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Found 2,344 results
  1. Content Article
    In this episode of 'Better Never Stops', Virginia Mason Institute Senior Partner Melissa Lin interviews Dana Nelson-Peterson, Vice President of Nursing Operations at Virginia Mason Franciscan Health, who shares what happens when you trust a management system and improvement process to solve your toughest challenges. Dana shares her story of leading a critical part of Virginia Mason’s Covid response.
  2. News Article
    More than two million people in the UK say they have symptoms of Long Covid, according to the latest Office for National Statistics (ONS) survey. Many long Covid patients now report Omicron was their first infection. But almost three years into the pandemic there is still a struggle to be seen by specialist clinics, which are hampered by a lack of resources and research. So has the condition changed at all, and have treatments started to progress? NICE defines Llong Covid, or post-Covid syndrome, as symptoms during or after infection that continue for more than 12 weeks and are not explained by an alternative diagnosis. An estimated 1.2m of those who answered the ONS survey reported at least one such symptom continuing for more than 12 weeks - health issues that they didn't think could be explained by anything else. It's easy to assume that new cases of long Covid have significantly decreased, given recent research suggesting the risk of developing long Covid from the Omicron variant is lower. However, the sheer scale of cases over the past year has resulted in more than a third of people with long Covid acquiring it during the Omicron wave, according to the ONS. Patients are usually referred to post-Covid assessment clinics after experiencing symptoms for 12 weeks - however, waiting times have not improved much within the past year. The latest NHS England figures show 33% of Londoners given an initial assessment had to wait 15 weeks or more from the time of their referral, compared to 39% from a similar period in 2021. The British Medical Association (BMA) has called on the government to increase funding for Long Covid clinics to deal with ever-increasing patient numbers. The BMA says that NHS England's 2022 strategy set out in July failed to announce any new funding. Read full story Source: BBC News, 18 November 2022
  3. Content Article
    The Covid-19 pandemic has led to the reorganisation of healthcare services to limit the transmission of the virus and deal with the sequelae of infection. This reorganisation had a detrimental effect on cardiovascular services, with reductions in hospitalisations for acute cardiovascular events and the deferral of all but the most urgent interventional procedures and operations. Aortic stenosis (AS) is the most common form of valvular heart disease. Once stenosis is severe, symptoms follow and the prognosis is poor, with 50% mortality within 2 years of symptom onset. Thus, timely treatment is of paramount importance. There was a large decline procedural activity to treat severe AS during the COVID-19 pandemic.  As we move into an era of ‘living with’ COVID-19, plans must urgently be put in place to best manage the additional waiting list burden for treatment of severe AS. In this study, Stickels et al. used mathematical methods to examine the extent to which additional capacity to provide treatment of severe AS should be created to clear the backlog and minimise deaths of people on the waiting list.
  4. Content Article
    Geraint Jones, a healthcare worker at a hospital in Wales, shares his experiences of Long Covid. Geraint tested positive for COVID-19 in April 2020, whilst working on the COVID-positive wards in a district general hospital.  This long-lasting illness is still little understood, but new research is uncovering some of the recurring symptoms that many patients experience and suggesting better options for treatment for adults and children.
  5. News Article
    Care homes and hospitals will be forced to allow visitors under plans being drawn up by the government. Helen Whately, the care minister, said shutting out relatives showed a lack of humanity. Covid-19 rules mean some of the country’s most vulnerable people still cannot have loved ones at their bedside. Whately, who has told of her personal grief and frustration at being barred from visiting her critically ill mother, is now developing laws to give residents and patients a right to receive visitors. Although official visiting restrictions were dropped in the spring in England, there are still widespread reports of care homes and hospitals refusing to let in relatives or imposing stringent conditions that ministers do not believe are justified by public health guidance. Hundreds of care homes still refuse to accept visitors entirely, according to government figures, while others restrict residents to one relative at a time. Campaigners report residents losing weight because their relatives cannot go in to help them at mealtimes amid staff shortages. They also fear residents are being left in bed for long periods because staff know there will be no visitors to check on them. Whately said that she was “determined to fix” the issue, adding: “No one can be in any doubt now how much visits matter”. Read full story (paywalled) Source: The Times, 11 November 2022 Related reading on the hub: Visiting restrictions and the impact on patients and their families: a relative's perspective It’s time to rename the ‘visitor’: reflections from a relative
  6. Content Article
    At the beginning of the pandemic, there was an important question to resolve: is coronavirus “airborne”? If it was, then this meant that the virus could transmit through the air from person to person, even over long distances, in indoor environments. We now know the answer is yes. In the 19th century diseases such as cholera and typhoid taught us the importance of water quality – coronavirus in the 21st century should provide that same realisation on the importance of air quality. Ideally, all indoor environments where people congregate should be fitted with modern, efficient ventilation systems that flush out potentially contaminated air and replace it with fresh, clean air continually. This would prevent the build-up of virus-containing aerosols and reduce the likelihood of transmission of covid-19 and other diseases such as influenza. With energy costs rising, it is vitally important to find methods of preventing virus transmission that are safe, quick to implement and affordable, writes Dr Alice Bunn in this HSJ article.
  7. News Article
    The share of referrals waiting more than three months for a diagnostic test — one of the key problems behind long waits for cancer treatment — is worse than at any point since February 2021, during the second national covid lockdown. NHS England data released this morning for September shows 12.4% of the 1.6 million awaiting a test had been on the list longer than 13 weeks. At the peak of June 2020, 32% waited more than 13 weeks, but the proportion dropped back beneath 1 in 10, in May 2021, as services ramped up activity following the impact of the major winter 2020-21 Covid wave. Echocardiography patients and those needing endoscopies had the highest proportion of patients waiting more than six weeks – these specialties jointly comprise about a third of the total national waiting list and had 48 and 38%, respectively, of their lists over six weeks. Katharine Halliday, president of The Royal College of Radiologists, said: ”Today’s cancer waiting times data is alarming. We know the longer patients wait for a diagnosis or treatment, the less their chance of survival. “Our members are clinical radiologists and clinical oncologists, and much of their work involves diagnosing and treating cancer. Today’s figures show the NHS in England would have to employ 441 radiology consultants, the equivalent of a 16% increase in the current workforce, in order to clear the six-week wait for CT and MRI scans in one month.” Read full story (paywalled) Source: HSJ, 10 November 2022
  8. News Article
    The number of falls and bed sores recorded in Scotland's hospitals has increased since the Covid pandemic, new data shows. NHS staffing pressures and the deconditioning effect of the Covid lockdown creating more frail patients are being blamed for the rise. The Scottish government paused work on a national prevention strategy for falls when the pandemic started. The strategy has now been shelved and experts argue this is a mistake. Figures released by NHS Healthcare Improvement Scotland (HIS) show that in 2018-19 - the last full year before the Covid pandemic - a total of 26,489 falls were recorded in hospitals. Dawn Skelton, a professor in ageing and health at Glasgow Caledonian University, said there was a "maelstrom" of problems fuelling the increase in hospital falls. She said: "You've got staffing issues definitely but you've also got people who are going in to hospital a step change frailer than they were pre-Covid because of what has happened with all the restrictions. "The people in these falls figures have got no reserves, blow on them and they will fall over, so they are at more risk when they go in." IProf Skelton said it was time to resurrect the Scottish government's falls and fracture prevention strategy as its "value now cannot be underestimated". She added: "Falls and frailty are one of the main causes of long hospital stays and demands on social care and without a spotlight on both the management, but also prevention, the financial and staffing demands on NHS and social care will only rise." Read full story Source: BBC News, 10 November 2022
  9. News Article
    A new report has highlighted for the first time an apparent rise in the suicide rate for pregnant or newly postpartum women in 2020, citing disruption to NHS services due to Covid-19 as a likely cause. According to the review of maternal deaths by MBRRACE-UK, 1.5 women per 100,000 who gave birth died by suicide during pregnancy or in the six weeks following the end of pregnancy in 2020, which is three times the rate of 0.46 per 100,000 between 2017 and 2019. The number of deaths by suicide within six weeks of pregnancy in 2020 was numerically small – 10 women – but this was the same as the total recorded across 2017 to 2019. This is also despite Office for National Statistics figures showing a year-on-year fall in suicides in the population overall in 2020. In relation to the rise in suicides during pregnancy and up to a year after birth, the report states: “During the first year of the covid-19 pandemic, very rapid changes were made to health services… Mental health services were not immune from this and there was a broad spectrum of changes from teams where some staff were redeployed to other roles, through to teams that were able to operate relatively normally… “All of this occurred on a background of a recent huge expansion in specialist perinatal mental health services." Read full story (paywalled) Source: HSJ, 11 November 2022
  10. Content Article
    The MBRRACE-UK collaboration, led from Oxford Population Health's National Perinatal Epidemiology Unit (NPEU), has published the results of their latest UK Confidential Enquiry into Maternal Deaths and Morbidity. These annual rigorous reports are recognised as a gold standard in identifying key improvements needed for maternity services. The latest Saving Lives, Improving Mothers' Care analysis examines in detail the care of all women who died during, or up to one year after, pregnancy between 2018 and 2020 in the UK. This is the first report to include data that demonstrates the impact of the COVID-19 pandemic on maternal deaths.
  11. Content Article
    This article in the BMJ highlights a number of recent articles that reflect on the realities facing the health service after the first brutal years of the Covid-19 pandemic. It summarises and links to articles in the BMJ about the elective care backlog, A&E waiting times, remote appointments, Government pressures that stop senior clinicians speaking out about pressures, and the need for credible policy solutions. It also highlights an article outlining how Brexit and the Northern Ireland Protocol have resulted in the UK being denied access to European research funding and meetings.
  12. Content Article
    It is well known that pausing planned hospital care during the pandemic worsened growing waiting lists, and that waits for routine care now stand at record-breaking levels. This research from the Nuffield Trust, supported by the NHS Race and Health Observatory, looks at how the fallout from the pandemic affected people across different ethnic groups, and whether that impact was spread evenly.
  13. Content Article
    In this blog, Roger Kline, Research Fellow at Middlesex University Business School, highlights the lack of support from the Government and NHS that healthcare staff with Long Covid face. He looks at the impact of the Government’s decision to scrap extended sick pay for NHS staff with Long Covid and argues that healthcare workers deserve better support. The blog includes accounts from 31 NHS nurses and midwives with Long Covid; some are having to use annual leave as they cannot work their full hours and some have been threatened with redundancy. Others describe their experiences of phased return to work and applying for the NHS Injury Allowance or ill health early retirement.
  14. Event
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    Sir Mike Richards’ review of diagnostics, Diagnostics: recovery and renewal, which was commissioned in response to recommendations in the NHS Long-Term Plan, outlined a new diagnostic model for services. The review identified key enablers to drive and deliver much needed to change to optimise diagnostic capacity and improve efficiency, along with the need for a major expansion of the workforce and improved connectivity and digitisation across all aspects of diagnostics. Demand for almost all aspects of diagnostics has been rising year on year. The public’s familiarisation with swab testing and testing closer to home through the Covid-19 has provided a strong launch pad to change the approach to diagnostics in response to this rising demand This King's Fund event will explore what can be learnt from the NHS reponse to Covid-19, how partners are working to reshape diagnostic pathways through community diagnostic centres, point-of-care testing and increasing workforce capability and capacity. Register
  15. News Article
    Patients are not always getting the care they deserve, says the head of NHS England. Amanda Pritchard told a conference the pressures on hospitals, maternity care and services caring for vulnerable people with learning disabilities were of concern. She even suggested the challenge facing the health service now was greater than it was at the height of the pandemic. Despite making savings, the NHS still needs extra money to cope, she said. Next year the budget will rise to more than £157bn, but NHS England believes it will still be short of £7bn. Ms Pritchard told the King's Fund annual conference in London that demand was rising more quickly than the NHS could cope with. "I thought that the pandemic would be the hardest thing any of us ever had to do," she said. "Over the last year, I've become really clear.... it's the months and years ahead that will bring the most complex challenges." Read full story Source: BBC News, 2 November 2022
  16. News Article
    Extreme disruption to NHS services has been driving a sharp spike in heart disease deaths since the start of the pandemic, a charity has warned. The British Heart Foundation (BHF) said ambulance delays, inaccessible care and waits for surgery are linked to 30,000 excess cardiac deaths in England. It has called for a new strategy to reduce "unacceptable" waiting times. Doctors and groups representing patients have become increasingly concerned about the high number of deaths of any cause recorded this year. New analysis of the mortality data by the BHF suggests heart disease is among the most common causes, responsible for 230 deaths a week above expected rates since February 2020. The charity said "significant and widespread" disruption to heart care services was driving the increase. Its analysis of NHS data showed that 346,129 people were waiting for time-sensitive cardiac care at the end of August 2022, up 49% since February 2020. It said 7,467 patients had been waiting more than a year for a heart procedure - 267 times higher than before the pandemic. At the same time, the average ambulance response time for a suspected heart attack has risen to 48 minutes in England against a target of 18 minutes, according to the latest NHS figures. The BHF said difficulty accessing face-to-face GP and hospital care may have also contributed to the rise. Read full story Source: BBC News, 3 November 2022
  17. News Article
    A consultant oncologist who ignored a hospital instruction and attended patients’ cancer surgery on two days when he knew he was still testing positive for Covid-19 has been suspended from the UK medical register for three months. Andrew Gaya admitted knowingly breaking the rules but told the medical practitioners tribunal he had feared that the patients’ treatments would be postponed if he could not attend the private London Gamma Knife Centre, part of HCA Healthcare UK. The two incidents occurred in the early weeks of the pandemic, at a time of high covid death rates. “I did not take the decision to attend the centre on 3 April 2020 lightly and was aware it was not in accordance with the instructions I had been given,” Gaya told the tribunal. “At the time I thought that I wasn’t going to do any harm and that I was acting in the best interests of the patient as the case was urgent. “I know I should have telephoned [the relevant manager] and asked if she would allow me to undertake the treatment, but I was afraid her answer would be ‘no’ and that the patient’s treatment would be cancelled,” he told the tribunal in a witness statement. Both patients have since died, but after the tribunal concluded Gaya told the Daily Telegraph, “One lived for 6 months with good quality of life.” Gaya, who was present as part of a multidisciplinary team, wore protective gear and observed social distancing. There is no evidence that he had infected anyone. Read full story Source: BMJ, 1 November 2022
  18. Content Article
    This report by the National Medical Examiner, Dr Alan Fletcher, summarises the progress made by medical examiner offices in 2021 and outlines areas of focus going forward. It highlights that medical examiners continued to receive positive feedback from bereaved people—many said they appreciated being given the opportunity to have a voice in the processes after a death and knowing any concerns were listened to. It includes information on: The national medical examiner system Implementation Guidance and publications Training Stakeholders Increasing the number of non-coronial deaths scrutinised Feedback received by medical examiners in England and Wales
  19. News Article
    The Covid public inquiry has asked to see Boris Johnson's WhatsApp messages during his time as prime minister as part of its probe into decision-making. Counsel for the inquiry, Hugo Keith KC, said the messages had been requested alongside thousands of other documents. He said a major focus of this part of the inquiry was understanding how the "momentous" decisions to impose lockdowns and restrictions were taken. The revelations came as he set out the details of how this module will work. The inquiry is being broken down into different sections - or modules as they are being called. The preliminary hearing for module one, looking at how well prepared the UK was, took place last month. Monday marked the start of the preliminary hearing for module two, which is looking at the political decision-making. Mr Keith said this allowed the inquiry to take a "targeted approach". He said it would look at whether lives could have been saved by introducing an earlier lockdown at the start of 2020. Read full story Source: BBC News, 31 October 2022
  20. Content Article
    Appreciative Inquiry (AI) is a research approach that aims to create practical and collaborative change by taking participants through an in-depth exploration of their organisation, team or role. This article in the European Journal of Midwifery reflects on the process of using AI in a study that explored staff wellbeing in a UK maternity unit. The authors share key lessons to help others decide whether AI will fit their research aims, and highlight issues in its design and application.
  21. News Article
    A surge in Covid cases over winter could lead to harsh visiting restrictions being reimposed in care homes and hospitals, MPs and campaigners have warned. Families are still facing a “postcode lottery” of Covid restrictions in care homes, with visiting times restricted and personal protective equipment (PPE) obligatory. However MPs are worried that some will reimpose even harsher measures if Covid cases rise this winter. Daily global Covid infections are projected to rise slowly to around 18.7 million by February, up from the current 16.7 million average daily cases this October. MPs are calling for the government to enact legislation that would enshrine the right for an essential care giver to be present with their loved ones in care settings. Liberal Democrat MP Daisy Cooper said that one of her constituents, Lynn, was not allowed into a hospital A&E ward to see her husband Andy when his dementia deteriorated over Christmas last year. The hospital refused to let Andy have any visitors for two weeks until Ms Cooper intervened. When she was allowed in, Lynn was distraught to find that Andy had lost a significant amount of weight in the weeks he was isolated. Ms Cooper continued: “We have come a long way since last Christmas, and since the start of the pandemic, but as winter approaches the NHS and care settings are once again expected to struggle with a surge in Covid cases. “It is not inconceivable that what happened to Lynn and Andy could happen again to them and to many others.” Read full story Source: Independent, 30 October 2022 Further hub reading Visiting restrictions and the impact on patients and their families: a relative's perspective It’s time to rename the ‘visitor’: reflections from a relative Mother knows best – a blog by Dr Abha Agrawal
  22. Content Article
    Emer Joyce is a Cardiologist at Mater University Hospital in Dublin who developed myocarditis as a result of a Covid-19 infection. This article by Professor Joyce in the European Journal of Heart Failure aims to "give a birds-eye view of the physician as patient, the sub-specialist as sub-specialist condition sufferer, the one on the far side of the bed as the one in the bed." She also looks at the pattern of previously healthy, highly active healthcare professionals developing serious long-term health issues as a result of Covid-19.
  23. Content Article
    The Covid-19 pandemic has, in many ways, been healthcare’s finest hour. Clinicians performed miracles as they battled to understand a new disease, learning as they went along the techniques and approaches that gave patients the best chance of survival. But, for all this quiet heroism, the crisis also turned a harsh spotlight on the deficiencies of health systems, writes Sarah Neville in this Financial Times article.
  24. Event
    This Westminster conference will discuss the future for Long Covid research, services, and care. It will be an opportunity to assess Long Covid: the NHS plan for improving Long Covid services and how its ambitions for improving access to services, patient experience and outcomes for patients can be achieved. Further sessions examine priorities for research and improving understanding of Long Covid, looking at implementing the latest developments in research to improve services, and the long-term health implications of Long Covid. There will also be discussion on addressing concerns around inequalities, capacity and wait times for Long Covid services, as well as the primary care referral system, and utilisation of investment. Sessions in the agenda include: latest developments: trends - key issues - assessing the NHS plan for improving long COVID services. clinical research: taking forward the understanding of Long Covid - advancing clinical trials - utilising data - funding and investment. improving patient outcomes, prediction and prevention - accelerating the development of effective treatments - areas for focus, such as cardiology. examining the increased risk of long-term health conditions and impacts of reinfection for Long Covid patients. improving specialist Long Covid services: progress made so far and priorities for moving forward. options for increasing capacity - addressing inequalities in provision, access to services and information - applying latest developments from research. children’s Long Covid services: assessing delivery - implications for child development and attainment. primary care: tackling key challenges for diagnosis and referral. the workforce: priorities for education and training - support for long COVID patients in the workforce. Register
  25. Content Article
    Recording of the recent All-Party Parliamentary Group (APPG)Coronavirus evidence session on Long Covid.
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