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Content ArticleThe health service needs to develop innovative ways of treating an increasingly elderly and frail population, while harnessing new technology to help mitigate the staffing crisis. As part of the Times Health Commission, this article outlines some potential solutions — encompassing new ways of working and regulation to promote healthier lifestyles — to some aspects of the health and social care crisis in the UK.
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Content ArticleYoung people and expert mental healthcare staff say patients are unlikely to receive in-patient mental health care unless they “have attempted suicide multiple times”, according to a new report published by Look Ahead Care and Support. Launched in the House of Lords, the report – funded by Wates Family Enterprise Trust and produced by experts Care Research – argues Accident and Emergency departments have become an ‘accidental hub’ for children and young people experiencing crisis but are ill-equipped to offer the treatment required. Based on in-depth interviews with service users, parents and carers, and NHS and social care staff from across England, the findings from the Look Ahead Care and Support report draws on experience of treating depression, anxiety, self-harm, suicidal thoughts and suicide attempts, eating disorders, addiction and psychosis.
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Content ArticleThis research by the Nuffield Trust looked at how smaller hospitals have fared over the pandemic. Smaller hospitals are sometimes overlooked when system planning gets done, so this report focuses on the operational responses and management approaches taken by staff from 10 smaller hospitals over the course of the first and second waves of the pandemic. It aims to tell the stories of those working in small hospitals in order to understand what happened to acute and emergency care in these institutions during the pandemic. The authors interviewed staff in smaller hospitals around the country during 2021 to understand their key concerns. The report makes a set of recommendations for future crisis planning and response.
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Content ArticleWith the NHS under relentless pressure this winter and as records keep getting broken for all the wrong reasons, Helen Buckingham takes a closer look at why hospitals are so full, and emphasises the importance of supporting and helping the health service’s staff.
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Content ArticleIn this letter to Steve Barclay MP, Secretary of State for Health and Social Care, the chair and chief executive of the Patients Association, Sir Robert Francis and Rachel Power, raised their concerns about how the Government is dealing with the growing crisis in health and social care. The letter asked him to declare a national incident in the NHS and to publish solutions to the current crisis, developed with patients and carers. The letter also asked the Minister to publish the long-term workforce plan and includes an offer from the Patients Association to work with the Department for Health and Social Care (DHSC).
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Content ArticleIn this article, Richard Murray, Chief Executive of The King's Fund, reflects on what 2023 has in store for the health and care system in England. Acknowledging the intense pressure all services are currently under, he highlights that patients aren't currently receiving the care they need meaning that coping with operational challenges is going to dominate the early part of the year for the health and care sector. He warns of the futility of the Government adding new performance management measures to the sector, and expresses hope that Integrated Care Boards (ICBs) could make a difference by bringing together stakeholders to tackle longer-term problems such as integration, population health and inequalities.
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Content ArticleIn this article, published by BMJ Opinion, author David Raven says: "Emergency care staff have been working under the shadow of a slow moving catastrophe for years". David, emergency medicine consultant and divisional director of urgent care, provides several examples of data and high level concerns raised that attempted to forewarn of these dangers. He argues that blaming Covid and high levels of flu for the pressures provides a false narrative to the reality and that the relentless hard work of staff is not enough to compensate for the challenges they face in what he says is a dysfunctional system.
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Content ArticleThis BMJ Opinion piece is written by Chris Ham (in a personal capacity)who was chief executive of The King’s Fund from 2010 to 2018. Chris talks about the recent funding announcement to support hospital discharges in order to free up bed space. He highlights a number of key considerations including: the impact on patient involvement in their discharge decisions staff shortages in care homes bed capacity in care homes. Chris questions whether these decisions are 'symbolic policy making' or whether they will actually make a difference to patients.
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Content ArticleAs the NHS crisis has deepened in recent weeks, frontline staff have posted vivid, troubling accounts on social media of what has been happening in their workplaces. Many have described the NHS, and often themselves too, as “broken”. They have related the difficulty of providing proper care, the impact of acute understaffing and their fears for the NHS’s future. In this Guardian article, read some of what doctors, nurses and other NHS staff have been saying.
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Content ArticleThe NHS saved William Fear's life and inspired him to change career. But when William started as a healthcare assistant on a hospital ward for older patients, it was clear how bad things had got. This is his story, told to the Guardian, of a typical shift
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Content ArticleHospitals are crammed full of patients, the staffing crisis in adult social care continues to escalate, and alarming numbers of junior doctors report that they are planning to quit their NHS posts to work abroad. The multiple problems confronting the UK’s health and care system are interconnected and have been years in the making. While the pandemic exacerbated many of them, hugely increasing pressures on staff, political failures and, above all, a lack of investment are making it impossible for the service to stand still this winter – let alone recover. This Guardian Editorial gives its view on the current state of the NHS.
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Content ArticleCrammed wards, burned-out GPs, patients waiting hours for ambulances – the health service is at breaking point. The Guardian journalists, Andrew Gregory and Denis Campbell, take a look at the current NHS situation.
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Content ArticlePatients are facing increased delays at almost every stage of their NHS treatment, as the health system struggles to find the resources to deal with demand. The latest data shows waiting lists across England have surpassed record highs every month for two years running, one of many major challenges currently facing the NHS. But what impact does this have on ordinary people trying to access the NHS in 2022? Through a combination of interviews with health professionals and analysis of official data, the Guardian has plotted the journeys of four fictional patients through their NHS journey and how waiting times have changed at each stage of their treatment and recovery.
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Content ArticleThis report provides an overview of the findings of Ireland's Health Information and Quality Authority (HIQA)’s monitoring programme against the national standards in emergency departments in 2022. Throughout 2022, HIQA commenced a new monitoring programme of inspections in healthcare services against the National Standards for Safer Better Healthcare. As part of the initial phase, HIQA’s core assessment in emergency departments focused on key standards relating to governance, leadership and management, workforce, person-centred care and safe and effective care. The report highlights, HIQA has identified key areas for both immediate and longer-term attention to address safety issues in our emergency departments.
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Content ArticleFor decades, western Europe’s national healthcare systems have been widely touted as among the best in the world. But an ageing population, more long-term illnesses, a continuing recruitment and retainment crisis plus post-Covid exhaustion have combined, this winter, to create a perfect healthcare storm that is likely to get worse before it gets better, writes Jon Henley (Berlin), Kate Connolly (Berlin), Sam Jones (Madrid) and Angela Giuffrida (Rome) in this Guardian article.
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Content ArticleIn the face of record high waiting times for elective care, The King's Fund undertook research to understand the strategies that have been used to reduce waiting times in England and elsewhere in the past 20 years. Elective care waiting lists and waiting times are a product of the fluctuations in and disparities between the demand for and available supply of healthcare. Understanding the root causes of these disparities and taking corrective action to restore balance between demand and supply and optimising the conditions within the health care system is therefore considered key to any strategy to reduce waiting times and sustain them at that level.
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Content ArticleThis briefing paper, from the Royal College of Radiologists, was produced to help inform an adjournment debate in the house of commons focusing on pulmonary embolism misdiagnosis. The briefing highlights concerns around staffing gaps, workforce planning and equipment shortages within this area, and the threat this poses to patient safety.
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Content ArticleBehind the outcry about waiting times lies the anxiety that our cherished GP system will, in the words of one Gloucester doctor, ‘soon reach a threshold where there is a collapse’. We witness life on the frontline in this Guardian article.
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Content ArticleThis analysis by The Health Foundation looks at NHS staff pay over the ten years to 2021. During those 10 years, there was very little change in overall average basic pay for NHS staff, after accounting for inflation. However, the analysis found considerable variation in how pay has changed across different NHS staff groups over the same period. After accounting for inflation, pay declines are particularly visible for nurses and health visitors, midwives, and scientific, therapeutic and technical staff.
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Content ArticleLetter from Mike Prentice, NHS England’s national director for emergency, planning and incident response, to hospitals and other care providers ahead of talks with the Royal College of Nursing later this week on the industrial action from nurses. At that meeting they will try to agree what areas of care will be hit on Thursday 15 and Tuesday 20 December, and which will continue as normal because they are covered by “derogations” – agreed exemptions to the action.
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Content ArticleThis article looks at the potential to use the continuous flow model to tackle unprecedented levels of overcrowding in emergency departments. The continuous flow model, also known as full capacity protocols, was first introduced in North America in the late 1990s. It mandates that a set number of patients are moved at set times from the emergency department to inpatient wards, regardless of whether a bed is available. This might mean putting an extra patient in a bay or two patients in a side room or boarding them in hospital corridors. In turn, this encourages wards to discharge existing patients, allows ambulances to offload new patients in the space created in the emergency department, and relieves pressure on the whole system. This article looks at the fact that evidence to support the continuous flow model is scarce, although positive, and that there are a number of important factors to consider before implementing the model, to ensure that it does not result in increased patient harm.
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Content ArticleThis letter from Dr Robert Farley, President of the Institute of Physics and Engineering in Medicine (IPEM) to Karen Reid, the Chief Executive Officer of NHS Education for Scotland (NES) highlights that lack of funding for Clinical Scientist training places is putting patient safety in Scotland at risk. Dr Farley says, "We understand NHS Education for Scotland are proposing funding that equates to less than a single training post in medical physics and clinical engineering in 2023. ‘This is despite the Scottish Government's Chief Healthcare Science Officer’s public acknowledgement of the importance of training. "Scotland currently has a 10 per cent Clinical Scientist vacancy rate across the medical physics specialisms. This equates to seven vacancies in radiotherapy, three in nuclear medicine, four in diagnostic radiology and radiation protection. These posts are critical to supporting diagnostics and cancer treatments."
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News Article
‘It feels very unsafe’: the NHS staff bracing for winter as cuts loom
Patient Safety Learning posted a news article in News
Further funding cuts to the NHS will unavoidably endanger patient safety, an NHS leader warned last week after the chancellor’s promise of spending cuts of “eye-watering difficulty”. Matthew Taylor, the chief executive of the NHS Confederation, said his members were issuing the “starkest warning” about “the huge and growing gulf between what the NHS is being asked to deliver and the funding and capacity it has available”. The warning came as figures showed that paramedics in England had been unavailable to attend almost one in six incidents in September due to being stuck outside hospitals with patients. Service leaders say wait times for A&E and other care are being exacerbated by an acute lack of nurses, with a record 46,828 nursing roles – more than one in 10 – unfilled across the NHS. "Patients are presenting more unwell," says a GP from South Wales, "Wait times in A&E have become unmanageable, so we’re seeing patients who have waited so long to be seen they’re bouncing back to us. Things we can’t deal with, like injuries and chest pain. We tell them they have to go back to A&E. "Abuse of surgery reception and admin staff began last year and it’s just scaled up from there. We’ve had staff members who have been verbally and physically threatened and we’re struggling to recruit and retain staff – people are hired and quit in a couple days. A lot of people are going off sick with stress." Five healthcare workers describe the pressures they are facing, including ambulance stacking, rising A&E wait times and difficulties discharging patients. Read full story Source: The Guardian, 1 November 2022 -
News Article
NHS Scotland in a perilous situation, says doctors' union
Patient Safety Learning posted a news article in News
Scotland's NHS is in "a perilous situation" amid a staffing and funding crisis, according to the chairman of the doctors' union. Dr Iain Kennedy said urgent action was needed to tackle workload pressures ahead of a potentially "terrifying" winter period. It comes after Scotland's health secretary Humza Yousaf admitted NHS Scotland was not performing well. Mr Yousaf told BBC Scotland it would take at least five years to fix. Dr Kennedy, who is chairman of the industry body BMA Scotland, said it was good to hear Mr Yousaf being honest about the scale of the problems, but added that "frankly we cannot wait five years" for things to improve. He told BBC Radio's Good Morning Scotland programme: "The NHS in Scotland is in a perilous situation and we have a particular crisis around the workforce - we simply do not have enough doctors in general practice and in hospitals. "We need more urgent action because the pressures and the workload have really shot up." Dr Kennedy has called on the government to publish a "heat map" showing where NHS vacancies are unfilled across Scotland. He said: "The public need to see transparency on where the vacancies are. We think that there are probably 15% vacancies across hospital consultant posts across Scotland. "Even the government admits to 7% and that we are at least 800 GPs short in Scotland - and I, and others, suspect we are probably well over that figure now." Read full story Source: BBC News, 31 October 2022 -
News Article
‘This cannot go on’: rise in under-18s on adult psychiatric wards in UK
Patient Safety Learning posted a news article in News
A growing number of children with mental health problems are being treated on adult psychiatric wards as services struggle to cope with a surge in demand following the pandemic, the NHS watchdog has warned. There were 249 admissions of under-18s to adult psychiatric wards in England in 2021-22, according to data provided by NHS trusts to the Care Quality Commission (CQC), up 30% on the year before. Of the children admitted to adult wards, 58% of cases were because the child needed to be admitted immediately for their safety. But in more than a quarter of cases, 27%, the child was admitted to the adult ward because there was no alternative child inpatient or community outreach service available. The findings come more than 15 years after the government set a target to end inappropriate admissions of children to adult psychiatric wards. The number of admissions gradually reduced but has now risen again, the CQC figures suggest. Dr Elaine Lockhart, chair of the Child and Adolescent Faculty at the Royal College of Psychiatrists, said the figures were “a concern but not a surprise. We’ve got a lot of children and young people who have become more unwell. Services are really struggling to meet their needs,” she said. Read full story Source: The Guardian, 30 October 2022
