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Found 959 results
  1. News Article
    Global supply problems have caused a “shock rise” in shortages of life-saving drugs like antibiotics and epilepsy medication, new research reveals. These shortages come at a cost to the patient and the taxpayer, and are happening despite the NHS spending hundreds of extra millions trying to mitigate the problem. The UK risks being left in the cold when it comes to co-ordinated EU attempts to tackle them. That’s according to a new report by the Nuffield Trust think tank and a group of academics, funded by the Health Foundation, which examined key indicators on drug shortages in the UK in the context of global problems with supply chains and the availability of key ingredients. It finds that the past two years have seen constantly elevated medicines shortages, in a "new normal" of frequent disruption to crucial products. Key findings on drugs shortages include: Price concessions (where the government gives extra funding because there are no drugs left at the NHS price) have risen sharply in recent months: prior to 2016 there were rarely more than 20 per month but in late 2022 they peaked at 199 and have remained high ever since. The excess cost for medicines in months when they were subject to price concessions was £220m across the year to September 2023. There are now over double the number of notifications by drugs companies warning of impending shortages than there were three years ago: in 2023 there were 1,634 such alerts issued, compared to 648 in 2020 (a spike in 2021 was caused by concerns over supply fears in Northern Ireland following Brexit). The UK has been slower to approve drugs than the EU for new drugs that are authorised centrally. Of drugs authorised in the year to December 2023, 56 drugs authorised in Europe were approved later in the UK and eight have not been approved. Four were approved faster. The report shows that the EU Exit has not caused the recent spike in medicine shortages, but it is likely to significantly weaken the UK’s ability to respond to them by splitting it from European supply chains, authorisations and collective efforts to respond to shortages. In particular, the research highlights the risks posed to the UK from being left out of key initiatives like the Critical Medicines Alliance and Voluntary Solidarity Mechanism, led by EU member states to work together to insulate themselves from the impact of medicines shortages. Read full story Source: The Nuffield Trust, 18 April 2024
  2. News Article
    This is a sick country, getting sicker. NHS waits will take years to clear, if at all. While people wait, they get sicker. When more and more people slip into absolute poverty – a fifth of people now – they get even sicker. More sicken as they age, and that peak has not yet been reached. Every part of the NHS feels at the sharp end, coping mostly because, amazingly, they just do, even with no end in sight to the stress. NHS data released last week on people waiting more than 18 weeks with serious heart problems suggests some will probably die before they get treatment. When waiting patients have heart attacks and strokes they call an ambulance – so there’s been an astonishing 7% rise in those category 1 calls. At an ambulance dispatch centre in Kent, Polly Toynbee listens in to calls like this at the South East Coast Ambulance Service dispatch centre in Gillingham, north Kent, covering Surrey, Sussex and Kent. She sat with D, a seasoned and sympathetic emergency medical adviser, call handler and life-and-death decider. Read full story Source: The Guardian, 17 April 2024
  3. Content Article
    This French cohort study in JAMA Internal Medicine aimed to find out whether spending a night in the emergency department (ED) associated with increased in-hospital mortality and morbidity among older patients. The results showed that older patients who spent a night in the ED showed a higher in-hospital mortality rate and increased risk of adverse events compared with patients admitted to a ward before midnight. This finding was particularly notable among patients with limited autonomy.
  4. News Article
    The number of people dying needlessly in A&E soars on a Monday as hospitals are stretched to the limit and failing to discharge patients at the weekend, new data shows. Figures uncovered by The Independent show an average of 126 patients died every Monday between 2020-2023 – 25% higher than any other day. On a Saturday, the average number of deaths drops as low as 90. Waiting times are also shown to spike massively at the start of the week, with an average of 9,300 patients spending more than 12 hours waiting on a Monday – up to 2,000 more than any other day. Medical experts said the rise in A&E waits can be attributed to people staying away from hospitals during weekends and patients not being discharged from medical care, causing a bottleneck in an already buckling system. The stark statistics also directly contradict repeated government efforts to make the NHS a seven-day service. Multiple coroners have warned the government and health leaders about delays to patients’ treatment and diagnosis due to variations in staffing and access to specialists – particularly over the weekend. Adrian Boyle, president of the Royal College of Emergency Medicine, said the NHS England data clearly signposted an “increased risk” at the start of the week. Another expert said the sharp rise in deaths on Mondays showed an A&E “running constantly in the red zone”. Read full story Source: The Independent, 8 April 2024
  5. News Article
    A woman who feared she was having a heart attack said she spent nine days in a hospital staff room because of a shortage of beds. Zoe Carlin, 23, was admitted to Altnagelvin Hospital in Londonderry in March after experiencing severe chest pain. She said she spent more than a week in a “locker room” where she had to use a hand bell to call staff during what she described as a “dehumanising” ordeal. The Western Health and Social Care Trust (WHSCT) said it faced "extreme pressures" in its hospital emergency departments but could not comment on individual cases due to confidentiality. “For the full nine days I was in this alcove,” she told BBC Radio Foyle’s North West Today programme. “It’s basically the nurses' locker room. You can see the nurses’ lockers with their names on them. They [staff] just said there’s not enough beds,” she added. A privacy screen did not fully cover the room’s doorway and she had no access to a private bathroom. She said she was forgotten about at meal times on three occasions. A spokesperson for WHSCT said, "We are acutely aware of the continuing challenges and extreme pressures not just in our emergency departments but across both of our acute hospital sites with full escalation of beds on all wards and departments. In the Western Trust, when we learn of examples where care falls below the standard we expect, we review the circumstances and explore ways to improve care in the future." Read full story Source: BBC News, 11 April 2024
  6. News Article
    A gran was left lying outside in the cold facing a seven hour wait for an ambulance following a fall before finally being rescued — by firefighters. Betsy Hulme, 83, was left in agony with a broken hip when she tumbled in her back garden in Leek, Staffordshire. Son Steve, 60, a former ambulance technician, dialled 999 only to be told it would be several hours until paramedics could get to them due to long handover delays. After a further three hours of Betsy waiting on cold concrete slabs while soaked in rain water, desperate Steve decided to drive to a nearby fire station to ask for help. Fire crews then came to rescue to lift gran-of-four Betsy into her son's car who took her to hospital where she remains after undergoing a hip repair operation. Dad-of-two Steve, of Leek, has now branded emergency response times as “absolutely disgusting”. He said: "It’s opened my eyes if I’m honest. It’s absolutely disgusting. I’m so grateful and thankful to the fire service - but it really isn’t their job. I can't remember in my time working as an ambulance technician going to someone and saying, 'I’m sorry it’s taken us twelve hours to get here'." “It was never anywhere near those ridiculous times when I worked there until 2000 and something has gone drastically wrong since. I can't speak highly enough of the boys and girls who work in the NHS, it's the people above them. Its systemic change that's needed." Read full story Source: Wales Online, 4 April 2024
  7. Content Article
    Read the Royal College of Emergency Medicine's general election manifesto. A one page summary is below and the full manifesto can be found at the link at the bottom of the page.
  8. News Article
    A new private ambulance service will offer faster travel to A&E for those caught out by half-day waits for NHS ambulances, The Independent can reveal, in a sign of a growing “two-tier” health service. MET Medical ambulance service will begin by charging £99 for a call-out, and could serve thousands of people a week, its chief executive Dave Hawkins has said. Mr Hawkins, who is a paramedic himself, said he launched the service after seeing his elderly relatives wait too long for NHS ambulance services following falls. It comes as waiting times for ambulance service reached a crisis point in the last year, with frail and vulnerable people waiting hours for an ambulance. Ambulance response times hit record highs over 2022-23, with people who should have an ambulance within 20 minutes waiting an hour and 30 minutes in December 2023. According to estimates from the Association of Ambulance Chief Executives, 34,000 patients were likely to have suffered harm due to these delays – this hit a high of more than 60,000 in December 2022. MET Medical will still have to wait to deliver patients if they are seen as a priority, but it said its patients are likely to be lower priority and can be dropped at A&E without waiting for a handover. Mr Hawkins said vulnerable patients waiting for an ambulance can wait up to 12 hours. “It’s that moment when you’re out of options, it’s really a horrible place to be, particularly if it’s a loved one … It is a shame, like we’ve seen from the stats and everything, that the health service is failing us." Read full story Source: The Independent, 3 April 2024
  9. News Article
    The NHS is experiencing an “avalanche of need” over autism and attention deficit hyperactivity disorder (ADHD), but the system in place to cope with surging demand for assessments and treatments is “obsolete”, a health thinktank has warned. There must be a “radical rethink” of how people with the conditions are cared for in England if the health service is to meet the rapidly expanding need for services, according to the Nuffield Trust. The thinktank is calling for a “whole-system approach” across education, society and the NHS, amid changing social attitudes and better awareness of the conditions. It comes days after the NHS announced a major review of ADHD services. Thea Stein, the chief executive of the Nuffield Trust, said: “The extraordinary, unpredicted and unprecedented rise in demand for autism assessments and ADHD treatments have completely overtaken the NHS’s capacity to meet them. It is frankly impossible to imagine how the system can grow fast enough to fulfil this demand. “We shouldn’t underestimate what this means for children in particular: many schools expect an assessment and formal diagnosis to access support – and children and their families suffer while they wait.” Read full story Source: The Guardian, 4 April 2024
  10. Content Article
    Long waiting times for autism and attention deficit hyperactivity disorder (ADHD) assessments can prevent people from getting the vital care and medication they need. Health and education support often relies on a formal diagnosis, without which there can be severe negative consequences. Estimates show that there might be as many as 1.2 million autistic people and 2.2 million people with ADHD in England, and providing them with the right support is no small task. Recent news reports have highlighted a huge rise in demand for autism and ADHD diagnoses amid increased awareness and understanding of neurodiversity. Exploring referrals and waits for autism and ADHD assessments is a key first step to understanding the scale of the issue, which can then be used to drive improvements and change. This blog from the Nuffield Trust looks at what the data is telling us.
  11. Content Article
    When Adam Luck’s mother, Ann, was admitted to hospital with a suspected stroke, it was the beginning of a distressing seven-week stay. The previously cheerful 82-year-old became stuck in a dysfunctional health system. Her story is presented here via her son Adam’s diary of her hospitalisation.
  12. Content Article
    Prime Minister Rishi Sunak promised speedier care, but specialists believe long waits for hospital beds are costing thousands of lives. The pledge he made in January last year, as one of five priorities on which he said voters should judge him, was that “NHS waiting lists will fall and people will get the care they need more quickly”. New calculations by the Royal College of Emergency Medicine (RCEM) show that, with regard to the broader aim of delivering speedier treatment, his government is falling shockingly short.
  13. Content Article
    The NHS England 2024/25 priorities and operational planning guidance reconfirms the ongoing need to recover core services and improve productivity, making progress in delivering the key NHS Long Term Plan ambitions and continuing to transform the NHS for the future.
  14. News Article
    More than 250 patients a week could be dying unnecessarily, due to long waits in A&E in England, according to analysis of NHS data. The Royal College of Emergency Medicine analysed the 1.5 million who waited 12 hours or more to be admitted in 2023. A previous data study had calculated the level of risk of people dying after long waits to start treatment and found it got worse after five hours. The government says the number seen within a four-hour target is improving. This is despite February seeing the highest number of attendances to A&E on record, it adds. The Royal College of Emergency Medicine (RCEM) carried out a similar analysis in 2022, which at that time resulted in an estimate of 300-500 excess deaths - more deaths than would be expected - each week. The analysis uses a statistical model based on a large study of more than five million NHS patients that was published in 2021. RCEM president Dr Adrian Boyle said long waits were continuing to put patients at risk of serious harm. "In 2023, more than 1.5 million patients waited 12 hours or more in major emergency departments, with 65% of those awaiting admission," he said. "Lack of hospital capacity means that patients are staying in longer than necessary and continue to be cared for by emergency department staff, often in clinically inappropriate areas such as corridors or ambulances. "The direct correlation between delays and mortality rates is clear. Patients are being subjected to avoidable harm." Read full story Source: BBC News, 1 April 2024
  15. Content Article
    The idea of Emergency care services experiencing seasonal spikes in demand – so called ‘Winter Pressures’ are fast becoming a thing of the past. Instead, long waits have become the new norm year-round, and staff are caring for patients in unsafe conditions on a daily basis. It is well established that long waits are associated with patient harm and excess deaths. Last year the UK Government published a Delivery Plan for the Recovery of Urgent and Emergency Care (UEC) services. A year on, far too many patients are still coming to avoidable harm.   New analysis by the Royal College of Emergency Medicine (RCEM) reveals that there were almost 300 deaths a week associated with long A&E waits in 2023.
  16. News Article
    An investigation published by The BMJ today reveals new details of requests to recall striking junior doctors from picket lines for patient safety reasons. Documents show that while most trusts in England did not make such requests, those that did were rejected by the BMA in most cases. Some of these trusts warned of potential harm to patients from cancelling operations at the last minute and short staffing, reports assistant news editor Gareth Iacobucci. However, the BMA said it takes concerns about patient safety “incredibly seriously” and provided The BMJ with summaries of why requests were turned down. The union’s chair of council Phil Banfield said, “Throughout industrial action we have engaged thoroughly and in good faith with the derogation process, considering each request carefully to ensure that granting a derogation is necessary and the last and only option.” He said that poor planning by some trusts had led to some routine care being inappropriately booked in on strike days. In other instances, he said trusts had failed to make sufficient effort to draft in the necessary cover for strike days. Read full story Source: BMJ, 28 March 2024
  17. News Article
    A senior mental health nurse suffered “degrading and humiliating” treatment while she languished for 10 days on an unsuitable NHS ward during a mental health crisis, The Independent has been told. Rachel Luby, 36, was admitted to Basildon Hospital A&E in Essex on 5 January this year after attempting to take an overdose of over-the-counter medicine following a traumatic assault. This, she claimed, was the start of weeks of horrific care she endured while waiting for a mental health bed. It culminated in her being restrained and forced into a caged van “like an animal”. She revealed her story after The Independent reported on a warning from top emergency doctors that self-harming and suicidal patients who go to A&E are not being treated with compassion because staff are overwhelmed. Ms Luby, an award-winning nurse, said she waited more than a week and a half in a general hospital before she was moved to a bed on a mental health ward. Ms Luby was able to leave the ward and find medication to overdose again, despite staff allegedly assessing her as a risk. In a second incident, she went to the bathroom and attempted to take her own life. She told The Independent: “I feel that this is something I will not recover from. I will not ever reach out for help in the future. “If this is the treatment that I’m getting as a nurse, then what the heck is happening to those that don’t have the voice or education that I have? It horrifies me to think what is happening to people that are far more vulnerable than me.” Read full story Source: The Independent, 27 March 2024
  18. News Article
    Public satisfaction with the NHS has dropped again, setting a new low recorded by the long-running British Social Attitudes survey. Just 24% said they were satisfied with the NHS in 2023, with waiting times and staff shortages the biggest concerns. That is five percentage points down on last year and a drop from the 2010 high of 70% satisfaction. The findings on the NHS, published by the Nuffield Trust and King's Fund think tanks, show once again that performance has deteriorated after a new record low was seen last year. In total, since 2020, satisfaction has fallen by 29 percentage points. Of the core services, the public was least satisfied with A&E and dentistry. The survey also showed satisfaction with social care had fallen to 13% - again the lowest since the survey began. The major reasons for dissatisfaction were long waiting times, staffing shortages and lack of funding. Read full story Source: BBC News, 27 March 2024
  19. News Article
    A&E staff are unable to properly look after the most vulnerable mental health patients or treat them with compassion because emergency departments are so overwhelmed, top medics have warned. An exclusive report shared with The Independent shows more than 40% of patients who needed emergency care due to self-harm or suicide attempts received no compassionate care while in A&E, according to their medical records. The data, collated by the Royal College of Emergency Medicine (RCEM), prompted a warning from top doctor Dr Adrian Boyle that mental health patients are spending far too long in A&E – where they are cared for by staff who are not specifically trained for their needs – before being moved to an appropriate ward. Dr Boyle, who is president of the RCEM, said there had been some progress in improving care for a “historically disadvantaged” group, but added: “Patients with mental health problems are still spending too long in our emergency departments, with an average length of stay of nearly 10 hours and this has not really improved. “An emergency department is frequently noisy and agitating, the lights never go off and cannot be described as an environment that promotes recovery.” When a patient goes to A&E after a self-harm attempt, they should receive an assessment by a clinician into the type of self-harm, reasons for it, future plans or further suicidal thoughts. The college said it indicates a “significant gap” in the NHS’ ability to provide holistic care for mental health patients with complex needs and warned “urgent” improvements are needed. Read full story Source: The Independent, 25 March 2024
  20. News Article
    Older people are routinely enduring hidden waits of several months to get essential care and support, according to new figures obtained from government. Waiting time figures for adult social care are not routinely published in England, but last summer the Department of Health and Social Care collected the information from councils for the first time in at least a decade. They have been released to HSJ after a freedom of information appeal, and show average waits of up to 149 days (about five months) in Bath and North East Somerset, with 25 councils (30% of the 85 councils which supplied this information) reporting waits of two months or more. Some people will be waiting much longer than the averages reported. Across the 85 councils which reported average waits, the average of those figures was around 50 days. But the figures released to HSJ show huge variation – with three councils reporting waits of less than 10 days – although this is partly due to recording differences. The lack of clear figures, and absence of national waiting time measures and standards for adult social care, in contrast to the many targets and published figures in the NHS, and has sparked calls for that to be changed. Sir David Pearson, a former integrated care system chair and director of adult social care, who led the government’s Covid-19 care taskforce in the wake of the disaster in care homes in spring 2020, said: “One way of ensuring public confidence is a timely response to need. “Being clearer about a small number of standards and measures would help to achieve this. Of course it has to be associated with the right funding and reform, including supporting the social care workforce”. Read full story (paywalled) Source: HSJ, 25 March 2024
  21. Content Article
    The aim of this study was to quantify the difference in weekday versus weekend occupancy, and the opportunity to smooth inpatient occupancy to reduce crowding at children's hospitals. They study found that hospitals do have substantial unused capacity, and smoothing occupancy over the course of a week could be a useful strategy that hospitals can use to reduce crowding and protect patients from crowded conditions.
  22. News Article
    Local NHS organisations are facing intense “pressure” from NHS England’s national and regional teams to cut staffing numbers to improve the service’s financial outlook for 2024-25. Multiple sources have told HSJ that first draft financial returns submitted by the 42 integrated care systems indicate a combined deficit of around £6bn for the service. The £6bn figure is likely to fall substantially as NHS England meets individually with integrated care systems with the worst numbers. The need to reduce the number is prompting “horrible” conversations about service cuts, according to HSJ sources. One local leader in the South East region said the need to reduce staffing numbers constituted a “very significant part of the pushback on first-cut numbers”. A senior source in the Midlands added: “We’ve got virtually no workforce growth in our plan now… and we’ve still got a deficit. To get to breakeven we’d have to be looking at quite a significant workforce reduction.” Another leader in the South of the country said there was “big pressure” to get down to pre-pandemic staff numbers, “despite [the] increases in acuity, demand and backlogs as a consequence of covid”. Read full story (paywalled) Source: HSJ, 18 March 2024
  23. News Article
    Gripping a bag of morphine handed to him by hospital staff, Antonio sheltered at a bus stop, cold and shivering, as he tried to work out what to do. It was three days after undergoing gruelling surgery to remove his testicular cancer and the 36-year-old had been discharged from NHS care with nowhere to go. He was clutching a referral letter for the council’s housing team, given to him by hospital staff. When he arrived at the council office, he explained he had been homeless for the past few months – but was told they could not house him. “They asked me: ‘If you are in so much pain and trouble, why did they send you here?’ and I didn’t know what to say,” Antonio, whose name has been changed, tells The Independent. He was given a piece of paper with a phone number on it and told to call the next day. It was now late in the afternoon and the Salvation Army’s homeless day centre, where he would usually go for help, was closed. He had no option but to turn around and ready himself for a night on the streets. Antonio’s story is, tragically, not unique. He is one of thousands of people across England who have been discharged from NHS hospitals into homelessness in recent years, many while still battling serious health conditions. Data obtained by The Independent, in collaboration with the Salvation Army, shows at least 4,200 people were discharged from wards to “no fixed abode” in 2022/23. Read full story Source: The Independent, 17 March 2024
  24. News Article
    Staff whistleblowers have raised concerns over patient safety at one of Northern Ireland's biggest health trusts. Information received by UTV under Freedom of Information shows that most of the worries from health workers at the Belfast Health Trust relate to the Royal Victoria Hospital. Belfast Health Trust said any concerns raised by staff are investigated. The Royal College of Nursing NI was due to hold a webinar with members on Tuesday evening to discuss concerns members have about safety of patients being treated on corridors. The RCN's Rita Devlin said that the number of concerns raised with health trusts through the whistleblowing policy is only the tip of the iceberg. The concerns included unsafe staffing levels, bed shortages, boarding of patients, ED overcrowding, alleged drug dealing on a hospital site, staff sleeping on night duty, lack of mental health beds and the quality of staff training. The Belfast Trust said all staff are encouraged to make management aware of issues giving them concern through the whistleblowing process. The Trust added: "Any concern we receive is subject to a fair and proportionate process of investigation. "Whistleblowing investigations are of a fact finding nature and all relevant learning is shared as appropriate and taken forward by the Trust." Read full story Source: ITVX. 12 March 2024
  25. News Article
    At least 50,000 people will die from pancreatic cancer over the next five years unless the government gives more funding to improve how quickly the condition is diagnosed and treated, a major charity has warned. Pancreatic Cancer UK hit out at 50 years of “unacceptably slow progress” compared to other types of cancer as it warned that thousands of lives will be lost unless £35m of “urgent” investment is put towards improving survival rates of the disease. The charity predicted that pancreatic cancer – described by experts as the “quickest-killing cancer” – is expected to kill more people each year than breast cancer by 2027, which would make it the fourth-biggest cause of cancer deaths in the UK. The charity has also called for a commitment to treat everyone diagnosed with the cancer within 21 days, which it says would double the number of people getting treatment in time. Figures show that, compared to the 52.5% survival rate across the 20 most common cancers in the UK, those with pancreatic cancer have just a 7% survival rate. Around 10,500 people are diagnosed with the disease each year, with 9,558 deaths a year, according to Cancer Research UK, with more than half of people dying within three months of diagnosis. Read full story Source: The Independent, 12 March 2024
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