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Found 1,512 results
  1. News Article
    A coroner has urged the health secretary to take action to prevent needless deaths after a woman died of heart failure following a four-hour wait in the back of an ambulance. Lyn Brind, 61, was taken to the Queen Elizabeth Hospital (QEH) in King’s Lynn, Norfolk, with chest pains and low blood oxygen levels but could not be admitted because the hospital had “no space”. Instead she remained in a queue of ambulances outside A&E without a timely diagnosis or treatment and where warning signs about her condition were missed. It was only after four hours and 25 minutes of waiting that she was transferred to a ward, by which time she was “agitated and short of breath”. She was placed on life support but died 22 minutes later. Brind’s family believe the grandmother of four, a former dinner lady from the town, “might still be alive today” had she been admitted more swiftly. “She wasn’t given a chance,” her partner of 38 years, Richard Bunton, said. After an inquest earlier this month into Brind’s death in May 2022, the senior coroner for Norfolk, Jacqueline Lake, took the unusual step of writing to England’s health secretary, Steve Barclay, to raise concerns about the NHS and social care. She warned that others could die in similar circumstances unless action was taken. “I believe you have the power to take such action,” Lake wrote in a prevention of future deaths report. Read full story Source: The Guardian, 29 January 2023
  2. News Article
    Hospitals in England have recorded more than 450 sewage leaks in the last 12 months, data shows, putting patients and staff in danger and prompting warnings that the NHS estate is “falling apart” after a decade of underinvestment. Freedom of information requests to NHS trusts by the Liberal Democrats found alarming examples of sewage leaking on to cancer wards, maternity units and A&E departments. The investigation also uncovered multiple cases of urine and faeces flowing into hospital rooms and on to general wards. Health officials called the revelations shocking. In some instances, sewage leaks made entire hospital departments unsafe for patients and led to staff struggling to work because they felt nauseous and had headaches. Ed Davey, the Liberal Democrat leader, said: “This is a national scandal. Our country’s hospitals are falling apart after years of underinvestment and neglect. Patients should not be treated in these conditions and heroic nurses should not have the indignity of mopping up foul sewage.” “At every turn, our treasured NHS is crumbling, from hospital buildings to dangerous ambulance wait times. The government needs to find urgent funds to fix hospitals overflowing with sewage. Patient and staff safety is a risk if ministers fail to act,” he said. Read full story Source: The Guardian, 17 February 2023
  3. News Article
    Pradeep Gill can see very little of the intense activity around him. He is leaning back in a reclining chair inside one of Heatherwood Hospital's operating theatres. Buzzing around him is the operating team, led by consultant orthopaedic surgeon Jeremy Granville-Chapman. For the surgeon and his team, this procedure is the very definition of routine. They have carried out more than 1,000 joint operations in the past 10 months. Heatherwood Hospital, part of the Frimley Health NHS Foundation Trust, is a specialist elective hub where patients can come in for routine but life-changing surgery at a super-charged pace with theatres working at full tilt, six days a week. It is busy. But it is a good-busy, not the bad-busy we have come to associate with the NHS during this winter crisis. The site opened in March last year and Frimley's hospital executives are keen to stress the impact it has made. "As a specialist planned care facility, Heatherwood has been able to perform surgery six days a week with four out of its six state-of-the-art theatres dedicated to orthopaedic procedures," it said in a press release. "The hospital has also successfully reduced the length of time patients stay in hospital, with 40% of patients safely discharged within 24 hours." This is the practice the NHS wants to adopt as it battles a record seven-million-strong waiting list. Heatherwood can do that because the hospital is ring-fenced from acute pressures that affect other hospitals, as one its most senior orthopaedic surgeons, Mr Rakesh Kucheira, explained. "We have now realised that winter pressures are 12 months not just three months, which means the acute sites are not going to be able to do planned activity that they planned for, so we've got to create more space," he said. Read full story Source: Sky News, 9 March 2023
  4. News Article
    "It would be much better if I was out there than in here," said Roger. The 69-year-old looked wistfully across Newport from the window next to his bed at the Royal Gwent Hospital in Wales. He has been here for three weeks after being admitted with an infection and although he is now well enough to leave, and desperate to do so, he can't. Roger has cerebral palsy and the impact of his recent illness means he needs extra care to be arranged before he can safely go home. Roger is not alone. "At least a quarter of patients in our care of the elderly beds are in a similar position," explained Helen Price, a senior nurse at the hospital. "It is very much a waiting game for that care to be available," she said. Hospitals in Wales are fuller than ever, according to the latest statistics. In the final week of January more than 95% of all acute beds in the Welsh NHS were occupied, which is the highest figure ever recorded. Paul Underwood, who manages urgent care in Aneurin Bevan University Health Board, said there are well over 350 patients medically fit enough to leave hospital. "Roughly a third of patients do not need to be accommodated on those sites and that's extremely difficult," he said. Read full story Source: BBC News, 16 February 2023
  5. News Article
    A new way of screening ambulance calls is to be introduced across England in an effort to improve response times. NHS England is asking ambulance crews to review which emergency calls other than those classed as immediately life threatening can be treated elsewhere. The calls - known as category two - include emergencies such as heart attacks and strokes. But the category also covers some that may not need such a fast response, such as burns and severe headaches. About 40% of these lower priority calls classed as category two by call handlers will now receive callbacks from a doctor, nurse or paramedic to see whether there is an alternative to sending an ambulance. In trials in London and across the West Midlands, nearly half of those receiving a callback were advised to go instead to an urgent treatment clinic, their GP or a pharmacist. NHS England is now asking the other eight ambulance services in England to adopt the approach. Read full story Source: BBC News, 16 February 2023
  6. News Article
    Ambulance staff will need to respond to category 2 calls during strike action under new government proposals. The Department of Health and Social Care has launched a consultation on minimum service levels in ambulance services. It comes as industrial action continues across the NHS and as legislation to ensure minimum services levels in key industries during strikes is making its way through Parliament. The consultation document read: “Our proposal is that calls classed as life-threatening and emergency incidents would always receive an appropriate clinical response when there is strike action. “In England, currently, these calls are classified as category 1 (immediately life-threatening) and category 2 (emergency) calls… “On strike action days, some workers would continue their work to ensure that these calls can be answered and responded to appropriately to protect the life and health of patients.” The proposals added services must also have “adequate capacity and resourcing” in call control rooms, to ensure all emergency 999 calls to ambulance services were answered. Read full story (paywalled) Source: HSJ, 13 February 2023
  7. News Article
    Some of the country’s most senior NHS clinicians are earning a lucrative sideline running private firms that offer to cut waiting lists at their own hospitals, the Observer can reveal. Top consultants in Manchester, Sheffield and London are among directors of “insourcing” agencies that charge the health service to treat patients at weekends and evenings and have won millions of pounds of work. Some hold leadership roles at NHS trusts that have awarded contracts to their own companies, raising concerns about potential conflicts of interest. One deputy medical director jointly ran a firm that provided “insourcing” solutions to his own NHS trust before it was sold in a £13m deal last year. Other consultants have set up firms that they and their colleagues work shifts through themselves, often at rates above NHS price caps. The Centre for Health and the Public Interest, an independent thinktank, called for a ban on such arrangements. The General Medical Council said current conflict of interest policies did not always deliver “the transparency and assurance that patients rightly expect”. Read full story Source: The Guardian, 12 February 2023
  8. News Article
    Nurses in England are preparing to escalate their dispute with the government by involving staff from NHS A&E departments, intensive care and cancer wards in a series of 48-hour strikes. The Royal College of Nursing (RCN) is understood to be planning to announce walk outs for two consecutive days and nights, rather than limiting action from 8am to 8pm as they have done so far. NHS leaders warned the looming strike could be the “biggest impact” on patients yet seen, with the union preparing to end a process where the RCN had agreed to exemptions with hospitals. The RCN told NHS leaders on Friday it is preparing to step up its dispute by asking its members working in emergency departments, intensive care units and oncology to join the strike. But the union, expected to announce the strike this week, will make a very limited set of provisions for the most urgent clinical situations as part of a legal obligation not to endanger life. Saffron Cordery, deputy chief executive at NHS Providers said: “A continuous 48-hour strike that includes staff from emergency departments, intensive care units and cancer care services would likely have the biggest impact on patients we’ve seen.” Read full story Source: The Independent, 12 February 2023
  9. News Article
    Ambulance crews reached emergencies such as heart attacks and strokes one hour quicker in January than December in England, figures show. They took 32 minutes on average, compared with more than 90 the month before. The target is 18 minutes but January's average was the quickest for 19 months. A&E waiting times also improved, with just over a quarter of patients waiting longer than four hours - down from more than a third in December. But Society for Acute Medicine president Dr Tim Cooksley said wait times remained "intolerable". And he highlighted the waits the sickest and most frail were facing for a bed on a ward. Nearly four out of every 10 patients waited over four hours on trolleys and in corridors. "The fundamental problem remains a significant shortage of workforce, leading to woefully inadequate inpatient bed and social-care capacity," Dr Cooksley added. Read full story Source: BBC News, 9 February 2023
  10. News Article
    More than a third of delayed discharges for long-stay patients are being caused by factors generally associated with the NHS, according to new data obtained by HSJ. Delayed discharges from hospital are often blamed on issues around social care, but figures for the nine months to January, for patients who have been in hospital for at least 21 days, suggest a significant proportion are due to NHS-related delays. The most common reason is waiting for rehabilitation beds in a community hospital or similar facility, which accounts for 23% of total delayed discharges, based on daily averages. Other reasons generally associated with NHS-related issues included delays around medical decisions (4%), therapist decisions (4 per cent), transfers to another acute site (2%), and diagnostic tests (1%). On top of this, a further 12% of the causes were at least partly associated with the NHS, such as delays relating to transfer of care hubs, which are generally jointly run with councils. Read full story (paywalled) Source: HSJ, 9 February 2023
  11. News Article
    The independent data watchdog has called for greater clarity from NHS England on how it will ensure there are “as strong… if not stronger” safeguards on health and care data following its takeover of NHS Digital. NHS Digital – whose role included controlling access to large amounts of NHS data – became part of NHS England on 1 February, and its teams and functions are due to merge in coming months. In an interview with HSJ, national data guardian Nicola Byrne said the merger creates “an inherent tension in having one organisation be both data custodian and the organisation seeking to access the data”, although it “makes sense in terms of streamlining and efficiencies”. Concerns have been raised about the merger’s information governance implications by campaign group medConfidential, the British Medical Association and politicians. These include that there would be less transparency over the handling of data, and that NHSE would be “marking its own homework” as both controller of, and a major user of, data. Read full story (paywalled) Source: HSJ, 8 February 2023
  12. News Article
    NHS waiting lists are unlikely to fall in 2023, and the backlog is unlikely to be significantly tackled until mid-2024 despite being one of Rishi Sunak’s priorities for this year, research suggests. The NHS has struggled to increase the number of people it is treating from its waiting lists each month due to ongoing pressures from Covid-19, although there have been signs of improvement in the past month, analysis from the Institute for Fiscal Studies (IFS) has found. Max Warner, an IFS economist and one of the report’s authors, said that although the NHS had made “real progress” to reduce the number of patients waiting a very long time for care, efforts to increase overall treatment volumes had “so far been considerably less successful”. The NHS Providers’ chief executive, Julian Hartley, urged the government to introduce a fully funded workforce plan and to talk to unions about pay for this financial year as strikes were causing huge disruption to services, and risked undoing hard-won progress made on care backlogs. “Mounting pressures on acute, ambulance, mental health and community services, such as chronic workforce shortages, could hamper efforts to cut the backlog further if left unchecked,” he said. Read full story Source: The Guardian, 8 February 2023
  13. News Article
    East Kent Hospital University Foundation Trust has been criticised for failures in services by the Care Quality Commission, after an unannounced inspection last month, years after major problems began to come to light. The Care Quality Commission has highlighted: Issues with processes for fetal monitoring and escalation at the William Harvey Hospital, Ashford. There had been “incidents highlighting fetal heart monitoring” problems in September and October, and the trust’s measures to improve processes were not “embedded and understood by the clinical team”; Slow maternity triage, due to staffing problems, and infection control problems at the William Harvey. The trust is reviewing how issues with infection prevention and control and cleanliness were not identified or escalated; and Fire safety issues at the Queen Elizabeth, the Queen Mother Hospital, in Thanet with problems linked to fire doors and an easily accessible secondary fire escape route. Three years ago issues with reading and acting on fetal monitoring were highlighted at the inquest into baby Harry Richford, whose poor care by the trust led to an independent inquiry into widespread failings in its maternity services, led by Bill Kirkup. Read full story (paywalled) Source: HSJ, 6 February 2023
  14. News Article
    Nurses could refuse to carry out any further strikes alongside other health workers because of fears over patient safety, The Independent has learnt. A mass walkout billed as the largest strike in NHS history is due to take place on Monday as tens of thousands of nurses, paramedics and 999 call handlers walk out in a bid to force ministers to the negotiating table. But the coordinated strikes could be a one-off if nurses feel that the decision to take part in direct action compromises patient safety, The Independent has been told. One union source said walkouts are not carried out on a “come what may” basis, and that the unions would have to assess whether striking together was “helpful” or not. Unions have been escalating their industrial action in recent weeks in an attempt to secure higher pay rises. Any de-escalation in tactics will be seen as a blow to their campaign and a boost to Rishi Sunak’s hopes of riding out the wave of protests. With patient safety the priority, sources insisted there are strong local controls that will pull nurses from picket lines if they think there is an issue. Read full story Source: The Independent, 5 February 2023
  15. News Article
    “Frustration with the system was why I went off in the end,” said Conor Calby, 26, a paramedic and Unison rep in southwest England, who was recently off work for a month with burnout. “I felt like I couldn’t do my job and was letting patients down. After a difficult few years it was challenging.” While he usually manages to keep a distinct divide between work and home life, burnout eroded that line. He also lost his sleep pattern and appetite. The final straw came when what should have been a 15-minute call resulted in three hours on the phone trying to persuade the services that were supposed to help a suicidal patient to come out. “I was on a knife edge. That was due to the system being broken. That’s the trigger.” Doctors and nurses are struggling under the strain too. After her third time with burnout - the last resulting in her taking six months off work – Amy Attwater, an A&E doctor, considered leaving the profession altogether. Attwater, 36, said in the Covid crisis, during which a colleague killed himself, she started having suicidal thoughts and doubting her own abilities. She twice reported that she was being bullied but said no action was taken. “The only thing I was left with was to take time off work. I ended up having therapy, seeing a psychiatrist and being on two antidepressants,” said Attwater, the Midlands-based committee member for Doctors’ Association UK. Read full story Source: The Guardian, 5 February 2023
  16. News Article
    Deadlock over NHS pay is putting patients in danger and risks hardening the position of unions, 10 chief nurses have warned. Unions have warned that the government is making no moves towards resolving the strikes, with one general secretary accusing the government of lying about the state of negotiations. In a joint statement shared with the Guardian, chief nurses from 10 leading hospitals known as the Shelford group highlighted their concern that patients’ health could suffer as a direct result of the increasing disruption the stoppages are causing. Tens of thousands of nurses and ambulance workers in England will stage what will be the biggest strike in the NHS’s 75-year history on Monday. In a plea to the government and health unions, but especially ministers, the 10 Shelford group chief nurses stress that they want both sides to end their standoff as a matter of urgency “because of the impact on the patients and communities we serve. “Industrial action means appointments cancelled, diagnostics delayed [and] operations postponed. The longer industrial action lasts, the greater the potential for positions to harden, waits for patients to grow, and risks of harm to accumulate.” This week will see just one day – Wednesday – when there are no NHS strikes. Nurses will strike again on Tuesday, physiotherapists will stage their second walkout on Thursday and ambulance personnel will stage a further stoppage on Friday. Read full story Source: The Guardian, 5 February 2023
  17. News Article
    More than 500,000 people in the UK will be diagnosed with cancer every year by 2040, according to analysis by Cancer Research UK. In a new report, researchers project that if current trends continue, cancer cases will rise by one-third from 384,000 a year diagnosed now to 506,000 in 2040, taking the number of new cases every year to more than half a million for the first time. While mortality rates are projected to fall for many cancer types, the absolute numbers of deaths are predicted to increase by almost a quarter to 208,000. In total, it estimates that between 2023 and 2040, there could be 8.4m new cases and 3.5 million people could have died from cancer. Cancer Research UK’s chief clinician, Charles Swanton, said: “By the end of the next decade, if left unaided, the NHS risks being overwhelmed by the sheer volume of new cancer diagnoses. It takes 15 years to train an oncologist, pathologist, radiologist or surgeon. The government must start planning now to give patients the support they will so desperately need.” Read full story Source: The Guardian, 3 February 2023
  18. News Article
    Commissioners have begun a ‘serious incident review’ across their integrated care system after early indications showed patients may have suffered harm due to long waits for cancer treatment. The review has been launched by Somerset Integrated Care Board into dermatology services after an initial review found five of 50 patients had seen their skin lesions increase in size since being referred to hospital by their GPs. ICB board papers stated “potential patient harm has been identified” for those patients, who were on the two-week wait pathway to be seen by a specialist following a referral by their GP. Read full story (paywalled) Source: HSJ, 3 February 2023
  19. News Article
    The CEO of a troubled trust has said evidence is emerging of ‘massively reduced’ length of stay in a new hospital criticised for being too small. Emergency staff have raised concerns about a lack of space and bed capacity at the new Royal Liverpool Hospital, which opened in October, as services have come under severe pressure this winter. The new building, on a next-door site to the old hospital, has fewer beds, although more have opened elsewhere in the city. In an interview with HSJ, Liverpool University Hospitals Foundation Trust chief executive officer James Sumner acknowledged aspects of the new building have created difficulties, including in relation to accident and emergency configuration and capacity, but added the move’s benefits are beginning to be seen. He said a new care model and single rooms throughout the whole hospital are helping to reduce length of stay, as well as eliminating bed closures due to infection outbreaks. He said: “We’ve got really good evidence of massively reduced length of stay in this new building, [with] about 70 fewer people every day waiting over seven, 14 and 21 days in hospital. Read full story (paywalled) Source: HSJ, 1 February 2023
  20. News Article
    A major hospital in the UK has declared a critical incident, warning it is facing “immense pressures” on its services. Wigan’s Royal Albert Edward Infirmary urged people to avoid its A&E unless suffering a “life or limb-threatening emergency”. Wrightington, Wigan and Leigh (WWL) Teaching Hospitals NHS Foundation Trust warned that “unprecedented attendances” meant the emergency department was “full”. It said it is working with partners to discharge patients who are ready to leave hospital. The trust, which previously declared a critical incident in December, said the safety of its patients is the “top priority”. By declaring a critical incident, hospitals are able to take action so that safe services are maintained despite increasing pressures. Read full story Source: The Independent, 1 February 2023
  21. News Article
    Donna Ockenden, who is leading an independent review examining how dozens of babies died or were injured at the Nottingham University Hospitals (NUH) trust, is due to meet with chief executive of NUH, Anthony May, and other members of the NUH executive team. Speaking ahead of the meeting, she said: "The commitment I want to give to the women and families of Nottingham is that real learning, real improvement in maternity safety will happen throughout the life of this review. "It won't be a case of waiting until the end and then presenting the trust with a huge amount of learning that they then have to start putting in place. "Today's meeting with the trust is at executive level. Along with colleagues from NHS England, I'll be meeting with the chief executive and some of his colleagues to talk about how we will ensure that learning reaches the trust on a regular basis and in a timely way so families can be assured that the maternity improvement plan is including learning from our review." Read full story Source: BBC News, 2 February 2023
  22. News Article
    NHS England has effectively admitted the backlog of cancer long-waiters will still be higher in March 2024 than before covid hit, in a document seen by HSJ. The consultation document, detailing trajectories for reducing numbers waiting 62 days or more from referral, shows the expected national total in March 2024 is 18,755. NHS England previously committed to reducing this to pre-pandemic levels (14,226) by March 2022, then delayed the target until March this year. There are now significant backlogs in diagnostics, with particular challenges in endoscopy and breast screening. NHS Providers director of policy and strategy Miriam Deakin said: “Cancer is a key priority for trusts. They understand the risk to patients who have to wait. “The pandemic left people waiting longer than NHS trusts wanted for diagnosis or to start treatment, with some people not coming forward, but now urgent referrals for suspected cancer are far higher than pre-pandemic. Read full story (paywalled) Source: HSJ, 1 February 2023
  23. News Article
    Thousands of ambulance staff across five services in England - London, Yorkshire, the South West, North East and North West - will walk out on Friday 10 February, Unison says. It means strikes over pay will now be happening across the NHS every day next week, apart from Wednesday. Life-threatening 999 calls will be attended to but others may not be. Downing Street says the continuing industrial action will concern the public. The NHS's biggest day of industrial action is set to happen on 6 February, when many nurses and ambulance crews across England and Wales will be on strike. Unison says the government must stop "pretending the strikes will simply go away" and act decisively to end the dispute by improving pay. The union warned that unless the government had a "major rethink" over NHS pay, and got involved in "actual talks" with unions, it would announce strike dates running into March. The government says the above-inflation pay rises requested are unaffordable. Read full story Source: BBC News, 31 January 2023
  24. News Article
    All three acute trusts in an integrated care system are failing to meet national requirements to tackle health inequalities after being overwhelmed by emergency and elective care pressures. A report by Devon Integrated Care Board found progress on addressing variation in poor health outcomes had “slipped due to capacity issues.” Both Royal Devon University Healthcare Foundation Trust and Torbay and South Devon FT were rated “red” for a lack of headway. All trusts were told by NHSE in 2021 to undertake a range of actions as part of work to reduce health inequalities during 2022-23. These included publishing analyses of waiting times disaggregated by ethnicity and deprivation, using the waiting list data to identify disparities between different patient groups, and measuring access, experience and outcomes for patients from a deprived community or an ethnic minority background. Sarah Sweeney, interim chief executive of National Voices, which represents health and care charities and patients, said she was “really concerned to see that some ICSs are not making as much progress on reducing health inequalities as expected and hoped”. “These inequalities are completely unjust and preventable,” she said. Read full story (paywalled) Source: HSJ, 30 January 2023
  25. News Article
    Trusts are getting better at coping with industrial action and are still on track to hit the national target of eliminating the backlog of 78-week waiters, an NHS England director has told staff. Paul Doyle, NHS England’s programme director for elective recovery, said: “We continue to make really good progress [on elective recovery]… we are very much in the end game now of meeting the 78-week ambition for the end of March.” There have been concerns about the impact of recent strike action on eliminating the 78-week backlog, but Mr Doyle praised managers’ handling of the strikes and said administrative staff were doing an “incredible job”. He added: “Most organisations affected have got better and better as time has gone on about making sure that there are as few cancellations as possible and that cancellations are rebooked quickly or that clinical time is put to good use such as doing virtual outpatient appointments or doing validation of waiting list.” Read full story (paywalled) Source: HSJ, 30 January 2023
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