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Found 965 results
  1. Content Article
    In 2019 The King's Fund discussed the following eight key problems facing social care and called for reforms to address them: means testing: social care is not free at point of use like the NHS catastrophic costs: some people end up paying large amounts and even selling their homes to pay for care unmet need: many people go without the care and support they need quality of care: a wide spectrum of concerns, from 15-minute care visits to neglect and lack of choice and control workforce pay and conditions: staff are underpaid, leading to high vacancy rates and turnover market fragility: care providers go out of business or hand back contracts disjointed care: health and care is not integrated around the individual and causes issues such as delayed transfers of care from hospital the ‘postcode lottery’: there is unwarranted variation between places in access to care and its quality. The pandemic has shone an uncompromising light on the social care sector. In this article, Simon Bottery explores how COVID-19 has exacerbated these pre-existing challenges.
  2. News Article
    Five-year survival rates are expected to fall due to delays in getting urgent referrals or treatment at the height of the pandemic. Thousands of lives may be lost to cancer because 250,000 patients were not referred to hospital for urgent checks, says a report to be published this week. Family doctors made 339,242 urgent cancer referrals in England between April and June, down from 594,060 in the same period last year — a drop of 43%. The fall in the number of people seeing their GP with symptoms, and in referrals for scans, is resulting in cancers being spotted too late, according to the research by the Institute for Public Policy Research (IPPR) and Carnall Farrar, a healthcare management consultancy. Full article on The Times website here (paywalled).
  3. News Article
    Almost a million people waited at least half an hour for an ambulance after having a medical emergency such as a heart attack or stroke last year, NHS figures show. Ambulance crews responding to 999 calls in England took more than 30 minutes to reach patients needing urgent care a total of 905,086 times during 2019–20. Of those, 253,277 had to wait at least an hour, and 35,960 – the equivalent of almost 100 patients a day – waited for more than two hours. In addition to heart attacks and strokes, the figures cover patients who had sustained a serious injury or trauma or major burns, or had developed the potentially lethal blood-borne infection sepsis. Under NHS guidelines, ambulances are meant to arrive at incidents involving a medical emergency – known as category 2 calls – within 18 minutes. The Liberal Democrat MP Layla Moran, who obtained the figures using freedom of information laws, said: “It’s deeply shocking that such huge numbers of seriously ill patients have had to wait so long for an ambulance crew to arrive after a 999 call. It shows the incredible pressure our ambulance services were under even before this pandemic struck. “Patients suffering emergencies like a heart attack, stroke or serious injury need urgent medical attention, not to be left waiting for up to two hours for an ambulance to arrive. These worryingly long delays in an ambulance reaching a seriously ill or injured patient could have a major long-term impact on their health.” Read full story Source: The Guardian, 16 August 2020
  4. News Article
    Unprecedentedly poor waiting time data for electives, diagnostics and cancer suggests the chances of NHS England’s ambitions for ‘near normal’ service levels this autumn being met are very unlikely, experts have warned. The statistics prompted one health think tank to urge NHS leaders to be “honest that with vital infection control measures affecting productivity, and a huge backlog, there are no shortcuts back to the way things were”. NHS England data published today revealed there were 50,536 patients who had been waiting over a year for elective treatment as of June – up from 1,613 in February before the covid outbreak, a number already viewed as very concerning. The number represents the highest level since 2009 and 16 times higher than they were in March. Nuffield Trust deputy director of research Sarah Scobie said: “These figures are a serious warning against any hope that the English NHS can get planned care back to normal before winter hits. The number of patients starting outpatient treatment is still a third lower than usual and getting back to 100 per cent by September will be a tall order.” “The increase in patients waiting more than a year has continued to accelerate at a shocking pace, with numbers now at their highest since 2009 and 16 times higher than they were in March. “Unfortunately, despite the real determination of staff to get back on track, some of these problems are set to grow… We need to be honest that with vital infection control measures affecting productivity, and a huge backlog, there are no shortcuts back to the way things were.” Read full story (paywalled) Source: HSJ, 13 August 2020
  5. News Article
    Gloucestershire Hospitals FT declares critical incident after ‘relentless demand’ on emergency care Pressure comes two months after trust downgraded one of its A&Es ‘Tired’ staff warned a ’Herculean effort’ is needed to reset emergency system NHS 111 cited as pinch point A trust has declared a critical incident after experiencing “relentless demand” on urgent and emergency care, months after downgrading one of its emergency departments. The internal critical incident was raised by Gloucestershire Hospitals Foundation Trust yesterday. An internal memo said the previous three days “have seen unprecedented demand fall on the Gloucestershire urgent and emergency care system”. Clinicians have been told that early discharges need to be identified on both its Cheltenham General and Gloucestershire Royal hospital sites, to try to free up bed-space, and that all non-essential meetings, besides those at executive level, should be cancelled. The incident comes after the trust decided in June to downgrade the A&E department at Cheltenham General to a minor injuries unit, operating from 8am to 8pm. Previously, the unit offered a full A&E service between 8am and 8pm, with a “nurse-led” minor injuries service outside these hours. The problems appear to be unrelated to covid-19, although infection control measures are known to have reduced capacity in many A&Es and wards. HSJ understands that local managers believe NHS 111, run by Care UK Health Care, has been a particular cause of the problems in recent days, because it has not been directing enough people to alternative services; as well as workforce pressures and the hot weather. Read full (paywalled) article here in the HSJ.
  6. News Article
    Doctors and surgeons’ leaders have issued a warning that the NHS must not shut down normal care again if a second wave of Covid-19 hits as that would risk patients dying from lack of treatment. Here, one patient tells her story. Marie Temple (not her real name) was distraught when her MRI was cancelled in March, shortly after the UK went into lockdown and Boris Johnson ordered the NHS to cancel all non-urgent treatment. Temple, who lives in the north of England, was diagnosed with a benign brain tumour last year after suffering seizures and shortly afterwards had surgery to remove it. She had been promised a follow-up MRI scan in late March to see if the surgery had been a success, but she received a letter saying her hospital was dealing only with emergency cases and she didn’t qualify. Read the full article here.
  7. News Article
    A leading doctor has warned that trusts will struggle to get back to anything like pre-covid levels of endoscopy services and will need to prioritise which patients are diagnosed. Endoscopy procedures are part of the diagnostic and treatment pathway for many conditions, including bowel cancer and stomach ulcers. Most hospitals have not done any non-emergency procedures since the middle of March because they are aerosol generating — meaning a greater covid infection risk and need for major protective equipment. Although some areas are now starting to do more urgent and routine work, capacity is severely limited. Kevin Monahan, a consultant gastroenterologist at St Marks’s Hospital, part of London North West Healthcare Trust, and a member of the medical advisory board for Bowel Cancer UK, said the time taken for droplets to settle in rooms after a procedure can be up to an hour and three quarters, depending on how areas are ventilated. Only then can the room be cleaned and another patient seen. Dr Monahan said his trust had restarted some endoscopy work and was currently doing around 17 per cent of its pre-covid activity. “We can provide a maximum of about 20 per cent of normal activity — and that is using private facilities for NHS patients,” he said. “I am not at all confident we will be able to double what we are doing now, even in three to four months’ time." Read full story Source: HSJ, 12 June 2020
  8. News Article
    Thousands of people lost their lives “prematurely” because care homes in England lacked the protective equipment and financial resources to cope with the coronavirus outbreak, according to council care bosses. In a highly critical report, social care directors say decisions to rapidly discharge many vulnerable patients from NHS hospitals to care homes without first testing them for COVID-19 had “tragic consequences” for residents and staff. In many places, vulnerable people were discharged into care facilities where there was a shortage of personal protective equipment (PPE) or where it was impossible to isolate them safely, sometimes when they could have returned home, the report says. “Ultimately, thousands have lost their lives prematurely in social care and were not sufficiently considered as part of wider health and community systems. And normality has not yet returned,” James Bullion, the president of the Association of Directors of Adult Social Services (Adass), said in a foreword to the report. Read full story Source: The Guardian, 11 June 2020
  9. News Article
    Senior doctors repeatedly raised concerns over safety and staffing problems at a mental health trust before a cluster of 12 deaths, an HSJ investigation has found. The deaths all happened over the course of a year, starting in June 2018, involving patients under the care of the crisis home treatment services at Birmingham and Solihull Mental Health Trust. The causes of the deaths included suicides, drug overdoses, and hanging. Coroners found several common failings surrounding the deaths and have previously warned of a lack of resources for mental health services in the city. HSJ has now seen internal documents which reveal senior clinicians had raised repeated internal concerns about the trust’s crisis home treatment teams during 2017 and early 2018. The clinicians warned of inadequate staffing levels, long waiting lists, and a lack of inpatient bed capacity. In the minutes of one meeting in February 2018, just two months before the first of the 12 deaths, a consultant is recorded as saying he had “grave concerns over safety in [the home treatment teams]”. Read full story Source: HSJ, 9 June 2020
  10. News Article
    Dozens of intensive care units are still running well over their normal capacity – in some cases more than double – weeks after the peak of demand, figures seen by HSJ reveal. It contrasts with the picture painted at some government coronavirus press conferences that there is huge “spare capacity” in critical care and has been throughout the outbreak, with Downing Street charts putting England-wide occupancy at around 20% currently. The government’s assertions include the additional “surge” capacity which was hurriedly established at the start of the outbreak. But intensive care staff have been frustrated by this being labelled spare capacity, when the number of patients being treated is still well above normal levels. In addition, the ongoing reliance on keeping surge beds open – with ICUs still spilling over other spaces and calling on staff and equipment from other services – will limit hospitals’ ability to resume normal care, such as planned surgery. Steve Mathieu, a consultant in intensive care medicine in the south of England, said: “The majority of ICUs will currently be operating at over 100 per cent capacity and typically somewhere around 130-150 per cent, although there is significant regional variation". “There are uncertainties whether this will now represent the ‘new normal’ for the foreseeable future and there is a national need to plan for further potential surges in activity requiring more critical care demand." Read full story Source: HSJ, 21 May 2020
  11. Content Article
    The lack of funding in social care doesn’t only mean that services are unable to meet demand – there is also under-investment in data and analytics. Laura Schlepper explains why social care data matters and what would help to increase its potential.
  12. News Article
    Intensive care capacity in London must be doubled on a permanent basis following the coronavirus pandemic, according to the chief executive of the city’s temporary Nightingale hospital. Speaking to an online webinar hosted by the Royal Society of Medicine, Professor Charles Knight said London had around 800 critical care beds under normal operations but “there’s a clear plan to double intensive care unit capacity on a permanent basis”. He added: “We must have a system of healthcare in this country that means, if this ever happened again, that we wouldn’t have to do this, that we wouldn’t have to build an intensive care unit in a conference centre because we had enough capacity under usual operating so that we could cope with surge.” It would also mean the NHS would no longer be in a position “where lots of patients, as we all know, get cancelled every year for lack of an ITU bed,” he said. Read full story Source: HSJ, 28 April 2020
  13. News Article
    The availability of dialysis equipment used to treat more than a quarter of ventilated COVID-19 patients has reached “critical” levels, HSJ has learned. Concerns are growing over an “exceptional shortage” of specialist dialysis machines used to treat intensive care patients with acute kidney failure. Although hospitals are able to deploy alternative machines which are not typically used in intensive care, this is logistically challenging and can carry increased risks for patients. Read full story Source: HSJ, 22 April 2020
  14. News Article
    Dozens of patients with Covid-19 have been turned away from the NHS Nightingale hospital in London because it has too few nurses to treat them, the Guardian can reveal. The hospital has been unable to admit about 50 people with the disease and needing “life or death” care since its first patient arrived at the site, in the ExCeL exhibition centre, in London’s Docklands, on 7 April. Thirty of these people were rejected because of a lack of staff. The planned transfer of more than 30 patients from established London hospitals to the Nightingale was “cancelled due to staffing issues”, according to NHS documents seen by the Guardian. The revelation raises questions about the role and future of the hospital, which up until Monday had only treated 41 patients, despite being designed to include almost 4,000 beds. One member of staff said: “There are plenty of people working here, including plenty of doctors. But there aren’t enough critical care nurses. They’re already working in other hospitals and being run ragged there. There aren’t spare people [specialist nurses] around to do this. That’s the problem. That leads to patients having to be rejected, because there aren’t enough critical care nurses.” Read full story Source: The Guardian. 21 April 2020
  15. Content Article

    Midwifery during COVID-19: A personal account

    Anonymous

    Anonymous posted an article in Blogs

    I am a case loading midwife, working during the coronavirus pandemic. This is my personal account of what we are doing in my area to keep our women and ourselves safe, and the barriers we are facing.
  16. Content Article
    This article, published by the American Association for Respiratory Care, discusses a Ventilator Training Alliance (VTA) that has been formed by several of the world’s ventilator manufacturers. The VTA has partnered with Allego to create a mobile app that frontline medical providers can use to access a centralised repository of ventilator training resources. To download the Ventilator Training Alliance knowledge hub app and to watch a video of it in action, please follow the link.
  17. Content Article
    Many people will be experiencing anxiety about their health and safety during this time. This page provides information about COVID-19 and how to manage your mental health during the pandemic. Guidance includes advice on accessing treatment and medication.
  18. Content Article
    In this anonymous blog, published by the Guardian, the author describes their experience of working in an inpatient psychaitry unit during the current cornovirus outbreak. They raise concerns over the impossibility of physical distancing, lack of personal protective equipment (PPE), patients not being allowed to go out and a rise in violence and anxiety.
  19. Content Article
    This article, published by the British Journal of Oral and Maxillofacial Surgery, concludes that in order for healthcare professionals to deliver safe care they need adequate protection and training in its use. Where employers are failing to provide adequate PPE safe healthcare cannot be delivered. This poses both moral and ethical dilemmas to healthcare professionals who are patient focused, thereby creating a sense of inadequacy and undervaluation resulting in workforce stress.
  20. News Article
    One in 10 nurses working in acute hospitals are off work due to coronavirus, according to internal NHS figures seen by HSJ. Internal NHS figures from the COVID-19 national operational dashboard state that, on Saturday, English acute trusts reported that 41,038 nurses and midwives were absent . 28,063 (68%) were COVID-19 related. The total nursing and midwifery headcount in acute trusts is about 280,000 — meaning roughly 10% are off on covid-related absence. There are ongoing complaints from staff about their access to COVID-19 tests — which, it is hoped, will hope reduce the absence rates from suspected cases — while national officials say these are now being made available. Read full story Source: HSJ, 14 April 2020
  21. News Article
    Hospitals are turning to the veterinary workforce to fill staffing gaps on intensive care wards ahead of an expected peak of COVID-19 patients, HSJ can reveal. Torbay and South Devon Foundation Trust has recruited 150 vets to enrol as “respiratory assistants”, amid preparations for a 10-fold increase of intensive care patients. Another trust, Hampshire Hospitals FT, has asked vets and dentists to become “bedside support workers” as part of its response to COVID-19 pressures. Read full story Source: HSJ, 9 March 2020
  22. Content Article
    The ongoing coronavirus outbreak is an understandable concern for all of us and people with a weakened immune system are at a higher risk of experiencing more serious complications from it. This web resource from the charity Anthony Nolan, gives advice on the coronavirus for people who have received or are waiting to receive a stem cell transplant to treat their blood cancer or blood disorder. Anthony Nolan is working alongside other cancer charities, medical experts and the NHS to make sure this advice is updated as the situation develops.
  23. Content Article
    Single-use N95 respirators are critical to protect staff and patients from airborne infections, but shortages may occur during disease outbreaks and other crisis situations. Wearing an N95 respirator for hours at a time (i.e. extended wear) or reusing a respirator several times (i.e., donning and doffing between uses) are practices used to ease shortages. The potential risks and benefits of these practices may vary greatly across locations and may evolve rapidly during a crisis. This report’s conclusions are not intended as a practice endorsement or call to action. Rather, this report is intended to provide practical guidance on the potential risks and benefits that clinical centers should consider during decision making about N95 respirator reuse or extended use. ECRI is a US-based organisation. 
  24. Content Article
    The COVID-19 pandemic is sweeping across the length and breadth of the UK. As a result, NHS England has issued guidelines for effective triaging of urgent cancer 'two-week wait' referrals. The intention of this guideline is to minimise the disruption to cancer services. In order to fully understand the implications of this manual triage approach, this article, Data-Drive Triage Automation – YouDiagnose’s fight against COVID-19, will first explain the triage process during normal circumstances, and then highlight the additional impacts due to the coronavirus emergency. Finishing with a suggested solution (from YouDiagnose) to improve the efficiency of the triaging process and save lives during the pandemic. 
  25. Community Post
    Do you usually access services, receive treatment or take medication for mental health difficulties? How is this being impacted by the coronavirus outbreak? We’re asking for patients, carers, family members and friends to share their stories, highlight weaknesses or safety issues that need to be addressed and share solutions that are working. We will be identifying themes and reporting to healthcare leaders with your insights. We want to help close the gaps that might emerge as everyone focuses on the pandemic. Please share your stories in the comments below. You’ll need to sign up (for free) to join the conversation. Register here - it's quick and easy.
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