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Found 959 results
  1. 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
  2. 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
  3. 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
  4. 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
  5. 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.
  6. 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.
  7. 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
  8. 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
  9. 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
  10. 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
  11. 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
  12. 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
  13. 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.
  14. 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
  15. 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.
  16. 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.
  17. News Article
    The NHS and a local council have been told to urgently find a home for a 28-year-old autistic man who is facing psychological and physical abuse within a mental health hospital, after an independent review of his care. Nicholas Thornton has autism and learning disabilities and is currently being held in the Rochford mental health unit, in Essex, after a decade of being locked away in places not able to care for him adequately. Now an independent safeguarding review into his care provided at the Essex hospital has ordered the local authority and NHS to find him a home in the community because his relationship with hospital staff has become so bad he is facing psychological and physical harm. He is one of the 2,045 people with learning disabilities and autism trapped within inpatient units across England. Mr Thornton has been in the unit, run by the Essex Partnership University NHS Foundation Trust (EPUT), since May this year. He is not under a mental health section, nor does he need mental health treatment, but he is unable to leave because the local authority has not agreed on a place into which he can be discharged. EPUT is currently facing a public inquiry probing the deaths of 2,000 patients following multiple reviews since 2016 from coroners, the police and health ombudsman criticising the care within the hospital. A safeguarding report into Mr Thornton’s situation, seen by The Independent and Channel Four News, revealed staff working in the Rochford hospital told investigators they cannot adequately care for Mr Thornton themselves as they are not trained in supporting patients with autism. Read full story Source: The Independent, 13 December 2023
  18. Content Article
    Healthcare Inspectorate Wales (HIW) is the independent inspectorate of the NHS and regulator of independent healthcare in Wales. The findings of their Annual report outline the sustained pressure on healthcare services across Wales, highlighting risks relating to emergency care, staffing concerns, poor patient flow and the accessibility of appointments. It sets out how the HIW carried out their functions across Wales, seeking assurance on the quality and safety of healthcare through a range of activities. This includes inspections and review work in the NHS, and regulatory assurance work in the independent healthcare sector. The report provides a summary of what HW's work has found, the main challenges within healthcare across Wales, and HIW's view on areas of national and local concern.
  19. News Article
    Regulators have warned hospital leaders they may have to ‘depart from established procedures’ over winter to minimise ambulance handover delays. In a joint letter to nursing and medical leaders, NHS England, the Care Quality Commission and professional regulators said it was “vital that we have a whole system approach to risk across the urgent and emergency care pathway”. The push has come amid a huge increase in instances of crews being held outside emergency departments, resulting in extended response times for time-critical 999 calls. The letter added: “We… understand there will be concerns about working under pressure, and that you and your teams may need to depart from established procedures on occasion to provide the best care. “Please be assured that your professional code and principles of practice are there to guide and support your judgments and decision making in all circumstances. This includes taking into account local realities and the need to adapt practice at times of significantly increased pressure. “In the unlikely event of a complaint to your professional regulator they will, as is their usual practice, consider carefully whether they need to investigate. If an investigation is needed, they will consider all relevant factors including the context and circumstances in which you were working. “One area that may be an example of this is in handing patients over to emergency departments from ambulance services. There is a strong correlation between ambulance handover delays at emergency departments and ambulance category 2 response delays, meaning longer handovers increase the chances those in need will wait longer for an ambulance.” Read full story (paywalled) Source: HSJ, 11 December 2023
  20. News Article
    Patients needing emergency treatment are becoming sicker in A&E as hospitals struggle to free up enough beds, top doctors have warned. Dr Adrian Boyle, president of the Royal College of Emergency Medicine (RCEM), told The Independent that elderly patients are waiting so long for treatment in A&E that they’re developing bed sores and delirium. Another senior NHS doctor, Dr Vicky Price, who is president-elect of the Society for Acute Medicine, warned that corridor care is now “routine practice” with the situation only set to worsen as A&E departments come under increasing pressure. Their comments highlight the ongoing chaos in emergency medicine, as strikes take place during the most difficult time of the year. The chief executive of the NHS, Amanda Pritchard, said on Thursday that last winter was the worst she’d ever seen for the health service, warning that strikes by junior doctors will only make the situation harder for hospitals this year The warnings come as the latest NHS data shows that the prime minister, Rishi Sunak, could fail in his promise to deliver 5,000 more acute hospital beds to the NHS this month. Current data shows that the NHS is falling short of the target by just under 1,200 beds, with 97,818 against a target of 99,000. Read full story Source: The Independent, 10 November 2023
  21. Content Article
    Mr Malone was diagnosed with treatment resistant schizophrenia in 1983 and had been sectioned multiple times. In May 2023 he was diagnosed with adult autism. At a review on 31 May he was considered to be stable. On 15 June a routine clozapine review identified sub-therapeutic levels but this was not notified to his clinicians. Sub-therapeutic levels of clozapine are likely to have contributed to a worsening in his symptoms. Around 24 June he was noted to have suffered a significant deterioration – with symptoms of thought disorder, anxiety, and responding to hallucinations – and following a mental health act assessment on 28 June clinicians wanted to detain him under section 2. No inpatient psychiatric bed was available. Whilst he awaited a bed, he remained in the community with daily visits from the mental health team. Last contact was on 1 July when he accepted his medication and appeared more settled. There was no answer when he was visited on 2 July. His room at supported accommodation was entered on 3 July and he was found deceased. Recently he had expressed no suicidal ideation. Post-mortem examination confirmed the medical cause of death was:  1a Cervical spinal cord injury. 1b Laceration. The conclusion of the inquest was that death was the consequence of suicide.
  22. Content Article
    Peter had a long history of depression, anxiety, and reported suicide attempts. He had acknowledged his reluctance to always engage fully with the treatment offered. On 3 August 2022 he was referred to the home treatment team for crisis intervention. After poor engagement he was transferred back to the community mental health team. On the 14 October he was detained by police under section 136 mental health act after expressing suicidal ideation. He told a psychiatric liaison service nurse he had no ongoing suicidal ideation and was referred to the community mental health team and his GP. He then contacted services further a number of times. On 10 November 2022 Peter was found deceased in his flat having taken a deliberate overdose of his prescribed medication. At the time of his death he was on the waiting list to be allocated a mental health care co-ordinator and there had been no multi-disciplinary meeting with all teams involved to agree how best to work with Peter. His cause of death was confirmed at post-mortem: 1a Carbamazepine toxicity. The conclusion reached was death was a consequence of suicide.
  23. News Article
    The failure of trusts to offer stroke patients the level of rehab required by standards introduced 10 years ago has not prevented the publication of new guidance which demands even higher performance. New guidance has been issued by the National Institute for Health and Care Excellence (NICE) which says recovering stroke patients should receive therapy for at least three hours a day, five days each week. Performance against this standard is not yet measured, but figures analysed by HSJ show nearly all units treating stroke patients are falling well short of the previous NICE standard issued in 2013. This required a much less ambitious 45 minutes per day. The figures suggest it is inconceivable the NHS will meet the new NICE rehab requirements in the near future. When they were launched, NICE said: “It shouldn’t be underestimated how important it is for people who have been left with disabilities following a stroke to be given the opportunity to benefit from the intensity and duration of rehabilitation therapies outlined in this updated guideline.” But Chartered Society of Physiotherapy chief executive Karen Middleton said there was no funding for physios to work on rehab, despite increases in staff supply. “Funding that we know is already limited is being prioritised to other things rather than into rehab,” she said. Read full story (paywalled) Source: HSJ, 29 November 2023
  24. News Article
    Mental health patients have been left languishing in hospitals for years due to a chronic shortage in community care, as the number of people trapped on wards hits a record high, The Independent can reveal. Analysis shows 3,213 patients were stuck on units for more than three months last year, including 325 children kept in adult units. Of those a “deeply concerning” number have been deemed well enough to leave but have nowhere to go. One of these cases was Ben Craig, 31, who says he was left “scarred” after being stranded on a ward for two years – despite being fit enough to leave – because two councils fought over who should pay for his supported housing. He missed his daughter's birth and didn’t meet her until she was 18 months old while waiting to be discharged, which only exacerbated his depression. He told The Independent: “I was promised I was going to be moving on, but it just seemed like it went on forever.” Saffron Cordery, deputy chief executive for NHS Providers, which represents hospitals, told The Independent mental health patients stuck in hospitals were experiencing “personal distress” and getting ill again while they wait. She called on the government to put mental health on an “equal foot” to physical care and said not doing so suggested the government was content not to treat all patients equally. Read full story Source: The Independent, 27 November 2023
  25. Content Article
    The COVID-19 pandemic highlighted systemic weaknesses in the healthcare system. This survey of 3,067 registered nurses working in New Jersey used the Donabedian framework to identify challenges related to providing safe care during the pandemic. Respondents identified several organisational factors, including inadequate resources and staffing, which adversely impacted their ability to adhere to patient safety and infection prevention and control protocols during the pandemic.
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