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Found 965 results
  1. News Article
    A major incident has been declared in Essex amid fears the number of COVID-19 cases could overwhelm the county's health services. The Essex Resilience Forum (ERF) said "growing demand" was putting stress on hospitals and social care settings. On Tuesday Mid and South Essex NHS Trust placed all three of its hospitals on critical alert. All of Essex is in tier four and the south of the county has some of the worst-affected districts in England. Essex Police Chief Constable BJ Harrington, who is co-chairman of the ERF, said declaring a major incident allowed it "to seek further support from the government to address the severe pressures which the health system is under". The forum said the number of patients being treated for Covid in the county had exceeded the levels seen at the peak of the first wave and "these levels are likely to increase further in the coming days". The ERF - comprised of health services, blue light responders and councils - said issues included "critical care and bed capacity, staff sickness/self-isolation levels and the system's ability to discharge patients quickly into safe environments". Mr Harrington urged the public to continue only dialling 999 or attending A&E in an emergency. Read full story Source: BBC News, 30 December 2020
  2. News Article
    The flagship Nightingale hospital is being dismantled as medics warn that there are not enough staff to run the facilities despite the NHS being at risk of being overwhelmed by coronavirus. Amid surging virus case numbers, elective surgery is being cancelled as the number of patients in hospitals in England passes the peak of the first wave in April. Although the NHS is "struggling" to cope, the majority of the seven Nightingale hospitals, created at a cost of £220 million, have yet to start treating COVID-19 patients during the second wave. The Exeter Nightingale has been treating Covid patients since mid-November. The facility at London's Excel centre has been stripped of its beds and ventilators. The NHS has told trusts to start preparing to use the overflow facilities in the coming weeks, but bosses have failed to explain how they will be staffed. Read full story (paywalled) Source: The Telegraph, 28 December 2020
  3. News Article
    Health workers are "back in the eye of the storm" as coronavirus cases continue to rise, NHS England's chief executive Simon Stevens has said. It has been the "toughest year" for the NHS, which has treated 200,000 severely ill Covid-19 patients, he added. Hospitals in England are currently treating more Covid patients than at the peak of the first wave in April. A government scientific adviser has warned national restrictions are needed to prevent a "catastrophe". On Monday, a record 41,385 new Covid cases were reported in the UK, though it is thought the infection rate was higher during spring when testing was much more limited. NHS England said 20,426 people were being treated for the virus in hospitals in England on Monday, which is higher than the previous peak of about 19,000 in April. Read full story Source: BBC News, 29 December 2020
  4. News Article
    NHS England has told hospitals to begin planning for the use of Nightingale Hospitals as the numbers of coronavirus patients in hospitals is expected to surge in coming weeks. In a letter sent on Wednesday night hospitals were told to activate all of their emergency capacity to cope with the expected pressures over the coming weeks. This is likely to mean the mass redeployment of staff and designating wards, surgical theatres and recovery areas as makeshift intensive care units for patients. NHS England did not explain how the Nightingale Hospitals would be staffed if the decision was made to activate them. Read full story Source: The Independent, 24 December 2020
  5. News Article
    An ambulance crew had to wait seven hours to hand over a patient in the West Midlands, it has been revealed. The case on 11 December was highlighted in the West Midlands Ambulance Service's in-house magazine, which said average waits had "ballooned". It said average waits at one hospital were running at nearly three hours in early December. The ambulance service said it hoped to put another 40 crews on the road by January. Delays in hospitals taking over care of patients is considered "risky", NHS England said, because it not only delayed patients receiving specialist assessment and treatment, but also reduced the number of ambulances available to respond to emergencies. The West Midlands trust's weekly briefing magazine, published on 17 December, said only the East of England trust had experienced a similar level of "horrendous" delays. It added that another four hospitals in the West Midlands had average delays of about two hours. The "knock-on" effect it said was some high-risk patients were waiting longer for an ambulance than they should. Meanwhile, some staff had to work late beyond their shifts and missed meal breaks. Read full story Source: BBC News, 23 December 2020
  6. News Article
    There are 14 hospital trusts on course to have at least a third of their beds filled by covid patients on New Year’s Eve. HSJ analysed current occupancy and growth at each general acute trust in the seven days to 21 December. Projecting the same rate of growth forward, the number of trusts with at least a third of their bedbase likely to be taken by covid patients would increase from 5 at present to 14. Three of the four acute trusts in Kent are projected to have covid bed occupancy of over 40%. Another two trusts are in areas covered by tier two restrictions. They are Queen Elizabeth in Norfolk, and Countess of Chester. A third, East Sussex, has one of its two general hospitals in “tier four” (St Leonards), and the other in Eastbourne, which is outside the Sussex “tier four” zone. There are also 27 trusts not in tier four areas which had more than 50 covid patients on 21 December, and where the number of covid patients grew by at least 20 per cent in that week. These include Liverpool University Hospitals and Sheffield Teaching Hospitals. HSJ last week projected that, if trends continued, English hospitals would have just short of 19,000 covid patients on New Year’s Eve in total — almost exactly the same as the 12 April first wave peak. Current projections put that number at over 20,000. Read full story (paywalled) Source: HSJ, 23 December 2020
  7. News Article
    Nearly 90% of hospital beds in England are full as hospitals try to cope with the demands of Covid in addition to normal winter pressures. Ambulances queuing to offload patients, staff sickness and a lack of beds mean hospitals are "at a really dangerous point", say emergency doctors. This could result in some trusts facing the decision to stop non-Covid work. Rises in hospital admissions are particularly affecting areas in the south. The percentage of NHS hospital beds which are occupied is increasing and has reached almost 89% in England for the week ending December 13. This is the highest occupancy rate so far this year - it's still lower than the same time last year, although the extra burden of Covid is likely to make hospitals feel they are much busier. A safe level for bed occupancy is below 90% but nearly half of NHS trusts report a figure currently higher than this - the largest proportion this season. Read full story Source: BBC News, 19 December 2020
  8. News Article
    Staff shortages and a lack of equipment are affecting the day-to-day decisions about patient care by doctors and nurses, a new YouGov survey has revealed. The representative survey of NHS clinicians revealed more than half, 54%, admitted that factors such as a lack of staff played a role in their decisions about patients beyond what was in their best interests. Almost a third of staff, 31%, said staffing levels were the top factor affecting decisions about patients. A fifth said the availability of services such as key tests were a significant factor; 16% cited a lack of equipment; and 12% cited beds. 10% of clinicians said a fear of being sued was part of their decision-making. YouGov carried out the research for JMW Solicitors and weighted the responses to be representative of the NHS workforce population. It also revealed more than two-fifths of clinicians, 42%, believe a “blame culture” in the NHS plays a top role in preventing staff admitting to mistakes in care. In maternity services specifically, 68% of nurses and midwives said at least one factor other than what was in patients’ best interest played a role in their decisions. Read full story Source: The Independent, 20 December 2020
  9. News Article
    A major London trust’s critical care staff have urged leaders to review elective work targets amid serious concerns over workload, safe staffing and burnout, HSJ has learned. In a letter to Guy’s and St Thomas’ Foundation Trust’s board, staff represented by trade union Unite said they had “repeatedly” raised concerns about the provider’s approach to elective work, as well as winter pressures and second wave planning, and the implications this has had for “the health, safety and wellbeing of both staff and patients”. The letter — which was also addressed to the trust’s health and safety committee and has been seen by HSJ — said: “Our primary concern is that the trust’s endeavours, and understandable need to square these circles, may be unrealistic given the current pressures on staffing and the high rates of sickness and burnout the trust is continuing to experience. “This is especially in critical care, where we are concerned this may compromise patient safety and is already damaging staff wellbeing and morale.” Read full story (paywalled) Source: HSJ, 18 December 2020
  10. News Article
    London’s hospitals are already beginning to run out of critical care beds ahead of the Christmas relaxation of rules – which is expected to increase cases further, a leaked NHS briefing has warned. The update on the situation in the capital comes as major hospitals have already started to cancel operations for other patients in order to find enough staff to deal with the rise in patients as NHS trusts open up extra surge capacity. More operations are expected to be cancelled in hospitals across London, with staff warned they could be redeployed at short notice. On Wednesday, there were a total of 2,289 coronavirus patients in London hospitals, an increase of 2 per cent on the day before. But the numbers of coronavirus patients in critical care beds jumped 8.6% in a single day, increasing from 302 to 345 patients on Wednesday, while an additional 900 people who have tested positive were receiving oxygen. Across London, there were just 49 adult critical care beds available on Wednesday. In total there were 904 beds occupied, 328 by patients with COVID-19. This meant the capital’s total critical care bed occupancy rate was almost 95%. Although the number of patients is much lower than it was the first wave, many hospitals are still treating routine and non-Covid patients – meaning they are struggling to staff critical wards and keep other services running. A briefing for NHS managers warned them: “A reduction of elective [routine] activity is likely to be needed in line with increasing acute activity.” Read full story Source: The Independent, 17 December 2020
  11. News Article
    More needs to be done to tackle safe staffing levels in Northern Ireland's health service, according to the Royal College of Nursing (RCN). A year on from the nurses' strike, the union has warned that problems caused by poor workforce planning and chronic underfunding have not been addressed. Instead they have been exacerbated by the CoOVID-19 pandemic, said the RCN. The Department of Health said dealing with staff shortfalls was a "key priority" for the health minister. Pat Cullen, the Northern Ireland director of the RCN, said "very little has actually changed" since about 15,000 healthcare workers took to the picket line in December last year for a series of protests over pay and safe staffing levels. "We need to remind the government that many of these issues have sadly not gone away," she added. Read full story Source: BBC News, 18 December 2020
  12. News Article
    There are not enough nurses to safely care for patients in the UK, according to the body that represents the profession, and many of those who are working are suffering from anxiety and burnout after a gruelling nine months treating Covid patients. A year after the prime minister pledged during the 2019 election campaign to add 50,000 nurses to the NHS, the Royal College of Nursing has accused Boris Johnson of being “disingenuous” for claiming the government is meeting this 2025 target. Johnson claimed last week that the government had “14,800 of the 50,000 nurses already” during prime minister’s questions in the Commons. Yet the latest NHS figures show there were 36,655 vacancies for nursing staff in England in September, with the worst shortages affecting mental health care and acute hospitals. Staff in some intensive care units (ICUs) have quit since the pandemic, with those whom the Observer spoke to choosing to work instead in supermarkets or as dog-walkers. Dame Donna Kinnair, the RCN’s chief executive and general secretary, said: “The simple, inescapable truth is that we do not have enough nursing staff in the UK to safely care for patients in hospitals, clinics, their own homes or anywhere else.” She said that even before the pandemic, “heavy demand” was rising faster than the “modest increases” in staff numbers. Read full story Source: The Guardian, 12 December 2020
  13. News Article
    One in 10 staff at some Welsh health boards are off sick or self-isolating, BBC Wales has been told. The NHS Confederation said staffing problems were having a "huge impact". It said the overall NHS Wales absence rate was between 8% and 9%, but some services have up to half their staff absent. Monthly absence rates in December are usually about 5%, but Aneurin Bevan, Cwm Taf Morgannwg and Betsi Cadwaladr health boards have rates of about 10%. Welsh NHS Confederation director Darren Hughes told Wales Live the NHS was in "the same storm but different parts will definitely be in different boats", with absence rates higher in areas hit hardest by coronavirus. Read full story Source: BBC News, 10 December 2020
  14. News Article
    All non-urgent elective operations are being postponed for at least two weeks in a health system still seeing significant and growing pressure from coronavirus. The four acute trusts in Kent and Medway will still carry out cancer and urgent electives, but other work is being postponed. Relatively few elective operations are usually carried out around Christmas and New Year, meaning the county is likely to see little or no elective work for the next four weeks. In a covid update bulletin issued last night, the Kent and Medway Clinical Commissioning Group acknowledged the pressure hospitals across its area were under but stressed cancer and other urgent operations would go ahead. It added: “However, we are now pausing non-urgent elective services. This will allow staff to move to support the increased number of covid-19 patients. “Initially this will be for a two-week period. We will keep this under weekly review and will contact individual patients where appointments need to be rescheduled.” Read full story (paywalled) Source: HSJ, 8 December 2020
  15. News Article
    Concern is growing that NHS hospitals may face a third wave of the coronavirus pandemic with a much higher level of covid-positive inpatients than at the beginning of the second wave. This raises the prospect of the service being overwhelmed during the January-February “winter pressures” period and having to once again halt elective and non-urgent work in many areas. HSJ understands national NHS leaders are concerned that anything over 5,000 covid patients in hospital by the year end would leave the service vulnerable to being overwhelmed. Their concerns are based on the fact that the second wave added 13,000 hospitalised covid patients at peak. During the first wave, covid hospitalisation peaked at just over 17,000, and in order to prepare for it the NHS cancelled most elective and non-urgent work. Read full story Source: HSJ, 7 December 2020
  16. News Article
    Emergency medics are writing to hospital chief executives warning them that some trusts are being ‘complacent’ about crowding in A&E, they have told HSJ. The Royal College of Emergency Medicine (RCEM) is sending a letter to trust chiefs today calling on them to urgently plan for how they will stop corridor waits and exit blocking ahead of January and February, typically the busiest months. It says some trusts were not treating emergency department crowding as a “high priority”, despite covid risks and pressures. It is also calling for overcrowding in the emergency department (ED) to be classed as a “never event” — a set of major safety risks. RCEM’s concern comes amid apprehension over long ambulance queues at hospitals across the UK, and difficulties enabling social distancing between patients in many EDs. Read full story (paywalled) Source: HSJ, 3 November 2020
  17. News Article
    The government has admitted the NHS in England does not have enough nurses and doctors to keep all its services running if there is a third spike in coronavirus cases as leaked figures show the number of staff off work because of the virus rising. An analysis of the impact of coronavirus, released by Downing Street on Monday, warned that even with a 6% growth in NHS staff since August 2019 and extra funding “there is a trade-off between the NHS’s ability to deliver COVID-19 and non-Covid-19 care in the event that COVID-19 hospitalisations rise”. It also warned of the psychological effects on staff saying: “It would be expected that higher rates of post-traumatic stress disorder (PTSD) would be seen amongst health and social care staff.” New leaked NHS data for England on Monday shows more than 82,000 NHS staff are absent from work with more than two-fifths, 42 per cent, linked to coronavirus either due to sickness or because they need to self-isolate. This includes almost 27,000 nurses and 4,000 doctors absent from NHS wards. Hospital leaders reiterated the strain the NHS was under in a briefing to MPs ahead of the vote on local tier restrictions today. Read full story Source: The Independent, 1 December 2020
  18. News Article
    More than a million patient operations could be delayed because of widespread shortages of anaesthetists in the NHS – with 9 out of every 10 hospitals reporting at least one vacancy. As coronavirus paralysed the NHS earlier this year, more than 140,000 NHS patients have already waited over a year for treatment. The Health Foundation has warned that 4.7 million fewer patients have been referred for treatment because of the impact of coronavirus on NHS services. The Royal College of Anaesthetists (RCOA) told The Independent the scale of the vacancies was getting worse and labelled it a “workforce disaster” that could cost patients’ lives and have a widespread impact on hospital services. Read full story Source: The Independent, 22 November 2020
  19. News Article
    The NHS is going into this winter with 5,500 fewer general acute beds than last year, NHS England data has revealed. The numbers of general and acute beds open overnight from July to September this year was 94,787 compared with 100,370 for the same period in 2019, a fall of 5.6% or 5,583 beds. The reduction in bed numbers is thought to be partly because of covid infection control measures, such as creating more distance between beds. HSJ reported this week that Cambridge University Hospitals Foundation Trust had taken nearly 100 beds out of use to allow for better social distancing. The figures showed significant regional differences. London had 8% fewer beds available compared with last year, while the East of England and the North East only had 3.4% fewer. The North West, which has been badly affected by the second wave of covid, had 6.6% fewer beds than last year. NHS Providers deputy chief executive Saffron Cordery said: “We have been arguing for some time that the NHS is short of beds as we head into winter… This is a real problem as trusts deal with pressures posed by the virus, growing demand for urgent and emergency care and the work to recover the backlog of routine operations.” Nuffield Trust deputy director of research Sarah Scobie said: “This drop in the number of beds available bears out our warning that infection control will mean a loss of capacity even between waves of the virus. Many of these will have been beds too close to others for physical distancing. This is why it will be so difficult to return to previous rates of activity while the virus remains at large, worsening waiting times and forcing difficult decisions about who gets priority." Read full story (paywalled) Source: HSJ, 19 November 2020
  20. News Article
    An Essex maternity department has been served with further warnings by the Care Quality Commission (CQC) and again rated “inadequate”. Serious concerns were raised about the services at Basildon University Hospital in the summer, after several babies were found to have been starved of oxygen and put at risk of permanent brain damage. Despite the CQC issuing warning notices to Mid and South Essex Foundation Trust in June 2020, a subsequent visit on 18 September found multiple problems had persisted. The CQC’s findings at Basildon included: the service was short-staffed and concerns were not escalated appropriately multidisciplinary team working was “dysfunctional”, which sometimes led to safety incidents doctors, midwives and other professionals did not support each other to provide good care. Read full story (paywalled) Source: HSJ, 19 November 2020
  21. News Article
    A hospital trust in Bristol has been accused of risking lives after raising its patient-to-nurse ward ratio to dangerously high levels, having allegedly dismissed staff concerns and national guidance on safe staffing. University Hospitals Bristol and Weston NHS Foundation Trust (UHBW) has introduced a blanket policy across its hospitals that assigns one nurse to 10 patients (1:10) for all general adult wards. This ratio, which previously stood at 1:6 or 1:8 depending on the ward, rises to 1:12 for nights shifts. The new policy, which is applicable to Bristol Royal Infirmary (BRI) and Weston General Hospital, also extends to all specialist high-care wards, which treat patients with life-threatening conditions such as epilepsy and anaphylaxis. Nurses at the trust have expressed their anger over the decision, saying they were never fully consulted by senior officials. Many are fearful that patient safety will be compromised as the second coronavirus wave intensifies, culminating in the unnecessary loss of life. “Patients who would have extra nursing staff because they are very acutely unwell and need close observation I think are going to unnecessarily die,” one nurse at BRI told The Independent. “Or if they survive, they’ll suffer long-term conditions because things were missed as they don’t have the staff at their bed side to watch the deterioration.” Read full story Source: The Independent, 18 November 2020
  22. News Article
    A top teaching hospital has blamed covid measures for a dramatic rise in the number of trolley waits in its accident and emergency department. In October, 111 patients at Cambridge University Hospitals (CUH) Foundation Trust, which runs Addenbrooke’s Hospital, waited more than 12 hours for admission, despite the region’s relatively low covid rates. CUH recorded just nine 12-hour waits in September and 27 in August. It had no 12-hour waits in either June or July this year, and in October 2019, it had only one. The trust also had 761 patients who waited more than four hours from the decision to admit to admission last month, out of a total of 2,998 emergency admissions. CUH director of operations Holly Sutherland said: “We have had to reorganise the hospital to meet infection control requirements and to reduce the risk of covid-19 transmission. With limited side room availability due to the age of our facilities, this has reduced the number of beds in the hospital by around 100 and has impacted on patient flow from the emergency department." “We would like to apologise to anyone affected by this, and to reassure our patients that their safety is our utmost priority and we are doing everything we can to treat them as quickly as possible.” Read full story (paywalled) Source: HSJ, 18 November 2020
  23. News Article
    Labour is demanding new investment for the NHS as part of the government’s spending review next week, after analysis shows hundreds of thousands of patients are waiting for life-changing operations. The party’s shadow health secretary, Jonathan Ashworth, will challenge Matt Hancock in Parliament on today over the latest NHS data, which reveal almost 500,000 patients are waiting for surgery on their hips, knees and other bones. Last week, NHS England published new data showing more than 1.7 million people were waiting longer than the NHS target of 18-weeks for treatment. The target was last met in February 2016. An analysis of NHS England data reveal which specialities have been hardest hit by the growing backlog of operations, which has soared since the first wave of coronavirus caused widespread hospital cancellations earlier this year. There were 4.3 million patients on NHS waiting lists for hospital treatments in September. Labour said this included 477,250 waiting for trauma and orthopaedic surgery, with 252,247 patients waiting over 18 weeks. The next worst specialty was ophthalmology, which treats eye disorders, with 444,828 patients on waiting lists, 233,425 of whom have waited more than 18 weeks. There were six figure waiting lists over 18 weeks for other specialties including gynaecology, urology, general surgery, and ear, nose and throat patients. Read full story Source: 17 November 2020
  24. News Article
    More than three-quarters of midwives think staffing levels in their NHS trust or board are unsafe, according to a survey by the Royal College of Midwives (RCM). The RCM said services were at breaking point, with 42% of midwives reporting that shifts were understaffed and a third saying there were “very significant gaps” in most shifts. Midwives were under enormous pressure and had been “pushed to the edge” by the failure of successive governments to invest in maternity services, said Gill Walton, the chief executive of the RCM. “Maternity staff are exhausted, they’re demoralised and some of them are looking for the door. For the safety of every pregnant woman and every baby, this cannot be allowed to continue,” she said. “Midwives and maternity support workers come into the profession to provide safe, high-quality care. The legacy of underfunding and underinvestment is robbing them of that – and worse still, it’s putting those women and families at risk.” RCM press release Read full story Source: The Guardian, 16 November 2020
  25. News Article
    The number of people waiting over a year for hospital treatment in England has hit its highest levels since 2008. Patients are meant to be seen within 18 weeks - but nearly 140,000 of the 4.35 million on the waiting list at the end of September had waited over a year. Surgeons said it was "tragic" patients were being left in pain while they waited for treatment, including knee and hip operations. And others warned the situation could become even worse during winter. In recent weeks, major hospitals in Bradford, Leeds, Nottingham, Birmingham and Liverpool, which have seen high rates of infection, have announced the mass cancellation of non-urgent work. Read full story Source: BBC News, 12 November 2020
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