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Found 1,519 results
  1. Content Article
    Royal Cornwall QI conference online book supporting the conference. The online brochure highlights all the quality improvement projects at Royal Cornwall Hospitals.
  2. Content Article
    The Invited Reviews service was formed in 1998 and offers consultancy services to healthcare organisations on which they may require independent and external advice. Reviews provide an opportunity to healthcare organisations to deal with issues and concerns at an early stage. Medical directors (MDs) or chief executive officers (CEOs) of healthcare organisations can request an invited review when they feel the practice of clinical medicine is compromised and there are potential concerns over patient safety. The Royal College of Physicians (RCP) Invited Reviews service has gained a wealth of experience dealing with demanding situations involving individuals, teams, departments and services. This is their learning from invited reviews report. It brings together their experiences across multiple specialities, identifying common themes and crystallising some of our generic findings, which will prove useful to all in clinical leadership roles.
  3. Content Article
    This report from the International Council of Nurses is intended to give an overview of the continuing challenges faced by nurses, highlight the potential medium- to long-term impacts on the nursing workforce, and inform policy responses that need to be taken to retain and strengthen the nursing workforce.
  4. Content Article
    Paul Batalden is the host of "The Power of Coproduction". Prepared as a pediatric physician, he has been an international architect, teacher, and advocate for the improvement of healthcare services for five decades. His current focus is the coproduction of healthcare services.
  5. Content Article
    A recently published report highlights the shortcomings in care provided by the NHS. Peter Walsh, Joanne Hughes and James Titcombe emphasise how millions could be saved if people were empowered early on to have their needs met without the need to turn to litigation
  6. Content Article
    How have the numbers of doctors in the NHS who come from the EU and the European Free Trade Association changed since the Brexit referendum in 2016? And do certain specialties face particular problems? Martha McCarey and Mark Dayan take a closer look at what’s happened since the vote.
  7. Content Article
    Letter from Mike Prentice, NHS England’s national director for emergency, planning and incident response, to hospitals and other care providers ahead of talks with the Royal College of Nursing later this week on the industrial action from nurses. At that meeting they will try to agree what areas of care will be hit on Thursday 15 and Tuesday 20 December, and which will continue as normal because they are covered by “derogations” – agreed exemptions to the action.
  8. Content Article
    Developed in 2020, this Picker survey aims to understand the experiences of cancer and tumour care among children and their parents/carers. The results will help improve children’s cancer services across England. The survey, conducted by the charity Picker on behalf of NHS England, included children, young people, and their parents – with separate questions designed to be appropriate to different age groups. Children and young people were included in the survey if they had a confirmed cancer or tumour diagnosis, received inpatient or day case care from an NHS Principal Treatment Centre (PTC) in 2021, and were under 16 years of age at the time of their discharge.
  9. Content Article
    A complaint from a patient was made to the Scottish Public Services Ombudsman (SPSO) about the care and treatment provided during the period January 2018 to September 2021. In January 2018 the patient underwent emergency surgery for a perforated sigmoid diverticulum (a complication of diverticulitis, an infection or inflammation of pouches that can form in the intestines). An emergency Hartmann's procedure (a surgical procedure for the removal of a section of the bowel and the formation of a stoma - an opening in the bowel) was performed. In April 2018, the patient was seen in an outpatient clinic and informed it would be possible to have a stoma reversal. The patient complained that the Board had continually delayed the stoma reversal surgery which they required, which as of September 2021 had not taken place. The patient also complained that Covid-19 could not account for the delays between the Board informing patient they were ready for surgery around December 2018 and the start of the pandemic in March 2020. The patient noted that as a consequence they had developed significant complications: a large hernia. The patient added that this had severely impacted their personal life and self-esteem, and left them unable to work and reliant on welfare benefits.
  10. News Article
    The Care Quality Commission (CQC) has issued two fixed penalty notices to University Hospitals Birmingham NHS Foundation Trust totalling £8,000 for failing to seek consent to care and treatment of someone in their care. A 55-year-old gentleman who had diagnoses of epilepsy and autism was admitted to Good Hope Hospital in Birmingham on six occasions between 12 May 2019 and 6 October 2019. He had also been deaf since birth and communicated via British Sign Language (BSL) and lip reading. These fixed penalty notices relate to the trust’s care and treatment of the patient at Good Hope Hospital in relation to three medical procedures, which occurred in September, October and November 2019. CQC found that on these three occasions, the trust did not comply with Regulation 11 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, requiring registered persons to obtain the consent of the relevant person when providing care and treatment to them. Regulation 11 also states if someone is 16 or over and is unable to give consent because they lack capacity, the registered person must act in accordance with the Mental Capacity Act 2005. The three procedures where CQC found consent failures, were feeding tubes, aimed at providing nutritional support to the patient, who was struggling with food. Read full story Source: CQC, 7 October 2022
  11. News Article
    A trust has called for ministers to make an ‘urgent’ decision on funding for a new hospital, as a raft of maintenance problems such as leaking roofs and overflowing sewage pipes are hampering efforts to tackle waiting list backlogs. There was a surge in estates’ incidents reported by Princess Alexandra Hospital Trust last year — to an average of nearly 12 each week — and the Essex trust is calling for clarity on whether it will be given the green light to build a new hospital. The trust is one of eight given priority status under the government’s new hospitals programme, but there has been speculation in recent weeks the programme could be scaled back as departments are told to find spending cuts. Michael Meredith, estates director at Princess Alexandra Hospital, said patients still received good care, but admitted the problems – which include sewage overflow, outdated electrics and theatre roofs leaking – were “absolutely” affecting the hospital’s ability to recover elective care. He told HSJ: “It means you have to cancel some of your elective work. And at the moment that is critical, because we know [we’ve] got a long waiting list, we know we need to recover, we know we’ve got people waiting longer than they need to… “That has a real impact on our staff morale, and a real impact on patients waiting to be seen.” Read full story (paywalled) Source: HSJ, 1 November 2022
  12. News Article
    Scotland's NHS is in "a perilous situation" amid a staffing and funding crisis, according to the chairman of the doctors' union. Dr Iain Kennedy said urgent action was needed to tackle workload pressures ahead of a potentially "terrifying" winter period. It comes after Scotland's health secretary Humza Yousaf admitted NHS Scotland was not performing well. Mr Yousaf told BBC Scotland it would take at least five years to fix. Dr Kennedy, who is chairman of the industry body BMA Scotland, said it was good to hear Mr Yousaf being honest about the scale of the problems, but added that "frankly we cannot wait five years" for things to improve. He told BBC Radio's Good Morning Scotland programme: "The NHS in Scotland is in a perilous situation and we have a particular crisis around the workforce - we simply do not have enough doctors in general practice and in hospitals. "We need more urgent action because the pressures and the workload have really shot up." Dr Kennedy has called on the government to publish a "heat map" showing where NHS vacancies are unfilled across Scotland. He said: "The public need to see transparency on where the vacancies are. We think that there are probably 15% vacancies across hospital consultant posts across Scotland. "Even the government admits to 7% and that we are at least 800 GPs short in Scotland - and I, and others, suspect we are probably well over that figure now." Read full story Source: BBC News, 31 October 2022
  13. News Article
    A growing number of children with mental health problems are being treated on adult psychiatric wards as services struggle to cope with a surge in demand following the pandemic, the NHS watchdog has warned. There were 249 admissions of under-18s to adult psychiatric wards in England in 2021-22, according to data provided by NHS trusts to the Care Quality Commission (CQC), up 30% on the year before. Of the children admitted to adult wards, 58% of cases were because the child needed to be admitted immediately for their safety. But in more than a quarter of cases, 27%, the child was admitted to the adult ward because there was no alternative child inpatient or community outreach service available. The findings come more than 15 years after the government set a target to end inappropriate admissions of children to adult psychiatric wards. The number of admissions gradually reduced but has now risen again, the CQC figures suggest. Dr Elaine Lockhart, chair of the Child and Adolescent Faculty at the Royal College of Psychiatrists, said the figures were “a concern but not a surprise. We’ve got a lot of children and young people who have become more unwell. Services are really struggling to meet their needs,” she said. Read full story Source: The Guardian, 30 October 2022
  14. News Article
    Results from the recently published Community Mental Health Survey highlight that issues with access to services and support, as evidenced in the 2020 and 2021 surveys, continue to persist. The 2022 Community Mental Health Survey – coordinated by Picker for the Care Quality Commission – collected feedback from more than 13,400 people in contact with services between September and November 2021. The survey is an important source of information to help us understand the quality of person-centred care provided to mental health service users. A key feature of a high-quality person centred mental health service is timely access to care. The survey shows that there is more to be done here to ensure that service users have a good experience as nearly a third (31%) reported not being told who was in charge of organising their care and services – up from 28% in 2021. In parallel with this, 30% of service users said that they had not seen NHS mental health services enough in the last 12 months (compared to 27% in 2021 and 24% in 2020) and only 55% said they were given enough time to discuss their needs and treatment. Just over half of service users (51%) said that they did not receive any help or advice with finding support for financial advice or benefits – a 3% point increase from last year’s survey. When asked a similar question regarding support for finding or keeping work, 50% said they did not receive help or advice but would have liked it. With the financial worries that the increased cost of living is causing for many people, signposting support and advice for employment, managing money, and claiming benefits are vital for helping people maintain good mental health. Commenting on the results, Jenny King, Picker’s Chief Research Officer, said: “On the 22nd September 2022, the Secretary of State for Health and Social Care and Deputy Prime Minister at the time, Thérèse Coffey, announced the UK government’s Our plan for patients. Whilst it notes that work will continue to improve the availability of mental health support through expansion of services, there was little detail on how this would be achieved and how backlogs of care in mental health services would be resolved. With the backdrop of the cost of living crisis and its impact on people’s mental health, the findings from this survey highlight the urgent need for more to be done to address accessibility issues. And not just in mental health services but across health and social care where, as highlighted by CQC’s 2021/22 State of Care report, people are waiting too long for appointments, assessments, and treatment. Without a plan for tackling the NHS’s workforce crisis, the ability to make sustainable service improvements to address the unmet need is severely restricted.” Read full story Source: Picker, 27 October 2022
  15. News Article
    Eighteen people died at two Teesside hospital trusts following patient safety lapses over a 12-month period. Sixteen such deaths were recorded at the South Tees Hospitals NHS Foundation Trust, with two at the North Tees and Hartlepool NHS Foundation Trust. Examples of patient safety lapses include a failure to provide or monitor care, a breakdown in communication, an out-of-control infection in a hospital, insufficient staffing or a missed diagnosis. NHS England figures show that, between April 2021 and March this year, there were 16,557 incidents at the South Tees Trust, which operates James Cook University Hospital in Middlesbrough, and Northallerton's Friarage Hospital. Thirty-four resulted in "severe" harm. Middlesbrough MP Andy McDonald told the Local Democracy Reporting Service the figures were a concern and that he planned to take them up with the South Tees Trust's chief executive. He said NHS staff worked under "the most demanding of conditions" but added: "Every person going into hospital rightly expects to receive the best treatment. Patient safety is paramount and no family wants to see a loved one suffer." Dr Mike Stewart, the trust's chief medical officer, said: "We encourage an open and transparent culture and promote the reporting of all patient safety incidents, even when there is uncertainty over a direct link between any problems in care and incidents of severe harm or death. "In the last year there were no deaths graded as definitely preventable due to a problem in the care delivered by the trust. "While our reporting has increased consistently over the last three years, the number of serious incidents has not risen, which is strong evidence of a positive safety culture." Read full story Source: BBC News, 30 October 2022
  16. News Article
    Hospitals and care homes have not received a single penny of a £500m emergency fund promised by the government to prevent the NHS becoming overwhelmed this winter, the Guardian has learned. Ministers announced they were injecting the cash into the health and social care system last month, to help get thousands of medically fit patients out of hospital into either their own home or a care home as soon as possible in an effort to better prepare the NHS for the coming months. “At the moment, one of the key challenges is discharging patients from hospital into more appropriate care settings to free up beds and help improve ambulance response times,” Thérèse Coffey, the then health and social care secretary, said on 22 September. “To tackle that, I can announce today that we are launching a £500m adult social care discharge fund for this winter.” However, the Guardian has been told that none of the funding has materialised. Senior health and social care sources described the government’s failure to release the promised cash as “inexplicable” and “outrageous”. More than 13,000 of the 100,000 NHS hospital beds in England currently contain “delayed discharge” patients, which has led to A&E units becoming heavily congested and long delays in ambulance handovers. As a direct result, thousands of 999 patients are suffering potential “severe harm” every month because ambulances are stuck outside hospitals. “Leaders across the NHS and local authorities are yet to see a single penny of this investment or any official detail on how it will be allocated,” said Matthew Taylor, the chief executive of the NHS Confederation. “Currently, only two-fifths of patients in hospital are able to leave when they are ready to do so, including due to problems accessing social care, yet health leaders still do not know how and when the £500m will be released to the system. So close to winter, this is unbelievable. Read full story Source: The Guardian, 31 October 2022
  17. News Article
    NHS England has launched the first substantive consultation on changes to the NHS provider licence since 2013. Licences set out the requirements providers must meet and are the legal mechanism NHS England can use to take enforcement action. Having a licence has long been mandatory for foundation trusts and independent providers, and will become so for trusts. The intention is for the proposals to take effect from next year. Most of the changes to the licence regime have been made to bring it into line with this year’s Health and Care Act and accompanying policy changes. For example, trusts will be required to collaborate with other providers and work effectively as part of their integrated care system. This extends to trusts delivering agreed financial plans decided at a system level. The aim is to provide “mutual accountability” and ensure each provider does not use “more than their fair share of NHS resources”.' Read full story (paywalled) Source: HSJ, 28 October 2022
  18. News Article
    Steve Barclay is back as England's health secretary, just as the NHS prepares for what its chief executive Amanda Pritchard says could be a "very, very challenging winter". The government has said "intensive work" is under way in the 15 most under-pressure hospital trusts in England, to speed up ambulance delays, free up beds and reduce waiting times in A&E. Emergency departments across the UK are struggling to quickly treat patients. Only 57% of people who turned up at major A&E departments in England last month were seen, admitted or discharged within four hours, well below the 95% national target. The latest figures from Gloucestershire Royal show it performs slightly worse than average, with 55% dealt with in four hours. One medic, speaking anonymously to the BBC, said: "I wouldn't bring a member of my family to this hospital. And winter is going to be worse unless something changes fast." Read full story Source: BBC News, 28 October 2022
  19. News Article
    A trust chief executive says the Care Quality Commission’s (CQC) inspection regime is still overly focussed on individual organisations, rather than systems, and this is driving the “risk aversion” which is partly responsible for the emergency care crisis. Mid Yorkshire Hospitals Trust CEO Len Richards acknowledged the CQC has started to scrutinise system-wide issues but suggested the “heat” of its regulation is still on individual providers. Mr Richards told the House of Lords’ public services committee on Wednesday that care homes and nursing homes in his area have declined to take patients ready to be discharged from hospital, due to concerns it would put their CQC accreditation at risk. He said: “[Last winter] we asked nursing homes and care homes to take patients and they couldn’t take them beyond a certain limit because it would put their accreditation at risk. “We went to the CQC to try and create some flexibility. Their perspective was very much of an independent regulatory body that would look at the organisation and not look at the system. I think we’ve got an awful long way to go there. “I think regulation does drive risk aversion… [and] the heat of regulation right at the moment is on individual organisations. “Therefore, when the CQC come and look at my organisation, they will talk about congestion in the A&E department. They won’t talk about the assessment that we made around there being a greater risk in the community if we didn’t offload ambulances.” Read full story (paywalled) Source: HSJ, 28 October 2022
  20. News Article
    A hospital trust has been fined £200,000 for putting four babies at "serious risk"of harm. Staff at Rotherham Hospital failed to spot non-accidental injuries during admissions, Sheffield Magistrates' Court heard. District Judge Naomi Redhouse criticised failures in the hospital's systems and processes. Health watchdog, the Care Quality Commission (CQC), had earlier highlighted problems with safeguarding training at the trust prior to the babies' admissions between January 2019 and February 2020. The court was told how one eight-day-old baby was brought into the hospital on 23 December 2019 suffering from breathing difficulties and bleeding from the nose and mouth. It was only on the child's fifth visit to hospital - after a GP raised concerns - that a child safety examination took place, revealing rib and leg fractures that were deemed non-accidental. Ms Redhouse also heard how a month-old baby brought in with a mouth injury on 20 January 2019 was on a child protection plan but this was not spotted by the paediatric nurse who examined the baby. This child was twice released from hospital, with no safeguarding concerns, before a scan and other examinations revealed multiple fractures, the court heard. Prosecutor Ryan Donohue said failings had been identified in areas including policy implementation, training, reporting, auditing and governance. Eleanor Sanderson, mitigating for the trust, said: "The trust wishes to express to the court its deep regret for the circumstances which gave rise to these offences and the risk posed to those who required safeguarding." Read full story Source: BBC News, 26 October 2022
  21. News Article
    Senior staff have questioned why a major hospital did not seek support from neighbours when emergency patients were left waiting more than 60 hours to be admitted to a bed. Cambridge University Hospitals Foundation Trust’s emergency department came under severe pressure last week, with patients being bedded down in corridors and facing very long waits to be admitted to a ward. Senior sources told HSJ there were two cases where patients were waiting more than 60 hours last Monday, and the trust declared an internal incident. But the sources felt the trust should have escalated its alert level to “Opel 4”, which prompts calls for external support when trusts are under the most severe levels of operational pressure. This can include diverting ambulances to other hospitals. The trust apologised to patients who had been kept “waiting for a long time” but that the required threshold for Opel 4 had not been reached. Read full story (paywalled) Source: HSJ, 25 October 2022
  22. News Article
    More than 900 invitees converged on Manchester Central last night to find out which projects would emerge winners in the latest edition of our Patient Safety Awards. The awards recognise and reward the hard-working teams and individuals who, in these times of austerity, pay restraints and workforce shortages, are striving to deliver improved patient care. HSJ correspondent Annabelle Collins gave a welcome speech before comedian and writer Justin Moorhouse hosted the event, which was held at the end of the first day of the Patient Safety Congress. Ms Collins said: “Not only are you treating more and more patients, in difficult circumstances, you’re treating them safely and innovating during a time when the health service is being told by the government to be more efficient. To do more, with less. I think this makes your work and achievements even more special. This year, the awards were presented under four key areas: Clinical and specialist excellence; Enacting organisation-wide change; Proactive prevention and harm avoidance; and Service/system innovation. Read about the winners Source: HSJ, 25 October 2022
  23. News Article
    The NHS in Wales needs to "speed up the process" of treating people waiting over two years for hospital treatment, the health minister said. Eluned Morgan said health boards need to prioritise the "longest waiters and they're not always doing that". There are 59,350 people waiting over two years in Wales, although the number has fallen for a fifth month in a row. The Welsh NHS Confederation, which represents NHS health organisations, has been asked to comment. In Wales, there are 183,450 operations and procedures waiting more than a year. Overall waits - from referral to treatment - have passed 750,000. Scotland has 7,650 patients waiting more than two years, England has 2,646. Asked on BBC Politics Wales why so many more people are waiting longer in Wales, Ms Morgan said: "Our health boards need to make sure that they're taking people from the longest waiters and they're not always doing that." Read full story Source: BBC News, 23 October 2022
  24. News Article
    The troubled agency that supplies blood to the NHS has a ’very serious problem’ with racism, a staff survey has revealed. Six hundred staff at NHS Blood and Transplant were surveyed and the results have been summarised in an internal memo, seen by HSJ. It said 55% of respondents felt the problem of racism at NHSBT is “extremely or very serious”, while half had little confidence in the organisation’s recent efforts to tackle racial inequality. When contacted for comment, a NHSBT spokeswoman said the results were “difficult to read” and added that “we are deeply sorry to those who have experienced negative behaviour”. The issues over race and leadership come at perhaps the most operationally challenging period in NHSBT’s history. It is struggling to find enough staff for its donation clinics, which meant it issued its first-ever “amber alert” over blood supplies recently. Read full story (paywalled) Source: HSJ, 21 October 2022
  25. News Article
    Paramedics in England cannot respond to 117,000 urgent 999 calls every month because they are stuck outside hospitals looking after patients, figures show. The amount of time ambulance crews had to wait outside A&E units meant they were unavailable to attend almost one in six incidents. Long delays in handing patients over to A&E staff meant 38,000 people may have been harmed last month alone – one in seven of the 292,000 who had to wait at least 15 minutes. Of those left at risk of harm, 4,100 suffered potential “severe harm”, according to the bosses of England’s ambulance services. Read full story Source: The Guardian, 21 October 2022
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