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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 -
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 -
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 -
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 -
Content ArticleA BBC Newsnight investigation hears devastating evidence and testimony of ambulance failings in the north east of England. What does it take to run a safe service that patients can trust?
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Content ArticleDifficulties discharging over thirteen thousand patients safely are slowing the flow through hospitals while being stuck in hospital when you don’t need medical care is both mentally and physically harmful. People risk picking up hospital acquired infections, muscle loss and impaired mobility, reduced confidence and independence skills. However, according to Gilda Peterson, Leeds KONP and Secretary, End Social Care, there are ten things wrong with the Government's plan to give the NHS £200m to buy beds in care homes, hotels, hospices and independent hospitals.
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Content ArticleOn 24 May 2022, Mrs Brind went to see her GP and was taken to Queen Elizabeth Hospital arriving at 13.05 hours. The Emergency Department was busy and Mrs Brind remained on the ambulance. Physiological observations were undertaken at 12.50, 13.24 and 13.53 which showed an elevated NEWS2 score. Mrs Brind required increasing oxygen which was not escalated to the ambulance navigator at the hospital, no further physiological observations were undertaken and no ECG was undertaken. Mrs Brind was taken to the ward at 17.30 hours, when she became agitated and short of breath. Advanced life support was put into place but Mrs Brind’s condition continued to deteriorate and she died at 17.52 hours.
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Content Article
Age UK: Fixing the Foundations (17 February 2023)
Patient Safety Learning posted an article in Older people
A new in-depth report from the Charity Age UK, ‘Fixing the Foundations’, reveals how our under-funded and overstretched NHS and social care system is struggling and sometimes failing to cope with the needs of older people. The report provides a first-hand account of older people’s difficulties in getting the good, joined up health and social care they need to manage at home, leaving them at risk of crisis which often results in being admitted to hospital. Yet the evidence is clear that with the right care at the right time many of these admissions could have been avoided. The report also includes perspectives from professionals and unpaid carers. It also shows how living with multiple long-term health conditions, as a significant proportion of older people do, including more than two-thirds of those aged over 85, makes it especially hard to navigate health services which are still usually organised around individual illnesses and diseases. Meanwhile social care was often inadequate or absent in these older people’s lives. Age UK estimates that astonishingly, over 1.6 million older people have some level of fundamental care and support need, such as help to get dressed, washed or getting out of bed, that is not being fully addressed. -
Content ArticleThis report by The Queen's Nursing Institute presents the findings of a survey of community nurses (also known as district nurses) conducted in 2022 to look at how digital technologies are used in community nursing. The survey found that: 43.1% respondents reported problems with lack of compatibility between different computer systems, compared to 32.7% in 2017 87% respondents reported issues with mobile connectivity, compared to 85% in 2017 53%.respondents reported problems with device battery life, compared to 29.5% in 2017 The report concludes that overall, the community nursing workforce has a high level of digital literacy and that poor user experience frequently appears to be around design and function rather than a lack of literacy or enthusiasm for technology. The workforce also has an appetite for high functioning technology and can see the potential of new applications, for example, in managing wound care or long-term conditions.
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Content ArticleTo support recovery of the NHS by improving waiting times and patient experience, a joint Department of Health and Social Care (DHSC) and NHS England plan sets out a number of ambitions, including: Patients being seen more quickly in emergency departments: with the ambition to improve to 76% of patients being admitted, transferred or discharged within four hours by March 2024, with further improvement in 2024/25. Ambulances getting to patients quicker: with improved ambulance response times for Category 2 incidents to 30 minutes on average over 2023/24, with further improvement in 2024/25 towards pre-pandemic levels. NHS England has engaged with a wide range of stakeholders to develop the plan, and it draws on a diverse range of opinion and experience, as well as views of patients and users. The Department of Health and Social Care, who produced the content on actions being taken in social care, have led on engagement with the sector.
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Content ArticleWhether it is the waiting lists for mental health support or the inadequacies of long-Covid clinics, millions of patients with long-term health conditions have been struggling for years to get basic healthcare. The chaotic decline that has befallen acute care in A&E has hit day-to-day services, with effects from delayed consultant appointments and year-long clinic waiting lists to slashed community care. Mental health bed shortages mean young people need now to have “attempted suicide several times” before they get a place in an inpatient unit in England. Record delays for cancer treatment are leaving patients facing lethal waits. Thousands of people with neurological conditions are waiting up to two years to even see a consultant. For them, the ground has long been shaking. It is just that no one else noticed. The Guardian has spoken to disabled people the length and breadth of England and Wales about their wait for care. For them, the NHS is not an “in case of emergency” service but the engine they rely on to keep their day-to-day life running.
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Content ArticleEmergency access to healthcare is in crisis. Unmet need in primary and community care and low capacity in hospitals and social care has left the emergency health services gridlocked and overwhelmed, unable to provide safe care. This Cross party House of Lords Public Services Committee report recommends that a COBR Committee be assigned the responsibility to address the crisis in emergency healthcare. In the long-term, it recommends a a substantial overhaul is needed, one which sets out a bold new operating model for the system as a whole, and which is backed by equally bold leadership.
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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.- Posted
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