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Found 778 results
  1. News Article
    Mental health patients are increasingly having to turn to A&E for help, experts have warned, as new research suggests nearly one in four are being forced to wait more than 12 weeks to start treatment. The Royal College of Psychiatrists said its research found 43% of adults with mental illness say the long waits for treatment have led to their mental health getting worse. Almost a quarter (23%) have to wait more than 12 weeks to start treatment, with many so desperate they turn to A&E or dial 999. The college said many people face a “hidden wait time” for starting treatment, with no publicly available data on how long people wait from their initial referral to actually starting treatment. Those surveyed for the research had a range of mental illnesses, including eating disorders, addiction, bipolar disorder, anxiety and depression. Dr Kate Lovett, the college’s presidential lead for recruitment, said: “We cannot sit idly by and watch the most vulnerable people in our society end up in crisis. Not only do spiralling mental health waiting times wreak havoc on patients’ lives, but they also leave NHS services with the impossible task of tackling rising demand.” One female patient, a 45-year-old from south London, told how she ended up in A&E after having to wait seven months to be referred to a community team. “The only other way to get help was to present to A&E, which was a traumatic experience – having to be reassessed and readmitted again and again. Turning up to A&E was the only way I could be seen regularly. No one should have to go through that.” Read full story Source: The Guardian, 10 October 2022
  2. News Article
    Patients face being removed from the NHS waiting list if they decline two dates offered to them for their treatment, new internal guidance seen by HSJ reveals. The “interim operational guidance” from NHS England says if patients decline two proposed dates for treatment, they should be moved on to “active monitoring” and removed from the NHS’s main elective waiting list. Waiting list consultant Rob Findlay said the guidance was an “abuse of national waiting times statistics”, and that “the menacing of patients [proposed in the strategies outlined in the guidance] is appalling”. The Royal College of Surgeons of England told HSJ it had not been consulted on the guidance, as it would have expected. The college said the guidance could be positive if used “sensibly” but it warned that “used poorly, it could see patients lost in the system, or banished to waiting list purgatory”. NHSE elective recovery adviser Sir Jim Mackey told HSJ the guidance was to support trusts to manage “a small number of patients who… continue to decline treatment date offers [and] to fill appointment slots so patients get seen as soon as possible”. He said there were long-waiting patients who have “refused offers of treatment alternative, sometimes multiple offers. This is absolutely their choice, but it does make access for other patients more difficult when slots are held for them”. Read full story (paywalled) Source: HSJ, 6 October 2022
  3. News Article
    Several ambulance trusts have moved to the highest level of alert in the wake of severe pressure on emergency services in recent days. Internal data seen by HSJ suggests ambulance response times have deteriorated dramatically, while the average time for call handlers to answer 999 calls has increased to almost two minutes in some areas. Staff across the country have been sounding the alarm over the pressures, with one senior source saying the situation was “really dire” again, after a period in which pressures had eased in August and September. The internal data showed ambulance trusts in the South West, East of England, London and the West Midlands had all declared the highest level of alert, known as REAP 4. More are expected to follow. The average response time for category 2 calls in the South West – including suspected heart attacks and strokes – was 1 hour 24 minutes, with 10% of these calls responded to in more than 3 hours 11 minutes. The target is 18 minutes. Emergency departments have also faced severe pressure. An emergency care consultant in Plymouth tweeted that patients were facing 70-hour waits to be admitted to wards, with some waiting 18 hours to be handed over by ambulance staff. Fionna Lowe added: “I have taken to asking families to feed their relatives. It has never been this bad.” Read full story (paywalled) Source: HSJ, 4 October 2022
  4. News Article
    Patients with suspected skin and breast cancer have experienced the largest increase in waiting times of everyone urgently referred to a cancer specialist, with 1 in 20 patients now facing the longest waits, analysis of NHS England data shows. Almost 10,000 patients referred by a GP to a cancer specialist had to wait for more than 28 days in July – double the supposed maximum 14-day waiting time. Three-quarters of them were suspected of having skin, breast or lower gastrointestinal cancer, a Guardian analysis has revealed. In total, 53,000 people in England waited more than two weeks to see a cancer specialist. That is 22% of all the patients urgently referred for a cancer appointment by their GPs. Minesh Patel, head of policy at Macmillan Cancer Support, said people were waiting “far too long for diagnosis or vital treatment”. Patients “are worried about the impact of these delays on their prognosis and quality of care”. “The NHS has never worked harder,” said Matt Sample, the policy manager at Cancer Research UK, but patients dealing with long waits “reflects a broader picture of some of the worst waits for tests and treatments on record”. “When just a matter of weeks can be enough for some cancers to progress, this is unacceptable.” Read full story Source: The Guardian, 2 October 2022
  5. News Article
    The number of people in Northern Ireland waiting more than a month to start cancer treatment is five times higher than a decade ago. Macmillan Cancer research collated between April 2011 and March 2012 said on average 18 people each month waited more than a month for treatment. By March 2022 that monthly figure had increased to 92 people - or by more than 400%. Macmillan Cancer said the jump revealed a system that was "failing" patients. Sarah Christie, Macmillan policy and public affairs manager, told BBC News NI that the figures revealed a "dark insight into a healthcare system that is failing time and again to meet the needs of people living with cancer". Ms Christie said: "People have a right to be frustrated. They deserve access to care at the right time. "We need a government in place so that change can happen and, crucially, that the three-year budget that had been planned before the executive collapsed can be signed off. "It is impossible to deliver transformation on short-term budget." Read full story Source: BBC News, 29 September 2022
  6. News Article
    Several patients awaiting treatment on the Welsh NHS have turned to surgery abroad as waiting lists hit record levels again. Waiting lists hit a record of almost 750,000 in July prompting surgeons to demand "urgent action". The Welsh government said waits of more than two years were improving. Health Minister Eluned Morgan said there were "signs of hope" that a target for no-one to wait more than a year for their first outpatient appointment could be hit by the end of 2022. But the Conservatives accused Labour ministers of having "little strategy" to tackle "extraordinary waits", while Plaid Cymru called for action "to increase capacity and improve patient flow". Sharon Seymour, 62, from Monmouthshire, went to Lithuania after being told she faced a "two years plus" wait for a hip replacement. The council worker said she also found out about Lithuania from other patients in Wales and had her surgery in July. She said the fact that people were taking matters into their own hands suggested the health system in Wales was not working. "[The NHS] does need a huge cash injection... a rethink completely now," she said. "The sadder point is the people who have the ability to pay will get it. "The inequality between those who can't and that [can is] a sad state of affairs," she added. "It's only through luck that we've managed to find the funds to go to Lithuania. "For most people, it isn't an option and that's horrible." Read full story Source: BBC News, 22 September 2022
  7. News Article
    Ministers are setting up a £500m emergency fund to get thousands of medically fit patients out of hospital as soon as possible in an attempt to prevent the NHS becoming overwhelmed this winter. Thérèse Coffey, the new health secretary, unveiled the move in the Commons on Thursday as part of her plans to tackle the growing crisis in the health service, especially patients’ long delays for care. The newly created adult social care discharge fund is intended to relieve the pressure on overstretched hospitals in England by ensuring that patients whom doctors have judged well enough to leave can be safely discharged either to their home or into a care home. In her first speech since becoming the health secretary 16 days ago, Coffey told MPs: “I can announce today that we are launching a £500m adult social care discharge fund for this winter. “The local NHS will be working with councils with targeted plans on specific care packages to support people being either in their own home or in the wider community. This £500m acts as the downpayment in the rebalancing of funding across health and social care as we develop our longer-term plan.” Read full story Source: The Guardian, 22 September 2022
  8. News Article
    Therese Coffey has pledged there will be no changes to the four-hour target for A&E waiting times – despite NHS England’s prolonged bid to axe the controversial measure. The new health and social care secretary told the House of Commons Thursday: “I can absolutely say there will be no changes to the target for four-hour waits in A&E.” Ms Coffey’s comments appear to represent a major blow to NHS England, which has since 2019 been pushing for a new bundle of metrics to replace the target. Fourteen trusts have been trialling these, which include measures such as average time spent in an emergency department and 12-hour waits from time of arrival, as part of the Clinical Review of Standards. NHSE had also, after a protracted battle, secured the support of key stakeholders, including the Royal College of Emergency Medicine, NHS Providers and Heathwatch England, to back its plans to ditch the target, for so long the NHS’s most significant performance metric. The bold position – with Ms Coffey just weeks into the role – also contradicts the stance taken by both recent predecessors Sajid Javid and Matt Hancock, who both signalled they were supportive of scrapping the target. Read full story (paywalled) Source: HSJ, 22 September 2022
  9. News Article
    Patients seeking treatment for mental health problems at hospital emergency departments in England were twice as likely to experience "unacceptable" waiting times of 12 hours or more than other patients, according to a service review. The Royal College of Emergency Medicine (RCEM) described its findings as "unacceptable" and said the system frequently failed who were most unwell and vulnerable, particularly children and young people. The report, Mental Health and Emergency Care, is the latest in the RCEM's acute insight series summarising important issues in emergency care and making recommendations for policymakers, NHS England, integrated care systems, and trusts. The analysis noted that recorded prevalence of patients experiencing mental health needs had "dramatically increased" over the last 5 years. Despite accounting for a small proportion of attendances to emergency departments (EDs), a "mismatch" between capacity and demand, cuts to dedicated mental health hospital beds, and poor patient flow through the hospital system had led to long waits in recent months. The greatest concern was for patients waiting for a mental health bed, those waiting for assessment under the Mental Health Act, and children and young people presenting in crisis, the RCEM said. Read full story Source: Medscape, 22 September 2022
  10. News Article
    The Care Quality Commission (CQC) has urged system leaders to move away from “quick fixes” to the “enormous gap in resources and capacity” in urgent and emergency care. A report by the CQC and a large group of emergency clinicians and other health and care leaders calls for a ”move away from reactive ‘quick fixes’ such as tents in the car park or corridor care to proactive long-term solutions and to address the enormous gap in resources and capacity”. The use of tents and treating more patients in corridors have been increasingly adopted by hospitals in recent months, sometimes encouraged by NHS England, particularly when they are under pressure to reduce handover delays from ambulances. The report, 'People First: a response from health and care leaders to the urgent and emergency care system crisis', suggests: expanding use of urgent community response teams to attend minor injuries 999/111 calls, giving acute and social care providers direct access to GP and community service booking systems, and providing “rapid access” to support packages to help people avoid hospital admission. Read full story (paywalled) Source: HSJ, 22 September 2022
  11. News Article
    Performance on waiting times targets at Scotland's hospital A&E units has hit a new low. Figures for the week ending 11 September showed just 63.5% of patients were dealt with within four hours. Health Secretary Humza Yousaf said the figures were "not acceptable" and he was determined to improve performance. Scottish Tory health spokesman Dr Sandesh Gulhane said the figures showed the "crisis in A&E is not merely continuing, but deepening". The Scottish government target is that 95% of patients attending A&E are seen and subsequently admitted or discharged within four hours. Doctors working in emergency medicine have issued stark warnings recently about the impact of long waits in A&E. It is simply not safe, and patients are dying as a result, they say. Read full story Source: BBC News, 20 September 2022
  12. News Article
    NHS England has issued a new deadline to treat patients who have been waiting more than two years for treatment, a month after saying it had ‘virtually eliminated’ the longest waits, it has emerged. The goal of no-one waiting more than 104 weeks for treatment by July this year was one of the first milestones in the elective recovery plan hammered out between NHSE and ministers. They were not eliminated by the end of July, but the number was reduced to 3,000, having stood at 22,000 in January. The remaining group consisted of nearly 1,600 patients who had been offered faster treatment elsewhere but did not want to travel, 1,000 who required complex treatment and could not be transferred to another provider and 168 who were not treated by the deadline, according to information issued in the summer by NHSE. Now integrated care systems have been told there is a new “national expectation” to treat the remaining, final two-year waiters by the end of September. HSJ was told the goal has been framed as an ambition rather than a target because it includes patients who have chosen to wait longer. Read full story (paywalled) Source: HSJ, 21 September 2022
  13. News Article
    Therese Coffey is considering abolishing four-hour A&E waiting time targets as part of her “emergency plan” to tackle the NHS. The new health secretary is understood to be looking at a range of measures to address the growing crisis in the NHS, understood to be announced next Thursday. But a source close to the discussions told The Independent getting rid of the four-hour waits – first suggested in March 2019 – would have to be given the green light by the new prime minister Liz Truss. The announcement will focus on the health secretary’s “ABCD” priorities – standing for “ambulances, backlog, care, dentists and doctors” – with improvements to mental health services as an addition. Policies also being looked at include more call handers for ambulances, more diagnostic community centres, speeding up the hospital building programme, reducing “bureaucratic” burdens on GPs, improving direct access to counselling services for patients and “robust” management of the national dentists’ contract. There is concern among those involved that the move would see the four-hour wait replaced by a new target, which could be as difficult as the current target to achieve. Read full story Source: The Independent, 18 September 2022
  14. News Article
    Watchdogs have been asked to investigate a Scottish government overhaul of NHS waiting times information after surgeons said that some of the figures were “grossly misleading”. A complaint has been made to the Office for Statistics Regulation, which ensures that important public data is trustworthy, about a new guide for patients on the NHS Inform website. Concerns have also been raised with Audit Scotland, which monitors public spending and NHS performance. Last month Humza Yousaf, Scottish health secretary, unveiled the platform claiming that it would reassure patients about waiting times. But the times given reflect only the experience of patients treated over a three-month period. In orthopaedics, surgeons say, only the most urgent cases are being prioritised while some patients face languishing on waiting lists for years due to lack of capacity. NHS Inform says that people waited a median of 26 weeks between April and June for orthopaedic care, but surgeons argue that this gives a false impression. Dr Iain Kennedy, new chairman of the British Medical Association in Scotland, said the way the figures have been compiled would suggest that people are still not getting a realistic picture of delays. Read full story (paywalled) Source: The Times, 16 September 2022
  15. Content Article
    With 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.
  16. Content Article
    The 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. 
  17. Content Article
    The 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.
  18. 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.
  19. Content Article
    How one Devon ICS has worked with local trusts to cut deliver extra capacity at a former Nightingale hospital, now converted into an elective centre.
  20. Content Article
    This report by the Royal College of General Practitioners (RCGP) sets out recommendations for the Government to tackle the workforce and workload crisis in general practice, and support GPs and their teams to meet the healthcare challenges of the 21st century. Based on a survey of more than 2,600 GPs and other practice team members from across the UK, the report provides a snapshot of what frontline staff have faced during one of the most difficult winters experienced in the NHS, and what they think needs to happen to make general practice more sustainable. Respondents describe a profession in crisis, with unmanageable workload and workforce pressures fuelling an exodus of fully qualified GPs.
  21. Content Article
    Can the NHS effectively combine the aims of clearing the elective backlog and tackling health inequalities? It’s a question that systems and providers have been faced with since NHS England requested that recovery in the wake of the pandemic is managed inclusively. Some may think these aims are at odds with one another, while others will champion their unification. In the first stage of a new research project about inclusive approaches to reducing the backlog, The Kings Fund look at what we can learn from NHS boards about how this issue is playing out.
  22. Content Article
    NHS waiting lists have risen to record numbers since the pandemic and attempts to bring down the numbers of people waiting for treatment have been ramping up. The NHS Elective Recovery Plan (ERP), launched in February 2022, is intended to make a major contribution to reducing waiting lists. This paper by consultancy firm Lane Clark & Peacock sets out: how the national waiting list has changed over the year and the impact of the ERP. inequalities in the waiting list by speciality and geography and how the ERP has so far impacted regions differently. how LCP's previous projections compare to 2022’s waiting list and what their projections are for 2027 in light of over a year's worth of new data being available.
  23. Content Article
    This discussion, published in HSJ, looks at the state of NHS waiting times in January 2023. All figures come from NHS England. The referral-to-treatment waiting list narrowly broke through previous records in January, edging up to 7,213,436 patient pathways. Waiting times rose too, with 8 per cent of the list waiting longer than 46.6 weeks, up from 46.3 weeks the previous month. Read the full blog and access the data via the link below.
  24. Content Article
    In this Channel 4 Dispatches programme, secret footage filmed over the winter reveals ambulance workers battling the odds and A&E departments overwhelmed as patients suffer needless harm and death The footage comes from Daniel Waterhouse, an emergency medical technician who wore a body-mounted camera during his shifts in north-west London for three months this winter, filming every crumbling layer of a system that is close to total destruction.
  25. Content Article
    The NHS was struggling before Covid-19 and was further severely disrupted by the pandemic. As a result, it is now dealing with a massive backlog in elective care. This blog by Saoirse Mallorie, Senior Analyst at The King's Fund, looks at the causes and state of the backlog and identifies ways to tackle the issue, including increasing workforce and investment, innovation and focusing on prevention.
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