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Found 1,519 results
  1. Content Article
    This report from the NHS Confederation explores practical shifts towards population health and population health management approaches.
  2. News Article
    Thousands more elderly people will be stuck in hospital over Christmas because of junior doctors’ strikes, Age UK has warned. The charity is among several who have said the timing of the strikes, which begin at 7am on Wednesday means it will be “extremely difficult to ensure safe and effective care” during them. Age UK is one of five organisations raising fears over patient safety and making a plea to the British Medical Association (BMA) and Victoria Atkins, the Health Secretary, for a resolution to the dispute. Junior doctors’ walkouts are due to last until Saturday, with their longest strike to come early in the new year, while flu, norovirus and Covid hospitalisations are rising. In a joint letter with the NHS Confederation, Patients Association, National Voices and Healthwatch , Age UK said strike action in the days ahead could leave thousands of patients stranded in hospital for want of staff to get them discharged. The latest figures show 13,000 such cases in hospitals despite being medically fit for discharge. The charities said the withdrawal of almost half the medical workforce in England would mean the most vulnerable are left “bearing the brunt” of the pay dispute. “Our concern is that, despite the best efforts of hard-working NHS staff, it will be extremely difficult to ensure safe and effective care during this period for all patients that need it.” Read full story (paywalled) Source: The Telegraph, 20 December 2023
  3. News Article
    The traditional model of NHS dentistry is gone for good, experts are warning. The Nuffield Trust think tank said the service had been cut back so much it was now at the most perilous position in its 75-year history in England. It said restoring services would probably need an unrealistic amount of money and called for radical reform, suggesting NHS support may need to be completely scaled back for some adults. The Nuffield Trust said funding for NHS dentistry had suffered huge cuts in recent years. Some £3.1bn was spent in 2021-22 - a drop of £525m since 2014-15 once inflation is taken into account. It said the number of treatments being done each year was now six million lower than it was before the pandemic. The Nuffield Trust said tough policy choices needed to be made, suggesting one option could be to start charging adults for the full cost of treatment beyond emergency work and check-ups. Shawn Charlwood, chairman of the British Dental Association's general dental practice committee, said the report "reads like the last rites for NHS dentistry" and that "patients and this profession deserve some honesty here". He added: "The government say NHS dentistry should be accessible for all who need it. "The plain facts are we're not seeing any evidence of the reforms or the resources to realise that ambition." Read full story Source: BBC News, 19 December 2023
  4. Content Article
    NHS-funded dental services in England are in near-terminal decline: nearly six million fewer courses of NHS dental treatment were provided last year than in the pre-pandemic year; funding in 2021/22 was over £500m lower in real terms than in 2014/15; and there are widespread problems in accessing a dentist. So what is to be done? This major new policy briefing from the Nuffield Trust proposes a series of short-term actions relating to appointment recall intervals, commissioning and the workforce. It also sets out two approaches for longer-term action, which involve improving the current dental model or adjusting the NHS offer.
  5. Content Article
    The Cultural Awareness Hub is a national service which provides interactive, expert experience and sustainable workshops which offer unique insights into culture and history for all organisations working with and supporting the public. It helps organisations to understand and identify barriers to services, while providing realistic and achievable solutions to ensure effective and efficient collaborative engagement is embedded with all communities. The training is developed to transform knowledge and empower both participants and the communities they are supporting. Understanding and respecting different cultures and communities is essential to ensure all services provide personalised care. Training provided through The Cultural Awareness Hub is subject to a fee, please contact us for more information. To find out more and to discuss creating your own training package, please contact TheCulturalAwarenessHub@EELGA.gov.uk.
  6. News Article
    Urgent action is needed to address NHS computer failings which are causing harm to patients, the patient safety watchdog has told BBC News. The watchdog has evidence of patient deaths due to IT system errors. The government called the reports "concerning" and said it would work with NHS England to take necessary action to protect patients. A recent investigation found thousands of hospital letters were unsent due to computer issues. The Health Services Safety Investigations Body (HSSIB) says IT failures are among the most serious issues facing hospitals in England. "We have seen evidence of patient deaths as a result of IT systems not working," said interim head, Dr Rosie Benneyworth. Dr Benneyworth cited the example of a patient who was found unresponsive and then wrongly identified by healthcare staff as not wishing to be resuscitated. Staff were unable to access information on the patient quickly through their IT system, which would have shown a mistake had been made, said the watchdog. Read full story Source: BBC News, 16 December 2023
  7. Content Article
    This overview provides detail on the structure of NHS England’s executive group.
  8. Content Article
    What is the impact of the poor condition of equipment and buildings? In September, the Chief Financial Officer of NHS England, Julian Kelly, told the Public Accounts Committee that every day ‘hospitals are having to shut units and decant patients into other spaces’. St Peter’s Hospital in Essex, a former Victorian workhouse, has had to relocate some inpatient services to other hospitals this winter amid issues with a leaking roof, weak flooring and broken lifts. And Queen Elizabeth Hospital in King’s Lynn has more steel props to stop RAAC (reinforced autoclaved aerated concrete) collapsing in its buildings than it does hospital beds. Underinvestment impacts the delivery of care, causing disruption for patients, and adding to the burden on staff who have to negotiate working in dilapidated buildings on top of their workload.  
  9. News Article
    Ambulance handover delays rose last week with close to 13,000 crews waiting more than an hour to offload patients — marginally more than the comparable week last year. Week of 27 November 2023 figures were missing data for several days from some trusts, NHSE said. The number of hour-plus waits for ambulancs to pass patients to emergency departments was 12,797, according to new NHS England data. That appeared to be steeply up from about 8,000 in the past two weeks, although NHSE said last week’s was not directly comparable due to missing data. It was just ahead of the 12,534 recorded for the week ending 11 December last year. Last year the numbers rose to over 16,000 in the third week in December then peaked at 18,720 in the week running up to New Year, in what many said was the worst winter crisis for decades, amid a sharp, early wave of flu. This year the numbers of long waits have risen earlier than last, and several ambulance trusts have reported coming under severe pressure in the last few days. NHS England has warned junior doctors strikes next week and in the new year may compound hospital flow problems. Read full story (paywalled) Source: HSJ, 15 December 2023
  10. Content Article
    Hearing and listening to patients is at the centre of patient safety. As healthcare services in England work to bring to reality the transformation sought in the NHS Patient Safety Strategy (July 2019), independent sector providers have the challenge of ensuring that they too provide an equal opportunity for private patients' voices to be heard. Taking complaints seriously, having robust processes and learning from them is integral to this, as ISCAS Director Sally Taber explains in her blog. 
  11. Content Article
    Since the launch of the national Perinatal Mortality Tool (PMRT) in early 2018, over 23,000 reviews have been started. This fifth annual report presents the findings for reviews completed from March 2022 to February 2023 coinciding with the third year of the global health emergency due to the COVID-19 virus.
  12. News Article
    A trust is reviewing more than 100,000 patients on its outpatient lists, after concerns emerged that some had ‘been lost whilst on hold’ for follow-up appointments. A report from Buckinghamshire Healthcare Trust, leaked to HSJ, found 116,575 patient records without a scheduled follow-up after an outpatient consultation, with more than half of those left inappropriately without action, some dating back a decade. The review was triggered after staff spotted cases in which patients had been “lost whilst on hold”, the report said. The trust this week told HSJ that, since the initial discovery in the summer of last year, it had been validating the lists and reduced the number of outstanding records to 47,778. It aims to complete the reviews in the next two months. It told HSJ it had undertaken a harm review and found no “systemic harm”. Concerns have been raised over several years about the extent of overdue and unreviewed patients on follow-up lists, and the potential for them to deteriorate and come to harm. There are no national figures monitoring the patients, many of whom have long-term health needs. Read full story (paywalled) Source: HSJ, 15 December 2023
  13. Event
    until
    Many people recognise that both the NHS and the health of the nation are in deep crisis. Whether in terms of life expectancy, levels of long-term ill health, inequalities, mental health, or the drivers of poor health such as obesity, England’s recent record is poor and often compares badly to its neighbours. Essentially, there is now a need to think differently about how to design and deliver health and care services to meet the challenge of reducing health inequalities.  This two-day virtual event from the King's Fund will bring together individuals and teams who have been working on shaping, informing and implementing strategies and action plans to address health inequalities at system, regional and place levels. Ahead of the upcoming general election, sessions will also provide an opportunity to discuss and explore the need for urgent action and policy change for the new government to improve population health and implement measures that help people to make healthier choices. Showcasing both international and domestic case studies, this conference will also explore how the health and care system is working in partnership with local authorities, the voluntary, community and social enterprise (VCSE) sector and community leaders to develop a collaborative approach to health inequalities that makes the most of local assets and networks and meets the needs of local communities. Register
  14. News Article
    The trusts paying the highest premiums for clinical negligence as a proportion of their income have been revealed through HSJ analysis of internal data. Several acute trusts in and around London are now spending more than 4% of their income on premium costs to insure themselves against clinical negligence, according to internal NHS data. One expert suggested trusts with higher proportions of ethnic minority patients often have high rates of negligence claims against them, partly due to the complexity of medical presentation, but also communication problems. Lisa Jordan, head of medical negligence at law firm Irwin Mitchell, said trusts that act as tertiary referral centres tend to admit the most complex cases, which are more likely to lead to claims. She added: “Trusts in areas with higher proportions of ethnic minority groups, also often have higher rates. That is in part about the complexity of medical presentation, and also communication problems.” Helen Hughes, chief executive of Patient Safety Learning, said: “Scarce funds that could be spent proactively improving the quality of care are being spent on the costs of error and harm.” Read full story (paywalled) Source: HSJ, 13 December 2023
  15. Content Article
    Healthcare Inspectorate Wales (HIW) is the independent inspectorate of the NHS and regulator of independent healthcare in Wales. The findings of their Annual report outline the sustained pressure on healthcare services across Wales, highlighting risks relating to emergency care, staffing concerns, poor patient flow and the accessibility of appointments. It sets out how the HIW carried out their functions across Wales, seeking assurance on the quality and safety of healthcare through a range of activities. This includes inspections and review work in the NHS, and regulatory assurance work in the independent healthcare sector. The report provides a summary of what HW's work has found, the main challenges within healthcare across Wales, and HIW's view on areas of national and local concern.
  16. News Article
    NHS Highland will no longer receive extra government support in leadership, governance or culture, following improvements after the Sturrock review. The board was initially escalated to Stage 3 of NHS performance escalation framework in 2018 following concerns of a culture of workforce bullying and harassment. An independent report by John Sturrock QC, commissioned by the Scottish government, confirmed “fear, intimidation and inappropriate behaviour” and called for wide-ranging changes. The Healing Process was created in response, with an independent review panel established to speak to victims of bullying and come up with recommendations for the health board to make improvements. A total of 272 current and former NHS Highland and local health and social care partnership staff provided testimony between 2019 and March this year, with more than £2.8m paid out to those affected by bullying. Concerns were raised by some of the first people to go through the healing process that the system was “broken” and many victims could end up “bitterly disappointed”. The board has also established systems and processes to allow colleagues to speak up in the wake of the Sturrock Review, including an independent Guardian Service and staff training in Courageous Conversations. NHS Highland was handed oversight of its own escalation and de-escalation, rather than a Scottish government-led oversight group, in November 2021. Following a letter of assurance from the board chair earlier this year, the Chief Executive of NHS Scotland, Caroline Lamb, agreed to the de-escalation in September. Independent progress tracking shows the board has delivered significantly against many actions laid out by the review but the board concluded in its final June update that ‘culture change is not yet embedded at all levels of our organisation’. Read full story Source: Health and Care Scotland, 2023
  17. News Article
    Regulators have warned hospital leaders they may have to ‘depart from established procedures’ over winter to minimise ambulance handover delays. In a joint letter to nursing and medical leaders, NHS England, the Care Quality Commission and professional regulators said it was “vital that we have a whole system approach to risk across the urgent and emergency care pathway”. The push has come amid a huge increase in instances of crews being held outside emergency departments, resulting in extended response times for time-critical 999 calls. The letter added: “We… understand there will be concerns about working under pressure, and that you and your teams may need to depart from established procedures on occasion to provide the best care. “Please be assured that your professional code and principles of practice are there to guide and support your judgments and decision making in all circumstances. This includes taking into account local realities and the need to adapt practice at times of significantly increased pressure. “In the unlikely event of a complaint to your professional regulator they will, as is their usual practice, consider carefully whether they need to investigate. If an investigation is needed, they will consider all relevant factors including the context and circumstances in which you were working. “One area that may be an example of this is in handing patients over to emergency departments from ambulance services. There is a strong correlation between ambulance handover delays at emergency departments and ambulance category 2 response delays, meaning longer handovers increase the chances those in need will wait longer for an ambulance.” Read full story (paywalled) Source: HSJ, 11 December 2023
  18. News Article
    After the $261 million verdict against Johns Hopkins All Children's Hospital, health system public relations departments have a new concern: unwillingly becoming the subject of a streaming service documentary. Released on Netflix in June, "Take Care of Maya" tells the story of Maya Kowalski, whose family brought her to the St. Petersburg, Fla., hospital's emergency department in 2016 with chronic pain. After physicians suspected child abuse, the then-10-year-old was kept there apart from her loved ones for nearly three months, during which time her mother killed herself. Millions of viewers watched the documentary, which detailed the family's then-unsuccessful attempt to sue the hospital. In November, a Florida jury awarded the Kowalskis the nine-figure sum for damages on counts including medical negligence and false imprisonment. "The level of global exposure and awareness of this case helped drive the interest, engagement and discussions in the community," Karen Freberg, PhD, professor of strategic communication at University of Louisville (Ky.), told Becker's. "This is a situation where hospitals across the board must evaluate their crisis communication plans from this experience and see how they would address this situation if it happened to them." She said any reputation-fixing lessons for this case, then, will come not from hospitals that have lost big lawsuits, but from companies that have been the subject of unflattering documentaries. Read full story Source: Becker's Hospital Review, 7 December 2023
  19. News Article
    The expert tasked by government and NHS England to investigate maternity scandals has criticised ministers for failing to provide the funding necessary to address the problems. Donna Ockenden said the funding provided so far was “nowhere near good enough” and progress made to improve services had been “extremely disappointing”. After her investigation into the deaths and harm of 295 babies and nine mothers at Shrewsbury and Telford Hospitals Trust, the Department of Health and Social Care endorsed recommendations to invest an additional £200m to £350m per year into maternity services. IMs Ockenden suggests the recent impact of inflation, pay awards, and other rising costs means the full £350m is required. According to NHSE an additional £165m per year has been invested since 2021, and the DHSC said this would rise to £187m from April. Ms Ockenden, a senior midwife, told HSJ: “What I would like to say loud and clear to the government is that we are broadly 50 per cent of the way there in receiving the money we know is needed for maternity services. That is nowhere near good enough. “There are workforce issues across [the whole team], whether that’s midwives, obstetricians or neonatologists, and it’s hardly surprising. “The government must now do more – whilst we were grateful for the endorsement [of her report], the lack of progress in providing what is known to be the required funding is extremely disappointing.” Read more (paywalled) Source: HSJ, 11 December 2023
  20. News Article
    The Care Quality Commission (CQC) has apologised after admitting it failed to act on whistleblowing concerns “in a timely manner”. Allegations had been made to the CQC about staff at Cambridgeshire and Peterborough Foundation Trust tampering with a patient’s record after they had died by suicide. As previously reported, the accusations by whistleblower Des McVey have sparked a review of the trust’s conduct in more than 60 suicide cases. Mr McVey says the trust only took action following media coverage and that the CQC had ignored his concerns. The regulator has now upheld a complaint from him, with operations manager James DeCothi writing to Mr McVey: “I have established that [the relevant CQC inspector] did not share your concerns with the provider in a timely manner and that our contact with you from July 2022 to June 2023 was inconsistent. I apologise on behalf of CQC for this. [The CQC inspector] has reflected on this and has asked me to offer her apologies to you also. “I can confirm that CQC have followed up the areas of concern that you have shared, and we will continue to use the information you have shared to inform future regulatory activity. I would like to thank you again for sharing this information with us.” Read full story (paywalled) Source: HSJ, 11 December 2023
  21. News Article
    Patients needing emergency treatment are becoming sicker in A&E as hospitals struggle to free up enough beds, top doctors have warned. Dr Adrian Boyle, president of the Royal College of Emergency Medicine (RCEM), told The Independent that elderly patients are waiting so long for treatment in A&E that they’re developing bed sores and delirium. Another senior NHS doctor, Dr Vicky Price, who is president-elect of the Society for Acute Medicine, warned that corridor care is now “routine practice” with the situation only set to worsen as A&E departments come under increasing pressure. Their comments highlight the ongoing chaos in emergency medicine, as strikes take place during the most difficult time of the year. The chief executive of the NHS, Amanda Pritchard, said on Thursday that last winter was the worst she’d ever seen for the health service, warning that strikes by junior doctors will only make the situation harder for hospitals this year The warnings come as the latest NHS data shows that the prime minister, Rishi Sunak, could fail in his promise to deliver 5,000 more acute hospital beds to the NHS this month. Current data shows that the NHS is falling short of the target by just under 1,200 beds, with 97,818 against a target of 99,000. Read full story Source: The Independent, 10 November 2023
  22. News Article
    A hospital has introduced a new artificial intelligence system to help doctors treat stroke patients. The RapidAI software was recently used for the first time at Hereford County Hospital. It analyses patients' brain images to help decide whether they need an operation or drugs to remove a blood clot. Wye Valley NHS Trust, which runs the hospital, is the first in the West Midlands to roll out the software. Jenny Vernel, senior radiographer at the trust, said: “AI will never replace the clinical expertise that our doctors and consultants have. "But harnessing this latest technology is allowing us to make very quick decisions based on the experiences of thousands of other stroke patients.” Radiographer Thomas Blackman told BBC Hereford and Worcester that it usually takes half an hour for the information to be communicated. He said the new AI-powered system now means it is "pinged" to the relevant teams' phones via an app in a matter of minutes. "It's improved the patient pathway a lot," he added. Read full story Source: BBC News, 7 December 2023
  23. News Article
    NHS leaders have issued a warning over surging flu cases as the number of patients in hospital with the bug soared by more than 50% in a week. An average of 234 people were in hospital with flu each day last week – up 53% on the previous seven days. Figures from NHS England also showed a rise in norovirus cases in hospitals last week with an average of 406 cases per day, up from 351 the previous week and a 28% rise from last year. The latest data comes after public health officials sent a warning over whooping cough levels, with 719 suspected cases reported between July and November, up from 217 last year. This week several NHS hospitals have sent out alerts to the public warning of “extremely busy” A&Es. Dr Tim Cooksley, former president of the Society for Acute Medicine, warned: “Pressures are being exacerbated by increasing rates of sickness among colleagues, as well as pressures on precious resources such as isolation areas and side rooms, adding to the strain on already overstretched services... “Undoubtedly we will see more older patients enduring prolonged degrading periods of corridor care and many people experiencing difficult symptoms whilst they sit on elective waiting lists. “Most hospitals are already experiencing chaotic and dangerous scenarios.” He added that there was “a lack of understanding of the gravity of the situation” from new health secretary Victoria Atkins. Read full story Source: The Independent, 7 December 2023
  24. News Article
    Private hospitals saw record admissions this year after hundreds of thousands of people sought care through their insurance amid rocketing NHS waiting lists, new figures show. Between January and June 443,000 private treatments took place – a 7% rise from 2022, the vast majority of which were claimed through medical insurance policies. According to the Private Hospital Information Network (PHIN), which collects data from hospitals in the sector, there was a 12% increase in the number of people paying for care via insurance with 157,000 people using this route from January to March and 148,000 from April to June this year. The news comes as the NHS’s waiting list continues to grow with almost 7.8 million appointments recorded. Recently published data shows that there is a total of 6.5 million individual people on the waiting list. Read full story Source: The Independent, 7 December 2023
  25. Content Article
    Mr Malone was diagnosed with treatment resistant schizophrenia in 1983 and had been sectioned multiple times. In May 2023 he was diagnosed with adult autism. At a review on 31 May he was considered to be stable. On 15 June a routine clozapine review identified sub-therapeutic levels but this was not notified to his clinicians. Sub-therapeutic levels of clozapine are likely to have contributed to a worsening in his symptoms. Around 24 June he was noted to have suffered a significant deterioration – with symptoms of thought disorder, anxiety, and responding to hallucinations – and following a mental health act assessment on 28 June clinicians wanted to detain him under section 2. No inpatient psychiatric bed was available. Whilst he awaited a bed, he remained in the community with daily visits from the mental health team. Last contact was on 1 July when he accepted his medication and appeared more settled. There was no answer when he was visited on 2 July. His room at supported accommodation was entered on 3 July and he was found deceased. Recently he had expressed no suicidal ideation. Post-mortem examination confirmed the medical cause of death was:  1a Cervical spinal cord injury. 1b Laceration. The conclusion of the inquest was that death was the consequence of suicide.
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