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News Article
NHS patient 'stuck in hospital with months to live'
Patient Safety Learning posted a news article in News
A woman who may only have months to live has told the BBC she is "angry and frustrated" at being in hospital five months after being cleared to go home. Charlotte Mills-Murray, 34, said attempts to organise care at her family home had been repeatedly delayed. Charlotte lives with intestinal failure caused by a severe form of Ehlers-Danlos syndrome, which weakens her body's connective tissue. She was admitted to St James's Hospital in Leeds in June 2022 following an infection, and a new Hickman line - a tube that allows feeding and the administering of pain relief - was inserted. By November, Charlotte was told she was well enough to be cared for at home, but she remains in hospital following delays in the hiring and training of staff able to support her. With limited access to a hoist which would enable her to use her wheelchair, Charlotte said she had spent 10 months "stuck in bed". Because of the complexity of her condition, Charlotte only has months to live. She believes her situation merits greater urgency because of the increased risk of infection in hospital. Charlotte qualifies for 24-hour home care support through the NHS Continuing Healthcare scheme, but she said decisions over how this would be put in place had been slow and unclear. The BBC has found a 16% rise over the past year in the number of patients in England who are in hospital despite being well enough to leave. The Department of Health and Social Care said it was "fully committed to speeding up the safe discharge of patients who no longer need to be in hospital" and was making £1.6bn available in England over the next two years to support this, on top of £700m of extra funding in 2022 to ease NHS pressures over the winter. Read full story Source: BBC News, 9 April 2023 -
News Article
Junior doctors’ strike will have ‘catastrophic impact’ on waiting lists
Patient Safety Learning posted a news article in News
The four-day strike by junior doctors in England will have a “catastrophic impact” on NHS waiting lists, with up to 350,000 appointments and operations likely to be cancelled, the chief executive of the NHS Confederation has said. Matthew Taylor said the industrial action this week posed risks to patient safety and called on the public to avoid “risky behaviour”. “These strikes are going to have a catastrophic impact on the capacity of the NHS to recover services,” he told Sky News. “The health service has to meet high levels of demand at the same time as making inroads into that huge backlog that built up before Covid, but then built up much more during Covid." He said he hoped everyone who needed urgent care would get it, but added: “There’s no point hiding the fact that there will be risks to patients – risks to patient safety, risks to patient dignity – as we’re not able to provide the kind of care that we want to.” He called on the public to use NHS services responsibly. Read full story Source; The Guardian, 10 April 2023 -
News Article
NHS England warns against block cancellations during ‘unprecedented’ strikes
Patient Safety Learning posted a news article in News
NHS England has told trust, system and regional leaders to avoid “block rescheduling” of elective cases during the four-day junior doctors’ strike next month. In a letter sent by national medical director Sir Steve Powis and NHSE’s chief operating officer Sir David Sloman, NHS leaders are asked instead to use “rolling day-to-day cancellations” and reschedule cases “based on clinical risk”. The letter also urges leaders to maintain “as much day case and outpatient capacity as possible” and to use digital or virtual consultations to support outpatient delivery. However, it acknowledges that because of the “unprecedented scale and timing of these strikes we accept that rescheduling activity is going to be essential to minimise risks to patients”. Read full story (paywalled) Source: HSJ, 31 March 2023 -
News Article
'Dire' situation for adults waiting for ADHD diagnosis in NI
Patient Safety Learning posted a news article in News
Adults in Northern Ireland seeking assessment for attention deficit hyperactivity disorder (ADHD) are being forced to go private because of a dire lack of referral services in some areas, a charity has said. Some health trusts have not been able to accept new referrals for adult assessment and diagnosis. ADHD charities said a lack of services or even waiting lists has forced many people to pay for a private diagnosis. The charity's chief executive Sarah Salters added that some people who do get a private diagnosis cannot then get medication from their GP through the NHS. The Department of Health said officials "are considering longer-term arrangements" for ADHD services, with future decisions "likely to be subject to ministerial approval and availability of funding". Read full story Source: BBC News, 2 April 2023 -
News Article
Bupa to cut 85 dental practices in staff shortage
Patient Safety Learning posted a news article in News
Bupa is set to cut 85 dental practices amid a national shortage of dentists, in a move that will affect 1,200 staff across the UK. The group said patients at some practices were unable to access the NHS dental service they need. Bupa, which provides NHS and private care, said the 85 practices would be closed, sold or merged later this year. The healthcare group's boss said the industry faced "systematic challenges" and the decision was a "last resort". In August the BBC revealed 9 in 10 NHS dental practices across the UK were not accepting new adult patients for treatment under the health service. Bupa has not been able to recruit enough dentists to deliver NHS care in many practices for months and in some cases years, it said. Read full story Source: BBC News, 30 March 2023 -
News Article
Children must wait for ‘crisis’ before autism diagnosis, say overwhelmed systems
Patient Safety Learning posted a news article in News
New restrictions are being introduced for autism assessments, with some areas now only accepting referrals for patients in crisis, HSJ has learned. Commissioners in North Yorkshire and York have become the latest to introduce new criteria for autism and attention deficit hyperactivity disorder referrals. Getting a diagnosis is key to unlocking care packages such as speech and language therapy, counselling, or special educational needs. They said the changes are due to “unprecedented demand that has exceeded supply, resulting in unacceptable wait times and the need to prioritise resources towards children and most at-risk adults”. Read full story (paywalled) Source: HSJ, 30 March 2023 -
Content ArticleA shortage of nurses across the world, including in countries that provide nurses for international recruitment, has created a global health emergency, according to the latest report from the International Council of Nurses. The report, Recover to Rebuild: Investing in the Nursing Workforce for Health System Effectiveness, lays out the devastating impact that the Covid-19 pandemic has had on nurses around the world. It urges that investment in a well-supported global nursing workforce is needed if health systems around the world are to recover and be rebuilt effectively. It also warned against reliance on the “quick fix” of international recruitment instead of investing in nursing education, as this was contributing to staff shortages even in countries with a long tradition of educating nurses to work in higher income countries. The report, co-authored by the organisation's chief executive, Howard Catton, and nursing workforce policy expert Professor James Buchan, includes the findings of workforce surveys from more than 25 countries, including the UK, as well as other research.
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News Article
Inside one hospice as struggling sector faces turning the dying away
Patient Safety Learning posted a news article in News
Hospices will be forced to turn dying patients away because they are struggling with steeply rising costs at a time when the NHS is not increasing funding. Hospices look after 300,000 patients and families every year across the UK. It costs about £1.5 billion a year for them to provide this care, with only a third of that coming from the NHS. The rest relies on charitable donations and fundraising in local communities as well as sales in charity shops. As hospices battle to keep going, the Treasury has rejected pleas for a £30 million rescue package this year. The money, those in the sector say, would prevent some from having to close inpatient units and beds or reduce their hospice-at-home teams, which care for patients in the community. Some are already making staff redundant and getting rid of beds. Toby Porter, chief executive of Hospice UK, said the government was making “a huge avoidable mistake”, adding: “People will have a lesser experience at an incredibly important moment and it will lead to system pressures affecting the whole health system.” Read full story (paywalled) Source: The Times, 26 March 2023 -
News Article
Invest in health workforce or risk collapse, WHO warns governments
Patient Safety Learning posted a news article in News
Last year the World Health Organization (WHO) released a report warning of a “ticking time bomb” threatening health systems in Europe and Central Asia: a growing shortage of health workers. With quickly ageing populations and an ageing health workforce—40% of doctors in Europe are close to retirement in a third of countries—along with a surge in chronic illnesses and the ongoing effects of the covid pandemic, WHO warned that many countries could soon see their healthcare systems collapse unless they take urgent action. Six months on, the situation has worsened, as healthcare workers throughout Europe increasingly resort to industrial action over pay and conditions. Hans Kluge, WHO regional director for Europe, said, “The health workforce crisis in Europe is no longer a looming threat—it is here and now. Health providers and workers across our region are clamouring for help and support... “We cannot wait any longer to address the pressing challenges facing our health workforce. The health and wellbeing of our societies are at stake—there is simply no time to lose.” Read full story (paywalled) Source: BMJ, 24 March 2023 -
News ArticleThe NHS in England needs a massive injection of homegrown doctors, nurses, GPs and dentists to avert a recruitment crisis that could leave it short of 571,000 staff, according to an internal document seen by the Guardian. A long-awaited workforce plan produced by NHS England says the health service is already operating with 154,000 fewer full-time staff than it needs, and that number could balloon to 571,000 staff by 2036 on current trends. The 107-page blueprint, which is being examined by ministers, sets out detailed proposals to end the understaffing that has plagued the health service for years. It says that without radical action, the NHS in England will have 28,000 fewer GPs, 44,000 fewer community nurses and an even greater lack of paramedics within 15 years. However, the Guardian understands that the chancellor, Jeremy Hunt, is playing a key role in behind-the-scenes moves by the Treasury to water down NHS England’s proposals to double the number of doctors that the UK trains and increase the number of new nurses trained every year by 77% – because it would cost several billion pounds to do that. A senior NHS leader said: “Jeremy Hunt has been very resistant to the numbers in the workforce plan. The Treasury and Hunt don’t want numbers in it. They want it to be not very precise. They want the numbers to be projected in a different way that would be less expensive and to not commit to training specific numbers of doctors, nurses and others. “While intellectually Hunt gets it, and emotionally he gets the patient safety argument, it seems that his priority, if the government has any financial headroom, is to use that for tax cuts or giving the army more money rather than training more doctors, nurses and speech and language therapists. Read full story Source: The Guardian, 26 March 2023
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News Article
Three-year wait for Essex girl, 8, to have tooth removed
Patient Safety Learning posted a news article in News
An eight-year-old girl waiting three years to have three teeth removed has been left in "agony". Ella Mann, from Dovercourt in Essex, first went to the dentist with an issue with a baby tooth in December 2019. She was given a temporary filling and told it needed to be removed but has still not had the NHS procedure. The youngster has now been placed on an NHS waiting list for the tooth extraction. Ella's dad Charlie Mann, 54, said his daughter was sometimes in "agony". Healthwatch England last year warned of people struggling to get dental treatment as increasing practices closed to new patients. A BBC investigation identified cases of people driving hundreds of miles in search of treatment and pulling out their own teeth without anaesthesia. Read full story Source: BBC News, 23 March 2023 -
News Article
‘It is not right to normalise the current GP workload’, says RCGP chair
Patient Safety Learning posted a news article in News
It is ‘not right to normalise’ the current workload in general practice as numbers of GPs and practices goes down, the RCGP chair told delegates at Pulse Live this week. Professor Kamila Hawthorne highlighted the pressure GPs are under with general practice appointments increasing most last year, compared to A&E and outpatients. She also said her priority from a new GP contract would be better resourcing for GPs working in deprived areas. Her speech looked at the challenges facing general practice and imagined what the future could look like, including what the college can do to bring about change. Professor Hawthorne said: ‘The workload that we’re facing – it’s not right to normalise it. The sort of work days that we have in general practice, it is not right to normalise this. ‘The number of GPs is going down because they’re leaving the profession faster than they’re entering it. The number of practices in England is going down, and compared with affluent areas, GPs in deprived areas earn less but see more patients with more chronic illness.’ Read full story Source: Pulse, 21 March 2023 -
News ArticleYoung people with eating disorders are coming to harm and ending up in A&E because they are being denied care and forced to endure long waits for treatment, GPs have revealed. NHS eating disorders services are so overwhelmed by a post-Covid surge in problems such as anorexia that they are telling under-19s to rely on charities, their parents or self-help instead. The “truly shocking” findings about the help available to young people with often very fragile mental health emerged in a survey of 1,004 family doctors across the UK by the youth mental health charity stem4. The shortage of beds for children and young people with eating disorders is so serious that some are being sent hundreds of miles from home or ending up on adult psychiatric wards, GPs say. “The provision is awful and I worry my young patients may die,” one GP in the south-east of England told stem4. Another described the specialist NHS services available in their area as “virtually non-existent and not fit for purpose”. Read full story Source: The Guardian, 22 March 2023
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News Article
Bristol children must be in crisis before autism referral, say parents
Patient Safety Learning posted a news article in News
Children must now be in crisis before they can be referred for an autism diagnosis, parents claim. The strict new eligibility criteria in the Bristol region comes after a 350% rise in the number waiting more than two years for assessment. Changes made by the NHS mean children will only be referred with "severe and enduring" mental health issues. The Integrated Care Board (ICB) said it meant resources could now focus on those with "the highest clinical need". Some parents have launched the campaign Assess for Autism in protest against the rule change. An Assess for Autism spokesperson said children would now have to be at crisis point before being referred, describing the policy as "deeply concerning" and "regressive". However, healthcare provider Sirona, which provides autism diagnosis services, and the Integrated Care Board (ICB), which formally approved the new policy, insist it is necessary because families are waiting too long. They said resources can now be focused on those with the "highest clinical need or are the most vulnerable". Read full story Source: BBC News, 22 March 2023 -
News Article
Hundreds left with lost or damaged eyesight after NHS delays
Patient Safety Learning posted a news article in News
Hundreds of patients have lost their eyesight or had it irreparably damaged because of NHS backlogs, new research suggests. NHS England clinicians have filed 551 reports of patients who lost their sight as a result of delayed appointments since 2019, with 219 resulting in “moderate or severe harm”, according to an FoI request by the Association of Optometrists, which believes that hundreds more cases are unreported. Its chief executive, Adam Sampson, said sight loss was a “health emergency”, and urged ministers to introduce a national eye health strategy to enable high street and community optometrists to ease some of the burden on hospitals. He said: “There are good treatments available for common age-related eye conditions like macular degeneration but many hospital trusts simply do not have the capacity to deliver services. “Optometry is ideally placed to take away some of that burden – optometrists are already qualified to provide many of the extended services needed and are available on every high street, so patients can be treated closer to home. It’s incomprehensible and absolutely tragic that patients are waiting, losing their vision, in many parts of the country because of the way eye healthcare is commissioned.” Read full story Source: The Guardian, 21 March 2023 -
News Article
Children getting ‘conveyor belt’ care due to waiting list pressure
Patient Safety Learning posted a news article in News
The pressure to tackle long waiting lists in children’s community services is impacting care quality, clinical leaders have warned. It comes after community health services waiting list figures were published for the first time by NHS England last week. They revealed more than 200,000 children were waiting, of whom 12,000 had been waiting more than a year, and 65,000 more than 18 weeks. While adult community services lists have been coming down fairly steadily since the autumn, children’s services are failing to make progress. The children’s services with the longest lists are community paediatrics (which mostly deals with neurological development issues such as autism and ADHD), speech and language therapy, and children’s occupational therapy. Specialists in those areas told HSJ it was the result of staffing gaps, rising and more complex demand, Covid backlog, and years of underfunding. Read full story (paywalled) Source: HSJ, 20 March 2023 -
Content ArticleThe Nuffield Trust held its fifteenth Summit in March 2023. In these video interviews captured at the summit, health and care leaders talk about the challenges and issues currently facing the NHS and social care: Prof Kevin Fong on the immense cost of the pandemic to NHS staff Prof Martin Marshall on the range of challenges facing health and care Nigel Edwards on how the NHS gets on the road to recovery Jill Rutter on squeezed budgets and hospitals dominating health finances Dr Arif Rajpura on practical policies for reducing inequality Chris Hopson on promises to decentralise the NHS to better meet patient need
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News Article
Doctors' strike fallout could take weeks to resolve, NHS bosses say
Patient Safety Learning posted a news article in News
The disruption caused by the junior doctors' strike in England could take weeks to resolve, health bosses say. Tens of thousands of appointments and treatments, including cancer care, had to be cancelled during the three-day walkout. Patients with appointments coming up may see them cancelled to make room for high-priority cases hit by the strike. Hospitals are also reporting problems discharging patients from wards, as consultants were sent to cover A&E. Saffron Cordery, of NHS Providers, which represents NHS trusts, said the scale and length of the walkout, coupled with the fact it started on a Monday - traditionally the busiest day of the week - had made it more difficult than previous strikes by nurses and ambulance staff. "It will take weeks to recover - just rebooking patients who have treatments and appointments cancelled is a big job," she said. "Patients have to be individually prioritised - it may mean some patients with bookings in the coming weeks being pushed further back." Read full story Source: BBC News, 16 March 2023 -
News Article
Patients ‘unaware of strike’ as some hospitals report ‘busiest day’
Patient Safety Learning posted a news article in News
Acute trusts are reporting high demand at emergency departments (EDs) despite junior doctor strikes, which in some cases threaten to lead to overflowing wards and long ambulance handover delays. Chief executives and directors from trusts around England told HSJ their EDs had been as busy or busier than usual. Many had hoped prominent media coverage and NHS announcements about the strikes would lead to reduced demand, helping them cope with fewer doctors on duty. Several claimed it showed national communications about the strikes were lacking. NHS England has said some hospitals saw their busiest Monday of the year so far yesterday, which it said “presents a major challenge as our staff continue to do all they can to mitigate the impact of the industrial action for patients.” Read full story (paywalled) Source: HSJ, 14 March 2023 -
Content ArticleThis discussion, published in HSJ, looks at the state of NHS waiting times in January 2023. All figures come from NHS England. The referral-to-treatment waiting list narrowly broke through previous records in January, edging up to 7,213,436 patient pathways. Waiting times rose too, with 8 per cent of the list waiting longer than 46.6 weeks, up from 46.3 weeks the previous month. Read the full blog and access the data via the link below.
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News Article
Watchdog says its lack of funding is compromising safety
Patient Safety Learning posted a news article in News
The patient safety commissioner has complained to MPs that she does not have enough staff to cope with her ‘significant workload’, it has emerged. Henrietta Hughes’ concerns are revealed in a letter from Commons health and social care committee chair Steve Brine to health and social care secretary Steve Barclay. Mr Brine asks for assurances over the commissioner’s resources and says he was “concerned” Dr Hughes had told him her current funding was “too little to make the necessary improvements” to safety oversight. Mr Brine wrote on 6 March: “I am in regular contact with Dr Hughes and the matter of resources for her office is something that she has raised with me. She tells me that her office is under extreme pressure, with a significant workload, including correspondence from patients.” Mr Brine told Mr Barclay he shared Dr Hughes’ concerns that without “sufficient resourcing” there was a risk that the safety commissioner role would – according to Dr Hughes – “let down the hopes of patients that were raised by the publication of Baroness Cumberlege’s report”. Read full story (paywalled) Source: HSJ, 14 March 2023 -
News Article
Three in four patients not seen within new target time
Patient Safety Learning posted a news article in News
Data revealed for the first time shows nearly three-quarters of adult patients needing community mental health care are waiting more than four weeks for treatment to start, which is the timeframe that NHS England wants to introduce as a national standard. Figures shared with HSJ also show two-thirds of children needing community care are waiting more than four weeks from referral to treatment. In 2021, NHS England proposed a series of new waiting time standards in mental health, including a four-week standard for non-urgent community care. A lack of new funding, as well as data recording problems, mean the new standards have not so far been introduced, and no timeline set for implementation. Read full story (paywalled) Source: HSJ, 14 March 2023 -
News Article
GPs ‘in crisis’ as one in four fear surgery is in danger of closing
Patient Safety Learning posted a news article in News
GPs are facing “insurmountable pressures”, experts have said as they warned that the NHS “will not survive” without general practice. A new report into GP pressures suggests one in four staff fear their practice is in danger of closing because of unmanageable workloads and rising demand. The document, from the Royal College of GPs (RCGP), says general practice is “in crisis”, and makes a series of calls to help ease pressures and stop the growing number of GPs from quitting. The report says GPs are bracing for “winter-style pressures” well into spring and summer. “The workload pressures in general practice over this winter have been immense, and high levels of patient demand are set to continue for some time,” the report authors wrote. “General practice is in crisis. We cannot rely on short-term emergency funding pots over winter to try and paper over the cracks." Read full story Source: The Independent, 10 March 2023 -
News Article
More than 500 deaths in England last year after long ambulance wait
Patient Safety Learning posted a news article in News
More than 500 seriously ill patients died last year before they could get treatment in hospital after the ambulance they called for took up to 15 hours to reach them, an investigation by the Guardian reveals. The fatalities included people who had had a stroke or heart attack or whose breathing had suddenly collapsed, or who had been involved in a road traffic collision. In every case, an ambulance crew took much longer to arrive than the NHS target times for responding to an emergency. Bereaved relatives have spoken of how the pain of losing a loved one has been compounded by the ambulance crew having taken so long to arrive and start treatment. Coroners, senior doctors and ambulance staff say the scale of the loss of life illustrates the growing dangers to patients from the implosion of NHS urgent and emergency care services. “These 500-plus deaths a year when an ambulance hasn’t got there in time are tragic and avoidable,” said Dr Adrian Boyle, the president of the Royal College of Emergency Medicine, which represents A&E doctors. “These numbers are deeply concerning. This is the equivalent of multiple airliners crashing.” Read full story Source: The Guardian, 9 March 2023 -
Content ArticleLast week, one of the country’s largest child and adolescent mental health services, Forward Thinking Birmingham, run by Birmingham Women’s and Children’s Foundation Trust, was rated “inadequate” by the Care Quality Commission. The inspection report makes for concerning reading — not least because it speaks to a range of issues being experienced by other providers of CAMHS services across the country. CQC inspectors warned there were not enough nursing and support staff to keep people using community services from avoidable harm. Nurses told the CQC that vacancies in the service impacted on people being allocated a care coordinator — and staff were leaving largely due to handling caseloads they felt were unsafe. Part of HSJ’s Mental Health Matters fortnightly briefing, covering safety, quality, performance and finances in the mental health sector.
