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Found 270 results
  1. Content Article
    This infographic by artist Sonia Sparkles highlights ways to prevent patient falls in hospital. A wide range of graphics relating to patient safety, healthcare and quality improvement is available on the Sonia Sparkles website.
  2. Content Article
    Falls have a significant negative impact on the health and well-being of people with dementia and increase service costs related to staff time, paramedic visits, and accident and emergency (A&E) admissions. The author of this study, published in the Journal of Patient Safety, examined whether a remote digital vision-based monitoring and management system had an impact on the prevention of falls.
  3. Content Article
    The National Early Warning Score (NEWS2) is calculated using routine vital sign measures of temperature, pulse and so on. It is used by ambulance staff and emergency departments to identify sick adults whose condition is likely to deteriorate.  NEWS2 has been shown to work among the general population. However, it has been unclear if it could monitor the condition of care home residents because of their age, frailty, and multiple long-term conditions. New research from the National Institute for Health and Care Research (NIHR) shows that, among care home residents admitted to hospital as an emergency, NEWS2 can effectively identify people whose condition is likely to get worse.
  4. Content Article
    Harold Pedley, known as Derek, attended his GP surgery during the late afternoon on 21.12.22 and after spending most of that day feeling unwell with symptoms including abdominal pain and vomiting. He was appropriately referred to the hospital and travelled there with his friend after his GP had discussed his case with doctors. Due to a lack of available beds in the assessment unit, Derek needed to remain in the emergency department. Following his arrival at 20.07 hours, doctors were not notified of his attendance. He remained in the emergency department waiting area for almost two hours during which time due to significant pressures faced by the department he was not assessed or spoken to by a medical professional. At 21.59 hours a triage nurse called for him. By then, Derek had been unresponsive for some time and had died, his death confirmed at 22.26 hours. A subsequent post mortem examination revealed he died from the effects of non-survivable extensive small bowel ischaemia caused by a significantly narrowed mesenteric artery. His death was contributed to by heart disease.
  5. Content Article
    This state-of-the-nation report from the National Hip Fracture Database (NHFD) focuses on the period from 1 January to 31 December 2022. It shows that the number of people who died in the month following a hip fracture now stands at 6.2%; down from 10.9% in 2007, when the NHFD was set up. However, the report also finds that it took longer for patients to reach a ward where a hip fracture team can work together (where there is the best chance of recovery) in 2022. It also states that fewer patients received prompt surgery to repair their broken hip by the day after they presented to hospital. There was an improvement in how many people with hip fracture received bone strengthening medicines to avoid future fractures in 2022, but some hospitals continue to report that none of their patients receive such treatment.
  6. Content Article
    The Acute Frailty Network (AFN) was a scheme run in England by NHS Elect, using an approach called Quality Improvement Collaboratives (QICs), to help trusts implement principles of Comprehensive Geriatric Assessment (CGA) as part of their acute pathway. In July 2023, Street et al published a paper in BMJ Quality and Safety analysing the impact of the AFN which concluded that there was no difference in length of hospital stay, in-hospital mortality, institutionalisation and hospital readmission between organisations that took part in AFN and those that did not. This article outlines the position of the British Geriatrics Society (BGS) on the paper, addressing why it thinks that focusing on older people’s healthcare is more important than ever. It highlights the importance of ensuring that the paper's findings are not used as a reason to abandon efforts to improve acute frailty care. Rather, they should be seen as a call to redouble efforts to identify and overcome the barriers to delivering CGA in acute settings.
  7. News Article
    Hospitals are sending frail, vulnerable patients home before they are better and without vital medical care, leaving them unable to fend for themselves. Over the past fortnight, The Mail on Sunday has received an alarming number of letters from readers who have told of their anger, frustration and sheer desperation at being denied support they were promised. Many have been left bed-bound and unable to wash, dress or use the bathroom for weeks on end. The daughter of an 87-year-old stroke survivor had to put a hospital bed in her living room and provide 24/7 care for her mother after the local health team failed to provide adequate support. Within a year, the woman was dead, having been treated with little more than paracetamol. In another case, a 70-year-old woman had to take her immobile 84-year-old husband to the hospital in a taxi every day for several weeks to have vital injections, because carers refused to come to their home. And the disabled wife of one 74-year-old man, who fell off a roof and broke his pelvis and ribs, told of the heartbreak at not being able to look after her husband due to her own poor health. Campaigners say a Government scheme designed address the ‘problem’ of bed-blockers – the somewhat derogatory term used to describe patients, most of them elderly, who are occupying a hospital bed that they don’t strictly need – is to blame. The protocol, called Discharge To Assess, launched eight years ago, aims to get patients home as quickly as possible amid reports that some elderly patients ended up stuck in wards for months on end – usually because the NHS hasn’t been able to organise the next stage of their care, so it’s not safe discharge them. Read full story Source: Mail Online, 2 September 2023
  8. News Article
    Older patients should walk around hospital wards and along corridors to prevent their muscles weakening, research suggests. Lying in a hospital bed for several days can cause a sharp deterioration in strength, leaving some elderly patients struggling to walk or live independently when they are discharged. New research shows this decline can be prevented if patients are helped to walk for at least 25 minutes a day while in hospital. The best effect was observed when patients walked around the hospital for at least 50 minutes a day. The study suggested that a mixture of physical activity, such as 20 minutes working with resistance bands while seated and 20 minutes of walking, also helped. The authors said patients who remained active during their stay in hospital were less likely to suffer “adverse events” after they were discharged. Read full story (paywalled) Source: The Times, 4 August 2023
  9. News Article
    A 94-year-old man has said his GP refuses to see him “unless it’s life or death”. Dennis Baker, from North Hampshire, said he felt “put off” by his doctor's surgery, which is a three-minute walk from his house. The pensioner, who lives with his wife who has advanced dementia and is bed-bound, said he found it “quite difficult to carry on a conversation with a doctor” and cannot get one to visit him at home. “The chances are [the receptionist] will say… ‘you're not dying, a doctor will phone you at some stage today’, that’s the usual response,” he told BBC Radio 4’s World at One. It comes as the president of the Royal College of GPs (RCGP) said family doctors should start “saying no” to extra work to tackle the crisis in primary care. Speaking at Pulse Live last week, Professor Dame Clare Gerada said the workload crisis was not the fault of GPs and they “cannot innovate [their] way out”. “When you’re in debates and people are saying to you 'you’ve got to work harder and smarter' - no, the rest of the system has to adapt,” she told the conference. “You have to start saying no.” Read full story (paywalled) Source: The Telegraph, 3 May 2022
  10. News Article
    Government policies on discharging untested patients from hospital to care homes in England at the start of the Covid pandemic have been ruled unlawful by the High Court. The ruling comes after two women took former Health Secretary Matt Hancock and Public Health England to court. Dr Cathy Gardner and Fay Harris said it had caused a "shocking death toll". Prime Minister Boris Johnson renewed his apologies for all those who lost loved ones during the pandemic. Dr Gardner and Ms Harris partially succeeded in claims against Mr Hancock and Public Health England. The women claimed key policies of discharging patients from hospitals into care homes were implemented with no testing and no suitable isolation arrangements in the homes. A barrister representing Dr Gardner and Ms Harris told the court at a hearing in March that more than 20,000 elderly or disabled care home residents died from Covid between March and June 2020 in England and Wales. Jason Coppel QC also said in a written case outline for the judicial review that the care home population was known to be "uniquely vulnerable" to Covid. "The government's failure to protect it, and positive steps taken by the government which introduced Covid-19 infection into care homes, represent one of the most egregious and devastating policy failures in the modern era," he added. Read full story Source: BBC News, 27 April 2022
  11. News Article
    A woman has described how she spent more than six hours of her 100th birthday waiting in agony for an ambulance after slipping and fracturing her pelvis while getting ready for a family lunch. Irene Silsby was due to be picked up by her niece, Lynne Taylor, for a celebration to mark her centenary on 9 April. But she fell in the windowless bathroom of her care home in Greetham, Rutland, and staff called an ambulance at 9am after she managed to summon help. “All I remember is I was in terrible pain,” said Silsby from her hospital bed on Saturday. When asked of the ambulance delay, she said: “It’s disgusting. I don’t know how I stood it so long, the pain was so severe.” Taylor expected to meet the ambulance as she arrived 45 minutes later. But when she reached the care home, the manager said it would be a 10-hour wait, she said. What was to be her aunt’s first trip outside the care home in more than five months turned into her lying on a cold floor surrounded by pillows and blankets to keep her warm and quell some of the discomfort. Taylor, 60, recalled her aunt saying: “They’re not coming to me because they know I’m 100 and I’m not really worth it any more.” Taylor said she had never felt so scared, frustrated and worried. After calling 999 and expressing her outrage, she was told that life-threatening conditions were being prioritised. “I thought she was going to die,” she said. “I didn’t think that any frail, tiny, 100-year-old body could put up with that level of pain on the floor.” Read full story Source: The Guardian, 20 April 2022
  12. News Article
    Senior medics have reacted in horror to NHS England’s decision to ‘dramatically’ cut the funding of a key long-term plan commitment designed to improve older people’s community services and deliver more care at home. British Geriatrics Society president Jennifer Burns told HSJ the professional body was “horrified” that the budget for the Ageing Well programme for 2022-23 would be £70m instead of the £204m originally promised in the long-term plan for the NHS. “We are dismayed that the promised funding for the Ageing Well programme as set out in the NHS long-term plan is being so dramatically cut at this time,” Dr Burns said. NHSE said: “The NHS is also investing an additional £200m in funding for virtual wards across the country by March 2023, delivering more care to patients safely in the comfort of their own home which will directly benefit older patients.” But Dr Burns said that although virtual wards would go “some way to helping with hospital admissions”, they were “no substitute” for the original commitments. “Older people suffered a devastating toll during the pandemic. Now is the time for systems to ensure the right services are in place and there is sustainable planning for the healthcare needs of an ageing population.” Read full story (paywalled) Source: HSJ, 7 April 2022
  13. News Article
    The NHS is “flying blind” and “woefully unprepared” to cope with England’s rapidly ageing population, senior doctors have warned as stark new figures reveal the country has only one full-time geriatrician to care for every 8,000 older people. The Royal College of Physicians (RCP) said the drastic shortage of specially trained physicians to look after the rising number of elderly people and a lack of NHS workforce planning meant England was “sleepwalking into an avoidable crisis of care for older people”. Its analysis of NHS and Office for National Statistics data shows there is just one full-time geriatrician for every 8,031 people over the age of 65 in England. There are also regional disparities, with one geriatrician caring for more than 12,500 over-65s in the east Midlands, while the figure in north-east and central London is one per 3,254. Estimates suggest that by 2040 there could be as many as 17 million over-65s. But the college warns that many doctors will soon be requiring geriatric care themselves as 48% of consultant geriatricians are due to retire within the next decade. The RCP said the health service was short of staff across all specialities and the shortage of geriatricians was one example of why the health service needed more workforce planning. It said there was no publicly available data on the number of staff the NHS needed to train now to meet future demand for care. Dr Jennifer Burns, the president of the British Geriatrics Society, said the crisis would only worsen with the “predictable rise” in the numbers of older people across the country. “It is absolutely vital that these fundamental issues around the recruitment, retention, development and support of the workforce are addressed, and that there is a properly resourced strategy for future needs,” she said. Read full story Source: The Guardian, 3 March 2022
  14. News Article
    Almost 900,000 older people are admitted to hospital every year as an emergency because the NHS is failing to keep them healthy at home, Age UK has warned. A major lack of services outside hospitals means elderly people are also suffering avoidable harm, such as falls and urinary tract infections, the charity said. In a new report it urges NHS bosses to push through huge changes to how the “hospital-oriented” service operates and establish “home first” as the principle of where care is provided. Doing so would reduce the strain on overcrowded hospitals and leave the NHS better set up to respond to the increase in the number of over-65s and especially over-85s, Age UK said. Its report, on the state of health and care of older people in England, concluded that “our health and care system is struggling, and too often failing, to meet the needs of our growing older population.” Read full story Source: The Guardian, 11 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. News Article
    A vaccine that promises to protect infants and the over-75s from a lung infection which adds to pressure on the NHS each winter has been backed by government advisers. Respiratory syncytial virus (RSV) is a leading cause of pneumonia in the very young and elderly. It typically causes between 22,000 and 30,000 hospital admissions of small children a year. RSV’s impact on the elderly is less well understood but important, and experts believe that an effective vaccine could significantly lessen winter pressures on the health service. After 60 years of research, vaccines for older adults from Britain’s GSK and its US rivals Pfizer and Moderna are in the final stages of development. The Joint Committee on Vaccination and Immunisation (JCVI) believes that they could be licensed this year or early next year and trial data suggest that they work well. Read full story (paywalled) Source: The Times, 23 June 2023
  17. News Article
    The NHS needs to do more to support care homes and people who have fallen with alternatives to ambulance calls and hospital admissions, the NHS England chief executive has said. Speaking at the Ambulance Leadership Forum, Amanda Pritchard acknowledged this winter would be a difficult one for the health service, saying: “The scale of the current and potential challenge mean that we do need to continue to look further for what else we can do… We need to pull out all the stops to make sure that they [patients] get that treatment as safely as possible and as quickly as possible.” She added one area of focus should be making sure certain patient groups can access other – more appropriate – forms of care, rather than calling an ambulance by default and often resulting in hospital admission. On care homes, she said: “Can we wrap around even more care for these care homes so they get to the point where they don’t need to call for help at all or, if they do, there are alternatives pathways [to the emergency department]?” She suggested another area where responses could be made more consistent was for patients who had fallen but without serious injuries, which she said made up a “really significant part of activity”. These patients took a long time to reach and, if admitted to hospital, risked long admissions, she said. Some areas were working to find other ways of responding to non-injury falls patients and trying to keep them away from hospital, she said. Read full story (paywalled) Source: HSJ, 6 September 2022
  18. News Article
    Millions of people will be invited for their autumn Covid booster jab in England and Scotland, with care home residents the first to receive them. Although infections are falling, health bosses are predicting a resurgence of Covid and flu this autumn and winter. They are urging those eligible to protect themselves from serious illness by getting vaccines against both. A recently approved vaccine against the Omicron variant will be used first. However, there is not enough of Moderna's "bivalent" vaccine to protect everyone aged over 50 so health officials say people should take whichever booster they are offered. These will be the vaccines used in the spring. The UK's Medicines and Healthcare products Regulatory Agency (MHRA) announced on Saturday that it had approved a second "bivalent" coronavirus vaccine from Pfizer/BioNTech for people aged 12 and over. Read full story Source: BBC News, 4 September 2022
  19. News Article
    There are big differences in how well patients with hip fractures are cared for by hospitals in England and Wales, a Bristol University study says. In some hospitals one in 10 people died within a month of surgery - more than three times worse than in the best. Getting patients into theatre quickly and out of bed the next day for physio are key ways to improve care. People should receive the same, high-quality care wherever they live, the researchers said. "If you get it right for older people with hip fractures, you're probably getting it right for older people in general," says Professor Celia Gregson, who led the study of more than 170,700 patients in 172 hospitals between 2016 and 2019. An NHS spokesperson said hip fracture care in the UK had "seen dramatic improvements in recent years". Read full story Source: BBC News (31 August 2022)
  20. News Article
    A 90-year-old woman waited 40 hours for an ambulance after a serious fall. Stephen Syms said his mother, from Cornwall, fell on Sunday evening and an ambulance arrived on Tuesday afternoon. She was then in the vehicle for 20 hours at the Royal Cornwall Hospital. It comes as an ambulance trust warns lives are at risk because of delays in patient handovers. It was also reported a man, 87, who fell, was left under a makeshift shelter waiting for an ambulance. South Western Ambulance Service said it was "sorry and upset" at the woman's wait for an ambulance. Mr Syms, from St Stephen, told BBC Radio Cornwall: "We are literally heartbroken to see a 90-year-old woman in such distress, waiting and not knowing if she had broken anything. "The system is totally broken." He said it took nine minutes before his 999 call was answered. "If that was a cardiac arrest, nine minutes is much too long, it's the end of somebody's life," he said. Mr Syms said paramedics were "absolutely incredible people". He added: "The system is not deteriorating, it's totally broken and needs to be urgently reviewed." Read full story Source: BBC News, 19 August 2022
  21. News Article
    Some pharmacies run by the High Street chain Boots have been criticised for telling some patients on multiple drugs that they can no longer have blister pack boxes, known as dosette boxes or multi-compartment compliance aids (MCCAs). Weekly pill organisers can help users keep track of their daily medication and stay safe. Pharmacists put the tablets into individual boxes in the trays, each one indicating when they should be taken. The NHS says boxes are not always available for free on the NHS and they're not suitable for every type of medicine. Tracey Hobbs' mother, Pat Garner, lives at home with care visits. For several years, she has had her MCCAs provided by her local Boots pharmacy. She takes more than 15 pills each day. Tracey says she was phoned by Boots and told that from one month later her mother would receive all the drugs in the original packaging, rather than organised into morning and night doses for each day of the week. Tracey told the BBC: "I pointed out that the blister packs were the only way we could know she had taken her medication at the right time. Handing seven individual boxes with different instructions on each one was totally unworkable and - quite frankly - dangerous". A Boots spokesperson said: "The latest Royal Pharmaceutical Society guidance indicates that the use of multi-compartment compliance aids is not always the most appropriate option for patients that need support to take their medicines at the right dose and time." "Pharmacists are speaking with patients who we provide with MCCAs to discuss whether it is the right way to support them, depending on their individual circumstances and clinical needs." Prof Gill Livingston, an expert in elderly medicine at University College London, said she was concerned to hear that some patients and their families were being told the boxes were being scrapped. She said: "Blister packs enable people with mild dementia or some memory problems to take their own medication and remain independent. They can check that they have taken it and they know they have taken the right thing, as it is already sorted out. "Later on in dementia or with other disabilities, it enables paid carers and families to help them take their medication and remain in the community and remain as well as possible." Read full story Source: BBC News, 21 June 2022
  22. News Article
    Heather Lawrence was shocked at the state she found her 90-year-old mother, Violet, in when she visited her in hospital. "The bed was soaked in urine. The continence pad between her legs was also soaked in urine, the door wide open, no underwear on. It was a mixed ward as well," Heather says. "I mean there were other people in there that could have been walking up and down seeing her, with the door wide open as well. My mum, she was a very proud woman, she wouldn't have been wanted to be seen like that at all." Violet, who had dementia, was taken to Tameside General Hospital, in Greater Manchester, in May 2021, after a fall. Her health deteriorated in hospital and she developed an inflamed groin with a nasty rash stretching to her stomach - due to prolonged exposure to urine. She died a few weeks later. Heather tells BBC News: "I don't really know how to put it into words about the dignity of care. I just feel like she wasn't allowed to be given that dignity. And that's with a lot of dementia patients. I think they just fade away and appear to be insignificant, when they're not." New research, shown exclusively to BBC Radio 4's File on 4 programme, has found other dementia patients have had to endure similar indignity. Dr Katie Featherstone, from the Geller Institute of Ageing and Memory, at the University of West London, observed the continence care of dementia patients in three hospitals in England and Wales over the course a year for a study funded by the National Institute for Health and Care Research. She found patients who were not helped to go to the toilet and instead left to wet and soil themselves. "We identified what we call pad cultures - the everyday use of continence pads in the care of all people with dementia, regardless of their continence but also regardless of their independence, as a standard practice," Dr Featherstone says. Read full story Source: BBC News, 21 June 2022
  23. News Article
    A new scheme in Wales to help people who have suffered falls has prevented 50 ambulances being unnecessarily sent this year. St John Ambulance works with Hywel Dda health board in Pembrokeshire to send its people when someone calls 999. The pilot has been used 96 times since January but it needs more health board funding to continue after March. Ageing Well in Wales estimates that between 230,000 and 460,000 over 60s fall each year. When people dial 999, it can be directed to the St John Ambulance falls response team, who are sent to perform an assessment and identify whether the person can stay home or needs an ambulance to take them to hospital. St John Ambulance operational team leader Robert James said in 60% of cases, the person was well enough to stay at home. "You can imagine if you were sending an ambulance crew out and it has wasted 60% of the crew's time, well it's a big saving towards the NHS and the ambulance service in itself," he added. "Provided there are no injuries, or reason for them to go to hospital, they can be discharged on the scene." Read full story Source: BBC News, 10 March 2023
  24. News Article
    Older and overweight patients are making it harder to clear NHS surgery backlogs, anaesthetists have warned. New data reveal an “extremely worrying picture” of increasing age, rates of obesity and complexity of surgical patients across the UK, the Royal College of Anaesthetists said. The average age of patients requiring anaesthesia increased by 2.3 years, from 50.5 to 52.8, over the last decade, while their BMI also jumped from 24.9 (borderline normal/overweight) to 26.7 (overweight). The proportion of patients who are complex or have other comorbidities has also significantly increased, the study found. When patients are older, overweight and have other problems, this makes anaesthetic and surgical care more complicated and higher risk, the authors said. Managing these patients safely takes longer during surgery and can lead to slower recovery times, requiring more time in hospital. Read full story (paywalled) Source: The Telegraph, 2 March 2023
  25. News Article
    Hundreds of thousands of older people in England are having to endure chronic pain, anxiety and unmet support needs owing to the worsening shortage of social care staff and care home beds. Age UK has said older people with chronic conditions such as diabetes, high blood pressure and heart failure are increasingly struggling with living in their own homes because of a lack of help with everyday tasks such as getting out of bed, dressing and eating. The decline in the amount of support and care provided to older people is piling pressure on families and carers and leaving the NHS in constant crisis mode, contributing heavily to ambulance queues outside A&E departments, the charity said in a new report It warned that there would be a repeat of the NHS crisis this winter – in which rising numbers of elderly people have been unnecessarily stuck in hospital because of an acute lack of social care – without a shift to preventing unnecessary admissions. Read full story Source: The Guardian, 17 February 2023
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