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Found 322 results
  1. News Article
    The safety of people with learning disabilities in England is being compromised when they are admitted to hospital, a watchdog says. The Health Services Safety Investigations Body (HSSIB) reviewed the care people receive and said there were "persistent and widespread" risks. It warned staff are not equipped with the skills or support to meet the needs of patients with learning disabilities. The watchdog launched its review after receiving a report about a 79-year-old who died following a cardiac arrest two weeks after being admitted to hospital. As part of its investigation, HSSIB also looked at the care provided in other places to people with learning disabilities. It warned systems in place to share information about them were unreliable, and that there was an inconsistency in the availability of specialist teams - known as learning disability liaison services - that were in place in hospitals to support general staff. It also said general staff had insufficient training - although it did note a national mandatory training programme is currently being rolled out. Senior investigator Clare Crowley said: "If needs are not met, it can cause distress and confusion for the patient and their families and carers, and raises the risk of poor health outcomes and, in the worst cases, harm." Read full story Source: BBC News, 2 November 2023
  2. Content Article
    The aim of this investigation and report is to help improve the inpatient care of adults with a known learning disability in acute hospital settings. It focuses on people referred urgently for hospital admission from a community setting, such as a person’s home or residential home. In undertaking this investigation, the Health Services Safety Investigations Body (HSSIB) looked to explore the factors affecting: The sharing of information about people with a learning disability and their reasonable adjustment needs following admission to an acute hospital. How ward-base staff are supported to delivery person-centred care to people with a learning disability.
  3. News Article
    NHS England has recorded more than 120,000 breaches of its mixed-sex hospital accommodation guidance in the past six years, a 257% increase. Guidance added to the NHS constitution in 2012 states that hospital patients will not share sleeping accommodation with members of the opposite sex “except where appropriate”. Exemptions include critical care wards or patients receiving treatment, such as chemotherapy, where they “may derive comfort from the presence of other patients with similar conditions”. The guidance also says patients should not share toilet or bathroom facilities with members of the opposite sex and should not “have to walk through an area occupied by patients of the opposite sex to reach toilets or bathrooms”. However, data from NHS England analysed by the Observer shows thousands of breaches every month, with patient dignity and safety put at risk. Caitlin (not her real name) worked on an acute mental health ward in a private hospital which switched from 12 women-only beds to 15 mixed beds. “Women on our ward often had a history of sexual or domestic abuse,” she said. “Some had tried to end their life in the wake of this, and a lot of them felt intimidated by the level of aggression shown by some men on the ward.” Women and men had separate wings but shared a communal area. “A lot of the women were really fearful of the men,” she added. Caitlin said the use of mixed-sex accommodation had a negative impact on some women’s recovery. “Women would stay in their rooms, not even coming out to watch TV,” she says. “Some acutely unwell women would display sexually disinhibited behaviour in the communal areas, which is a symptom of their diagnosis. They were put in a position where their dignity could not be protected.” “Women make hundreds of conscious and unconscious decisions to keep ourselves safe from men,” said Karen Ingala-Smith, author of Defending Women’s Spaces. “Women should not have to be on their guard like this when they are in hospital.” Read full story Source: The Guardian, 15 October 2023
  4. News Article
    At least two trusts are set to fall short on a high-profile pledge to eradicate ‘dormitory’ style wards in mental health facilities, with delays caused by cost pressures and shortage of materials and labour. In 2020, ministers said more than 1,200 beds in mental health dormitories across more than 50 sites would be replaced with single, en-suite accommodation by March 2025. Around £400m was allocated to achieve this. However, information gathered by HSJ via freedom of information requests suggests there will be at least 37 dormitory beds still in use beyond that date. In 2018, the Care Quality Commission said: “In the 21st century, patients, many of whom have not agreed to admission, should not be expected to share sleeping accommodation with strangers, some of whom may be agitated”. Patients have told HSJ they felt “distressed”, “unsafe” and “intimidated” on dormitory style wards. Leaders of trusts impacted by delays told HSJ of rising cost pressures, shortages of construction materials and availability of labour. Read full story (paywalled) Source: HSJ, 17 October 2023
  5. Content Article
    This infographic by artist Sonia Sparkles highlights ways to prevent patient falls in hospital. A wide range of graphics relating to patient safety, healthcare and quality improvement is available on the Sonia Sparkles website.
  6. News Article
    Transgender people may be banned from single-sex hospital wards under plans to restore "common sense" in the NHS, the health secretary says. Speaking at the Conservative party conference, Steve Barclay announced a consultation on strengthening the protections in place for women. NHS guidance issued in 2021 said trans people may be placed on wards according to the gender they identify as. The change would stop that with trans people given their own rooms and areas. But doctors have questioned whether there are the facilities available to achieve that. And the move would have to meet the legal threshold set by the Equality Act, which allows trans people to be excluded from single-sex spaces if there is a proportionate means of achieving a legitimate aim, such as privacy or safety. Mr Barclay said he wanted to make sure the "dignity, safety and privacy" of all patients was respected, while the rights of women are protected. Read full story Source: BBC News, 3 October 2023
  7. Content Article
    The Acute Frailty Network (AFN) was a scheme run in England by NHS Elect, using an approach called Quality Improvement Collaboratives (QICs), to help trusts implement principles of Comprehensive Geriatric Assessment (CGA) as part of their acute pathway. In July 2023, Street et al published a paper in BMJ Quality and Safety analysing the impact of the AFN which concluded that there was no difference in length of hospital stay, in-hospital mortality, institutionalisation and hospital readmission between organisations that took part in AFN and those that did not. This article outlines the position of the British Geriatrics Society (BGS) on the paper, addressing why it thinks that focusing on older people’s healthcare is more important than ever. It highlights the importance of ensuring that the paper's findings are not used as a reason to abandon efforts to improve acute frailty care. Rather, they should be seen as a call to redouble efforts to identify and overcome the barriers to delivering CGA in acute settings.
  8. Content Article
    This alert is for action by all those responsible for the use, purchase, prescription and maintenance of medical beds, trolleys, bed rails, bed grab handles and lateral turning devices including all Acute and Community healthcare organisations, care homes, equipment providers, Occupational Therapists and early intervention teams. From 1 January 2018 to 31 December 2022, the MHRA received 18 reports of deaths related to medical beds, bed rails, trolleys, bariatric beds, lateral turning devices and bed grab handles, and 54 reports of serious injuries. The majority of these were due to entrapment or falls. Investigations into incidents involving falls often found the likely cause to be worn or broken parts, which should have been replaced during regular maintenance and servicing, but which were either not carried out or were carried out improperly.
  9. News Article
    The NHS is on trajectory to fall short of a flagship pledge to have around 24,000 “virtual ward beds” in place by December 2023, internal data has revealed. NHS England’s figures from March, seen by HSJ, suggest the system is instead more likely to have created around 18,500 virtual beds by the 2023 deadline. Senior clinicians, including the Royal College of Physicians and the Society of Acute Medicine, have recently raised concerns about the speed and timing of the roll-out and staffing implications. And now fresh concerns are also being raised about the programme following publication of a new academic study which suggests virtual wards set up by the NHS during Covid made little impact on length of stay or readmissions rates. Alison Leary, professor of healthcare and workforce modelling, London South Bank University, was one of the first senior leaders to publicly voice concerns about the NHS’s virtual wards programme. Professor Leary told HSJ: “I am not surprised [systems are falling] short. Since Elaine [Elaine Maxwell, visiting professor, London South Bank University] and I published our piece in HSJ, I have been contacted by several clinicians who have serious concerns over virtual wards and staffing them.” Read full story (paywalled) Source: HSJ, 31 March 2022
  10. News Article
    Hospitals are still banning patients from having bedside visitors in ‘immoral’ Covid restrictions. Last night, MPs, patient groups and campaigners criticised the postcode lottery that means some frail patients are still denied the support of loved ones. Nine trusts continue to impose total bans on any visitors for some patients, The Mail on Sunday has found. Almost half of trusts maintain policies so strict that they flaunt NHS England’s guidance that patients should be allowed at least two visitors a day. Shrewsbury and Telford Hospital NHS Trust, Sandwell and West Birmingham Hospitals NHS Trust and Royal Papworth Hospital NHS Foundation Trust are among those continuing total bans on visiting for some of their patients. University College London Hospitals NHS Foundation Trust (UCLH) has even been imposing its draconian restrictions on disabled patients who need special help for their care – only allowing visits on three days a week for a maximum of an hour each time. Tory MP Alicia Kearns said: ‘It is utterly unforgivable and immoral. There is no scientific evidence for any remaining inhumane restrictions on visiting. Trusts are breaching the rights of families. 'Visitors save lives, they advocate and calm their loved ones. When will this madness end?’ Read full story Source: MailOnline, 1 May 2022 You may also be interested in: Visiting restrictions and the impact on patients and their families: a relative's perspective It’s time to rename the ‘visitor’: reflections from a relative
  11. News Article
    Overstretched hospitals are stopping routine Covid tests for new patients as “brutal” pressures mount on doctors and nurses, The Independent understands. On Monday there were 1,702 new Covid admissions to hospitals in England as of 9 April – with 16,442 positive patients occupying beds – the NHS leaders warn their ability to tackle the backlog in planned care is at risk. Despite pleas from NHS chiefs to measures such as mask-wearing back into force, ministers said there were no plans to change guidance. The Independent understands at least two major hospitals, in Newcastle and York, have dropped testing of all patients without symptoms in order to alleviate pressure on beds – raising fears that Covid could spread on unchecked wards. Other hospitals are also likely to do the same as bed pressures worsen. Sources have told The Independent some trusts have begun to drop “red” Covid only wards, while some are considering not separating patients in A&E. One expert, critical care doctor Tom Lawton, who analyses hospital-acquired infection data, said that stopping patient testing in hospitals was “worrying” and that the NHS would be putting “blinkers on” just as in-hospital infections were “as high as they’ve ever been”. Read full story Source: The Independent, 11 April 2022
  12. News Article
    Patients in nine hospitals in Ireland were often treated in the wrong places, sometimes corridors, in situations where it was “unclear” who was supposed to be providing their care, a clinical review has found. It warned of the potential for people to receive inappropriate specialist input and recommended specific wards be used to avoid so-called “safari rounds” where consultants must seek out scattered patients. The independent review team consisted of clinical and management experts from Scotland and England who undertook a programme of visits between August and November, 2019. “The review team witnessed widespread boarding and outliers – any bed, anytime, anywhere and including mixed gender,” the document said. “This does not create extra capacity, leads to safari rounds, increases length of stay, introduces harm by non-specialist care and increases staff absenteeism.” Although acknowledging often excellent work by staff, the report was commissioned to examine non-scheduled care at nine hospitals found to be “under the greatest pressures” during the winter season of 2018/2019. These had “significant numbers” of patients waiting for long periods on trolleys. Read full story Source: The Irish Times, 4 April 2022
  13. News Article
    Two national reviews are taking place into hospital discharge policy, it has emerged, amid major changes to funding and legislation. One review, led by the Department of Health and Social Care, is developing discharge policy for once the Health and Care Bill comes into force; and a second is reviewing the “clinical criteria to reside”. Delayed discharge has been a major problem in the acute and emergency care system this winter, with the number of long-staying patients significantly up on previous years. It has been blamed for long patient waits for ambulances, to get into emergency departments, and to be admitted; and for interrupting elective care recovery. An NHSE letter confirmed that the government’s national “discharge taskforce” was developing “best practice in improving discharge processes and addressing barriers to timely discharge”, in preparation for the new system. It went on: “This includes improving hospital processes to support discharge; minimising delays in the transfer of care from an acute hospital on to follow-up care services; minimising long lengths of stay in rehabilitation at home or in bedded care and ensuring social care services are available at the right time for people with ongoing care requirements. Further resources and support will be shared as learning from these systems becomes clear.” Read full story (paywalled) Source: HSJ, 28 March 2022
  14. News Article
    A hospital in Devon has declared a second critical incident following extreme pressures, as Covid-19 admissions in the region double, The Independent has learnt. North Devon Healthcare Trust declared a critical incident on Monday, after it declared another earlier this month it has confirmed. The news comes as the number of people with Covid-19 across two hospitals in Devon has doubled in just two weeks. As of Thursday, there were 292 Covid positive patients in across hospitals in Devon, with a further 37 awaiting test results. According to a statement from healthcare leaders in Devon, Plymouth and Torbay, as of Thursday there were almost 1,200 NHS staff off work due to Covid. Meanwhile 183 care services, such as care homes and other social care providers, in the area have reported Covid outbreaks, making it harder to discharge patients, the leaders said. NHS data published on Thursday showed there were 213 patients across three hospitals in Devon, waiting to be discharged. Covid-19 infections are also continuing to rise across most of the UK, with levels in Scotland hitting another record high, new figures show. Read full story Source: The Independent, 19 March 2022
  15. News Article
    An inspection of a county's urgent and emergency services found delays were caused by a lack of empty beds and prolonged waiting times. The Care Quality Commission (CQC) inspected Gloucestershire emergency care services in November and December. The report found staff worked well in challenging circumstances but the CQC said pressures on workers across the system needed addressing. Dr Jeremy Welch said: "The system is being stretched and we need to adapt." CQC deputy chief inspector for hospitals, Nigel Acheson, said: "We found the system to be complicated. As a result, staff and patients weren't always able to understand which urgent and emergency care service was best suited to their needs. "This meant people sometimes attended the emergency department when they could have been treated more appropriately elsewhere." In addition the report touched on adult social care and the possibility of using empty care home beds when hospitals were struggling to cope. Dr Welch recognised "it's been a blinking tough time in care homes" over the pandemic and credited the relaxing of rules to allow visits but said there are other factors that would need to be considered. However he added: "We've got enough beds when we map across, it's just getting patients through the hospital and home because home is where they want to be." Read full story Source: BBC News, 17 March 2022
  16. News Article
    Patients face limits on visitors in every hospital trust in England, The Telegraph has revealed, with restrictions set to continue even once the country moves to "living with Covid". It comes as Boris Johnson announces that all Covid regulations including self-isolation will be abolished at the end of February. The health service supports keeping some visiting restrictions in place while Covid remains in circulation among the general population, it is understood. A spokesman said: "The NHS regularly reminds hospitals that visits for patients should continue to go ahead as much as possible and extra measures should already be in place so that this can be done safely." NHS England encourages trusts to facilitate visits "wherever possible, and to do so in a risk-managed way", but it is up to individual trusts to set their own policies based on UK Health Security Agency guidelines. Analysis by The Telegraph found that at least 34 hospital trusts across England still have routine visits suspended, with exceptions such as those for patients receiving end-of-life care and people with dementia. All 125 trusts have some form of visiting restriction in place. The most common policy is to have one named visitor per patient for the entirety of a patient's stay, who can only visit for one hour once a day. Helen Wildbore, the director of the Relatives and Residents Association, said limiting patients to one nominated visitor put pressure on families, leaving the carer "exhausted". She added: "If you’re going into hospital and you're not able to have your family with you, you're going to come out worse." In some cases, patients who needed hospital care had chosen not to go because they were worried about being isolated from family, she said. Caroline Abrahams, the Charity Director at Age UK, said it was "imperative that hospitals open their doors to visitors again as wide as they possibly can" as the pandemic eases. Read full story (paywalled) Source: The Telegraph, 18 February 2022 You may also be interested in reading: Visiting restrictions and the impact on patients and their families: a relative's perspective
  17. News Article
    The government has announced £250m in funding to provide an extra 5,000 NHS hospital beds in England this winter. Ministers say 900 new beds should be ready by January, with the remainder to follow soon after, boosting capacity and helping lower record waiting lists. The increase will mean nearly 100,000 permanent beds on wards and in A&E, available at the busiest time of the year - a 5% rise on current levels. NHS Providers said the extra capacity was needed "before winter begins". Miriam Deakin, director of policy and strategy at NHS Providers, said trusts would welcome the support but cautioned any new beds would need to be staffed. She added that, since winter is the busiest time of the year for urgent and emergency care, trust leaders would be concerned that the promised extra capacity is only expected to be in place by January. "For the best results, trusts would need these new beds before winter begins," she said. Pat Cullen, from the Royal College of Nursing, added: "The elephant in the room is who will staff these additional beds? Nursing staff are already spread too thinly over too many patients." Read full story Source: BBC News, 15 August 2023
  18. News Article
    Older patients should walk around hospital wards and along corridors to prevent their muscles weakening, research suggests. Lying in a hospital bed for several days can cause a sharp deterioration in strength, leaving some elderly patients struggling to walk or live independently when they are discharged. New research shows this decline can be prevented if patients are helped to walk for at least 25 minutes a day while in hospital. The best effect was observed when patients walked around the hospital for at least 50 minutes a day. The study suggested that a mixture of physical activity, such as 20 minutes working with resistance bands while seated and 20 minutes of walking, also helped. The authors said patients who remained active during their stay in hospital were less likely to suffer “adverse events” after they were discharged. Read full story (paywalled) Source: The Times, 4 August 2023
  19. News Article
    A director at a major acute trust said it needs to stop “caving in” to demand pressures by opening extra escalation beds. Board members at Mid and South Essex were discussing a recent report from the Care Quality Commission (CQC), which rated medical services as “inadequate”. The CQC flagged significant staffing shortages and repeated failures to maintain patient records, among other issues. Deputy chair Alan Tobias told yesterday’s public board meeting: “We have just got to hold the line on these [escalation] beds. We never do. Every year we cave in… “We have just got to hold the line with this… Do what some other hospitals do, they shut the doors then. We have never had the bottle to do that.” Barbara Stuttle, another non-executive director, said: “Our staff are exhausted… We don’t have the staff to give the appropriate care to our patients when we have got extra beds. To have extra beds on wards, I know we have had to do it and I know why, [but] you are expecting an already stretched workforce to stretch even further. “And when that happens, something gives. Record keeping, that’s usually the last thing that gets done because they’d much rather give the care to patients.” Read full story (paywalled) Source: HSJ, 28 July 2023
  20. News Article
    A woman treated in a hospital corridor says the lack of privacy was "wholly inappropriate" after other patients saw her without a top. Isabel Aston was taken to Princess Royal Hospital in Shropshire with pneumonia and sepsis and said she spent seven hours on a bed in a corridor. She said she felt exposed when other patients saw her changing her clothes. She explained: "People were walking in both directions [and] there aren't screens around your bed so people wanting the toilet who couldn't get out of bed were faced with the thought of using a bed pan in full view." She added that on feeling hot at one point, she wanted to change her t-shirt, but the process proved lengthy due to cannulas in her arms. "I did not have anything on underneath," she said. "I'm 64 years of age, I've probably reached an age where I'm not so self-conscious perhaps, but that could have been a much younger patient. "That could have been a patient for whom perhaps culturally they couldn't have change their t-shirt... or somebody who had mastectomy scars [and] were very self conscious. "It is wholly inappropriate for patients to be so exposed when they are so ill." The hospital trust said it aimed to maintain patients' dignity despite being under operational pressures. Read full story Source: BBC News, 28 July 2023
  21. News Article
    The Royal College of Nursing (RCN) has said patients are waiting for days in corridors at Belfast's Royal Victoria Hospital's Emergency Department. Rita Devlin, NI director of the RCN, visited the unit on Thursday after getting calls from nursing staff. She described the situation as "scandalous". Speaking to Radio Ulster's Evening Extra programme, Ms Devlin said while it was the Royal Hospital on Thursday, the situation is "bad right across the EDs". She said talking to nurses at the Royal, she was struck by "the absolute despair" some are feeling. "I spoke to some young, newly qualified nurses who are leaving because they just can't take the stress and the pressure any more," she said. Read full story Source: BBC News, 20 July 2023
  22. News Article
    NHS trusts across London are set to start moving patients from A&E onto wards “irrespective” of whether there are beds available, The Independent has learned. The new model, which involves moving patients every two hours out of A&E and onto wards called acute medical units, has prompted concerns that patients could be “double lodged” on hospital wards. The move follows the trial of a new system by North Bristol NHS Trust last month, which said it would be moving three patients every hour from A&E onto wards in a bid to address severe ambulance handover delays. On Thursday, health secretary Steve Barclay said that the “number one” priority for the NHS currently is tackling ambulance handover delays, with a “small” number of trusts accounting for half of all delays. In a memo seen by The Independent, NHS clinicians in one hospital were told that London trusts would be rolling out the North Bristol model at “pace” ahead of winter. The system involves moving one patient from A&E onto a ward every two hours “irrespective of bed availability”. Speaking to The Independent, one NHS director said the move would lead to “double lodging” patients, which means squeezing more patients into wards, and that this could be “dangerous” for patients. However, A&E doctors told The Independent that the move should be welcomed, as it spreads the crowding and risk for patients across hospital departments rather than confining it to A&E. Read full story Source: The Independent, 4 September 2022
  23. News Article
    When the new Royal Liverpool Hospital opens its doors in October, every patient will have a single room with an en-suite bathroom. That set-up is unusual for acute hospitals in England, but many feel it is the future for all new buildings. "There's the privacy and dignity from the patient's point of view," says Jacqui Stamper, the hospital's associate chief nurse. "If they're in the room and talking to the doctors or the nurses, there isn't somebody just the other side of a curtain listening." "And then there's the infection prevention side of it as well. "It's absolutely the state of the art way of hospital care really." The new system will require staff to work differently, so patients can be properly monitored. Each ward has been broken up into smaller zones of between six and eight beds, and each zone has its own base where the nurses will sit. The trust which runs the hospital is currently running workshops to get staff used to the layout. "Nursing staff will be used to working in a bigger team than a couple of people, so it is a different way of working," Ms Stamper says. "We're listening to our staff and their concerns and answering those to see how we can address them going forward." Read full story Source: BBC News, 2 September 2022
  24. News Article
    Specialist nurses at an NHS hospital have been told they may be taken off clinical shifts to help clean wards, it has emerged. Bedfordshire Hospitals NHS Foundation Trust has said it asked nursing staff to help clean wards as the hospital faced the “most challenging circumstances” it has ever faced. Clinical specialist nurses, who are advanced nurses and can usually have hundreds of patients under their care, were among those asked to spend entire shifts helping other wards “cleaning”, “tidying” and “decluttering”. The news has prompted criticism from unions, however, multiple nurses have reported that the requests happen “often” during winter. Alison Leary professor of healthcare and workforce at South Bank University warned that asking specialist nurses to drop their work was “very risky”. She said: “This problem keeps cropping up-as soon as there is pressure on wards they are expected to abandon their patients. It usually happens in winter and so it’s concerning that it has now started to happen in summer. “This also shows very little respect for nursing generally and will not help retention. Trusts need to plan workforces accordingly and should ensure they have the right amount of cleaning, administrative and housekeeping staff-all staff groups which contribute to patient safety and care quality." Read full story Source: The Independent, 8 August 2022
  25. News Article
    People who go to hospital for non-covid treatment are at higher risk of the virus compared with the general public, which is why high levels of hospital-acquired Covid-19 in England are worrying some doctors. They fear that the coronavirus is becoming a potential hazard of a hospital stay for older or vulnerable people, in a similar way to “superbugs” such as methicillin-resistant Staphylococcus aureus (MRSA). People who go to hospital for non-covid-19 treatment are at higher risk from the virus compared with the general public, says Tom Lawton, an intensive care doctor in Bradford, UK. Read full story (paywalled) Source: The New Scientist, 21 July 2022
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