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Found 322 results
  1. News Article
    Admissions of people to hospital with Covid in England have begun to grow again, new data from the NHS shows, as fears were raised over a new wave. Analysis by John Roberts of the Covid Actuaries group, set up in response to the pandemic, showed hospital admissions had stopped falling after a period of decline. Figures on Tuesday showed weekly admissions increased by 4% across England as of 5 June and were up by 33% in the North East and Yorkshire. When asked if the UK was heading into another wave, Mr Roberts told The Independent: “Yes we could be but...how big that wave and how serious it will be in terms of admissions and deaths is very, very difficult to judge at this stage.” His comments come after experts in Europe warned there will be a new wave driven by the growth of the BA.5 and BA.4 Covid variants. The figures, which cover hospitals in England only, show the weekly average of admissions for patients in hospital with Covid stood at 531 as of 5 June. Read full story Source: The Independent, 9 June 2022
  2. News Article
    The number of patients stuck in hospitals despite being ‘medically fit’ to leave has continued to increase in recent months, leading to warnings from NHS Confederation that trusts are finding it ‘impossible’ to make progress on reducing the numbers. Official statistics for April suggest an average of 12,589 patients per day in NHS hospitals in England – 13% of all occupied beds – did not meet the “criteria to reside”. At 31 trusts, the proportion was 20% or more. NHS England has since told local leaders to make reducing the numbers of delayed discharges an operational priority. The issue is a key factor behind the long waits in emergency care, as ward beds are taking longer to become available to accident and emergency patients. Rory Deighton, acute lead at NHS Confederation, said targets to reduce delayed discharges “will not be met” unless the government “invests in domiciliary care wages,” amid high numbers of vacancies in the social care sector. Read full story (paywalled) Source: HSJ, 1 June 2022
  3. News Article
    Children's services could be forced to close at a hospital that is accused of leaving young patients traumatised and sick through poor care. The care regulator said it had taken action to "ensure people are safe" on Skylark ward at Kettering General Hospital (KGH) in Northamptonshire. Thirteen parents with serious concerns after their children died or became seriously ill have spoken to the BBC. A BBC Look East investigation has heard allegations spanning more than 20 years about the treatment of patients on Skylark ward, a 26-bed children's unit. The BBC discovered: An independent report found staff left a 12-year-old boy - who died at KGH in December 2019 - for four hours suffering seizures, and suggests little effort was made to obtain critical care support. In April 2019, nurses allegedly dragged a "traumatised" four-year-old girl down a corridor in agony, insisting that she could walk. Medics are accused of refusing to carry out an MRI scan, which would have detected a dangerous cyst on her spine. Mothers claim to have been threatened with safeguarding referrals, with one stating a referral was made against her after she complained her son was struggling to breathe, while another likened it to blackmail. Read full story Source: BBC News, 20 February 2023
  4. News Article
    The ‘optimal layout’ for an isolation room to contain the spread of Covid has been created following tests at a London hospital. The room was designed by researchers at Imperial College London to reduce the risk of infection for health care staff as far as possible. Researchers used a state-of-the-art fluid model to simulate the transmission of the virus within an isolation room at the Royal Brompton Hospital in Chelsea, west London. They found that the area of highest risk of infection is above a patient’s bed at a height of 0.7 to two metres, where the highest concentration of Covid is found. After the virus is expelled from a patient’s mouth, the research team explained that it gets driven vertically by wind forces within the room. The research, published in the journal Physics of Fluids, is based on data collected from the room during a Covid patient’s stay. The work centred on the location of the room’s air extractor and filtration rates, the location of the bed, and the health and safety of the hospital staff working within the area. Read full story Source: The Independent, 8 February 2023
  5. News Article
    Six wards in a busy London Hospital, added at a cost of £24 billion during the pandemic, are lying empty because the builders did not install sprinklers. With the NHS in crisis, the Royal London Hospital in east London, has had to mothball the space, which is large enough to take 155 intensive care beds, while officials work out what to do with it. They have no patients in it since last May. Source: The Sunday Times, 29 January 2023 Shared by Shaun Lintern on Twitter
  6. News Article
    Devon care homes say they are being asked to accept patients with Covid-19, flu and other infectious diseases to ease the pressure on local hospitals. One owner said it felt like the start of the pandemic again, as the safety of care homes was being "compromised". Devon has some of the longest waits for emergency care in the country, according to NHS figures. Simon Spiller, owner of The Croft Residential Care Home in Newton Abbot, said since the start of winter the home was being asked to shortcut its assessment process to help ease the blockages in Devon's hospitals. He said other local care homes have told him they were facing the same pressure. Mr Spiller said: "We're being encouraged, or really asked, to shortcut our assessment process. Normally, one of our team would go to the hospital to assess people, to really understand their care needs, to ensure they're an appropriate fit for our care home, which specialises in dementia. "Increasingly, because of the speed they're trying to achieve a discharge, we're being asked to accept people at kind of face value, as presented by the NHS." Read full story Source: BBC News, 26 January 2023
  7. News Article
    Hospitals are ‘horrible’ and unsafe places, which should be avoided ‘unless you really need to be there’, a longstanding trust chief executive has argued. East Suffolk and North Essex Foundation Trust boss Nick Hulme also said the NHS had to be honest about the state of its acute services. Speaking at a public meeting of the East Suffolk and North Essex Integrated Care Board, he described hospitals as “awful” and “horrible”, and said NHS leaders had “got to get that message out” to the public. He added: “The food’s rubbish, we don’t let you sleep, we don’t let you know what’s going on” and that although he had stayed in some “fairly dodgy” hotels, none had forced him to share a bathroom with six people. The trust CEO told the meeting he wanted to emphasise to the public that “the worst place you can possibly be in the health system is a hospital, unless you need to be there”, according to a report in the East Anglian Daily Times. He added that hospitals were “not safe places”. Read full story (paywalled) Source: HSJ, 26 January 2023
  8. News Article
    Care providers are demanding double the usual fees to look after thousands of people who need to be discharged from hospitals to ease the crisis in the NHS. Care England, which represents the largest private care home providers, said on Sunday it wanted the government to pay them £1,500 a week per person, citing the need to pay care workers more and hire rehabilitation specialists so people languishing in hospital can eventually be sent home. The rate is about double what most local authorities currently pay for care home beds, an amount Martin Green, the chief executive of Care England, described as “inadequate”. The demand comes as the health secretary, Steve Barclay promised “urgent action” with up to £250m in new funding for the NHS to buy care beds to clear wards of medically fit patients. The money will be used to buy beds in care homes, hospices and hotels where people are looked after by homecare providers, as well as pay for hospital upgrades. Stays will be no longer than four weeks until the end of March. The use of hotels as care homes began during the pandemic and has been controversial, with reports of problems with hygiene and supplies of specialist equipment. The charity Age UK last week criticised their renewed use as “not an appropriate place to provide high-quality care for older people in need of support to recuperate after a spell in hospital”. Read full story Source: The Guardian, 9 January 2023
  9. News Article
    All new hospitals built in England must have only single patient rooms, health infrastructure chiefs have confirmed, requiring an overhaul of many trusts’ current proposals. Leaders of the New Hospitals Programme said the NHS needed to be “brave”, with the move marking an end for multi-bed bay wards and representing a major change in hospital design. Previously, NHS trusts were expected to consider a minimum of 50% single rooms when refurbishing or building new facilities, but HSJ revealed in September that officials were considering a 100 per cent requirement. Natalie Forrest, senior responsible officer for NHP, said England was “behind the times” on single patient rooms. She said: “If we really want to look for evidence of why patients should have the ability to sleep in privacy and choose to socialise in social areas… we need not look very far. Scotland, Wales, Ireland, Europe, the US – where they wouldn’t dream of building a hospital that didn’t provide single bedroom occupancy.” Ms Forrest, who is also a nurse, acknowledged an “anxiety” among NHS staff that they can’t care for patients in single rooms as well, and stressed the need to combine them with “digital technology”. “I have said we need to be brave and take on new challenges, and this is one of those brave decisions the NHS needs to stand up and move forward with.” Read full story (paywalled) Source: HSJ, 13 December 2022
  10. News Article
    The government has proposed new legislation to make patient visiting a legal right and also give the Care Quality Commission (CQC) fresh powers to enforce it. The Department of Health and Social Care has launched a consultation to seek views from patients, care home residents, families, professionals and providers on the introduction of new legislation which will require health and care settings, including hospitals, to accommodate visitors in most circumstances. It said the new visiting laws will also provide the CQC with a “clearer basis for identifying where hospitals and care homes are not meeting the required standard”, and enable it to enforce the standards by issuing requirement or warning notices, imposing conditions, suspending a registration or cancelling a registration. It said although the CQC currently has powers “to clamp down on unethical visiting restrictions”, the expected standard of visiting rules is not “specifically outlined in regulations”. Read full story (paywalled) Source: HSJ, 21 June 2023
  11. News Article
    Children presenting with 'high-risk' behaviours are being cared for in NHS paediatric wards that may put them and others at risk of harm, according to a new report from the Healthcare Safety Investigation Branch (HSIB). HSIB's interim report warns that the placement of children and young people with complex mental health issues on NHS paediatric wards can impact on the wellbeing of these patients and their families, and pose a risk to other patients and staff. The report emphasises that paediatric wards are designed to care for patients who only have physical health needs and not for those who are exhibiting high-risk behaviours, which include attempts to die by suicide, self-harm, attempts to leave the hospital without permission, and episodes of violence and aggression. Examples of children and young people being restrained or sedated in front of other sick and vulnerable patients, families feeling concerned for their and their children's safety during incidents, rooms being stripped down to remove any risk of self-harm or death by suicide, and paediatric staff being physically assaulted are cited in the report. Saskia Fursland, HSIB national Investigator, said,"We know that NHS staff are trying to provide a safe environment for their patients, but they are facing difficult choices in wards that are not designed to support children and young people displaying high-risk behaviours. Our ongoing investigation will take a longer-term look at effective design, adaptations and risk management in the wards. A whole system response is now needed to ensure we can keep children and young people safe." Read full story Source: Medscape, 25 May 2023
  12. News Article
    Extra beds squeezed into hospitals as part of winter planning are crowding out space for rehab, pushing up length of stay and knock-on costs, and increasing the chance of readmission, NHS leaders have been warned. Systems and trusts were encouraged to staff thousands of additional ward beds in the run-up to last winter to try to ease emergency care pressures, and government and NHS England have since asked for many of them to be kept open through the year. However, many of the additional beds are not in proper ward spaces, instead being located in gyms and other areas used for physiotherapy and other rehab. This followed on from some rehab areas already being lost during the pandemic, to be used for beds or storage. NHSE has sent out a warning about the issue, following a commitment by ministers earlier this year. However, senior figures in physio and older people’s care remain concerned the spaces will not be restored without checks and enforcement, especially as acute trusts remain under pressure to increase general bed space.
  13. News Article
    A safety investigation has warned that young people with complex mental health needs are being put at significant risk, by being placed on general children's wards in England. The findings come from the Healthcare Safety Investigation Branch (HSIB). BBC News recently highlighted the plight of a 16-year-old autistic girl, who spent several months in a children's ward. Other families have since contacted the BBC describing similar situations. The majority had faced similar difficulties getting appropriate support. HSIB says that paediatric wards are designed to care for patients who only have physical health needs and not for those with mental health needs. It describes the situation in 18 hospitals it visited as "challenging", and 13 were described as "not safe" for children who were suicidal or at risk of harming themselves to be on their paediatric wards. Read full story Source: BBC News, 25 May 2023
  14. News Article
    An autistic girl aged 16 spent nearly seven months in a busy general hospital due to a lack of suitable children's mental health services in England. The teenager, called Molly, spent about 200 days living in a side-room of a children's ward at the Queen Alexandra Hospital in Portsmouth. It is not a mental health unit. Experts say a general hospital was not the right place for her, but she had nowhere else to go because of a lack of help in the community. Agency mental health nurses were brought in because she needed constant, three-to-one observations to keep her safe. Her family says security guards were also often stationed outside her room. Like many autistic people, Molly finds dealing with noise difficult. The clamour of the hospital overloaded her senses and her behaviour sometimes became challenging. She was restrained numerous times. A spokesperson for Hampshire and Isle of Wight Integrated Care System (ICS) said it was sorry Molly "did not receive care in an environment better suited to her needs", adding: "Molly's safety has always been our priority." Campaigners describe the shortage of appropriate support for people with autism as a human rights crisis. Read full story Source: BBC News, 10 May 2023
  15. News Article
    Thousands of children in mental health crisis are being treated on inappropriate general wards – with some forced to stay for more than a year and staff not properly trained to care for them, shocking new data reveals. New figures uncovered by The Independent show at least 2,838 children needing mental health care were admitted to non-psychiatric hospitals last year as the NHS battled with a lack of specialist staff and a surge in patients. Children with eating disorders – who often need to be restrained to be fed through tubes – are among those being routinely put on general wards. It means staff without any specialist training, including security guards, are sometimes left to restrain these young patients. One trust chief nurse told The Independent that porters had to be trained to restrain children on paediatric wards, causing trauma for both patients and staff. Dr Camilla Kingdon, president of the Royal College of Paediatrics and Child Health, said she was “deeply concerned” about the situation. “We now find ourselves in a situation where children and young people who have an eating disorder or mental ill health, and who may be on long waiting lists for treatment, are increasingly ending up in emergency settings and then being treated on general paediatric wards. This simply isn’t good enough,” she said. Read full story Source: The Independent, 1 May 2023
  16. News Article
    A major acute trust has warned ahead of next week’s nursing strike that it will face ‘very severe staffing shortages’ in children’s A&E, with ‘as few as one nurse per ward’, much less critical care capacity, and fewer operating theatres open than on Christmas Day. Cambridge University Hospitals Foundation Trust’s medical director said in a note, seen by HSJ, that the hospital would only have 60 to 70% of its critical care beds open and that “it is not possible to guarantee patient safety on our wards over the forthcoming weekend” with severe staffing shortages in “almost all areas”. The Royal College of Nursing is planning no derogations (exceptions) to its planned 48-hour walkout, from 8pm on Sunday until 8pm on Tuesday, whereas its previous action has exempted emergency care. There have been national warnings about the significant safety threat posed, but the CUH message, sent to all staff by medical director Ashley Shaw, sets out a more stark picture of critical services scaled back. It says: ”Our current information indicates there will be a severe shortage of nurses in almost all ward areas, with as few as 1 nurse per ward per shift." Read full story (paywalled) Source: HSJ, 26 April 2023
  17. News Article
    The safety of a ward accused of failing children has been rated as inadequate by inspectors. The care regulator warned Kettering General Hospital (KGH) in Northamptonshire over its children's and young people's services. Inspectors' worries include sepsis treatment, staff numbers, dirt levels and not having an "open culture" where concerns can be raised without fear. Since the BBC's first report in February highlighting the concerns of parents with children who died or became seriously ill at KGH, dozens more families have come forward, bringing the number to 50 to date. Inspectors found that "staff did not always effectively identify and quickly act upon patients at risk of deterioration". They said there were sometimes "delays in medical reviews being undertaken outside of normal working hours", highlighting one case where a seemingly deteriorating patient was not seen until three hours after being escalated to the on-call team. Read full story Source: BBC News, 20 April 2023
  18. News Article
    Delays in people leaving hospital in England could be costing an average of £395 per night, according to researchers at a health think tank. The direct costs of delayed discharges, where patients are considered medically fit to leave hospital, is estimated to be around £1.89 billion for the past financial year, the King's Fund said. This estimate does not count extra costs, including cancelled operations or staff time spent arranging care packages. Ambulance handover delays are often linked to a shortage of space caused by people who no longer need to be in hospital beds. The most recent PA analysis of NHS figures showed an average of 13,300 beds per day in the week to March 26 were filled by people ready to be discharged, compared with 12,643 at that point last year. Overall, 42% of medically fit patients in England were discharged, though the rate varied between regions, from 31% in the North West to 52% in eastern England. Read full story Source: Medscape, April 2023
  19. Content Article
    A significant amount of professional time is wasted during a medical ward round retrieving patient notes from the ward trolley. If the efficiency of this non-clinical, non-functional interaction could be improved it would save time, maintain continuity and have financial implications. One identified constraint was the structure of the traditional ward trolley; a stationary filing tray with vertical sleeves. During ward round, time is spent returning and retrieving each patients notes from outside the patient bay and additional time may be wasted if the notes are misplaced or in use elsewhere. To resolve this, the ‘Vista 90’ trolley with horizontal, transparent trays, is portable and has an ergonomic writing surface was selected as a potential second generation replacement. An assessment of the impact of the Vista 90 trolley over the traditional trolley in the clinical setting was carried out on Erringham (medical) Ward, Worthing Hospital, West Sussex Hospital Trust, UK. This was by way of qualitative analysis performed by semi-structured interview of 12 doctors and other healthcare professionals who regularly interacted with the Vista 90 and traditional trolley in December 2012. The audit found that those interviewed preferred using the Vista 90 trolley over its predecessor as it improved the efficiency of the ward round and subsequent clinical work. It’s mobility allowed it to be easily transported with the ward round, reducing disruption during a consultation and between consecutives ones. The ergonomic writing surface was noted to improve legibility of documentation due to greater comfort and if placed appropriately, did not interfere with the doctor-patient interaction. The financial savings of this greater efficiency was found to be of significance and justify the cost of the Vista 90 within two weeks.
  20. Content Article
    Dr Gordon Caldwell shares how he changed his whole approach to ward rounds after seeing spaghetti maps of where a nurse walked during a shift. He cut down walking distance on rounds by creating a mobile office on wheels out of an old electricians trolley. See also: Making the ward a more efficient place: a qualitative evaluation of the impact of the Vista 90 trolley  
  21. Content Article
    This study in JAMA Health Forum aimed to assess the costs of inpatient falls and cost benefits associated with the Fall TIPS (Tailoring Interventions for Patient Safety) Program. The authors carried out an economic evaluation across a large cohort of 900,635 patients. The average total cost of a fall was $62 521 ($35 365 direct costs), and injury was not significantly associated with increased costs. The Fall TIPS Program was associated with $22 million in savings at study sites across the five year study period. The findings of this study indicate that implementation of cost-effective, evidence-based safety programs was associated with lower cost and care burdens associated with inpatient falls and are a step toward safer, more affordable patient care.
  22. Content Article
    The original National Safety Standards for Invasive Procedures (NatSSIPs) were published in 2015. Understanding of how to deliver safe care in a complex and pressurised system is evolving. These revised standards (NatSSIPs2) are intended to share the learning and best practice to support multidisciplinary teams and organisations to deliver safer care.
  23. Content Article
    In this blog Patient Safety Learning considers the impact on patient safety of the shortage of hospital beds facing the NHS this winter. It focuses on two specific issues stemming from this, the increasing numbers of patients being cared for in corridors and other non-clinical areas, and current proposals to reduce the number of patients waiting to be discharged.
  24. Content Article
    Ensuring everyone has clean hands can protect patients from serious infections in healthcare facilities. However, studies show that on average, healthcare workers wash their hands less than half as many times as they should. This contributes to the spread of healthcare-associated infections, which affect 1 in 31 hospital patients in the US. This campaign by the US Centers for Disease Control and Prevention (CDC) aims to improve healthcare provider adherence to hand hygiene recommendations, address myths and misperceptions about hand hygiene, and empower patients to play a role in their care by asking or reminding healthcare providers to clean their hands.
  25. Content Article
    The NHS saved William Fear's life and inspired him to change career. But when William started as a healthcare assistant on a hospital ward for older patients, it was clear how bad things had got. This is his story, told to the Guardian, of a typical shift
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