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Found 1,519 results
  1. News Article
    ADHD awareness hassoared among women in the UK in the past year, but waiting times and the dearth of clinical awareness are leaving people awaiting diagnosis in a perilous position, leading experts have warned. Dr Max Davie, a consultant paediatrician and co-founder of ADHD UK, said that people talking openly about their diagnoses – including a number of high-profile celebreties – had led to more people seeking referrals for the condition. However, while awareness is increasing many trusts and private providers have shut waiting lists because of demand. “I think it’s probably as big a year as we’ve ever had. We are seeing a lot more people from all walks of life seeking a diagnosis later in life, particularly women,” Dr Davie said. “At the same time waiting lists have gone through the roof. NHS services have been swamped for a while and private providers are also closing their lists – there are wildly inadequate services for ADHD diagnosis, particularly for adults.” Dr Tony Lloyd, the chief executive of the ADHD foundation, said its own figures suggested a 400% increase in the number of adults seeking a diagnosis since 2020, adding that prescription volumes did not take account of those who do not use medication. “ADHD remains significantly under-diagnosed and under-treated in the UK – at great cost to public services and to the individual and the workforce,” he said. "Stigma around the condition, which the charity says affects one in 20 people in the UK, resulted in negative outcomes for individuals and high costs to the economy. Dismissing ADHD as a cultural construct and undeserving drain on finite NHS resources only adds to the enduring stigma and stereotyping of those with ADHD,” Read full story Source: The Guardian, 13 January 2023
  2. News Article
    The chair of an inquiry into hundreds of deaths at a mental health trust has revealed she may not be able to deliver it in its current form following a ‘hugely disappointing’ lack of staff coming forward to give evidence. Former national clinical director for mental health, Geraldine Strathdee, chair of the non-statutory inquiry into deaths at Essex Partnership University Trust, has penned an open letter warning just 11 of 14,000 staff contacted said they will attend evidence sessions. It was meant to report in spring 2023. However, after raising concerns with ministers, Dr Strathdee said she believes the inquiry will not be able to meet its terms of reference with a non-statutory status. The inquiry was announced in 2021 and last year chiefs revealed they were probing 1,500 deaths of people in contact with Essex mental health services between 1 January 2000 and 31 December 2020. However, without statutory powers, staff are not compelled to give evidence under oath. Many bereaved families, of which just one in four has engaged with the current probe, are campaigning for a statutory inquiry into deaths. Read full story (paywalled) Source: HSJ, 13 January 2023
  3. News Article
    Eight trusts have been awarded roles trialling a new accreditation scheme for surgical hubs as part of an NHS England pilot that will run until March. The creation of up to 140 surgical hubs, sites which are ring-fenced for surgical work only, is a key plank of the NHS England and government elective recovery plan for addressing the backlog. The full benefits are still being finalised but accredited trusts will likely get better access to additional recovery funding and central support from the Getting It Right First Time team. The hubs will focus mainly on providing high volume, low complexity surgery, as previously recommended by the Royal College of Surgeons of England, with particular emphasis on ophthalmology, general surgery, trauma and orthopaedics (including spinal surgery), gynaecology, ear nose and throat, and urology. Read full story (paywalled) Source: HSJ, 12 January 2023
  4. News Article
    Other countries are looking on appalled as the UK’s failure to reform social care has left its health service struggling to survive. There are blockages on the way in to the hospital, blockages inside them, and perhaps most frustrating for healthcare staff and patients, blockages getting those who have been treated and have recovered out of the front door and home, or into the community. It is this last problem that is proving hardest to crack. Despite promises from successive UK prime ministers to mend the broken social care system, it remains completely dysfunctional. This country is by no means unique in its health and social care struggles. Even in nations often held up as having model healthcare systems – such as France and Germany – the combined pressures caused by ageing populations, financial constraints, recruitment problems, Covid-19 and flu have taken their toll. On the issue of social care, French doctors and experts admit to shortcomings, though not on the scale of those in the UK. “It’s not that we don’t have problems, but things are organised differently,” said Blanche Le Bihan, a professor at the French School of Public Health and researcher at the Arènes scientific research centre in Rennes specialising in social care. “The system is far too fragmented, that’s the main issue with social care in France – communication, coordination are always complicated,” Le Bihan says. “But while it’s far from perfect, it’s not a major factor in hospitals’ current problems.” Read full story Source: The Guardian, 8 January 2023
  5. News Article
    Patient safety is at risk “every single day”, with patients in desperate need of intensive care waiting hours in Accident and Emergency departments across Scotland, the deputy chair of British Medical Association Scotland has said. The harrowing description of the scenes in hospitals came as health secretary Humza Yousaf admitted patients were receiving care he would not want to receive himself as the NHS continues to battle intense winter pressures. Dr Lailah Peel, deputy chair of the Scottish arm of the British Medical Association (BMA), told the BBC’s Sunday Show the crisis was “years in the making”. She blamed a creaking social care system and increased delayed discharges. The comments come after details of a January 2021 briefing from the Royal College of Emergency Medicine (RCEM) and the College of Paramedics to the health secretary warned of an unacceptable situation in Scotland’s hospitals. Reported in the Sunday Times, the briefing also specified the actions needed to avoid a similar situation during the current winter crisis, warning an increase of at least 1,000 new beds was needed as well as more doctors and nurses. Dr Peel said it was the case patients were “absolutely” dying in hospitals in Scotland due to the ongoing crisis in the health service. "There’s no shadow of a doubt that that is happening,” she told the BBC. Read full story Source: The Scotsman, 8 January 2023
  6. News Article
    Rishi Sunak has held emergency talks over the weekend with NHS and care leaders in an attempt to tackle the winter healthcare crisis in England. The NHS Recovery Forum at No 10 on Saturday focused on four key issues: social care and delayed discharge, urgent and emergency care, elective care and primary care. A Downing Street spokesperson said the aim was “to help share knowledge and practical solutions so that we can tackle the most crucial challenges such as delayed discharge and emergency care”. But Sunak has been warned that the meeting is unlikely to reverse the NHS’s fortunes. Labour said patients deserved more than a “talking shop” and the Liberal Democrats said it was “too little, too late”. Senior doctors say the NHS is on a knife-edge, with many A&E units struggling to keep up with demand and trusts and ambulance services declaring critical incidents. Matthew Taylor, the chief executive of the NHS Confederation, said there were “no silver bullets” to solving the crisis at hospitals and other care centres. “This crisis has been a decade or more in the making and we are now paying the high price for years of inaction and managed decline,” he said. “Patients are experiencing delays that we haven’t seen for years". Read full story Source: The Guardian, 7 January 2023
  7. News Article
    Care providers are demanding double the usual fees to look after thousands of people who need to be discharged from hospitals to ease the crisis in the NHS. Care England, which represents the largest private care home providers, said on Sunday it wanted the government to pay them £1,500 a week per person, citing the need to pay care workers more and hire rehabilitation specialists so people languishing in hospital can eventually be sent home. The rate is about double what most local authorities currently pay for care home beds, an amount Martin Green, the chief executive of Care England, described as “inadequate”. The demand comes as the health secretary, Steve Barclay promised “urgent action” with up to £250m in new funding for the NHS to buy care beds to clear wards of medically fit patients. The money will be used to buy beds in care homes, hospices and hotels where people are looked after by homecare providers, as well as pay for hospital upgrades. Stays will be no longer than four weeks until the end of March. The use of hotels as care homes began during the pandemic and has been controversial, with reports of problems with hygiene and supplies of specialist equipment. The charity Age UK last week criticised their renewed use as “not an appropriate place to provide high-quality care for older people in need of support to recuperate after a spell in hospital”. Read full story Source: The Guardian, 9 January 2023
  8. News Article
    With NHS staff being forced to witness our patients dying in corridors, in cupboards, on floors and in stranded ambulances, we can only thank our lucky stars that the country’s second most powerful politician is the man who last year published Zero: Eliminating Unnecessary Deaths in a Post-Pandemic NHS. Because the chancellor, Jeremy Hunt, cannot possibly stand back and permit these crisis conditions to continue, can he? He knows better than anyone – having written 320 pages on precisely this fact – that avoidable deaths are the very worst kinds of death, the ones that sicken families and clinicians to their core. Let’s remind ourselves of how strongly Hunt feels about this subject. The blurb of his book, published only last May, rings out with moral righteousness. “How many avoidable deaths are there in the NHS every week?” he asks. “150. What figure should we aim for? Zero. Mistakes happen. But nobody deserves to become a statistic in an NHS hospital. That’s why we need to aim for zero.” He even offers a road map towards achieving that end that, unusually for a politician, centres on radical candour. Don’t lie. Don’t deflect. Don’t spin. Don’t cover up. Be honest and open about mistakes and failures because this is the first, essential step to fixing them. To the collective despair of frontline staff, the government’s actual, as opposed to rhetorical, response to the humanitarian crisis gripping the NHS is a perverse inversion of everything the chancellor purports to hold dear. Read full story Source: The Guardian, 6 January 2023
  9. News Article
    The NHS is on the verge of collapse due to demand for healthcare rising significantly faster than funding levels, a consultant has warned. Peter Neville, a consultant for NHS Wales, took to social media to explain why, in his view, the system is failing. The consultant physician, who has been working in the NHS in Yorkshire and Wales for 32 years, set out the challenges facing the health service in a Twitter thread. He said he had experienced the NHS at its best, in 2008, and its worst, in 2022. He wrote: "Over at least the past 15 years, we have seen a relentless increase in demand, both in primary care and in hospital care. This has been absolutely predictable by social statisticians for decades and is based on the fact that our elderly are surviving much longer. "Our elderly use a very large percentage of NHS of resources, unsurprisingly because they are more prone to disease, frailty, and dementia. They need more social care and hospital care as they get older. And they are living longer. (Immigrants, by the way, use much less care). "Over this period NHS funding has, broadly speaking, risen about 1-2% over inflation. If NHS funding increases with inflation yet demand increases, then clearly spend per person will drop. Demand has increased considerably above 2%, which is why the NHS is failing to manage it." Read full story Source: Wales Online, 3 January 2023
  10. News Article
    An ICS chief has said the NHS workforce crisis is not the result of a ‘funding issue’ but caused by an inefficient use of resources. Patricia Miller, chief executive of Dorset Integrated Care Board, told a board meeting on Thursday that “constantly talking about the NHS needing more money” was undermining leaders’ case to government. She said: “We have got a workforce issue in the NHS, there is no doubt about that. I don’t actually believe we have got a funding issue. We just don’t use our resources very efficiently and I don’t think we do our case any positive favour with government when we’re constantly talking about the NHS needing more money when we can’t demonstrate that what we do is efficient. “So I don’t actually accept we’ve got a funding issue unless we start to work at the optimum and then we can absolutely demonstrate that. “I think what this comes down to is that our systems are too complicated and that starts at the centre, where every initiative we have is not about redesigning service models end-to-end but about layering on different solutions to different ends of the pathway and it just makes it more complicated. “I’ve no doubt that we’ve probably got 50-plus entrance and exit points to our urgent emergency care service, it’s ridiculous. I can’t navigate my way around 50 or 60, so there’s no way a patient can do it.” Read full story (paywalled) Source: HSJ, 6 January 2023
  11. News Article
    An acute trust has announced the ‘reluctant’ return of ‘corridor care’ – having previously eradicated the unsafe practice – due to extreme ambulance handover delays and other emergency pressures. Last year, University Hospitals North Midlands Trust chief executive Tracy Bullock said the trust had been “resisting” placing patients in corridors as it “brought significant patient safety and staff wellbeing issues”. This was despite the trust having large numbers of handover delays, being singled out for criticism by the ambulance service, and ‘corridor care’ being commonplace in many other acute hospitals amid severe bed pressures. The trust had successfully eliminated the practice several years earlier, because of these issues. However, at its board meeting today, the trust confirmed the practice was formally introduced at its Royal Stoke site on the day of the ambulance staff strike (21 December) because it was “holding more ambulances than we deem acceptable”. Read full story (paywalled) Source: HSJ, 4 January 2023
  12. News Article
    Managers in an NHS area are considering using "field hospitals" to deal with the surge in patients. Sarah Whiteman, chief medical director of the Bedfordshire, Luton and Milton Keynes Integrated Care Board told colleagues the use of tents was a "real possibility". In an email, she also asked colleagues to sign temporary contracts to work in emergency departments. The board said the use of tents in hospital grounds was not imminent. Dr Whiteman's email, obtained by The Sunday Times and seen by the BBC, began with the statement: "Call to arms". It emphasised how busy the acute units were within her board's operational area, including Bedford, Milton Keynes and Luton and Dunstable Hospitals. In the message, she promised staff would receive training and induction if they stepped forward to support colleagues. Read full story Source: BBC News, 4 January 2023
  13. News Article
    People have been urged to wear face coverings and remain at home if feeling unwell, as an already crisis-stricken NHS faces down multiple waves of winter illnesses. With children returning to school at a time when high levels of flu, Covid-19 and scarlet fever are all being reported, the UK Health Security Agency (UKHSA) has issued fresh guidance in a bid to minimise the diseases’ spread. Parents have been urged to keep children at home if they are unwell and have a fever, with adults told to only go out if necessary and wear face coverings if they are ill and avoid visiting vulnerable people. While transport secretary Mark Harper said the advice was “very sensible”, Downing Street insisted that such guidance was “pretty longstanding”, stressing that it was “not mandatory” and remained a far cry from ministers “telling people what to do” at the height of the pandemic. The government has also reintroduced travel bans for those testing positive for Covid-19 in China from 5 January amid a mass outbreak there. It comes as pressure on the NHS continues to grow, but Rishi Sunak said he was “confident” the NHS has the funding it needs despite accusations from senior doctors his government is in denial about the scale of the crisis in the health service. Read full story Source: The Independent, 3 January 2023
  14. News Article
    NHS England has shelved priorities on Long Covid and diversity and inclusion – as well as a wide range of other areas – in its latest slimmed down operational planning guidance, HSJ analysis shows. NHSE published its planning guidance for 2023-24, which sets the national “must do” asks of trust and integrated care systems, shortly before Christmas. HSJ has analysed objectives, targets and asks from the 2022-23 planning guidance which do not appear in the 2023-24 document. The measures on which trusts and systems will no longer be held accountable for include improving the service’s black, Asian and minority ethnic disparity ratio by “delivering the six high-impact actions to overhaul recruitment and promotion practices”. Another omission from the 2023-24 guidance compared to 2022-23 is a target to increase the number of patients referred to post-Covid services, who are then seen within six weeks of their referral. Several requirements on staff have been removed, including to ”continue to support the health and wellbeing of our staff, including through effective health and wellbeing conversations” and ”continued funding of mental health hubs to enable staff access to enhanced occupational health and wellbeing and psychological support”. Read full story (paywalled) Source: HSJ, 4 January 2022
  15. News Article
    A combination of Covid, flu, and Strep A has seen more than a dozen trusts and ambulance services declare critical incidents in recent days. NHS patients are sleeping in their cars outside hospitals, as the chaos engulfing the health service is set to last until Easter. Some 13% of hospital beds in England are filled with people with Covid or flu, NHS England figures show, with the treatment backlog also at a record high of 7.2 million. But Matthew Taylor, the chief executive of the NHS Confederation, which represents health service managers, said no reprieve is expected until April. "It seems likely that the next three months will be defined by further critical incidents needing to be declared and the quality of care being compromised," he told the Guardian. Read full story (paywalled) Source: The Telegraph, 3 January 2023
  16. News Article
    Police have carried out more than 5,500 investigations into patients who have been reported missing from NHS facilities in Scotland since 2019. The figures were outlined in a written response from Keith Brown, the justice secretary, to Jamie Greene, the Conservative MSP. Greene, who is the justice spokesman for the Conservatives, said the figures gave serious cause for concern. He said that the complete figure could be much higher because the data provided only included those reported to police. He urged Brown and Humza Yousaf, the health secretary, to provide adequate resources for policing and the health sector to ensure vulnerable patients were not slipping through the cracks. Greene said: “These figures are deeply alarming. Relatives expect their loved ones to be safe while they are staying, or being treated in, an NHS facility. It gives serious cause for concern that over 200 investigations have had to be launched in just the last few years to determine the whereabouts of young people who went missing from NHS grounds.” Read full story (paywalled) Source: The Times, 3 January 2023
  17. News Article
    The crisis engulfing the NHS will continue until Easter, health leaders have warned, as senior doctors accused ministers of letting patients die needlessly through inaction. More than a dozen trusts and ambulance services have declared critical incidents in recent days, with soaring demand, rising flu and Covid cases and an overstretched workforce piling pressure on the health service. But amid warnings that up to 500 people a week may be dying due to delays in emergency care alone, and of oxygen for seriously ill patients running out in parts of England, NHS leaders warned more chaos was expected until April. “It seems likely that the next three months will be defined by further critical incidents needing to be declared and the quality of care being compromised,” said Matthew Taylor, chief executive of the NHS Confederation, which represents the whole healthcare system in England, Wales and Northern Ireland. Ministers face growing pressure to grip the crisis. The British Medical Association (BMA) said the government’s “deafening” silence and failure to act was a “political choice” that was leading to patients “dying unnecessarily”. The Liberal Democrats urged the government to recall parliament, while Labour blamed government “mismanagement” for creating a sense of “jeopardy” around the NHS. Read full story Source: The Guardian, 2 January 2022
  18. News Article
    The government should declare a national NHS major incident to rescue the healthcare system from the current crisis, a senior health official says. Dr Tim Cooksley, president of the Society for Acute Medicine (SAM), says that the pressures on the NHS seen over the festive period are not new. He added that a number of recommendations had been outlined since the pandemic that offer the “best hope” of a short-term solution. Declaring a national NHS major incident would mean all four UK nations would co-ordinate their response and allocate resources to help meet the overwhelming demand for care that is enveloping many hospitals around the country. Taking that step would help combat the current situation, Dr Cooksley says, which NHS chiefs believe is having a similar effect on the service to the first wave of the Covid-19 pandemic. “The current situation in urgent and emergency care is shocking. It is in a critical state for patients and it is an extremely difficult for healthcare staff who are unable to deliver the care they want to," Dr Cooksley said. “Political leaders across the UK need to listen, meet urgently and accept the need to declare a national NHS major incident. "The outcome must be a four-nation emergency strategy which results in short-term stabilisation, medium-term improvement and long-term growth – the grave situation we are in means it will be a long journey. Sustainable workforce and capacity plans are required urgently to boost morale among staff and patients – as we have long called for – and we now need to see action.” Read full story Source: Manchester Evening News, 1 January 2022
  19. News Article
    Up to 500 people are dying every week because of delays in emergency care, Britain’s top accident and emergency doctor has said. Dr Adrian Boyle, the president of the Royal College of Emergency Medicine (RCEM), said a bad flu season was compounding systemic problems, leading to hundreds of unnecessary deaths. NHS leaders warned last week that the health service is in the grip of a “twindemic”, with soaring flu admissions and the impact of Covid “hitting staff hard”. Dr Boyle told Times Radio: “If you look at the graphs they all are going the wrong way, and I think there needs to be a real reset. We need to be in a situation where we cannot just shrug our shoulders and say this winter was terrible, let’s do nothing until next winter. “We need to increase our capacity within our hospitals, we need to make sure that there are alternative ways so that people aren’t all just funnelled into the ambulance service and emergency department. We cannot continue like this – it is unsafe and it is undignified.” Read full story Source: The Telegraph, 1 January 2023
  20. News Article
    Families of people with dementia have said there is a national crisis in care safety as it emerged that more than half of residential homes reported on by inspectors this year were rated “inadequate” or requiring improvement – up from less than a third pre-pandemic. Serious and often shocking failings uncovered in previously “good” homes in recent months include people left in bed “for months”, pain medicine not being administered, violence between residents and malnutrition – including one person who didn’t eat for a month. In homes in England where standards have slumped from “good” to “inadequate”, residents’ dressings went unchanged for 20 days, there were “revolting” filthy carpets, “unexplained and unwitnessed wounds” and equipment was ”encrusted with dirt”, inspectors’ reports showed. Nearly one in 10 care homes in England that offer dementia support reported on by Care Quality Commission inspectors in 2022 were given the very worst rating – more than three times the ratio in 2019, according to Guardian analysis. Read full story Source: 29 December 2022
  21. News Article
    The government could scrap a number of NHS targets after a review of the health service, it has been reported. Chancellor Jeremy Hunt and health secretary Steve Barclay commissioned Patricia Hewitt, a former Labour health secretary, last month to review how the NHS’s new integrated care systems should work, as well as how the health service should work to “empower local leaders”, giving them more autonomy. According to the i newspaper, the government could abolish a majority of health service targets as a result of the review, so it can be run along similar lines to schools. Ms Hewitt is set to publish her review next spring. The newspaper said ministers believe the NHS has become “overly centralised”, with doctors and trusts having to meet many different targets - more than 70 for GPs - and forced to tailor their work to meet them. Instead, the government would rather run the NHS “more like we do the schools system”, a senior government source told the i, giving local leaders increased responsibility on how to effectively meet NHS goals. The idea of fewer targets was received positively by the Royal College of GPs, which described many of the targets as “tick box exercises”. Professor Kamila Hawthorne, chair of the Royal College of GPs, told the newspaper that GPs are working under “intense workload” and pressure, with a “bureaucratic burden” adding to their workload. Read full story Source: The Independent, 26 December 2022
  22. News Article
    NHS England has revealed the latest list of trusts which it has identified as needing the most support to meet electives and cancer targets. The national body identified 15 trusts which have been assessed as being at most risk of not meeting the key targets of either having no patients waiting 78 weeks or more for elective treatment by April 2023, or returning their 62-day cancer waiting list backlog to pre-pandemic levels by March 2023. The 15 challenged trusts, which make up around 12% of acute trusts in England, are receiving “tier one” support which involves oversight from national teams, on-site expertise, extra funding and recruitment, and possible calls between their CEOs and government ministers. NHS England said it has recently added four trusts to “tier one” for electives and cancer – York and Scarborough Teaching Hospitals Foundation Trust, Sheffield Teaching Hospitals FT, North West Anglia FT, and Royal Devon and Exeter FT. York and Scarborough FT, Sheffield FT, and North West Anglia FT has previously been in tier two for cancer services only, while Royal Devon and Exeter FT had previously been in tier one for electives only but is now in tier one support for cancer as well. Read full story (paywalled) Source: HSJ, 23 December 2022
  23. News Article
    The health service in England is returning to a payment-by-results-style system for elective activity, new guidance confirms. Providers struggled to hit elective targets in 2022-23, in large part due to ongoing covid, emergency care and staffing pressures, but some have argued that incentives to carry out more activity are too weak. Proposals for the NHS payment system for 2023-24 issued state: “The large backlog in elective care is a significant issue for the NHS and the patients who rely on it. We want the NHSPS to include an elective funding mechanism which means that providers are paid based on the level of activity they deliver.” The plans add: “The approach we are proposing gives providers maximum financial incentive to deliver the elective activity targets they are being set.” Read full story (paywalled) Source: HSJ, 23 December 2022
  24. News Article
    Ambulance staff in five areas of England are to stage two further strikes in January, union leaders say. The industrial action on 11 and 23 January is likely to heap more pressure on emergency care, which is already under serious strain. Health Secretary Steve Barclay said further strike action was in no one's best interest. Unison leaders say the action is a direct result of the government's refusal to negotiate over pay. Life-threatening calls to 999, as well as the most serious emergency calls, will still be responded to, they say. Services in London, Yorkshire, the North West, North East and South West will take action over pay and staffing. The January strikes will each last for 24 hours from midnight, Unison says, and will involve all ambulance employees - not just 999 response crews. Read full story Source: BBC News, 22 December 2022
  25. News Article
    A teaching hospital that was lauded for its culture and championed by ministers has been downgraded from ‘outstanding’ to ‘requires improvement’ by the Care Quality Commission. CQC inspectors found multiple issues at Salford Royal Hospital during an inspection in August and September. These included nurse staffing, governance, and some cultural concerns. The trust’s urgent and emergency services were rated “inadequate” for safety. The hospital in Greater Manchester had been rated “outstanding” since 2015, and was frequently hailed as a leader on the patient safety agenda, particularly by former health secretary Jeremy Hunt. Read full story (paywalled) Source: HSJ, 22 December 2022
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