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Found 963 results
  1. News Article
    The NHS is on the verge of collapse due to demand for healthcare rising significantly faster than funding levels, a consultant has warned. Peter Neville, a consultant for NHS Wales, took to social media to explain why, in his view, the system is failing. The consultant physician, who has been working in the NHS in Yorkshire and Wales for 32 years, set out the challenges facing the health service in a Twitter thread. He said he had experienced the NHS at its best, in 2008, and its worst, in 2022. He wrote: "Over at least the past 15 years, we have seen a relentless increase in demand, both in primary care and in hospital care. This has been absolutely predictable by social statisticians for decades and is based on the fact that our elderly are surviving much longer. "Our elderly use a very large percentage of NHS of resources, unsurprisingly because they are more prone to disease, frailty, and dementia. They need more social care and hospital care as they get older. And they are living longer. (Immigrants, by the way, use much less care). "Over this period NHS funding has, broadly speaking, risen about 1-2% over inflation. If NHS funding increases with inflation yet demand increases, then clearly spend per person will drop. Demand has increased considerably above 2%, which is why the NHS is failing to manage it." Read full story Source: Wales Online, 3 January 2023
  2. News Article
    More and more older people are being “warehoused” in inappropriate care beds, condemned unnecessarily to long-term care, and “lost” to health and care services, due to the rush to discharge from full hospitals and a lack of community rehab services, leaders have warned. Several senior figures in community and social care have raised the issue with HSJ, warning it has been a growing concern over the past 18 months of severe system pressure following on from acute covid peaks. The Health and Safety Investigation Branch has also raised the issue, telling HSJ inappropriate care placements are leading to harm and readmissions, while a major accountability gap remained over the safety of discharges. The average length of hospital stay has increased compared to pre-Covid, with a big jump in those staying more than three weeks. Many in the NHS put this down to a lack of social care capacity meaning more medically fit people are stuck in hospital. Senior staff in community health and social care services told HSJ hospitals were increasingly demanding rapid discharges, often as part of “surge” measures when they are very full and under pressure to reduce ambulance queues. Homecare cannot be organised, and with suitable step-down and care beds also full, trusts are instead “spot purchasing” space in unsuitable homes which may be a long journey from the person’s home area, and in a different council area. Read full story (paywalled) Source: HSJ, 5 January 2023 Further reading HSIB interim bulletin - Harm caused by delays in transferring patients to the right place of care
  3. News Article
    A man turned up to an accident and emergency department in the Midlands complaining about ear wax on the day a hospital declared a critical incident, a nurse who works there has said. Lesley Meaney, a sister at University Hospitals of North Midlands (UNHM), said the patient presented to A&E with “no pain, no discomfort, just eat war wax!” Earlier on 30 December officials at the trust declared a critical incident, citing “extremely high demand for all of our services.” The disclosure by Ms Meaney underlines the scale of the challenge facing the NHS and staff working in hospitals across the country. Writing on Twitter, Ms Meaney added: “Seriously what is up with the general population? A major incident declared, ambulances queuing, and you decide to come to the emergency department on New Year’s Eve with ear wax.” Dr Matthew Lewis, medical director at UNHM, said: “The accident & emergency departments at UHNM are some of the busiest in the country so we would urge the public to only come to our Emergency Departments if it’s for serious, life-threatening conditions that need immediate medical attention, such as persistent severe chest pain, loss of consciousness, acute confusion, severe blood loss, serious burns, broken bones, suspected stroke. Read full story Source: The Independent, 4 January 2023
  4. News Article
    Care workers are taking as little as three minutes to help vulnerable people in their own homes, the social care ombudsman has found, after discovering a council was allocating extremely short visits to hundreds of people. Amid chronic staff shortages and rising unmet care needs nationwide, a homecare worker commissioned by Warrington borough council sometimes stayed for just three minutes, despite the family paying for the full visit. The council was found to have allocated 15-minute care calls to more than 300 people in the region, despite national guidance stressing these were “not usually appropriate”. The Homecare Association, which represents care providers, said the number of short calls being commissioned was increasing more widely and said “15-minute visits are inappropriately short”, result in inadequate care and are stressful for workers placed under “unfair pressure”. The case that triggered the investigation involved a woman with dementia who was paying the full costs of her care under a plan devised by the council. In 15 minutes two agency care workers were expected to wake her, prepare a meal and a drink, ensure she ate and drank, administer her medication, change her incontinence pad, administer any personal care and tidy the kitchen. Electronic monitoring showed they regularly stayed less than 15 minutes and the ombudsman said it was probable her care needs were not met and her care was not dignified. Read full story Source: The Guardian, 5 January 2023
  5. News Article
    When Steve Parsons's grandfather collapsed at his Monmouthshire home, his family immediately dialled 999. However when they were told there were no ambulances available, they had to take measures into their own hands. In desperation, Mr Parsons drove and then carried the 83-year-old, who had suffered a cardiac arrest, into the Grange Hospital near Cwmbran, Torfaen. Aneurin Bevan University Health Board (ABUHB) and Welsh Ambulance Service Trust (WAST) admitted the incident did not match the service they wished to offer - but said it was indicative of the "unprecedented" pressures both organisations were under. Mr Parsons said: "It was horrible. They're on the phone, you're there and he's grey in the face and looks horrendous. You just panic." By the time Mr Parsons drove to the hospital, his grandfather had gone into cardiac arrest. He then carried his relative on his shoulder across the car park "yelling for help". A passing nurse heard his calls and was able to help save the 83-year-old's life using CPR. His grandfather is now recovering at Nevill Hall Hospital in Abergavenny, but Mr Parsons said his family has been traumatised. "It makes me feel angry," said the 31-year-old. "If my grandfather had that ambulance, had that oxygen, I fully believe he wouldn't have gone into cardiac arrest and my family wouldn't have gone through what they've gone through these past seven days." Read full story Source: BBC News, 4 January 2023
  6. News Article
    Paramedics will only wait with patients for 45 minutes before leaving them on a trolley in A&E, one ambulance trust has said. One in five ambulances are waiting at least an hour outside accident and emergency departments to hand over patients, the latest data show, despite NHS standards stating it should only be 15 minutes. Now, London Ambulance Service (LAS) leaders have told hospitals their staff will only remain with patients for a maximum of 45 minutes for handover due to “the significant amount of time being lost” waiting in A&E departments. A leaked letter, seen by ITV News, from the LAS said: "From January 3 we are asking that any patients waiting for 45 minutes for handover... are handed over immediately to ED (emergency department) staff allowing the ambulance clinicians to leave and respond to the next patient waiting in the community. "If the patient is clinically stable the ambulance clinicians will ensure the patient is on a hospital trolley or wheelchair/chair and approach the nurse in charge of the emergency department to notify them that the patient is being left in the care of the hospital and handover the patient." The email added that if the patient was not clinically stable, ambulance crews would stay with the patient until handover is achieved but added that the clinical responsibility for the patient lied with the hospital. Read full story (paywalled) Source: The Telegraph, 3 January 2023
  7. News Article
    Managers in an NHS area are considering using "field hospitals" to deal with the surge in patients. Sarah Whiteman, chief medical director of the Bedfordshire, Luton and Milton Keynes Integrated Care Board told colleagues the use of tents was a "real possibility". In an email, she also asked colleagues to sign temporary contracts to work in emergency departments. The board said the use of tents in hospital grounds was not imminent. Dr Whiteman's email, obtained by The Sunday Times and seen by the BBC, began with the statement: "Call to arms". It emphasised how busy the acute units were within her board's operational area, including Bedford, Milton Keynes and Luton and Dunstable Hospitals. In the message, she promised staff would receive training and induction if they stepped forward to support colleagues. Read full story Source: BBC News, 4 January 2023
  8. News Article
    A combination of Covid, flu, and Strep A has seen more than a dozen trusts and ambulance services declare critical incidents in recent days. NHS patients are sleeping in their cars outside hospitals, as the chaos engulfing the health service is set to last until Easter. Some 13% of hospital beds in England are filled with people with Covid or flu, NHS England figures show, with the treatment backlog also at a record high of 7.2 million. But Matthew Taylor, the chief executive of the NHS Confederation, which represents health service managers, said no reprieve is expected until April. "It seems likely that the next three months will be defined by further critical incidents needing to be declared and the quality of care being compromised," he told the Guardian. Read full story (paywalled) Source: The Telegraph, 3 January 2023
  9. News Article
    The crisis engulfing the NHS will continue until Easter, health leaders have warned, as senior doctors accused ministers of letting patients die needlessly through inaction. More than a dozen trusts and ambulance services have declared critical incidents in recent days, with soaring demand, rising flu and Covid cases and an overstretched workforce piling pressure on the health service. But amid warnings that up to 500 people a week may be dying due to delays in emergency care alone, and of oxygen for seriously ill patients running out in parts of England, NHS leaders warned more chaos was expected until April. “It seems likely that the next three months will be defined by further critical incidents needing to be declared and the quality of care being compromised,” said Matthew Taylor, chief executive of the NHS Confederation, which represents the whole healthcare system in England, Wales and Northern Ireland. Ministers face growing pressure to grip the crisis. The British Medical Association (BMA) said the government’s “deafening” silence and failure to act was a “political choice” that was leading to patients “dying unnecessarily”. The Liberal Democrats urged the government to recall parliament, while Labour blamed government “mismanagement” for creating a sense of “jeopardy” around the NHS. Read full story Source: The Guardian, 2 January 2022
  10. News Article
    The number of children in England needing treatment for serious mental health problems has risen by 39% in a year, official data shows. Experts say the pandemic, social inequality, austerity and online harm are all fuelling a crisis in which NHS mental health treatment referrals for under-18s have increased to more than 1.1m in 2021-22. In 2020-21 – the first year of the pandemic – the figure was 839,570, while in 2019-20 there were 850,741 referrals, according to analysis of official figures by the PA Media. The figures include children who are suicidal, self-harming, suffering serious depression or anxiety, and those with eating disorders. Dr Elaine Lockhart, chair of the child and adolescent psychiatry faculty at the Royal College of Psychiatrists, said the rise in referrals reflected a “whole range” of illnesses. She said “specialist services are needing to respond to the most urgent and the most unwell”, including young people suffering from psychosis, suicidal thoughts and severe anxiety disorder. Lockhart said targets for seeing children urgently with eating disorders were sliding “completely” and that more staff were needed. Read full story Source: The Guardian, 3 January 2023
  11. News Article
    The government should declare a national NHS major incident to rescue the healthcare system from the current crisis, a senior health official says. Dr Tim Cooksley, president of the Society for Acute Medicine (SAM), says that the pressures on the NHS seen over the festive period are not new. He added that a number of recommendations had been outlined since the pandemic that offer the “best hope” of a short-term solution. Declaring a national NHS major incident would mean all four UK nations would co-ordinate their response and allocate resources to help meet the overwhelming demand for care that is enveloping many hospitals around the country. Taking that step would help combat the current situation, Dr Cooksley says, which NHS chiefs believe is having a similar effect on the service to the first wave of the Covid-19 pandemic. “The current situation in urgent and emergency care is shocking. It is in a critical state for patients and it is an extremely difficult for healthcare staff who are unable to deliver the care they want to," Dr Cooksley said. “Political leaders across the UK need to listen, meet urgently and accept the need to declare a national NHS major incident. "The outcome must be a four-nation emergency strategy which results in short-term stabilisation, medium-term improvement and long-term growth – the grave situation we are in means it will be a long journey. Sustainable workforce and capacity plans are required urgently to boost morale among staff and patients – as we have long called for – and we now need to see action.” Read full story Source: Manchester Evening News, 1 January 2022
  12. News Article
    Up to 500 people are dying every week because of delays in emergency care, Britain’s top accident and emergency doctor has said. Dr Adrian Boyle, the president of the Royal College of Emergency Medicine (RCEM), said a bad flu season was compounding systemic problems, leading to hundreds of unnecessary deaths. NHS leaders warned last week that the health service is in the grip of a “twindemic”, with soaring flu admissions and the impact of Covid “hitting staff hard”. Dr Boyle told Times Radio: “If you look at the graphs they all are going the wrong way, and I think there needs to be a real reset. We need to be in a situation where we cannot just shrug our shoulders and say this winter was terrible, let’s do nothing until next winter. “We need to increase our capacity within our hospitals, we need to make sure that there are alternative ways so that people aren’t all just funnelled into the ambulance service and emergency department. We cannot continue like this – it is unsafe and it is undignified.” Read full story Source: The Telegraph, 1 January 2023
  13. News Article
    Hundreds of thousands of children have been left waiting by the NHS for the developmental therapies they need, with some waiting more than two years, The Independent can reveal. The long waiting lists for services such as speech and language therapy will see a generation of children held back in their development and will “impact Britain for the long haul”, according to the head of the Royal College of Paediatrics and Child Health (RCPCH). More than 1,500 children have been left waiting for two years for NHS therapies, according to internal data obtained by The Independent, while a further 9,000 have been waiting for more than a year. The total waiting list for children’s care in the community is 209,000. Dr Camilla Kingdon, president of the RCPCH, told The Independent: “The extent of the community waiting lists is extremely alarming. Community health services such as autism services, mental health support and speech and language therapy play a vital role in a child’s development into healthy adulthood, and in helping children from all backgrounds reach their full potential. “A lack of access to community health services also has direct implications for children and families in socio-economic terms. Delays accessing these essential services can impact social development, school readiness and educational outcomes, and further drive health inequalities across the country.” She said health and care staff are working immensely hard, but that without support they will struggle to address the long delays, which will “impact Britain for the long haul”. Read full story Source: The Independent, 26 December 2022
  14. News Article
    Ambulance staff in five areas of England are to stage two further strikes in January, union leaders say. The industrial action on 11 and 23 January is likely to heap more pressure on emergency care, which is already under serious strain. Health Secretary Steve Barclay said further strike action was in no one's best interest. Unison leaders say the action is a direct result of the government's refusal to negotiate over pay. Life-threatening calls to 999, as well as the most serious emergency calls, will still be responded to, they say. Services in London, Yorkshire, the North West, North East and South West will take action over pay and staffing. The January strikes will each last for 24 hours from midnight, Unison says, and will involve all ambulance employees - not just 999 response crews. Read full story Source: BBC News, 22 December 2022
  15. News Article
    The NHS entered the last six hours of the ambulance strike with a sense that the real test will be seen in the coming days. Call volumes were down and many A&Es quieter than in previous days. NHS111 was very busy. Despite the fears expressed by leaders ahead of the strike not yet coming to fruition, the day ended with eight integrated care systems declaring critical incidents, along with all striking ambulance trusts and a number of hospital trusts. Leaders across the country told HSJ they feared that those who stayed away today in response to pleas for “common sense” amid industrial action may come back tomorrow, seeing demand return strongly. A senior London source said: “The ambulances will have stacked some calls and we may have a flood of movement tomorrow.” Read full story (paywalled) Source: HSJ, 21 December 2022
  16. News Article
    The Welsh ambulance service has apologised after a 93-year-old woman was left “screaming in pain” while lying on the floor with a broken hip during a 25-hour ambulance wait. Elizabeth Davies fell at her care home on Saturday and was finally picked up at 1.15pm on Sunday and admitted to Ysbyty Gwynedd hospital in Bangor on Monday, where she endured another 12-hour wait before being admitted to a ward. A hip fracture was later confirmed in surgery. Her family have said the incident, which occurred before a 24-hour strike on Wednesday by ambulance workers, was “unacceptable”. Her son, Ian Davies, from Pwllheli, said: “It was very upsetting to have to see her lying on the floor screaming in pain for over 24 hours.” After her injury, staff at the care home, where Davies has lived for 17 years, are understood to have propped a pillow under her head and tried to make her comfortable on the wooden floor, using a small heater to keep her warm in case she went into shock, as well as providing an absorbent pad so she could urinate. Her son, a community care worker, said: “They called for an ambulance but were advised an ambulance wouldn’t be available for six to eight hours as they were so busy. “They said my mother would be a priority because of her age. The care home then called us and we came immediately. “I don’t blame the ambulance staff because they are told what jobs to do and my mother wasn’t on the list.” It is understood the care home made nine calls, with a 10th made by Ian Davies. Read full story Source: The Guardian, 20 December 2022
  17. News Article
    The mother of a sick girl has confronted the health secretary during a hospital visit in London, telling him that NHS staff are “worked to the bone” and the government is doing “terrible damage” to families on waiting lists. Sarah Pinnington-Auld, whose three-year-old daughter, Lucy, has cystic fibrosis, rebuked Steve Barclay over NHS staff working conditions and long waits for treatment as he visited King’s College hospital. She told the Conservative cabinet minister how her daughter was pushed off an “absolutely horrific” waiting list because of “the obscene number of people who came through and the lack of resources”. “The damage that you’re doing to families like myself is terrible, because it was agony for us as a family waiting for that call,” she said. “Preparing our children, for their sister and her hospital visit, for then it to be cancelled. And I know you look and we’re all numbers, but actually they’re people waiting for care.” “The doctors, the nurses, everyone on the ward is just brilliant, considering what they’re under, considering the shortage of staff, considering the lack of resources,” she said. “That’s what’s really upsetting, actually, because we have a daughter with a life-limiting, life-shortening condition and we have some brilliant experts and they’re being worked to the bone, and actually the level of care they provide is amazing, but they are not being able to provide it in the way they want to provide it because the resourcing is not there.” Read full story Source: The Guardian, 19 December 2022
  18. News Article
    Some patients waiting for an endoscopy in Guernsey may be "at risk" because of a large backlog in procedures, the States medical director has warned. The government has announced a tender process to bring in clinicians to help clear the list, which is three times longer than before the Covid pandemic. More than 430 people were on the gastroenterology waiting list as of Tuesday, Dr Peter Rabey said. "We're worried that there is risk to patients in waiting too long," he said. "Although a lot of patients who get an endoscopy have completely normal results, and some have benign disease which can be treated with tablets and things, there will be some patients who might have cancer and we need to find out as best as possible". Read full story Source: BBC News, 20 December 2022
  19. News Article
    Nine ambulance trusts in England and Wales are expected to be affected by industrial action on Wednesday, coordinated by the GMB, Unison and Unite unions. The ambulance strikes will involve paramedics as well as control-room staff and support workers. The threat to patient safety on Wednesday will be exceptional. Under trade union laws, life-preserving care must be provided during the strikes. But there remains a lack of clarity about what will be offered. Even at this late stage, NHS leaders say negotiations are continuing between unions and ambulance services to agree which incidents will be exempt from strike action. All category 1 calls – the most life-threatening cases – will be responded to, while some ambulance trusts have agreed exemptions with unions for specific incidents within category 2 calls. However, in some cases, elderly people who fall during the strikes may not be sent help until they have spent several hours on the floor. Heart attack and stroke patients may get an ambulance only if treatment is deemed “time critical”. There is no doubt that many of those patients making 999 calls on Wednesday will not get the care they need. Some will probably die as a result. NHS leaders believe Wednesday’s strike will present a completely different magnitude of risk. Quite simply, patients not getting emergency treatment quickly enough can mean the difference between life and death. Read full story Source: The Guardian, 19 December 2022
  20. News Article
    Unions must ensure there will be "sufficient" staffing during this week's ambulance strike to protect patients, the health secretary says. Workers in England and Wales will walk out on Wednesday in a dispute over pay, but life-threatening emergencies will be responded to. Unions say discussions were still taking place with ambulance trusts to draw up detailed plans for cover. Steve Barclay said there is a lack of clarity about what is being offered. He said it was for the unions to ensure they "meet their obligations" for emergency cover so that people in crisis get the care they need. But Unite leader Sharon Graham, whose union is co-ordinating the ambulance strikes with Unison and GMB, said Mr Barclay will "have to carry the can if patients suffer". The ambulance walkouts will involve paramedics as well as control room staff and support workers. The action by the three main ambulance unions - Unison, GMB and Unite - will affect non-life threatening calls, meaning those who suffer trips, falls or other injuries may not receive treatment. Read full story Source: BBC News, 19 December 2022
  21. News Article
    Patients are not safe from harm in three out of seven emergency departments, a damning new Hiqa inspection report has revealed. The report was released on the same day as an Oireachtas committee was warned of a growing crisis in primary care, with patients in some parts of the country unable to access basic GP services. Emergency Departments in Cork University Hospital (CUH) and University Hospital Limerick (UHL) were among seven EDs assessed by the health watchdog. In three EDs, including Cork and Limerick, inspectors found failures to ensure “service providers protect service users from the risk of harm.” Inspectors also found patients’ “dignity, privacy and autonomy” was not respected in UHL, while CUH was only partially compliant in this area. The report also highlighted lengthy waiting times, including one patient who spent 116 hours on a trolley at UHL. Read full story Source: The Irish Examiner, 15 December 2022
  22. News Article
    Three more children have died from strep A, it has emerged, and pharmacists in the UK have been told they can supply alternative antibiotics to those originally prescribed, in a bid to ease shortages of certain forms of penicillin. The UK Health Security Agency (UKHSA) data shows at least 19 children have now died across the UK, while there are 7,750 cases of scarlet fever so far this season. This is more than treble the 2,538 at the same point in the year during the last comparably high season in 2017 to 2018. The Department of Health and Social Care (DHSC) has issued serious shortage protocols (SSPs) for three penicillin medicines amid increased demand for the antibiotics. Pharmacists and GPs in the UK have faced serious difficulties in securing supplies of penicillin and amoxycillin, antibiotics used to treat infections including strep A. As a result, parents have reported having to visit a string of pharmacies to obtain medicines prescribed for their sick children, while the price of some antibiotics has risen sharply – a situation pharmacists say has left them facing losses. The health minister Will Quince said: “The increased demand for the antibiotics prescribed to treat strep A has meant some pharmacists have been unable to supply the medicine shown on the prescription. “These serious shortage protocols will allow pharmacists to supply an alternative form of penicillin, which will make things easier for them, patients, and GPs. “We are taking decisive action to address these temporary issues and improve access to these medicines by continuing to work with manufacturers and wholesalers to speed up deliveries, bring forward stock they have to help ensure it gets to where it’s needed, and boost supply to meet demand as quickly as possible.” Read full story Source: The Guardian, 15 December 2022
  23. News Article
    Elderly people who fall may only be sent an ambulance after they have spent four hours on the floor, and some category 2 calls may not be responded to under one of the first agreements with ambulance unions about next week’s strikes. But the deal between South East Coast Ambulance Service and the GMB union will see many union staff continue to work on ambulances and in control rooms – and others may be asked to come off the picket line if operational pressures escalate. HSJ has seen the details of the deal – thought to be one of the first agreed before next Wednesday’s strike. Some other trusts are hoping to conclude negotiations shortly, but for several — such as in the North West and London — it is thought no strike “derogations” (exceptions) have so far been agreed, and managers are concerned that unions are resistant. Trusts have been pushing for more cover on strike days – especially around category 2 calls. Read full story (paywalled) Source: HSJ, 15 December 2022
  24. News Article
    Nearly 8,900 more people have died of cancer than expected in Britain since the start of the pandemic, amid calls for the Government to appoint a minister to deal with the growing crisis. In an essay in The Lancet Oncology, campaigners and medics said the upward trend of cancer deaths is likely to continue, with 3,327 in the last six months alone. They urged the Government to tackle the crisis with the same focus and urgency given to the Covid vaccine rollout, and called for a cancer minister to get on top of the backlog. NHS data from November showed that in the last 12 months, 69,000 patients in the UK have waited longer than the recommended 62-day wait from suspected cancer referral to start of treatment. Professor Gordon Wishart, a former cancer surgeon and chief medical officer of Check4Cancer, said: “The Covid-induced cancer backlog is one of the deadliest backlogs and has served to widen the cracks in our cancer services". “Now we face a deadly cancer timebomb of treatment delays that get worse every month because we don’t have a sufficiently ambitious plan from policymakers. I urge the Government to work with us.” Read full story (paywalled) Source: The Telegraph, 15 December 2022
  25. News Article
    Pharmacists say supplies of key antibiotics to treat strep A have "gone from bad to worse" in the past week. The Association of Independent Multiple Pharmacies (AIMP) said the situation was "unacceptable" and it was time for the government to get a plan in place. Four antibiotics, which treat different conditions, have been added to a list of products that the UK cannot export. The UK government says it is working urgently with manufacturers and wholesalers to speed up deliveries. However, Leyla Hannbeck, chief executive of the AIMP, which represents 4,000 pharmacies in the UK, said the supply of antibiotics to treat bacterial infections including strep A and scarlet fever was "very poor". She said the problem had been highlighted a week ago, but it was now getting worse, making it very difficult to get hold of any antibiotics. "People are having to go from one pharmacy to another - it's chaos," she said. "Supplies are not coming through to us and it feels like no-one cares." Read full story Source: BBC News, 14 December 2022
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