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Found 195 results
  1. News Article
    System leaders are telling hospitals to prepare for a potential suspension of all non-emergency elective procedures which could last for months, as they get ready for a surge in coronavirus patients. Senior sources told HSJ NHS England had asked trusts to risk stratify elective patients in readiness for having to suspend non-emergency work to free up capacity. HSJ understands trusts have been told to firm up their plans for how they would incrementally reduce and potentially suspend non-emergency operations, while also protecting “life saving” procedures such as cancer treatment. An announcement is expected soon, with patients affected given at least 48 hours notice. It has not been decided how long it might last for, as the duration of any surge in cases and acute demand is unknown. But HSJ has been told it could stretch out for several months, with three or four months discussed, which would potentially mean tens of or even hundreds of thousands of cancelled operations. Read full story (paywalled) Source: HSJ, 12 March 2020
  2. News Article
    NHS hospitals have been told to expect a “several-fold” increase in demand for intensive care beds during a serious coronavirus outbreak. Professor Keith Willett, NHS England’s incident director for the coronavirus outbreak, told a secret briefing of chief nurses from across the NHS that they needed to prepare now for the unprecedented demand which could overwhelm existing critical care services. Sources who were in the briefing told The Independent Prof Willett warned the demand was likely to be not just double but “several fold” the existing 4,000 intensive care beds in the NHS. Prof Willett said the NHS will also be holding large-scale simulations next week for an expected coronavirus surge in an effort to “stress test the system” ahead of rising cases of infection. If the predictions are right the NHS will likely be forced to cancel large numbers of operations and re-deploy nurses and doctors. Read full story Source: The Independent, 12 March 2020
  3. News Article
    The coronavirus outbreak has been labelled a pandemic by the World Health Organization (WHO). WHO chief Dr Tedros Adhanom Ghebreyesus said the number of cases outside China had increased 13-fold in two weeks. He said he was "deeply concerned" by "alarming levels of inaction". A pandemic is a disease that is spreading in multiple countries around the world at the same time. Dr Tedros said that calling the outbreak a pandemic did not mean the WHO was changing its advice about what countries should do. He called on governments to change the course of the outbreak by taking "urgent and aggressive action". "Several countries have demonstrated that this virus can be suppressed and controlled," he said. "The challenge for many countries who are now dealing with large clusters or community transmission is not whether they can do the same - it's whether they will." Read full story Source: BBC News, 11 March 2020
  4. News Article
    Third year undergraduate trainee nurses will be invited into clinical practice to support the coronavirus effort, while routine care quality inspections are “going to need to be suspended”, the Chief Executive of NHS England has said. Speaking at the Chief Nursing Officer’s summit event in Birmingham this morning, Sir Simon Stevens told delegates NHSE was working with the Nursing and Midwifery Council to “see how many of the 18,000 [relevant] undergraduates are available”. It is understood they would be paid, and follows government moves to pass emergency legislation to relax rules around working in healthcare. Asked about Care Quality Commission inspections during the outbreak, Sir Simon said: “There will be a small number of cases where it would be sensible to continue for safety related reasons… but the bulk of their routine inspection programmes is clearly going to need to be suspended and many of the staff who are working as inspectors need to come back and help with clinical practice.” Read full story (paywalled) Source: HSJ, 11 March 2020
  5. News Article
    With the number of UK coronavirus cases set to rise, NHS England says it is scaling up its capacity for testing people for the infection. It means 10,000 tests a day can be done – 8,000 more than the 1,500 being carried out currently. Confirmation of any positive test results will be accelerated, helping people take the right action to recover or quickly get treatment. Most of the people tested should get a result back within 24 hours. Scotland, Wales and Northern Ireland will be expected to roll out their own testing services, but there will be some shared capacity between nations, depending on need. Read full story Source: BBC News, 11 March 2020
  6. News Article
    Regional NHS leaders in England have been ordered to immediately organise a primary care management service to care for covid-19 patients who “do not require immediate admission” to hospital. In a letter sent on 8 March, seen by The BMJ, NHS England and NHS Improvement’s strategic incident director for coronavirus, Keith Willett, has ordered regional primary care and public health directors to set up a 24 hour, seven day a week service to manage patients in the community. This service should be delivered by an out-of-hours provider, and every part of England must be covered by Tuesday 10 March, the letter said. The service will be used to manage patients who are deemed well enough to be isolated at home, with active monitoring for people who are at high risk of developing severe illness, and advice to those not deemed high risk on what to do if their illness deteriorates. The letter advises that patients “remain in isolation until 5 days after resolution of symptoms, unless [they are a] healthcare worker or work with high risk groups, in which case require one negative sample 5 days after resolution of symptoms before return to work.” People with mild illness and not in a high risk group will be told to isolate themselves at home and will be given health advice on how to identify deterioration. All patients managed at home will be given a phone number to call if they feel more unwell. The letter said that the community service should be provided by a nurse and GP team and that all clinical information should be recorded and transferred to the patient’s general practice. Providers must also provide regular situation reports, including confirmed numbers of patients cared for under the service, numbers of patients who deteriorate, and numbers of patients admitted to and discharged from the service. Read full story Source: BMJ, 9 March 2020
  7. News Article
    Visitors to a hospital are stealing hand sanitising gel daily – as demand for the product surges amid fears over coronavirus. Bottles have been taken from patients' beds and dispensers ripped off walls at Northampton General Hospital. Bosses said the gel was "disappearing every day" and they have had to limit the supply on wards. "Nothing like this has ever happened in all the years we've had the gel," said a hospital spokeswoman. "Over the past week we've seen stocks on wards disappear from the end of beds every single day," Sally-Anne Watts, associate communications director, told the BBC. "Three wall-mounted dispensers have been ripped off and we've even seen people coming in and topping up their own dispensers with our product," she said. Since the hospital's supplies have been going missing, Mrs Watts said, bottles were no longer being put at the end of all beds. "We don't have an unlimited supply and would ask that visitors to the site respect the fact that we are doing all we can to keep our patients, visitors and staff safe, and we need their support," she added. Read full story Source: BBC News, 6 March 2020
  8. News Article
    The health service lacks the beds, staffing and resources to cope with a serious outbreak of the coronavirus, The Independent has been told by senior doctors and nurses. NHS staff from across the country warned hospitals are already unable to cope, with patients being looked after in spill-over wards and waiting hours for a bed, with one doctor saying it was already a “one in, one out mentality” for intensive care. Other staff reported delays in lab tests, rationing of protective masks and equipment, and a lack of isolation areas for suspected coronavirus patients. Suggestions from the Health Secretary Matt Hancock that the NHS would use “home ventilation kits”, and that an extra 5,000 intensive care beds could be created, were labelled “fanciful” by the chair of the British Association of Critical Care Nurses today. Nicki Credland said: “If you already have a system running at 100 per cent capacity, the idea you can get a significant amount of additional beds is just not realistic. There simply aren’t enough beds for them. We will need to make difficult decisions about which patients are going to be admitted to intensive care." Read full story Source: The Independent, 5 March 2020
  9. News Article
    Technology and healthcare companies are racing to roll out new tools to test for and eventually treat the coronavirus epidemic spreading around the world. But one sector that is holding back are the makers of artificial-intelligence-enabled diagnostic tools, increasingly championed by companies, healthcare systems and governments as a substitute for routine doctor-office visits. In theory, such tools, sometimes called “symptom checkers” or healthcare bots,sound like an obvious short-term fix: they could be used to help assess whether someone has Covid-19, the illness caused by the novel coronavirus, while keeping infected people away from crowded doctor’s offices or emergency rooms where they might spread it. These tools vary in sophistication. Some use a relatively simple process, like a decision tree, to provide online advice for basic health issues. Other services say they use more advanced technology, like algorithms based on machine learning, that can diagnose problems more precisely. But some digital-health companies that make such tools say they are wary of updating their algorithms to incorporate questions about the new coronavirus strain. Their hesitancy highlights both how little is known about the spread of Covid-19 and the broader limitations of healthcare technologies marketed as AI in the face of novel, fast-spreading illnesses. Some companies say they don’t have enough data about the new coronavirus to plug into their existing products. London-based symptom-checking app Your.MD Ltd. recently added a “coronavirus checker” button that leads to a series of questions about symptoms. But it is based on a simple decision tree. The company said it won’t update the more sophisticated technology underpinning its main system, which is based on machine learning. “We made a decision not to do it through the AI because we haven’t got the underlying science,” said Maureen Baker, Chief Medical Officer for Your.MD. She said it could take 6 to 12 months before sufficient peer-reviewed scientific literature becomes available to help inform the redesign of algorithms used in today’s more advanced symptom checkers. Read full story Source: The Wall Street Journal, 29 February 2020
  10. News Article
    A new poll has found only 8 out of the 1,618 respondents believed the health service was ready to deal with an outbreak when asked by The Doctors’ Association UK (DAUK), despite the prime minister’s insistence that the NHS will cope if it is hit by a surge in the number of people falling ill. Common concerns included difficulties coping with increased demand, a shortage of beds and poor staffing levels, according to the group who led the poll. Some doctors asked said they were worried that there could be not enough laboratory space to do testing in the case of a pandemic. Others claimed that NHS 111 had been giving out “inappropriate advice” to go to A&E and GP practices, according to DAUK. “The NHS has already been brought to its knees and many frontline doctors fear that our health system simply will not cope in the event of a Coronavirus (Covid-19) outbreak,” Dr Rinesh Parmar, the DAUK chair, said. “Many hoped the threat of Covid-19 would prompt an honest conversation to address the issue of critical care capacity and our ability to look after our sickest patients. By simply saying ‘the NHS is well prepared to deal with coronovirus’ it seems that yet again doctors’ concerns have been brushed under the carpet.” The findings come after the number of people infected with the coronavirus which rose to 39 in the UK on Monday. Read full story Source: The Independent, 3 March 2020
  11. News Article
    The NHS is currently rolling out services on NHS sites to test people for coronavirus, including a new service now in action in west London, offering ‘drive through’ coronavirus testing. The new service, provided by Central London Community Healthcare NHS Trust in Parsons Green, is only accessed through a referral from NHS 111, and means people worried about the virus can safely and quickly get checked close to home. The model is one of the ways in which community testing and home testing are being rolled out nationwide, with the NHS’ strategic incident director for coronavirus, asking health services in every part of England to set up home and community testing. After being referred through NHS 111, people are invited to an appointment in their car, during which two community nurses carry out a swab in the nose and mouth, which are checked and assessed within 72 hours. People are asked to self-isolate while checks are completed, to prevent any potential onward transmission of the virus. Dr Joanne Medhurst, medical director for Central London Community Healthcare NHS Trust, said: “Anyone who is worried about coronavirus should call NHS 111 for up to date advice. We’ve set up the ‘drive through’ service to make sure people in our community can get safe, convenient and quick checks for coronavirus, as part of NHS efforts to keep everyone safe." “It’s crucial that, as a community service, we help residents in our area to get accurate, timely advice while managing extra pressure on the NHS, and so far this week we’ve had good feedback from people that the swabbing service offers reassurance at what can be a difficult time.” Read full story Source: NHS England, 28 February 2020
  12. News Article
    Prime Minister Boris Johnson will say there is “little doubt” the coronavirus will present a “significant challenge” for the UK as he chairs a Cobra meeting to discuss the government’s response to the outbreak. The health secretary, Matt Hancock, has warned it was now “inevitable” the deadly virus would “become endemic” in the UK as 13 more cases of Covid-19 were announced, bringing the total number to 36. The Cobra meeting will bring together senior ministers and the Chief Medical Officer, Professor Chris Whitty and Chief Scientific Adviser Sir Patrick Vallance. Meanwhile the worldwide death toll from the disease has passed 3,000, with more than 80,000 cases worldwide. Several countries in Europe, the Middle East and the Americas have banned large gatherings and imposed stricter travel restrictions in an attempt to limit infections.the Americas have banned large gatherings and imposed stricter travel restrictions in an attempt to limit infections. Read full story Source: The Indpendent, 2 March 2020
  13. News Article
    NHS patients could be denied lifesaving care during a severe coronavirus outbreak in Britain if intensive care units are struggling to cope, senior doctors have warned. Under a so-called “three wise men” protocol, three senior consultants in each hospital would be forced to make decisions on rationing care such as ventilators and beds, in the event hospitals were overwhelmed with patients. The medics spoke out amid frustration over what one said was the government’s “dishonest spin” that the health service was well prepared for a major pandemic outbreak. The doctors, from hospitals across England, said the health service’s existing critical care capacity was already overstretched and “would crumble” under the demands of a pandemic surge in patients who may all need ventilation to help them breathe. Those denied intensive care beds could be those suffering with coronavirus or other seriously ill patients, with priority given to those most likely to survive and recover. Doctors said this would lead to “tough decisions” needing to be made about the wholesale cancellation of operations to free-up beds. Read full story Source: Independent, 28 February 2020
  14. News Article
    Tests for coronavirus are being increased to include people displaying flu-like symptoms at 11 hospitals and 100 GP surgeries across the UK. The tests will provide an "early warning" if the virus is spreading, Public Health England Medical Director Prof Paul Cosford said. Up to now, people were tested only if they displayed symptoms having recently returned from one of the countries where there has been an outbreak, including China, South Korea and northern Italy. However, Prof Cosford said Public Health England was now working with hospitals and GP surgeries to conduct "random" tests. These will target some patients with coughs, fevers or shortness of breath, regardless of whether they have travelled to a place where the virus is spreading. "If we do get to the position of a more widespread infection across the country, then it will give us early warning that's happening," said Prof Cosford. Read full story Source: BBC News, 26 February 2020
  15. News Article
    The number of British cases of coronavirus has doubled to eight – with two healthcare workers among those testing positive – while a GP surgery in Brighton was closed amid fears of the infection spreading. Brighton’s County Oak medical centre closed on Monday with a warning notice on its door telling patients it was “closed due to operational difficulties”. According to reports, one of those infected was a GP, who was at work for one day but did not see any patients. Workers wearing protective suits were pictured cleaning the surgery and pharmacy on Monday afternoon. The government has since classified the virus, which has infected more than 40,000 people in China and led to the death of more than 1,000, as a “serious and imminent threat” to public health while activating emergency powers that can see it force people to remain in quarantine. “I will do everything in my power to keep people in this country safe,” Matt Hancock, the Health Secretary, said in a statement. “We are taking every possible step to control the outbreak of coronavirus. NHS staff and others will now be supported with additional legal powers to keep people safe across the country.” Read full story Source: The Independent, 11 February 2020
  16. News Article
    All NHS hospitals in England have been ordered to create secure areas for coronavirus testing to “avoid a surge in emergency departments”, according to a leaked NHS letter. Hospitals have been told to create “coronavirus priority assessment pods”, where people will be checked for the virus, which will need to be decontaminated each time they are used. The letter, seen by The Independent and dated 31 January, instructs all chief executives and medical directors to have the pods up and running no later than Friday 7 February. It comes as the global death toll from the virus has reached 565 with around 28,000 infected. One hospital chief executive told The Independent he believed the requirement was “an overreaction”, adding: “I think we should be sending teams out to swab in patients homes as the advice is to stay at home and self-manage as with any other flu". In the letter, Professor Keith Willett, who is leading the NHS’s response to coronavirus, told NHS bosses: “Plans have been developed to avoid a surge in emergency departments due to coronavirus. “Although the risk level in this country remains moderate, and so far there have been only two confirmed cases, the NHS is putting in place appropriate measures to ensure business as usual services remain unaffected by any further cases or tests of coronavirus.” Read full story Source: 5 February 2020
  17. News Article
    In early January, authorities in the Chinese city of Wuhan were trying to keep news of a new coronavirus under wraps. When one doctor tried to warn fellow medics about the outbreak, police paid him a visit and told him to stop. A month later he has been hailed as a hero, after he posted his story from a hospital bed. It's a stunning insight into the botched response by local authorities in Wuhan in the early weeks of the coronavirus outbreak. Dr Li was working at the centre of the outbreak in December when he noticed seven cases of a virus that he thought looked like SARS - the virus that led to a global epidemic in 2003. On 30 December he sent a message to fellow doctors in a chat group warning them about the outbreak and advising they wear protective clothing to avoid infection. What Dr Li didn't know then was that the disease that had been discovered was an entirely new coronavirus. Four days later he was summoned to the Public Security Bureau where he was told to sign a letter. In the letter he was accused of "making false comments" that had "severely disturbed the social order". "We solemnly warn you: If you keep being stubborn, with such impertinence, and continue this illegal activity, you will be brought to justice - is that understood?" He was one of eight people who police said were being investigated for "spreading rumours". At the end of January, Dr Li published a copy of the letter on Weibo and explained what had happened. In the meantime, local authorities had apologised to him but that apology came too late. For the first few weeks of January officials in Wuhan were insisting that only those who came into contact with infected animals could catch the virus. No guidance was issued to protect doctors. "A safer public health environment… requires tens of millions of Li Wenliang," said one reader of Dr Li's post. Read full story Source: BBC News, 4 February 2020
  18. News Article
    Two people have tested positive for coronavirus in the UK, the Chief Medical Officer for England has announced. They are both members of the same family and are receiving specialist NHS care. No more details are being released about their identity or where they are being treated. At least 213 people in the China have died from the virus, mostly in Hubei, with almost 10,000 cases nationally. There have been 98 cases of the virus in another 18 countries. Prof Chris Whitty, Chief Medical Officer for England said: "The NHS is extremely well-prepared and used to managing infections and we are already working rapidly to identify any contacts the patients had, to prevent further spread. "We have been preparing for UK cases of novel coronavirus and we have robust infection control measures in place to respond immediately," he added. Prof Whitty said the UK was working closely with the World Health Organization (WHO) and the international community as the outbreak in China develops "to ensure we are ready for all eventualities". The new coronavirus was declared a global emergency yesterday by the World Health Organization, as the outbreak continues to spread outside China. "The main reason for this declaration is not what is happening in China but what is happening in other countries," said WHO Chief Tedros Adhanom Ghebreyesus. The concern is that it could spread to countries with weaker health systems. Read full story Source: BBC News, 31 January 2020
  19. News Article
    An outbreak of norovirus on hospital wards across the NHS has forced the closure of more than 1,100 beds in the last week. The news comes amid record numbers of patients turning up to emergency departments at some hospitals and higher than expected cases of flu. There are fears the dire situation could herald the start of a winter crisis for the NHS which is starting earlier than in previous years. Miriam Deakin, Director of Policy and Strategy at NHS Providers, which represents hospitals said: “We are going into what is traditionally the NHS’s busiest time with a health and care system already under severe demand pressure." “Patient safety is the top priority for trusts, but alongside high levels of staff vacancies, an outbreak of flu or norovirus could have a serious effect on the delivery of services.” Read full story Source: The Independent, 5 December 2019
  20. Content Article
    This blog is written in time for the WHO's World Immunisation Week. It explores vaccination programmes, in particular that for COVID-19 – it's uptake, both in the UK and globally, and the negative impact the pandemic has had on vaccination programmes for other diseases.
  21. Content Article
    This e-book provides an extensive overview of the day-to-day challenges posed by antimicrobial resistance, tools for setting up stewardship programmes and guidance of how to make the most of existing programmes. Its resources apply the principles of antimicrobial stewardship to a wide range of professions, populations and clinical/care settings. It was published by the British Society for Antimicrobial Chemotherapy in collaboration with the European Society of Clinical Microbiology and Infectious Diseases.
  22. Content Article
    World Antimicrobial Awareness Week takes place from the 18-24 November every year. On this page the WHO explains what antimicrobial resistance is and provides several short explanatory videos about how this can be prevented.
  23. Content Article
    Antimicrobial resistance (AMR) is a global problem that impacts all countries and all people, regardless of their wealth or status. The scale of the AMR threat, and the need to contain and control it, is widely acknowledged by country governments, international agencies, researchers and private companies alike. This document sets out the UK’s 2019–2024 national action plan to tackle AMR within and beyond our own borders. Developed in consultation with a broad range of stakeholders across different sectors, it builds on the achievements of our last strategy (2013–2018), and is aligned with global plans and frameworks for action. The plan has ultimately been designed to ensure progress towards our 20-year vision on AMR, in which resistance is effectively contained and controlled. It focuses on three key ways of tackling AMR: reducing need for, and unintentional exposure to, antimicrobials; optimising use of antimicrobials investing in innovation, supply and access. 
  24. Content Article
    The purpose of this investigation by the Healthcare Safety Investigation Branch (HSIB) is to help improve patient safety in relation to recognition of the acutely ill infant and child, recognising the difficulty in distinguishing between simple viral illnesses and life-threatening bacterial infections in very young patients. This Healthcare Safety Investigation Branch investigation reviewed the case of Mohammad, a baby who had become unwell and was taken to an emergency department by ambulance following a call to NHS 111. He arrived at 8.04pm and was considered to have a mild viral illness, subsequently being transferred to a paediatric observational ward, and discharged at 11.45pm with a diagnosis of likely bronchiolitis. At approximately 3.40am his mother contacted the ward as his condition worsened, which resulted in a 999 call. The ambulance crew did not consider that Mohammad was seriously ill so did not conduct a ‘blue light’ emergency transfer to hospital. Mohammad was admitted to the emergency department at approximately 4.40am and suffered a respiratory and then cardiac arrest at 5:28am, with attempts to resuscitate unsuccessful and stopped at 6:10am. Mohammad died of septicaemia caused by meningococcus (serogroup B) bacteria.
  25. Content Article
    On 1 February the UK Health Security Agency warned that coverage of the measles, mumps, and rubella (MMR) vaccine’s first dose had dropped below 90% in 2 year olds. By age 5, uptake of two doses had dropped to 85.5%—well below the World Health Organization’s 95% target needed for elimination of measles. The latest quarterly vaccination figures show very small drops in uptake in England from July to September 2020, and uptake continued to decline over the next year. And it’s not just MMR: small decreases have been seen in coverage of other childhood vaccines including the combined diphtheria, hepatitis B, Hib, polio, tetanus, and whooping cough vaccine, as well as those for rotavirus and meningitis B. But MMR is the one that public health officials worry about most because of historically lower uptake and the risks of outbreaks. With uptake of the MMR vaccine falling in the UK, Emma Wilkinson examines whether anti-vaccination sentiment around Covid-19 has played a part.
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