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Content ArticleThe 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.
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Content ArticleThe 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.
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UCLPartners proactive care programme
PatientSafetyLearning Team posted an article in Exit strategies
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.- Posted
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Content ArticleCOVID-19 continues to have a severe effect on planned surgery in the UK, and dealing with the resulting backlog is a critical concern for the NHS. In this BMJ Editorial, Andrew Carr and colleagues look at why the waiting times have increased so much and what can be done.
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Content ArticleRecently, NHS England and NHS Improvement published planning guidance for the year ahead, outlining six priorities for the NHS as it emerges from the pandemic. The guidance strikes a balance between prioritising covid response and recovery efforts and advancing the broader service transformation objectives of the NHS Long Term Plan. With NHS surgical waiting lists now standing at a record 4.6 million, it is not surprising that accelerating the restoration of elective care is one of the priorities. The elective backlog challenge is not a new one for the NHS, but addressing it has acquired a new urgency and scope. Clearing the backlog sustainably and equitably will require the NHS, as the guidance states, “to do things differently.” In this BMJ article, Jugdeep Dhesi and Lisa Plotkin what they think "doing things differently" must include.
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Content ArticleThis article written for The Guardian provides an inside look from the University College hospital who allowed access to its new facility and staff to show how the health service is trying to tackle backlogs.
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Content ArticleIn this blog, retired Occupational Health Doctor, Clare Rayner draws on personal experience to illustrate the impact delayed surgery can have on a patient. Clare’s insights as a physician, patient and relative lead several questions around risk management for patients as the NHS deals with the pressures of the surgical backlog.
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Content ArticleThis is the first of two blogs by Patient Safety Learning looking at the key patient safety issues faced by the healthcare system in the UK in tackling the care and treatment backlog created by the Covid-19 pandemic. This blog outlines the scale of the challenge and sets out the key patient safety considerations associated with this. It stresses the need for national and local plans to address the backlog, with an emphasis on patient engagement and placing patient safety at their core.
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Content ArticleThe waiting list for elective treatment in the NHS in England has reached an unprecedented level, with one in ten people – over 5.3 million – now waiting for a routine procedure. This report published by Policy Exchange sets out the scale of the challenge, opportunities to reform the existing approach to elective care and their proposed elective care recovery plan.
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Content ArticleUK-based charity Versus Arthritis are campaigning to ensure that the needs of people with arthritis are prioritised by policymakers as plans for the COVID-19 recovery are developed. As part of this work, in this report they set out a six-part support package to help to meet the needs of people with arthritis who are on surgery waiting lists.
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Communication is key to building patient trust in ‘the system’
Lotty posted an article in Patient-centred care
In this blog, Lotty Tizzard, Patient Safety Learning's Content and Engagement Manager, looks at how positive, proactive communication improves patient trust in health services. She highlights that negative past experiences can prevent patients accessing the support and treatment they need, and looks at possible ways to build patient trust in the health system.- Posted
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Hospitals are in serious trouble (7 January2022)
Patient Safety Learning posted an article in Blogs
Omicron is inundating a healthcare system that was already buckling under the cumulative toll of every previous surge, writes Ed Yong in an article for the Atlantic. When a healthcare system crumbles, this is what it looks like. Much of what’s wrong happens invisibly. At first, there’s just a lot of waiting. Emergency rooms get so full that “you’ll wait hours and hours, and you may not be able to get surgery when you need it,” says Megan Ranney, an emergency physician in Rhode Island. When patients are seen, they might not get the tests they need, because technicians or necessary chemicals are in short supply. Then delay becomes absence. The little acts of compassion that make hospital stays tolerable disappear. Next go the acts of necessity that make stays survivable. Nurses might be so swamped that they can’t check whether a patient has their pain medications or if a ventilator is working correctly. People who would’ve been fine will get sicker. Eventually, people who would have lived will die. This is not conjecture; it is happening now, across the United States. -
Content ArticleIn this opinion piece for The BMJ, Partha Kar, consultant endocrinologist and NHS England National Specialty Advisor for Diabetes, looks at the crisis facing primary care in the UK. He highlights that many primary care professionals are feeling burnt out due to the intense pressure and negative attention GPs are currently experiencing. The cost of relying on primary care for the vaccination programme is that treatment for mental health and long term conditions has been neglected. GPs are at the receiving end of patients' frustrations about delays to their care. Partha highlights the need to: prepare well in advance for potential future waves of Covid-19, including by developing a vaccine delivery workforce that is not reliant on primary care. ensure vaccines are distributed to less developed countries, and move away from seeing vaccination as an issue of nationalism. increase funding for primary care in a focused and sustained way.
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Content ArticleThis report by the Health and Social Care Commons Select Committee looks at the catastrophic impact of the Covid-19 pandemic on patients waiting for NHS care and outlines the findings of the Select Committee's inquiry. Waiting lists are at their highest since records began, and the 5.8 million patients waiting to start treatment in September 2021 may be only the tip of the iceberg, with missing patients meaning that the true waiting list could be as high as 13 million. The report highlights the need to carefully plan how to tackle the elective care backlog. It outlines the risks involved, including the danger of prioritising areas that are well suited to numerical targets to the detriment of other areas of care, such as mental health, general practice and community services. It also highlights that the challenges the NHS faces are greater than just tackling elective care. With a record number of 999 calls and waiting times in emergency departments at record levels, work to tackle the backlog is being threatened by pressure on emergency care.
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Content ArticleNHS England has set out 10 priorities for the 2022-23 financial year in its annual planning guidance. NHSE chief executive Amanda Pritchard makes clear in the introduction that many of its goals remain contingent on covid, stating: ”The objectives set out in this document are based on a scenario where covid-19 returns to a low level and we are able to make significant progress in the first part of next year.”
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Content ArticleSerena Roberts died as the result of an ovarian cancer which was not diagnosed until her death. She was initially seen for an ultrasound scan in April 2020 having reported symptoms of recurrent very heavy vaginal bleeding, and had been recommended to be referred to a gynaecologist for review but was not referred. In November 2020 her GP marked her referral letter as urgent, but this was entered as routine on the e-referral system and did not include important risk factor details regarding her BMI. Her condition worsened and on her second admission to hospital in March 2021 she died. The Coroner in her report highlights concerns about significant delays in patients being seen in secondary care for gynaecological referrals from GPs, the understanding and application of NICE guidance on heavy premenstrual bleeding in General Practice and the documentation and processes relating to referrals to secondary care from the GP.
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Content ArticleThis is the second of a short series of blogs in which we take a look back at our work in five areas of patient safety during 2021. In this blog, we look at our work to highlight key patient and staff safety issues resulting from the ongoing Covid-19 pandemic. Through our work, Patient Safety Learning seeks to harness the knowledge, insights, enthusiasm and commitment of health and social care organisations, professionals and patients for system-wide change and the reduction of avoidable harm. We believe patient safety is not just another priority; it is a core purpose of health and social care. Patient safety should not be negotiable.
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Content ArticleIn this blog for National Voices, Sue Brown, CEO of the Arthritis and Musculoskeletal Alliance, argues that using the word 'elective' when referring to elective surgery is misleading, and downplays the seriousness of waiting for a long time for treatment or surgery. She looks at the impact of waiting too long for surgery such as joint replacement on the lives of patients. Intense, long term pain and loss of mobility can lead to deteriorating mental health, isolation from friends and family and job loss, among other things. Patients needs support while they wait for surgery, and Sue outlines what she believes is needed to support patients who have had community and secondary care delayed: Design support with those with lived experience – ask what is important to them. Use the things we know can help, like social prescribing and health coaching – individual or group personal support. Use the voluntary and community sector who have a wealth of experience in supporting long term condition management – people need to know they are not alone and get support from others in the same situation.
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Content ArticleThis is a video recording of a Health Service Journal (HSJ) Patient Safety Congress webinar, in association with BD, considering some of the key emerging patient safety issues for 2022. The panel discuss the legacy of the Covid-19 pandemic patient and staff safety, what needs to be done to ensure that patient safety is designed into elective care recovery plans and the important role for co-production as part of this.
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BBC Sounds podcast - The Backlog (9 February 2022)
Patient-Safety-Learning posted an article in Exit strategies
This is the first episode in a series of podcasts by Natasha Loder, Health Policy Editor at The Economist, about the care backlog currently facing the health service. After more than two years battling Covid-19, the NHS is struggling through its worst winter crisis in living memory and is facing a daunting task to clear the huge backlog exacerbated by the pandemic. Nearly six million people are on the NHS waiting list for routine treatment in England alone. As patients, often with worsening conditions, pour back into the NHS after putting off treatment, health secretary Sajid Javid warns waiting lists could top thirteen million. In this first episode, Natasha speaks to frontline workers, managers, policy experts, and patients to assess the pressure created by the unprecedented demand on the different areas of the NHS from emergency services to GP surgeries.- Posted
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Content ArticleIn this article in The BMJ, Farah Hameed highlights that the backlog of care in the aftermath of the Covid-19 pandemic is having a significant and detrimental effect on primary care services, not just elective hospital treatment. The combined impact of patients not coming forward for treatment during the pandemic, and hospitals having to cancel non-urgent procedures and routine clinics, has led to a huge backlog of patients living with conditions that are gradually getting worse. It is primary care that has to support these patients in the absence of capacity in secondary care. Consultant-led hospital services rejecting GP referrals due to lack of capacity is a major problem, with the number of GP referrals rejected due to lack of slots jumping from 238,859 in February 2020 to 401,115 in November 2021. Farah argues that emphasis must be placed on how tackling the build-up of care in our communities can help the wider system. For example, making GP continuity of care a policy priority would be a cost-effective way of improving patient outcomes and reducing the burden on other parts of the healthcare system, including secondary care.
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Content ArticleRichard Murray, Chief Executive of The King’s Fund, comments on the NHS elective recovery plan.
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Content ArticleThe Covid-19 pandemic has had a significant impact on the amount of planned care the NHS has been able to provide. This delivery plan sets out how the NHS will recover elective care over the next three years. It has been developed with a wide range of expert partners and explains how the NHS will capitalise on current success and embed new ideas to ensure elective services are fit for the future.
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