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Found 943 results
  1. Content Article
    On the 9 December 2022, Dennis John William King suffered sudden chest pain which extended down his arm. His wife called 999 and spoke with an ambulance service call handler. Following triage of the call, the response to Mr King's call was graded as a Category 3 (a potentially urgent condition which is not life threatening with a target response of 120 minutes). This call was subsequently re-graded following review in the call centre to a Category 2 (a potentially serious condition requiring rapid assessment, urgent on scene intervention or transport to hospital, with a response within 40 minutes and a target of 18 minutes).   Upon hearing that the waiting time for an ambulance could be as long as six hour, Mr and Mrs King decided to make their own way to the West Suffolk Hospital. The ambulance service were advised and the response stood down.   Within 40 minutes of arrival Mr King had been diagnosed as suffering an ST segment elevation myocardial infarction (STEMI). Treating clinicians assessed his condition as necessitating an urgent transfer to the Royal Papworth and for the angioplasty procedure to be conducted forthwith. The ambulance call centre was contacted by the hospital emergency department with a request for an urgent transfer to the Royal Papworth. Emergency department staff were advised that there would be a 5 hour delay for an ambulance to attend. The call from the hospital emergency department to the ambulance service was graded by the ambulance call handler as a category 2 response. When the response timing was challenged the emergency department matron was advised that the hospital was a place of safety. The ambulance call handler assessment did not seem to take into account the clinical assessment of accident and emergency department staff who, in consultation with the regional cardiac intervention hospital, had determined Mr King's further treatment at the regional cardiac centre was a matter of urgency. An ambulance subsequently arrived at West Suffolk Hospital Accident and Emergency Department and transferred Mr King to the Royal Papworth Hospital where he underwent treatment for what was identified as an occluded left anterior descending artery. About 1 hour after the procedure, Mr King's condition deteriorated and he suffered a left ventricular wall rupture, a recognised complication of either the myocardial infarction he had suffered or the surgical procedure to correct the occluded artery, or both. He received emergency surgery to repair the rupture by way of a patch which was successful. However, his condition deteriorated and he died on the 13 December 2022. The medical cause of death was confirmed as: 1a Multi Organ Failure 1b Post myocardial infarction left ventricular free wall rupture (operated on).
  2. News Article
    Boston-based Massachusetts General Hospital is requesting permission from the state to add more than 90 inpatient beds amid what it says is an "unprecedented capacity crisis." The hospital's emergency department has experienced critical levels of overcrowding nearly every day for the past six months, Massachusetts General said in a news release. The hospital boards between 50 to 80 ED patients every night who are waiting for a hospital bed to open. On 11 January, Massachusetts General had 103 patients boarding in the ED, representing one of the most crowded days in the hospital's more than 200-year history. "While hospital overcrowding has significantly affected patient care for many years, COVID-19 and the post-pandemic demand for care has escalated this challenge into a full-blown crisis – for patients seeking necessary emergency care, as well as for staff who are required to work under these increasingly stressful conditions," David F.M. Brown, president of Massachusetts General, said in a news release. Massachusetts General's request comes as hospitals across the state grapple with capacity issues, workforce shortages and a jump in respiratory illnesses this winter. On 9 January. the Massachusetts Department of Public Health issued a memo urging hospitals to expedite discharge planning amid the capacity crunch. Some health plans have also waived the need to obtain prior authorisation for short stays in post-acute care facilities. Read full story Source: Becker Hospital Review, 19 January 2024
  3. News Article
    The availability of ambulances to transfer patients to specialist units is a "matter of concern", a coroner has warned. Darren Stewart, area coroner for Suffolk, made the comments in a Prevention of Future Deaths report. It followed the death of 84-year-old Dennis King, who waited three hours to be transferred from West Suffolk Hospital to Royal Papworth in 2022. Mr King had made his own way to the West Suffolk Hospital's accident and emergency department in December 2022, after being told an ambulance could take six hours to arrive at his home due to high demand in the area, the report said. His call had been graded as category two, which should have led to a response within 40 minutes - or a target of 18 minutes. After tests at West Suffolk Hospital showed Mr King had suffered a STEMI heart attack, emergency clinicians liaised with experts from the regional heart unit and decided he needed an urgent transfer to Royal Papworth in Cambridgeshire. The report said a matron at West Suffolk told ambulance call handlers they needed an urgent transfer - but because Mr King was classed as being in a "place of safety", control room staff said the delay would be "several hours". Mr Stewart said: "the availability of ambulances to carry out transfers in a timely manner, in urgent cases" was "a matter of concern". In the report, Mr Stewart said the circumstances of the case "raised concerns about the NHS approach to centralising care in regional centres" if the means to deliver it were "inadequate". Read full story Source: BBC News, 23 January 2024
  4. News Article
    A national shortage of epilepsy medication is putting patients' safety at risk, consultants have said. Medical professionals are becoming genuinely concerned as ever more frequent supply issues continue to bite tens of thousands of sufferers. According to the Epilepsy Society charity, over 600,000 people in the UK have the condition, or about one in every 100 people. Among them is Charlotte Kelly, a mother of two living in London who has had epilepsy for over 20 years. She must take two tablets a day to manage her condition but issues with supply have forced her to start rationing her medication. Speaking to Sky News, Ms Kelly told us of the fear surrounding the restricted access to the medicate she needs to survive. "I'm scared. If I'm truly honest, I'm scared knowing that I might not get any medication for a few weeks, or a couple of months, I just don't know when. "It's scary to know that I have to worry about getting hold of medication. I do believe that something needs to happen very quickly because even if it's pre-ordered there's no guarantee you're going to get it. Speaking to Sky News, Professor Ley Sander, director of medical services at the Epilepsy Society, says the supply concern is not just on the minds of patients but those in the industry too. "It might be that we need a strategic reserve for storage of drugs, we might have to bring drugs over from other parts of the world to avoid this from recurring. "We're not at that point yet, but this is an urgent issue." Read full story Source: Sky News, 21 January 2024
  5. News Article
    One in 20 patients has to wait at least four weeks to see a GP at a time when funding for family doctor services is falling, NHS figures show. In November 2023, 1.5m appointments in England at a GP surgery took place four weeks or more after they were booked, 4.8% of the 31.9m held that month. In one in six appointments, 5.4m (17.3%), the patient was forced to wait at least two weeks after booking it to see a GP, practice nurse or other health professional. “Millions of people are being left anxious or waiting in pain because they can’t get an appointment with their GP,” said Ed Davey, the leader of the Liberal Democrats, who highlighted the latest evidence underlining the long delays that many patients face to see a GP. “Staggering” numbers of patients now have to wait a long time, he said. GP leaders blamed the situation on the widespread shortage of family doctors, which they said was making it impossible to keep up with the rising demand for appointments. Burnout due to intense workloads is prompting more GPs to work part time. Read full story Source: The Guardian, 22 January 2024
  6. Content Article
    Meeting cancer performance targets is a challenge for many trusts with waiting times for diagnosis and treatment growing since the pandemic. But this is a worrying time for patients as well, and they would welcome quicker turnaround of results and diagnosis. Cutting time out of this pathway would benefit everyone but are there ways to do this which do not compromise patient safety? An HSJ webinar, in association with SS&C Blue Prism, addressed this important question and tried to find ways trusts could reduce waiting times.
  7. Content Article
    Elizabeth Roberts was severely frail and bedbound, supported by visits from care agency carers four times per day and her local District Nursing Team. She had ischaemic and hypertensive heart disease and developed a large sacral sore with associated sepsis. She was admitted to Tameside General Hospital on 19 May 2023 where despite treatment, she died the same day of Sepsis with congestive cardiac failure. In this report the Coroner notes concerns about the her case and the capacity of the District Nursing Team providing here care.
  8. News Article
    Patients have suffered cardiac arrests while waiting in A&E departments or in ambulances queueing outside because Scottish hospitals are overwhelmed, doctors have warned. At least three cases in which patients’ hearts stopped beating while they were waiting for care have been reported to the Royal College of Emergency Medicine in Scotland. Some of the incidents, the college said, may have been preventable. One frontline doctor told The Times that a patient with heart problems had died waiting in a queue of ambulances outside an emergency department. Staff could not take the patient inside because there was no capacity. JP Loughrey, vice-president of the college and an A&E consultant in the west of Scotland, said that people who should be in resuscitation rooms with a team of experts and equipment to monitor their vital signs were instead lying in ambulances outside hospital buildings. He also said that tensions were growing between frontline staff and NHS managers in large hospitals because doctors and nurses, who were already struggling to cope, were under increasing demands to work harder to process more patients. Read full story Source: The Times, 19 January 2024
  9. News Article
    Half of surgeons in England have considered leaving the NHS amid frustration over a lack of access to operating rooms, a new survey shows. More than 3,000 surgeons contemplated quitting the health service in the last year, with two-thirds reporting burn out and work-related stress to be their main challenge, a new survey by the Royal College of Surgeons England has revealed. As the NHS tries to reduce the 7.61 million waiting list backlog, the survey, covering one quarter of all UK surgeons, found that 56% believe that access to operating theatres is a major challenge. RCS England president, Mr Tim Mitchell, said: “At a time when record waiting lists persist across the UK, it is deeply concerning that NHS productivity has decreased. “The reasons for this are multifactorial, but access to operating theatres and staff wellbeing certainly play a major part. If surgical teams cannot get into operating theatres, patients will continue to endure unacceptably long waits for surgery. “There is an urgent need to increase theatre capacity and ensure existing theatre spaces are used to maximum capacity. There is also a lot of work to be done to retain staff at all levels by reducing burnout and improving morale.” Read full story Source: The Independent, 18 January 2024
  10. News Article
    One of Britain’s three high-security hospitals – where notorious people including Ian Huntley and Charles Bronson have been detained – is so understaffed that neither workers nor patients are safe, a damning new report has found. Rampton Hospital in Nottingham faces severe staff shortages, leading workers to restrain patients and lock them away in their rooms and putting patients at risk of self harm, according to the Care Quality Commission. In a report looking into the hospital, inspectors – who rated the hospital as inadequate – said there were around half the staff needed on one ward. In one example of those at the hospital being at risk, a patient self-harmed with glass from their watch, while another was able to harm themselves with a CD while they were confined to their room. One deaf patient was secluded several times on another ward for “being loud”, according to the CQC. “We spoke with people in the learning disabilities services who told us they sometimes get locked in their room from dinner time until the next morning,” the report said. “They told us that they don’t like being locked in their rooms.” Read full story Source: The Independent, 17 January 2024
  11. News Article
    More than 8,500 patients in England were being treated on virtual wards in the run-up to Christmas, figures have revealed, as the NHS moves to ease pressures on hospital capacity. However, experts said the so-called hospitals at home are not a “silver bullet to solve the crisis in health and social care”. Figures published by NHS Digital revealed some 8,586 patients were treated virtually in December 2023, up from 7,886 in November. The snapshot was taken on 21 December 2023, meaning it is likely those patients spent Christmas on a virtual ward rather than an actual hospital. Virtual wards allow patients to receive care in their own homes, with clinical staff using apps or wearable technology to monitor them remotely. Professor Sir Stephen Powis, NHS national medical director, said the “rapid expansion” of virtual wards beds and patients “is a real NHS success story”. He added: “This not only frees up vital hospital beds for those who need them most but ensures patients can recover in the place they are most comfortable with support from families, carers and friends, and while occupancy has been growing rapidly as NHS teams make the most of all bed capacity available, we want to see continued growth right across the country so as many patients as possible can benefit." However, Wendy Preston, the head of nursing practice at the Royal College of Nursing (RCN), said “virtual wards aren’t a silver bullet to solve the crisis in health and social care”. “Whether they’re in a physical bed or on a virtual ward, patients still need to be able to see a nurse,” she added. “But there are over 40,000 nursing vacancies across the NHS, and social care is chronically understaffed. Run effectively, virtual wards can relieve pressure, but on every single shift nursing staff are fighting an uphill battle to care for too many patients. “If the UK government wants to turn around the state of the NHS and deliver the ‘hospital level’ care at home that patients expect, nursing staff need to see game-changing investment in the workforce.” Read full story Source: The Independent, 15 January 2024
  12. News Article
    An unprecedented medicines shortage in the NHS is endangering lives, pharmacists have said, as unpublished figures reveal that the number of products in short supply has doubled in two years. A treatment for controlling epileptic seizures was the latest to be added on Wednesday to a UK drugs shortage list that includes treatments for conditions ranging from cancer to schizophrenia and type 2 diabetes. Causes of the crisis are thought to include the plummeting purchasing value of the pound since the Brexit referendum, which reduces the NHS’s ability to source medicines abroad, and a government policy of taxing manufacturers. According to Department of Health and Social Care (DHSC) figures provided to the British Generic Manufacturers Association, there were 111 drugs on a shortages list on 30 October last year and 96 on 18 December, with supply notifications issued for a further 10 treatments to NHS providers in the UK since then. It amounts to a 100% increase in shortages compared with January 2022, with pharmacists and health charities claiming the conditions of some patients were deteriorating as a result. Delyth Morgan, the chief executive of Breast Cancer Now, said her organisation had been contacted over the past 12 months by several patients unable to source the medicines they needed to control the spread of their disease. She said: “Last year many people shared with us, via Breast Cancer Now’s helpline, that they’d been facing difficulties accessing their hormone treatment including letrozole, anastrozole and tamoxifen, causing them huge worry and anxiety. Trying to track down a treatment by travelling to a number of different pharmacies is an added burden for patients at an already difficult time. “It may also sometimes be that certain brands of drugs are out of stock and people may have to switch to another brand or different drug. In the worst case someone may have a period of time without the medication, a drug which could help reduce the risk of their breast cancer coming back or spreading.” Read full story Source: The Guardian, 14 January 2024
  13. News Article
    Thousands of patients are being readmitted to NHS mental health units in England every year soon after being discharged, raising concerns about poor care, bed shortages and increased risk of suicide. Experts say being discharged prematurely can be upsetting, set back the patient’s chances of making a full recovery and be “disastrous” for their health. Figures from NHS mental health trusts in England show that last year almost 5,000 people – children and adults – were readmitted to a mental health facility within a month of leaving. The Labour MP Dr Rosena Allin-Khan said the “alarming” data, which she obtained under freedom of information laws, showed too many patients were not receiving enough help to recover. Allin-Khan said: “With record waiting lists and mental health beds in short supply, it is alarming that many patients are being discharged only to be readmitted within days. Every patient expects to receive full and appropriate mental health support, so it is concerning that in many cases patients are being discharged prematurely. “Being discharged too soon can have a disastrous impact, stunting progress towards a full recovery, ultimately causing further damage to a patient’s mental health.” Read full story Source: The Guardian, 12 January 2024
  14. Content Article
    Hospitals are complex adaptive systems. They are industrial environments where it isn't always possible to expect predictable responses to inputs. Patient safety management practices need to adapt to align with the environment in which events occur. It is time to reimagine safety event reporting and management solutions that guide, not prescribe, investigations and improvement actions.
  15. Content Article
    The NHS remains under immense pressure. Each part of the system is experiencing demand beyond its capacity, which is continually increasing the problem. This is most vividly illustrated in urgent and emergency care settings. Each winter in the past decade has become slightly worse,2 and that trend, which has not been reversed, has resulted in a dire situation that may not yet have reached its nadir. A continuum of often predictable perfect storms has caused a struggling system to reach collapse, writes Tim Cooksley, immediate past president, Society for Acute Medicine in this BMJ opinion piece.
  16. News Article
    The Welsh Ambulance Service is struggling to cope as many A&E departments are full and some patients have reportedly been waiting to be offloaded from ambulances for as long as 15 hours. The service has issued a plea for the public to "use 999 responsibly" amid severe pressure. An employee of the service said: "Nearly every A&E department is at capacity. Patients have been on ambulances for the last 15 hours. The ambulance service is only responding to red [immediately life-threatening] calls." The service has received almost 13,000 calls to 999 since Boxing Day and there have been almost 36,000 calls to the NHS 111 Wales service. Lee Brooks, the ambulance service’s operations boss, said: “Pent-up demand from the Christmas and New Year period, coupled with the seasonal illnesses we see at this time of year, means there are lots of people across Wales trying to access health services currently. When hospitals are at full capacity, it means ambulances can’t admit their patients, and while they’re tied up at emergency departments, other patients in the community are waiting a long time for our help, especially if their condition isn’t life-threatening. “We’re working really hard as a system to deliver the best possible care to patients, but our ask of the public today – and in the coming days – is only to call 999 if they are seriously ill or injured, or where there is an immediate threat to someone’s life. That’s people who’ve stopped breathing, people with chest pain or breathing difficulties, loss of consciousness, choking, severe allergic reactions, catastrophic bleeding or someone who is having a stroke." Read full story Source: Wales Online, 3 January 2024
  17. Event
    until
    The health and care system continues to face profound challenges, whether it’s staff shortages, financial pressures, all-time low public satisfaction, or record high waiting times for elective care. At this free online event, our expert panel will provide insight and context into the wider health and care landscape, the challenges the sector is facing, and the big issues they want to see progress on in 2024. In the run-up to the anticipated general election, our panel will also explore how recent trends, political parties’ policy proposals and future developments could affect those working in the sector, as well as people, patients and communities. Join the discussion and share your comments and questions about the wider challenges and opportunities facing the health and care sector. Register
  18. News Article
    Almost one in four people have bought medicine online or at a pharmacy to treat their illness after failing to see a GP face to face, according to a UK survey underlining the rise of do-it-yourself treatment. Nearly one in five (19%) have gone to A&E seeking urgent medical treatment for the same reason, the research commissioned by the Liberal Democrats shows. One in six (16%) people agreed when asked by the pollsters Savanta ComRes if the difficulty of getting an in-person family doctor appointment meant they had “carried out medical treatment on yourself or asked somebody else who is not a medical professional to do so”. Ed Davey, the leader of the Liberal Democrats, said delays and difficulty in accessing GP appointments constituted a national scandal, and face-to-face GP appointments had become “almost extinct” in some areas of the country. He said: “We now have the devastating situation where people are left treating themselves or even self-prescribing medication because they can’t see their local GP.” Dr Richard Van Mellaerts, the deputy chair of the British Medical Association’s GP committee in England, said: “While self-care and consulting other services such as pharmacies and NHS 111 will often be the right thing to do for many minor health conditions, it is worrying if patients feel forced into inappropriate courses of action because they are struggling to book an appointment for an issue that requires the attention of a GP or a member of practice staff.” Read full story Source: The Guardian, 2 January 2024
  19. News Article
    Hundreds of children’s appointments – including for lifesaving operations and cancer treatments – have been cancelled on each day that NHS strikes took place over the last year, as hundreds of thousands of youngsters languish on the waiting list for treatment, The Independent can reveal. More than 20,000 paediatric treatments and surgeries were shelved because of the walkouts, while the families of 400 children were told that their lifesaving operations had been cancelled. With junior doctors due to stage the longest strike in NHS history this week – for six days, starting on Wednesday – the problem is set to get worse. Dr Camilla Kingdon, president of the Royal College of Paediatrics and Child Health, warned that long waits for children can be particularly damaging, and can have a lifelong impact as treatment is often time-critical. She said that children are seldom prioritised in national policy-making, and urged the government to put children’s needs “back on the agenda”. Read full story Source: The Independent, 2 January 2024
  20. News Article
    Patients have been harmed as a result of doctors striking this year, and others needing time-critical treatment will be at risk during next month’s walkout in England, hospital bosses have said. Cancer patients and women having induced or caesarean section births will be in danger of damage to their health unless junior doctors in those areas of care abandon their plans to strike for six days in January, they said. People awaiting urgent eye surgery risk permanent sight loss unless the British Medical Association (BMA) lets junior doctors keep working in that area, according to NHS Employers, which represents health service trusts in England. Its intervention comes amid mounting concern in the NHS that it may prove impossible to maintain patient safety in high-risk, time-sensitive areas of treatment when tens of thousands of junior doctors stage what will be the longest strike in NHS history from 3 January, when hospitals are facing what is often the service’s busiest week of the year. Read full story Source: The Guardian, 21 December 2023
  21. News Article
    Thousands more elderly people will be stuck in hospital over Christmas because of junior doctors’ strikes, Age UK has warned. The charity is among several who have said the timing of the strikes, which begin at 7am on Wednesday means it will be “extremely difficult to ensure safe and effective care” during them. Age UK is one of five organisations raising fears over patient safety and making a plea to the British Medical Association (BMA) and Victoria Atkins, the Health Secretary, for a resolution to the dispute. Junior doctors’ walkouts are due to last until Saturday, with their longest strike to come early in the new year, while flu, norovirus and Covid hospitalisations are rising. In a joint letter with the NHS Confederation, Patients Association, National Voices and Healthwatch , Age UK said strike action in the days ahead could leave thousands of patients stranded in hospital for want of staff to get them discharged. The latest figures show 13,000 such cases in hospitals despite being medically fit for discharge. The charities said the withdrawal of almost half the medical workforce in England would mean the most vulnerable are left “bearing the brunt” of the pay dispute. “Our concern is that, despite the best efforts of hard-working NHS staff, it will be extremely difficult to ensure safe and effective care during this period for all patients that need it.” Read full story (paywalled) Source: The Telegraph, 20 December 2023
  22. Content Article
    On 8 November 2023, NHS England wrote to health leaders and staff with a focus on addressing the significant financial challenges created by industrial action in 2023/24, and immediate actions to take. Follow the link below for full details.
  23. News Article
    The traditional model of NHS dentistry is gone for good, experts are warning. The Nuffield Trust think tank said the service had been cut back so much it was now at the most perilous position in its 75-year history in England. It said restoring services would probably need an unrealistic amount of money and called for radical reform, suggesting NHS support may need to be completely scaled back for some adults. The Nuffield Trust said funding for NHS dentistry had suffered huge cuts in recent years. Some £3.1bn was spent in 2021-22 - a drop of £525m since 2014-15 once inflation is taken into account. It said the number of treatments being done each year was now six million lower than it was before the pandemic. The Nuffield Trust said tough policy choices needed to be made, suggesting one option could be to start charging adults for the full cost of treatment beyond emergency work and check-ups. Shawn Charlwood, chairman of the British Dental Association's general dental practice committee, said the report "reads like the last rites for NHS dentistry" and that "patients and this profession deserve some honesty here". He added: "The government say NHS dentistry should be accessible for all who need it. "The plain facts are we're not seeing any evidence of the reforms or the resources to realise that ambition." Read full story Source: BBC News, 19 December 2023
  24. Content Article
    NHS-funded dental services in England are in near-terminal decline: nearly six million fewer courses of NHS dental treatment were provided last year than in the pre-pandemic year; funding in 2021/22 was over £500m lower in real terms than in 2014/15; and there are widespread problems in accessing a dentist. So what is to be done? This major new policy briefing from the Nuffield Trust proposes a series of short-term actions relating to appointment recall intervals, commissioning and the workforce. It also sets out two approaches for longer-term action, which involve improving the current dental model or adjusting the NHS offer.
  25. Content Article
    Conflicts and wars contribute substantially to the development and spread of antimicrobial resistance (AMR). War-related factors that contribute to AMR include restricted resources, high casualties, suboptimal infection prevention control, and environmental pollution from infrastructure destruction and heavy metals release from explosives. This article in The Lancet looks at the impact of the war in Gaza on AMR. It highlights that access to essential antibiotics, primarily through donations, has been a continuous challenge due to the blockade of Gaza and that Gaza's already restricted national surveillance system for AMR adds to the challenges.
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