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Found 258 results
  1. 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
  2. News Article
    NHS England has revealed a new intervention regime, as it seeks to deliver on its new urgent and emergency care recovery plan. Systems will be placed in three “tiers of intervention”, with those systems deemed “off-target on delivery” being given “tier three intensive support” from NHSE, which will include on-the-ground planning, analytical and delivery capacity, “buddying” with leading systems and “targeted executive leadership”. The approach follows that which has been taken over the past year for elective and cancer care recovery. The urgent care plan, published by NHSE and the Department of Health and Social Care today, says: “NHS England will identify and share good practice so that all can learn from the best. For those systems that are struggling, we will offer support to ensure that they have the best opportunities to drive improvement locally.” Read full story (paywalled) Source: HSJ, 30 January 2023
  3. News Article
    The new national target to see 76% of A&E patients within four hours by March 2024 has been described as ‘extremely unambitious’ by senior emergency clinicians. Adrian Boyle, president of the Royal College of Emergency Medicine, also told the Commons Health and Social Care Committee that the objective – included in NHS England planning guidance for 2023-24 and agreed with government – could also drive “perverse incentives” for some emergency department managers. The new target to admit, transfer or discharge 76% of patients by the end of 2023-24 is the first time a specific bar has been set against the four-hour standard for several years. In December, just three acute trusts were hitting the new 76% objective. But Dr Boyle told MPs: “The aspiration from NHS England is that we return to a four-hour target performance of 76%. We think that is too unambitious, and we think that is going to create all sorts of perverse incentives, because it’s going to encourage managers and senior clinicians just to focus on people who can be discharged from hospital, without dealing with our problem, which is exit block [people who cannot be admitted as wards are full]. “We think the 76 per cent is an extremely unambitious target. It was 95% – I know that’s going to be a long way to go back to and we haven’t achieved it since 2015, but we would say we need to have a trajectory to a higher target.” Read full story (paywalled) Source: HSJ, 24 January 2023
  4. News Article
    An ICS chief has said the NHS workforce crisis is not the result of a ‘funding issue’ but caused by an inefficient use of resources. Patricia Miller, chief executive of Dorset Integrated Care Board, told a board meeting on Thursday that “constantly talking about the NHS needing more money” was undermining leaders’ case to government. She said: “We have got a workforce issue in the NHS, there is no doubt about that. I don’t actually believe we have got a funding issue. We just don’t use our resources very efficiently and I don’t think we do our case any positive favour with government when we’re constantly talking about the NHS needing more money when we can’t demonstrate that what we do is efficient. “So I don’t actually accept we’ve got a funding issue unless we start to work at the optimum and then we can absolutely demonstrate that. “I think what this comes down to is that our systems are too complicated and that starts at the centre, where every initiative we have is not about redesigning service models end-to-end but about layering on different solutions to different ends of the pathway and it just makes it more complicated. “I’ve no doubt that we’ve probably got 50-plus entrance and exit points to our urgent emergency care service, it’s ridiculous. I can’t navigate my way around 50 or 60, so there’s no way a patient can do it.” Read full story (paywalled) Source: HSJ, 6 January 2023
  5. News Article
    NHS England has shelved priorities on Long Covid and diversity and inclusion – as well as a wide range of other areas – in its latest slimmed down operational planning guidance, HSJ analysis shows. NHSE published its planning guidance for 2023-24, which sets the national “must do” asks of trust and integrated care systems, shortly before Christmas. HSJ has analysed objectives, targets and asks from the 2022-23 planning guidance which do not appear in the 2023-24 document. The measures on which trusts and systems will no longer be held accountable for include improving the service’s black, Asian and minority ethnic disparity ratio by “delivering the six high-impact actions to overhaul recruitment and promotion practices”. Another omission from the 2023-24 guidance compared to 2022-23 is a target to increase the number of patients referred to post-Covid services, who are then seen within six weeks of their referral. Several requirements on staff have been removed, including to ”continue to support the health and wellbeing of our staff, including through effective health and wellbeing conversations” and ”continued funding of mental health hubs to enable staff access to enhanced occupational health and wellbeing and psychological support”. Read full story (paywalled) Source: HSJ, 4 January 2022
  6. News Article
    Some integrated care systems (ICSs) still require “an awful lot of control” from the centre, Patricia Hewitt has told HSJ, tempering any expectations that her government-commissioned review will bring about a wholesale roll-back of national performance management. The former Labour health secretary, who is also an integrated care board chair, was commissioned in November by chancellor Jeremy Hunt and health secretary Steve Barclay to review ICS autonomy and accountability. In her first interview since she started the work, Ms Hewitt also said: She had not ruled out “legislative tweaks” as a result of her review, but emphasised ICBs already had substantial ”soft power”; Some ICBs were still indulging in ‘old school’ combative behaviour, and stressed they should not become ‘top down regulators’; She wanted to “catalyse” the Care Quality Commission’s move to focus on systems and integration; and It appeared there were probably too many non-clinical support staff in the NHS, but not too many managers, and she would look more closely at the issue. Read full story Source: HSJ, 30 December 2022
  7. News Article
    A teaching hospital that was lauded for its culture and championed by ministers has been downgraded from ‘outstanding’ to ‘requires improvement’ by the Care Quality Commission. CQC inspectors found multiple issues at Salford Royal Hospital during an inspection in August and September. These included nurse staffing, governance, and some cultural concerns. The trust’s urgent and emergency services were rated “inadequate” for safety. The hospital in Greater Manchester had been rated “outstanding” since 2015, and was frequently hailed as a leader on the patient safety agenda, particularly by former health secretary Jeremy Hunt. Read full story (paywalled) Source: HSJ, 22 December 2022
  8. News Article
    Mid and South Essex Foundation Trust has received a Care Quality Commission warning notice about the medical care provided by its three hospitals. It has been told to make urgent improvements after inspectors found a deterioration in quality across its Broomfield, Basildon and Southend hospitals. The overall ratings for Broomfield and Basildon hospitals have dropped to “inadequate” as a result. The CQC carried out a focused inspection in January and February that was prompted by concerns over the safety and quality of medical care and older people’s services, including over people’s nutrition and hydration. Hazel Roberts, CQC deputy director in the east of England, said inspectors “found a leadership team who didn’t have complete oversight of the issues they’re facing”. Among the concerns raised by the CQC’s report were the safety of the premises and equipment, a lack of nursing and support staff, staff not always respecting people’s dignity and privacy, and risk assessments not always being completed and updated. Read full story (paywalled) Source: HSJ, 16 June 2023
  9. News Article
    An external review of waiting list management at a large acute trust has found several serious problems – including ‘pop-up’ patients and thousands of cancelled appointments each week – but concluded they were no worse than would be found at ‘most NHS trusts’. The review appears to have been triggered after University Hospitals of the North Midlands declared unexpected increases in the number of 78-week and 104-week waiters earlier this year, while the government and NHS England have been intensively performance managing these measures. The independent report by independent consultant Wendy Baines states: “The review found no evidence of deliberate irregularities in the management of waiting times. “Although as the case for most NHS trusts, the capacity to misrepresent the ‘true’ volume of waiters at a certain point in time is significant. “Managing this risk by minimising the capacity for errors through training, the right pathway administration systems and tools, and the ability to monitor data quality through a defined set of process assurance measures is key. Whilst UHNM possesses these components, they are not necessarily working in cohesion to provide the assurance and oversight needed to manage patient waiting times.” Read full story (paywalled) Source: HSJ, 13 June 2023
  10. News Article
    These are challenging times for hospitals. Covid-19 put unprecedented stress on health systems, as have inflation and global financial uncertainty. In the USA and around the world, leading hospitals are dealing with rising costs, aging populations and a medical workforce exhausted from battling a global pandemic. Among the hallmarks of great hospitals, however, are not just first-class care, first-class research and first-class innovation. The very best institutions also share another quality: consistency. The world's best hospitals consistently attract the best people and provide the best outcomes for patients as well as the most important new therapies and research. Of all the hospitals in the world, relatively few can do all those things year in and year out. To recognise them, Newsweek and global data firm Statista have put together their fifth annual listing of the World's Best Hospitals 2023. This year, they have ranked over 2,300 hospitals in 28 countries, including one that is new to the list, Taiwan. For the first time, they have ranked all top 250 global hospitals. They have listed the best hospitals by country; each country list also includes a listing of top specialty hospitals. Read full story Source: News Week
  11. News Article
    Seven integrated care systems and one ambulance trust have been placed in ‘intensive support’ because of their performance against urgent and emergency care metrics. NHS England launched the new intervention regime for emergency care earlier this year to measure progress against the urgent and emergency care recovery plan. The most troubled systems and organisations are now placed in a first “tier” and will receive central support from NHSE. Other systems requiring support from NHSE regional teams are placed in a secondary tier. This tiered approach is already in place for cancer and elective performance. Support will include help with analytical and delivery capacity, “buddying” with leading systems and “targeted executive leadership”. Read full story (paywalled) Source: HSJ, 7 June 2023
  12. News Article
    The mother of a seriously ill boy said she was "very alarmed" when a doctor at an under-fire children's ward admitted they were "out of their depth". In October, Carys's five-year-old son Charlie was discharged from Kettering General, but she returned him the next day in a "sort of lifeless" state. She said it seemed "quite chaotic" on Skylark ward before he was transferred to another hospital for further tests. Since the BBC's report in February that highlighted the concerns of parents with children who died or became seriously ill at the hospital, dozens more have come forward. In April, Care Quality Commission (CQC) inspectors rated the Northamptonshire hospital's children's and young people's services inadequate. Among the findings, inspectors said "staff did not always effectively identify and quickly act upon patients at risk of deterioration". Read full story Source: BBC News, 6 June 2023
  13. News Article
    Failing mental health services that do not improve, whether run by private firms or the NHS, could be shut, a Care Quality Commission (CQC) chief has said. It follows the watchdog judging as "inadequate" three child wards at the Priory Group's biggest hospital. The wards at Cheadle Royal, near Manchester, "did not always provide safe care", the CQC found. The unannounced inspection of Cheadle Royal took place earlier this year "in response to concerns about safety". BBC News first reported in January three women had died at the hospital last year, although not in the wards inspected for this report. The CQC's new director of mental health services, Chris Dzikiti, said he was determined to drive up standards in all units and warned he will close services who fail to improve. Read full story Source: BBC News, 31 May 2023
  14. News Article
    After health inspectors considered closing a maternity unit over safety fears, the BBC's Michael Buchanan looks at a near-decade of poor care at East Kent Hospitals NHS Trust. "I've been telling you for months. The place is getting worse." The message in February, which Michael received from a member of the maternity team, was stark but unsurprising. In a series of texts over the previous few months, the person had been getting increasingly concerned about what was happening at the East Kent trust. The leadership is "totally ineffective" read one message. "How long do we have to keep hearing this narrative - we accept bad things happened, we have learned and are putting it right. Nothing changes." Friday's report from the Care Quality Commission (CQC) is unfortunately just the latest marker in a near-decade of failure to improve maternity care at the trust. The revelation that inspectors considered closing the unit at the William Harvey Hospital in Ashford comes nine years after the trust's head of midwifery made a similar recommendation for the same reasons - that it was a danger to women and babies. The failure to act decisively then allowed many poor practices to continue. Read full story Source: BBC News, 28 May 2023
  15. News Article
    Health inspectors considered shutting down a maternity unit earlier this year over safety concerns. The Care Quality Commission (CQC) instead called for "immediate improvements" following a visit to the William Harvey hospital in Ashford, Kent. Helen Gittos, whose newborn daughter died in the care of the East Kent Hospitals Trust, said there were "fundamental" problems at the trust. The inspection of East Kent's William Harvey hospital laid bare multiple instances of inadequate practices at the unit, including staff failing to wash their hands after each patient, and life-saving equipment not being in the right place. Days after the visit, the watchdog raised safety concerns and threatened the trust with enforcement action to ensure patients are protected. Ms Gittos, whose baby Harriet was born at the East Kent trust's Queen Elizabeth the Queen Mother Hospital (QEQM) in 2014 and died eight days later, said: "When my daughter Harriet was born, the then head of midwifery was so concerned about safety that she thought that the William Harvey in particular should be closed down." She told BBC Radio 4's Today programme: "Here we are, almost nine years later, in a similar kind of situation. What has been happening has not worked. "I keep being surprised at how possible it is to keep being shocked about all of this, but I am shocked, that under so much scrutiny, and with so much external help, it's still the case that so much is not right. "The problems that are revealed are so fundamental that we have to do things differently." Read full story Source: BBC News, 26 May 2023
  16. News Article
    Pregnant women and new mothers are facing wide variation in access to mental health support, new figures suggest, as NHS England admits national performance on a key long-term plan goal to expand services is ‘over a year behind trajectory’. Analysis of access rates for perinatal mental health services from NHS Digital shows the rates of women accessing support within the past 12 months range from 3.7 per cent in Humber and North Yorkshire to 15 per cent in Shropshire, Telford and Wrekin ICS. The long-term plan target is for 66,000 women per year to be accessing specialist perinatal services, which can help with conditions such as post-partum psychosis, by March 2024. NHSE admitted in its papers that “although access is increasing, performance remains over a year behind trajectory”. Read full story (paywalled) Source: HSJ, 25 May 2023
  17. News Article
    Patients spent up to 25 hours on trolleys in corridors waiting for treatment and in some cases were left lying on "urine-soaked sheets" and in another on a "blood-stained pillow for several hours" at the Royal Infirmary of Edinburgh. Healthcare Improvement Scotland (HIS) inspectors also raised concerns over fire safety in the overcrowded A&E after two visits to the hospital - the first of which was carried out between February 20 to 22 and a further unannounced follow-up in March. The watchdog found "multiple systemic failures" in a report published on Thursday but NHS Lothian said a major improvement drive was already underway. The health board added that the hospital was had just endured its busiest winter on record ahead of the inspections. At the time of the inspection, the emergency department was on some days operating at over three times its capacity. The report described this as unsafe and a "fire safety risk" with the evacuation plan in place at the time not reflecting the "significant" impact of overcrowding. Read full story Source: The Herald, 18 May 2023
  18. News Article
    An ‘outstanding’ trust’s Care Quality Commission rating has been dropped to ‘requires improvement’, after inspectors found potential safety risks and a disconnect between board and ward. A highly critical report on University Hospitals Sussex Foundation Trust also downgraded its well-led rating to “inadequate” and recommended the trust be placed in segment four – the bottom tier – of NHS England’s system oversight framework. Its main tertiary centre – the Royal Sussex County Hospital – was also rated “inadequate”, including for safety. Deanna Westwood, Care Quality Commission’s director of operations in the South, said “staff and patients were being let down by senior leaders, especially the board, who often appeared out of touch with what was happening on the wards and clinical areas and it was affecting people’s care and treatment”. Read full story (paywalled) Source: HSJ,12 May 2023
  19. News Article
    Up to 10 junior doctor posts will be reinstated at a small district general hospital after regulators agreed it had improved its learning environment. In 2021, Health Education England removed 10 doctors from Weston Hospital over concerns they were being left without adequate supervision on understaffed wards. The unusual move prompted University Hospitals Bristol and Weston Foundation Trust to launch a “quality improvement approach” to improve its learner and clinical supervision environment. The regulator said the trust had made significant improvements that included: Better staff engagement with the trust leadership at all levels. Better clinical supervision, particularly around shift handovers and senior oversight of clinical decisions. Better learner experience in new training settings in rheumatology and intensive care medicine. Read full story (paywalled) Source: HSJ, 10 May 2023
  20. News Article
    Maternity services at a trust in Staffordshire have been rated as 'requires significant improvement' by the Care Quality Commission (CQC). University Hospitals of North Midlands NHS Trust in Stoke-on-Trent must now make urgent changes by June 30th 2023, to ensure patients are cared for safely. It follows an inspection in March where inspectors said staff did not have enough effective systems in place to ensure patients were looked after to the standard they should be. Staff also failed to implement a prioritisation process to ensure delays in the induction of labour were monitored and effectively managed, according to the review of services. The CQC said midwives evaluating patients and handling triage processes did not effectively assess, document and respond to the ongoing risks associated with safety through triage. Read full story Source: ITV News, 28 April 2023
  21. News Article
    NHS England has demanded recovery plans from six systems with a poor record on delivering urgent cancer checks. NHS England has told the chief executives of the six integrated care boards they must “present and deliver a plan” to make more use of their diagnostic facilities for patients who need urgent cancer checks. The “facilities” referred to are all community diagnostic centres. The six were selected because they diagnosed or ruled out fewer than 70% of urgent cancer referrals within 28 days during February. This benchmark is known as the “faster diagnostic standard”. A letter to the chief executives said: “improving waiting times for patients referred for urgent suspected cancer will be a critical priority for the NHS over the coming year”. It adds: “it is essential… our national investments in diagnostic capacity are more clearly prioritised for patients being investigated for urgent suspected cancer”. Read full story (paywalled) Source: HSJ, 28 April 2023
  22. News Article
    NHS trusts have been given targets to increase elective activity that range from 103% of pre-pandemic levels to nearly 130%, internal data seen by HSJ reveals. The wide gap between the targets, which are based on past performance and reflect the value of activity carried out, indicate the slow pace of recovery at many trusts last year. Forty trusts have been set the least ambitious target, to deliver 103% of pre-covid activity levels in 2023-24, including Leeds Teaching Hospitals, Barts Health, and University Hospitals Birmingham. All providers were supposed to deliver at least 104% of pre-covid activity last year, but few managed to achieve this, with emergency pressures, the impact of covid and flu, and workforce problems hampering efforts to ramp up activity. Amanda Pritchard has previously admitted the health service would have to “re-profile” the trajectory to achieving 130% of pre-covid activity levels by 2025. Read full story (paywalled) Source: HSJ, 20 April 2023
  23. News Article
    The NHS should abolish many of its national targets while shifting its focus towards preventive healthcare, according to a review by a former Labour health secretary. The study by Patricia Hewitt, commissioned by the government said that, while targets can help concentrate the minds of those responsible for a service, having too many makes them less effective. It comes at a time when record numbers of people are on NHS waiting lists and as the health service in England continues to miss targets on A&E waits, the speed of ambulance responses, and cancer treatment times. The review sets out new targets and failing to provide adequate funding for new initiatives makes it far harder to plan new services and recruit staff. It adds that an excessive focus on hitting targets by managers can lead to “gaming” of the targets and a “disastrous neglect of patients themselves”. Read full story Source: The Guardian, 3 April 2023
  24. News Article
    NHS trusts have been given until 2027-28 to employ enough midwives to meet safe staffing requirements, NHS England’s new maternity delivery plan has said. The three-year delivery plan for maternity and neonatal services sets out to “make maternity and neonatal care safer, more personalised and more equitable for women, babies and families”. It says: “Trusts will meet establishment [requirements] set by midwifery staffing tools and achieve fill rates by 2027-28, with new tools to guide safe staffing for other professions from 2023-24.” The plan follows a series of high-profile maternity scandals in the NHS at Shrewsbury and Telford, East Kent, Morecambe Bay and an ongoing independent review by Donna Ockenden into Nottingham University Hospitals Trust. The Care Quality Commission has highlighted a string of other concerns across the NHS. Read full story Source: HSJ, 31 March 2023
  25. News Article
    Plans for integrated care systems (ICSs) to be given Care Quality Commission (CQC) ratings are on hold, and no ratings will be issued until summer 2024 at the earliest, HSJ understands. The government had previously said ICSs would be given ratings – after pressure from Jeremy Hunt, then Commons health committee chair and now chancellor – and there was an expectation the process would begin next month. However, while legislation says the CQC will review and assess ICSs, it does not require it to give ratings. HSJ understands the Department of Health and Social Care supports the CQC beginning early work on assessing ICSs shortly, but does not plan to sign off on ratings being issued, nor set any date for that to happen. It means that, at the very earliest, more detailed reviews leading to ratings could happen from spring/summer 2024. One source with knowledge of the decision said there was not strong support for ratings work to start, and the CQC still needed to do a lot of work to adapt its approach to ICSs. Read full story (paywalled) Source: HSJ, 27 March 2023
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