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Found 965 results
  1. News Article
    Thousands of UK doctors are planning to quit the NHS after the Covid pandemic because they are exhausted by their workloads and worried about their mental health, a survey has revealed. Almost one in three may retire early while a quarter are considering taking a career break and a fifth are weighing up quitting the health service to do something else. Long hours, high demand for care, the impact of the pandemic and unpleasant working environments are taking their toll on medics, the British Medical Association findings show. Dr Chaand Nagpaul, the leader of the BMA, said the high numbers of disillusioned doctors could worsen the NHS’s staffing problems and leave patients waiting longer for treatment. “It’s deeply worrying that more and more doctors are considering leaving the NHS because of the pressures of the pandemic – talented, experienced professionals who the NHS needs more than ever to pull this country out of a once-in-a-generation health crisis,” Nagpaul said. Read full story Source: The Guardian, 2 May 2021
  2. News Article
    Doctors, nurses and NHS bosses have pleaded with Boris Johnson to spend billions of pounds to finally end the chronic lack of staff across the health service. The strain of working in a perpetually understaffed service is so great that it risks creating an exodus of frontline personnel, they warn the prime minister in a letter published on Wednesday. They have demanded that the government devise an urgent plan that will significantly increase the size of the workforce of the NHS in England by the time of the next general election in 2024. Their intervention comes after the latest NHS staff survey found that growing numbers of them feel their work is making them sick and that almost two-thirds believe they cannot do their jobs properly because their organisation has too few people. NHS poll shows rising toll of work stress on staff health The letter has been signed by unions and other groups representing most of the NHS’s 1.4 million-strong workforce, including the Royal College of Nursing, British Medical Association and Unison. NHS Providers and the NHS Confederation, which both represent hospital trusts, have also endorsed it, as has the Academy of Medical Royal Colleges, a professional body for the UK’s 240,000 doctors. Read full story Source: The Guardian, 21 April 2021
  3. News Article
    Hospital bosses are bracing themselves for a clash with ministers over how quickly they can clear the backlog of NHS care that built up during the pandemic. They are warning that it will take “years” to treat all those whose care was cancelled because Covid disrupted so many hospital services, particularly surgery and diagnostic tests. Staff shortages, exhaustion among frontline personnel after tackling the pandemic and their need to have a break mean that progress will be slower than the government expects, NHS trust chiefs say. “We can’t say with certainty how long it will take to tackle the backlog of planned operations because we don’t really know how big that backlog will end up being,” said Chris Hopson, the chief executive of NHS Providers. “The NHS will obviously go as fast as it can, as we always do. But it’s already apparent that clearing the entire backlog will take years rather than months.” Read full story Source: The Guardian, 18 March 2021
  4. News Article
    The NHS's "insufficient" critical care capacity has been laid bare by the pandemic, with the UK having one of the lowest number of beds per head in Europe, NHS Providers has said. The group, which represents trusts in England, is calling for a review of the health service's capacity. The UK has 7.3 critical care beds per 100,000 people, compared to Germany's 33.8 and the US's 34.3, analysis found. The government said it was investing £72bn in the next two years in the NHS. "The UK is towards the bottom of the European League table for critical care beds per head of population," NHS Providers said. The group added that the UK had comparatively fewer critical care beds than France, Italy, Australia and Spain. "It's neither safe nor sensible to rely on NHS hospital trusts being able to double or triple their capacity at the drop of a hat as they've had to over the last two months, with all the disruption to other care and impossible burdens on staff that involves." Seeking a review into critical care capacity in England, the organisation said it wanted the government to commit to providing additional finances in areas where it was needed. "There have been too many reviews of NHS capacity in the past where huge amounts of time have been wasted because the government has not been willing to fund the results of what's been found," the group said. Read full story Source: BBC News, 1 March 2021
  5. News Article
    Hospitals across London are racing to tackle a backlog of tens of thousands of urgent operations that need to be carried out in the coming weeks to prevent patients dying or losing limbs, The Independent has learnt. The slow decline in Covid patient numbers means many hospitals across the capital are warning they will still be relying on extra staff, and “surge” beds opened at the height of the crisis, well into March. NHS bosses have been briefed that across the city there are about 15,000 priority two (P2) patients. These are classed as needing urgent surgery, including for cancer, within 28 days, or they could die or be at risk of losing a limb. But the lack of available operating theatres, nurses and anaesthetists mean the city has a shortfall of more than 500 half-day surgical lists a week. The Independent has spoken with multiple NHS insiders and seen briefing documents detailing the challenges facing the capital’s hospitals, which are expected to last up to 21 March in some areas. One briefing warned: “Hospitals have insufficient capacity to meet urgent elective demand for P2. P2 demand is intended to be seen within 28 days, the surge has occurred for over 28 days. Patients who would normally have been seen are waiting longer than clinically advisable." Read full story Source: The Independent, 25 February 2021
  6. News Article
    Staff at a Midlands hospital trust told regulators they had repeatedly raised safety concerns internally without action being taken. The Care Quality Commission (CQC) has downgraded maternity services at Worcestershire Acute Hospital from “good” to “requires improvement” following an inspection prompted by the whistleblowers’ concerns. Staff had reported “continuously escalating” staffing level concerns to senior managers, but said they got “no response”. Some said they were fearful of raising concerns internally. Whistleblowers also reported delays to induction of labour, with examples of women waiting up to a week to be induced instead of one to two days. Managers said women who suffered delays were risk assessed. The CQC also identified a risk women might not be informed of significant harm caused to them or their babies following an incident, due to the way the trust was grading some babies who were admitted to the neonatal unit. However, it added: “When things went wrong, staff apologised and gave patients honest information and suitable support.” The report added the trust’s leaders were aware of the challenges in maternity, but “timely” action was not always taken to address the concerns. Read full story (paywalled) Source: HSJ, 19 February 2021
  7. News Article
    Elective activity levels were significantly lower in January than were achieved before Christmas, according to provisional NHS data seen by HSJ. In the three weeks to 20 December, the NHS was reporting around 110,000 day cases and 18,000 ordinary admissions each week. But during January these totals dropped to around 85,000 day cases and 10,000 ordinary admissions per week. This equates to a reduction of 23% and 44%, respectively. Regions that were more severely impacted by the third wave of coronavirus saw steeper reductions as covid pressures forced staff working in routine care services to be redeployed. In London and the South East, day case activity reduced by around 40 per cent between the same periods, while ordinary admissions fell by around 57%. Data for the Christmas fortnight was discounted, as activity always falls dramatically in this period. However, the activity levels in January appear to be significantly higher than those reported in the first wave of coronavirus in the spring. Read full story (paywalled) Source: HSJ, 10 February 2021
  8. News Article
    Maternity staff are facing extreme burnout during the pandemic as staff shortages and longer, busier shift patterns lead to the workforce becoming increasingly overwhelmed, healthcare leaders warned. Senior figures working in pregnancy services told The Independent healthcare professionals are working longer hours, covering extra shifts around the clock, and spending more time on call to compensate for increasing numbers of employees taking time off work after getting coronavirus. Staff say stress-related absences have reached “worryingly” high levels, with junior doctors and midwives “thrown into the deep end” due to having to fill in for colleagues. Professionals argued the coronavirus crisis will lead to a rise in doctors, nurses and midwives suffering post-traumatic stress disorder (PTSD) and other mental health issues – raising concerns staff exhaustion could curb patient safety and standards of care. Read full story Source: The Independent, 31 January 2021
  9. News Article
    Dozens and potentially hundreds of urgent operations for children have been cancelled during the third wave of the covid pandemic, HSJ can reveal. There are also concerns that national guidance for prioritising surgery “disadvantages” young people. Several well placed sources told HSJ that urgent operations for children have been delayed in recent weeks because of covid pressures. This is because of a combination of staff being diverted to help with adults sick with covid, and space in children’s facilities — including intensive care — being taken over for adult covid care, as well as other staff being absent due to covid. The royal college of surgeons has told HSJ that urgent children’s operations “are increasingly being cancelled around the country”. Dozens and potentially hundreds of children’s operations rated as priority two — those which are urgent and should be carried out within a month — have been cancelled and delayed in recent weeks in the capital, according to several well placed sources. This is alongside potentially thousands of priority three operations being cancelled, which are those needing to be carried out within three months. Read full story Source: HSJ, 31 January 2021
  10. News Article
    Cancer services at large hospital trust have been at ‘catastrophic’ risk of being overwhelmed, after two of its hospital sites had to suspend life-saving cancer surgeries in the last month due to COVID-19. In its latest board papers Mid and South Essex Foundation Trust rated the “cancellation of cancer elective activity” at its highest risk level of 25 – which based on their own risk-scoring key is “catastrophic”. It said the expected consequences at this risk level include “permanent disability or death, serious irreversible health effects” and an “unacceptable… quality of service”. The trust runs three general acute hospitals in the county. Its 2,000 plus beds make it the third largest trust in England after University Hospitals Birmingham FT and Leeds Teaching Hospitals. The same board papers, dated 28 January, said cancer surgery at Southend University Hospital, one of three hospital sites run by the trust, “ceased on 24 December”. At a second hospital site, Mid Essex Hospital covid “hit hard just before Christmas” and elective work was “dramatically impacted with short period of life and limb only carried out on site”. This meant all P2 cancer surgery — which requires treatment in less than four weeks — did not take place. Both hospital sites said they hoped the independent sector could help them restart cancer surgeries this month with a focus on “long waiting and clinical urgent patients”. It is not clear how much capacity the sector has to work through waiting lists and the board papers said “some of this capacity may be reduced” because of recent changes to a new national contract for the independent sector. Read full story (paywalled) Source: HSJ, 29 January 2021
  11. News Article
    Mental health services in England do not have the capacity to cope with the impact of the coronavirus pandemic on children, Anne Longfield, the children’s commissioner for England, has warned. Despite an expansion in the four years before the pandemic, the supply of treatment for child mental health problems was already falling well short of demand, with referrals rising 35%, but treatments only increasing by 4%, the watchdog said as she called for a “rocket boost” in funding. Longfield cited an NHS study before the latest national lockdown, which found one in six children had a probable mental health condition and said it is highly likely that the level of underlying mental health problems will remain significantly higher as a result of the pandemic, with an increase in referrals to NHS services already observed last autumn. “Even before the Covid pandemic, we faced an epidemic of children’s mental health problems in England and a children’s mental health service that, though improving significantly, was still unable to provide the help hundreds of thousands of children required,” Longfield said. “It is widely accepted that lockdown and school closures have had a detrimental effect on the mental health of many children.” Read full story Source: The Guardian, 28 January 2021
  12. News Article
    London’s largest acute trust has been accused of ‘emotional blackmail’ by suggesting junior doctors could do voluntary shifts in its ‘really short staffed’ critical care unit. In an email cascaded to all junior doctors at Whipps Cross Hospital, run by Barts Health Trust, hospital medical director Heather Noble said day and night shifts at another trust site, the Royal London Hospital, “really need cover”. She said doctors could work overtime through a “voluntary or paid shift”, and that if they made contact, should “state whether or not they want to be paid”. Doctors working at the trust who received the email, who wished to remain anonymous, described the email as “tone deaf” and “not the right way to incentivise anyone to do what they want”. One medic said: “There has been a lot of anger generated by this correspondence amongst junior doctors. People already working antisocial and demanding rotas are very unhappy about being asked to work more hours for free.” Read full story (paywalled) Source: HSJ, 26 January 2021
  13. News Article
    There were 800 fewer cancer surgeries in the first two weeks of January than usually take place during the period, according to provisional data seen by HSJ. The bulk of this reduction came in London and the surrounding counties such as Essex, Bedfordshire, and Surrey. London and the south east have been severely hit by coronavirus pressures, causing widely reported mass cancellations of non-urgent elective surgery. However, the impact on cancer cases has, so far, been less clear. NHS England has insisted in the last week that urgent cancer cases should be given the same priority as coronavirus patients. Read full story (paywalled) Source: HSJ, 25 January 2021
  14. News Article
    The chief executive of a small acute trust has described the “terrifying situation” faced by ambulance crews and hospital staff in trying to provide adequate emergency care as coronavirus threatens to overwhelm the local NHS services. Susan Gilby, of Countess of Chester Hospital Foundation Trust, told HSJ staff are seeing “tragic and potentially avoidable” instances where patients with COVID-19 have reached the emergency department too late. She suggested this is due to a combination of patients waiting too long to call 999, and then having to wait long periods for an ambulance to arrive. Cheshire has been among the hardest hit areas in England during this third wave of coronavirus, with all four of its acute hospitals having very high covid occupancy rates. Dr Gilby, a former critical care consultant, said her trust has been at around 60 per cent covid occupancy for the last fortnight, which has made her increasingly fearful of the difficulties in admitting patients through the emergency department due to a lack of beds. This can then cause knock-on delays for patients arriving in ambulances, and ties those ambulance crews up for long periods, preventing them from responding to further 999 calls. She said ambulance turnaround times had been relatively good at the Countess of Chester, but she had spoken to paramedics handing over patients who were “really struggling” to get to people quickly enough. Read full story (paywalled) Source: HSJ, 22 January 2021
  15. News Article
    NHS bosses have instructed hospitals to keep performing urgent cancer surgery despite Covid pressures, after a growing number cancelled procedures because they did not have enough intensive care beds or available staff. They have told England’s regional directors of cancer to ensure treatment of people who need cancer surgery within four weeks gets the same priority as care of patients who have Covid. The move was unveiled in a letter, obtained by HSJ, sent last Friday by Amanda Pritchard, the chief operating officer at NHS England and NHS Improvement. It was also signed by Cally Palmer, the NHS’s national cancer director, and Prof Peter Johnson, a highly respected specialist who is the NHS’s national clinical director for cancer. They have acted after unease among cancer specialists that growing numbers of hospitals, including all those in London, had cancelled urgent operations. Hospitals have felt obliged to do so either because they did not have enough intensive care beds for patients who might need one after their cancer procedure or because surgical staff had been repurposed to help care for Covid patients. Doctors voiced alarm at the scale of recent postponements of what the NHS classes as “priority two” operations. That means they should be done within 28 days to ensure that someone with cancer does not see their disease spread or become inoperable because it was delayed. More than 1,000 cancer patients in London are now waiting to have “priority two” or “P2” urgent surgery, but none have been given a new date for when it will happen, HSJ reported last week. Read full story Source: The Guardian, 18 January 2021
  16. News Article
    A London hospital is being forced to send patients back to ambulances for treatment due to an ‘overwhelming’ number of Covid patients on ICU wards, according to a frontline doctor. The medic, who asked to remain anonymous, said A&E staff are "running" into waiting ambulances to treat patients there until space becomes available. He said: "It’s not the fault of the staff, but the sheer numbers are so unprecedented and being full like this means that you just have to do your best to adapt. But it’s not the standard (of care) I signed up to." "It’s extremely stressful for us to be doing our best but knowing that significant patient harm is happening because there isn’t space and the patient load is too high." He raised concerns that "significant patient harm" was occurring due to a lack of beds available and the emergency system means medics are limited in the care they can provide. Read full story Source: The Metro, 14 January 2021
  17. News Article
    Nearly a quarter of a million people have been waiting more than a year for operations and other hospital procedures, HSJ has learned. Official NHS England data for November, released on Thursday, showed 192,000 patients had been waiting for treatment for more than a year. However, figures leaked to HSJ of weekly data up to 3 January showed a steep increase to 223,000 patients — the highest reported so far throughout the COVID-19 pandemic and before. According to the leak, just under 4.2 million people are waiting for treatment, of which year-long waiters comprise 5.4%. The data also showed 175 patients across England had waited more than two years for treatment. In February, before the pandemic, 1,613 patients were waiting more than a year — meaning there has been a 138-fold increase. Read full story (paywalled) Source: HSJ, 15 January 2021
  18. News Article
    Patients are missing out on potentially life-saving organ transplant surgery because hospital intensive care beds are filled by coronavirus patients, The Independent has learnt. Major organ transplant centres in London, as well as the Queen Elizabeth Hospital in Birmingham and Addenbrooke’s Hospital in Cambridge, have been forced to close their doors to transplant cases because of a lack of beds, the increased risk to patients, and the need to redeploy doctors and nurses to the coronavirus front line. The impact on organ transplant services follows hundreds of urgent cancer operations being delayed in London and across the country, as NHS trusts run out of spare beds to treat non-Covid patients. Most routine operations have also been stopped in the hardest-hit areas. Teacher Shona McFadyen was diagnosed with liver cancer in December 2018 and needs an urgent liver transplant at the Queen Elizabeth Hospital in Birmingham. She has already waited 22 months for her surgery. She told The Independent: “It’s not the hospital’s fault. I get that. But it just adds to the feeling of hopelessness and it feels like as patients we have been forgotten about. It is life and death for us.” Read full story Source: The Independent, 13 January 2021
  19. News Article
    NHS England has asked hospitals across the country to open hundreds more intensive care beds so they can take in patients from the hardest hit areas, to prevent those patches having to ration access. A letter sent to dozens of acute trusts today by NHS England asks them to enact their “maximum surge” for critical care from tomorrow, opening up hundreds of beds, which will rely on them redeploying staff and cancelling more planned care. The letter is to trusts in the Midlands but HSJ understands a similar approach is being taken in the other regions where critical care is not currently under as much pressure as London, the East of England and the South East. The message to surge capacity to support a “national critical care service” was reinforced to trusts nationwide in a call with Keith Willett, NHS England covid incident director, also on Wednesday. The letter, from the NHSE Midlands regional team, said there had been a national request for the region to surge beyond its own needs to support London and the East of England. “Significant” numbers are likely to be transferred, HSJ was told. Read full story (paywalled) Source: HSJ, 13 January 2021
  20. News Article
    Private hospitals are ‘pushing back’ on requests from NHS trusts to send them more NHS patients, following a change to the national contract with the independent sector, and amid high pressure from COVID-19. Manchester University Foundation Trust, one of the largest NHS providers, has reported difficulties in accessing capacity at its local Spire, BMI and Ramsay hospitals this month. It comes as the NHS is facing “unthinkable” pressures from coronavirus patients, with dozens of hospitals on the brink of being overwhelmed. Throughout most of 2020, the bulk of private providers in England were on a national block contract whereby the NHS could use as much capacity as it needed. But a new contract, agreed with oversight from the Treasury last month, is now in place between January and April, and only offers trusts a minimum volume of activity which equates to activity provided in October and November. Pressures on the NHS have since intensified to unprecedented levels, with many areas now in far greater need of the private capacity than they were two months ago. And there appears to be a misunderstanding or lack of clarity in some areas about the extent to which they can now call on private capacity. Read full story (paywalled) Source: HSJ, 13 January 2021
  21. News Article
    More than 1,000 people needing urgent cancer surgery in London have no date for their treatment, HSJ can reveal. A document leaked to HSJ showed that, at the end of last week, more than 1,000 of London’s cancer surgery patients without an appointment date were defined as P2 (priority two), meaning they needed to be seen within four weeks or risk their condition worsening. The report seen by HSJ also showed more than 300 P2 patients had their surgery postponed in the past week, a statistic NHS England London has so far refused to disclose. Hospitals in the capital are facing their highest-ever COVID-19 occupancy rates, with surgical lists at many trusts being cancelled. Meanwhile, a separate NHSE London document reported in the press this week revealed: “Most NHS Green sites [those cancer surgery sites intended to be covid-free to avoid risk to very frail patients] are now compromised with only a limited number of cases being undertaken in NHS sites this week”. The papers also said the current plans to increase indepedent sector capacity usage were “insufficient to offset the NHS shortfall”, and noted there was a two week lead-in time to move patients into private hospitals “based on clinical rotas, theatre bookings, [and] patient isolation”. Read full story (paywalled) Source: HSJ, 12 January 2021
  22. News Article
    More than a third of critical care units in the East of England are either at or have exceeded their maximum surge capacity, information leaked to HSJ reveals, and all but one are above their normal capacity. Data from the region’s critical care network shows that as of 11 January, seven of the region’s 19 critical care units were either at 100% of, or had exceeded, what is known as ”maximum safe surge” capacity. This represents the limit of safe care, mostly based on available staffing levels. The units have opened more beds, but they require dilution of normal staffing levels. Across the East of England, 482 of the region’s current 491 intensive care beds, after the opening of surge capacity, were occupied. This included 390 patients in intensive care with confirmed covid-19, six with suspected covid and 86 non-covid patients. It gives a regional occupancy rate of 91 per cent against total “safe surge” capacity. Published government figures show the rapid increase in demand for intensive care in the East of England in the last two weeks — the number of patients with covid in mechanical ventilation beds is more than double what it was just after Christmas. Read full story (paywalled) Source: HSJ, 11 January 2021
  23. News Article
    NHS England has told hospitals in the Midlands to further dilute their staffing ratios so critical care capacity can be doubled, HSJ has learned. In a letter sent on 9 January to the boards of all trusts in the region, national leaders said they needed to “dilute nursing ratios beyond the current ask of 1:2” to achieve the significant increase in capacity. In November, all trusts in England were told they could dilute staffing ratios in critical care from the standard one nurse to one patient ratio, to one nurse to two patients. Informal reports from around the country suggest some trusts have already had to move beyond these ratios. The letter said trusts had already been asked to surge capacity to 150% cent of the normal baseline on 6 January, and were expected to be at 175% today. But it said some units were still not achieving this and the region was “transferring patients to other regions.” It added: “In addition to this, you need to have well developed plans in place that can be rapidly activated to surge to 200% of baseline, which may need to be enacted in the coming days. Read full story (paywalled) Source: HSJ, 11 January 2021
  24. News Article
    A hospital's oxygen supply has "reached a critical situation" due to rising numbers of COVID-19 infections. A document shared with the BBC showed Southend Hospital has had to reduce the amount it uses to treat patients. It said the target range for oxygen levels that should be in patients' blood had been cut from 92% to a baseline of 88-92%. Hospital managing director, Yvonne Blucher, said it was "working to manage" the situation. "We are experiencing high demand for oxygen because of rising numbers of inpatients with Covid-19 and we are working to manage this," she said. Read full story Source: BBC News, 11 January 2021
  25. News Article
    The NHS faces a mounting beds crisis as care homes suffering unprecedented staff shortages are forced to stop taking patients from hospitals, health and care leaders have warned. Ministers are desperately trying to free up space in the NHS to tackle a backlog of 5.6 million people – equivalent to almost 10% of people in England – awaiting treatment. But efforts to speed up the discharge of hospital patients into the community are being hampered by care worker shortages. Britain’s largest not-for-profit care home provider, MHA, has already had to close 1 in 10 of its homes to admissions from hospitals, its chief executive, Sam Monaghan, told the Guardian. The warning comes as a comprehensive assessment on Wednesday reveals that care homes in England are facing the biggest staff shortage on record, with 105,000 positions unfilled according to the 2021 State of the Adult Social Care Sector and Workforce report by Skills for Care, an industry body. Read full story Source: The Guardian, 13 October 2021
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