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News Article
NHS was ‘overwhelmed’ in January surge, study finds
Patient Safety Learning posted a news article in News
The NHS “was largely overwhelmed” at the height of the UK’s Covid second wave in January, according to a study. New research published in Anaesthesia, a journal of the Association of Anaesthetists, revealed the scale of the pressure on hospitals during the pandemic and how stretched some units were. Based on surveys of all NHS hospitals, with more than half responding, the study found almost a third of anaesthetists were redeployed to look after critically ill patients, leaving 42% of operating theatres closed. This meant operations, including for cancer and emergency surgery patients, had to be cancelled. The research, by Professor Tim Cook, a consultant in anaesthesia and intensive care at the Royal United Hospitals Bath Foundation Trust, said: “Three-quarters of critical care units were so expanded that planned surgery could not be safely resumed. At all times, the greatest resource limitation was staff.” It is thought the findings are an underestimate of how bad the situation really was in some hospitals because the busiest units were less able to respond to the survey. Read full story Source: The Independent, 19 May 2021 -
EventIn November 2021, the Chancellor announced £5.9 billion in funding to help the UK's health and social care system address the backlog and provide much-needed support to NHS staff and patients. But how are healthcare professionals addressing the NHS backlog for 2022/23? Whilst the future pattern of COVID-19 transmission and the resulting demands on the NHS are unknown, there is an urgent need to increase NHS capacity and resilience to deliver safe, high-quality services that meet the full range of people's health and care needs. Here at National Health Executive, we will be hosting our first online event of the year, NHE365 NHS backlog, on February 17th, 2022. This event will investigate how the NHS will continue to rise to the challenges of restoring services, meeting new care demands, and reducing care backlogs caused by the pandemic. Register
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Event
HSJ: Beds, backlog and bureaucracy
Sam posted an event in Community Calendar
untilAs the health service continues to absorb covid-19 pressures, and with Omicron adding further strain to an already debilitated workforce, this webinar will look into the core issues and gaps around staff safety and wellbeing and the subsequent risk to patients. Join this webinar to engage in an open and honest discussion with valuable perspectives from frontline clinicians on some of the key emerging challenges around workforce safety and contingency options and innovation solutions that will help ensure essential services can be maintained safely. The realities of dealing with continued service disruption and uncertainty: A perspective from frontline clinicians on the impact on patient safety. Is enough being done around staff wellbeing? Find out what kind of support staff really need to ensure they can maintain high standards of care Safety education: How to bring organisational safety standards to the forefront with sections on People, Processes and Performance and discuss the impact of multidisciplinary team training on patient. Register -
Content ArticleOver the past year, delays in transferring patients from an ambulance to a hospital have risen exponentially. In April 2022 there were over 41,000 delays of over 60 minutes, up over a staggering 450 per cent in 12 months. This equates to 71,000 hours lost, with a significant risk of harm to patients, even though the proportion being taken to hospital by ambulance has fallen thanks to successful initiatives such as “hear and treat” and “see and treat”. These delays mean that, too often, ambulance crews are not able to respond to 999 calls from critically ill patients. Instead they are being held in “stacks” of hundreds each day – as ambulance control room teams strive to prioritise overstretched resources. The current reality is that crews are often waiting with patients in hospital corridors or outside, hearing urgent calls to which they are unable to respond. In addition to the direct impact on patients, this is incredibly demoralising, even traumatising, for many staff involved. So why is this happening? In an article for the Independent, Daren Mochrie, chair of AACE – the Association of Ambulance Chief Executives, and Saffron Cordrey, interim chief executive at NHS Provider, discusses what is happening in the NHS.
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Content Article1 in 6 people in the UK live with a neurological condition, but there simply isn’t the workforce or services in place to provide the support they need. Every two years, The Neurological Alliance runs My Neuro Survey to give a picture of the experience of care, treatment and support for people with neurological conditions. From a lack of mental wellbeing support, delays to life changing treatment and care and a lack of information and support at diagnosis, over 8,500 people living with or affected by neurological conditions across the UK shared their experiences in the 2021/22 My Neuro Survey.
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Content ArticleIntegrated care systems (ICSs) face a difficult task. The health of the population and the scope of some of the major concerns vary considerably across ICSs. As a result, authorities need to examine all aspects to ensure that ICSs run effectively, writes Phoebe Dunn in this HSJ article.
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Content ArticleEmergency Department (ED) patient waiting times provide an important barometer for the wider pressures experienced in the NHS. There are currently alarming levels of crowding in our EDs, indicating that the health service is unable to meet the needs of patients with the current level of resource and capacity. In March 2022, for the first time in the history of the metric, the numbers of patients waiting 12-hours or more from decision to admit (DTA) exceeded 20,000. However the Royal College of Emergency Medicine (RCEM) argue that this number represents the tip of iceberg, as far greater numbers of patients experience extreme waits of 12 hours or more from their time of arrival. To investigate this issue further, RCEM carried out a Freedom of Information (FOI) request examining the extent of very long stays in EDs, with a particular focus on the numbers of patients waiting 12 hours or more from their time of arrival. They found that the current 12-hour data is a gross underrepresentation of the reality of patient waits, as it fails to capture the vast majority of patients who have no choice but to spend extended lengths of time in EDs. It additionally conceals the patients who are discharged home after very long stays.
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Content ArticleShared decision making and regular communication throughout a patient’s surgery pathway would, a recent HSJ webinar argued, help the NHS move from the concept of waiting lists to one of preparation lists – and to a better way of dealing with the backlog. Claire Read reports.
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Content ArticleMore must be done to avoid harm to patients while waiting for treatment. The backlog for planned care is one of the biggest challenges for the NHS in Wales. Waiting times targets have not been met for many years. This backlog has been made much worse due to the pandemic. In February 2022, there were nearly 700,000 patients waiting for planned care, a 50% increase since February 2020. Over half of the people currently waiting have yet to receive their first outpatient appointment which means that they may not know what they’re suffering from and their care cannot be effectively prioritised. Modelling shows it could take up to seven years or more to return waiting lists to pre-pandemic levels. This report makes five recommendations based on what the Welsh Government needs to do as it implements its national plan.
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Content ArticleThis report from the Royal College of Nursing (RCN) reveals the full extent of the UK nursing workforce crisis. In March 2022, nursing and midwifery staff from across the UK were invited to tell the RCN about their experiences of the last time they were at work. The survey report provides valuable insight into the realities of staffing levels across the UK, and the impact on our members and the people they are caring for.
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Content ArticleSince 2010/11, the NHS has lost almost 25,000 beds across the UK. The evolving nature of healthcare provision means that the role of hospital admission has changed, but hospital beds still represent an essential part of healthcare, and the number available to the NHS should be carefully considered. A broad consensus has developed in recent years that the reduction in beds has happened too quickly. The outcome is that the NHS is now under-bedded. This has important consequences; patients must now endure long waits to be admitted with emergency department staff providing care normally provided in wards even as they continue to care for new arrivals; ambulance handover delays increase and there are delays to calls for an ambulance; planned operations are cancelled. Reducing long stays in emergency departments requires adequate staffing, space, efficient processes, and sufficient inpatient bed capacity. This report from the Royal College of Emergency Medicine (RCEM) focuses on inpatient bed capacity. While the unit of measurement is a bed, it must be remembered that a bed requires medical, nursing and other staff to safely function.
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Content ArticleSean Mansell had a medical history of alcohol dependence syndrome. On the 5 July 2021, the West Midlands Ambulance Service received a 999 call at 19.23 hours from a neighbour of who reported that Shaun couldn't walk. The call was allocated a category 3 disposition which had a target response time frame of 120 minutes. An ambulance arrived on scene at 03.38 on the 6 July which was 8 hours and 15 minutes later and not within the response time frame. This was due to the fact that demand outstripped available resources. A welfare call was undertaken at 21.28 hours by a paramedic who had been asked to go into the control room to assist with welfare calls due to the high volume of 999 calls outstanding. The paramedic had not received prior training on how to complete these calls. The welfare call was conducted with the neighbour. No contact was made directly with Shaun during the 8 hour delay which led to a missed opportunity to identify a change in his condition. When the ambulance arrived, Shaun had passed away on the sofa in his front room. There was evidence of blood loss on the floor next to him and around his mouth. The police did not find any suspicious circumstances. A post mortem examination found the cause of death to be acute gastrointestinal haemorrhage and liver disease due to chronic alcoholism. The medical evidence was not able to determine if the delay in the arrival of the ambulance contributed to the death because there was no certainty of timeline about the bleeding.
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Content ArticleThe link between nurse staffing levels and patient outcomes has been proven time and again – so why do we have a persistent shortage of nurses? Is it all due to lack of funding? And do, or should, nurses have a role in calling this out and finding solutions? These questions are explored in the latest episode of the Nursing Standard podcast, which hears from Jane Ball, professor of nursing workforce and policy at the University of Southampton, who has spent 30 years researching nurse staffing issues. She speaks about the positive impact on patient care of having the right number of nurses who are well-trained and have a good working environment.
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Content ArticleExpanding workforce capacity, and allowing staff to recover, is going to be fundamental in achieving the ambitions set out in the elective recovery delivery plan. To help support, protect and retain staff, this letter from NHS England details a number of high impact enablers that providers should consider implementing to help improve staff experience. It also sets out a number actions being taken forward at a national level with the aim of making the workload more sustainable for staff.
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Content ArticleTherese Coffey, the new health and social care secretary, sets out the government’s plans for the NHS and social care to deliver for patients, this winter and next. The government's plan for patients sets out the priorities for health and care, delivering across four key areas: ambulances backlogs care doctors and dentists. Read her Ministerial foreword below.
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Content ArticleThis letter from NHS Confederation to Thérèse Coffey MP, the new Secretary of State for Health and Social Care, sets out what needs to be done to support the delivery of an emergency winter plan for health and social care services. It outlines the views of NHS Confederation members on what will be needed to deliver the ‘ABCD’ highlighted as priorities by the Secretary of State: ambulances, backlogs, care and doctors and dentists.
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Content ArticleThe NHS Confederation, NHS Providers, the Academy of Medical Royal Colleges, National Voices and the Richmond Group of Charities have penned a joint letter to the new Prime Minister warning that without urgent action on key priorities the NHS risks being trapped in a relentless cycle unable to meet rising patient need and demand. The five organisations, which together represent NHS leaders, clinicians and patients, are calling on the new government to take rapid action to address five key priorities in the short term. These priorities are: Workforce Social care Capital funding The impact of the cost of living crisis and inflation Strengthening the voice of people living with ill health in decision making.
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Content ArticleIn a television studio in Stoke-on-Trent last month, Liz Truss and Rishi Sunak traded blows over everything from credit card economics to Channel migrants to the accessories chain Claire’s. The list of issues the pair clashed over was dizzyingly long. There was one glaring omission, however. In the hour-long debate there was not a single mention of the NHS – despite being engulfed in its biggest ever crisis. The NHS now shares the same traits as many of those relying upon it to keep them alive and well: it is elderly, has multiple comorbidities, and is in dire need of emergency care. Summer has left it on its knees. Worse is expected this winter. “The new prime minister will inherit an NHS in its worst state in living memory,” says Matthew Taylor, the chief executive of the NHS Confederation, which represents the healthcare system in England, Wales and Northern Ireland. “There is no escaping that the NHS is in a state of crisis.”
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Content Article“I will deliver on the National Health Service” was as much detail as the new prime minister offered on health policy in her victory speech on Monday. One idea floated during her campaign, that £13bn of new funding earmarked for the NHS should be diverted to social care, might once have won plaudits. But such is the crisis now engulfing hospitals that the moment has passed. Next week, a ballot opens that could see nurses in England and Wales go on strike for the first time. A record 132,139 – or almost 10% of all NHS posts – were vacant in June. This shocking rise in the number of NHS vacancies is a symptom of the government’s dangerous neglect, says the Guardian newspaper in its Editorial.
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Content ArticleThe NHS often appears to be in a state of permanent crisis. Recently, there've been headlines about long waiting times for ambulances and the huge backlog for routine surgery. Before that, the NHS faced a two-year pandemic which may rear its head again this winter. But the NHS also has a big underlying problem that it has tens of thousands of vacancies for doctors, nurses and other medical workers – and that makes all the other pressures on the NHS even harder to handle. So why does the NHS have a staffing problem? And what can be done to fix it?
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Content ArticleMaking the Patient Tracking List (PTL) available to general practice in North Central London (NCL) is proving to be an effective approach. When thinking about how best to address the backlog of patients, it’s natural to only consider the locations where the patients will be treated, but Amy Bowen, director of system improvement for NCL, says her team saw the value of involving primary care in the conversation. “Initially, everyone considered the PTL from secondary care, but we thought ‘let’s flip it on its head’,” she says. The approach uses funding from the NHS’s elective accelerator sites initiative to form multi-disciplinary Proactive Integrated Teams (PITs) that can access the PTL using the elective recovery dashboard in the Cerner population health platform, HealtheIntent®. Find out more in this article in the Integrated Care Journal.
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Content Article“The National Health Service and the adult social care sector are facing the greatest workforce crisis in their history”, said Parliament’s Health and Social Care Select Committee in July. The aspirations to rebuild services post-Covid, and tackle rising waiting times and other access challenges, are limited by the same challenge: there are simply not enough staff, writes Richard Murray in this article for the Independent.
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Content ArticleThis report by The Tony Blair Institute for Global Change sets out an action plan to save the NHS this winter. It highlights the pressures the health service faces, worsened by the Covid-19 pandemic, including a resurgent flu epidemic, the effect of the cost-of-living crisis, the unprecedented elective-care backlog and a depleted and exhausted workforce. The authors call for the Government to immediately: focus leadership minimise demand on the service improve patient flow and efficiency maximise capacity.
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Content ArticleAs dentists hand back their NHS contracts in record numbers, GPs are seeing the impact on their workload and patients’ health, especially in “dental deserts,” reports Sally Howard in this BMJ article. Over one week this spring, 20 patients presented at GP Abbie Brooks’ York surgery with abscesses, dental pain, and broken teeth—demanding antibiotics and painkillers. Brooks could not prescribe because she was not indemnified to perform dental work. Many of these patients, Brooks says, were not registered with a dentist or able to find an NHS dentist, and had already been told to call 111. The NHS medical helpline had advised patients to visit emergency NHS dentists 50 miles away from Brooks’ surgery. “Vulnerable patients often can’t get to emergency dentist appointments in Bradford or Leeds for logistical or financial reasons,” she says, adding that a small proportion of patients became difficult when Brooks was unable to help. “One woman was really quite angry that I wouldn’t incise and drain her abscess,” she says. “It’s not acceptable for GPs to have to deal with this crisis not of our doing.”
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Content ArticleThis article published by The Conversation looks at the pressures faced by ambulance services and emergency departments across Australia as a result of Covid-19. There has been an increase in 'ramping', where ambulances queue up outside hospitals. Ramping is a sign that the whole health system is under immense pressure. The article looks at the large amounts of funding Australian local governments are putting into ambulance services and emergency departments (EDs), but highlight that this will not solve the issues face by the health system if issues discharging patients into community and social care remain. It highlights a model developed in Leeds, UK, that has been adopted by the health service in Victoria, Australia, focused on solving more systemic issues. The Leeds model aims to improve patient flow in and out of the hospital and ensure that patients are quickly transferred from ambulances into EDs. Discharge coordinators organise the care patients need in the community after an ED or hospital stay. The authors also look at the role of community paramedics in keeping patients out of hospital and their potential to reduce financial and capacity pressure on health systems worldwide.
