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Found 1,519 results
  1. News Article
    The availability of ambulances to transfer patients to specialist units is a "matter of concern", a coroner has warned. Darren Stewart, area coroner for Suffolk, made the comments in a Prevention of Future Deaths report. It followed the death of 84-year-old Dennis King, who waited three hours to be transferred from West Suffolk Hospital to Royal Papworth in 2022. Mr King had made his own way to the West Suffolk Hospital's accident and emergency department in December 2022, after being told an ambulance could take six hours to arrive at his home due to high demand in the area, the report said. His call had been graded as category two, which should have led to a response within 40 minutes - or a target of 18 minutes. After tests at West Suffolk Hospital showed Mr King had suffered a STEMI heart attack, emergency clinicians liaised with experts from the regional heart unit and decided he needed an urgent transfer to Royal Papworth in Cambridgeshire. The report said a matron at West Suffolk told ambulance call handlers they needed an urgent transfer - but because Mr King was classed as being in a "place of safety", control room staff said the delay would be "several hours". Mr Stewart said: "the availability of ambulances to carry out transfers in a timely manner, in urgent cases" was "a matter of concern". In the report, Mr Stewart said the circumstances of the case "raised concerns about the NHS approach to centralising care in regional centres" if the means to deliver it were "inadequate". Read full story Source: BBC News, 23 January 2024
  2. News Article
    To help patients with high-risk pregnancies receive care at hospitals that are staffed and equipped to deliver care appropriate to their needs, the Department of Public Health will require licensed birthing hospitals to use a system called Levels of Maternal Care. The system classifies hospitals based on their capacity to meet the needs of patients with a range of potential complications during childbirth. The impetus is the rising levels of severe maternal morbidity, large racial disparities in outcomes, and concerns that higher-risk patients who deliver in hospitals that over-estimate the level of care they are able to provide are more likely to experience complications. Levels of care describe a hospital’s physical facilities, capabilities and staffing, indicating its ability to serve people giving birth across a range of medical needs. For example, Level 1 is appropriate for low-risk patients with uncomplicated pregnancies, including twins and labor after cesarean delivery. To that group, Level II adds patients with poorly controlled asthma or hypertension and other higher-risk conditions. Subsequent levels include patients at increasingly high risk of complications, up to Level IV, which is appropriate for patients with severe cardiac disease, those who need organ transplant and others. Established by the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine in 2015, the classification system is one tool used by states across the country to improve maternal health and birthing outcomes. Read full story Source: Betsy Lehman Center. 17 January 2024
  3. News Article
    Theatre staff at a major hospital “deliberately slowed down” elective activity to limit the number of operations that could be done each day, an NHS England review has been told. The culture in theatres at the William Harvey Hospital in Ashford, run by East Kent Hospitals University Foundation Trust, was a “significant issue” according to an education quality intervention review report into trauma and orthopaedic training at the hospital. The review, dated October and made public by NHSE in December 2023, was launched after concerns were raised by staff at the trust in the General Medical Council’s national training survey, published every July. Problems raised by junior doctors and their supervisors to the NHSE review included perceptions that juniors were made to feel uncomfortable by the trauma theatre team and that there was also “animosity” from the trauma theatre team towards surgeons. The review said trauma theatre staff were heard “bragging” about their behaviour towards surgeons and that they resisted the number of cases scheduled on a list, claiming it was “unrealistic". Read full story (paywalled) Source: HSJ, 19 January 2024
  4. Content Article
    Meeting cancer performance targets is a challenge for many trusts with waiting times for diagnosis and treatment growing since the pandemic. But this is a worrying time for patients as well, and they would welcome quicker turnaround of results and diagnosis. Cutting time out of this pathway would benefit everyone but are there ways to do this which do not compromise patient safety? An HSJ webinar, in association with SS&C Blue Prism, addressed this important question and tried to find ways trusts could reduce waiting times.
  5. News Article
    The mother of an 11-year-old Aberdeenshire girl with Long Covid has launched a legal action against their health board, in what lawyers claim is the first case of its kind in Scotland. Helen Goss, from Westhill, is seeking damages from NHS Grampian on behalf of her daughter, Anna Hendy. The action claims the health board is responsible for "multiple failings" in Anna's treatment and care. The claim alleges failings were avoidable, that they caused Anna "injury and damage", and led to her condition worsening. Anna became unwell after contracting Covid in 2020. The action alleges a number of failings by the health board. These include claims that requests for Anna to be referred to the specialist paediatric services of immunology and neurology were refused. It also claims no further help was offered after Anna was diagnosed with Chronic Fatigue Syndrome (CFS) and Paediatric Acute-onset Neuropsychiatric Syndrome (PANS). And it says these failings "could have been avoided had NHS Grampian followed contemporary guidance on diagnosis and treatment". Read full story Source: BBC, 19 January 2024
  6. News Article
    A hospital trust has been breaching national guidance by excluding some long waiters from its reported waiting list figures, in a move experts warned could put patient safety at serious risk. The practice appears to have helped Sandwell and West Birmingham Hospitals report zero patients waiting more than two years for treatment during most of last year. Its policy means cases that unexpectedly “pop up” as two-year waits in its datasets are temporarily removed. The trust will then review whether the cases are data errors or genuine two-year waits, and if genuine, aim to provide treatment within a month. If not treated within a month, the cases would be added back to the reported waiting list the following month. Rob Findlay, an expert on RTT waiting lists, said the implications of the SWBH policy are far more serious than simply reporting incomplete numbers for a month. He said allowing a month to deal with the pop-up without declaring it “relieves them of pressure to solve the problems that are causing patients to be lost in the first place”. He added: “Some patients – the hospital would never know – might never pop up and be lost from the waiting list forever. “[This is] a serious patient safety issue which could potentially have a significant impact on how long patients are waiting for treatment.” Read full story (paywalled) Source: HSJ, 19 January 2024
  7. News Article
    Half of surgeons in England have considered leaving the NHS amid frustration over a lack of access to operating rooms, a new survey shows. More than 3,000 surgeons contemplated quitting the health service in the last year, with two-thirds reporting burn out and work-related stress to be their main challenge, a new survey by the Royal College of Surgeons England has revealed. As the NHS tries to reduce the 7.61 million waiting list backlog, the survey, covering one quarter of all UK surgeons, found that 56% believe that access to operating theatres is a major challenge. RCS England president, Mr Tim Mitchell, said: “At a time when record waiting lists persist across the UK, it is deeply concerning that NHS productivity has decreased. “The reasons for this are multifactorial, but access to operating theatres and staff wellbeing certainly play a major part. If surgical teams cannot get into operating theatres, patients will continue to endure unacceptably long waits for surgery. “There is an urgent need to increase theatre capacity and ensure existing theatre spaces are used to maximum capacity. There is also a lot of work to be done to retain staff at all levels by reducing burnout and improving morale.” Read full story Source: The Independent, 18 January 2024
  8. Content Article
    In 2017-18, the Department of Health & Social Care (DHSC) implemented a new operating model and delivery body for NHS procurement known as NHS Supply Chain (to replace the previous, fully outsourced model which was also called NHS Supply Chain). The new body was responsible for procuring products, warehousing, and delivering goods on behalf of the NHS. NHS Supply Chain (Supply Chain) estimates that the NHS collectively spends approximately £8 billion annually on buying medical equipment and consumables, from gloves and paper to stents and prosthetic hips.
  9. News Article
    A record 420,000 patients had to wait more than 12 hours in A&E last year, analysis has shown. The latest NHS England figures revealed a 20% increase on 2022 in people facing lengthy delays after a decision to admit them to hospital from the emergency department. In 2023, 419,560 people – or one in 15 A&E patients – faced “trolley waits” of 12 hours or more, according to the Liberal Democrats, who compiled the analysis. It marks by far the highest number since records began in 2011, and amounts to an average of 1,150 patients a day. Ed Davey, the party leader, criticised the “appalling delays” and accused Rishi Sunak’s government of “ignoring the suffering of patients and driving our health service into the ground”. Significant waits in A&E have been linked to excess deaths and increased harm to patients, as their condition could deteriorate before they are admitted or given a bed on a ward. Davey said: “Every year A&E delays are getting worse and worse under this Conservative government as hospitals are starved of the resources and staff they need. These appalling delays are leaving often vulnerable and elderly patients waiting for hours on end in overcrowded A&Es." Read full story Source: The Guardian, 14 January 2024
  10. News Article
    More than 8,500 patients in England were being treated on virtual wards in the run-up to Christmas, figures have revealed, as the NHS moves to ease pressures on hospital capacity. However, experts said the so-called hospitals at home are not a “silver bullet to solve the crisis in health and social care”. Figures published by NHS Digital revealed some 8,586 patients were treated virtually in December 2023, up from 7,886 in November. The snapshot was taken on 21 December 2023, meaning it is likely those patients spent Christmas on a virtual ward rather than an actual hospital. Virtual wards allow patients to receive care in their own homes, with clinical staff using apps or wearable technology to monitor them remotely. Professor Sir Stephen Powis, NHS national medical director, said the “rapid expansion” of virtual wards beds and patients “is a real NHS success story”. He added: “This not only frees up vital hospital beds for those who need them most but ensures patients can recover in the place they are most comfortable with support from families, carers and friends, and while occupancy has been growing rapidly as NHS teams make the most of all bed capacity available, we want to see continued growth right across the country so as many patients as possible can benefit." However, Wendy Preston, the head of nursing practice at the Royal College of Nursing (RCN), said “virtual wards aren’t a silver bullet to solve the crisis in health and social care”. “Whether they’re in a physical bed or on a virtual ward, patients still need to be able to see a nurse,” she added. “But there are over 40,000 nursing vacancies across the NHS, and social care is chronically understaffed. Run effectively, virtual wards can relieve pressure, but on every single shift nursing staff are fighting an uphill battle to care for too many patients. “If the UK government wants to turn around the state of the NHS and deliver the ‘hospital level’ care at home that patients expect, nursing staff need to see game-changing investment in the workforce.” Read full story Source: The Independent, 15 January 2024
  11. News Article
    The NHS must treat at least 10% more non-emergency hospital cases a month if it wants to reduce the hefty backlog caused by the pandemic, according to new analysis. From February 2020 to October 2022, the waiting list for non-urgent care in England grew by 2.6m cases – a projected 1.8m more than if the pandemic had not hit. NHS England’s recovery plan aims to increase capacity by 30% by 2025 compared with pre-pandemic levels, but figures published on Thursday showed that the waiting list in England stood at 7.6m, down just 1.3% from the previous month. Researchers at the Universities of Edinburgh and Strathclyde examined the number of referrals awaiting treatment between January 2012 and October 2022. They calculated that an estimated 10.2m fewer referrals were made to elective care from the beginning of the pandemic to 31 October 2022. They then modelled how many of these missing patients might return for care to estimate the potential impact on waiting lists. NHS trusts would have to treat more than 10% to reverse the increasing trend in waiting lists, the authors conclude. “Even if the ambitious target of 30% increase in capacity is achieved during the next three years, several years (beyond the end of 2025) will be needed for the backlog to clear.” The research comes as NHS England monthly data published on Thursday revealed the health service is going backwards on some key targets. Read full story Source: The Guardian, 11 January 2024
  12. News Article
    Thousands of patients are being readmitted to NHS mental health units in England every year soon after being discharged, raising concerns about poor care, bed shortages and increased risk of suicide. Experts say being discharged prematurely can be upsetting, set back the patient’s chances of making a full recovery and be “disastrous” for their health. Figures from NHS mental health trusts in England show that last year almost 5,000 people – children and adults – were readmitted to a mental health facility within a month of leaving. The Labour MP Dr Rosena Allin-Khan said the “alarming” data, which she obtained under freedom of information laws, showed too many patients were not receiving enough help to recover. Allin-Khan said: “With record waiting lists and mental health beds in short supply, it is alarming that many patients are being discharged only to be readmitted within days. Every patient expects to receive full and appropriate mental health support, so it is concerning that in many cases patients are being discharged prematurely. “Being discharged too soon can have a disastrous impact, stunting progress towards a full recovery, ultimately causing further damage to a patient’s mental health.” Read full story Source: The Guardian, 12 January 2024
  13. Content Article
    A series of LinkedIn articles on systems thinking from Phil Evans, Independent HealthTech Consultant.
  14. Content Article
    Hospitals are complex adaptive systems. They are industrial environments where it isn't always possible to expect predictable responses to inputs. Patient safety management practices need to adapt to align with the environment in which events occur. It is time to reimagine safety event reporting and management solutions that guide, not prescribe, investigations and improvement actions.
  15. Content Article
    A story of a bereaved mother’s experience with the Coroner's Service in the aftermath of her previously well 25-year-old daughter Gaia’s unexpected and unexplained death and why she set up TruthForGaia.com in her search for the truth.  This case demonstrates systemic failings in the Coroner Service: the dismissive way that bereaved family members are treated through the inquest process and a lack of clinical curiosity to determine the primary cause of death.  This inconclusive inquest prompts wider questions about who speaks up for the dead. Just as we have Martha’s rule in life, should there be a Gaia’s rule in death to help families be heard about failed inquests? Gaia’s death and failed inquest are chilling reminders that this could happen to any one of us and our families.
  16. Content Article
    The USA National Nurses United is proposing for minimum, mandated, nurse-to-patient staffing ratios to protect patients’ right to nursing care. Every patient deserves a single standard of high-quality care. The ratios, coupled with nurses’ powerful voice of advocacy secured in collective bargaining, protect patients from complications that arise from missed care such as medical errors, health care disparities, infections, and so much more.
  17. Content Article
    The NHS remains under immense pressure. Each part of the system is experiencing demand beyond its capacity, which is continually increasing the problem. This is most vividly illustrated in urgent and emergency care settings. Each winter in the past decade has become slightly worse,2 and that trend, which has not been reversed, has resulted in a dire situation that may not yet have reached its nadir. A continuum of often predictable perfect storms has caused a struggling system to reach collapse, writes Tim Cooksley, immediate past president, Society for Acute Medicine in this BMJ opinion piece.
  18. News Article
    A coroner overseeing a teenager's inquest has warned there will be more deaths unless mental health services improve for autistic people at risk of self-harm. Morgan-Rose Hart, 18, who had ADHD, autism and a history of mental illness had been a patient at a unit in Harlow, Essex, for three weeks. An inquest jury concluded she died by misadventure contributed to by neglect. Ms Hart, from Chelmsford, died in hospital six days after she was found unresponsive in the bathroom of her mental health accommodation in the Derwent Centre in Harlow, Essex in July 2022. The inquest into her death heard staff observations were falsified and critical observations were missed. In her Prevention of Future Deaths report, Ms Hayes said: "There is a significant shortfall of appropriate placements for people with autism who have mental health and self-harm risks in Essex both inpatient and in the community." She added: "During the course of the inquest the evidence revealed matters giving rise to concern. "In my opinion, there is a risk that future deaths will occur unless action is taken." Read full story Source: BBC News, 8 January 2024
  19. News Article
    Trusts reduced the number of 65-week breaches by around 20% and cut the overall elective waiting list between October and mid-December, NHS England has said. The claim is based on provisional data published by NHSE on 2 January, which came with a warning of possible “significant issues regarding the quality and completeness”. The figures suggest the number of 65-week waiters fell from around 114,000 on 8 October to around 93,000 by 17 December. The last official “referral to treatment” figures were published last month (see table below). They reported there were around 107,000 65-week breaches in October. Sources familiar with the provisional data, from the “waiting list minimum data set”, said while it was not as accurate as official referral to treatment statistics, it gives an accurate picture of the direction of travel and overall performance. Read full story (paywalled) Source: HSJ, 3 January 2024
  20. News Article
    NHS England has been accused of bowing to political pressure and trying to “undermine” the junior doctors strike. British Medical Association council chair Philip Banfield tonight wrote to NHSE chief executive Amanda Pritchard accusing her organisation of the “weaponisation” of the process used to agree minimum services level during the strike. Junior doctors walked out yesterday to begin a six day strike, the latest in their 10 month campaign and the longest in NHS history. Professor Banfield’s letter claims that NHSE is not respecting the terms of the voluntary agreement to provide “derogations”. These, says the letter, “allow for junior doctors to return to work in the event of safety concerns arising from ‘unexpected and extreme circumstances’ unrelated to industrial action”. The BMA accuses trusts of not providing the information the union needs to determine if the requests for derogations are justified. It said that the lack of information provided by trusts had led to it turning down 20 requests for derogations. The letter states: “We are increasingly drawing the conclusion that NHS England’s change in attitude towards the process is not due to concerns around patient safety but due to political pressure to maintain a higher level of service, undermine our strike action and push the BMA into refusing an increasing number of requests; requests, we believe, would not have been put to us during previous rounds of strike action. “The change in approach also appears to be politicisation and weaponisation of a safety critical process to justify the Minimum Service Level regulations.” Read full story (paywalled) Source: HSJ, 3 January 2024
  21. News Article
    People in some more rural areas are missing out on specialist treatments they should be getting, while Londoners are receiving a lot more than their “fair share”, new NHS England figures suggest. NHS England has suggested the main cause is “systematic shortfalls in access [in] remote communities”, leaving “unmet need” for specialised services in these areas. However other factors, including coding and reporting practices, year-to-year fluctuation, and weaknesses in the formula, are also likely to be confusing the picture, sources said. The variation is being uncovered now because NHSE is preparing to fund many specialised services via allocations to integrated care boards. These allocations will be based on estimates of their populations’ healthcare needs, rather than NHSE negotiating payments directly with provider trusts – as it has since 2013. Read full story (paywalled) Source: HSJ, 3 January 2023
  22. Event
    until
    The health and care system continues to face profound challenges, whether it’s staff shortages, financial pressures, all-time low public satisfaction, or record high waiting times for elective care. At this free online event, our expert panel will provide insight and context into the wider health and care landscape, the challenges the sector is facing, and the big issues they want to see progress on in 2024. In the run-up to the anticipated general election, our panel will also explore how recent trends, political parties’ policy proposals and future developments could affect those working in the sector, as well as people, patients and communities. Join the discussion and share your comments and questions about the wider challenges and opportunities facing the health and care sector. Register
  23. News Article
    Hundreds of children’s appointments – including for lifesaving operations and cancer treatments – have been cancelled on each day that NHS strikes took place over the last year, as hundreds of thousands of youngsters languish on the waiting list for treatment, The Independent can reveal. More than 20,000 paediatric treatments and surgeries were shelved because of the walkouts, while the families of 400 children were told that their lifesaving operations had been cancelled. With junior doctors due to stage the longest strike in NHS history this week – for six days, starting on Wednesday – the problem is set to get worse. Dr Camilla Kingdon, president of the Royal College of Paediatrics and Child Health, warned that long waits for children can be particularly damaging, and can have a lifelong impact as treatment is often time-critical. She said that children are seldom prioritised in national policy-making, and urged the government to put children’s needs “back on the agenda”. Read full story Source: The Independent, 2 January 2024
  24. News Article
    NHS bosses fear patient safety could be compromised during this week’s junior doctors strikes if medics do not honour an agreement to abandon picket lines if hospitals become overwhelmed during the winter crisis. Hospital bosses can ask the British Medical Association (BMA) to allow junior doctors to return to work to help if an emergency arises during their six-day strike starting on Wednesday. But there is concern among health trust leaders that the doctors’ union could reject such “recall requests” – or take worryingly long to consider them – despite “highly vulnerable” hospitals having too few staff on duty to cope with a surge in patient numbers. A spike in cases of flu, Covid and norovirus has left the NHS under intensifying strain in the first week of the new year, a period in which its winter crisis often bites. On the eve of the 144-hour strike – the longest in NHS history – the NHS Confederation, which represents trusts, urged the BMA to ensure the “recall system” worked reliably if it was triggered. “With the next round of junior doctors strikes coinciding with what is always an exceptionally busy week for the NHS, health leaders hope that escalation plans run smoothly and with a shared understanding that protecting patient safety is the most important priority,” Danny Mortimer, the confederation’s deputy chief executive, said. Read full story Source: The Guardian, 1 January 2024
  25. Content Article
    The prevalence of noncommunicable diseases (NCDs) or chronic diseases is increasing in Europe. NCDs now account for 90% of deaths in the WHO European Region, yet most health systems were developed to treat and care for people with acute conditions. Health care services are still lagging behind in terms of responding to the particular needs of those living with chronic conditions, including diabetes, cardiovascular disease (hypertension and heart failure) and respiratory diseases (asthma and chronic obstructive pulmonary disease).  Policy-makers and health-care managers are working to better organize health services to reflect and cater to the needs of these patients, for example by strengthening integrated primary health-care services. Important work is also needed to increase people’s knowledge, skills and confidence to manage their own conditions on a day-to-day basis, outside of health-care settings. Patients spend on average 2 hours per year with their health professional and the rest of the time they need to take care of their health themselves. Supporting patients to self-manage their condition is crucial to improving outcomes and reducing anxiety and complications.  WHO Regional Office for Europe has published a new “how-to” guide for policy-makers, health professionals, and education and training bodies on therapeutic patient education (TPE). The guide covers commissioning, designing and delivering TPE services and training programmes for health professionals. It also looks at the evidence and theory underpinning patient education, outlines key components for delivering a high-quality service and identifies implementation opportunities and barriers. 
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