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Found 965 results
  1. News Article
    The percentage of patients visiting A&E who are seen within four hours has hit a “terrifying” new low in Scotland, latest figures show, with ministers urged to “get a grip” on the growing crisis. The figure has been declining since the summer amid high demand, staffing shortages and a lack of patient flow through hospitals. In the week to 3 October, just 71.3% of patients were seen within four hours, a five percentage point drop on the previous week, according to a data published by Public Health Scotland. The figure is the lowest since records began in 2015, with the Scottish Government target set at 95%. With 25,000 visits to A&E in that week, it means more than 7,000 patients waited longer than four hours. Some 1,782 people waited more than eight hours, while a record 591 patients waited longer than 12 hours. Last week, Scotland’s Health Secretary, Humza Yousaf, warned that Scotland’s NHS faces an “incredibly difficult winter” despite announcing a £300 million funding boost. But opposition parties have now accused him of “overseeing a scandalous situation” and leaving A&E departments “beyond breaking point”. Read full story Source: The Scotsman, 12 October 2021
  2. News Article
    Ministers are being warned of a mounting workforce crisis in England’s hospitals as they struggle to recruit staff for tens of thousands of nursing vacancies, with one in five nursing posts on some wards now unfilled. Hospital leaders say the nursing shortfall has been worsened by a collapse in the numbers of recruits from Europe, including Spain and Italy. The most recent NHS figures reveal there are about 39,000 vacancies for registered nurses in England, with one in 10 nursing posts unfilled on acute wards in London and one in five nursing posts empty on mental health wards in the south-east. Thousands of nursing shifts each week cannot be filled because of staff shortages, according to hospital safe staffing reports seen by the Observer. Patricia Marquis, England director for the Royal College of Nursing (RCN), said: “There just aren’t enough staff to deliver the care that is needed, and we now have a nursing workforce crisis. We should never have got into a position where we were so dependent on international nurses. We are on a knife-edge.” Read full story Source: The Guardian, 9 October 2021
  3. News Article
    Dr Katherine Henderson, a senior A&E consultant in London and President of the Royal College of Emergency Medicine, says physical and verbal attacks have increased in recent months. Speaking to the Guardian, she says: “It is a sad reality that in recent months there has been a rise in abuse directed towards healthcare workers, but this abuse is not something new to frontline staff or emergency departments. It was bad before the pandemic, but there’s a changed atmosphere now. “During the pandemic people were being very positive about healthcare workers. But now the public are frustrated that services aren’t getting back to normal. Maybe people who weren’t the source of abuse before are now being the source of abuse. Abuse may be physical or verbal, it may be through social media, or it may be racial or misogynistic. “People are being angry – very angry – with us. They are angry about long waits, about having to stand outside emergency departments in queues, about delays in ambulances coming, including to take their relative home from hospital. The public haven’t really caught up with how struggling the whole NHS is." Read full story Source: The Guardian, 10 October 2021
  4. News Article
    One of the largest hospital trusts in England has been downgraded by the care watchdog amid safety fears and criticism that bosses did not act on staff concerns. The Care Quality Commission (CQC) said it found bedpans covered in faeces, urine and hair during 10 visits to wards at University Hospitals Birmingham Trust in June. Staff in A&E told inspectors they were put under pressure to nurse patients in corridors. At one stage 20 ambulances were queuing outside Heartlands Hospital with patients waiting outside. The CQC said staff felt “disconnected from leaders” who didn’t show an understanding of the pressures they were under. Consultants to the regulator staff were experiencing fatigue and they felt executives at the trust “were no longer interested in staff welfare”. In its inspection report, the CQC said staff did not always clean equipment and said labels for when items were last cleaned were being applied incorrectly. Read full story Source: The Independent, 8 October 2021
  5. News Article
    Continuity of care in general practice reduces use of out-of-hours care, acute hospitalisations and mortality, researchers have shown - as GP leaders warned staff shortages and heavy workload means it is becoming harder to deliver in the UK. Long-lasting personal continuity with a GP is 'strongly associated with reduced need for out-of-hours services, acute hospitalisations, and mortality', according to a study by researchers in Norway. An association lasting more than 15 years between a patient and a specific GP reduces the probability of any of these factors by 25-30%, the study published in the British Journal of General Practice found. The researchers said 'promoting stability among GPs' should be a priority for health authorities, and warned that continuity of care was under pressure. The findings come as general practice in the UK faces intense pressure amid a shortage of GPs and intense workload after more than 18 months of the COVID-19 pandemic. Responding to the findings, RCGP chair Professor Martin Marshall said: "Continuity of care is highly valued by patients and GPs and our teams alike. It is what allows us to build relationships with our patients, often over time, and this study builds the strong evidence base of its benefits for patients and the NHS." Read full story Source: GP Online, 4 October 2021
  6. News Article
    One in 10 posts for consultant psychiatrists in England are vacant with growing waiting times for people needing mental health treatment, experts have warned. A census of the current situations across England by the Royal College of Psychiatrists has found there is just one psychiatrist for every 12,567 people in England. Health service bosses at NHS England have acknowledged there are an estimated 1.5 million people who are waiting for mental health support amid fears the situation will worsen as the effects of the Covid pandemic become clear. This is on top of the 5.6 million patients waiting for routine operations and treatments for physical illness. The Royal College said there was a shortage of 568 empty consultant posts in the NHS out of a total of 5,367 which it said meant patients would have to wait longer for treatment. In total there are 4,500 full time consultants working in the NHS. The highest rates of unfilled positions are in the fields of addiction, eating disorders and child and adolescent psychiatry. Read full story Source: The Independent, 6 October 2021
  7. News Article
    Sick patients have been forced to wait outside a hospital A&E department on chairs and wrapped only in blankets while being treated by nurses in shocking photographs and videos captured by one worried relative. The situation, at Addenbrooke's Hospital in Cambridge, is a regular occurrence, workers have told The Independent. Footage shared with The Independent by a concerned member of the public shows one patient being cannulated, where a needle and intravenous line is inserted into a vein, while another patient has a monitor attached to track their vital signs. Patients waiting outside the A&E were said to be extremely sick, with some vomiting and complaining of worsening symptoms. “It was like something out of a horror movie,” said Maria, who has asked for her surname not to be used. “The system is completely broken from the beginning to the end..." Addenbrooke’s Hospital has been under severe pressure for months with patients queuing out the door earlier this year and patients waiting over 24 hours for a bed. One mental health patient was detained in the back of an ambulance for over 12 hours. It is just one symptom of a nationwide summer crisis in the NHS, with the military called in to support ambulance services that have reported their busiest months ever. A&E units are also witnessing record levels of attendance. Patients are being made to wait so regularly outside Addenbrooke’s A&E that heat lamps have been installed on the walls outside one entrance, used by non-Covid patients. The hospital has also built a marquee as a permanent space for waiting patients. Read full story Source: The Independent, 28 September 2021
  8. News Article
    "To be put in a position where you're basically begging off people, it's infuriating." Last October, 12-year-old Hayden Kildea was diagnosed with severe scoliosis, a condition where the spine twists and curves to the side. Left untreated, it can become a dangerous and life-limiting condition. The Kildeas, who live in Strabane, Northern Ireland, say they were told Hayden would need urgent surgery - but that because of the backlog caused by the pandemic, he would have to wait more than two years. His mum Shauna found a clinic in Turkey that was able to carry out the operation immediately, but it would cost £50,000 - money the family didn't have. So in the summer, they turned to crowdfunding and campaigning to raise the money. Millions of people across the UK are currently on NHS waiting lists - in Northern Ireland there are over 465,000 people, while in England, 5.6m are queuing for treatment. Data shared with BBC Panorama shows that on average, waiting lists have grown by 50% in the most deprived parts of England since the start of the pandemic, compared with nearly 35% in the most affluent areas. The research, conducted by the King's Fund, also shows that people on waiting lists in poorer areas are nearly twice as likely as those in wealthier areas to wait more than one year for treatment. The Health and Social Care Board in Northern Ireland said patient demand continued "to exceed capacity across a range of specialties". It added: "As a result, even before the pandemic, the number of people waiting longer than the target waiting times was increasing." Read full story Source: BBC News, 27 September 2021
  9. News Article
    The backlog of serious clinical incidents that need investigating is building up throughout the NHS, due to the impact of coronavirus and emergency service pressures. Concerns have been raised by commissioners in some areas over the delays. Meanwhile, patients and families who have been harmed are waiting longer to see their cases resolved and the organisations involved are not learning the lessons taught by care failures as quickly as they should. Staff redeployment or absences due to COVID-19 are among the reasons why many investigations are being delayed. As result, trusts are attempting to recruit additional investigators to manage their backlogs. Tina Ivanov, the trust’s director of quality governance, said: “Learning from serious incidents when they occur is an important part of our improvement culture. “We are increasing the number of trained investigators at the trust and have brought in additional resource to help complete the outstanding investigations. The reasons for the increase in outstanding serious incidents include staff absences and clinical pressures.” Read full story (paywalled) Source: HSJ, 27 September 2021
  10. News Article
    NHS bosses plan to shut every local ambulance station in London, prompting fears that patients could be harmed if 999 crews take longer to reach them, the Guardian can reveal. The London ambulance service (LAS) has started a controversial programme to close all 68 ambulance stations and replace them with 18 new “ambulance deployment centres” or “hubs”. A patient group has criticised the plan as “dangerous” and MPs are worried that having fewer ambulance stations around the capital could mean patients wait longer to get to hospital. “This move to shut every ambulance station in London could cause significant harm to patients because of the delays that will take place in getting to them,” said Malcolm Alexander, the chair of the LAS Patients’ Forum, a non-statutory watchdog, and Hackney Healthwatch, a government-funded statutory body that scrutinises NHS services in the east London borough. “We have come across many situations where people have suffered harm because ambulances have taken too long to get there. It looks like this is quite dangerous from the point of view of patient safety.” Read full story Source: The Guardian, 25 September 2021
  11. News Article
    A major acute trust in the East Midlands has been forced to restrict how much chemotherapy it is able to offer due to staff shortages. Nottingham University Hospitals Trust confirmed in a statement its chemotherapy service has been affected by long-term staff sickness and staff vacancies. A trust spokeswoman said: “We continue to provide chemotherapy to patients who benefit most from the treatment and the small number of patients affected have been contacted directly by their specialist cancer team and offered support.” She added: “We are recruiting to posts as well as working with neighbouring NHS and private providers to ensure that any delays are minimal.” The trust added all its patient care decisions adhered to national guidance aimed at helping chemotherapy centres categorise and prioritise treatments when these situations arise. The Nottingham Post first reported the difficulties facing the trust, suggesting the restrictions would specifically affect palliative care patients who receive chemotherapy at NUH’s City Hospital site. Read full story (paywalled) Source: HSJ, 23 September 2021
  12. News Article
    Scotland's Health Secretary Humza Yousaf says the NHS is facing the "biggest crisis" of its existence. There's a shortage of beds, the demand for ambulances is soaring and waits in accident and emergency departments are getting longer. On top of that, COVID-19 admissions have been rising fast as the number of infections in Scotland spiralled at the end of the summer. BBC News share five charts illustrating the enormous pressures currently being felt by NHS Scotland. Read full story Source: BBC News, 23 September 2021
  13. News Article
    Consultants at a major tertiary centre have written to their chief executive, warning services are in ‘an extremely unsafe situation’ and calling for elective work to be diverted elsewhere. Surgeons and anaesthetists at the former Brighton and Sussex University Hospitals Trust — now part of University Hospitals Sussex Foundation Trust — said: “We are devastated to report that the care we aspire to is not being provided at UHS… we are forced to contemplate that it is not safe to be open as a trauma tertiary centre and we feel elective activity must be proactively diverted elsewhere.” The letter from BSUH’s anaesthetist and surgical consultant body is dated yesterday and was sent to UHSussex chief executive Dame Marianne Griffiths. The Royal Sussex County Hospital in Brighton — part of the trust — is the major trauma centre for the South East coast, from Chichester to parts of Kent. In the letter, seen by HSJ, the consultants claimed a shortage of theatre staff is leading to “clinical safety issues, gross operational inefficiencies and burnout within our remaining depleted staff groups”. Read full story (paywalled) Source: HSJ, 21 September 2021
  14. News Article
    The Scottish government has asked the MoD for military assistance for the country's ambulance service. Nicola Sturgeon said health services were dealing with the most challenging combination of circumstances in their history due to the COVID-19 pandemic. Opposition politicians have highlighted a series of serious ambulance delays, including one where a man died after a 40-hour wait. They said this should not be happening in Scotland in 2021. Ms Sturgeon said her government was looking at a range of plans to deal with the significant challenges facing the health services, with the detail of a request for military assistance being considered. Investigations are ongoing into several cases reported in the media on Thursday, including one where a Glasgow pensioner died after a 40-hour wait for an ambulance. The Herald newspaper reported that the family of 65-year-old Gerard Brown were told that he could have survived had help arrived sooner. Mr Brown's GP - who is said to have repeatedly warned 999 call handlers that the patient's status was critical - was quoted as describing the crisis engulfing the Scottish Ambulance Service as being like "third world medicine". The Scottish Ambulance Service is investigating the circumstances of the case, and said it will be "in contact with Mr Brown's family directly to apologise for the delay". Read full story Source: BBC News, 16 September 2021
  15. News Article
    The NHS may be unable to cope this winter because of a “frightening” shortfall of more than 50,000 doctors, the head of the British Medical Association has warned. The number of medics in England has fallen further behind comparable European countries over the summer, ahead of what is predicted to be one of the worst winters in the 73-year history of the health service, Dr Chaand Nagpaul said. “Winter is an incredibly difficult time for the health service,” he said. “With flu season on the horizon and even fewer staff this time round, it’s a total unknown as to how well our services will cope – if they even cope at all.” With more GPs and hospital doctors quitting over the summer, the shortage has risen to 50,191, according to the BMA. This reflects a loss of 919 doctors in primary care and 110 in secondary care over the last two months. Yet more doctors are actively considering quitting in the coming months due to burnout and excessive workloads. “Alarm bells” should be ringing, Dr Nagpaul said. The workforce crisis means staff are working longer hours to keep up with patient demand. Some feel they have no choice but to hand in their notice to get the respite they need. This piles pressure on those that remain, Dr Nagpaul said. Last week, Prof Martin Marshall, the chair of the Royal College of General Practitioners, told the Guardian that GPs in England are “finding it increasingly hard to guarantee safe care” for millions of patients, because the shortage of medics means they are unable to cope with soaring demand." Read full story Source: The Guardian, 13 September 2021
  16. News Article
    Cancer operations at one of England’s largest hospital trusts are being delayed as bosses admit patient care on wards is being compromised. Nottingham University Hospitals Trust has been forced to convert one of its few remaining wards for cancer surgery patients into an emergency medical ward to cope with an influx of patients. The Independent understands the trust’s A&E department is regularly overcrowded with 40 or more patients waiting for a bed at the start of most days. In a leaked message to staff sent on Friday and shared with The Independent, bosses at the hospital said the trust was facing an “exceptionally difficult time” which was “probably the most challenging position we have been in since the pandemic began”. It added: “There is no doubt that we are having to compromise the quality of care we are providing to some patients to ensure that we are able to maintain a service for the whole population.” “Our emergency department is over capacity continuously, which means that patients are waiting for extended periods on trolleys with little privacy and dignity because they do not have a bed to go to. We are having to make difficult decisions every day as to whether we can proceed with cancer and urgent operations and we are not able to tell some patients when they will get their operation." Read full story Source: The Independent, 13 September 2021
  17. News Article
    A third of all children’s acute hospital beds in parts of England are being occupied by vulnerable children who do not need acute medical care but have nowhere else to go, safeguarding experts have warned. Doctors say they feel like very expensive “babysitters” for vulnerable children, many of whom are in care but whose placements have broken down because of their violent and self-harming behaviour. Others have severe neurodevelopmental or eating disorders and need specialist treatment not available on ordinary children’s wards, where they get “stuck”, sometimes for months at a time. Paediatricians told the Guardian they have had to deal with vulnerable children who were not physically ill but displayed such challenging behaviour that they could not be looked after in children’s homes. “It is estimated that roughly a third of acute hospital beds at the moment are full of these vulnerable young people, many who are subject to child protection plans, or they are already children in care, living in a residential placement that’s falling apart,” said Dr Emilia Wawrzkowicz, a paediatric consultant who is the assistant officer for child protection at the Royal College of Paediatrics and Child Health (RCPCH). Though many of these children are in extreme distress, they often have no diagnosable mental illness and do not qualify for a psychiatric “tier four” bed. “Some children have such extreme emotional and behavioural issues or are at risk of exploitation that they can’t get back to their residential placements or their foster parents. They can’t obviously go back to their homes, and we’ve got to keep them safe. So they sit in the hospital because there’s nowhere else to go. There are children sitting on our wards for months,” said Wawrzkowicz. Charlotte Ramsden, president of the Association of Director of Children’s Services, warned that a failure to increase the suitable provision for traumatised children would lead to more child suicides and more children ending up in custody after harming others. Read full story Source: The Guardian, 13 September 2021
  18. News Article
    GPs in England are finding it "increasingly hard to guarantee safe care" as the number of doctors falls and demand surges, a senior medic said. Prof Martin Marshall, chair of the Royal College of GPs, told the Guardian GP numbers had fallen by 4.5% despite an ageing population with an increased need for care. GPs feared making serious mistakes due to excessive workloads, he said. Prof Marshall also defended the continued use of remote consultations. Prof Marshall said the demand for services from GPs, including more complex consultations and the vaccination programme, on top of this decline in numbers was putting family doctors under strain. "The fact that general practice is under such enormous pressure means it can't deliver the patient-centred services that it wants to. Many GPs are even finding it challenging to maintain a safe service," he said. He said family doctors were more likely to make a mistake if they were working 11- or 12-hour days, seeing 50 or 60 patients. "GPs are finding it increasingly hard to guarantee safe care to their patients," he said. "The chances of making a mistake in a diagnosis or a mistake in a referral decision or a mistake in prescribing are all greater when you're under stress." Read full story Source: BBC News, 11 September 2021
  19. News Article
    A care home owner has said she was "forced" to ask two staff with Covid-19 to work because of a staff shortage. The Caledonia home in Holyhead, Anglesey, said 11 of its 12 residents had Covid and the two staff only cared for residents who were also positive. Ann Bedford said Anglesey council and an agency had both been unable to provide emergency cover for staff who were sick or isolating. After speaking to social services, it was agreed the staff could work. "I have never known a situation as bad as we faced over the last weekend. As a matter of course we have contingency plans in place to cope in emergencies but even these buckled under the strain," she said. "My heart sinks when I think about the weeks and months ahead. We felt abandoned and alone. I called on social services for help but they were facing their own emergencies." "The shortage of carers on Anglesey is at dangerous levels and is being intensified by the pandemic." Read full story Source: BBC News, 8 September 2021
  20. News Article
    More than 600,000 cancer patients in the UK are facing treatment delays or missing out on vital support because of a shortage of specialist nurses, a new report from Macmillan Cancer Support reveals. One in five of all those living with cancer (21%) are lacking dedicated support. The NHS is suffering from a “shocking” shortfall of 3,000 specialist nurses in England alone, according to the analysis by Macmillan Cancer Support. As a result, cancer patients are struggling with medication, having hospital appointments cancelled because there are not enough staff or experiencing devastating delays to chemotherapy. In some cases, patients are ending up in A&E. Patricia Marquis, England director of the Royal College of Nursing, warned the workforce crisis was having a “devastating impact” on people living with cancer. “Expertise built up over many years is lost very quickly and it is patients who pay the price, as this report shows,” she added. Read full story Source: The Guardian, 8 September 2021
  21. News Article
    "Bodies would have been piling up" if the Covid vaccine had not been available, the director of intensive care at Belfast City Hospital has said. Dr George Gardiner, a consultant, also said his biggest fear would be having to stop routine cancer surgery. He has called for an end to "tribal politics" in Northern Ireland to allow transformation of the health service, so that cancer and coronavirus can be tackled in tandem. He said the system was currently "one step from chaos" and warned hospitals will not cope with winter if Covid numbers continue to rise. "We need to get everyone who can take a vaccine to take it now before the winter pressures are on us," Dr Gardiner added. "The cancer surgery that we are doing at the minute is life saving. A few more Covid admissions, which could be prevented, will cause us to stop operating because we simply haven't got the capacity to do both." Read full story Source: BBC News, 7 September 2021
  22. News Article
    Dozens of acute trusts have operated at very high levels of bed occupancy in the past month, as they deal with a surge in non-covid patients with thousands fewer beds than normal. At one point in May, 49 general acute trusts out of 145 — the most since before covid — operated at occupancy of 95 per cent or more in adult acute beds. Up to eight trusts at a time were operating at 99 or 100% occupancy during May, according to analysis of published data. NHS England, prior to covid, told trusts to keep occupancy below 92%, and others believe even this is dangerously high, although trusts do often exceed it during winter. Trusts are seeing the largest numbers of non-covid emergency patients since at least winter 2019-20; and are also trying to return as many planned operations as possible. They are doing so with thousands fewer beds than normal, due to measures to deal with ongoing covid patients without further outbreaks of the virus in hospital. Read full story (paywalled) Source: HSJ, 8 June 2021
  23. News Article
    Rising numbers of patients needing care and a shortage of GPs is threatening to overwhelm the system, doctors and patient groups are warning. It comes after the pandemic has caused severe disruption to GP practices for more than a year. Analysis of NHS England data by the Health Foundation found more than 28 million appointments were booked in March, among the highest recorded. Doctor's leaders say what they are being asked to achieve is "undoable". The analysis of NHS data in England carried out by the Health Foundation for the BBC also that that between 2019-20 and 2020-21: The total number of appointments dropped by 10% - meaning 31 million fewer consultations with GPs and practice nurses Major shift from face-to-face to remote consultation, with the proportion seen in practices dropping from 79% to 54% The number of patients referred by GPs for urgent cancer check-ups dropped by 15%, putting lives at risk The escalating situation has prompted patient groups to call for an urgent review of access to services, amid reports that patients are struggling to get through. Read full story Source: BBC News, 27 May 2021
  24. News Article
    Coroners have warned the NHS nearly a dozen times in recent years that a lack of imaging capacity could lead to more deaths, HSJ can reveal. Five of these warnings followed deaths at a single site, Tameside General Hospital in Greater Manchester. The most recent case concerned a patient that died after developing covid during a prolonged wait for an MRI scan. Sir Mike Richards last year warned in a major report for NHS England about the lack of imaging equipment, and the Royal College of Radiologists has highlighted national shortages of radiology staff on numerous occasions in recent years. HSJ combed through more than 100 prevention of future death reports and responses published between 2018 and 2021 in an effort to quantify harm linked to these shortages. Of dozens of reports mentioning imaging issues, including software problems, poor note-taking and incorrect interpretation of results, HSJ identified 11 cases where coroners specifically warned either the trust or system concerned, and/or NHS England or the Department for Health and Social Care, that capacity issues could lead to future deaths. In some of the cases, coroners concluded that shortages likely contributed to a patient’s death. Read full story (paywalled) Source: HSJ, 20 May 2021
  25. News Article
    Changes to vascular services in north Wales must be reversed urgently after a report highlighted safety risks, campaigners warned. Services were centralised from Ysbyty Gwynedd to Ysbyty Glan Clwyd - about 30 miles away - in April 2019. An independent report, by the Royal College of Surgeons, highlights bed shortages and confusion over staffing levels. Betsi Cadwaladr health board said it was making urgent changes to services. In the report, commissioned by BCUHB after patients and staff raised fears about the new service, the Royal College of Surgeons makes nine "urgent recommendations to address patient safety risks". The report sets out issues, including too many patients being transferred to the hub hospital at Glan Clwyd, and a lack of vascular beds leading to frequent delays in transfers. The report also refers to a lack of clarity regarding the availability of consultant vascular surgeons. Read full story Source: BBC News, 20 May 2021
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