
Patient Safety Learning posted a news article in News
A care home manager said it had become an "impossibility" to get NHS dentists to visit her elderly residents when they needed treatment. Liz Wynn, of Southminster Residential Home, near Maldon in Essex, said she had battled for years for site visits. It comes as a health watchdog revealed that 25% of care home providers said their patients were denied dental care. NHS Mid and South Essex said it was considering a number of approaches to improve access for housebound patients. Ms Wynn said the shortage of NHS community dentists available to come into the home to carry out check-ups and treatment had been an "on-going concern" for almost 10 years. Ms Wynn said the home relied on its oral care home procedures - such as checking residents' mouths daily - to prevent problems from escalating. However, she said while its residents were "our family", conditions such as dementia made it difficult to spot when patients were in pain. She also said poor dental hygiene in the elderly could result in a number of potentially life-threatening infections. Read full story Source: BBC News, 24 April 2023 -
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Investigation launched into gel nail polish allergic reactions
Patient Safety Learning posted a news article in News
The government is investigating reports that growing numbers of people are developing life-changing allergies to some gel nail products. Dermatologists say they are treating people for allergic reactions to acrylic and gel nails "most weeks". Dr Deirdre Buckley of the British Association of Dermatologists urged people to cut down on gel nail use and stick to "old-fashioned" polishes. Some people have reported nails loosening or falling off, skin rashes or, in rarer cases, breathing difficulties, she said. Although most gel polish manicures are safe and result in no problems, the British Association of Dermatologists is warning that the methacrylate chemicals - found in gel and acrylic nails - can cause allergic reactions in some people. It often occurs when gels and polishes are applied at home, or by untrained technicians. Dr Buckley said: "We're seeing it more and more because more people are buying DIY kits, developing an allergy and then going to a salon, and the allergy gets worse." The allergies can leave sufferers unable to have medical treatments like white dental fillings, joint replacement surgery and some diabetes medications. This is because once a person is sensitised, the body will no longer tolerate anything containing acrylates. Read full story Source: BBC News, 15 April 2023- Posted
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Age UK: Fixing the Foundations (17 February 2023)
Patient Safety Learning posted an article in Older people
A new in-depth report from the Charity Age UK, ‘Fixing the Foundations’, reveals how our under-funded and overstretched NHS and social care system is struggling and sometimes failing to cope with the needs of older people. The report provides a first-hand account of older people’s difficulties in getting the good, joined up health and social care they need to manage at home, leaving them at risk of crisis which often results in being admitted to hospital. Yet the evidence is clear that with the right care at the right time many of these admissions could have been avoided. The report also includes perspectives from professionals and unpaid carers. It also shows how living with multiple long-term health conditions, as a significant proportion of older people do, including more than two-thirds of those aged over 85, makes it especially hard to navigate health services which are still usually organised around individual illnesses and diseases. Meanwhile social care was often inadequate or absent in these older people’s lives. Age UK estimates that astonishingly, over 1.6 million older people have some level of fundamental care and support need, such as help to get dressed, washed or getting out of bed, that is not being fully addressed.- Posted
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Content ArticleThis document summarises the current landscape of virtual wards from the perspective of healthcare for older people, and provides advice to those looking to set up such services for older people living with frailty.
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Content ArticleThis paper from Natalie Offord and colleagues describes a service redesign in which has gained learning and experience in two areas. First, a description of measured improvement by the innovation of redesigning the traditional hospital-based assessment of frail older patients’ home support needs (assess to discharge) into their own home and meeting those needs in real time (discharge to assess). In combination with the formation of a collaborative health and social care community team to deliver this new process, there has been a reduction in the length of stay from completion of acute hospital care to getting home (from 5.5 days to 1.2 days for those patients that require support at home). Second, the methodology through which this has been achieved. The authors describe their translation of a Toyota methodology used for the design of complex cars to use for engaging staff and patients in the design of a healthcare process.
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