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Found 1,519 results
  1. News Article
    Financial directors need to take responsibility for safety, which should be at the core of how the NHS runs services, the leadership of the Health Services Safety Investigations Body (HSSIB) said at its launch Wednesday. The Healthcare Safety Investigation Branch is now an independent body – and has been renamed HSSIB – although maternity investigations are hosted by the Care Quality Commission. Questioning how many finance directors across the NHS take responsibility for safety, HSSIB’s interim chief investigator Rosie Benneyworth said: “We need a position where finance directors in every organisation are as responsible for safety as the person leading the safety agenda and vice versa, the safety person works with the finance agenda to support them. “Often you see the finance director and safety lead don’t work effectively together and we need to change that.” Dr Benneyworth said progress will not be made unless operational delivery, financial delivery and safety are tackled “in the same breath”. HSSIB’s new chair Ted Baker also called for safety to become a core part of running services “in the way running the accounts is”, as it is currently still seen “as an add-on”. He stressed that safety “drives efficiencies, enables innovation and saves costs”. Read full story (paywalled) Source: HSJ, 19 October 2023
  2. News Article
    At least two trusts are set to fall short on a high-profile pledge to eradicate ‘dormitory’ style wards in mental health facilities, with delays caused by cost pressures and shortage of materials and labour. In 2020, ministers said more than 1,200 beds in mental health dormitories across more than 50 sites would be replaced with single, en-suite accommodation by March 2025. Around £400m was allocated to achieve this. However, information gathered by HSJ via freedom of information requests suggests there will be at least 37 dormitory beds still in use beyond that date. In 2018, the Care Quality Commission said: “In the 21st century, patients, many of whom have not agreed to admission, should not be expected to share sleeping accommodation with strangers, some of whom may be agitated”. Patients have told HSJ they felt “distressed”, “unsafe” and “intimidated” on dormitory style wards. Leaders of trusts impacted by delays told HSJ of rising cost pressures, shortages of construction materials and availability of labour. Read full story (paywalled) Source: HSJ, 17 October 2023
  3. News Article
    An ambulance trust has apologised after a patient who was declared "dead" later woke up in hospital. As first reported by The Northern Echo, the individual was taken by paramedics to Darlington Memorial Hospital on Friday. The newspaper reported they had been declared dead following an incident earlier that day. The North East Ambulance Service (NEAS) apologised to the patient's family and said an inquiry had begun. The patient has not been identified or their current condition revealed. NEAS director of paramedicine Andrew Hodge said: "As soon as we were made aware of this incident, we opened an investigation and contacted the patient's family. "We are deeply sorry for the distress that this has caused them. "A full review of this incident is being undertaken and we are unable to comment any further at this stage. "The colleagues involved are being supported appropriately and we will not be commenting further about any individuals at this point." Read full story Source: BBC News, 17 October 2023
  4. News Article
    More than a quarter of ‘critical incidents’ have been declared by just four trusts since the start of the crisis in urgent and emergency care. Data obtained by HSJ shows 241 critical incidents have been declared by organisations due to “operational” or “system pressures” between April 2021, when long waits for urgent care began to surge upwards, and last month. Four trusts account for 68 of these (28%). Critical incidents are declared when the level of disruption “results in an organisation temporarily or permanently losing its ability to deliver critical services, or where patients and staff may be at risk of harm”. These incidents may require “special measures and support from other agencies, to restore normal operating functions,” according to the NHS England definition. Most critical incidents were only in place for a few days before being stood down by the trust or system, but some were in place for much longer – sometimes for several months at a time, the data suggests. Read full story (paywalled) Source: HSJ, 25 October 2023
  5. News Article
    A coroner has found neglect contributed to a baby's death at the hospital where he was born. Jasper Brooks died at the Darent Valley Hospital in Kent on 15 April 2021. The coroner found gross failures by midwives and consultants at the hospital and says Jasper's death was "wholly avoidable". Jasper was a second child for Jim and Phoebe Brooks. Due to a complication during pregnancy of her first child, Phoebe was booked in to have an elective Caesarean section to deliver Jasper. But in April 2021 those plans changed overnight. A check-up found Phoebe had raised blood pressure. She was told to remain in hospital and that the C-section would happen the following morning - nine days earlier than planned - when there were more staff on duty. Jasper's parents say the midwives caring for Phoebe repeatedly failed to listen to her and Jim's concerns - that she was shaking violently, feeling sick, and thought she was bleeding internally. "We felt like an inconvenience - no-one wanted to deal with me that night," Phoebe says. "The doctor didn't want to do my C-section, the midwife that's meant to be looking after me, she just doesn't really care. "I remember saying clearly to her, 'my whole body is shaking - something's happening, and no-one's taking the time to listen to what I'm saying or listen in on my baby'." At the inquest hearing, midwife Jennifer Davis was accused by the family's barrister, Richard Baker KC, of "failing to act on signs of blood loss, failing to determine if Phoebe was in active labour, and failing to call a senior doctor when necessary". Jasper was born without a heartbeat, so a resuscitation team was called. But during the inquest, the family learned that further errors were made because the correct people failed to attend the resuscitation. There was no consultant neonatologist on site - a doctor with expertise in looking after newborn infants or those born prematurely. Intubation, the process of placing a breathing tube into the windpipe - which should only take a few minutes - did not occur for 18 minutes. There was also a delay in administering adrenaline to try to stimulate Jasper's heart. Read full story Source BBC News, 24 October 2023
  6. News Article
    Lessons still have not been learned at a Kent hospital trust which was criticised in a damning report, a mother has said. Dr Bill Kirkup's review found at least 45 babies might have survived with better care at East Kent NHS hospitals. Victoria, whose six-year-old daughter needs 24-hour support, said: "I've had no contact from anyone from the trust." Her case was one of 202 that were examined by Dr Kirkup in his report, which was published exactly a year ago. Victoria, whose daughter is living with the consequences of failings in her care during her birth, said: "Our children have become unwell because of what has happened to them. "I don't feel lessons have been learned whatsoever. "Treatment hadn't been made available as easily as it should have done for children that are still living this experience every day." Read full story Source: BBC News, 19 October 2023
  7. News Article
    Dozens more children than initially thought have come to “severe” harm following failings in audiology care, HSJ can reveal. Two more trusts have confirmed that, between them, 30 children suffered severe harm – which is defined as ”permanent or long-term harm” – after the failings. Northern Lincolnshire and Goole Foundation Trust said an external investigation had revealed 14 such cases, while Worcestershire Acute Hospitals Trust found 16 more after going through the same process. A total of 36 confirmed or suspected severe harm cases from paediatric audiology failings across six English trusts are now known about. I NHS England wrote to all 42 integrated care boards at the end of August, asking them to ensure the “approximately” 130 paediatric hearing services in England were running safely. Sir David Sloman, then-chief operating officer, and Dame Sue Hill, chief science officer, said the NHSE “review of these trusts has identified root causes that have led to poor service delivery and outcomes… [which include] lack of clinical governance and oversight, poor reporting of data, poor interpretation of results, poor retention of diagnostic data, and lack of accreditation.” The National Deaf Children’s Society called the speed of the NHS’s response “a scandal”. Read full story (paywalled) Source: HSJ, 19 September 2023
  8. News Article
    More patients than ever before will be put at risk when consultants and junior doctors begin the “biggest walkout the NHS has ever seen”, the body that speaks for health trusts has warned. The latest round of industrial action in England, when consultants will strike in a dispute over pay on Tuesday and Wednesday and junior doctors on Wednesday, Thursday and Friday, would force hospitals to cancel a higher number of appointments and operations than ever before, the NHS Confederation revealed. Among the patients who were being placed in the greatest danger were the increasing number of people who have already had their operations cancelled due to strike action, and now face having their rescheduled appointments cancelled again, health officials have warned. That included growing numbers of cancer patients, who were expected to be more affected than in previous rounds of strikes. The government will launch a consultation on Tuesday over plans to impose new regulations on striking doctors and nurses to ensure hospitals provide a minimum level of cover. The regulations, which would cover urgent, emergency and “time-critical” hospital-based health services, would mean that employers could issue a “work notice” compelling doctors and nurses to work during industrial action, in order to maintain “necessary and safe levels of service”. Clinicians who still take industrial action could run the risk of losing their job. Read full story Source: The Guardian, 19 September 2023
  9. News Article
    Sick children’s health problems are getting worse as record numbers wait up to 18 months for NHS care, doctors treating them have warned. The number of under-18s on the waiting list for paediatric care in England has soared to 423,500, the highest on record. Of those, 23,396 have been forced to wait over a year for their appointment. Delays facing children and young people are now so common that Dr Jeanette Dickson, the chair of the Academy of Medical Royal Colleges, the body representing all UK doctors professionally, warned that children are “the forgotten casualties of the NHS’s waiting list crisis”. “As a paediatrician, I’ve seen first hand the damaging impact that long waiting times have on children, on their education and overall wellbeing, and of course on their families,” said Dr Camilla Kingdon, the president of the Royal College of Paediatrics and Child Health (RCPCH). The figures came from the RCPCH’s analysis of official performance data recently published by NHS England. The health of some children was deteriorating while they languished on the waiting list because their illness and age meant they needed to have their treatment fast, Kingdon added. “Many treatments and interventions must be administered within specific age or developmental stages. No one wants to wait for treatment, but children’s care is frequently time-critical.” Read full story Source: The Guardian, 17 September 2023
  10. News Article
    Derby and Burton’s maternity services are now among the “most challenged in England”, requiring national involvement to boost improvements. The University Hospitals of Derby and Burton NHS Foundation Trust joins 31 other NHS trusts across England which are now under closer scrutiny aimed at improving the quality of maternity services. A report from the trust details that it asked to be added to the national NHS England Maternity Safety Support Programme (MSSP) "voluntarily". Midwifery and obstetric improvement advisors have now been allocated to the trust to spend two days a week on the trust’s sites and also to provide “virtual” assistance. A letter to Stephen Posey, the trust’s chief executive, sent by Sascha Wells-Munro, the deputy chief midwifery officer for NHS England, details that the organisation’s addition to the national support programme comes after a number of concerning reports – not just its request. It references the Healthcare Safety Investigation Branch report, published in February, which highlighted the cases of seven women and their babies between January 2021 and May 2022, with three mothers and a baby dying and four mothers suffering extreme consequences. Read full story Source: Derbyshire Live, 13 September 2023
  11. News Article
    A London coroner has warned the health secretary that preventable child suicides are likely to increase unless the government provides more funding for mental health services. Nadia Persaud, the east London area coroner, told Steve Barclay that the suicide of Allison Aules, 12, in July 2022 highlighted the risk of similar deaths “unless action is taken”. In a damning prevention of future deaths report addressed to Barclay, NHS England and two royal colleges, Persaud said the “under-resourcing of CAMHS [child and adolescent mental health services] contributed to delays in Allison being assessed by the mental health team”. An inquest into Allison’s death last month found that a series of failures by North East London NHS foundation trust (NELFT) contributed to her death. In her report, Persaud said delays and errors that emerged in the inquest exposed wider concerns about funding and recruitment problems in mental health services. “The failings occurred with a children and adolescent mental health service which was significantly under-resourced. Under-resourcing of CAMHS services is not confined to this local trust but is a matter of national concern,” she said. Read full story Source: The Guardian, 14 September 2023
  12. News Article
    Leaders of two maternity services have been told to take urgent action, after inspectors found understaffing and declining levels of care, despite safety warnings from midwives. Maternity services at University Hospital North Durham and Darlington Memorial Hospital have been downgraded from “good” to “inadequate” in Care Quality Commission reports, published today. The CQC noted a “concerning deterioration” in the care the two services provided, despite midwives telling managers they felt the service was unsafe. Sue Jacques, chief executive of County Durham and Darlington Foundation Trust, which runs the hospitals, said the CQC’s findings would be taken “extremely seriously”. The reports also said staff reported “feeling ‘frozen out’ or that their concerns were ignored by leaders” and that staff felt “‘continuity of carer’ was the trust’s main focus, despite depleted safe staffing levels, skill mix, and staff being pulled in to cover acute areas on a frequent basis”. Last year, trusts were told not to pursue continuity of carer models – which were previously championed by NHS England – unless they had adequate staffing levels to do so safely. Read full story (paywalled) Source: HSJ, 15 September 2023
  13. News Article
    Ambulance chiefs say handover delays have got worse at some trusts in recent months, despite the picture improving nationally since last winter. A report from the Association of Ambulance Chief Executives says there are continuing concerns about handover delays at emergency departments. Jason Killens, the body’s lead chief executive for operations, told HSJ: “There’s been some improvement [at some sites] since February, but what we’ve also seen is a commensurate or bigger decay in other sites across that same period.” Mr Killens said “it’s difficult to be precise” about why some trusts have struggled more than others but that challenged hospitals are often affected by “pathway issues” including delayed discharges. “And then maybe there are challenges around stable leadership or the visibility of the leadership, the culture there about managing that risk dynamically, and so on,” he added. Read full story (paywalled) Source: HSJ, 14 September 2023
  14. News Article
    Children have suffered severe harm at two further hospital trusts as a result of failures in paediatric audiology, HSJ has revealed. HSJ reported in July that three children at Croydon Health Service Trust may have come to “severe harm” – meaning they may have suffered permanent damage – following failures in the trust’s processes in audiology. Now East and North Hertfordshire Trust and North West Anglia Foundation Trust have also confirmed a small number of cases of severe or serious harm; while some trusts have yet to confirm findings from case reviews they have carried out. Major problems emerged earlier this year, initially in Scotland, of poor quality checks missing children with hearing problems who should have received support, and of a failure to inspect the services. NHS England ordered a review of data from the national newborn screening programme which, alongside other review work, identified six English trusts as having likely failures in their service: Croydon, East and North Herts, North West Anglia, Warrington and Halton Hospitals, North Lincolnshire and Goole, and Worcestershire Acute Hospitals. Read full story (paywalled) Source: HSJ, 14 September 2023
  15. News Article
    A trust chief executive has warned of a ‘really significant increase’ in patient anxiety and frustration created by the ongoing doctors’ strikes. Lance McCarthy, the chief executive officer of Princess Alexandra Hospital Trust, made the comments during the most recent four-day junior doctors’ strike, which also coincided with two days of consultant strike action. The trust leader told Hertfordshire and West Essex integrated care board on Friday: “We shouldn’t underestimate the impact industrial action is having.” Mr McCarthy said this impact was not just confined to strike days but also affected the run-up and aftermath of each bout of industrial action. He said every series of strike days caused service disruption for at least another 72 hours. He said: “We are seeing increasing frustration [from] our colleagues around it, because we are constantly duplicating work, cancelling patients, rebooking the same patients, etc. “We are [also] quite understandably starting to see in the last two months a really significant increase in anxiety and concern and frustration from our patients, who took it quite well the first couple of rounds but are understandably really frustrated. It is having a really significant impact.” In a further statement to HSJ, Mr McCarthy reiterated comments that trust staff had noticed an increase in anxiety, concern and frustration among both patients and colleagues in recent months. Read full story (paywalled) Source: HSJ, 25 September 2023
  16. News Article
    The national director for patient safety in England has cautioned against the ‘false hope’ of trying to achieve ‘zero harm’ from healthcare, describing it as unachievable. Speaking at HSJ’s Patient Safety Congress earlier this week Aidan Fowler told delegates: “The dream of zero harm is appealing. It’s what we all want. But it’s unachievable in reality, it’s unmeasurable [and] it carries risk.” Mr Fowler said what is really meant is eliminating “avoidable harm”, but also described this as “problematic”. He said: “I challenge any one of you to define ‘avoidable’. We start to define a complex system in simplistic terms. We hear, ‘we’ve had no avoidable harm for six hears in our hospital’. And you think, ‘is that real?’” Mr Fowler stressed the ambition should be to reduce harm to minimal levels, but said the notion that any provider could claim they had no harm for period of years was “hard to credit”. He said by pursuing the “zero harm” ambition, the NHS was also “setting unattainable goals to our staff”. “[We are] creating unrealistic expectations and burning them [staff] out and potentially creating moral distress when they’re not achieving something they’re told they should achieve,” he said. Read full story (paywalled) Source: HSJ, 21 September 2023
  17. News Article
    A cancer patient with months to live has spoken of her fear and anger after chemotherapy was delayed by this week’s strikes. Flora White, 51, began chemotherapy last month, which is required fortnightly to shrink a tumour so it can be surgically removed. But it has now been set back, after the appointment she was due to have with her oncologist the day before was cancelled as a result of strikes. Ms White said that until she got the devastating news about her own delays she had thought cancer patients would be protected from the impact of industrial action. “It’s hard to deal with as it is, let alone the extra worry and stress,” she said. “Your treatment being cancelled and delayed, they don’t understand how they’re affecting some people.” Earlier this week, Prof Karol Sikora, a leading consultant oncologist, said it was “against the ethics of medicine” for doctors to strike, as he urged medics to think again. “If you miss cancer and someone goes for another two years without a diagnosis, it’s as good as leaving someone in the gutter bleeding ... people will die,” he said. Read full story (paywalled) Source: The Telegraph, 21 September 2023
  18. News Article
    Hospital bosses fear that further strikes by doctors will push the NHS “close to breaking point” as it struggles to cope with its winter crisis in the months ahead. NHS leaders are concerned that medics’ plans to continue their campaign of stoppages until February will make it even harder for the service to manage what is always its toughest period. Four days of strikes this week in England have included the first-ever 24-hour joint strike over pay on Wednesday by consultants and junior doctors. This latest series of stoppages – two days by consultants and three days by junior doctors – has forced hospitals to reschedule many thousands of outpatient appointments and non-urgent operations because of the lack of staff. “Winter pressures, respiratory illness and rising Covid again mean that the next six months will be exceptionally difficult. Winter always is,” said one hospital trust chief executive, who asked not to be named. “The NHS is effective at absorbing pressure but the industrial action may, at times, take us close to breaking point and often patient harm and the impact on NHS staff is not fully recognised,” he said. Read full story Source: The Guardian, 20 September 2023
  19. News Article
    The family of a young trans woman who is believed to have taken her own life have said she was “failed by those tasked with her care”, as the coroner investigating her death described services for transgender people as “underfunded and insufficiently resourced”. Alice Litman had been waiting to receive gender-affirming healthcare for more than three years when she died in Brighton at the age of 20 in May 2022. Ahead of an inquest which began in Hove on Monday, her mother, Dr Caroline Litman, described Alice’s death as “preventable with access to the right support”. Adjourning the inquest on Wednesday to give a narrative conclusion in two weeks’ time, the coroner Sarah Clarke told the court: “It seems to me that all of these services are underfunded and insufficiently resourced for the level of need that the society we live in now presents". Describing the trans healthcare system as “not fit for purpose”, Alice's family, who are being supported by the Good Law Project, added: “We are grateful that the coroner has agreed that the conditions of Alice’s death warrant a report to prevent future deaths.” Read full story Source: The Guardian, 20 September 2023
  20. News Article
    NHS England’s national mental health director admitted she was ‘concerned’ that 20% of mental health nurse roles were unfilled and about the impact this could have on a nationwide push to improve safety and tackle closed cultures. Claire Murdoch was speaking to HSJ a year on from a series of high-profile documentaries exposing abuse and poor care at mental health trusts. In their wake, Ms Murdoch urged providers to urgently review safeguarding, while a separate three-year quality programme was also launched to look at closed cultures and improve safety. Now in the middle of that programme, Ms Murdoch stressed that stability in staffing is “vital” to developing safe and therapeutic care, but that many services across the country are struggling with significant nursing vacancies. She said: “The bit that absolutely we need to acknowledge [around changing cultures] is there are some significant workforce and staffing challenges, which I’m concerned about, with a 20%t vacancy of qualified registered mental health nurses nationally. “There are new support roles, psychology assistant roles, physician associates – there are all sorts coming into being in inpatient care, but a lot of services are still struggling with staffing". Read full story (paywalled) Source: HSJ, 21 September 2023
  21. News Article
    A mental health provider has apologised after telling a whistleblower he was being declined treatment due to an employment tribunal he had brought against a neighbouring trust. Andrew Wardley was among a group of staff who raised concerns over a major research project at The Christie, a prominent cancer trust in Greater Manchester. Dr Wardley, a leading oncologist, has claimed he was sidelined and effectively bullied out after raising legitimate concerns. He has brought an employment tribunal against the specialist trust. The ongoing case has caused him severe stress and anxiety, prompting him to seek psychological treatment with South West Yorkshire Partnership Foundation Trust, which runs services near his home in Huddersfield. He told HSJ an initial phone conversation with trust staff had been positive and ended with an agreement he would benefit from treatment with the Improving Access to Psychological Therapies team. But he subsequently received a letter from the trust, which said: “Given the ongoing litigation IAPT would not be in a position to offer any therapy". Read full story (paywalled) Source: HSJ, 20 September 2023
  22. News Article
    National leaders are looking to greatly reduce the number of direct hospital referrals made by GPs, by insisting that they first discuss cases with hospital consultants. The approach – known as “advice and guidance” or “A&G” – involves GPs sending a patient’s details to a consultant who specialises in their condition before making a referral. The consultant then advises on the best course of action. “A&G’ has been voluntarily adopted by many health systems, but HSJ has now learnt that a move to significantly increase its use of it is being discussed as part of a new national strategy for outpatient services, due to be published by December. Theresa Barnes, outpatients lead at the Royal College of Physicians, is part of a group of clinicians helping to develop the strategy in partnership with NHS England, and said there is a case for A&G to be used “in preference” to direct referrals in a vast number of cases where it is clinically appropriate. She told HSJ: “I think there should be a push to use advice and guidance in preference to direct referrals, so we can maximise that pre-referral interaction and deliver as much care as close to patients’ homes as they can get it and without the delay of potentially waiting for a secondary care appointment.” Read full story (paywalled) Source: HSJ, 20 September 2023
  23. Content Article
    NHS colleagues are working hard to restore elective care, but data shows that activity for children and young people (CYP) is still below pre-pandemic levels and recovery remains behind rates seen in adult services. The specialties of ENT, dental services, ophthalmology, urology, and trauma and orthopaedics (including spinal surgery) are especially challenged, with the longest waiting lists for surgery for young patients. Getting It Right First Time (GIRFT) has supported NHS England’s drive for CYP elective recovery by developing concise guidance –Closing the gap: Actions to reduce waiting times for children and young people – offering ten actions which can help reduce waiting times for children, as well as quick links to data, resources and best practice case studies. The ten actions address how to improve theatre capacity, increase theatre utilisation and streamline pathways of care, and include practical measure such as adding extra sessions or ‘super events’ for children’s surgery, avoiding procedures of limited medical benefit by using clinical decision tools, and staggering children’s admission times. The guidance links to a series of case studies demonstrating how teams across England have taken innovative measures to address their waiting times.
  24. Content Article
    The Care Quality Commission (CQC) State of Care is an annual assessment of health care and social care in England. The report looks at the trends, shares examples of good and outstanding care, and highlights where care needs to improve.
  25. Event
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    This two-day King's Fund conference aims to explore how the current strain on services makes listening to people more difficult but even more important, at a time when public satisfaction with the NHS is at an all-time low. Join us to hear about how you can make sure building in the user voice is routine and core to the business of the health and care system, not just ‘a nice to have’. Conference sessions will: discuss how the NHS and social care cannot deliver quality unless listening to patients and carers, and acting on their feedback, lies at the heart of its culture.   provide learning on how to listen well and what meaningful engagement with people and communities looks like. Gain insight into the findings from the Fund’s project on understanding integration with the HOPE (Heads of Patient Experience) network by working with six sites on an action learning piece. Learn about how health and social care decision-makers cannot overcome challenges and answer long-term questions alone - such as how the system will address the deep inequalities and how it can adapt to provide the joined-up, efficient care that people want and gives them more control – public input is crucial. Join peers to share learning on grasping this opportunity to finish building a culture where listening to patients, service-users, and communities is everyone's business.   Register
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