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Found 800 results
  1. News Article
    One in eight adults in the UK have paid for private medical care in the last year because of long delays in getting NHS treatment, renewing fears that the NHS is becoming “a two-tier system”. “Around one in eight (13%) adults reported they had paid for private medical care, with 5% using private insurance and 7% paying for the treatment themselves,” according to a new report by the Office for National Statistics (ONS). Patients also say that waiting for tests or treatment is badly affecting them, including making their illness worse. The ONS survey of 2,510 adults across the UK found that one in five were waiting for an appointment, test or treatment at an NHS hospital. Of those in that situation: Three-quarters said their delay had had either a strongly (34%) or slightly (42%) negative impact on their life 36% said waiting had made their condition worse 59% said it had damaged their wellbeing A third said long waits had affected either their mobility (33%) or ability to exercise (34%) Read full story Source: The Guardian, 16 December 2022
  2. News Article
    Vulnerable patients, including some children, have faced long delays for a suitable bed as organisations argue over whose responsibility it is to fund and deliver their care, HSJ understands. In a letter outlining winter arrangements, NHS England has warned trust leaders and commissioners against delaying emergency mental health admissions – typically needed when a patient is away from home, and understood to be more common over the Christmas period – while determining which area has which responsibility. National mental health director Claire Murdoch wrote: “It is not acceptable to delay an emergency mental health admission while determining which area has clinical and financial responsibility for the care of an individual.” She added such admissions should be arranged “as quickly as possible, and without delay caused by any financial sign-off process”. It comes as HSJ has been told patients can often end up waiting for several days in emergency departments or in “inappropriate” out of area or acute beds when disputes occur over who is responsible for their care. Read full story (paywalled) Source: HSJ, 15 December 2022
  3. News Article
    Nearly 8,900 more people have died of cancer than expected in Britain since the start of the pandemic, amid calls for the Government to appoint a minister to deal with the growing crisis. In an essay in The Lancet Oncology, campaigners and medics said the upward trend of cancer deaths is likely to continue, with 3,327 in the last six months alone. They urged the Government to tackle the crisis with the same focus and urgency given to the Covid vaccine rollout, and called for a cancer minister to get on top of the backlog. NHS data from November showed that in the last 12 months, 69,000 patients in the UK have waited longer than the recommended 62-day wait from suspected cancer referral to start of treatment. Professor Gordon Wishart, a former cancer surgeon and chief medical officer of Check4Cancer, said: “The Covid-induced cancer backlog is one of the deadliest backlogs and has served to widen the cracks in our cancer services". “Now we face a deadly cancer timebomb of treatment delays that get worse every month because we don’t have a sufficiently ambitious plan from policymakers. I urge the Government to work with us.” Read full story (paywalled) Source: The Telegraph, 15 December 2022
  4. News Article
    Orthopaedic patients in NHS Highland face a wait of up to seven years for surgery, new research has found. A University of Aberdeen study said the worst case estimate would apply if surgical rates did not increase for those listed in July this year. Researchers also discovered the average wait across Scotland's 14 health boards could be as long as two years and three months. The Scottish government said it was working to maximise NHS capacity. Luke Farrow, clinical research fellow, warned that the significance of the delays could not be underestimated. He said: "Prolonged waits for certain orthopaedic procedures can have a major negative impact on patient health. "This occurs both in terms of deterioration in quality of life whilst awaiting surgery, as well as potential negative connotations for post-operative recovery and longer-term health in addition to reduced independence and increased social care needs." Read full story Source: BBC News, 14 December 2022
  5. News Article
    Increasing numbers of emotionally troubled children have been taken into care while waiting long periods for NHS treatment because their condition deteriorated to the point where their parents could no longer cope with their behaviour, child protection bosses have revealed. Association of Directors of Children’s Services (ADCS) president Steve Crocker said that since the pandemic, youngsters with complex emotional needs had become a significant factor in rising child protection referrals. “We are seeing children in the social care system because they have not been supported in the [NHS] mental health system,” he said. Crocker urged ministers to “do better” for children facing “unacceptable” delays in NHS mental health treatment, adding that it was not uncommon for waiting lists to involve waits of over a year. Councils were “filling gaps” in NHS provision but struggling to find placements for children with severe behavioural problems, and when they did, typically paid “untenable” fees of tens of thousands of pounds a week. He accused private children’s residential care providers and their “rapacious” hedge fund backers of “profiteering” from the care crisis, and urged the government to intervene to cap typical profit margins that were currently about 20%. “We do not see how this can be allowed to continue,” he said. Read full story Source: The Guardian, 13 December 2022
  6. Content Article
    Writer and commentator Roy Lilley writes a daily email about what's happening on the ground in the NHS, and how this relates to policy decisions and guidance. Roy describes his eLetters as "a combination of opinion, my take on issues of the day and a news digest of things that I think are important or interesting." In this email, Roy shares several recent accounts sent to him by doctors and other healthcare professionals working in NHS hospitals. They describe dangerous staff ratios, overcrowding and medication shortages. The common theme is dangerously long working hours that could impact on patient safety. Sign up to receive Roy Lilley's daily eLetter.
  7. News Article
    The number of operations cancelled by the NHS in England because of staff shortages may have doubled in three years, with an estimated 30,000 not proceeding because no staff were available to perform them. At least a third of cancelled operations were those that were deemed urgent, according to the analysis by Labour. It suggested at least 2,500 cancelled operations for cancer patients and 8,000 on children. It found staff shortages were the most common reason given for cancellations by hospitals, accounting for one in five of all operations cancelled for non-clinical reasons last year. The Department of Health and Social Care said it was “misleading” to extrapolate that figure from the data in the FOIs. “Thousands of elective appointments and procedures had to be cancelled during the pandemic to protect the NHS, and since then we’ve been focused on delivering the biggest catch-up programme in health history - virtually eliminating the longest 2-year waits for treatment,” a spokesman said. In total, 158,000 operations were cancelled for issues including equipment failures, a shortage of beds, and 5,700 because of equipment failure, administrative errors, and theatre lists overrunning. Labour cited one case that involved a 72-year-old woman who had two operations to remove a brain tumour cancelled in September, blamed on a lack of available beds. About 9,500 operations were cancelled because an emergency case took priority, and 250 due to adverse weather. Separate figures from the NHS show record numbers of operations cancelled at the last minute are not rearranged to take place within a month, with one in five patients waiting longer. Read full story Source: The Guardian, 12 December 2022
  8. News Article
    Bosses at the North West Ambulance Service issued an urgent warning to members of the public on 999 calls and apologised for delays last night. At 5pm on Monday (December 12), more than 600 patients were waiting for an ambulance across the North West, the service said. Another 100 emergency vehicles were parked outside of hospitals waiting to handover patients. 'Severe weather and hospital handover delays' had an impact on the service last night, as well as 'significant demand'. Ambulance chiefs said they had to 'maximise resources' by putting all clinically-trained staff on the frontline and increasing use of private providers. In an urgent message issued on Monday night, medical director Dr Chris Grant said: "This is an urgent message for the public across the whole of the North West. Tonight, across both our 111 and 999 services, we're seeing a really significant demand and I apologise for the delay in getting care to you but I do need your help. "We've called in all our operational and clinical resources to make sure we prioritise those who have the most life-threatening conditions. We need to keep our phone lines free so please only call us back if you no longer need our help or if your own condition has got significantly worse. Thanks for your support." Ged Blezard, director of operations at NWAS said: "Please only call 999 if someone has a serious illness or injury, you think their life is at risk, and you cannot get them to hospital by any other means. We know there are patients waiting for our help and we are sorry that we are unable to respond as quickly as we would like. Read full story Source: Manchester Evening News, 13 December 2022
  9. News Article
    A “decade of neglect” by successive Conservative administrations has weakened the NHS to the point that it will not be able to tackle the 7 million-strong backlog of care, a government-commissioned report has concluded. The paper by the King’s Fund says years of denying funding to the health service and failing to address its growing workforce crisis have left it with too few staff, too little equipment and too many outdated buildings to perform the amount of surgery needed. The UK’s poor public finances, health service staff suffering from exhaustion, and a wave of NHS strikes this winter will also lead to ministers being unable to deliver key pledges on eradicating routinely long waits, the thinktank says. “Though Covid certainly exacerbated the crisis in the NHS and social care, we are ultimately paying the price for a decade of neglect,” said the King’s Fund chief executive, Richard Murray. “The sporadic injections of cash during the austerity years after 2010 were at best meant to cover [the service’s] day-to-day running costs. This dearth of long-term investment has led to a health and care system hamstrung by a lack of staff and equipment and crumbling buildings. These critical challenges have been obvious for years. “The NHS in 2022 faces many of the same challenges it faced in 2000: unacceptably long waiting times and a service hobbled by staff shortages. To that is now added a cost of living crisis, industrial action by staff and a backdrop of a weak economy and weak public finances.” Read full story Source: The Guardian, 12 December 2022
  10. Content Article
    In the face of record high waiting times for elective care, The King's Fund undertook research to understand the strategies that have been used to reduce waiting times in England and elsewhere in the past 20 years. Elective care waiting lists and waiting times are a product of the fluctuations in and disparities between the demand for and available supply of healthcare. Understanding the root causes of these disparities and taking corrective action to restore balance between demand and supply and optimising the conditions within the health care system is therefore considered key to any strategy to reduce waiting times and sustain them at that level.
  11. News Article
    The number of people waiting more than two months to start cancer treatment remained over 30,000 — double the pre-covid level — for three months to the end of October, according to new data published. NHS England previously committed to bringing the number of people waiting longer than 62 days to be diagnosed and begin treatment, after referral for suspected cancer, to pre-pandemic levels – roughly 14,000 – by March 2023. But the number has been generally growing since the spring, and remained above 30,000 from August through to the end of October, the latest figures available. September and October’s monthly totals were higher than the previous monthly peak in May 2020, after services were disrupted in the first covid wave. The increase in waiters this year has been caused by diagnostic and treatment capacity falling short of an increased number of referrals. Matt Sample, policy development manager at Cancer Research UK, said: “While it’s good to see significant numbers of people coming forward with potential cancer symptoms, performance against key targets are among the worst on record, continuing a trend that existed long before the pandemic hit, with one target having been missed for almost seven years.” Read full story (paywalled) Source: HSJ, 8 December 2022
  12. News Article
    Busy, noisy, highly stressful - and sometimes violent. This is the reality of A&E as the NHS gears up for what will be an incredibly difficult winter. That much is clear from the experience of staff and patients at Royal Berkshire Hospital's emergency department. Like all units, it is struggling to see patients quickly - more than a third of patients wait more than four hours. The stress and frustration means tempers can easily boil over. Receptionist Tahj Chrichlow says it can get so busy patients end up "packed like sardines". "Sometimes people can be not as nice to us as we like," he adds, explaining how earlier this week the window of the reception office had been smashed by one angry person. The Royal College of Emergency Medicine is warning delays are putting patients at risk. Vice president Dr Ian Higginson says hospitals are "full to bursting". "When our hospitals are full, we can't get patients out of our emergency departments. "That means emergency departments become overcrowded and we see patients waiting for long periods on uncomfortable trollies in corridors or other rubbish places." Dr Higginson says his colleagues are "very worried" and unable to deliver the care they would like to give to patients. Read full story Source: BBC News, 8 December 2022
  13. Content Article
    The waiting list in England stood at more than seven million in September 2022, up by 1.2 million since September 2021 and 2.6 million since 2019. This analysis by the King's Fund outlines what different patients on the waiting list are waiting for, breaking this figure down into: different medical and surgical specialties whether patients are waiting for admission, diagnostics or decisions It highlights that many on the waiting list are awaiting further diagnostics or decisions before treatment can commence, and others are waiting for treatment that does not require admission to hospital.
  14. News Article
    Patients will be encouraged to choose private hospitals for NHS care under plans to help clear backlogs of routine operations through outsourcing more treatment. A task force of private healthcare bosses and NHS chiefs met in Downing Street for the first time yesterday in an effort to find more capacity for hip replacements, cataracts and other routine procedures in the independent sector. NHS bosses are hopeful of meeting a target to eliminate waits of more than 18 months by April, but there is increasing concern in government about whether one-year waits can be eliminated by 2025 as planned. Private hospitals say they have spare capacity that could help bring down waits but NHS bosses have been sceptical. Patients have long had a legal right to choose where they are treated but ministers are planning a fresh push for GPs to offer them the choice of having NHS treatment in private hospitals, in a revival of a Blair-era scheme. Steve Barclay, the health secretary, said he wanted to “turbocharge our current plans to bust the backlog and help patients get the treatment they need”. Read full story (paywalled) Source: The Times, 8 December 2022
  15. News Article
    Lying on a trolley in a hospital corridor in pain from a broken hip, Anne Whitfield-Ray could not believe she was in the care of the NHS. "It was absolute chaos - like something out of a third world country," said the 77-year-old from Worcestershire. "The staff were rushed off their feet, paint was peeling off the walls and patients were being squeezed in everywhere they could - in makeshift bays, in corridors and side rooms. It was horrific." Anne spent 15 hours in that position until a bed could be found for her. Such delays used to be the exception, something that happened on the odd occasion in the depths of winter. Now they are commonplace. Latest figures show nearly 40% of A&E patients who need admitting face what is called a trolley wait - a delay of four hours or more waiting for a bed to be found. These are the sickest and frailest patients - the ones who cannot be sent home immediately after treatment. Research has linked delays like this with longer hospital stays and even a higher risk of death. By the time patients get to this point, they may have already faced hours of waiting in A&E or, increasingly, stuck outside A&E in the back of an ambulance, as was the case for Anne. She is now back home recovering after surgery, a few days after her fall in October. She said that despite her experience she cannot fault the staff: "They are doing the best they can. But this is not what should be happening in the NHS". Read full story Source: BBC News, 8 December 2022
  16. News Article
    The government is setting up 19 more diagnostic centres in communities across England to help tackle the Covid backlog. Ninety one are already open and have delivered more than 2.4 million tests, checks and scans since last summer, ministers say. It is hoped the centres will speed up access to services for patients, thereby reducing waiting times. Seven million people in England are now waiting for hospital treatment. GPs can refer patients to community diagnostic centres so that they can access life-saving checks and scans, and be diagnosed for a range of conditions, without travelling to hospital. Some are located in football stadiums and shopping centres and can offer MRI and CT scans, as well as x-rays. In September, according to the government, the hubs delivered 11% of all diagnostic activity - and its ambition is for 40% to be achieved by 2025. Read full story Source: BBC News, 7 December 2022
  17. Content Article
    This article looks at the potential to use the continuous flow model to tackle unprecedented levels of overcrowding in emergency departments. The continuous flow model, also known as full capacity protocols, was first introduced in North America in the late 1990s. It mandates that a set number of patients are moved at set times from the emergency department to inpatient wards, regardless of whether a bed is available. This might mean putting an extra patient in a bay or two patients in a side room or boarding them in hospital corridors. In turn, this encourages wards to discharge existing patients, allows ambulances to offload new patients in the space created in the emergency department, and relieves pressure on the whole system. This article looks at the fact that evidence to support the continuous flow model is scarce, although positive, and that there are a number of important factors to consider before implementing the model, to ensure that it does not result in increased patient harm.
  18. News Article
    Ambulance services across England are set to go on strike before Christmas as thousands of paramedics and call handlers voted for action. The announcement by union Unison comes as the Royal College of Nursing (RCN) confirmed 100,000 nurses across England, Wales and Northern Ireland will walk out on 15 and 20 December. The union is calling for action on pay and a big increase in staff numbers, warning that unless these things happen, services will continue to decline. Saffron Cordery, interim chief of NHS Providers, said on BBC radio four: “I think in terms of the ambulance strike, we know the challenges already of not having enough paramedics, call handlers available, because we’ve seen the challenges to ambulance handover times that we have at the moment in terms of not being able to transfer patients from ambulances into A&E departments and the challenges that brings when they can’t get back out on the road. “Additional challenges on top of that, I think, will make response times incredibly stretched.” Sources told The Independent that one option could be for services to maintain levels of staff to be able to respond to the most serious calls - category one and two calls - and deprioritise the less serious category three and four calls. This has previously been negotiated during smaller-scale strikes. However, senior sources suggested that on a larger scale it would be hard to not respond to category three calls, which might include an older person who has fallen. It is also unclear how 999 call centres would operate during strikes as this work would likely count as life-saving emergency care, The Independent understands. Read full story Source: The Independent, 2 December 2022
  19. News Article
    More than 11,000 ambulances a week are caught in queues of at least an hour outside A&E units in England, a BBC News analysis shows. The total - the highest since records began, in 2010 - means one in seven crews faced delays on this scale by late November. Paramedics warned the problems were causing patients severe harm. One family told BBC News an 85-year-old woman with a broken hip had waited 40 hours before a hospital admission. She waited an "agonising" 14 hours for the ambulance to arrive and then 26 in the ambulance outside hospital. When finally admitted, to the Royal Cornwall Hospital, which has apologised for her care, she had surgery. Both ambulance response times and A&E waits have hit their worst levels on record in all parts of the UK in recent months. In Cornwall, patients facing emergencies such as heart attacks and strokes are now waiting more than two hours on average for an ambulance. The target is 18 minutes. They are thought to be among the worst delays in the country but none of England's ambulance services is close to the target, while Wales, Scotland and Northern Ireland are all missing their targets. Read full story Source: BBC News, 1 December 2022
  20. News Article
    NHS England has acted unlawfully by making thousands of patients with gender dysphoria wait “extreme” periods of time for treatment, the high court has heard. Transgender claimants, who have suffered distress as a result of delays, want the court to declare that NHSE broke the law by failing to meet a target for 92% of patients to commence treatment within 18 weeks. NHSE figures show there are 26,234 adults waiting for a first appointment with an adult gender dysphoria clinic, of whom 23,561 have been waiting more than 18 weeks. The number of children on the waiting list is approximately 7,600, of whom about 6,100 have been waiting more than 18 weeks. In a witness statement, one of the claimants, Eva Echo, said she received a referral in October 2017 but had still not been given a first appointment, leaving her in “painful indefinite limbo”. A co-claimant, Alexander Harvey, who has been waiting for a first appointment since 2019, said the delay “means that I have to continue to live in a body which I don’t feel is mine and which does not reflect who I am”. He said he had twice tried to kill himself. In written submissions for Tuesday’s hearing, David Lock KC, representing the claimants, said delays to puberty-blocking treatment – the current waiting time for children to access services is more than two years – could cause “intense anxiety and distress” to adolescents as a result of them experiencing “permanent and irreversible bodily changes”. While NHSE accepts it has not met the 92% target across the cohort of patients for whom its health services are commissioned, it claims a breach does not give rise to enforceable individual rights. Read full story Source: The Guardian, 29 November 2022
  21. Content Article
    In this opinion piece for the Daily Mail, journalist Tom Utley recounts his recent experience of a seven hour wait at A&E after receiving abnormal blood test results from his GP. He argues that fear of litigation is causing GPs to refer patients on to A&E unecessarily, contributing to the overcrowding happening at emergency departments. He also highlights inefficiencies in the system and states that lack of staff capacity to tell him he didn't require any treatment meant he stayed an additional hour and a half in the waiting room.
  22. Content Article
    This article by Rebecca Rosen and Trisha Greenhalgh in the BMJ looks at the safety of remote GP consultations. It begins by looking at the case of student David Nash, who tragically died in 2020 after four telephone consultations with his GP; he was denied an in-person appointment for a painful ear infection that led to a fatal brain abscess. One coroner has raised concerns that this is not a one-off incident, noting that in five inquest reports they wrote during the pandemic, they question whether deaths could have been prevented by in-person consultations. The authors look at the recommendations of the ongoing 'Remote by Default 2' study, which is exploring how best to embed remote consulting in future GP services. They highlight better triage of appointment requests, active listening, checking back, increasing the use of video consulting and better training for clinicians as factors that could improve the safety of remote consultation.
  23. News Article
    NHS England’s chief executive has admitted the service is behind on its commitment to increase elective activity to 130% of pre-covid levels by 2025, saying the recovery would need to be ‘reprofiled’ to catch up after this year. Amanda Pritchard told MPs on the Public Accounts Committee that NHS England would need to “re-profile some of the [elective recovery] trajectories”, as progress this year was being hampered by a combination of higher than expected covid rates, flu, workforce challenges and industrial action. She later added that the 2025 target could “theoretically” be missed, but stressed “we are a very long way from that” and indicated she believed the NHS could catch up in future years. Elective recovery plans agreed between NHSE and government last autumn said activity would recover to 110% of pre-covid levels in 2022-23. Yet published data shows many systems have so far been carrying out fewer procedures than before covid in most months. Asked by the committee’s chair Meg Hillier if she was confident the NHS would hit the 2025 activity target, first agreed for the 2021 spending settlement, Ms Pritchard replied: “I think at the moment we are absolutely aiming [to hit the target] at the end of that period of time, but we do recognise that we are going to need to re-profile trajectories to get there.” Read full story (paywalled) Source: HSJ, 28 November 2022
  24. News Article
    People suffering from mental illness are increasingly struggling to access help at every level of the NHS – from record numbers facing “unacceptable” delays in referrals to patients waiting up to eight days in A&E for a hospital bed. Figures seen by The Independent show almost four times as many people are waiting more than 12 hours in emergency departments as two years ago. In the community, more than 16,000 adults and 20,000 children who should receive NHS care are unable to access vital services each month. Nearly 80% of those eligible for counselling on the health service are left waiting more than three months for a second appointment, which is when treatment usually begins. Health leaders say they are “deeply concerned” by the lack of resources available to handle the rise in demand – and warned that the cost of living crisis would exacerbate the issue further. Monica Smith went to A&E at Lewisham last month after her mental health deteriorated when her medication ran out and she was unable to get more. The 32-year-old said: “I was told, ‘We can’t find any beds – there’s no bed in the whole country or the whole region, so we’re going to have a bed on A&E and hopefully you’ll get a bed in the morning.’” Monica started hallucinating and was given medication to calm her down, but in the morning there was still no bed. Doctors tried to send her home, she said, but crisis services assessed her three times over the following days and each time decided she was too unwell. Instead, Monica stayed in an annex off A&E with other mental health patients. She said: “I was on this, like, mattress, like a mental health mattress on the floor.” Read full story Source: The Independent, 27 November 2022
  25. News Article
    Some of the country’s GP are advising patients requiring urgent hospital care to “get an Uber” or use a relative’s car because of the worst ever delays in the ambulance service in England. Patients with breathing difficulties and other potentially serious conditions are being told in some cases that they are likely to be transferred more quickly from a general practice to accident and emergency if they travel by cab or private vehicle. NHS England data shows that October’s average ambulance response times for category 1 to 3 emergencies, which cover all urgent conditions, appear to be the highest since the categories were introduced nationally in 2017. Some patients who require emergency treatment may have to wait several hours for an ambulance to arrive. Dr Selvaseelan Selvarajah, a GP partner in east London, said: “If somebody is not having a heart attack or a stroke, my default advice is ‘have you got someone who can drive you or do you want to get an Uber?’ “These are patients who may have breathing difficulty or are suffering severe abdominal pain, but their life is not in immediate danger.” He said such patients would have previously been transferred by ambulance. Read full story Source: The Guardian, 27 November 2022
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