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Found 1,519 results
  1. 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
  2. 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
  3. 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
  4. 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
  5. 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
  6. News Article
    Hospice charities providing end-of-life services in partnership with the NHS have warned they will have to shut beds and sack staff because of the catastrophic impact of rising energy bills on their day-to-day running costs. The UK’s network of independent, mainly voluntary-run palliative care providers said hospices were experiencing a perfect storm of soaring costs and rising demand just as revenues from traditional public fundraising methods are collapsing. They have also warned that many patients who receive palliative care at home are struggling to maintain optimal care standards because they can’t afford to run central heating and the electrical medical equipment used in their everyday clinical care. Hospices, which typically rely on charitable donations for 70%-80% of their running costs, and which are intensive users of gas and electricity, have reported facing energy bill rises of up to 350%. Rachel McMillan, the chief executive of one of the UK’s biggest hospices, St Ann’s, in Greater Manchester, said: “We are at the point where we will have to take some very difficult decisions in terms of our business model and our service provision. Closing beds would be a last resort, but we are seriously going to have to think about this. “The government needs to sit up and listen to hospices; we are an essential part of the care delivery system. We are not a luxury.” Read full story Source: 22 December 2022
  7. News Article
    The risk to patients will only get worse unless the government reaches an agreement to prevent further strikes, NHS leaders have warned. In a letter to the prime minister and health secretary, they said there was "deep worry" about today's strike. People are being asked to only call 999 in a life-threatening emergency, but NHS England says emergency care will continue to be provided. Ambulance response times are already twice as long as two years ago. The letter, signed by the leaders of NHS Confederation and NHS Providers, says the action being taken by ambulance workers "isn't just about pay but working conditions: many have said they are doing this because they no longer feel able to provide the level of care that their patients need and deserve." They urged ministers to "do all you can to bring about an agreed solution". Health Secretary Steve Barclay said the pay deal on offer to both ambulance staff and nurses had been agreed by an independent pay review body. In England, eight out of the 10 major ambulance services have declared critical incidents - a sign of the intense pressure they are already under. Ministers have urged the public to take extra care and suggested they avoid contact sports and unnecessary car journeys. Read full story Source: The Guardian, 21 December 2022
  8. News Article
    The Birmingham MP Preet Gill has called on the UK health secretary to launch a major public inquiry into allegations that a bullying and a toxic culture is risking patient safety at University Hospitals Birmingham (UHB). The MP for Edgbaston, where UHB is based, said she had received complaints from staff alleging elderly patients had been left on beds in corridors outside wards due to mismanagement, and medics were discouraged from speaking out about problems. In a letter to Steve Barclay, seen by the Guardian, Gill said: “I have been inundated by messages from UHB staff, past and present, who have contacted me to share their experience of what has been repeatedly described as a toxic culture that has had an alarming impact on staff and patient care.” After an investigation by BBC Newsnight earlier this month, which found that doctors at the trust were “punished” for raising safety concerns, the Birmingham and Solihull Integrated Care Board (ICB) announced a three-part review into the culture at UHB. The first report is expected at the end of January. But Gill criticised the plans, saying she did not think it would “be sufficient to adequately investigate this scandal”, and instead called for a major independent public inquiry, similar to the 2013 Francis inquiry into the Stafford hospital scandal. “We cannot rely on an ICB investigation to solve this issue. Many of those on the ICB are former members of the senior leadership team from UHB and would not offer the independence required to recommend the changes that are so needed or give confidence to whistleblowers,” she said. Read full story Source: The Guardian, 19 December 2022
  9. News Article
    The NHS in England has more funding and staff than before the pandemic - but in many types of care, it is treating fewer patients. Why? The Institute for Fiscal Studies (IFS) says this is a puzzle with no simple explanation - but the pandemic has dealt a lasting blow to the NHS and it could be costing more to treat patients, on average, than before. Despite higher staff sickness rates, compared with pre-pandemic levels, the NHS has available to work: 8% more nurses 9% more consultants 15% more junior doctors. But - not counting those filled by patients who have tested positive for Covid, even though they may be there mainly for something else - there were 5% fewer beds available in the third quarter of this year than in 2019, the IFS says. IFS research economist Max Warner says: "The NHS is showing clear signs of strain heading into the winter and is treating fewer patients than it was pre-pandemic, across many types of care. "The real risk, almost three years on from the start of the pandemic, is that the Covid hit to NHS performance is not time-limited. "Going forward, we need to grapple with the possibility that the health service is just able to treat fewer patients with the same level of resources." A Department of Health spokesperson said: "As the IFS report acknowledges, Covid had a significant impact on the NHS, and we are focused on delivering the biggest catch-up programme in health history". Read full story Source: BBC News, 14 December 2022
  10. News Article
    The mother of a sick girl has confronted the health secretary during a hospital visit in London, telling him that NHS staff are “worked to the bone” and the government is doing “terrible damage” to families on waiting lists. Sarah Pinnington-Auld, whose three-year-old daughter, Lucy, has cystic fibrosis, rebuked Steve Barclay over NHS staff working conditions and long waits for treatment as he visited King’s College hospital. She told the Conservative cabinet minister how her daughter was pushed off an “absolutely horrific” waiting list because of “the obscene number of people who came through and the lack of resources”. “The damage that you’re doing to families like myself is terrible, because it was agony for us as a family waiting for that call,” she said. “Preparing our children, for their sister and her hospital visit, for then it to be cancelled. And I know you look and we’re all numbers, but actually they’re people waiting for care.” “The doctors, the nurses, everyone on the ward is just brilliant, considering what they’re under, considering the shortage of staff, considering the lack of resources,” she said. “That’s what’s really upsetting, actually, because we have a daughter with a life-limiting, life-shortening condition and we have some brilliant experts and they’re being worked to the bone, and actually the level of care they provide is amazing, but they are not being able to provide it in the way they want to provide it because the resourcing is not there.” Read full story Source: The Guardian, 19 December 2022
  11. News Article
    Nurses in England, Wales and Northern Ireland will strike today in an ongoing dispute with the government about pay and concerns about patient safety. Up to 100,000 members of the Royal College of Nursing (RCN) will take part after it balloted its members in October. It has said that low pay is the cause of chronic understaffing that is putting patients at risk and leaves NHS staff overworked. It will be the second day of strikes in December, after an initial day of industrial action on 15 December, the RCN’s biggest in its history. It meant the cancellation of thousands of outpatient appointments and non-urgent operations. More strikes have been threatened for January unless talks between union negotiators and the government takes place before Thursday, 48 hours after the strike on Tuesday. The RCN’s general secretary and chief executive, Pat Cullen, said: “For many of us, this is our first time striking and our emotions are really mixed. The NHS is in crisis, the nursing profession can’t take any more, our loved ones are already suffering. “It is not unreasonable to demand better. This is not something that can wait. We are committed to our patients and always will be.” Read full story Source: The Guardian, 20 December 2022
  12. News Article
    Patients should “make their own way to hospital” if they can do so during Wednesday’s strike by ambulance workers, a cabinet minister said yesterday, as the government warned that the industrial action would put lives at risk. Senior government figures said that ambulance unions had still not agreed national criteria for what conditions would be considered life threatening and responded to during the strike. Steve Barclay, the health secretary, is understood to be writing to all striking unions, including nurses, seeking discussions on patient safety. Yesterday Oliver Dowden, the Cabinet Office minister, said people should still call 999 in an emergency but might in less serious cases have to make their own way to hospital. “We are working to ensure that if you have a serious injury, in particular a life-threatening injury, you can continue to rely on the ambulance service, and we would urge people in those circumstances to dial 999,” he told Sunday with Laura Kuenssberg on BBC1. “If it is the case that you have less serious injuries, you should be in touch with 111, and you should seek to make your way to hospital on your own if you are able to do so.” Read full story (paywalled) Source: The Times, 19 December 2022
  13. News Article
    Asystemic failure to provide basic physical care on NHS mental health wards is killing patients across the country, despite scores of warnings from coroners over the past decade, The Independent can reveal. An investigation has uncovered at least 50 “prevention of future death” reports – used by coroners to warn health services of widespread failures – since 2012, involving 26 NHS trusts and private healthcare providers. Cases include deaths caused by malnutrition, lack of exercise, and starvation in patients detained in mental health facilities. Experts warn that poor training and a lack of funding are factors in the neglect of vulnerable patients. The Independent investigation uncovered: Staff failing to carrying out basic health checks, such as assessment for risk of blood clots. Cases of nurses and care assistants without adequate CPR training. Doctors unable to carry out emergency response procedures. Patients not treated for side effects of antipsychotic medication. Rapidly deteriorating health going unnoticed and untreated. Coroners have exposed multiple cases of mental health patients receiving inadequate treatment in general hospitals, with their illness being mistaken for a psychiatric problem. Read full story Source: The Independent, 18 December 2022
  14. News Article
    Unions must ensure there will be "sufficient" staffing during this week's ambulance strike to protect patients, the health secretary says. Workers in England and Wales will walk out on Wednesday in a dispute over pay, but life-threatening emergencies will be responded to. Unions say discussions were still taking place with ambulance trusts to draw up detailed plans for cover. Steve Barclay said there is a lack of clarity about what is being offered. He said it was for the unions to ensure they "meet their obligations" for emergency cover so that people in crisis get the care they need. But Unite leader Sharon Graham, whose union is co-ordinating the ambulance strikes with Unison and GMB, said Mr Barclay will "have to carry the can if patients suffer". The ambulance walkouts will involve paramedics as well as control room staff and support workers. The action by the three main ambulance unions - Unison, GMB and Unite - will affect non-life threatening calls, meaning those who suffer trips, falls or other injuries may not receive treatment. Read full story Source: BBC News, 19 December 2022
  15. News Article
    The collaboration seen between the independent sector and the NHS during the peaks of the pandemic “doesn’t exist any more”, the boss of one of the UK’s largest private hospital companies has said. Mr Justin Ash, chief executive of Spire Healthcare and a member of the government’s recently convened elective recovery task force, whose purpose is to ”focus on how the NHS can [better] utilise independent sector to cut the backlog’.” He told the Westminster Health Forum earlier this week: “In spirit there is collaboration but in practice, it doesn’t exist anymore. There is no more commissioning by trust[s]”. Mr Ash told the conference Spire had previously had administrative teams working at 39 different NHS hospitals examining which NHS patients could be treated at one of its facilities. That number was now three, a decline which he described as “a shame”. He said: “There has to be a mindset change. We have people say ‘you have our nurses and consultants working for you’. “[But] just like patients, nurses and consultants should be able to move around the system [as] one workforce.” Read full story (paywalled) Source: HSJ, 16 December 2022
  16. News Article
    Patients are not safe from harm in three out of seven emergency departments, a damning new Hiqa inspection report has revealed. The report was released on the same day as an Oireachtas committee was warned of a growing crisis in primary care, with patients in some parts of the country unable to access basic GP services. Emergency Departments in Cork University Hospital (CUH) and University Hospital Limerick (UHL) were among seven EDs assessed by the health watchdog. In three EDs, including Cork and Limerick, inspectors found failures to ensure “service providers protect service users from the risk of harm.” Inspectors also found patients’ “dignity, privacy and autonomy” was not respected in UHL, while CUH was only partially compliant in this area. The report also highlighted lengthy waiting times, including one patient who spent 116 hours on a trolley at UHL. Read full story Source: The Irish Examiner, 15 December 2022
  17. News Article
    One in eight adults in the UK have paid for private medical care in the last year because of long delays in getting NHS treatment, renewing fears that the NHS is becoming “a two-tier system”. “Around one in eight (13%) adults reported they had paid for private medical care, with 5% using private insurance and 7% paying for the treatment themselves,” according to a new report by the Office for National Statistics (ONS). Patients also say that waiting for tests or treatment is badly affecting them, including making their illness worse. The ONS survey of 2,510 adults across the UK found that one in five were waiting for an appointment, test or treatment at an NHS hospital. Of those in that situation: Three-quarters said their delay had had either a strongly (34%) or slightly (42%) negative impact on their life 36% said waiting had made their condition worse 59% said it had damaged their wellbeing A third said long waits had affected either their mobility (33%) or ability to exercise (34%) Read full story Source: The Guardian, 16 December 2022
  18. News Article
    The ambulance staff strike next week represents a far higher risk to patient safety and services than the nurses’ strike, but a blanket elective ban will only be used as “an absolute last resort”, a senior NHS England director said today. However, NHSE elective recovery chief Sir Jim Mackey’s comments come despite several local leaders telling HSJ significant amounts of elective activity are likely to need to be postponed due to the ambulance staff walkout on 21 and 28 December, to free up capacity to deal with emergency care pressure. Speaking at a King’s Fund conference this morning, Sir Jim said: “The ambulance strike is a completely different order of magnitude of risk [than the nurses’ strike]. I think that’s the main thing people are worried about because of the complexity and fragility of urgent care.” However, he added: “If we were to give [national guidance on what elective activity to cancel] today, the only guidance we could give would be to cancel absolutely everything, and that’s really not going to help anybody… “I think we’ll just have to take it day-by-day and keep learning from each other and sharing intelligence… and then, if at some point, there is a case for blanket order, we’ll consider that… But, we really want to do that as an absolute last resort.” Read full story (paywalled) Source: HSJ, 15 December 2022
  19. News Article
    Vulnerable patients, including some children, have faced long delays for a suitable bed as organisations argue over whose responsibility it is to fund and deliver their care, HSJ understands. In a letter outlining winter arrangements, NHS England has warned trust leaders and commissioners against delaying emergency mental health admissions – typically needed when a patient is away from home, and understood to be more common over the Christmas period – while determining which area has which responsibility. National mental health director Claire Murdoch wrote: “It is not acceptable to delay an emergency mental health admission while determining which area has clinical and financial responsibility for the care of an individual.” She added such admissions should be arranged “as quickly as possible, and without delay caused by any financial sign-off process”. It comes as HSJ has been told patients can often end up waiting for several days in emergency departments or in “inappropriate” out of area or acute beds when disputes occur over who is responsible for their care. Read full story (paywalled) Source: HSJ, 15 December 2022
  20. News Article
    Nurses in England, Wales and Northern Ireland have started a nationwide strike in the largest action of its kind in NHS history. Staff will continue to provide "life-preserving" and some urgent care but routine surgery and other planned treatment is likely to be disrupted. The Royal College of Nursing said staff had been given no choice after ministers refused to reopen pay talks. RCN general secretary Pat Cullen has called on the government to "do the decent thing" and resolve the dispute before the year ends. Ms Cullen told BBC Breakfast the strike marked "a tragic day in nursing". "We need to stand up for our health service, we need to find a way of addressing those over seven million people that are sitting on waiting lists, and how are we going to do that? By making sure we have got the nurses to look after our patients, not with 50,000 vacant posts, and with it increasing day by day," she said. Health Minister Maria Caulfield, a former nurse, accepted "it is difficult" living on a nurse's wage, but said that a 19% pay rise "is an unrealistic ask". Under trade union laws, the RCN has to ensure life-preserving care continues during the 12-hour strike. Chemotherapy and kidney dialysis should run as normal, along with intensive and critical care, children's accident and emergency and hospital neonatal units, which look after newborn babies. Read full story Source: BBC News, 15 December 2022
  21. News Article
    NHS leaders fear patients will come to harm as cancer services are “hit hard” by upcoming nurses’ strikes. The NHS’s four chief nurses wrote to the Royal College of Nursing (RCN) general secretary Pat Cullen warning patients’ lives are at risk due to life-saving services not being protected when nurses walk out on Thursday. And a separate letter from Dame Cally Palmer, the national cancer director for NHS England, urged Ms Cullen to protect urgent cancer operations from strike action “to ensure a consistent and compassionate approach for patients across the country”. The RCN has since agreed that staff will cover emergency cancer and mental health crisis services on strike days but has maintained only night-level staffing for inpatient services. But trust executives told The Independent that they were concerned they won’t be able to fill any gaps with agency staff due to RCN rules, which will worsen existing shortages. One senior NHS source claimed cancer services weren’t being prioritised by unions despite national agreements to protect chemotherapy treatments. They said: “I fear that someone is going to get hurt as the system is so pressured and fragile right now, whether strike-related or not, public sympathy will shift considerably if this were to happen.” Read full story Source: The Independent, 14 December 2022
  22. News Article
    Increasing numbers of emotionally troubled children have been taken into care while waiting long periods for NHS treatment because their condition deteriorated to the point where their parents could no longer cope with their behaviour, child protection bosses have revealed. Association of Directors of Children’s Services (ADCS) president Steve Crocker said that since the pandemic, youngsters with complex emotional needs had become a significant factor in rising child protection referrals. “We are seeing children in the social care system because they have not been supported in the [NHS] mental health system,” he said. Crocker urged ministers to “do better” for children facing “unacceptable” delays in NHS mental health treatment, adding that it was not uncommon for waiting lists to involve waits of over a year. Councils were “filling gaps” in NHS provision but struggling to find placements for children with severe behavioural problems, and when they did, typically paid “untenable” fees of tens of thousands of pounds a week. He accused private children’s residential care providers and their “rapacious” hedge fund backers of “profiteering” from the care crisis, and urged the government to intervene to cap typical profit margins that were currently about 20%. “We do not see how this can be allowed to continue,” he said. Read full story Source: The Guardian, 13 December 2022
  23. News Article
    Medics and nurses have been urgently called upon to support London Ambulance Service during next week’s strike action, as it will otherwise have to rely on staff only able to provide ‘first aid’. The North East London primary care team has sent out a request for clinical staff working for integrated care boards to be released from duties ahead of industrial action on 21 December. Unison members are preparing to walk out, alongside thousands of other staff at nine other ambulance trusts across the country, in a dispute over pay. The letter, seen by HSJ, was sent yesterday afternoon. It said: “LAS are keen to have experienced medics and nurses, who have current urgent and emergency clinical exposure, have knowledge of how to navigate the system and can operate as a senior clinical decision maker. Medical Practitioners would ideally be from general practice and emergency medicine. “Advanced Paramedics and Advanced Care Practitioners with urgent care or IUC CAS experience are also required. A knowledge of ambulance services is preferred as it removes the need to learn very quickly the significant differences in ambulance services and LAS control rooms." Read full story (paywalled) Source: HSJ, 13 December 2022
  24. News Article
    All ambulance services have declared the highest level of alert due to ‘extreme pressures’ facing the urgent and emergency care system. One senior ambulance chief told HSJ that ambulance response times have dropped dramatically in the last few days, while A&E handover delays have surged. They said: “The wheels are falling off [the emergency care system] now, we’re in a really awful situation.” They said ambulance leaders have major concerns about the planned strike action by nurses on Thursday, fearing this will exacerbate discharge delays and have a knock-on effect on ambulance handover problems. It also comes ahead of strike action planned by ambulance staff for next week. HSJ has seen internal communications which confirm all ten ambulance trusts in England are now in level four of their “resource escalation action plan”, which means they can seek assistance from other nearby trusts or services. However, this is more difficult when an entire sector is under pressure, as is the case currently. Read full story (paywalled) Source: HSJ, 13 December 2022
  25. News Article
    The number of operations cancelled by the NHS in England because of staff shortages may have doubled in three years, with an estimated 30,000 not proceeding because no staff were available to perform them. At least a third of cancelled operations were those that were deemed urgent, according to the analysis by Labour. It suggested at least 2,500 cancelled operations for cancer patients and 8,000 on children. It found staff shortages were the most common reason given for cancellations by hospitals, accounting for one in five of all operations cancelled for non-clinical reasons last year. The Department of Health and Social Care said it was “misleading” to extrapolate that figure from the data in the FOIs. “Thousands of elective appointments and procedures had to be cancelled during the pandemic to protect the NHS, and since then we’ve been focused on delivering the biggest catch-up programme in health history - virtually eliminating the longest 2-year waits for treatment,” a spokesman said. In total, 158,000 operations were cancelled for issues including equipment failures, a shortage of beds, and 5,700 because of equipment failure, administrative errors, and theatre lists overrunning. Labour cited one case that involved a 72-year-old woman who had two operations to remove a brain tumour cancelled in September, blamed on a lack of available beds. About 9,500 operations were cancelled because an emergency case took priority, and 250 due to adverse weather. Separate figures from the NHS show record numbers of operations cancelled at the last minute are not rearranged to take place within a month, with one in five patients waiting longer. Read full story Source: The Guardian, 12 December 2022
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