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Found 1,519 results
  1. News Article
    Every health and care system — including those carrying huge deficits going into the pandemic — will be told to deliver financial balance in 2022-23, according to draft guidance seen by HSJ. For the last two years, local NHS organisations have effectively seen all their spending covered by the government under temporary Covid measures. But a more typical financial regime is now due to begin in April, with systems expected to deliver services from within funding envelopes set at the start of the year, and to be held to account on this. Some integrated care systems went into the pandemic with deficits of more than £100m, and will likely struggle to reach a balanced position. But draft guidance circulated to local leaders in recent months by NHS England says: “NHS England and NHS Improvement intend to use additional powers in the legislation to set a financial objective for each integrated care board [the local commissioning body] and its partner trusts to deliver a financially balanced system, namely a duty on break even.” However, it is unclear what the consequences will be for an ICS that fails to meet what is described as a “new joint legal duty”. Read full story (paywalled) Source: HSJ, 31 March 2022
  2. News Article
    Sajid Javid has issued an apology for the maternity service failings reported at Shrewsbury and Telford Hospital NHS Trust. The health secretary spoke in the Commons on Wednesday after an independent inquiry into the UK’s biggest maternity scandal found that 201 babies and nine mothers could have - or would have - survived if the NHS trust had provided better care. Speaking in the Commons, the health secretary said Donna Ockenden - a maternity expert who led the report - told him about “basic oversights” at “every level of patient care” at the trust. He said the report “has given a voice at last to those families who were ignored and so grievously wronged”. Javid said the report painted a tragic and harrowing picture of repeated failures in care over two decades which led to unimaginable trauma for so many people. Rather than moments of joy and happiness for these families their experience of maternity care was one of tragedy and distress and the effects of these failures were felt across families, communities and generations. The cases in this report are stark and deeply upsetting. Mr Javid offered reassurances that the individuals who are responsible for the “serious and repeated failures” will be held to account. Read full story and Sajid Javid's statement Source: The Independent, 30 March 2022
  3. News Article
    A policy ‘at the heart’ of NHS England’s efforts to improve maternity care is under question after being sharply criticised by an independent inquiry, and is the subject of major tensions within NHSE and midwifery, HSJ understands. The Ockenden report into major care failings at Shrewsbury and Telford Hospital Trust included 15 “immediate actions” for all maternity services in England, which government has accepted and said it would begin implementation. However, one of these relates to the “continuity of carer” model, which NHS England has championed since 2017, when it was described as “at the heart of” its national plans for improving maternity care and outcomes. The model intends to give women “dedicated support” from the same midwifery team throughout their pregnancy, with claimed benefits including improved outcomes, with a particular focus on some minority groups. However, Ms Ockenden indicated its implementation in recent years had stretched staffing, and therefore harmed quality and safety overall, and also appeared to question whether the model was evidenced. Some midwifery leaders are advocates for the model, but others have described how it can result in awful working patterns, with concerns it is causing some staff to leave the profession. Royal College of Midwives director for professional midwifery Mary Ross-Davie told HSJ: “With the right resources and the right number of midwives, CoC can have a positive impact on maternity care – but in too many trusts and boards this is simply not the situation. We are really pleased, therefore, to see that the review team has echoed the RCM’s recommendations around the suspension of continuity of carer where too few staff puts safe deployment at risk.” She said the model was “something to which many maternity services aspire, particularly for women who need enhanced monitoring throughout their pregnancy to deliver better outcomes for them and their baby”. Helen Hughes, chief executive of Patient Safety Learning charity, said that although it had heard positive feedback that the model can improve outcomes, there must also be a “robust assessment of the safety impact of implementing such changes and the sources and staffing in place to deliver this”. “Otherwise the core intentions and benefits will be lost,” Ms Hughes said. Read full story (paywalled) Source: HSJ, 31 March 2022 Further reading Midwifery Continuity of Carer: What does good look like? Midwifery Continuity of Carer: Frontline insights The benefits of Continuity of Carer: a midwife’s personal reflection
  4. News Article
    NHS staff are significantly less likely to recommend their organisations as places to work or believe they employ enough people to deliver effective care, the service’s annual staff survey has revealed. The 2021 survey results, published today, showed regression across a broad range of questions, including in areas such as motivation, morale, workload pressures and staff health. One of the biggest drop-offs in survey scores related to the question asking whether there were enough staff in their organisation for respondents to do their job properly. Only 27.2% of those surveyed said staffing was adequate, a fall of 11% points from the previous year (38.4%). Only 59.4%nof staff said they would recommend their organisation as a place to work. This represented a 7% point decline from the previous year (66.8%). The rating had steadily improved since 2017 when it was at 59.7%. While a decline was seen across all sectors, the steepest drop was found among ambulance trusts. Ambulance trusts performing worse compared to other sectors appeared to be a recurring theme across the survey. Read full story (paywalled) Source: 30 March 2022
  5. News Article
    A damning report into hundreds of baby deaths has condemned the trust at the centre of the biggest maternity scandal in the history of the NHS for blaming mothers while repeatedly ignoring its own catastrophic blunders for decades. The independent inquiry into maternity practices at Shrewsbury and Telford hospital NHS trust uncovered hundreds of cases in which health officials failed to undertake serious incident investigations, while deaths were dismissed or not investigated appropriately. Instead, grieving families were denied access to reviews of their care and mothers were blamed when their babies died or suffered horrific injuries. A combination of an obsession with natural births over caesarean sections coupled with a shocking lack of staff, training and oversight of maternity wards resulted in a toxic culture in which mothers and babies died needlessly for 20 years while “repeated failures” were ignored again and again. Tragically, it meant some babies were stillborn, dying shortly after birth or being left severely brain damaged, while others suffered horrendous skull fractures or avoidable broken bones. Some babies developed cerebral palsy after traumatic forceps deliveries, while others were starved of oxygen and experienced life-changing brain injuries. The report, led by the maternity expert Donna Ockenden, examined cases involving 1,486 families between 2000 and 2019, and reviewed 1,592 clinical incidents. “Throughout our final report we have highlighted how failures in care were repeated from one incident to the next,” she said. “For example, ineffective monitoring of foetal growth and a culture of reluctance to perform caesarean sections resulted in many babies dying during birth or shortly after their birth. “In many cases, mother and babies were left with lifelong conditions as a result of their care and treatment. The reasons for these failures are clear. There were not enough staff, there was a lack of ongoing training, there was a lack of effective investigation and governance at the trust and a culture of not listening to the families involved. “There was a tendency of the trust to blame mothers for their poor outcomes, in some cases even for their own deaths. What is astounding is that for more than two decades these issues have not been challenged internally and the trust was not held to account by external bodies. “This highlights that systemic change is needed locally, and nationally, to ensure that care provided to families is always professional and compassionate, and that teams from ward to board are aware of and accountable for the values and standards that they should be upholding. Going forward, there can be no excuses.” Read full story Source: The Guardian, 30 March 2022
  6. News Article
    Public satisfaction with the NHS has dropped to its lowest level for 25 years after a sharp fall during the pandemic, a survey suggests. The British Social Attitudes poll, seen as the gold standard measure of public opinion, found 36% of the 3,100 asked were satisfied in 2021. That is a drop from 53% the year before - the largest fall in a single year. Only once have satisfaction levels been lower since the poll started in 1983. That was in 1997, and shortly after that the Blair government started increasing the budget by record amounts. The public said it was taking too long to get a GP appointment or hospital care, and there was not enough staff. Satisfaction with GP care and hospital services were both at their lowest levels since the survey began. Dan Wellings, senior fellow at the King's Fund, described them as "extraordinary". He said the NHS initially saw a "halo" effect early on in the pandemic, with satisfaction rates being maintained as the NHS battled through the first wave. But he said it was clear that had now gone. "People are often struggling to get the care they need. These issues have been exacerbated by the extraordinary events of the past two years, but have been many years in the making following a decade-long funding squeeze, and a workforce crisis that has been left unaddressed for far too long." Read full story Source: BBC News, 30 March 2022
  7. News Article
    Official draft guidance has encouraged trusts to grow their ‘private patient opportunities’, despite facing huge backlogs of NHS work. The NHS England document, leaked to HSJ, includes instructions to local leaders for the new financial year starting in April. It said: “Trusts should continue to actively explore and develop opportunities to grow their external (non-NHS) income… Private patient services continue to be a significant source of material opportunity in the NHS.” It adds that NHS England and NHS Improvement will work with trusts to “identify and scale-up NHS export opportunities and support development of private patient opportunities to generate revenue and provide benefits for NHS staff and local patients and services”. It comes as the NHS faces huge backlogs of elective patients waiting for treatment. NHSE’s own plan to recover from Covid said the waiting list could rise to 14 million, up from the current 6 million. Sally Gainsbury, senior policy analyst at the Nuffield Trust, said the guidance was “capitalising” on the surge in people paying for private treatment during the pandemic. Ms Gainsbury said: “It is a concern that with over 6 million patients on the NHS waiting list, NHS England is actively encouraging NHS trusts to expand their private patient activity." “Scarce NHS capacity should be focused and prioritised on treating NHS patients and bringing these unacceptable waits down, not capitalising on the growth in the private treatment market on the back of this unprecedented backlog of care.” Read full story Source: HSJ, 29 March 2022
  8. News Article
    Scottish Liberal Democrat leader and health spokesperson Alex Cole-Hamilton MSP today said the SNP/Green Government has “yet again let down long Covid sufferers” as it is revealed that not a single penny of the £10 million announced by ministers last September has been spent. On 9 September 2021, the Scottish Government announced the £10 million Long Covid Support Fund. Now a parliamentary question from Alex Cole-Hamilton and a freedom of information request have confirmed that the money remains entirely unspent. Alex Cole-Hamilton commented: “The latest official statistics showed a record are a record 119,000 long Covid sufferers in Scotland. The SNP/Green Government has let down every single one of them by failing to spend any of the £10 million it announced last September. “Time and again I have pressed Nicola Sturgeon for answers on the absence of long Covid clinics, pressed for automatic referrals and urged the rollout of in-home support for sufferers. Now we’ve learned that none of the money announced more than six months ago has been spent. “Long Covid sufferers need new hope. Scottish Liberal Democrats are determined to see the rollout of proper care. Read full story Source: Scottish Liberal Democrats, 27 March 2022
  9. News Article
    The Royal College of Obstetricians and Gynaecologists (RCOG) has called for the immediate suspension of charging for NHS maternity care for migrant women because members say this government policy is harming the health of pregnant women and their babies. It is the first time the health professionals’ body has issued a position statement on this issue. The charity Maternity Action and the Royal College of Midwives have long expressed concern about the impact of NHS charging on this group of women. Charging forms a key plank of the Home Office’s hostile environment for migrants. The government says the charging policy is in place to deter health tourism but medics treating migrant pregnant women say there is little evidence that previously free NHS maternity care for all attracted health tourists. According to the 2019 MBRRACE-UK confidential inquiry into maternal deaths, three women were found to have died between 2015 and 2017 who may have been reluctant to access maternity care due to fears about charging and impact on their immigration status. Dr Brenda Kelly, an NHS consultant obstetrician working in Oxford, treats many pregnant migrant women. She is calling for the barriers to them accessing maternity care to be removed urgently. She described the case of one migrant woman who arrived in A&E shortly before delivering a stillborn baby. The woman had been fearful of coming forward for antenatal care although she was suffering from multiple, pregnancy-related health problems. “I hope I never have to hear cries like that woman’s cries ever again,” said Kelly. “The way to safeguard these women is to build up trust. If they are landed with a bill of several thousand pounds they will disengage. They are not health tourists, they are desperate. The commitment to maternal health equity means ending charges for maternity care. The time for action is now.” Read full story Source: The Guardian, 27 March 2022
  10. News Article
    An investigation has been launched after a woman died during childbirth at a hospital's maternity unit. It was the third death of a mother in just over three years at Basildon University Hospital in Essex, in addition to a newborn baby's death. The trust that runs the hospital said it could not comment on the case while it was under investigation. Basildon University Hospital is part of Mid and South Essex NHS Foundation Trust, which also runs Southend and Broomfield hospitals. The latest fatality follows the death of 36-year-old Gabriela Pintilie in February 2019. Ms Pintilie died after losing six litres of blood giving birth to her second child at the unit. In separate incidents, a mother died and another woman had a stillborn baby at the unit in March 2019, while the trust was being inspected by the Care Quality Commission (CQC) following Ms Pintilie's death. The unit at Basildon had its rating upgraded from "inadequate" to "requires improvement" in December by the CQC. The hospital also apologised for the death of newborn Frederick Terry after he suffered a brain haemorrhage during a failed forceps delivery in November 2019. Read full story Source: BBC News, 27 March 2022
  11. News Article
    More than 1,500 patient deaths are to be investigated in the largest-ever independent inquiry into “unacceptable” mental health care. A probe into the deaths of patients who were cared for by NHS mental health services across Essex has revealed its investigation will cover deaths from 2000 to 2020. All 1,500 people died while they were a patient on a mental health ward in Essex, or within three months of being discharged from one. In 2001, following an investigation into 25 deaths, police criticised the trust for “clear and basic” failings but did not pursue a corporate manslaughter prosecution. And in 2021, the Health and Safety Executive fined the trust £1.5m due to failures linked to the deaths of 11 patients. The regulator said the trust did not manage the risks of ligature points for a period of more than 10 years. In January 2021, following pressures, former patient safety minister Nadine Dorries commissioned former NHS England mental health director Dr Geraldine Strathdee to chair an independent inquiry. While it is not known yet how many of the 1,500 deaths were caused by neglect, Dr Strathdee said evidence had so far shown some “unacceptable” and “dispassionate” care. Melanie Leahy, who has campaigned for change within Essex mental health services since her son died in 2012, has been leading the call for it to become a public inquiry on behalf of the families. Her son, Matthew Leahy, died as an inpatient at the Linden Centre, following multiple failings in his care. A 2018 parliamentary health service ombudsman report on his death, and that of another young man called Richard Wade, identified “systemic” failings on behalf of the trust. These included the failure to manage his risk level, to look after his physical health and to take action when he reported being raped in the unit. Read full story Source: The Independent, 28 March 2022
  12. News Article
    NHS England must find hundreds of millions of pounds in last-minute savings to pay for ongoing covid staff tests, it has been revealed NHSE chief financial officer Julian Kelly told a meeting of NHS England’s board: “We have been asked to see if we can cut core NHS funding - at the moment that is probably to the tune of £500m.” Mr Kelly said achieving this would likely involve “slowing down” some transformation programmes and ambitions in the Long Term Plan. He added that rising inflation could add an extra £1bn in financial pressure, telling the board “we’re going to have to look at what that means for our ability to deliver NHS goals in the round.” It was reported in February that Health Secretary Sajid Javid and Chancellor Rishi Sunak were at loggerheads over whether the Department of Health and Social Care (DHSC) should receive additional funding for covid testing on top of the health service’s spending envelope. The row is said to have led to a delay in plans to scrap all remaining virus-related restrictions. The DHSC reduced its ask for extra cash down from £5bn to an eventual £1.8bn but even this lower sum was rejected by the Treasury, according to reports. This means continuing staff testing will have to paid for out of the existing NHS budget. Read full story (paywalled) Source: HSJ, 24 March 2022
  13. News Article
    The use of temporary treatment areas for patients arriving via ambulance at over-crowded A&Es is ‘borderline immoral’ and ‘a danger to patient safety and dignity’, the Royal College of Emergency Medicine has warned. The college said NHS England had told regional bosses to prepare to errect more of the so-called “tents” outside their major emergency departments as part of plans to get a grip on ambulance handover delays, which have reached record highs in the last two weeks. Senior figures also told HSJ that trusts have been instructed by NHS England to call the overflow facilities “temporary external structures” and not tents – a move also criticised by RCEM president Katherine Henderson. Dr Henderson told HSJ: “Using tents is just wrong on every level… We’ve been down this route before. It doesn’t work. It’s a huge distraction, and I think what upsets me the most about it is it creates the appearance that people are taking action when it’s not the action that will deal with the problem.” In an opinion piece for HSJ, Dr Henderson says: “We find ourselves in the completely unacceptable situation where the ‘solution’ to ambulance handover problems is to put up tents or sheds in front of emergency departments – euphemistically being called ‘temporary external structures’. “Trust leaders and NHS England must not be afraid to stand up and make this case – putting patients in tents is a bad, borderline immoral bodge job to treat the symptom rather than cause, and our patients need to see some real leadership to protect them." Read full story (paywalled) Source: HSJ, 25 March 2022
  14. News Article
    The government has doubled the annual efficiency expectation on the NHS, he has said, as systems and trusts grapple with large gaps in their financial plans for 2022-23. The Treasury told the media over the weekend the Chancellor was doubling the NHS’s annual savings target to 2.2% from 1.1%. Reports said this would deliver an annual saving of £4.75bn. It is unclear whether the move represents a change to the underlying efficiency expectation in NHS planning — which would require all systems and trusts to revise their plans for 2022-23 — or is simply a re-statement or recognition that the effective efficiency requirement was already well above the 1.1 per cent envisaged under the pre-covid NHS long-term plan. Rishi Sunak told the Mail on Sunday the move was linked to the “health and social care levy” which will see a rise in National Insurance next month. He also said he would chair a new cabinet committee to reduce waste in the public sector. Speaking ahead of his Spring Statement on Wednesday, he said: “Your readers should be reassured that unlike any other tax that they pay, every penny of this levy goes specifically to the thing that they care most about… So we are setting up a new Cabinet committee, that I am chairing, to focus on efficiency, value for money, waste and reform. Working with the health secretary we are doubling the efficiency target for the NHS. Every pound from this levy is going to go incredibly far.” In NHS England’s annual report, published last month, its chief executive Amanda Pritchard said: ”The certainty we have recently received on both capital and revenue budgets for the years ahead provide a welcome basis on which the NHS nationally and locally can now plan. We should however be under no illusions that the challenges ahead – for financial balance and operational performance – are anything other than unprecedented.” Read full story (paywalled) Source: HSJ, 20 March 2022
  15. News Article
    A man who experiences regular mental health crises says an NHS scheme designed to offer support during emergency episodes has become broken. The trust running the service says a crisis team offers immediate support in an emergency, and a 24-hour helpline. But when Mark Doody, who has bipolar disorder, cried "down the phone, begging the team for help", he was told to call an ambulance, his wife said. The trust said a 999 call could sometimes be the appropriate action. Trish Doody cited a "dreadful" deterioration in mental healthcare where the couple lived in Redditch, Worcestershire. She said while her husband was able to get support if an emergency happened "between 9am and 5pm", assistance became difficult outside of those hours. Mr Doody said his condition meant he experienced a mental health crisis every three months. He has also made suicide attempts. Mental healthcare provision in the county had gone downhill over the last 20 years, Mrs Doody said, with her husband adding: "The system is just broken really." Healthwatch Worcestershire, which helps hold the NHS to account locally, said it was "exploring" whether there was a problem with the crisis helpline, and was also aware of delays for those seeking one-to-one counselling, which it said the trust was tackling. Read full story Source: BBC News, 22 March 2022
  16. News Article
    North west London’s acute trusts are exploring whether to set up a new elective orthopaedic centre in the region as they seek to capitalise on the concept of “fast-track” surgical hubs. Last week, a report to Imperial College Healthcare Trust’s board said a more “strategic, larger-scale” approach was being sought to improve capacity for more high-volume, low-complexity work across the sector. This covers the four acute trusts in the area, which now share a single chair, and have a total turnover of more than £3bn: Imperial, Chelsea and Westminster, London North West, and Hillingdon. The board report said leaders were exploring how best to establish the centre for the region while “maximising” planned surgery capacity overall, with the South West London Elective Orthopaedic Centre run by Epsom and St Helier University Hospitals Trust highlighted as a “well-established example”. Central Middlesex Hospital, which is operated by London North West University Healthcare Trust, has been identified as a preferred location for the centre, the report said. A project management team is also being set up to explore the options available before proposals are developed for broader consideration. It comes after 14 “fast-track” hubs were set up across hospitals in north west London to maximise theatre capacity, which predominantly focused on high-volume, low-complexity work surrounding specialties such as gynaecology, urology, orthopaedics and ear, nose and throat. The report to ICHT’s board warned that, without some “further intervention,” the number of patients awaiting orthopaedic surgery in north west London could increase to just under a fifth by 2030 from a current position of 12,000 people seeking inpatient or outpatient care. However, it added that a “large amount of work” was still required to explore the case for an elective orthopaedic centre, including establishing the best location and identifying capital and revenue funding and workforce requirements. Read full story (paywalled) Source: HSJ, 22 March 2022
  17. News Article
    The former health secretary Jeremy Hunt will join doctors’ representatives today in a call to stem the “bleed” of GPs or risk endangering patients. Polling shows that almost nine in ten GPs fear that patient safety is being put at risk by shortages of family doctors and too little time for appointments. The government has admitted that it will fail to fulfil an election pledge to recruit 6,000 extra full-time GPs by 2024. Hunt is campaigning with the British Medical Association and the GPDF, which represents local medical committees, in calling for the government to put forward a GP workforce plan to “rebuild general practice”. He said: “The workforce crisis is the biggest issue facing the NHS. We can forget fixing the backlog unless we urgently come up with a plan to train enough doctors for the future and, crucially, retain the ones we’ve got. “As someone who tried hard to get more GPs into local surgeries but ultimately didn’t succeed because the numbers retiring early exceeded those joining, I’m passionate about fixing this.” The campaign wants the government to deliver on its pledge for an extra 6,000 GPs in England and action to tackle the reasons for GPs leaving the profession, such as burnout. It says that a plan is needed to reduce GP workload, which would improve patient safety.
  18. News Article
    An inspection of a county's urgent and emergency services found delays were caused by a lack of empty beds and prolonged waiting times. The Care Quality Commission (CQC) inspected Gloucestershire emergency care services in November and December. The report found staff worked well in challenging circumstances but the CQC said pressures on workers across the system needed addressing. Dr Jeremy Welch said: "The system is being stretched and we need to adapt." CQC deputy chief inspector for hospitals, Nigel Acheson, said: "We found the system to be complicated. As a result, staff and patients weren't always able to understand which urgent and emergency care service was best suited to their needs. "This meant people sometimes attended the emergency department when they could have been treated more appropriately elsewhere." In addition the report touched on adult social care and the possibility of using empty care home beds when hospitals were struggling to cope. Dr Welch recognised "it's been a blinking tough time in care homes" over the pandemic and credited the relaxing of rules to allow visits but said there are other factors that would need to be considered. However he added: "We've got enough beds when we map across, it's just getting patients through the hospital and home because home is where they want to be." Read full story Source: BBC News, 17 March 2022
  19. News Article
    A large mental health trust has highlighted a lack of additional funding for the sector, in contrast to the £8bn earmarked for acute providers to tackle elective waiting lists. Tees, Esk and Wear Valleys Foundation Trust expects demand for its services to be 20% higher than pre-covid levels, but says uncertainties around funding could “impede” progress and “wider service sustainability”. In an interview with HSJ last week, TEWV’s chief executive Brent Kilmurray said: “Quite often, we are facing the challenge of trying to find beds and meet demand. What we’ve seen is an increase in occupancy and an increase in length of stay. And we are relating that to an increase in acuity. “We really welcome the investment that goes into the long-term plans on the specialist services that are coming through. [But] what we want to do with our work is give greater transparency to the backlogs that have developed and some of the additional pressures. Asked about the trust’s actions to address multiple concerns around safety and quality, Mr Kilmurray said staffing had improved in forensics, although the vacancy rate is still higher than the trust average, and that a leadership development programme is aiming to improve the culture of the organisation. He said he hopes the CQC “would see significant improvement” when they are inspected again. He added that “a lot has changed” since the high-profile deaths of two teenagers under the care of the trust, which are subject to an ongoing inquiry He said: “We will be able to build on the legacy of those young women in terms of the learning that we want to embed within the organisation.” Read full story (paywalled) Source: HSJ, 16 December 2022
  20. News Article
    Women and NHS staff have warned that mothers are being “forgotten” after giving birth, with a staff crisis only making matters worse. Kate, a 32-year-old from Leeds, says she has been left in “excruciating” pain for nine years after horrifying postnatal care. Other women have told The Independent stories of care ranging from “disjointed” to “disastrous”. It comes as midwives warn there are “horrendous” shortages in community services, which have prevented women from accessing adequate antenatal and postnatal care. Mary Ross-Davie, the Royal College of Midwives’ director for professional midwifery, said that with each Covid wave midwifery staffing has been hit worse than the last. To provide safe care during labour, antenatal and postnatal care, teams are sent into wards putting “huge pressure on care”. She said this could mean clinicians end up “missing things”, such as women struggling emotionally after birth. The warnings over poor antenatal and postnatal care come after experts at the University of Oxford said in November there were “stark” gaps in postnatal care, despite the highest number of deaths being recorded in the postnatal period. Dr Sunita Sharma, lead consultant for postnatal care at Chelsea and Westminster Trust, said that when NHS maternity inpatient staffing overall is in crisis “often the first place staff are moved from is the postnatal ward, which is clinically very appropriate, but it can come at a cost of putting more pressure on postnatal care for other mothers”. Dr Sharma said postnatal teams were doing their best to improve services but need national drivers and funding to sustain improvement. Read full story Source: The Independent, 16 March 2022
  21. News Article
    The purpose of Care Quality Commission (CQC) ratings has been a hotly contested question since the creation of the four category classifications in the last decade. The original idea was to give the public a sense of how good their local hospital was, as well as providing commissioners, system managers and government with an idea of whether the local, regional or national health services they had responsibility for were getting better or worse. The practicality of the first aim was always questionable given the public’s inability and unwillingness, in most cases, to take their custom elsewhere. The second ran into the lack of desire and/or courage on behalf of most commissioners to challenge their local provider, but it did seem to have traction at the top of the shop. Jeremy Hunt, told HSJ, once they had been dished out across the sector, that their CQC classification now mattered much more then whether or not it had achieved foundation status or not. Another function, whether intended or not, was that by splashing “inadequate” and unsafe care on the front pages, in the wake of the Francis report, CQC ratings fuelled a drive to put more staff on the wards (forcing the Treasury to pay for the consequent agency bills and deficits, and curtailing Simon Stevens’ transformation funds). Whatever your take on their purpose, however, they only make sense if they accurately reflect the state of the service. And the latest data suggests that may not be the case. Read full story (paywalled) Source: HSJ, 17 March 2022
  22. News Article
    More than 1,300 patients a year are having NHS funding for their palliative care withdrawn after living longer than expected, BBC analysis shows. Terminally ill or rapidly-declining patients are given fast-track support, allowing them to live outside hospital. From 2018 to 2021, a total of 9,037 people had this funding reviewed in England and Wales, with 47% of them losing all support. A further 15% of patients had their continuing healthcare support replaced with the more limited NHS-funded nursing care. Sandra Hanson was referred to the fast-track pathway of the NHS continuing healthcare scheme in mid-2020, after her needs were judged by a clinician to be "end of life". She was diagnosed with end-stage dementia, and had been in hospital eight times in the previous year following multiple falls and bouts of pneumonia. The funding covered the costs of a nursing home, where she suffered fewer falls. But in March 2021, this funding was reviewed by her local Clinical Commissioning Group (CCG). These assessments, usually undertaken by a multi-disciplinary team including health and social care professionals, consider the severity of a person's needs in areas such as mobility, cognition and behaviour. Sandra's daughter, Charlotte Gurney, said the family was represented by a social worker they had not previously met, and describes the meeting as "traumatic" as she tried to explain her mum's needs. "We just felt not listened to... we were treated as if we were trying to swindle the system. Sandra's support was withdrawn, and she had to be moved to a new nursing home, financed by her husband Malcolm. Shortly afterwards, she broke her wrist following a fall and injured her face. The family believe had the review correctly identified Sandra's needs and risks, this could have been avoided. Read full story Source: BBC News, 17 March 2022
  23. News Article
    Patients waiting for surgery and cancer care in England will face long delays for years to come, MPs have warned in a new report that is highly critical of both ministers and NHS bosses. The already-record 6.1 million-strong waiting list for vital treatment will keep growing and officials are “too optimistic” that plans to tackle it will succeed, the public accounts committee (PAC) said in a report on Wednesday. “For the next few years it is likely that waiting time performance for cancer and elective care will remain poor and the waiting list for elective care will continue to grow,” it said. The committee of MPs, which monitors spending across Whitehall, acknowledges Covid-19’s role in contributing to the ballooning backlog and lengthening waiting times. But it singled out years of inaction by the Department of Health and Social Care (DHSC) for particular blame. Patients waiting for surgery and cancer care in England will face long delays for years to come, MPs have warned in a new report that is highly critical of both ministers and NHS bosses. The already-record 6.1 million-strong waiting list for vital treatment will keep growing and officials are “too optimistic” that plans to tackle it will succeed, the public accounts committee (PAC) said in a report on Wednesday. “For the next few years it is likely that waiting time performance for cancer and elective care will remain poor and the waiting list for elective care will continue to grow,” it said. The committee of MPs, which monitors spending across Whitehall, acknowledges Covid-19’s role in contributing to the ballooning backlog and lengthening waiting times. But it singled out years of inaction by the Department of Health and Social Care (DHSC) for particular blame. Read full story Source: The Guardian, 16 March 2022
  24. News Article
    The government has overseen years of decline in cancer care and non-urgent hospital services in England, MPs say. The House of Commons Public Accounts Committee said services had started deteriorating long before the pandemic. It pointed out key targets had not been met since 2016 and the pandemic had just exacerbated the problems. But ministers said they were investing extra money and creating more capacity to treat patients, to address the backlog that had now developed. More than six million people are currently on a hospital waiting list - one in nine of the population - the highest figure on record. This includes people waiting for operations such as knee and hip replacements. Meanwhile, just two-thirds of urgent cancer patients start treatment within the target time of 62 days. And the number of referrals for cancer care has dropped by between 240,000 and 740,000 since the pandemic started. The MPs said people would face serious health consequences because of delays in cancer treatment, with some dying earlier. The government is also accused of failing to recognise staffing the health service remains its biggest problem. The MPs said the workforce was crippled by shortages and exhausted by two years of the pandemic. Read full story Source: BBC News, 15 March 2022
  25. News Article
    The chief executive of three NHS trusts says ringfencing elective care within an acute hospital site is potentially more ‘productive’ than sending it to a separate ‘cold’ site. Glen Burley, who leads a “provider group” in the West Midlands, says his trusts have been grappling with the challenge of how to maximise elective activity without it being disrupted by emergency pressures. The conventional view – as outlined in the NHS long-term plan – is that performing more elective care on a separate site from emergency can help ensure theatre lists are not disrupted. But George Eliot Trust, which has been led by Mr Burley since 2018 and only has a single district general hospital, has created a “ringfenced” elective hub within the site. In an interview with HSJ, Mr Burley said: “So I actually think the most productive model in the NHS is if you can pull that off. “If you can actually protect your elective capacity and offer it on the same site [as] urgent care, so the clinicians are not having to move between sites, you’ve got optimal productivity. “The challenge right across the NHS has been avoiding that spillage, of emergency care into your elective capacity. “As you get busier and you escalate… the order in which you encroach into areas that you should not encroach into, is really key in that. We are saying we are going to protect our elective beds in a way that we haven’t done before." Read full story (paywalled) Source: HSJ, 14 March 2022
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