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  1. News Article
    Ambulance crews could not respond to almost one in four 999 calls last month – the most ever – because so many were tied up outside A&Es waiting to hand patients over, dramatic new NHS figures show. An estimated 5,000 patients in England – also the highest number on record – potentially suffered “severe harm” through waiting so long either to be admitted to A&E or just to get an ambulance to turn up to help them. Ambulance officers warned that patients were dying every day directly because of the delays since the service could no longer perform its role as a “safety net” for people needing urgent medical help. “The life-saving safety net that NHS ambulance services provide is being severely compromised by these unnecessary delays and patients are dying and coming to harm as a result on a daily basis,” said Martin Flaherty, managing director of the Association of Ambulance Chief Executives (AACE), which represents the heads of England’s 10 regional NHS ambulance services. Flaherty added: “Our national data for hospital handover delays during October 2022 is extremely worrying and underlines the fact that in some parts of the country efforts to reduce or eradicate these devastating and unnecessary delays are simply not working.” Read full story Source: The Guardian, 23 November 2022
  2. News Article
    Greater Manchester’s mental health trust has been placed into the ‘equivalent of special measures’, the Manchester Evening News can reveal. The crisis measures enforced by the NHS come after allegations that patients were abused at a mental health unit run by the beleaguered trust. The Edenfield Centre is a mental health care facility in the grounds of the former Prestwich Hospital and was the subject of a BBC Panorama programme that claims patients were abused. Since the episode aired, 30 staff are facing disciplinary action and a dozen have already been sacked, the Manchester Evening News understands. The chair of the trust, Rupert Nichols, resigned last week after 'inexcusable behaviour and examples of unacceptable care' were 'exposed' at a mental health unit, he said. Now, NHS England is placing the Recovery Support Programme, the 'equivalent to the former special measures', multiple senior NHS sources say. Greater Manchester Mental Health NHS Foundation Trust (GMMH) is now under the highest level of NHS England intervention, the M.E.N. can confirm. Every trust is part of the NHS' Oversight Framework, those placed into its highest level are identified as experiencing the most significant and complex challenges in achieving financial sustainability and/or high-quality care receive intensive mandatory support. Read full story Source: 23 November 2022, Manchester Evening News
  3. News Article
    Performance failings at NHS Supply Chain are impacting patient care, staff wellbeing and retention, and local procurement teams are struggling to mitigate their impact, local procurement chiefs have claimed. The group of senior NHS buyers have raised their concerns in a highly critical letter to NHS Supply Chain chief executive Andrew New and NHS England’s chief commercial officer Jacqui Rock. The letter, seen by HSJ, was signed by 22 heads of procurement at trusts and integrated care systems. It raises concerns about the NHSSC’s core functions, like delivering products on time and in full, its governance, and highlights unanswered questions about how it interacts with NHSE’s new central commercial function. Read full story (paywalled) Source: HSJ, 22 November 2022
  4. News Article
    The Care Quality Commission (CQC) has hired two independent whistleblowing champions, Joy Warmington and Arpita Dutt, to oversee a major review of how it listens to concerns. The CQC previously announced it had appointed Zoe Leventhal KC, of Matrix Chambers, to lead the first phase of the review, which is considering how the CQC handled protected disclosures made by Shyam Kumar, an orthopaedic surgeon at University Hospitals of Morecambe Bay Foundation Trust, and whether ethnicity “played any part in the management of those disclosures”. On Friday it issued details of the second phase of the work, including that it had brought in two outside experts, and long-time champions of whistleblowers, to “help to ensure the independence and credibility of the review”. This was launched amid wider concerns about how it responds to whistleblowing concerns in the service and among its own staff, including potential discrimination and also comes as the CQC itself seeks to begin a major restructure. Read full story (paywalled) Source: HSJ, 22 November 2022
  5. News Article
    The government has been urged to protect “catastrophically” under-resourced mental health social services after a vulnerable man was discharged from a hospital into a Travelodge. Will Mann, a 42-year-old with long-term mental health illness, was “abandoned” by social care services after he was discharged from an NHS hospital, his mother Jackie has said. Speaking with The Independent, Jackie Mann, explained how Will, who had to declare himself homeless before his discharge this year, was told the only available housing accommodation for him was a Travelodge. Mr Manns story has sparked warnings over the state of the shortage of social care and supported accommodation for those with severe mental illness, from the charity Rethink Mental Illness, which warned: “This is another reminder of how the crisis engulfing social care is impacting people’s lives, and why the government must protect mental health in the upcoming budget.” In an interview with The Independent, Jackie Mann, Mr Mann’s mother said: “He had to go straight from there to a Travelodge in Christchurch, which was a very unsuitable place because it was just a room, no cooking facilities. “During the time he was there, nobody came to visit him, he was just sort of abandoned there and during his time there, he was told he had to leave the Travelodge and go to another one because that Travelodge was overbooked.” According to our major charity Rethink, the shortage of “appropriate accommodation” is one of the biggest drivers of delayed discharges for mental health patients. Read full story Source: The Independent, 21 November 2022
  6. News Article
    A coroner has written to the health secretary warning a lack of guidance around a bacteria that could contaminate new hospitals' water supply may lead to future deaths. It follows inquests into the deaths of Anne Martinez, 65, and Karen Starling, 54, who died a year after undergoing double lung transplants at the Royal Papworth Hospital in Cambridge in 2019. Both were exposed to Mycobacterium abscessus, likely to have come from the site's water supply. The coroner said there was evidence the risks of similar contamination was "especially acute for new hospitals". In a prevention of future deaths report, external, Keith Morton KC, assistant coroner for Cambridgeshire and Peterborough, said 34 people had contracted the bacteria at the hospital since it opened at its new site in 2019. He said the bacteria "poses a risk of death to those who are immuno-suppressed" and there was a "lack of understanding" about how it entered the water system. There was "no guidance on the identification and control" of mycobacterium abscesses, the coroner said. Mr Morton said documentation on safe water in hospitals needed "urgent review and amendment". "Consideration needs to be given to whether special or additional measures are required in respect of the design, installation, commissioning and operation of hospital water systems in new hospitals," he said. Read full story Source: BBC News, 22 November 2022
  7. News Article
    When David Morganti’s case notes landed on Andrew Cox’s desk this autumn they told a devastating story — but one which was depressingly familiar to the senior coroner for Cornwall. The 87-year-old RAF veteran had fallen and hit his head in the bathroom of the house he shared with his wife, Valerie, in April. It took nine hours for paramedics to reach their home near St Austell, Cornwall. As they waited, the bleeding on his brain became gradually worse until he lost consciousness. By the time he reached hospital it was too late. An expert neurosurgeon told Cox that had he reached hospital faster, Morganti might have survived. The coroner said the effects of the injuries he suffered were likely to have been exacerbated “by a delay in the arrival of an ambulance and his subsequent admission into hospital.” It was the latest in a series of similar deaths the coroner had encountered. After Morganti’s inquest, Cox resolved to carry out a wider investigation into what appeared to be a broken system. He has now sent his findings to Steve Barclay, the health secretary, and demanded he act to prevent more deaths. Read full story (paywalled) Source: The Times, 19 November 2022
  8. News Article
    Health spending over the next two years will grow less than during the austerity era of the last decade, according to a new analysis of the autumn statement. The chancellor, Jeremy Hunt, a former health secretary who previously campaigned for greater resources from the backbenches, announced last week that the NHS would receive an extra £3.3bn in each of the next two years. With severe pressures growing on the service, he said it would be one of his “key priorities”. However, research by the Health Foundation charity has found that when the whole health budget is included – covering the NHS, training, public health services and capital investment – it will only increase by 1.2% in real terms over the next two years. That is below the 2% average seen in the decade preceding the pandemic, as well as the historical average of about 3.8%. The research comes as NHS trusts face almost impossible decisions over staff wages, waiting lists and keeping buildings and equipment up to date. The Health Foundation analysis highlighted the continued “significant uncertainty” facing the delivery of health services over the remainder of this parliament. It said there were now “difficult trade-offs” on issues such as pay and the backlog. Anita Charlesworth, director of the Real (Research and economic analysis for the long term) Centre at the Health Foundation, said that there had been “short-term relief” for the health service, especially when compared with the cuts made to non-protected departments. However, she said it would be “treading water at best as inflation bites and it faces rising pressures from an ageing population, pay, addressing the backlog and continuing Covid costs”. “If other parts of the system – especially social care and community care – are also struggling with cost pressures, this makes it harder to deliver healthcare and the 2% will buy less,” she said. “Efficiency can only take the NHS so far. Since 2010, if we had kept up with German health spending we’d have spent £73bn more each year, and £40bn more if we’d kept up with France.” Read full story Source: The Guardian, 19 November 2022
  9. News Article
    Paramedics describe a health service in crisis with a lack of investment and increasing demand, of lengthy waits to transfer patients to hospitals and of a social care system facing collapse. So what does a typical ambulance shift look like? The area covered by the East of England Ambulance Service's nearly 400 front-line ambulances is vast. In 2020-21, the service received nearly 1.2 million 999 calls. Ed Wisken has been a paramedic for 13 years. An advanced paramedic specialising in urgent care, Mr Wisken says: "It is really sad to see patients who have had to wait such a long time for an ambulance - but this is just the culmination of years of underfunding and of reduced resources peaking now where demand outstrips supply." "It is upsetting to see it," he says. "It is not nice to see people who have been waiting hours and hours for an ambulance - but we have really hit crisis point now." He says the morale of fellow paramedics and other healthcare workers is currently very low. "The key is you just have to do just one job at a time and just take the patients that you see and do the best for them," he says. "If you worry about the bigger picture too much you will get frustrated and angry - but that's not going to be beneficial for yourself or your patients." Read full story Source: BBC News, 21 November 2022
  10. News Article
    NHS leaders in Scotland have discussed abandoning the founding principles of the service by having the wealthy pay for treatment. The discussion of a "two-tier" health service is mentioned in draft minutes of a meeting of NHS Scotland health board chief executives in September. They also raise the possibility of curtailing some free prescriptions. Scotland's Health Secretary Humza Yousaf insisted the NHS would stay publicly owned and publicly operated. He added that health services "must always" be based on individual patient need and "any suggestion" that it should be about the ability to pay was "abhorrent". The minutes of the meeting seen by BBC News highlight the degree of official concern about the sustainability of Scotland's NHS in its present form. They include suggestions that hospitals should change their appetite for risk by aiming to send patients home more quickly, and pause the funding of some new drugs. The group were advised that they had been given the "green light to present what boards feel reform may look like" and that "areas which were previously not viable options are now possibilities". Describing a "billion pound hole" in the budget, the minutes warn that it "is not possible to continue to run the range of programmes" the NHS currently offers while remaining safe "and doing no harm." And they warn that: "Unscheduled care is going to fall over in the near term before planned care falls over." Read full story Source: BBC News, 21 November 2022
  11. News Article
    Nearly a fifth of trusts providing maternity care have been red rated for their infant mortality rates in a national audit. Twenty-three trusts were flagged for their perinatal mortality in the latest Mothers and Babies: Reducing Risk through Audit and Confidential Enquiries audit for maternity services. Trusts with mortality rates more than 5% higher than an average of peer group providers are given a red rating. The report was published last month and looked at data for 2020. Average perinatal mortality rates have been falling across England since 2013, although there is significant variation across England. Six trusts in the latest audit were red rated for both stillbirths and neonatal mortality; Buckinghamshire Healthcare; Gloucestershire Hospitals; University Hospitals Dorset; Sandwell and West Birmingham Hospitals; University Hospitals Coventry and Warwickshire; and University Hospitals of Leicester. Twenty-three trusts rated red on a combined perinatal mortality indicator (including the six listed above). For 17 of them, their mortality rates were not high enough on one of the stillbirth or neonatal measures to be red rated, but sufficiently high enough on both indicators to tip their overall extended overall perinatal rating into the red. Andrew Furlong, medical director of University Hospitals Leicester, said: “Where learnings have been identified from reviews of care, we have developed robust action plans and strengthened care practice to shape and improve future services.” These include aiming to improve access to interpreters, provide clearer medical review guidelines, and update ultrasound scanning processes, he added. Read full story (paywalled) Source: HSJ, 21 November 2022
  12. News Article
    Ambulance waiting times for stroke and suspected heart attacks have quadrupled in four parts of England since before Covid-19 – whereas others have only grown by half – underlining the severe impact of long accident and emergency handovers. Response times have leapt across England over the past two years, particularly for category 2 and 3 incidents, but the data makes clear that the steepest increases are in areas where hospitals have the biggest handover delay problems. Of the 10 patches with the largest increases in average category 2 performance between 2018-19 and 2021-22, four are served by major hospitals which make up NHS England’s “cohort one” of trusts selected for the worst handover problems; and four more are on government’s list of 15 which accounted for the most long handover delays last winter. The increase in handover delays – in turn linked to delayed discharge, staffing, lack of community services and social care’s collapse – are the stand-out reason for areas with a steep rise in response times. Read full story (paywalled) Source: HSJ, 18 November 2022
  13. News Article
    The NHS will receive an extra £3.3bn in each of the next two years, the chancellor has announced, but experts warn the cash is probably only half of what is needed to keep the health service afloat. Jeremy Hunt told the Commons during his autumn statement he had been assured the funding would mean the NHS can hit its “key priorities”. Its chief executive, Amanda Pritchard, later issued a statement welcoming the funding, saying it showed that “the government has been serious about its commitment to prioritise the NHS”. However, it was only last month that NHS England, the organisation Pritchard leads, had forecast a £7bn shortfall in its funding next year, which it warned it could not plug with efficiency measures alone. “The NHS warned it needed more money to cope with the impact of inflation on its costs,” said Nigel Edwards, the chief executive of the independent thinktank Nuffield Trust. “Today’s autumn statement has provided much-needed extra cash from April over the next two years, but this is only around half of what the NHS had warned last month would likely be needed.” Hunt pledged to grow the NHS budget in 2023-24 and 2024-25 by £3.3bn in each year. But Edwards warned that would not account for the £2.5bn worth of inflation and other unexpected cost pressures the NHS has faced in the current financial year. “The impact of today’s funding announcement is that real terms health spending per head after adjusting for age will increase by less than 1% for the next two years,” Edwards added. “This is compared to the long-term average of 2.6% and comes at a time when the NHS cannot afford to stand still and is desperately trying to increase the work it can do to clear record waiting times.” Read full story Source: The Guardian, 17 November 2022
  14. News Article
    The plan to tackle long waits in hospital treatment and cancer care in England by 2025 is at serious risk, the spending watchdog says. The National Audit Office report warned inflation and other pressures on the NHS could undermine the push. These included a lack of staff and hospital beds, which was affecting productivity, the watchdog said. But NHS bosses said they could overcome the challenges and the health service was on track to hit its targets. NHS England and the government have set a series of targets over the next three years. They include: returning performance on the 62-day target for cancer treatment to pre-pandemic levels by March 2023 ending waits of over a year and a half for planned treatment, such as knee and hip operations, by April 2023 ending waits of over a year for planned treatment by March 2025 The NAO report comes as the chancellor prepares to set out his tax and spending plans in his Autumn Statement on Thursday. Cuts to public spending are likely but Health Secretary Steve Barclay has strongly hinted the NHS will receive more money. Read full story Source: BBC News, 17 November 2022
  15. News Article
    Doctors have warned of "unsafe" maternity services at a Sussex hospital in emails seen by the BBC. In the email chain between senior staff at the Royal Sussex County Hospital in Brighton, consultants wrote of "compromises" to patient care. One doctor said during a birth "we were one step away from a potential disaster". One senior doctor wrote in the exchange that "increasing workforce issues" had contributed to making the situation in the maternity unit "almost unmanageable at times". They added: "We are making compromises to patient care every day as a result." Another wrote that their workload was often "unmanageable, and obviously impacted by the staffing issues". A senior member of maternity staff said "we are delivering suboptimal care" and "we are one step away from potential disaster". A doctor also said staff were being "stretched", and that there were delays to women's care. Another consultant wrote: "We have an unsafe service and we have to strive for better than that." Read full story Source: BBC News, 16 November 2022
  16. News Article
    Following the blistering verdict last week of the independent review into the General Medical Council's (GMC) handling of the notorious 'laptop' case, which highlighted the "worrying trend" of ethnic minority doctors facing disproportionate regulatory action, the GMC has launched a new resource 'hub' to support doctors facing racism at work. A new dedicated area on the GMC website offers advice on how to address racism in the workplace, and sits alongside its existing dedicated whistleblowing webpage as the latest of 12 areas in an 'ethical hub' that brings together resources on how to apply GMC guidance in practice, focussing on areas doctors often query or find most challenging, and helping to address important ethical issues. Announcing the launch, the GMC said: "Tackling discrimination and inequality continues to be an urgent priority for health services." It added: "The GMC has committed to working with organisations to drive forward change, setting targets on tackling inequality." Its equality, diversity, and inclusion targets set last year aimed, inter alia, "to eliminate disproportionate complaints from employers about ethnic minority doctors, by 2026, and to eradicate disadvantage and discrimination in medical education and training by 2031". In March this year it published its first progress report, which showed that the gap between employer referral rates for ethnic minority doctors and international medical graduates, compared with white doctors, had "reduced slightly". Read full story Source: Medscape UK, 15 November 2022
  17. News Article
    Hundreds of mental health patients in England are sent to hospitals miles from home each month because of local bed shortages - more than a year after the NHS aimed to end the practice. NHS data shows that 630 patients were in inappropriate out of area placements (OAPs) at the end of August 2022. An inappropriate OAP is when someone is sent to a hospital in a different area because no beds are free locally. Of the 630 patients in inappropriate OAPs in August 2022, more than half were sent away that month. In 2019, Kelly was sectioned and - because no local bed was free - sent to a hospital 23 miles from her home. "I didn't have anything on me", she says, "I only had my phone and the clothes that I was in." With family members too far away to bring her possessions, the hospital provided basics: pyjamas, trousers, a T-shirt, one pair of socks and two pieces of underwear. "All I could wear were the pyjamas and the same top and trousers every day for three weeks," says Kelly. "It was just awful. When you're stuck in a strange place as it is... It's even more distressing not having your own familiar things to take comfort in." Shortly after her discharge, Kelly was sectioned again - this time closer to home. She says this made a "massive difference", adding: "When you're closer to home you've got your friends and your family coming to visit you and take you out for a walk." Paul Spencer, the charity Mind's head of health, policy & campaigns, describes OAPs as traumatic, isolating and costly to the NHS. He says that "people are cut off from their support networks right at the very moment they need them most". Read full story Source: BBC News, 16 November 2022
  18. News Article
    The national director for mental health has said she was shocked to discover how many ward managers do not work at weekends, adding this could contribute to abuse and poor care going undetected. Asked at the NHS Providers conference about recent reports into care scandals, NHS England’s director for mental health Claire Murdoch said it was crucial to listen to frontline staff, such as healthcare assistants, who spend most of their time with patients. But she added: “[It’s also] making sure your ward managers do work of a night and at the weekend. “I’ve been a bit shocked to hear that we’ve moved with agenda for change and quite often ward managers are Monday to Friday people.” Her comments come amid a string of high-profile care scandals, such as at the Edenfield Centre in Greater Manchester, as well as an ongoing debate around seven-day working across the NHS. It is understood Ms Murdoch is concerned managers are spending too much time on bureaucratic tasks, which typically happen during Monday to Friday shifts, meaning they are then not working night or weekend shifts. In September, the national director ordered all trusts to carry out safety reviews, warning in a letter they should leave “no stone unturned” in seeking to eradicate and prevent poor care. She also urged all boards to urgently review safeguarding of care in their organisations, and identify any immediate issues requiring action now. Read full story (paywalled) Source: HSJ, 15 November 2022
  19. News Article
    Directors of a major hospital have ordered their accident and emergency staff to continue receiving ambulance patients into their department “in all instances”, following angry exchanges with paramedics. Hospital staff and ambulance crews have clashed at the new Royal Liverpool Hospital since its opening last month, after ambulance crews were prevented from bringing patients inside accident and emergency department when it was deemed to be full to capacity. The problems were escalated to hospital directors and North West Ambulance Service Trust earlier this month, resulting in new instructions being issued to the emergency department. In a letter to managers in A&E and the other divisions, seen by HSJ, the three most senior directors at the Royal Liverpool, wrote: “As you are aware we are currently experiencing long delays in accepting handover of patients from ambulance crews. “This phenomenon is not unique to us at the Royal Liverpool, nor is it particularly new, but our recent challenges have undoubtedly been exacerbated due to teams still familiarising themselves with working in a new environment and the patient flow challenges we have been experiencing on site. “However, what has changed has been the extent to which we have managed these pressures by continuing to hold patients in the back of ambulances, which we collectively agree is an unacceptable situation. Whilst providing corridor care is not what any of us would aspire to, we have to recognise and respond to the risk of patients awaiting response in the community. “We have therefore today met with NWAS colleagues and agreed that, with immediate effect, we will, in all instances, continue to receive crews from NWAS into the hospital building.” Read full story (paywalled) Source: HSJ, 16 November 2022
  20. News Article
    A Northern Ireland hospital closed its doors to new admissions on Saturday night because conditions had become unsafe, a health chief has said. Jennifer Welsh, chief executive at the Northern Health Trust, said the situation in the emergency department (ED) at Antrim Area Hospital on Monday remained “extremely pressured”. A major incident was declared at the weekend when a high number of critically ill patients arrived in quick succession at the Co Antrim hospital, prompting the decision to temporarily close the doors to new admissions. Ms Welsh said there were 45 patients in the ED on Monday for whom a decision to admit had been made, but for whom no bed is available. She told the BBC Good Morning Ulster programme: “That would have been unthinkable about four or five years ago, we would have never seen numbers like that." She said: “We had a high number of people arriving. A very high number of patients in the department. “At the time we called the incident there were 131 patients and about 66 of them had a decision to admit and no bed available. “At that stage our resuscitation unit was already full, it was over full. “Then we got the news we had three more standby ambulances coming in. That is critically ill patients who had to be brought into our resuscitation department as quickly as possible and we simply could not cope. “The safest thing to do in those circumstances is to call the major incident, to effectively close the door and what that means is that people are conveyed to the next nearest emergency department to ensure they begin the urgent treatment that they need because we were not able to do that. “It was the right call to say that it was unsafe. It was unsafe at that time.” Read full story Source: The Independent, 14 November 2022
  21. News Article
    A policy change to speed up hospital discharge could save the NHS more than £7bn over a decade, according to a government evaluation – but ministers have not funded it. A Department of Health and Social Care impact assessment of the Health and Care Act, passed earlier this year, says that wider use of discharge to assess could free up as many as 6,000 hospital beds and save the NHS £7bn by 2031, the equivalent of £800m a year. It adds: “The overall societal benefits of this would likely be higher as beds could be allocated to patients with more urgent health care needs.” The “discharge to assess” approach, which has been used on a temporary basis for several years and more widely during the pandemic – with government funding to back it – sees patients discharged more quickly, and provided with support at home while their long-term care needs are assessed. It was credited with significant reductions in the amount of time patients spent in hospital. Changes in the Health and Care Act were intended to remove legal obstacles to the approach, by revoking a requirement for an assessments be carried out before discharge, which often leads to delays in the patient leaving hospital. Read full story (paywalled) Source: 15 November 2022
  22. News Article
    Doctors and nurses are “absolutely frightened and petrified” about how bad this winter will be for the NHS in England, hospital bosses have revealed. Staff fear services will not be able to cope with a combination of flu, resurgent Covid, winter and the cost of living crisis damaging people’s health, and also the wave of looming strikes over pay. “People are genuinely scared,” said the chief executive of one acute NHS trust in England. “I’m talking to senior clinicians and consultants and nurses who are absolutely frightened and petrified about what’s potentially to come,” added the hospital boss, speaking on condition of anonymity. Staff are anxious because of “the potential for the impact of Covid and flu, the impact of industrial action, the impact of cost of living, the impact on people’s health from that, [and] the massive increases in mental health need, and the breakdown in primary care and social care.” Chiefs of other NHS trusts in England said they shared that gloomy prognosis. They are bracing themselves for having to curtail and cancel services on days when staff stop work over pay, including outpatient clinics and non-urgent surgery. The NHS will face an “onslaught” this winter, one said. Read full story Source: The Guardian, 15 November 2022
  23. News Article
    Trust leaders have raised concerns about other major unions striking on the same dates as the Royal College of Nursing in co-ordinated action, which would make avoiding disruption and harm ‘more hairy’. The concerns were raised after the Royal College of Nursing confirmed members at various trusts had voted in favour of unprecedented action last week, with Unison and a raft of other unions also balloting members on strike action this month and in December. Unison told HSJ co-ordinated action between itself, the RCN and the other health unions was “the best way to ensure industrial action is effective”. One senior trust leader said that while the RCN strike days would prove a major challenge, they predicted their trust would be able to cope with the fallout. But they said the challenge would get even “more hairy” if Unison members also walked out on the same dates – a prospect they feared likely. HSJ also understands that trust bosses have concerns about what will and won’t be classified as urgent and also about the emergency work to be carried out throughout a strike. One senior provider figure used the example of insulin injections, which are at present to be part of the urgent and emergency care activities to continue throughout a strike, and wound treatment services, which, at this stage, are not. They said: “If people don’t get those [insulin] injections twice a day, that person, by the end of 24 hours, will be in hospital [but] we are negotiating on [other areas] for example wound care. If you don’t dress people’s wounds at the right time, the worst situation is that a [deteriorating] wound means your leg has to be chopped off. At the moment, doing wound care is not being considered urgent care.” Read full story (paywalled) Source: HSJ, 15 November 2022
  24. News Article
    A Guardian analysis has found that as many as one in three hospital beds in parts of England are occupied by patients who are well enough to be discharged, with a chronic lack of social care meaning many do not have suitable places to go. Barry Long's 91-year-old mother has Alzheimer’s and was admitted to Worthing hospital on 30 May after a minor fall. She was a bit confused but otherwise unhurt, just a bit shaken. Whilst in hospital, she caught Covid and had to be isolated, which she found distressing, and became increasingly disoriented. She was declared medically fit to be discharged but no residential bed could be found for her. Then, in August, she was left unsupervised and fell over trying to get to the toilet and she fractured her hip, which required surgery. Her hip was just about healed when she caught her shin between the side bars and the frame of the bed, cutting her shin so badly that she is being reviewed by a plastic surgeon to see if it needs a skin graft. "Since the operation, my mum is pretty much bedbound and lives in a state of confusion and anxiety", says Barry. "Her physical health and mental wellbeing have deteriorated considerably in the almost five months she has spent in the care of the NHS. She spends all day practically trapped in bed, staring into space or with her eyes shut, just rocking to and fro. She has little mental stimulation." Read full story Source: The Guardian, 13 November 2022
  25. News Article
    Ambulances called to serious emergencies in the East of England, which encompasses Essex, have the longest waiting times of anywhere in the UK, according to new data. The East of England Ambulance Service, which serves the county of Essex, has the longest wait times for life-threatening injuries of anywhere in the country. Ambulances took an average of 11 minutes and 12 seconds to respond to category one calls - those for life threatening injuries - in the Essex region in October. That’s up from 10 minutes 49 seconds in September, and far longer than the 7 minute target set by the NHS. This means it’s also the longest category one response time of any ambulance service in England, as compared to the average wait time for ambulances across England as a whole, category one calls were responded to in an average of 9 minutes and 56 seconds. A spokesperson for the East of England Ambulance Service said: "Our service is under extreme pressure with many ambulances delayed outside hospitals and high call volumes. "To help us respond effectively we have increased our escalation state across the Trust. We urge the public to please support us by using our services wisely and only calling for life-threatening illnesses and injuries." Read full story Source: Essex Live, 10 November 2022
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