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Found 800 results
  1. Content Article
    National Voices were asked by NHS England and Improvement to explore the experience of waiting for care. They wanted to understand how waits, delays and cancellations impact on people and their families, particularly those living with long-term, multiple and chronic conditions. The findings have compelling insights into issues around communication, receipt of referral, contacting health and care teams, estimations around length of wait, updates on delays, access to support and self-management and much more. COVID-19 has led to many cancellations and delays, and it is clear that waiting will be an important feature of healthcare in England in years to come. Health inequalities also impact access to care and treatment and the experience of waiting. This makes the findings in Patient. Noun. Adjective even more important. "Health and wellbeing deteriorates whilst being on a waiting list. For instance, recent polls found that half of those with experience of joint replacement surgery said their physical health deteriorated and one third said their mental health deteriorated while they were waiting."
  2. News Article
    Three acute trusts have teamed up to carry out surgical procedures on hundreds of children over several weekends as part of plans to tackle waiting lists in the region. Trusts across the Bath and North East Somerset, Swindon and Wiltshire Integrated Care System are pooling resources to tackle long waits in paediatric oral and ear, nose and throat services. The initiative began on the April bank holiday weekend. Thirty-eight of the longest waiters from Royal United Hospitals Bath Foundation Trust, who had been waiting up to 74 weeks for oral surgery, were treated by Salisbury FT. The other trust involved in the plans is Great Western Hospitals FT. More than 400 children are expected to be treated over a series of joint surgery weekends. The next, which will also focus on both oral and ENT surgery, will take place over the early May bank holiday. RUH’s chief executive Cara Charles-Barks told HSJ the joint surgery plans will have a “huge impact” on the region’s elective waiting lists. Read full story (paywalled) Source: HSJ, 21 April 2021
  3. Content Article
    The ongoing impact of COVID-19 on health services across Europe has in most cases led to significant reductions in cancer screening, testing and diagnosis. The resultant delays in diagnosis are impacting cancer treatment and survival and are likely to do so for many years to come. Responses in individual countries and for individual tumour groups have differed, but there are common challenges in all countries. Some solutions go above and beyond the obvious actions that all countries are taking, and there are examples of how the system has reacted so far that provides the basis for further discussion on building lasting resiliency into healthcare systems and preparing for post-pandemic recovery. This report, published by IQVIA, highlights some of the approaches already being taken, as well as suggestions for what should be done going forward. It considers different stakeholders – from local pharmacies to national and international organisations – and their roles, as well as multi-stakeholder collaboration and cooperation. It aims to highlight initiatives adopted in some countries that can be shared more widely.
  4. Content Article
    This analysis, from The Health Foundation, looks at what we know about the impact of the second wave of the COVID-19 pandemic on elective care in England.Updated
  5. News Article
    The NHS in England is required by legislation to ensure that at least 92 per cent of patients on the waiting list have been waiting no longer than 18 weeks from referral to treatment. At the end of February, following a year of covid restrictions, that waiting time measure exceeded 52 weeks. How much longer than 52 weeks? We don’t know, because the data stops at “52 plus”. But there is good news, because this is about to change. Guidance was issued during March requiring two major improvements to the published RTT data. Firstly, instead of stopping at 52 weeks plus, the weekly waiting time cohorts will continue up to 104 weeks plus. Secondly, we are going to get a lot more information about mental health and other RTT waiting times, because the catch-all “Other” specialty is going to be broken down into medical, surgical, mental health, paediatric and the rest. Read full story (paywalled) Source: HSJ, 16 April 2021
  6. News Article
    Hundreds of senior NHS managers have voiced their fears for the future of the health service amid the ongoing coronavirus crisis without a significant pay rise to help retain staff on the frontline. A survey of more than 800 senior NHS managers has revealed the extreme pressure some have been working under, with many working 20 or more hours of unpaid extra hours each week. More than 90 per cent backed a significant pay rise for NHS staff to try and head off a feared exodus of nurses, doctors and other staff leaving the NHS after the pandemic. This would help shore up the service as it faces the daunting task of tackling record waiting lists now totalling 4.7 million patients. Some managers said that the government’s planned 1 per cent pay rise was an “insult” and made them feel “worthless”, in responses to the survey, run by the Managers in Partnership union. Another described NHS staff as being treated like “cannon fodder” during the crisis. Read full story Source: The Independent, 16 April 2021
  7. News Article
    Around 4.7 million people were waiting for routine operations and procedures in England in February - the most since 2007, NHS England figures show. Nearly 388,000 people were waiting more than a year for non-urgent surgery compared with just 1,600 before the pandemic began. During January and February, the pressure on hospitals caused by COVID-19 was particularly acute. NHS England said two million operations took place despite the winter peak. However, surgeons said hospitals were still under huge pressure due to the second wave of Covid, which had led to "a year of uncertainty, pain and isolation" for patients waiting for planned treatment. Speaking on a visit to Dartmouth, Prime Minister Boris Johnson said the government would "make sure that we give the NHS all the funding that it needs... to beat the backlog". He said the situation had been "made worse by Covid", and added: "We do need people to take up their appointments and to get the treatment that they need." Read full story Source: BBC News, 15 April 2021
  8. News Article
    The NHS must think “very radically” about how it redesigns its elective pathways following the coronavirus pandemic, Sir Simon Stevens has told HSJ. Speaking at the HSJ Leadership Congress yesterday, NHS England’s chief executive said the service should ensure as much elective work is done as possible, while covid prevalence is low, while at the same time thinking about “different ways of doing things”. He declined to outline how many very long-waiters the service had or would have in coming months, explaining that some predictions have been “significantly off” in the past, and that future demand is unknown. The NHS chief stressed that other areas of the service would also face post-covid pressures, announcing a further investment in and expansion of long-covid clinics. “We want to see equivalent attention paid to the increased needs we’ve seen in mental health services, including eating disorders, and we want to make sure that the health service continues to expand its offer for long covid,” he said. “To that end we have 69 clinics identified last year, we will have 83 long covid clinics in place by the end of this month, so a significant expansion there.” There will be at least one in each integrated care system area, he said. Read full story (paywalled) Source: HSJ, 14 April 2021
  9. Content Article
    In this piece for the BMJ, Partha Kar argues that in these unprecedented times, we need to be honest and clear about what’s feasible within existing staffing and funding envelopes, and that to suggest that all will be OK isn’t fair to the staff or the people.
  10. News Article
    Patients could be waiting as much as two years for vital operations by the time of the next election due to a “truly frightening” backlog of care caused by the pandemic, the NHS’s former boss has said. Lengthening delays in getting treatment in England are will become a major political problem for Boris Johnson and pose a risk to patients’ health, Sir David Nicholson told the Guardian. “The backlog is truly frightening. We can very easily get to the next election with people waiting over two years. It’s easy to do that,” said Nicholson, citing an explosion in the number of people waiting at least a year since the start of the COVID-19 crisis. “The whole issue of access [to care] is a greater threat to the NHS than privatisation because poor access undermines confidence amongst those people who fund the service – taxpayers,” he added. The widespread suspension of normal NHS diagnostic tests and surgery during the pandemic as hospitals prioritised Covid care has left the service in England with a record 4.59 million people waiting for hospital treatment. That number is set to rise to what the NHS Confederation believes could be as much as 6.9m cases by the end of the year as people on a “hidden waiting list” – who put off seeking help after discovering symptoms of illness – finally visit a GP. According to the most recent figures, the number of people who have been waiting for at least a year has rocketed from 1,613 before the pandemic struck to 304,044. Under the NHS Constitution, 92% of people waiting are meant to be treated within 18 weeks. However, a third of the 4.59 million people have already waited longer than that. Read full story Source: The Guardian, 2 April 2021
  11. News Article
    Hospital bosses are bracing themselves for a clash with ministers over how quickly they can clear the backlog of NHS care that built up during the pandemic. They are warning that it will take “years” to treat all those whose care was cancelled because Covid disrupted so many hospital services, particularly surgery and diagnostic tests. Staff shortages, exhaustion among frontline personnel after tackling the pandemic and their need to have a break mean that progress will be slower than the government expects, NHS trust chiefs say. “We can’t say with certainty how long it will take to tackle the backlog of planned operations because we don’t really know how big that backlog will end up being,” said Chris Hopson, the chief executive of NHS Providers. “The NHS will obviously go as fast as it can, as we always do. But it’s already apparent that clearing the entire backlog will take years rather than months.” Read full story Source: The Guardian, 18 March 2021
  12. News Article
    A group of 47 cancer charities says that without urgent action, the UK's cancer death rate will rise for the first time in decades. NHS figures suggest tens of thousands fewer people started cancer treatment since the first lockdown compared to normal times. One Cancer Voice says that the NHS needs more resources. The government says cancer treatment remains a top priority and urges people to see their GP if they have symptoms. Radio 1 Newsbeat has spoken exclusively to One Cancer Voice about the impact of coronavirus on cancer care. The group of charities wants to see more staff available to diagnose and treat cancer, with greater NHS access to private facilities in order to "clear the backlog". "We are calling on the government to invest more money in ensuring the backlog of cancer cases is reduced and eliminated," says Michelle Mitchell, the boss of Cancer Research UK, which heads up One Cancer Voice. "We could face, in this country today, the prospect of cancer survival reducing for the first time in decades. That's why urgent action is required by the government." Read full story Source: BBC News, 16 March 2021
  13. News Article
    NHS England’s cancer director has said it could take another year for the level of cancer treatments and diagnosis carried out to return to normal, after being impeded by COVID-19. National cancer director Dame Cally Palmer told HSJ’s national cancer forum event last week that activity over the past 12 months had been 89% of the previous year, but the service was committed to getting “fully reset” to 2019 levels by March 2022. She shared information showing that, by December 2020, the amount of treatment being carried out following an urgent referral, for most cancers, exceeded December 2019 levels, but that there are still significant treatment backlogs. And, for lung cancer patients, the number of treatments carried out in December 2020 was only 73% of that a year earlier — a decrease from September and October 2020 levels — as covid pressures rose during the third wave. Lung cancer is one of the most amenable to treatment if picked up early. Other areas of diagnostics and treatment have also been severely impeded because of requirements to change practice to reduce the risk of spreading covid, particularly to vulnerable patients. Dame Cally, also chief executive of the Royal Marsden Foundation Trust, said the service was committed to returning to at least normal levels of activity across the board by March next year. Read full story (paywalled) Source: HSJ, 12 March 2021
  14. News Article
    The Covid surge in January hit key services including cancer and routine surgery, NHS England figures show. Less than half the expected number of operations were done, pushing the waiting list to a record-high of 4.6m. More than 300,000 of those have been waiting more than a year for treatment - compared to 1,600 before the pandemic began. Surgeons described it as a dire situation which would take a long time to turnaround. Tim Mitchell, of the Royal College of Surgeons of England, said: "Behind today's statistics are people waiting in limbo. Many will be in considerable pain, others will have restricted mobility and be at risk of isolation and loneliness." "Dealing with this daunting backlog will take time, and also sustained investment in the NHS," he said. Similar problems are also being seen in Scotland where 39,000 people have been waiting over a year for treatment. The NHS Confederation has warned the true picture could be much worse with nearly 6 million fewer referrals made by GPs in England for routine treatments, which includes operations such as knee and hip replacements, last year, suggested there was an additional hidden backlog. The organisation, which represents hospitals, said it was likely people have not sought help or found it difficult to access services during the pandemic. Read full story Source: BBC News, 11 March 2021
  15. Content Article
    The pandemic has impacted on all aspects of NHS care, with elective and diagnostic activities among those services that have been disrupted. This has led to a considerable backlog of people waiting for NHS treatment.  This briefing, from the NHS Confederation, explores what lies ahead for the health service and patients, based on their modelling of referral-to-treatment waiting trajectories in 2021. It offers an outline policy framework, drawn up by their members, for starting to reduce waiting lists in an effective, equitable and efficient way. 
  16. News Article
    NHS clinics were still seeing just two-thirds of the number of chronic pain patients they normally would by the end of last year, with some patients having waited a year or more. In Ayrshire and Arran, 94 of the 112 chronic pain patients seen between October and December – equivalent to nearly 84% – had been on the waiting list for their first appointment for 52 weeks or longer. Only nine were seen within the 18-week target. This was by far the worst performance for any health board in Scotland. Pain relief clinics across NHS Scotland were paused for four months at the beginning of the pandemic, leading to reports that some patients with problems such as nerve damage and arthritis were paying thousands of pounds to travel to private facilities in England for medical infusions or injections to ease their symptoms. In a statement at the end of last year, Joanne Edwards, the director of acute service at NHS Ayrshire and Arran, apologised for the delays, saying the coronavirus pandemic "has had a significant impact on the capacity of the chronic pain service". Ms Edwards said the health board was increasing the number of face to face and telephone clinics that the chronic pain team can undertake, adding that an "enhanced clinical review" of the waiting list was also being carried out to prioritise patients for appointment based on clinical need. Read full story Source: The Herald, 10 March 2021
  17. News Article
    As many as 6 million “hidden” patients could join the queue for NHS treatment in the coming months, swelling official waiting lists to records not seen for more than a decade, health chiefs have warned. In the wake of a Budget that offered no new investment for the health service ministers must level with the public that previous guarantees on waiting times are now impossible to meet, the head of the NHS Confederation has said. In an interview with The Independent, Danny Mortimer said some patients should expect to wait many months, or possibly even beyond a year, for their treatment. He said: “It's going to take many years to recover the waiting list position to where we want it to be. “We have to be realistic about the time that it will take us to address these issues, and the government have to be realistic about what it will take particularly if this week’s Budget is an indication that actually there won’t be money made available to the NHS to truly address these issues. “The government has to take responsibility for explaining to the public what the consequences of that are.” Read full story Source: The Independent, 7 March 2021,
  18. News Article
    A woman with dementia was effectively left housebound for the last eight years of her life due to surgical delays, an investigation found. The Public Services Ombudsman for Wales said the individual worried about being "caught short" due to incontinence and it affected her family relationships. Her son complained about the care she received at Glan Clwyd Hospital in Denbighshire, in particular. Betsi Cadwaladr University Health Board has since apologised to the family. Ombudsman Nick Bennett said it was clear there was "significant injustice" in the case of the individual, who was identified in the report findings as Mrs B. The patient's son complained there had been surgical delays for a rectal prolapse issue dating back to 2011, concerns over inpatient medical care provided by an elderly care consultant, and a delayed diagnosis of terminal ovarian cancer during a hospital stay. The ombudsman found that clinical decision-making by colorectal surgeons "was not in keeping with accepted clinical practice". Read full story Source: BBC News, 2 March 2021
  19. News Article
    The government has been called on to take action over the national “backlog” for a specialist mental health service after a woman died after a substantial wait to access treatment. Carole Mitchell, who died by suicide on 22 November 2019, waited almost seven months for a first appointment after being referred to Greater Manchester Mental Health Foundation Trust for psychology services. In a prevention of future deaths report, published earlier this month, coroner Alison Mutch said the inquest was told waits had since increased and “someone in Mrs Mitchell’s position today would be more likely to wait nine months”. The coroner added evidence heard suggested the delay experienced was “reflective of both the regional and national backlog for appointments”. The report has been sent to both the Department of Health and Social Care and Greater Manchester Health and Social Care Partnership. Read full story (paywalled) Source: HSJ, 1 March 2021
  20. Content Article
    UCLPartners have developed a series of proactive care frameworks to restore routine care by prioritising patients at highest risk of deterioration, with pathways that mobilise the wider workforce and digital/tech, to optimise remote care and self-care, while reducing GP workload. The frameworks include: atrial fibrillation high blood pressure high cholesterol type 2 diabetes asthma COPD. The frameworks are being implemented by GPs across the country, helping practices to identify who needs priority care, and those whose care can safely be delayed. Find out more by following the link below.
  21. News Article
    Hospitals across London are racing to tackle a backlog of tens of thousands of urgent operations that need to be carried out in the coming weeks to prevent patients dying or losing limbs, The Independent has learnt. The slow decline in Covid patient numbers means many hospitals across the capital are warning they will still be relying on extra staff, and “surge” beds opened at the height of the crisis, well into March. NHS bosses have been briefed that across the city there are about 15,000 priority two (P2) patients. These are classed as needing urgent surgery, including for cancer, within 28 days, or they could die or be at risk of losing a limb. But the lack of available operating theatres, nurses and anaesthetists mean the city has a shortfall of more than 500 half-day surgical lists a week. The Independent has spoken with multiple NHS insiders and seen briefing documents detailing the challenges facing the capital’s hospitals, which are expected to last up to 21 March in some areas. One briefing warned: “Hospitals have insufficient capacity to meet urgent elective demand for P2. P2 demand is intended to be seen within 28 days, the surge has occurred for over 28 days. Patients who would normally have been seen are waiting longer than clinically advisable." Read full story Source: The Independent, 25 February 2021
  22. Content Article
    Urgent action is needed in the NHS to meet a ballooning backlog of procedures put on hold during the pandemic and build a more resilient health care system. This report from Reform, produced jointly with Edge Health, shows the scale of the challenges the NHS faces: 6 million fewer patients were referred to treatment in 2020 than in 2019 • 10 million patients could be on a waitlist by April By April, 52-week waits for care are projected to have risen 12,008% since March 2020 (by December they had already risen by 7139%) Cancellations of diagnostic testing and delayed treatment may lead to 1,660 extra deaths from lung cancer alone.
  23. News Article
    Waiting lists for NHS surgery in England could hit 10 million by April, a think tank has claimed while calling for NHS hospitals to use more private sector capacity to reduce delays for patients. In a new report the right-wing think tank Reform said the worst case scenario for patient waits could see one in six people in England waiting for treatment by April. It said the impact of coronavirus had turned the NHS into a “national Covid service” with six million fewer referrals for treatment in 2020. It warned the delays in treatments could have dire consequences for patients with an estimated 1,660 additional lung cancer deaths. But NHS bosses have hit back at the report saying it is inaccurate to say the NHS focused only on Covid, and that despite widespread cancellations it has continued to treat other patients. Predictions that the NHS waiting list would hit 10 million were made last year and proved wrong after hospitals ramped up routine services during the summer – although the second wave of the virus has again led to widespread cancellations including for surgery patients. The new Reform report claims capacity in private sector hospitals, where NHS England has secured new contracts to take on additional work during the Covid surge, have not been effectively used. The think tank wants NHS England to mandate the publication of ‘waiting list recovery plans’ by NHS trusts setting out how each hospital will use the private sector. Read full story Source: The Independent, 17 February 2021
  24. Content Article
    Jerome, a patient safety manager, discusses the impact the pandemic is having on patient referrals and waiting lists, and the subsequent increases in serious incidents and never events that will arise. With an already overstretched and exhausted workforce, how will these be investigated, how will this be managed? Jerome urges NHS England to give guidance.
  25. News Article
    The backlog of patients who have been waiting for cancer treatment for more than 104 days has more than doubled since last year, according to internal NHS England papers seen by HSJ. At the start of February, the backlog of cases already at more than 15 weeks had hit 6,109, compared to 3,000 at the same point in 2020. National targets state cancer patients should be treated with 62 days of being referred. In the North West region, the backlog has nearly tripled over the same time period, from 289 to 831 (see regional breakdown below). Senior sources told HSJ the increase had been largely driven by acute providers in Greater Manchester and Merseyside. Cases in which patients have to wait more than 104 days for treatment are generally considered serious breaches, and typically trigger a process to identify if the delay has caused harm to the patient. Some local systems have declared a “zero tolerance” for such instances. The data in the papers is provisional. Michelle Mitchell, Cancer Research UK’s chief executive, said the impact of covid-19 on cancer patients has been “devastating”. She added: “The government must urgently make sure the NHS gets the funding it needs to increase cancer service capacity, and give every person with cancer the timely diagnosis and treatment they deserve.” Read full story (paywalled) Source: HSJ, 13 February 2021
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