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Found 1,324 results
  1. News Article
    NHS England’s national cancer director has said that she is “cautiously optimistic” about reaching cancer waiting time targets by March 2023, but she refused to be drawn on what had happened to the government’s proposed 10 year cancer plan. Cally Palmer was speaking to MPs on the Health and Social Care Committee at a special one-off session on the urgent challenges facing cancer services, including workforce shortages, winter pressures, and poor performance. Latest figures from September, published on 10 November, show that 60.5% of patients began their first treatment within 62 days of being urgently referred for suspected cancer, against a target of 85%. That target was pushed back to March 2023 from March this year. Palmer told the committee on 23 November that the 85% target aimed to reduce the 62-day backlog to pre-pandemic levels. Read full story (paywalled) Source: BMJ, 24 November 2022
  2. News Article
    Ministers have effectively ditched NHS England’s planned new bundle of A&E targets and want trusts to be firmly regulated on the existing four-hour standard and 12-hour breaches, HSJ understands. Multiple senior figures familiar with the process, from inside the NHS and government, said the performance focus for the next two years will be on the two existing accident and emergency waiting time measures, as well as ambulance handover delays. For the last three years, NHS England has been lobbying government to scrap the headline four-hour target, and replace it with a bundle of measures which have been trialled at around a dozen providers. This work has been led by medical director Steve Powis. HSJ understands the decision to continue using the existing four-hour target was driven by concerns among ministers and senior NHS figures that the bundle of measures was too confusing, both for patients and as a means for government to hold the service to account. Read full story (paywalled) Source: HSJ, 23 November 2022
  3. News Article
    Performance failings at NHS Supply Chain are impacting patient care, staff wellbeing and retention, and local procurement teams are struggling to mitigate their impact, local procurement chiefs have claimed. The group of senior NHS buyers have raised their concerns in a highly critical letter to NHS Supply Chain chief executive Andrew New and NHS England’s chief commercial officer Jacqui Rock. The letter, seen by HSJ, was signed by 22 heads of procurement at trusts and integrated care systems. It raises concerns about the NHSSC’s core functions, like delivering products on time and in full, its governance, and highlights unanswered questions about how it interacts with NHSE’s new central commercial function. Read full story (paywalled) Source: HSJ, 22 November 2022
  4. News Article
    Health spending over the next two years will grow less than during the austerity era of the last decade, according to a new analysis of the autumn statement. The chancellor, Jeremy Hunt, a former health secretary who previously campaigned for greater resources from the backbenches, announced last week that the NHS would receive an extra £3.3bn in each of the next two years. With severe pressures growing on the service, he said it would be one of his “key priorities”. However, research by the Health Foundation charity has found that when the whole health budget is included – covering the NHS, training, public health services and capital investment – it will only increase by 1.2% in real terms over the next two years. That is below the 2% average seen in the decade preceding the pandemic, as well as the historical average of about 3.8%. The research comes as NHS trusts face almost impossible decisions over staff wages, waiting lists and keeping buildings and equipment up to date. The Health Foundation analysis highlighted the continued “significant uncertainty” facing the delivery of health services over the remainder of this parliament. It said there were now “difficult trade-offs” on issues such as pay and the backlog. Anita Charlesworth, director of the Real (Research and economic analysis for the long term) Centre at the Health Foundation, said that there had been “short-term relief” for the health service, especially when compared with the cuts made to non-protected departments. However, she said it would be “treading water at best as inflation bites and it faces rising pressures from an ageing population, pay, addressing the backlog and continuing Covid costs”. “If other parts of the system – especially social care and community care – are also struggling with cost pressures, this makes it harder to deliver healthcare and the 2% will buy less,” she said. “Efficiency can only take the NHS so far. Since 2010, if we had kept up with German health spending we’d have spent £73bn more each year, and £40bn more if we’d kept up with France.” Read full story Source: The Guardian, 19 November 2022
  5. News Article
    NHS leaders in Scotland have discussed abandoning the founding principles of the service by having the wealthy pay for treatment. The discussion of a "two-tier" health service is mentioned in draft minutes of a meeting of NHS Scotland health board chief executives in September. They also raise the possibility of curtailing some free prescriptions. Scotland's Health Secretary Humza Yousaf insisted the NHS would stay publicly owned and publicly operated. He added that health services "must always" be based on individual patient need and "any suggestion" that it should be about the ability to pay was "abhorrent". The minutes of the meeting seen by BBC News highlight the degree of official concern about the sustainability of Scotland's NHS in its present form. They include suggestions that hospitals should change their appetite for risk by aiming to send patients home more quickly, and pause the funding of some new drugs. The group were advised that they had been given the "green light to present what boards feel reform may look like" and that "areas which were previously not viable options are now possibilities". Describing a "billion pound hole" in the budget, the minutes warn that it "is not possible to continue to run the range of programmes" the NHS currently offers while remaining safe "and doing no harm." And they warn that: "Unscheduled care is going to fall over in the near term before planned care falls over." Read full story Source: BBC News, 21 November 2022
  6. News Article
    Health and Human Services (HHS) Secretary Xavier Becerra startled a recent meeting of senior health system leaders by declaring in opening remarks that a plane crash had just killed all 200 passengers. He immediately added that this hadn’t really happened; he’d said it only to illustrate the toll taken by medical error. The 14 November meeting at which Becerra spoke signalled a renewed commitment by HHS to preventing patient harm as it launched an “Action Alliance to Advance Patient Safety.” The Alliance aims to recruit the nation’s largest health systems as participants. “We’re losing pretty much an airline full of Americans every day to medical error, but we don’t think about it,” said Becerra. (The department’s fiscal 2022-2026 strategic plan actually estimated the death toll at roughly 550 daily, which would be a very large airliner.) “But the worst part about it is that it’s avoidable.” Though the meeting rhetoric was rousing and the invitee list impressive, specifics remained scarce. The Alliance is described only in general terms as a partnership among health systems, federal agencies, patients and others to implement Safer Together: A National Action Plan to Advance Patient Safety. Read full story Source: Forbes, 17 November 2022
  7. News Article
    The Government is looking to hire a new cyber security chief for the NHS and Department of Health and Social Care (DHSC), at a time of heightened risk of cyber attacks against the health service. The DHSC last month issued a job advert for a “national chief information security officer”, who will sit within the digital policy unit of NHS England’s transformation directorate. It comes at a time when the risk of cyber attacks against the NHS is increasing. Earlier this summer, an attack on an NHS electronic patient record supplier impacted several providers, including a dozen mental health trusts, with some trusts still not having recovered their service fully. Meanwhile, in February, NHSE wrote to trusts to tell them to strengthen their cyber defences in the wake of Russia’s invasion of Ukraine. Read full story (paywalled) Source: HSJ, 18 November 2022
  8. News Article
    The NHS will receive an extra £3.3bn in each of the next two years, the chancellor has announced, but experts warn the cash is probably only half of what is needed to keep the health service afloat. Jeremy Hunt told the Commons during his autumn statement he had been assured the funding would mean the NHS can hit its “key priorities”. Its chief executive, Amanda Pritchard, later issued a statement welcoming the funding, saying it showed that “the government has been serious about its commitment to prioritise the NHS”. However, it was only last month that NHS England, the organisation Pritchard leads, had forecast a £7bn shortfall in its funding next year, which it warned it could not plug with efficiency measures alone. “The NHS warned it needed more money to cope with the impact of inflation on its costs,” said Nigel Edwards, the chief executive of the independent thinktank Nuffield Trust. “Today’s autumn statement has provided much-needed extra cash from April over the next two years, but this is only around half of what the NHS had warned last month would likely be needed.” Hunt pledged to grow the NHS budget in 2023-24 and 2024-25 by £3.3bn in each year. But Edwards warned that would not account for the £2.5bn worth of inflation and other unexpected cost pressures the NHS has faced in the current financial year. “The impact of today’s funding announcement is that real terms health spending per head after adjusting for age will increase by less than 1% for the next two years,” Edwards added. “This is compared to the long-term average of 2.6% and comes at a time when the NHS cannot afford to stand still and is desperately trying to increase the work it can do to clear record waiting times.” Read full story Source: The Guardian, 17 November 2022
  9. News Article
    The national director for mental health has said she was shocked to discover how many ward managers do not work at weekends, adding this could contribute to abuse and poor care going undetected. Asked at the NHS Providers conference about recent reports into care scandals, NHS England’s director for mental health Claire Murdoch said it was crucial to listen to frontline staff, such as healthcare assistants, who spend most of their time with patients. But she added: “[It’s also] making sure your ward managers do work of a night and at the weekend. “I’ve been a bit shocked to hear that we’ve moved with agenda for change and quite often ward managers are Monday to Friday people.” Her comments come amid a string of high-profile care scandals, such as at the Edenfield Centre in Greater Manchester, as well as an ongoing debate around seven-day working across the NHS. It is understood Ms Murdoch is concerned managers are spending too much time on bureaucratic tasks, which typically happen during Monday to Friday shifts, meaning they are then not working night or weekend shifts. In September, the national director ordered all trusts to carry out safety reviews, warning in a letter they should leave “no stone unturned” in seeking to eradicate and prevent poor care. She also urged all boards to urgently review safeguarding of care in their organisations, and identify any immediate issues requiring action now. Read full story (paywalled) Source: HSJ, 15 November 2022
  10. News Article
    A policy change to speed up hospital discharge could save the NHS more than £7bn over a decade, according to a government evaluation – but ministers have not funded it. A Department of Health and Social Care impact assessment of the Health and Care Act, passed earlier this year, says that wider use of discharge to assess could free up as many as 6,000 hospital beds and save the NHS £7bn by 2031, the equivalent of £800m a year. It adds: “The overall societal benefits of this would likely be higher as beds could be allocated to patients with more urgent health care needs.” The “discharge to assess” approach, which has been used on a temporary basis for several years and more widely during the pandemic – with government funding to back it – sees patients discharged more quickly, and provided with support at home while their long-term care needs are assessed. It was credited with significant reductions in the amount of time patients spent in hospital. Changes in the Health and Care Act were intended to remove legal obstacles to the approach, by revoking a requirement for an assessments be carried out before discharge, which often leads to delays in the patient leaving hospital. Read full story (paywalled) Source: 15 November 2022
  11. News Article
    Trust leaders have raised concerns about other major unions striking on the same dates as the Royal College of Nursing in co-ordinated action, which would make avoiding disruption and harm ‘more hairy’. The concerns were raised after the Royal College of Nursing confirmed members at various trusts had voted in favour of unprecedented action last week, with Unison and a raft of other unions also balloting members on strike action this month and in December. Unison told HSJ co-ordinated action between itself, the RCN and the other health unions was “the best way to ensure industrial action is effective”. One senior trust leader said that while the RCN strike days would prove a major challenge, they predicted their trust would be able to cope with the fallout. But they said the challenge would get even “more hairy” if Unison members also walked out on the same dates – a prospect they feared likely. HSJ also understands that trust bosses have concerns about what will and won’t be classified as urgent and also about the emergency work to be carried out throughout a strike. One senior provider figure used the example of insulin injections, which are at present to be part of the urgent and emergency care activities to continue throughout a strike, and wound treatment services, which, at this stage, are not. They said: “If people don’t get those [insulin] injections twice a day, that person, by the end of 24 hours, will be in hospital [but] we are negotiating on [other areas] for example wound care. If you don’t dress people’s wounds at the right time, the worst situation is that a [deteriorating] wound means your leg has to be chopped off. At the moment, doing wound care is not being considered urgent care.” Read full story (paywalled) Source: HSJ, 15 November 2022
  12. News Article
    Thirty-three provider groups in the USA penned a joint letter to President Joe Biden this week warning of “gridlocked” hospital emergency departments that are threatening patients’ lives and the well-being of shorthanded healthcare workers. “In recent months, hospital emergency departments (EDs) have been brought to a breaking point. Not from a novel problem—rather, from a decades-long, unresolved problem known as patient ‘boarding,’ where admitted patients are held in the ED when there are no inpatient beds available,” provider associations including the American College of Emergency Physicians (ACEP) and the American Medical Association (AMA) wrote. “While the causes of ED boarding are multifactorial, unprecedented and rising staffing shortages throughout the healthcare system have recently brought this issue to a crisis point.” The issue of boarding “has become its own public health emergency” for adult and paediatric care alike, the latter of which is being driven by a spike in mental health visits and, more recently, a “triple threat” of flu, COVID-19 and respiratory illnesses that have backed up children’s hospitals. “If the system is already this strained during our ‘new normal,’ how will emergency departments be able to cope with a sudden surge of patients from a natural disaster, school shooting, mass casualty traffic event or disease outbreak?” the groups wrote. The letter included a handful of firsthand accounts solicited by ACEP from anonymous emergency physicians describing patients deteriorating or dying “during their tenth, eleventh or even twelfth hour of waiting to be seen by a physician.” Read full story Source: Fierce Healthcare, 10 November 2022
  13. News Article
    Ministers have offered about 1 million NHS staff in England – everyone bar doctors and dentists – a pay rise of at least £1,400 for 2022-23. That represents a rise of between 4% and 5% for staff covered by the longstanding Agenda for Change negotiating framework. Health unions have rejected the £1,400. They want a rise that would at least match inflation – which is currently 10.1% – while the Royal College of Nursing (RCN) is seeking inflation plus 5%. Without inflation-proof rises, staff will suffer a real-terms cut in their take-home pay, unions say. “Our members will no longer tolerate a financial knife-edge at home and a raw deal at work”, said the RCN general secretary, Pat Cullen. Sara Gorton, head of health at Unison, added: “Inflation has already wiped out this year’s 72p-an-hour increase. The government must put pay right to spare the NHS, its staff and all those relying on its care from a dispute no one wants to see.” The RCN has balloted its members across the UK. The results, published on Wednesday, show that a majority of nurses in most but not all hospitals and other NHS services across the four home nations have rejected the government’s offer and decided to strike in pursuit of better pay. Wes Streeting, the shadow health secretary, has condemned as “unacceptable” the fact that strikes will disrupt services and affect patients’ care. While he has not criticised nurses or any health union, he has blamed ministers for not negotiating with the RCN to try to avert strike action. “I’m concerned, I think lots of people are concerned about the impact of disruption”, he told LBC’s Tonight with Andrew Marr on Monday. “That’s still a disruption to patients, which I think is unacceptable.” If he were the health secretary he would see patients as his “first and foremost” responsibility, he said. “That’s why I think the government have to get a grip on this and get the unions around the table because there is a deal there to be done.” Read full story Source: The Guardian, 9 November 2022
  14. News Article
    The only two female ambulance chief executives in the country have said there is something ‘deeply wrong’ with the culture in ambulance services. Helen Ray, the chief executive of the North East Ambulance Service Foundation Trust, said women working in the ambulance service “accept [inappropriate] banter, they accept sexualised behaviour from their male colleagues, and from patients, and they think it is okay”. She stressed “it is absolutely not [okay]” and said women must be given “safe spaces for talking and speaking up about that”. “There is something deeply wrong with the culture in the ambulance service”, she told the NHS Confederation’s Health and Care Women Leaders Network event on Tuesday. Siobhan Melia, interim chief executive of South East Coast Ambulance Service, said when she joined the trust four months ago on secondment from Sussex Community FT, it felt like she had “landed on a different planet”. Ms Melia said it was a culture “not like any other part of the NHS”. “The gender pay gap in my organisation is significant, so we see men in senior roles are taking it upon themselves to abuse their power, [with] both female students and female lower graded staff.” Read full story (paywalled) Source: HSJ, 10 November 2022
  15. News Article
    Abortion access is a “fundamental” part of women’s healthcare the government’s women’s health ambassador has warned. Dame Lesley Regan, who was appointed as Women’s Health Ambassador by the Government in July, has said in answer to questions from The Independent about the voting records of ministers: “I think it’s really important that we never ever get complacent about freedom of choice. “Now what my view is about whether abortion is good or bad is really irrelevant. My job is to tell the Prime Minister if he’ll listen and the Secretary of State that it [abortion] is an absolutely fundamental part of women’s healthcare." “Because I’ve done so much work overseas during my career, what I know is that if you make it difficult to access, or you make it illegal, the problem doesn’t go away but women die as a result.” Her comments come after it was revealed this week that the prime minister and senior members of his government have voted against boosting access to abortions or have opted out of key votes. More than a third of the government’s current cabinet voted against early medical abortion at-home measures rolled out in the wake of the pandemic being made permanent. The Department for Health and Social Care’s minister for women, Maria Caufield, who has been granted responsibility for abortion care, has previously voted to curtail access rights. Earlier this year The Independent revealed women seeking abortions in the UK are having to travel hundreds of miles to access care as “untenable” waiting times put unsustainable pressure on services. Read full story Source: The Independent, 8 November 2022
  16. News Article
    Thousands of hospital surgeries are likely to be cancelled as NHS leaders prepare for unprecedented strike action, The Independent has been told. Most operations apart from cancer care are likely to be called off when nurses take to the picket line, with NHS trusts planning for staffing levels to be similar to bank holidays. Multiple sources say they are almost certain that the upcoming Royal College of Nursing ballot will result in strike action. Results are expected to be finalised on Wednesday. “Trusts are looking at the totality of it. It’s the waiting list that is going to be hit, massive questions over waiting lists, and we’re going to lose days of activity in terms of addressing that growing pressure. “The more we see strike action the harder it is, the risk is [that] the rate of recovery [of waiting list] slows.” They added: “The unions normally provide bank holiday cover and maintain emergency service basically.” Read full story Source: The Independent, 7 November 2022
  17. News Article
    A boss at a trust which was heavily criticised in a damning report says patients have lost confidence in the care they provide. Raymond Anakwe, executive director of East Kent Hospitals Trust, said regaining patient trust would be "possibly the largest challenge". He was speaking at a board meeting two weeks after a review found a "clear pattern" of "sub-optimal" care. Mr Anakwe said: "The reality is we have lost the confidence of our patients." He also said the trust has lost the confidence "of our local community and sadly also many staff". The trust's chief executive, Tracey Fletcher, told the meeting that she believed many staff thought "enough is enough", and that the trust has to be "brave" if it's to move forward. Stewart Baird, a non-executive director, said: "I think it's clear the buck stops here with the people sat round this table, and where there are bad behaviours in the trust, it's because we have allowed it. "Where people don't feel able to speak up, it's because we have not provided an environment for them to do that." Read full story Source: BBC News, 3 November 2022
  18. News Article
    Patients are not always getting the care they deserve, says the head of NHS England. Amanda Pritchard told a conference the pressures on hospitals, maternity care and services caring for vulnerable people with learning disabilities were of concern. She even suggested the challenge facing the health service now was greater than it was at the height of the pandemic. Despite making savings, the NHS still needs extra money to cope, she said. Next year the budget will rise to more than £157bn, but NHS England believes it will still be short of £7bn. Ms Pritchard told the King's Fund annual conference in London that demand was rising more quickly than the NHS could cope with. "I thought that the pandemic would be the hardest thing any of us ever had to do," she said. "Over the last year, I've become really clear.... it's the months and years ahead that will bring the most complex challenges." Read full story Source: BBC News, 2 November 2022
  19. News Article
    Trusts underperforming on leadership diversity should not be rated “good” or “outstanding” by the Care Quality Commission (CQC), the NHS Confederation chair has told HSJ. Victor Adebowale said he did not understand how organisations can achieve the top CQC ratings if they do not demonstrate sufficient diversity at senior levels. Lord Adebowale was speaking to HSJ alongside Marie Gabriel, following Ms Gabriel being appointed last month to chair the new NHS Race and Health Observatory, which is being hosted by the confederation. The influential peer’s comments also follow the new People Plan tightened criteria around equality, diversity and inclusion in the “well-led” aspect of the care quality regulator’s inspections. He said: “I struggle to see [how] any NHS trust that performs badly, [on] racial equality and leadership, can be considered to be good and outstanding. I don’t get it. “It seems to me there is enough regulation to take into account the requirement to lead all the people, all the time. But, obviously, if you’re not, then you shouldn’t be [getting] slaps on the back, and [be rated] outstanding or good in anything else.” Read full story (paywalled) Source: HSJ, 28 August 2020
  20. News Article
    A damning new report has exposed numerous lapses in nursing care on wards at Shrewsbury and Telford Hospital Trust amid a culture which left patients at risk of “unsafe and uncaring” treatment, the care watchdog has said. Inspectors from the Care Quality Commission (CQC) cited multiple examples of nurses at the scandal-hit trust lacking the knowledge to look after patients safely and failing to record key information needed to keep patients safe during an inspection of medical wards in June this year. The inspectors found poorly completed nursing records, equipment unavailable and nurses not following procedures. This meant some patients developed pressure sores, fell from their beds and were injured or suffered pain at the end of their life. Other patients were at risk of suffering similar harm. Inspectors ruled the trust, which was rated inadequate and put into special measures in 2018, was unsafe and criticised the hospital leadership for what it said was a “collective failure” that was perpetuating the problems at the hospital. Read full story Source: The Independent, 14 August 2020
  21. News Article
    Leeds Teaching Hospitals has launched a support fund for patients, their relatives and volunteers who may be struggling financially due to the coronavirus pandemic. The fund is intended to assist (but is not limited to): Bereaved relatives facing immediate financial pressures until their personal financial affairs are sorted eg having weekly bills to meet and no immediate access to bank accounts Patients isolating for 14 days in advance of admission to hospital and suffering income loss, excess cost or other financial hardship as a result Patients, their immediate families or volunteers who have experienced significant household income loss as a result of the pandemic and are struggling with financial obligations Those experiencing significant increases in costs as a direct result of the pandemic, eg increased childcare costs Read the full article here
  22. News Article
    Hospital bosses at scandal-hit Shrewsbury and Telford Hospital Trust were more concerned with reputation management than addressing patient safety concerns in its maternity department, according to a new NHS investigation. Families harmed by poor care at the trust have called for chairman Ben Reid to resign after the report by NHS England revealed how senior figures in the trust, including the former chief executive, tried to soften a report into maternity services that raised serious concerns over safety. The Royal College of Obstetricians and Gynaecologists (RCOG) report was not published until after the college had agreed to an “unprecedented” addendum report 12 months after its inspection in 2017, that presented the trust in a more positive light. When the final report was made public in July 2018 the addendum was placed at the front of the report. The original RCOG report warned: “Neonatal and perinatal mortality rates will not improve until areas of poor / substandard care are addressed.” Read full story Source: The Independent, 22 July 2020
  23. News Article
    The Parliament and Health Service Ombudsman (PHSO) been working with the NHS and other public service organisations, members of the public and advocacy groups to develop a shared vision for NHS complaint handling. We've called this the Complaint Standards Framework. Now they want to hear from you. Have your say in shaping the future of NHS complaint handling by taking part in their survey. Read the Complaint Standards Framework: Summary of core expectations for NHS organisations and staff
  24. News Article
    The list is a dismal and shameful one - Mid-Staffordshire, Morecambe Bay, the rogue surgeon Ian Paterson, maternity care at the Shrewsbury and Telford. All are patient safety scandals involving tragic stories of life-changing mistreatment of patients and, in some cases, the loss of loved ones. Pledges have been made that patient safety will be put front and centre of health policy. New regulators have been put in place. But now yet another review has found the health system in England to be "disjointed, siloised and defensive" and that the culture needs a shake-up. It has called for a new patient safety champion with legal powers to be put in place. The plan is to have an individual with "real standing" outside and independent of the system, accountable to the parliamentary Health and Social Care Select Committee. The Commissioner would be expected to take up and investigate patient complaints where appropriate, and hold organisations to account - the review had stated that the failure of health authorities to respond to concerns was a recurrent theme. Read full story Source: BBC News, 8 July 2020
  25. News Article
    The NHS will be unable to meet the needs of patients unless significant action is taken to tackle staff shortages, an unprecedented coalition of health leaders has warned. Medical royal colleges, NHS trade unions and bodies representing senior hospital managers and other health organisations have joined together to warn bosses at NHS England and the government that they must act to ensure the health service workforce is supported in the wake of coronavirus. The organisations said they were united in the belief that meaningful action on long-standing workforce issues would be the best way to repay the efforts of NHS staff during the virus outbreak – calling for a public commitment to boost numbers, increase flexible working, and improve leadership and support for staff. Professor Carrie MacEwen, chair of the Academy of Medical Royal Colleges, which organised the statement, told The Independent: “Continued staff shortages in the NHS will be hugely damaging for patients. It has long been recognised that there is a serious shortage of doctors and nurses and right now we need to keep the staff we have, who have done a brilliant job during the pandemic, as well as increase the size of the workforce." Read full story Source: The Independent, 7 July 2020
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