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News ArticleDoctors and nurses in areas of northern England with some of the highest Covid infection rates have described being “physically and emotionally” exhausted, as the NHS braces itself for the second wave of the pandemic. Most of the north has been put into the tier 2 “high risk” category, with Merseyside in the highest – tier 3 – bracket. While politicians debate whether a nationwide circuit breaker would be a more effective instrument to curb spread of the virus, frontline staff – still scarred from the first wave – are under no illusions as to what lies in store. Carmel O’Boyle, a nurse in Liverpool, who is also chair of the Royal College of Nursing’s Greater Liverpool and Knowsley branch, said members of the public had used A&E and primary care sparingly during the first national lockdown but mixed messages and a lack of trust in the government had led to people throwing caution to the wind and attendances were rising accordingly. “The nurses across my branch are frightened and exhausted – physically and emotionally,” she said. “They’ve been dealing with this for months and now there are more people in hospitals than there were in March. Although we know a little bit more about how to treat people and the kind of path of the disease process, it’s still frightening. It’s just so demanding and so draining to be nursing people in this manner without any family involvement and with the complications that there are.” A consultant in Manchester, who did not want to be named, said her hospital coped with the first wave but “the difference this time is that we’re trying to continue all of the elective activity and that’s going to be challenging. “I do think that we will manage the Covid cases. I just now worry about whether we will be able to continue to keep the normal care for people who need their operations [and] need care for cancer." Read full story Source: The Guardian, 15 October 2020
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News ArticleAt the age of 49, Sarah Fisher feels her life is on a knife-edge. She had a heart attack during lockdown and has subsequently been diagnosed with heart failure. In July, she was told she needed to have an implantable cardioverter defibrillator (ICD) fitted, which can shock the heart back into rhythm when it detects a potential cardiac arrest. But 12 weeks on, she is still waiting. "I could have a cardiac arrest at any point," Sarah says. "It is awful not knowing what is going to happen. "I am on the urgent list – but the infection rates are rising and the clinics are closing." "I don't know when I will get it. "There are so many people in my position – we don't have Covid but our lives are at risk too. We are the forgotten victims of this pandemic." British Heart Foundation analysis of Office for National Statistics data for England and Wales found almost 800 extra deaths from heart disease among under-65s from March to July - 15% more than would be expected. The rate of death was highest during the full lockdown - but, worryingly, the trend continued afterwards. The charity blames delays in people seeking care, as well as reduced access to routine tests and treatments. And NHS England figures show a sharp rise in the numbers waiting over six weeks for a whole range of key tests, including echocardiograms for hearts. Read full story Source: BBC News, 15 October 2020
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News Article"Long Covid" – the long-lasting impact of coronavirus infection – may be affecting people in four different ways, according to a review, and this could explain why some of those with continuing symptoms are not being believed or treated. There could be a huge psychological impact on people living with long-term COVID-19, the National Institute for Health Research report says. They need more support – and healthcare staff require better information. Most people are told they will recover from mild coronavirus infections within two weeks and from more serious disease within three. But the report says thousands could be living with "ongoing Covid". Based on interviews with 14 members of a long-Covid support group on Facebook and the most recent published research, the review found recurring symptoms affecting everything from breathing, the brain, the heart and cardiovascular system to the kidneys, the gut, the liver and the skin. These symptoms may be due to four different syndromes: permanent organ damage to the lungs and heart post-intensive-care syndrome post-viral fatigue syndrome continuing COVID-19 symptoms Some of those affected have had a long stay in hospital with severe Covid-19 - but others, who have had a mild infection, have never even been tested or diagnosed. The review says coming up with a "working diagnosis for ongoing COVID-19" would help people access support. Read full story Source: BBC News, 15 October 2020
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News Article
Liverpool intensive care units '90% full' as city braces for second wave
Patient Safety Learning posted a news article in News
Intensive care units in Liverpool’s hospitals are more than 90% full, according to a local health leader, as the city braces for a second wave of COVID-19 infections. Councillor Paul Brant, cabinet member for adult health and social care at Liverpool City Council, warned that hospital services were once again being forced to care for patients critically ill with coronavirus. "Our intensive, critical care beds are filling up very fast,” he told BBC Radio 4's Today programme. "The most recent figures I've seen suggest they are over 90 per cent full and our acute hospital trusts have occupancy levels of Covid-positive patients of over 250. At the current rate of increase, we would expect Liverpool to surpass the peak of the first wave probably within the next seven to 10 days." Addressing the intensive care situation, he added: "They are not all Covid patients, I should say, but they are running very full and they are running with an increasing number of people who are Covid-positive." He added: "It has become clear that the intensity of the demand on hospital services here in Liverpool is crowding out anything other than dealing with Covid." Read full story Source: The Independent, 14 October 2020 -
News ArticleCovid’s second surge has begun disrupting elective care at hospitals outside the north west, HSJ has learned. At Nottingham University Hospitals Trust, the number of patients with COVID-19 is “rising fast”, causing ward closures and elective care disruption, according to an internal memo seen by HSJ. The memo, sent by the trust’s divisional director for surgery Simon Parsons, said covid admissions to the trust “are way past 100 and rising fast”. “There are also outbreaks of covid on certain wards, which have resulted in closures of beds,” Mr Parsons said. “I am afraid the elective programme is going to be disrupted and we are doing everything we can to preserve as much elective work as possible,” said the memo to staff at the major teaching hospital. Mr Parsons called on clinicians to concentrate on “getting patients discharged in a timely way” and for them to escalate instances where patients were fit for discharge but not leaving the trust. “We are not asking you to make unsafe discharges but to keep length of stay as short as possible,” Mr Parsons said. Read full story (paywalled) Source: HSJ, 14 October 2020
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News ArticleIncreasing staff absence due to COVID-19 will have a ‘significant impact’ on the ability of the NHS to deliver critical care services and routine operations, leading intensive care doctors have said. The latest NHS England data has shown the number of COVID-19 related absences of staff, either through sickness or self-isolation, has risen from 11,952 on 1 September to 19,493 on 1 October. Staff absence has almost doubled in the North West in this time as well – from 2,664 to 5,142 during the same period. It peaked at 17,628 in the region on 11 April and means the October total accounts for nearly a third of that amount already (29%). Alison Pittard, dean of the Faculty of Intensive Care Medicine, confirmed increasing numbers of NHS critical care staff were absent from work. “I suspect this is due to having to be at home with children asked to isolate and therefore the parent needing to isolate, as was the case in the first wave," she told HSJ. “This will have an impact on our ability to deliver critical care services. We know that staff numbers are inadequate at the best of times, with a significant vacancy rate especially for critical care nurses.” Royal College of Anaesthetists council member Helgi Johannsson said the rising absence rate was “likely to have a significant impact”, particularly on routine operations. Dr Johannsson, a consultant anaesthetist at Imperial College Healthcare Trust, said: “In my hospitals, I have been aware of several doctors and nurses having to isolate due to their children being asked to self-isolate. These healthcare staff were otherwise well and would have been at work." Read full story (paywalled) Source: HSJ, 14 October 2020
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News ArticleA 45-year-old British man has been left with permanent hearing loss after developing COVID-19. UK doctors say it is the first such case they have seen linked to the pandemic coronavirus. Although rare, sudden hearing loss can follow other viral infections, such as flu. The ear-nose-and-throat experts told BMJ Case Reports journal steroid drugs could help avoid this damage if given early enough. The patient, who has asthma, had been admitted to a London hospital with COVID-19 symptoms and transferred to intensive care after struggling to breathe. Tests confirmed he had coronavirus and he was put on a ventilator machine. He also needed various drugs and a blood transfusion before beginning to recover and coming off the ventilator 30 days later. A week after the breathing tube was removed and he left intensive care, he noticed tinnitus (a ringing or buzzing noise) followed by sudden hearing loss in his left ear. A hearing test suggested the loss was linked to damage to the hearing nerve, the middle ear, or both, rather than inflammation or a blockage to the ear canal. Doctors could find no explanations for his hearing problem, other than his recent COVID-19 illness. They gave him steroid tablets as well as injections into the ear, which helped a little, but he has some irreversible hearing loss. Read full story Source: BBC News, 14 October 2020
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News Article
NHS England at loggerheads with Test and Trace over staff testing
Patient Safety Learning posted a news article in News
The introduction of weekly covid tests for NHS staff in ‘high risk areas’ will mean other groups missing out or waiting longer, well-placed sources have told HSJ. There is also understood to be a standoff between NHS England and Test and Trace over the regular testing of asymptomatic staff, which was announced for the North of England on Monday. NHS trust labs don’t have enough capacity to test all their staff; and there is not enough spare in “pillar two” commercial labs to carry out hundreds of thousands of additional tests. National bodies are said to be in disagreement over who should do it. NHSE believes they should be provided by T&T, and T&T says NHS labs should expand their capacity to carry them out themselves, HSJ has been told. A senior source involved in the testing programme said there would have to be “trade-offs” for T&T to meet the new NHS demand, with supply having to be cut for others who want tests — mostly the general population, or care home staff. At present the NHS has agreed to carry out 100,000 daily tests by the end of the month, as part of the T&T’s overall 500,000 target. It has been encouraged to do more by T&T, but any expansions may face shortages of equipment and supplies such as reagents, as well as staff and space. Read full story (paywalled) Source: HSJ, 13 October 2020 -
News Article
Covid reinfection: Man gets Covid twice and second hit 'more severe'
Patient Safety Learning posted a news article in News
A man in the United States has caught Covid twice, with the second infection becoming far more dangerous than the first, doctors report. The 25-year-old needed hospital treatment after his lungs could not get enough oxygen into his body. Reinfections remain rare and he has now recovered. However, the study in the Lancet Infectious Diseases raises questions about how much immunity can be built up to the virus. The man from Nevada had no known health problems or immune defects that would make him particularly vulnerable to Covid. Scientists say the patient caught coronavirus twice, rather than the original infection becoming dormant and then bouncing back. A comparison of the genetic codes of the virus taken during each bout of symptoms showed they were too distinct to be caused by the same infection. "Our findings signal that a previous infection may not necessarily protect against future infection," said Dr Mark Pandori, from the University of Nevada. "The possibility of reinfections could have significant implications for our understanding of COVID-19 immunity." Read full story Source: BBC News, 13 October 2020 -
News ArticleCare homes should refuse to take coronavirus patients from hospitals if they cannot prevent the spread of the disease, the care watchdog has told The Independent. Staff should admit these patients only if care homes are equipped with the right personal protective equipment (PPE) and infection prevention measures, the Care Quality Commission (CQC) said. During the first wave of the pandemic, care homes saw widespread outbreaks of the virus with 16,000 deaths. Homes struggled to access protective clothing for staff and were forced to take 25,000 untested patients discharged from hospitals. In an in-depth interview, Kate Terroni, the CQC’s chief inspector of social care, said care homes should not be put under pressure during a second wave to take infected patients they could not properly look after. She said any home that refused to admit patients would have her support. “Care home providers should only admit a resident when they are confident they can meet their care needs, so where they are confident they’ve got good infection prevention control, they’ve got the right PPE, they’ve got the right workforce." “We will absolutely support a provider to say they cannot admit someone if those ingredients aren’t in place.” Read full story Source: The Independent, 12 October 2020,
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News ArticleHospitals in Liverpool are scaling back non-urgent operations to help them cope with COVID-19 patients despite NHS bosses insisting that normal care continues during the second wave. NHS trusts elsewhere in north-west England, as well as in the north-east and Midlands, are also preparing to cancel routine surgery such as joint replacements and hernia repairs amid a rapid rise in seriously ill coronavirus patients. A potential second suspension of non-Covid care is looming despite warnings that this may lead to many thousands dying because their cancer, heart problem or other illness is not diagnosed or treated. Steve Warburton, the chief executive of Liverpool University Hospitals NHS trust, acknowledged that doing less surgery would be “distressing” for patients affected but said the city’s three main acute hospitals had reached a “critical point”. It is the first trust in England to make clear it cannot provide normal levels of non-Covid care during the second coronavirus surge, even though NHS England has told all hospitals to do so. The decision is likely to lead to other trusts doing the same. Warburton said: “We will continue to prioritise surgery based in clinical need with a view to maintaining urgent and cancer surgery where possible.” He promised that the trust would continue to provide outpatient appointments “wherever possible” and keep giving patients diagnostic tests such as CT and MRI scans. Read full story Source: The Guardian, 12 October 2020
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News ArticleAn urgent investigation into blanket orders not to resuscitate care home residents has been launched amid fears some elderly people may still be affected by the “unacceptable” practice. After COVID-19 cases rose slightly in care homes in England in the last week, with 116 residences handling at least one infection, the Care Quality Commission (CQC) said it was developing the scope of its investigation “at pace” and it would cover care homes, primary care and hospitals. In March and April, there were reports that some GPs had applied “do not attempt resuscitation” (DNAR) notices to groups of care home residents that meant people would not be taken to hospital for potentially life-saving care. This was being done without their consent or with little information to allow them to make informed decisions, the CQC said. Cases emerged in care homes in Wales and East Sussex. Care homes said the blanket use of the orders did not appear to be as prevalent ahead of a possible second wave of infections and families were reporting fewer concerns, although that could be because visiting restrictions meant they had less access to the homes and were getting less information. There are also concerns that steps may not have been taken to review DNAR forms added to care home residents’ medical files, and so they could remain in place, without proper consent. The CQC review will examine the use of “do not attempt cardiopulmonary resuscitation” (DNACPR) notices, which only restrict chest compressions and shocks to the heart. Dr Rachel Clarke, a palliative care expert in Oxford, has described the CPR process as “muscular, aggressive, traumatic” and said it often resulted in broken ribs and intubation. The review will also investigate the use of broader do not resuscitate and other anticipatory care orders. “We heard from our members about some pretty horrific examples of [blanket notices] early in the pandemic, but it does not appear to be happening now,” said Vic Rayner, the executive director of the National Care Forum, which represents independent care homes. “DNAR notices should not be applied across settings and must be only used as part of individual care plans.” It will also investigate the use of broader do not resuscitate and other anticipatory care orders. Read full story Source: The Guardian, 12 October 2020
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News ArticleWomen are being disproportionately affected by a rise in mental health problems caused by increasing workloads as people do their jobs from home amid the pandemic. The length of the working day has increased steadily, resulting in a 49% rise in mental distress reported by employees when compared with 2017-19. Women are bearing the brunt of problems as they juggle work and childcare, according to a report by the 4 Day Week campaign and thinktanks Compass and Autonomy. The report, Burnout Britain, cshows that women are 43% more likely to have increased their hours beyond a standard working week than men, and for those with children, this was even more clearly associated with mental health problems: 86% of women who are carrying out a standard working week alongside childcare, which is more than or equivalent to the UK average, experienced problems in April this year. The report warns that “as well as an impending recession and mass unemployment, we are heading into an unprecedented mental health crisis”. Read full story Source: The Guardian, 9 October 2020
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News ArticleOne of the earliest signs that black, Asian and minority ethnic (BAME) people were being disproportionately harmed by the coronavirus pandemic came when the Intensive Care National Audit and Research Centre (ICNAR) published research in early April showing that 35% of almost 2,000 Covid patients in intensive care units in England, Wales and Northern Ireland were non-white. A lot has happened in the intervening six months with numerous reports, including by the Office for National Statistics and Public Health England (PHE), confirming the increased risk to ethnic minorities and recommendations published on how to mitigate that risk. However, as the second wave intensifies, the demographics of those most seriously affected remain remarkably similar. ICNARC figures show that the non-white proportion of the 10,877 Covid patients admitted to intensive care up to 31 August was 33.9% in England, Wales and Northern Ireland. This rises to 38.3% of patients admitted since 1 September, albeit of a much smaller cohort (527 intensive care admissions). The government mantra “we’re all in this together” proved to be little more than an empty rallying cry early in the pandemic and the ICNARC figures show it remains the case that people in the most deprived socioeconomic groups make up a greater proportion of patients in critical care. Read full story Source: The Guardian, 9 October 2020
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News ArticleYoung people's risk of becoming ill with COVID-19 is tiny - but could the long-term mental health impact of virus restrictions be far more damaging? A growing number of psychologists, psychiatrists and child health experts believe the needs of the young are being ignored in this pandemic. Prof Ellen Townsend, an expert in child and adolescent self-harm and suicide from Nottingham University, says the way students are being treated "is massively damaging for their mental health". "It doesn't make sense to lock up young people," she says. "We have to move past this one disease - a more nuanced approach is needed." She is not alone - a group of UK academics who work with children and adolescents have set up an online noticeboard collecting scientific evidence that these age groups are being forgotten by policy-makers. Problems such as self-harm and anxiety were already on the rise before lockdown, particularly among teenagers, with one in eight children and young people estimated to have a mental health condition. There is a lack of hard evidence, but research suggests growing feelings of loneliness and social isolation during the pandemic have had a negative impact. A study in The Lancet Psychiatry found children's mental health deteriorated most during that period compared with other age groups. More worrying was the "massive drop-off" in troubled children and teenagers being sent to specialist psychiatrists over several months - from 40 a day to four a day, according to the Royal College of Psychiatrists. Although services stayed open during lockdown, either the message didn't get through or people were too frightened to make contact. The fear is that these young people could now become more seriously ill without the help they need. Eating disorders, which have a high death rate, are a particular concern. Read full story Source: BBC News, 10 October 2020
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News ArticleFamous faces, including TV chefs Gordon Ramsay, Nadiya Hussein, and actress Emma Thompson are backing a major new campaign urging anyone concerned about cancer to get checked and to keep routine appointments, as new research found that even now, nearly half (48%) of the public would delay or not seek medical help at all. A fifth (22%) would not want to be a burden on the health service while a similar number said that fear of getting coronavirus or passing it onto others was a major reason for not getting help. More than four in ten people would leave it longer to get health advice than they normally would have before the coronavirus outbreak, however delaying can have serious consequences for some cancers. NHS staff have pulled out all the stops to keep cancer services going throughout the pandemic, with almost one million people referred for checks or starting treatment since the virus took hold. The NHS’s Help Us Help You access campaign will use TV adverts, billboards and social media to urge people to speak to their GP if they are worried about a symptom that could be cancer, and also remind pregnant women to attend check-ups and seek advice if they are worried about their baby. People with mental health issues are also been encouraged to access NHS support. Read full story Source: NHS England, 9 October 2020
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News ArticleHundreds of thousands of vulnerable people living in coronavirus hotspots could be told to "shield" this winter as infections continue to rise. Ministers are expected to outline a three-tier local lockdown system next week, which may see those most at risk if they catch COVID-19 being told to stay at home for a month. A decision on shielding has not been finalised and may be delayed because of fears for the mental health of those told to avoid seeing other people. Around 2.2 million people in England deemed "clinically extremely vulnerable" were asked to shield at the height of the coronavirus pandemic before the scheme was "paused" at the end of July. Sky News understands that the level of self-isolation required in each area will vary depending on the restrictions in place there. It is thought the advice will be clinically led, with GPs helping guide what people should do bearing in mind possible negative effects on mental health. This compares with the more blanket advice on shielding last time around. Read full story Source: Sky News, 9 October 2020
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News ArticleThe numbers waiting over a year for hospital treatment have hit a 12-year high in England as hospitals struggle to get services back to normal. Nearly 2m patients have been waiting more than the target time of 18 weeks for routine care with 111,000 left for over a year, NHS England figures show. The numbers starting cancer treatment and getting urgent checks are also below the levels seen a year ago. But NHS England said "progress" was being made. It pointed out more patients were starting to be seen - although there are now warnings service may have to be cut back on again as admissions for Covid continue to rise. About 500 patients a day are being admitted to hospital with the disease - double the number two weeks ago. Health Secretary Matt Hancock said the UK was in a "perilous" position and the ability of the NHS to see non-Covid patients was under threat. Health minister Nadine Dorries predicted within 10 days hospitals would be a "critical" point. Read full story Source: BBC News, 8 October 2020
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News Article
Less than half UK population to receive coronavirus vaccine, says task force head
Patient Safety Learning posted a news article in News
Less than half of the UK population will get a Covid vaccine with the elderly being top priority - a top advisor has warned. Kate Bingham, who was appointed as the chair of the Vaccine Taskforce back in May has claimed that the public has been “misguided” when it comes to availability of a vaccine. In an interview with the Financial Times, she said the government “needs to vaccinate everyone at risk”. She said: “People keep talking about ‘time to vaccinate the whole population’, but that is misguided." “There’s going to be no vaccination of people under 18. It’s an adult-only vaccine, for people over 50, focusing on health workers and carehome workers and the vulnerable.” Read full story Source: Financial Times, 4 October 2020 -
News Article
Former ministers to hold 'rapid' inquiry into government's COVID-19 response
Patient Safety Learning posted a news article in News
A pair of Conservative former ministers have announced they are to lead a rapid, cross-party investigation into the UK’s handling of the coronavirus crisis, amid worries a government inquiry will take too long for lessons to be learned in time. In a rare set of joint hearings, the Commons health committee, led by ex-health secretary Jeremy Hunt, and the science committee, chaired by Greg Clark, who was business secretary, are to hear from witnesses in the hope of producing a report by the spring. Announcing the plan, Hunt and Clark said the inquiry would aim to produce interim recommendations along the way. It will hold weekly joint sessions, with early witnesses set to include Chris Whitty, the chief medical officer for England, and Patrick Vallance, the government’s top scientific adviser. Hunt said he would expect the inquiry to cover the need for regular, large-scale coronavirus testing, an issue he has repeatedly raised in parliament, and whether this could help people visit loved ones in care homes. The hearings begin next Tuesday with a session on social care. Other promised areas of examination include the efficacy of lockdown measures; how well modelling and statistics have been used; the efficacy of government messaging; wider preparedness for a pandemic; and the impact on BAME communities. Read full story Source: The Guardian, 8 October 2020 -
News Article
Stevens announces £10m for ‘long covid’ clinics
Patient Safety Learning posted a news article in News
NHS England will spend £10m on new clinics for ‘long covid’ sufferers, it was announced yesterday. Sir Simon Stevens, NHSE chief executive, told the NHS Providers annual conference the clinics would offer support to the “probably hundreds of thousands” of people suffering persisting symptoms such as fatigue, breathlessness and ‘brain fog’ months after being infected with COVID-19. It comes amid growing calls for wider services to support people with ‘long covid,’ as hospital follow-up clinics are generally only open to those who were previously admitted with the virus. HSJ was last month only able to identify one genuine “long covid clinic”, despite claims by health secretary Matt Hancock they had “announced them in July”. It appears that comment was a mistake. Speaking about long covid, he said: “The NHS has got to be just as responsive and agile in respect of… new needs, including long covid, as we were in repurposing critical care, and ventilators, and acute capacity in the first phase in March, April and May." “Today we are going to be allocating £10m to establish a network of designated long covid clinics across the country, which, in line with new NICE guidelines on effective treatment pathways, will offer support for the tens of thousands, probably hundreds of thousands, of patients who have got long covid.” Sir Simon also told the conference today that NHSE was “enthusiastic” about introducing regular asymptomatic covid testing for NHS staff “if and when” it is recommended by the government chief medical officer, and when Test and Trace has enough capacity. There are growing calls for regular testing of asymptomatic NHS staff, especially in hotspot areas, including from former health secretary Jeremy Hunt. Sir Simon said it was “something the chief medical officer and the test and trace programme are continuing to review”. He said: “We would be enthusiastic about doing that if and when that is the clinical recommendation and if and when the Test and Trace programme has got the testing capacity to do that. The plan was always that it would largely have to be sourced out of the total testing capacity available to the nation, not just the NHS labs.” Read full story Source: HSJ, 7 October 2020 Read Patient Safety Learning's response to this news Please share your thoughts with us on the support that is needed on our patient safety platform, the hub. -
News Article
NHS to offer ‘Long Covid’ sufferers help at specialist centres
Patient Safety Learning posted a news article in News
People suffering 'Long Covid’ symptoms will be offered specialist help at clinics across England, the head of the NHS announced today. Respiratory consultants, physiotherapists, other specialists and GPs will all help assess, diagnose and treat thousands of sufferers who have reported symptoms ranging from breathlessness, chronic fatigue, 'brain fog', anxiety and stress. Speaking at the NHS Providers conference today (Wednesday), NHS chief executive Sir Simon Stevens will announce that £10 million is be invested this year in additional local funding to help kick start and designate Long Covid clinics in every area across England, to complement existing primary, community and rehabilitation care. Sir Simon said new network will be a core element of a five-part package of measures to boost NHS support for Long Covid patients: New guidance commissioned by NHS England from NICE by the end of October on the medical ‘case definition’ of Long Covid. This will include patients who have had covid who may not have had a hospital admission or a previous positive test. It will be followed by evidence-based NICE clinical guidelines in November on the support that Long Covid patients should receive, enabling NHS doctors, therapists and staff to provide a clear and personalised treatment plan. This will include education materials for GPs and other health professionals to help them refer and signpost patients to the right support. The ‘Your Covid Recovery’ – an online rehab service to provide personalised support to patients. Over 100,000 people have used the online hub since it launched in July, which gives people general information and advice on living with Long Covid. Phase 2 of the digital platform will see people able to access a tailored rehabilitation plan. This service will be available to anyone suffering symptoms that are likely due to COVID-19, regardless of location or whether they have spent time in hospital. Designated Long Covid clinics, as announced today. This will involve each part of the country designating expert one-stop services in line with an agreed national specification. Post-covid services will provide joined up care for physical and mental health, with patients having access to a physical assessment, a cognitive assessment and a psychological assessment. Patients could also then be referred from designated clinics into specialist lung disease services, sleep clinics, cardiac services, rehabilitation services, or signposted into IAPT and other mental health services. NIHR- funded research on Long Covid which is working with 10,000 patients to better understand the condition and refine appropriate treatment. The NHS’s support will be overseen by a new NHS England Long Covid taskforce which will include Long Covid patients, medical specialists and researchers. Read full story Source: NHS England, 7 October 2020 Read Patient Safety Learning's response to this news Please share your thoughts with us on the support that is needed on our patient safety platform, the hub. -
News ArticleInspectors have demanded improvements from a hospital after a report highlighted a number of failings over COVID-19 precautions. The Care Quality Commission (CQC) inspected the emergency department and medical wards at the William Harvey Hospital in Ashford, Kent, on 11 August. Inspection teams visited a ward where patients showed symptoms and were awaiting test results as well as a ward caring for patients who had COVID-19. A ward for patients without the virus and a fourth ward where there had been an outbreak of COVID-19 were also inspected. The CQC said it took urgent enforcement action, telling the trust to ensure there was an "effective system to manage the health and safety of people using the hospital". The report revealed staff did not always wear PPE or face coverings correctly in medical wards. One member of the nursing team was seen to be wearing a mask incorrectly in the ward where there had been an outbreak of the coronavirus. At least seven members of staff were seen entering and leaving the ward caring for people who were suspected of having COVID-19 without adhering to hand hygiene practices. Staff did not always remove PPE upon entering a new clinical area of the emergency department. Nor did they always put on or take off their PPE when entering and leaving patient bays. While equipment was said to have been cleaned on the day, inspectors found this was not always recorded. The report also detailed that five members of staff were seen in one room that was too small to enable the practised social distancing in that space. East Kent Hospitals Trust chief executive Susan Acott said: "In August, a CQC inspection team visited the William Harvey Hospital and saw examples of practice which falls short of the high standard we all want to provide for our patients." "Keeping our patients and staff safe is our priority. We have responded to the CQC with the actions we are taking and we are committed to the care and safety of every patient in our hospitals." Read full story Source: BBC News, 7 October 2020
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News ArticleFor most people, COVID-19 is a brief and mild disease but some are left struggling with symptoms including lasting fatigue, persistent pain and breathlessness for months. The condition known as "long Covid" is having a debilitating effect on people's lives, and stories of being left exhausted after even a short walk are now common. There is no medical definition or list of symptoms shared by all patients - two people with long Covid can have very different experiences. However, the most common feature is crippling fatigue. Others symptoms include: breathlessness, a cough that won't go away, joint pain, muscle aches, hearing and eyesight problems, headaches, loss of smell and taste as well as damage to the heart, lungs, kidneys and gut. Mental health problems have been reported including depression, anxiety and struggling to think clearly. Long Covid is not just people taking time to recover from a stay in intensive care. Even people with relatively mild infections can be left with lasting and severe health problems. "We've got no doubt long Covid exists," Prof David Strain, from the University of Exeter, who is already seeing long-Covid patients at his Chronic Fatigue Syndrome clinic, told the BBC. A study of 143 people in Rome's biggest hospital, published in the Journal of the American Medical Association, followed hospital patients after they were discharged. It showed 87% had at least one symptom nearly two months later and more than half still had fatigue. The Covid Symptom Tracker App - used by around four million people in the UK - found 12% of people still had symptoms after 30 days. Its latest, unpublished data, suggests as many as one in 50 (2%) of all people infected have long-Covid symptoms after 90 days. The number of people with long-Covid appears to be falling with time. However, the virus emerged only at the end of 2019 before going global earlier this year so there is a lack of long-term data. "We've asked, deliberately, to follow people for 25 years, I certainly hope only a very small number will have problems going beyond a year, but I could be wrong," said Prof Brightling. However, there are concerns that even if people appear to recover now, they could face lifelong risks. People who have had chronic fatigue syndrome are more likely to have it again and the concern is that future infections may cause more flare-ups. "If long Covid follows the same pattern I'd expect some recovery, but if it takes just another coronavirus infection to react then this could be every winter," said Prof Strain. It is still possible more problems could emerge in the future. Read full story Source: BBC News, 6 October 2020
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News ArticleMuch has been said about the delays to patient care during the first wave of COVID-19, but the full picture has been hard to pin down as statistics come in different forms and are released gradually. However, one recently-published poll performed by Ipsos Mori, with more than 2,000 UK adults aged between 18-75, revealed two-thirds of people who needed treatment for new or recently changed conditions had their care cancelled or delayed during March and July. The poll also revealed three-quarters of people missed out on routine treatment in the same timeframe. It is believed to be the hitherto largest patient-focused survey exploring the impact of the pandemic on non-COVID-19 care during its first peak. It found that – of the people who needed treatment for a new or changed condition – 23% chose to cancel their treatment while 42% had their treatment cancelled or delayed by their healthcare provider. Within the group of people requiring care for an ongoing problem, 31% of patients delayed or cancelled their treatment. Mark Davies, chief medical officer at IBM – which commissioned the poll – told HSJ the number of people with new or recently changed conditions choosing to cancel or delay their care was “really worrying”. “This survey backs up the anecdotal evidence we hear about people being worried about going into hospital during the pandemic,” he said. “It is striking that the proportion of this group of patients who did not get treatment is roughly similar to the proportion of patients requiring treatment for an ongoing health problem who cancelled or delayed their care." He said he would have expected the former group – those with new or changed conditions – to be more anxious to get treated, and warned of a “backlog of unmet need that is only going to emerge in the next few months”. Read full story (paywalled) Source: HSJ, 6 October 2020
