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Found 965 results
  1. Content Article
    The Association of Ambulance Chief Executives (AACE) has published a new report charting the major increase in the frequency and length of hospital handover delays over the past ten years, calling for an even greater focus on improvements that will reduce and eradicate delays, prevent more patients from coming to significant harm and stop the drain on vital ambulance resources.
  2. Content Article
    Community hospitals play a very important role in supporting patients but, unlike with larger hospitals, little has been known until now about how they struggle with delayed discharges. Following a freedom of information request, the Nuffield Trust reveals the number of patients experiencing delays leaving community hospitals, and highlights the capacity challenges such hospitals face.
  3. Content Article
    A global shortage of an estimated 18 million health workers is anticipated by 2030, a record 130 million people are in need of humanitarian assistance, and there is the global threat of pandemics such as COVID-19. At least 400 million people worldwide lack access to the most essential health services, and every year 100 million people are plunged into poverty because they have to pay for healthcare out of their own pockets. There is, therefore, an urgent need to find innovative strategies that go beyond the conventional health-sector response. WHO recommends self-care interventions for every country and economic setting as critical components on the path to reaching universal health coverage (UHC), promoting health, keeping the world safe and serving the vulnerable.
  4. News Article
    Staffing shortages are likely to restrict the use of a beneficial painkiller in birthing suites, even once its use has been recommended by national guidance. Research by HSJ suggests that just over half of trusts are already offering remifentanil to women in labour, although some are having to restrict its use due to lack of staffing. Responses to freedom of information requests from 108 trusts revealed 55 offered remifentanil during labour in 2022-23. Recent draft National Institute for Health and Care Excellence guidance on intrapartum care, published in April, suggested healthcare professionals “consider intravenous remifentanil patient-controlled analgesia” in obstetric units. This is partly because it reduces the likelihood of forceps or ventouse being required compared to intramuscular pethidine (an opioid commonly used in labour). However, the drug is not yet mentioned in official NICE guidelines and the opioid’s use in labour is currently off-label (its more common licenced use is alongside anaesthesia in surgery). A Royal College of Anaesthetists spokesperson said the use of drugs off-label “is extremely common in obstetrics given that drug trials do not often include pregnant women”. Read full story (paywalled) Source: HSJ, 1 September 2023
  5. News Article
    More than 120,000 died waiting for NHS treatment, as backlog hits all-time high. The number of NHS patients dying while waiting for treatment has doubled in five years, new figures suggest. More than 120,000 people died while on waiting lists last year, according to an analysis of health service data. The total is even higher than it was in lockdown, with health leaders saying the pandemic and NHS strikes have made clearing backlogs more difficult. Matthew Taylor, the chief executive of the NHS Confederation, said: “These figures are a stark reminder about the potential repercussions of long waits for care. They are heartbreaking for the families who will have lost loved ones and deeply dismaying for NHS leaders, who continue to do all they can in extremely difficult circumstances." “Covid will have had an impact on these figures – but we can’t get away from the fact that a decade of under-investment in the NHS has left it with not enough staff, beds and vital equipment, as well as a crumbling estate in urgent need of repair and investment.” Read full story (paywalled) Source: The Telegraph, 31 August 2023
  6. Content Article
    In February 2022, NHS England published its Delivery Plan for Tackling the Covid-19 Backlog of Elective Care, aiming for an unprecedented 30% rise in elective activity by 2024-25. In an effort to cut waiting times and the number of people waiting for first appointments, the plan set an improbably ambitious target of reducing follow-up outpatient visits by 25% by March 2023 from 2019-20, to leave more capacity for first appointments. All first appointment waits of over 52 weeks were to be abolished by 2025. In this BMJ opinion piece, David Oliver looks at why the targets are unlikely to be met.
  7. Content Article
    Even those at the top admit the NHS can’t do what is being asked of it today. But it is far from unsalvageable – we just need serious politicians who will commit to funding it, writes Gavin Francis, who shares his experience as a GP in this Guardian long read.
  8. News Article
    At least 20 patients have suffered harm due to their follow-up appointments not being booked at a hospital department where people ‘continue to come to harm’, according to an internal review. Torbay and South Devon Foundation Trust is reviewing its ophthalmology service after 22 people were harmed following “system failures” with their follow-up appointments. The trust’s initial investigation, obtained by HSJ with the Freedom of Information Act, warned there were “potentially” other patients affected by the failures who had not yet been identified. In response, the trust said its ophthalmology department had already “undertaken a significant amount of work to address a large proportion of the actions arising from the review”, including building another operating theatre and recruiting more staff. Read full story (paywalled) Source: HSJ, 21 August 2023
  9. News Article
    As junior doctors begin a four-day strike today with a two-day strike by consultants a fortnight later, Sir Julian Hartley, chief executive of NHS Providers, said: "Trust leaders are very worried about six more days of severe disruption across the NHS this month. "We could be close to a tipping point. Trusts and staff are pulling out all the stops to reduce waiting times for patients but with no end to strikes in sight the sheer volume of planned treatment being put back due to industrial action will make it almost impossible for trusts to cut waiting lists as much as the government wants. "Waiting lists are now at a record high of 7.57 million, the pressure on urgent and emergency care services is relentless and an already stretched NHS is gearing up for another high-demand winter as pressure on tight budgets mounts. "A string of strikes – which have led to more than 835,000 routine treatments and appointments being put back since December – is estimated to have cost the NHS around £1bn already including lost income and hiring expensive staff cover. "The number of rescheduled appointments could be close to 1 million after this month's strikes and consultants have called another two-day strike in September. There will be a long-lasting effect on patients who have had treatment delayed and on already low staff morale. "Concerns are mounting too over how patient safety will be maintained during August's strikes as many NHS services will be even more stretched as many staff are on much-needed summer holidays and cover is harder to secure. "It's vital that the government and unions find a breakthrough urgently. Trust leaders understand the strength of feeling among striking staff and why they're taking action. Everyone in the NHS wants to concentrate on treating more patients more quickly rather than spend days making plans to cope with strikes. "People can still rely on the NHS during strikes, calling 999 in an emergency. For less urgent cases people should use 111 online for help and advice."
  10. News Article
    Steve Gulati, Associate Professor and Director of Healthcare Leadership at HSMC (University of Birmingham) discusses the concept of "time to care" within healthcare. A UK-wide poll of healthcare workers revealed that most NHS staff think they have too little time to help patients and the quality of care that services provide is falling. This reported reduction in the time to care is perhaps inevitable after almost a decade of health funding failing to keep up with increases in demand, and is a cause for concern for all of us – patients, carers or those working in the NHS. Where does this fit in to the wider picture – and can anything be done about it? It is not just NHS workers who are feeling the pinch – levels of public satisfaction with the NHS are at an all-time low. Interestingly, the two most cited reasons relate to access (difficulties or delays in getting appointments) and, tellingly, to staff shortages. Even against this gloomy backdrop, the collectivised funding model upon which the NHS is founded continues to find significant public support. All of this points towards a painful congruence – NHS staff feel that they do not have enough time to care, and the public is noticing. Is ‘time to care’ an outdated concept, harking back to an age of long patient stays, a paternalistic bedside manner and unrealistic expectations? Both staff and patient experience suggest not. Although technology plays an increasing role in healthcare diagnostics, treatment and recovery, delivering care remains a deeply human phenomenon and is essentially a relational and personal task. Recognising that frontline healthcare workers need time to care is not a new phenomenon. Influenced by service improvement methodologies, the ‘productive ward’ initiative in the mid-2000s placed an explicit emphasis on using efficiency techniques for the express purpose of releasing nursing staff to have “time to care”. It was acknowledged that productivity was more than metrics around bed occupancy and throughput, for example, and that the driving purpose of service improvement was to time to care. Whilst research indicated a nuanced impact, the principle is long recognised. If solutions to these problems were easy, they would have been implemented by now. There is no doubt that on one level, it really is a matter of resources – no system can carry a vacancy factor of around 10% for any length of time without there being an evident impact. However, even within an environment of constrained resources, choices are made every day by caregivers and leaders alike about what receives attention and what is allowed to move into the ‘important but not urgent’ category. That is in no way to blame the hard-pressed caregivers, but instead to indicate that even when it really does not feel like it, every individual has a level of agency. Feeling as though one does not have time to do one’s job is, put simply, unpleasant for all workers but should especially concern us in care environments. The impact on clinical safety and quality is an obvious starting point, but it is also important to recognise the impacts on care workers themselves with regard to emotional labour and the impact on the psychological contract that working in a caring profession, when people feel that they don’t have enough time to care, must have. As eloquently stated by the Vice-President of the Royal College of Physicians in Wales, it is “…very clear that good clinicians, be they nurses, doctors, therapists or pharmacists, need time to train, time to care and time to rest”. Even in challenging times, self-care and compassionate, values driven leadership can make a difference. Caring is everyone’s business. Link to original article: https://www.birmingham.ac.uk/news/2023/healthcare-workers-need-more-time-to-care
  11. News Article
    The use of the private sector to tackle the NHS backlog in England is to be expanded, the government says. Ministers say they want to unlock spare capacity to get more people the treatment and operations they need. This includes opening eight privately-run diagnostic centres and using new rules to make it easier for the NHS to purchase care in the private sector. It comes as a record 7.5 million people are waiting for treatment - three million more than before the pandemic. The private sector already carries out hundreds of thousands of treatments and appointments for the NHS every year. But it has said it has the capacity to carry out about 30% more than it is. Read full story Source: BBC News, 4 August 2023
  12. Content Article
    The Covid-19 public inquiry has been in the news recently, with former Chancellor George Osborne and ex Prime Minister David Cameron denying that austerity policies in the UK before the pandemic weakened how prepared the NHS was for such a crisis. In this blog, published by the Nuffield Trust, Leonora Merry and Sally Gainsbury take a closer look at how true this is.
  13. News Article
    The prospect of waiting at least six weeks for a biopsy was too much for Neil Perkin. In February, the 56-year-old was told that he had suspected prostate cancer which needed to be confirmed by examining a sample of his tissue. “After the initial appointment with the consultant, there were no letters, texts or anything,” Perkin said. Instead, he decided to pay for it himself: £5,000 – a substantial sum for the part-time ferry operator. The results from a private hospital in Guildford confirmed the cancer. “I’d lost faith in the NHS by this point and I went private,” he said. “The cancer was spreading and my surgeon made it clear that if I’d waited for the NHS for my prognosis, [the] chances of cancer recurrence would be far worse.” In May he paid another £22,500 for the prostate to be removed at a private hospital in London, with financial help from his family. “I feel let down. It turned out from the pathology that this was urgent and a delay would have made a huge difference to my outcome, my prognosis and quality of life. They got there in the nick of time.” Portsmouth Hospitals University Trust said it was sorry to have been unable to meet Perkin’s expectations and strived to provide quality and timely care. “But we recognise that across the NHS there is an increased demand on services and this can impact patient waiting times.” Read full story Source: The Guardian, 30 July 2023
  14. News Article
    Soaring numbers of families struggling to care for someone with dementia have hit a “crisis point” with nowhere to turn for help when their loved one puts themselves or others at risk of harm, a charity has said. More than 700,000 people in the UK look after a relative with dementia. Many feel they can no longer cope with alarming situations where they or their relative are at immediate risk of being harmed, according to Dementia UK. Dementia can affect a person’s ability to manage their reactions to difficult thoughts and feelings. This can lead to them experiencing such intense states of distress that they become verbally or physically aggressive, putting themselves and those around them at risk of harm. The charity says carers and their loved ones are being failed because health and social care support services are already stretched to their limit, which has led to a surge in calls to its helpline. Sheridan Coker, the deputy clinical lead at Dementia UK, said: “We’re increasingly being contacted by families who are at risk of harm with no one to turn to. We receive calls where the person with dementia has become so distressed that they have physically assaulted the person caring for them, often a family member." Read full story Source: The Guardian, 31 July 2023
  15. News Article
    A director at a major acute trust said it needs to stop “caving in” to demand pressures by opening extra escalation beds. Board members at Mid and South Essex were discussing a recent report from the Care Quality Commission (CQC), which rated medical services as “inadequate”. The CQC flagged significant staffing shortages and repeated failures to maintain patient records, among other issues. Deputy chair Alan Tobias told yesterday’s public board meeting: “We have just got to hold the line on these [escalation] beds. We never do. Every year we cave in… “We have just got to hold the line with this… Do what some other hospitals do, they shut the doors then. We have never had the bottle to do that.” Barbara Stuttle, another non-executive director, said: “Our staff are exhausted… We don’t have the staff to give the appropriate care to our patients when we have got extra beds. To have extra beds on wards, I know we have had to do it and I know why, [but] you are expecting an already stretched workforce to stretch even further. “And when that happens, something gives. Record keeping, that’s usually the last thing that gets done because they’d much rather give the care to patients.” Read full story (paywalled) Source: HSJ, 28 July 2023
  16. News Article
    A woman treated in a hospital corridor says the lack of privacy was "wholly inappropriate" after other patients saw her without a top. Isabel Aston was taken to Princess Royal Hospital in Shropshire with pneumonia and sepsis and said she spent seven hours on a bed in a corridor. She said she felt exposed when other patients saw her changing her clothes. She explained: "People were walking in both directions [and] there aren't screens around your bed so people wanting the toilet who couldn't get out of bed were faced with the thought of using a bed pan in full view." She added that on feeling hot at one point, she wanted to change her t-shirt, but the process proved lengthy due to cannulas in her arms. "I did not have anything on underneath," she said. "I'm 64 years of age, I've probably reached an age where I'm not so self-conscious perhaps, but that could have been a much younger patient. "That could have been a patient for whom perhaps culturally they couldn't have change their t-shirt... or somebody who had mastectomy scars [and] were very self conscious. "It is wholly inappropriate for patients to be so exposed when they are so ill." The hospital trust said it aimed to maintain patients' dignity despite being under operational pressures. Read full story Source: BBC News, 28 July 2023
  17. Content Article
    New research from Healthwatch shows that people are currently facing multiple cancellations or postponements of care which are having a significant impact on their lives and symptoms, while further increasing health inequalities.   Healthwatch cmmissioned a survey of 1084 people who have seen their NHS care either cancelled or postponed this year to understand the extent of disruption to care amid rising waiting lists, workforce issues, and industrial action, and other pressures on the NHS.  
  18. News Article
    Most NHS staff think they have too little time to help patients and the quality of care the service provides is falling, a survey reveals. Medical and nursing groups said the “very worrying” findings showed that hard-pressed staff cannot give patients as much attention as they would like because they are so busy. In polling YouGov carried out for the Guardian, 71% of NHS staff who have direct contact with patients said they did not have the amount of time they would like to have to help them. A third (34%) felt they had “somewhat less than enough time” and 37% “far less than enough time” than they wanted. Almost a quarter (23%) felt they had the right amount of time while just 3% said they had “more time” than they wanted. The survey presents a worrying picture of the intense pressures being felt at the NHS frontline. Those same personnel were asked if they thought the quality of care the service is able to offer has got better or worse over the last five years. Three-quarters (75%) said “worse”, including a third (34%) who answered “much worse”, while 17% said “about the same” and only 6% replied “better”. Read full story Source: The Guardian, 24 July 2023
  19. News Article
    The Royal College of Nursing (RCN) has said patients are waiting for days in corridors at Belfast's Royal Victoria Hospital's Emergency Department. Rita Devlin, NI director of the RCN, visited the unit on Thursday after getting calls from nursing staff. She described the situation as "scandalous". Speaking to Radio Ulster's Evening Extra programme, Ms Devlin said while it was the Royal Hospital on Thursday, the situation is "bad right across the EDs". She said talking to nurses at the Royal, she was struck by "the absolute despair" some are feeling. "I spoke to some young, newly qualified nurses who are leaving because they just can't take the stress and the pressure any more," she said. Read full story Source: BBC News, 20 July 2023
  20. News Article
    Adults across an integrated care system area are facing ‘unacceptable’ 10-year waits for an NHS assessment for attention deficit hyperactivity disorder, the longest known wait for such services in England. Herefordshire and Worcestershire integrated care board has warned in board papers of “exceptionally high waiting times for ADHD assessment and treatment for Worcestershire patients (10 years+), with workforce challenges and service fragility compromising service delivery”. HSJ understands the long waits for ADHD diagnosis, which is a national problem, is predominately affecting adults with approximately 2,000 people on Herefordshire and Worcestershire’s ADHD list alone. Local provider Herefordshire and Worcestershire Health and Care Trust also warned on its website that its paediatric services were also “experiencing unprecedented demand”. Read full story (paywalled) Source: HSJ, 19 July 2023
  21. News Article
    Children in some areas of England are waiting up to 18 months on average for dental general-anaesthetic treatment and teeth extractions, an investigation reveals. Some have been left with prolonged dental pain, according to information shared with BBC News. The parents of one girl who has waited three years for extractions say the pain keeps her up at night. At the start of this year, more than 12,000 under-18s were on waiting lists for assessment or treatment at community dental service (CDS) providers, data obtained by the Liberal Democrats from the NHS Business Services Authority and shared with BBC News earlier this year reveals. Children are referred to a CDS provider when they have tooth decay too severe to be treated in general practice. They also treat those with physical or learning disabilities when general practice is not a practical option. The longest average wait faced by children for general-anaesthetic treatment at a CDS provider is 80 weeks, at Harrogate and District NHS Foundation Trust. Read full story Source: BBC News, 19 July 2023
  22. News Article
    A14-year-old girl could lose the ability to walk after her brain surgery was cancelled three times as NHS children’s services are stretched to breaking point. Piper Miller, who has severe autism, needs urgent surgery to remove fluid on her brain that if unaddressed could also leave her unable to control her bladder. But her operation has been pushed back three times in the past month due to emergency operations taking priority and severe short staffing made worse by junior doctors’ strikes. Her mum, Toni Milner said the delays had had a “heartbreaking and gut-wrenching” effect on her daughter whose anxiety is “sent through the roof” each time she is told she is not having her surgery. Piper’s story comes as NHS data uncovered by The Independent reveals at least 340 life-saving children’s operations, such as transplant and lung surgery, were shelved from April to December 2022, while 763 emergency operations were refused due to a lack of intensive care beds. Read full story Source: The Independent, 16 July 2023
  23. News Article
    Children with suspected ADHD and autism are waiting as long as seven years for treatment on the NHS, as the health service struggles to manage a surge in demand during a crisis in child mental health. Experts said “inhumane” waits are putting a generation of neurodiverse children at risk of mental illness as they are “pushed to the back of a very long queue” for children and adolescent mental health services (Camhs). UK children with suspected neurodevelopmental conditions faced an average waiting time of one year and four months for an initial screening in 2022, more than three times longer than the average wait for all Camhs services, according to research carried out by the House magazine and shared with the Guardian. Half of all trusts responding to a freedom of information request had an average wait of at least a year, and at one-sixth of trusts it was more than two years. The NICE guidance for autism and mental health services stipulates that no one should wait longer than 13 weeks between being referred and first being seen. Read full story Source: The Guardian, 17 July 2023 Related reading on the hub: Long waits for ADHD diagnosis and treatment are a patient safety issue
  24. Content Article
    NHS urgent and emergency care is under intolerable strain. This strain is increasingly causing harm to patients. Timely and high quality patient care is often not being delivered due to overcrowding driven by workforce and capacity constraints. While the covid-19 pandemic has accentuated and arguably expedited the crisis; the spiral of decline in urgent and emergency care has been decades long and unless urgent action is taken, we may not yet have reached its nadir, writes Tim Cooksley and colleagues in this BMJ opinion article.
  25. Content Article
    “Crisis,” “collapse,” “catastrophe” — these are common descriptors from recent headlines about the NHS in the UK. In 2022, the NHS was supposed to begin its recovery from being perceived as a Covid-and-emergencies-only service during parts of 2020 and 2021. Throughout the year, however, doctors warned of a coming crisis in the winter of 2022 to 2023. The crisis duly arrived. In this New England Journal of Medicine article, David Hunter gives his perspective on the current state of the NHS.
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