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Content ArticleThe results from the 2022 British Social Attitudes survey made for very difficult reading for those of us working in the NHS right now. Overall satisfaction with the NHS is at the lowest level ever recorded and similarly satisfaction with individual services is at record lows across the board, but it was satisfaction with A&E services that saw the sharpest fall in 2022. Kelly Ameneshoa, an Emergency Medicine Doctor working across South London and Surrey, reflects on the findings.
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News Article
Scandal of mentally ill children dumped on the wrong hospital wards
Patient Safety Learning posted a news article in News
Thousands of children in mental health crisis are being treated on inappropriate general wards – with some forced to stay for more than a year and staff not properly trained to care for them, shocking new data reveals. New figures uncovered by The Independent show at least 2,838 children needing mental health care were admitted to non-psychiatric hospitals last year as the NHS battled with a lack of specialist staff and a surge in patients. Children with eating disorders – who often need to be restrained to be fed through tubes – are among those being routinely put on general wards. It means staff without any specialist training, including security guards, are sometimes left to restrain these young patients. One trust chief nurse told The Independent that porters had to be trained to restrain children on paediatric wards, causing trauma for both patients and staff. Dr Camilla Kingdon, president of the Royal College of Paediatrics and Child Health, said she was “deeply concerned” about the situation. “We now find ourselves in a situation where children and young people who have an eating disorder or mental ill health, and who may be on long waiting lists for treatment, are increasingly ending up in emergency settings and then being treated on general paediatric wards. This simply isn’t good enough,” she said. Read full story Source: The Independent, 1 May 2023 -
Content ArticleWith record-long waits for treatment, it has never been so important for NHS trusts to understand the level of risk to patients on the waiting lists. But while it’s one thing to assess and categorise the patients and their risks while waiting, it’s quite another to then subsequently intervene to effectively care for patients during that wait. With the use of technology, there are potentially enormous gains to be made on waiting list management, and one integrated care system is forging ahead on this front. The ICS in question is Cheshire and Merseyside. HSJ takes a look at the progress Cheshire and Merseyside are making.
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News Article
Who is being hit hardest by the NHS' waiting list of 7 million people?
Patient Safety Learning posted a news article in News
Seven million people in England are currently waiting for treatment on the NHS. That's more than the entire populations of some countries, including Denmark and New Zealand. Just under half of those referred to a specialist will have been in the queue for longer than 18 weeks — the maximum target set in 2004 by the Government. And more than 360,000 of them will have been waiting a year or more. It's a deeply troubling state of affairs that has been thrown into sharp focus by the impact of the junior doctors' strike. However, 'treatment delays existed long before the doctors' strike — and also the Covid-19 pandemic,' Danielle Jefferies, a senior analyst with independent think-tank The King's Fund, told Good Health. Indeed, while the impact of the virus may have worsened the bottlenecks, the problem of rising patient demand is of longer standing. And the potential consequences are terrifying. Studies show that for each month patients with breast, bowel or head and neck cancers have their treatment delayed, the chances of them dying from the disease increase by 6 to 13%. Meanwhile, eye specialists fear some people may suffer permanent sight loss because they cannot get to a specialist in time to prevent the worsening of serious conditions such as glaucoma, which affects around 700,000 people in Britain. Read full story Source: MailOnline, 19 April 2023 -
News ArticleChronically ill patients across the UK allege they've had to go without vital medication amid delays by a private company contracted by the NHS to deliver drugs. In the last year alone, Sciensus was awarded NHS contracts worth more than £5 million, despite being placed into special measures by health regulators in 2021 following widespread delivery failings. ITV News has revealed that the CQC is currently reviewing whether to take further regulatory action against Sciensus, having been made aware of concerns about the company’s performance. The company, which is based in Burton-on-Trent and says it "works with every NHS Trust in the country", should provide a lifeline for those who rely on specialised medications. These include those with long-term conditions - like cancer, HIV, and haemophilia - which often require drugs that can't be collected from high street or hospital pharmacies. One new mother with rheumatoid arthritis said she was taken to A&E after Sciensus left her without medication for three weeks. The 37-year-old, who wishes to remain anonymous, told ITV News: "I was unable walk with a small baby... it was such a chronic flare that I couldn't walk, which I've never, ever had before in my life." Read full story Source: ITV News, 21 April 2023
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Content ArticleThe objective of this study from Sharma et al. was to evaluate the accuracy of a new elective surgery clinical decision support system, the ‘Patient Tacking List’ (PTL) tool (C2-Ai(c)) through receiver operating characteristic (ROC) analysis. They found that the PTL tool was successfully integrated into existing data infrastructures, allowing real-time clinical decision support and a low barrier to implementation. ROC analysis demonstrated a high level of accuracy to predict the risk of mortality and complications after elective surgery. As such, it may be a valuable adjunct in prioritising patients on surgical waiting lists. Health systems, such as the NHS in England, must look at innovative methods to prioritise patients awaiting surgery in order to best use limited resources. Clinical decision support tools, such as the PTL tool, can improve prioritisation and thus positively impact clinical care and patient outcomes.
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Content ArticleThe number of people waiting for elective healthcare is at record levels. As well as compelling moral reasons to reduce NHS waiting lists, there is also a convincing economic case to go further and faster on elective recovery. We find that delivering against the target set by the Elective Recovery Plan would deliver an estimated increase in production of £73 billion over five years. But delivering a 30% increase in elective activity is a challenging task – and not one that data suggest will happen without further policy intervention. To help identify immediate opportunities for intervention, this report from the Progressive Policy Think Tank explores the most pressing bottlenecks in the elective treatment pathways.
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News Article
NHS plans new elective target after April deadline missed
Patient Safety Learning posted a news article in News
System leaders are discussing pushing back the NHS’s target to virtually eliminate 78-week breaches from the waiting list by this month to ‘June or July’, HSJ understands. The discussions come after the service missed its original targeted trajectory of clearing the backlog by this month, as first proposed in NHS England’s elective recovery plan last February, despite a steep reduction over the past 18 months. Internal NHS forecasts suggest there will be around just over 10,000 long waiters still on the waiting list by the end of April, as HSJ first revealed last month. Senior sources said this week that this figure remained a likely position for the end of the month. HSJ understands there has not been any official communication to trusts about pushing back the 78-week target, and it was not yet clear when the centre’s expectations would be finalised. Read full story (paywalled) Source: HSJ, 21 April 2023 -
News Article
Millions wait more than a fortnight to see a GP in England
Patient Safety Learning posted a news article in News
Nearly five million patients each month in England wait more than a fortnight for a GP appointment, NHS figures show, which Labour is calling "unacceptable". The government says it expects all patients needing a GP appointment to be seen within two weeks. The Royal College of GPs says 85% of appointments happen within two weeks and nearly half on the same day. Those taking longer than two weeks may be routine ones for which the wait is therefore appropriate, it says. Prof Kamila Hawthorne, who chairs the Royal College of GPs, said: "GPs and our teams are working tirelessly to deliver safe, timely and appropriate care and to give patients the choice of appointment they want. "We share our patients' frustration when they struggle to access our care. However, this is not down to GPs and their hard-working teams, but due to decades of underfunding and poor resource planning." Read full story Source: BBC News, 21 April 2023 -
News Article
Forty trusts are set elective target less ambitious than last year
Patient Safety Learning posted a news article in News
NHS trusts have been given targets to increase elective activity that range from 103% of pre-pandemic levels to nearly 130%, internal data seen by HSJ reveals. The wide gap between the targets, which are based on past performance and reflect the value of activity carried out, indicate the slow pace of recovery at many trusts last year. Forty trusts have been set the least ambitious target, to deliver 103% of pre-covid activity levels in 2023-24, including Leeds Teaching Hospitals, Barts Health, and University Hospitals Birmingham. All providers were supposed to deliver at least 104% of pre-covid activity last year, but few managed to achieve this, with emergency pressures, the impact of covid and flu, and workforce problems hampering efforts to ramp up activity. Amanda Pritchard has previously admitted the health service would have to “re-profile” the trajectory to achieving 130% of pre-covid activity levels by 2025. Read full story (paywalled) Source: HSJ, 20 April 2023 -
News Article
Hundreds of British people are needlessly going blind. Why?
Patient Safety Learning posted a news article in News
The backlog for ophthalmology appointments in England is the second-largest in the NHS, with UK eye doctors concerned about the number of patients losing sight unnecessarily. Their shock is palpable. How this could be happening in a rich country such as Britain? There are treatments for common blindness-causing conditions such as macular degeneration, but to get them patients must be able to access the service. And right now the NHS doesn’t have the capacity to deliver them in a timely way. As junior doctors’ unions – and possibly those of consultants and nurses – proceed with strike action, it’s easy to attack medical professionals with the question: “How many people are dying because of your actions?” The truth is that the entire system has been struggling, and people have been dying anyway because of system failures. Now add to this people living with disabilities that were preventable, such as going blind. When Labour was in power, it made a real effort, including with financial allocation, to reduce waiting-list times for non-emergency care. But since the Tories were elected in 2010, years of austerity and public-sector neglect – and the shifting of resources and wealthy patients into a lucrative and growing private sector – has meant that the NHS has been transformed from a robust, preventive healthcare service into an acute one. Its basic offering is now: “If you’re dying, we will save you.” Read full story Source: The Guardian, 19 April 2023 -
News Article
Junior doctors’ April strike led to 195,000 NHS hospital cancellations
Patient Safety Learning posted a news article in News
Almost 200,000 hospital appointments and procedures in England were cancelled during last week’s junior doctors’ strikes, it has been revealed. There were 20,000 more appointments cancelled in the strikes that ran between 11 and 15 April than in the shorter strike in March, NHS England figures show. A total of 27,361 staff were not at work during the peak of the strikes, though the true figure could be higher as some workforce data was incomplete. The NHS’s national medical director, Prof Sir Stephen Powis, said the figures showed the “colossal impact of industrial action on planned care in the NHS”, with nearly half a million appointments rescheduled over the last five months. He said every postponed appointment had “an impact on the lives of individuals and their families and creates further pressure on services and on a tired workforce – and this is likely to be an underestimate of the impact as some areas provisionally avoided scheduling appointments for these strike days”. Read full story Source: The Guardian, 17 April 2023 -
News ArticleAn all-out nurses’ strike over the May bank holiday will present “serious risks and challenges” to the NHS, a health leader has warned. Sir Julian Hartley, chief executive of NHS Providers, said the “unprecedented” strike action – which will involve staff in emergency departments, intensive care units and cancer care for the first time – was “extremely worrying”. He also said the threat of coordinated industrial action with junior doctors could result in the “most difficult challenge” for the NHS to date. Sir Julian told BBC Breakfast: “If this takes place in the way that it’s been described, then it would be the first time that we’ve seen nurses not working in those key areas, which of course would present serious risks and challenges for trusts to manage and mitigate that.” Nick Hulme, chief executive of Ipswich and Colchester hospitals, told Radio 4 the latest round of nurses’ strikes will “significantly increase the risk to patients”, adding cancer patients will face greater risks as care could be delayed. He said: “If there is a delay to cancer care, some delays won’t cause significant effects, but there are many people who have been waiting far too long for care and this will only exacerbate that risk." Read full story Source: The Independent, 16 April 2023
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News Article
‘Buckling’ NHS fails to treat 250,000 children with mental health problems
Patient Safety Learning posted a news article in News
A quarter of a million children in the UK with mental health problems have been denied help by the NHS as it struggles to manage surging case loads against a backdrop of a crisis in child mental health. Some NHS trusts are failing to offer treatment to 60% of those referred by GPs, the research based on freedom of information request responses has found. The research carried out by the House magazine and shared with the Guardian also revealed a postcode lottery, with spending per child four times higher in some parts of the country than others, while average waits for a first appointment vary by trust from 10 days to three years. Olly Parker, head of external affairs at YoungMinds, said the freedom of information findings showed a “system is in total shutdown” with “no clear government plan to rescue it”, after the 10-year mental health plan was scrapped. “In the meantime, young people are self-harming and attempting suicide as they wait months and even years for help after being referred by doctors,” he said. “This is not children saying ‘I’m unhappy.’ They are ill, they are desperate and they need urgent help.” Read full story Source: The Guardian, 16 April 2023 -
Content Article"One family told me their mum had only been waiting six hours on the floor for an ambulance. Only six hours. For a moment I thought this was a positive outcome. A patient in their 80s, lying on a cold hard floor for the equivalent of three quarters of my shift and I felt this was good patient care. Sadly, this genuinely was better than earlier in the year with patients waiting over 12 hours on the floor and an additional 16 plus hours in an ambulance. I cried when I got home about how far we’ve fallen." An anonymous junior doctor shares his experience on the NHS frontline.
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News Article
One in 10 A&E patients waits 12hrs, long-hidden data reveals
Patient Safety Learning posted a news article in News
Around 10 per cent of the 1.2 million accident and emergency attendees in February waited 12 hours or more, newly published NHS England data has revealed, laying bare the true extent of the NHS’s emergency care crisis. The data – which NHSE has collected for years but has only now started to publish – shows 125,505 patients waited 12 hours or more from their arrival at A&E to be admitted, transferred or discharged. This is more than double the highest figure under the existing metric of around 55,000, which only starts the clock from when the patient has received a decision to admit. NHSE’s decision to publish the data for 12-hour breaches from time of arrival follows a concerted campaign by the Royal College of Emergency Medicine, which has long raised concerns the measure from decision to admit has significantly masked the true extent of long waits in A&E. Read full story (paywalled) Source: HSJ, 13 April 2023 -
News Article
Over two million patients have to visit GP four times for referral
Patient Safety Learning posted a news article in News
More than two million patients each year have to make four or more repeat visits to their GP before they get a referral, a patient watchdog has warned. Patient safety campaigners said people faced waits of “weeks, months or even years” before officially joining NHS waiting lists, and that their health and wellbeing was suffering as a result. They warned it would also add to pressure on other services such as A&E departments. Research by Healthwatch England revealed what the patient watchdog called a “hidden waiting list”. “People wait for a GP appointment; they wait for their GP to tell them they will be referred; they wait for the hospital to confirm that referral; and then they join a hospital waiting list,” it said. “NHS statistics monitor only the hospital waiting list, leaving the steps between getting a GP referral and a letter confirming a hospital appointment as a dangerous ‘blind spot’ for the NHS and patients.” Read full story (paywalled) Source: The Times, 11 April 2023 -
News Article
Junior doctors’ strike will have ‘catastrophic impact’ on waiting lists
Patient Safety Learning posted a news article in News
The four-day strike by junior doctors in England will have a “catastrophic impact” on NHS waiting lists, with up to 350,000 appointments and operations likely to be cancelled, the chief executive of the NHS Confederation has said. Matthew Taylor said the industrial action this week posed risks to patient safety and called on the public to avoid “risky behaviour”. “These strikes are going to have a catastrophic impact on the capacity of the NHS to recover services,” he told Sky News. “The health service has to meet high levels of demand at the same time as making inroads into that huge backlog that built up before Covid, but then built up much more during Covid." He said he hoped everyone who needed urgent care would get it, but added: “There’s no point hiding the fact that there will be risks to patients – risks to patient safety, risks to patient dignity – as we’re not able to provide the kind of care that we want to.” He called on the public to use NHS services responsibly. Read full story Source; The Guardian, 10 April 2023 -
News Article
NHS England should scrap many of its national targets, review says
Patient Safety Learning posted a news article in News
The NHS should abolish many of its national targets while shifting its focus towards preventive healthcare, according to a review by a former Labour health secretary. The study by Patricia Hewitt, commissioned by the government said that, while targets can help concentrate the minds of those responsible for a service, having too many makes them less effective. It comes at a time when record numbers of people are on NHS waiting lists and as the health service in England continues to miss targets on A&E waits, the speed of ambulance responses, and cancer treatment times. The review sets out new targets and failing to provide adequate funding for new initiatives makes it far harder to plan new services and recruit staff. It adds that an excessive focus on hitting targets by managers can lead to “gaming” of the targets and a “disastrous neglect of patients themselves”. Read full story Source: The Guardian, 3 April 2023 -
News Article
'Dire' situation for adults waiting for ADHD diagnosis in NI
Patient Safety Learning posted a news article in News
Adults in Northern Ireland seeking assessment for attention deficit hyperactivity disorder (ADHD) are being forced to go private because of a dire lack of referral services in some areas, a charity has said. Some health trusts have not been able to accept new referrals for adult assessment and diagnosis. ADHD charities said a lack of services or even waiting lists has forced many people to pay for a private diagnosis. The charity's chief executive Sarah Salters added that some people who do get a private diagnosis cannot then get medication from their GP through the NHS. The Department of Health said officials "are considering longer-term arrangements" for ADHD services, with future decisions "likely to be subject to ministerial approval and availability of funding". Read full story Source: BBC News, 2 April 2023 -
News Article
Thousands of children in England facing ‘unacceptable’ NHS delays
Patient Safety Learning posted a news article in News
Thousands of children experiencing “unacceptable” long waits for NHS treatment face a “lifelong” impact on their health, a senior doctor has warned, as shocking figures reveal that nearly 15,000 paediatric operations were cancelled over the last year. Dr Camilla Kingdon, president of the Royal College of Paediatrics and Child Health, said the mounting treatment backlog in England risked “serious” and “devastating” physical and mental consequences for children and their families. She sounded the alarm as data obtained under freedom of information laws by the Liberal Democrats showed that a record high 14,628 children’s operations were postponed in 2022, up from 11,870 the year before and the highest in five years of data examined. Some children have now waited several years for surgery, according to the data. Delaying a child’s operation risks having a “lifelong impact” on their development, Kingdon said, and also “seriously impact” their mental health, with knock-on effects on their ability to socialise, go to school and reach their full potential. Read full story Source: The Guardian, 3 April 2023 -
News Article
Children must wait for ‘crisis’ before autism diagnosis, say overwhelmed systems
Patient Safety Learning posted a news article in News
New restrictions are being introduced for autism assessments, with some areas now only accepting referrals for patients in crisis, HSJ has learned. Commissioners in North Yorkshire and York have become the latest to introduce new criteria for autism and attention deficit hyperactivity disorder referrals. Getting a diagnosis is key to unlocking care packages such as speech and language therapy, counselling, or special educational needs. They said the changes are due to “unprecedented demand that has exceeded supply, resulting in unacceptable wait times and the need to prioritise resources towards children and most at-risk adults”. Read full story (paywalled) Source: HSJ, 30 March 2023 -
News Article
NHS to miss April deadline to end 78-week waits by around 11k patients
Patient Safety Learning posted a news article in News
National NHS forecasts are predicting there will be around 11,000 patients on the elective waiting list who have been waiting longer than 78 weeks at the start of April, the target for clearing this cohort, HSJ understands. Senior NHS figures familiar with the forecasts told HSJ they had stood at around 9,000 last week, but mass cancellations during the three-day junior doctors’ strike had pushed up the potential outstanding cases by approximately 2,000. One senior NHS figure close to national efforts said they “hoped” trusts could cut the figure to under 10,000 by the deadline, and that intense work was going on across systems to ensure the figure was as small as possible. It is understood system leaders expect the 78-week breach figure to be cut to around 2,000 by the summer. However, as has been the case for the 104-week breaches, they are also predicting a long tail due to a combination of complex cases and patients choosing to wait longer. Read full story (paywalled) Source: HSJ, 23 March 2023 -
News Article
Three-year wait for Essex girl, 8, to have tooth removed
Patient Safety Learning posted a news article in News
An eight-year-old girl waiting three years to have three teeth removed has been left in "agony". Ella Mann, from Dovercourt in Essex, first went to the dentist with an issue with a baby tooth in December 2019. She was given a temporary filling and told it needed to be removed but has still not had the NHS procedure. The youngster has now been placed on an NHS waiting list for the tooth extraction. Ella's dad Charlie Mann, 54, said his daughter was sometimes in "agony". Healthwatch England last year warned of people struggling to get dental treatment as increasing practices closed to new patients. A BBC investigation identified cases of people driving hundreds of miles in search of treatment and pulling out their own teeth without anaesthesia. Read full story Source: BBC News, 23 March 2023 -
Content ArticleHow one Devon ICS has worked with local trusts to cut deliver extra capacity at a former Nightingale hospital, now converted into an elective centre.
