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Found 800 results
  1. Content Article
    This is part of our series of Patient Safety Spotlight interviews, where we talk to different people about their role and what motivates them to make health and social care safer. Martin talks to us about the role of Professional Nurse Advocates (PNAs) in improving patient safety through restorative clinical supervision for nurses. He also talks about the need to recognise the close relationship between staff safety and patient safety, and the impact that long waiting lists and limited NHS capacity are currently having.
  2. News Article
    Campaigners are planning to launch legal action after NHS chiefs in North Yorkshire placed limits on which adults can get referrals for autism and attention deficit hyperactivity disorder (ADHD) assessments. North Yorkshire and York Health and Care Partnerships introduced a pilot programme in March in which adults seeking an NHS assessment for autism or ADHD are triaged via an online screening tool. NHS chiefs say this screening process prioritises those with the most severe needs, rather than processing referrals in chronological order. These priority needs reportedly include the patient being at risk of immediate self-harm or harming others, at risk of being unable to have lifesaving hospital treatment or care placement, or an imminent risk of family court decisions being determined on diagnosis. Those who do not meet the criteria are given guidance and signposted to other support networks. But campaigners say that in practise that means that most people cannot get a referral for an assessment – GPs can no longer make referrals themselves. Read full story Source: The Big Issue, 19 July 2023 Related reading on the hub: Long waits for ADHD diagnosis and treatment are a patient safety issue
  3. News Article
    Adults across an integrated care system area are facing ‘unacceptable’ 10-year waits for an NHS assessment for attention deficit hyperactivity disorder, the longest known wait for such services in England. Herefordshire and Worcestershire integrated care board has warned in board papers of “exceptionally high waiting times for ADHD assessment and treatment for Worcestershire patients (10 years+), with workforce challenges and service fragility compromising service delivery”. HSJ understands the long waits for ADHD diagnosis, which is a national problem, is predominately affecting adults with approximately 2,000 people on Herefordshire and Worcestershire’s ADHD list alone. Local provider Herefordshire and Worcestershire Health and Care Trust also warned on its website that its paediatric services were also “experiencing unprecedented demand”. Read full story (paywalled) Source: HSJ, 19 July 2023
  4. News Article
    Children in some areas of England are waiting up to 18 months on average for dental general-anaesthetic treatment and teeth extractions, an investigation reveals. Some have been left with prolonged dental pain, according to information shared with BBC News. The parents of one girl who has waited three years for extractions say the pain keeps her up at night. At the start of this year, more than 12,000 under-18s were on waiting lists for assessment or treatment at community dental service (CDS) providers, data obtained by the Liberal Democrats from the NHS Business Services Authority and shared with BBC News earlier this year reveals. Children are referred to a CDS provider when they have tooth decay too severe to be treated in general practice. They also treat those with physical or learning disabilities when general practice is not a practical option. The longest average wait faced by children for general-anaesthetic treatment at a CDS provider is 80 weeks, at Harrogate and District NHS Foundation Trust. Read full story Source: BBC News, 19 July 2023
  5. News Article
    A14-year-old girl could lose the ability to walk after her brain surgery was cancelled three times as NHS children’s services are stretched to breaking point. Piper Miller, who has severe autism, needs urgent surgery to remove fluid on her brain that if unaddressed could also leave her unable to control her bladder. But her operation has been pushed back three times in the past month due to emergency operations taking priority and severe short staffing made worse by junior doctors’ strikes. Her mum, Toni Milner said the delays had had a “heartbreaking and gut-wrenching” effect on her daughter whose anxiety is “sent through the roof” each time she is told she is not having her surgery. Piper’s story comes as NHS data uncovered by The Independent reveals at least 340 life-saving children’s operations, such as transplant and lung surgery, were shelved from April to December 2022, while 763 emergency operations were refused due to a lack of intensive care beds. Read full story Source: The Independent, 16 July 2023
  6. News Article
    Children with suspected ADHD and autism are waiting as long as seven years for treatment on the NHS, as the health service struggles to manage a surge in demand during a crisis in child mental health. Experts said “inhumane” waits are putting a generation of neurodiverse children at risk of mental illness as they are “pushed to the back of a very long queue” for children and adolescent mental health services (Camhs). UK children with suspected neurodevelopmental conditions faced an average waiting time of one year and four months for an initial screening in 2022, more than three times longer than the average wait for all Camhs services, according to research carried out by the House magazine and shared with the Guardian. Half of all trusts responding to a freedom of information request had an average wait of at least a year, and at one-sixth of trusts it was more than two years. The NICE guidance for autism and mental health services stipulates that no one should wait longer than 13 weeks between being referred and first being seen. Read full story Source: The Guardian, 17 July 2023 Related reading on the hub: Long waits for ADHD diagnosis and treatment are a patient safety issue
  7. Content Article
    NHS urgent and emergency care is under intolerable strain. This strain is increasingly causing harm to patients. Timely and high quality patient care is often not being delivered due to overcrowding driven by workforce and capacity constraints. While the covid-19 pandemic has accentuated and arguably expedited the crisis; the spiral of decline in urgent and emergency care has been decades long and unless urgent action is taken, we may not yet have reached its nadir, writes Tim Cooksley and colleagues in this BMJ opinion article.
  8. Content Article
    “Crisis,” “collapse,” “catastrophe” — these are common descriptors from recent headlines about the NHS in the UK. In 2022, the NHS was supposed to begin its recovery from being perceived as a Covid-and-emergencies-only service during parts of 2020 and 2021. Throughout the year, however, doctors warned of a coming crisis in the winter of 2022 to 2023. The crisis duly arrived. In this New England Journal of Medicine article, David Hunter gives his perspective on the current state of the NHS.
  9. Content Article
    The pain and distress of not being able to see an NHS dentist are "totally unacceptable", an inquiry has told the government. A review was launched after a BBC investigation found 9 in 10 NHS dental practices across the UK were not accepting new adult patients. Some people drove hundreds of miles for treatment or even resorted to pulling out their own teeth, the BBC found. The government says it invests more than £3bn a year in dentistry. But a damning report, by the Commons' Health and Social Care Committee, says more needs to be done, and quickly. The House of Commons Committee report with recommendations to government can be viewed at the link below. The Government has two months to respond.
  10. News Article
    NHS waiting lists in England have climbed to a record level, according to new figures that show 7.47 million patients were waiting to start routine hospital treatment at the end of May, up from 7.42 million at the end of April. The growing list includes 416,000 children waiting to start treatment – up 9.7% in just one month, and including 21,282 who have been waiting more than a year. Royal College of Paediatrics and Child Health president Camilla Kingdon said it is “unacceptable” and “unfathomable” to have so many children waiting so long. However, hospital leaders warned on Thursday they are not confident they will hit key NHS targets to reduce the waiting list in 2024 and 2025. The figures come during a five-day junior doctors’ strike during which tens of thousands of operations and appointments are expected to be cancelled and ahead of NHS consultants’ strikes where the major of planned care is expected to be paused. Read full story Source: The Independent, 13 July 2023
  11. News Article
    NHS England has reduced its elective activity target for the service because of the impact of junior doctors’ strike, and acknowledged the service may not hit the prime minister’s pledge to reduce waiting lists before the next general election if the industrial action continues. NHSE has agreed a deal with ministers which will see the “value based” elective activity target set for the service reduced for 2023-24 from 107 per cent of pre-pandemic levels to 105 per cent (See explainer box on value-based targets below). Trust finance bosses were briefed by NHSE chief finance officer Julian Kelly this morning (Wednesday 12 July) on the eve of junior doctors’ longest strike action to date. Read full story (paywalled) Source: HSJ, 12 July 2023
  12. News Article
    Cheshire and Merseyside won Gold in the ‘Supporting Elective Recovery Through Digital’ category, at the HSJ Digital Awards, alongside technology partner C2-Ai, after transforming how waiting lists are managed with the help of an AI-backed waiting list model. The tool helps surgical teams identify previously hidden high-risk patients, and to make informed decisions on how, when and where to treat patients to achieve the best outcomes. NHS England, who commissioned the project, reported that within six weeks patient waiting lists dropped by nearly 30%, as well as a 66% decrease in intensive care needs for high-risk patients, saved about 2,500 hospital bed-days across 20,000 patients, and cut emergency admissions to the waiting list by 8%. Read full story Source: NHS Cheshire and Merseyside, 3 July 2023
  13. News Article
    The quality of care that the NHS provides has got worse in many key areas and patients’ long waits to access treatment could become even more common, research has found. The coalition government’s austerity programme in the early 2010s led to the heath service no longer being able to meet key waiting time targets, the Nuffield Trust and Health Foundation said. Austerity ushered in “really concerning deterioration across the board” in the overall quality of NHS care, as judged by patients’ experience and prevention of ill-health, not just speed of access. Analysis by the two thinktanks’ joint Quality Watch programme, which monitors more than 150 indicators of care quality over time, found that in England: Fewer people with long-term heath conditions such as cancer, diabetes and depression, are getting enough help to manage their condition. Breast cancer screening rates for women aged 53-74 have fallen. It has become harder for patients to see a named GP. Only 6% of midwives think their maternity unit has enough staff to do its job properly. Read full story Source: The Guardian, 5 July 2023
  14. News Article
    A Conservative minister has acknowledged the NHS waiting list, which stands at a record high with more than 7.4 million people waiting for treatment in England, will “probably go up” before it goes down. Speaking on the 75th anniversary of its creation, the health minister Maria Caulfield claimed the NHS would be “thriving” in 25 years’ time, saying a two-year waiting time had “virtually been eliminated”. But experts have called for more investment in the NHS, with Prof Philip Banfield, the British Medical Council’s chair of council, saying the health service is so fragile that it may not survive until its 80th anniversary. The shadow health secretary, Wes Streeting, said the NHS would die without “the necessary investment and reform” to change and modernise. Read full story Source: The Guardian, 5 July 2023
  15. News Article
    A pensioner is furious with Northern Ireland politicians who, she said, left her with no option but to spend her savings on knee surgery in Poland. Christine Wallace was told the wait for her knee replacement surgery could be five years - although the health department says most waits are shorter. She spent £8,500 on her hospital stay. While Ms Wallace said the relief of her new knee was fantastic, she felt she had no alternative but to pay as she could no longer live with the pain. The latest available health department figures, from 31 March, showed 25,075 patients were waiting for inpatient or day case admission under the trauma and orthopaedic surgery specialty. The department said its median waiting time for such operations was 74 weeks, with only 1 in 20 patients waiting more than five years. "Our preferred measure of average is the median... because waiting times tend to be skewed by longer waits and therefore more patients are waiting for less time than the mean," said a department statement. Read full story Source: BBC News, 28 June 2023
  16. Content Article
    This is part of our series of Patient Safety Spotlight interviews, where we talk to people working for patient safety about their role and what motivates them. Dan talks to us about how his experiences as a paediatrician and military doctor have influenced his view of patient safety. He also describes the increasing complexity in healthcare systems and highlights the need for the Government to commit policy and resources to building and sustaining the NHS workforce.
  17. News Article
    England is engulfed in a cardiovascular disease emergency, health bosses have said, as stark figures reveal there have been almost 100,000 excess deaths since the start of the Covid pandemic. Analysis of official government data suggests that more than 500 people a week are dying needlessly from heart disease, heart attacks or strokes. There have been 96,540 extra cardiovascular-related deaths since March 2020, according to the report by the British Heart Foundation (BHF). The BHF said other factors were likely to be driving the continued increase in excess deaths involving cardiovascular disease, including severe and ongoing disruption to NHS heart services. “Covid-19 no longer fully explains the significant numbers of excess deaths involving cardiovascular disease,” said Dr Sonya Babu-Narayan, a consultant cardiologist and associate medical director at the BHF. “Other major factors are likely contributing, including the extreme and unrelenting pressure on the NHS over the last few years. “Long waits for heart care are dangerous – they put someone at increased risk of avoidable hospital admission, disability due to heart failure and premature death. Yet people are struggling to get potentially lifesaving heart treatment when they need it due to a lack of NHS staff and space, despite cardiovascular disease affecting record numbers of people.” Read full story Source: The Guardian, 22 June 2023
  18. News Article
    At least 100,000 people across the UK have had their lives put at risk over the last decade because of delays to them getting tested or treated for cancer, a new report claims. In some cases, patients’ treatment options narrowed or their cancer spread or became incurable as a direct result of their long waits for NHS care, according to Macmillan Cancer Support. The “inhumane” impact of delays on patients is “shameful”, it said, blaming ministers across the four home nations for underfunding and not tackling staff shortages in cancer services. “I’ve had patients arrive for their radical chemotherapy appointment, who wait three hours only to be told that because of staff shortages we can’t deliver their treatment today. It’s inhumane”, said Naman Julka-Anderson, an advanced practice therapeutic radiographer who is also an allied health professional clinical adviser for Macmillan. Many waited longer than 62 days to start treatment – surgery, chemotherapy or radiotherapy – after a GP referred them as an urgent case, the charity’s analysis of official NHS data found. At least 100,000 of those 180,000 people have seen their symptoms worsen, or their cancer progress or their chances reduce of successfully being treated because they have had to wait. Read full story Source: The Guardian, 20 June 2023
  19. News Article
    Thousands of disabled adults and children, including those with the highest and most complex needs, are having to wait more than four months for an NHS wheelchair, official health figures show. In one part of the country more than two-thirds of patients referred to the wheelchair service face waits of more than 18 weeks, or roughly four months, to get the help they need. Besides preventing them from getting around independently, and the mental health problems that can come from the resulting social isolation, a leading disability charity says disabled people can also be left with physical pain if forced to use poorly fitting or unsuitable chairs while they wait for upgrades and adaptations. Data published by NHS England shows 16.5% of patients – one in six – were waiting longer than the NHS target time of 18 weeks for a wheelchair, equipment for a wheelchair, or wheelchair modifications between October and December last year. This represents more than 6,000 adults and almost 1,600 children, of which thousands were registered as having high or specialist needs. The figures include new patients as well as re-referred patients whose needs may have changed or whose current equipment needs adjusting or modified. Read full story Source: National World, 21 March 2023
  20. Content Article
    The government has published its mandate to NHS England. This mandate is intended to apply from 15 June 2023 until a new mandate is published. NHS England has a duty to seek to achieve the objectives in the mandate. The Secretary of State keeps progress against the mandate under review, setting out his views in an annual assessment which is laid in Parliament and published. The government will agree with NHS England how it should report on overall progress against the mandate to support the Secretary of State in keeping this under review. This will include reporting at agreed intervals on other delivery expectations listed beneath the objectives.
  21. Content Article
    In April 2022, an investigation commenced into the communications provided to patients and/or their carers following placement on a waiting list in Northern Ireland. The primary focus of the investigation is the adequacy of Trust communications to patients, and/or their carers, across various stages of the waiting list process, with significant consideration being given to the content of the Integrated Elected Access Protocol (Department of Health guidance), and its application by the Trusts. The objective was to determine whether or not systemic maladministration has arisen within the communication practices of the Northern Ireland Health and Social Care Trusts (the Trusts) and whether improvements are required. It also aims to publicise what patients and/or their carers should expect from waiting list communications. The Investigative Methodology drew evidence from a wide range of sources. This included extensive queries and information requests to the Trusts and the Department; a General Public survey (with 646 responses); a General Practitioner (GP) survey (with 321 responses); follow up interviews with a number of General Public and GP survey respondents; and a number of Case Study reviews. 
  22. News Article
    The system for communicating with patients on healthcare waiting lists in Northern Ireland is in disarray, the Public Services Ombudsman has found. Its year-long investigation found that significant and repeated failures in updating patients amounted to "systematic maladministration". The ombudsman urged the Department of Health (DoH) to work with trusts, GPs and others to address the failings. DoH said it appreciated the distress and frustration of patients on lists. The investigation found that failures by trusts across Northern Ireland to follow guidance meant that patients were given little or no information once a referral had been made. Commenting on the findings, Ombudsman Margaret Kelly said the investigation found a waiting list system "which is in disarray and sometimes even chaos". "There is a lack of coherence between the different parts of the system, a lack of clear communication, and a lack of an overall agreed plan for improvement." Read full story Source: BBC News,15 June 2023
  23. News Article
    A reduction in the number of GP referrals to hospitals could be creating a "hidden backlog" of patients needing help, according to a new report. The study by the Institute for Government (IFG) and Public First says that not enough data is published about the "advice and guidance" referral system. Family doctors have been told to reduce the number of people they refer for hospital care by using the 'advice and guidance' route – whereby a GP will call or email a hospital doctor to ask for advice on whether or not a referral is required. The method has been used since 2015 but NHS England introduced a target for GPs to have 12 "advice and guidance" patients for every 100 outpatient appointments in October 2021 in an attempt to reduce the backlog of hospital care. This has now increased to 16 but it has been reported that as many as 22 out of 100 potential hospital appointments are being handled this way. The IFG and Public First report states: "There is a risk that GPs making fewer referrals – in part to address hospital capacity concerns – is creating a 'hidden backlog' by allowing treatable conditions to deteriorate and possibly leading to more unplanned admissions." Read full story Source: Medscape, 14 June 2023
  24. News Article
    Retired doctors will have an option to “keep caring” and re-join the NHS to carry out outpatient appointments in a new initiative to help reduce waiting lists. From autumn, newly-retired doctors will be able to sign up to a new digital platform where they will be able to offer their availability to trusts across England to perform outpatient appointments, either virtually or in person. NHS hospitals will choose the consultant whose skillset and availability best matches the appointments they need covered, which are scheduled and arranged with patients in the normal way. More than four-fifths of people on the waiting list require an outpatient appointment such as a follow-up for cardiology or rheumatology – rather than a surgical procedure. Consultants carrying out remote appointments could be based anywhere in England, which can help those hospitals in areas with higher demand. Those requiring a face-to-face appointment or follow-up will be seen in the usual way. Speaking at NHS Confed Expo, Amanda Pritchard, NHS Chief Executive, said: “Ahead of the NHS 75th birthday in July, this new platform is an innovative example of how we are constantly adapting the way we work to benefit patients by helping to reduce waiting times as well as supporting staff. “Using this digital tool will help us to match patients with retired doctors who we know are keen to stay working in a flexible way so they can keep caring for patients, as well as allowing us to expand capacity to see even more patients – and faster. “NHS staff have already made excellent progress against our Elective Recovery Plan – and this platform will not only help us continue to reduce the longest waits but it will also help us slash agency spend, using the existing capacity of experienced doctors who still have so much to offer the NHS”. Read full story Source: NHS England, 14 June 2023
  25. News Article
    An external review of waiting list management at a large acute trust has found several serious problems – including ‘pop-up’ patients and thousands of cancelled appointments each week – but concluded they were no worse than would be found at ‘most NHS trusts’. The review appears to have been triggered after University Hospitals of the North Midlands declared unexpected increases in the number of 78-week and 104-week waiters earlier this year, while the government and NHS England have been intensively performance managing these measures. The independent report by independent consultant Wendy Baines states: “The review found no evidence of deliberate irregularities in the management of waiting times. “Although as the case for most NHS trusts, the capacity to misrepresent the ‘true’ volume of waiters at a certain point in time is significant. “Managing this risk by minimising the capacity for errors through training, the right pathway administration systems and tools, and the ability to monitor data quality through a defined set of process assurance measures is key. Whilst UHNM possesses these components, they are not necessarily working in cohesion to provide the assurance and oversight needed to manage patient waiting times.” Read full story (paywalled) Source: HSJ, 13 June 2023
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