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Found 2,344 results
  1. News Article
    Hospitals should ramp up their treatment of COVID-19 patients at home to free up more beds during the peak of the pandemic, under plans announced by NHS England/Improvement. All NHS trusts will receive up to 300 oximeters, which measure oxygen saturation levels and can be used to monitor COVID-19 patients in their own homes, rather than in hospital beds. NHSE has “recommended” that all areas of England “pursue immediate roll-out” given the “intense pressure on hospital beds right now”, according to a letter from medical director Steve Powis and two other national directors. Currently, nearly 60 trusts have COVID-19 patients in at least a third or more of their beds, and the total number of COVID-19 patients is peaking at around 37,000. There have been particular strains on hospital discharge, particularly of covid patients, whom many care homes are unable or unwilling to receive. The scheme, dubbed “covid virtual wards”, has been used at some trusts since the pandemic’s first wave. Read full story (paywalled) Source: HSJ, 19 January 2021
  2. News Article
    There has been a sharp drop in the number of patients admitted to hospitals in England with heart attacks or heart failure in recent months, research reveals. Experts are worried that people who need urgent medical help are not seeking it. This was also the case during the first wave of the pandemic. The researchers included 66 hospitals in the study and compared daily admission rates in the year before the pandemic with those during the first and second waves in England, up to 17 November. During the first lockdown, daily admissions for heart attacks or heart failure decreased by more than 50%. They went up again in the summer, as coronavirus rates decreased in the UK and the NHS became less busy with the virus. From October, when coronavirus cases were rising again, heart admissions began to drop - by between 35% and 41% compared with pre-pandemic data, according to the study published in the Journal of the American College of Cardiology. Researcher Prof Chris Gale, from Leeds University, said: "Medical emergencies do not stop in a pandemic. I am afraid that we are seeing a re-run of one of the preventable tragedies of the first wave - people were either too afraid to go to hospital for fear of contracting COVIDd-19 or were not referred for treatment." "The message to patients needs to be clear. If they experience symptoms of a heart attack or acute heart failure, they need to attend hospital." Read full story Source: BBC News, 20 January 2021
  3. News Article
    Nearly a third of people who were discharged from hospitals in England after being treated for COVID-19 were readmitted within five months – and almost one in eight died, a study suggests. The research, which is still to be peer-reviewed, also found a higher risk of problems developing in a range of organs after hospital discharge in those younger than 70 and ethnic minority individuals. “There’s been so much talk about all these people dying from Covid … but death is not the only outcome that matters,” said Dr Charlotte Summers, a lecturer in intensive care medicine at the University of Cambridge who was not involved in this study. “The idea that we have that level of increased risk in people – particularly young people – it means we’ve got a lot of work to do.” There is no consensus on the scale and impact of “long Covid”, but scientists have described emerging evidence as concerning. According to recent figures provided by the Office for National Statistics (ONS), a fifth of people in England still have coronavirus symptoms five weeks after being infected, half of whom continue to experience problems for at least 12 weeks. Read full story Source: The Guardian, 18 January 2021
  4. News Article
    For the last 10 months, everyone in healthcare has lived their lives as if they were trapped in a burning building without a fire escape. No matter how much water we throw on the fire or how many firefighters (healthcare providers in this instance) we send in, we cannot gain control of the flames. The catastrophic loss of life has been insurmountable, and we often haven’t had enough physicians to take care of everyone. This is not new for a healthcare system. For years prior to this pandemic, there has been a physician shortage in the United States that is expected to worsen over the coming years. The Association of Medical Colleges (AAMC) predicts that the US could see a shortage between 54,000 and 139,000 physicians in both primary and specialty care by 2033. Although the total physician supply is expected to grow, it won’t be at a fast enough rate to outpace demand. This is where physician assistants (PAs) and advanced practice nurses (APRNs) come in. Many people don’t realise that PAs and APRNs have been around for over 50 years. For 50 years, a plethora of research has shown that PAs and APRNs are safe, reliable, high quality healthcare providers and essential members of the healthcare team. But too often critics claim that because they have not gone through physician training, they cannot provide exceptional medical and surgical care. In fact, they already do. A recent comprehensive review of PA and APRN outcomes from 2008 to 2018 found that PAs and APRNs had similar outcomes compared to physicians including hospital length of stay, readmission rates, quality and safety and patient and staff satisfaction. Read full story Source: The Hill, 16 January 2021
  5. News Article
    NHS bosses have instructed hospitals to keep performing urgent cancer surgery despite Covid pressures, after a growing number cancelled procedures because they did not have enough intensive care beds or available staff. They have told England’s regional directors of cancer to ensure treatment of people who need cancer surgery within four weeks gets the same priority as care of patients who have Covid. The move was unveiled in a letter, obtained by HSJ, sent last Friday by Amanda Pritchard, the chief operating officer at NHS England and NHS Improvement. It was also signed by Cally Palmer, the NHS’s national cancer director, and Prof Peter Johnson, a highly respected specialist who is the NHS’s national clinical director for cancer. They have acted after unease among cancer specialists that growing numbers of hospitals, including all those in London, had cancelled urgent operations. Hospitals have felt obliged to do so either because they did not have enough intensive care beds for patients who might need one after their cancer procedure or because surgical staff had been repurposed to help care for Covid patients. Doctors voiced alarm at the scale of recent postponements of what the NHS classes as “priority two” operations. That means they should be done within 28 days to ensure that someone with cancer does not see their disease spread or become inoperable because it was delayed. More than 1,000 cancer patients in London are now waiting to have “priority two” or “P2” urgent surgery, but none have been given a new date for when it will happen, HSJ reported last week. Read full story Source: The Guardian, 18 January 2021
  6. News Article
    People in high-risk minority ethnic groups must be prioritised for Covid immunisations, alongside a targeted publicity campaign, experts and politicians have said amid growing concerns over vaccine scepticism. With figures on Monday recording more than 4m Covid vaccine doses now administered across the UK, and the rollout being expanded to all over-70s, public health experts and MPs called for black, Asian and minority ethnic (BAME) communities to be better protected. The Scientific Advisory Group for Emergencies (Sage) has also raised concerns after research showed up to 72% of black people said they were unlikely or very unlikely to have the jab. Prof Martin Marshall, chair of the Royal College of GPs, urged Whitehall to begin a public health campaign. “We are concerned that recent reports show that people within BAME communities are not only more likely to be adversely affected by the virus but also less likely to accept the Covid vaccine, when offered it,” he said. “As such, where appropriate, we’re calling for public health communications to be tailored to patients in BAME communities, to reassure them about the efficacy and safety of the vaccine and ultimately encourage them to come forward for their vaccination when they are invited for it.” His remarks came as the vaccines minister, Nadhim Zahawi, admitted he feared some BAME communities could remain exposed to coronavirus despite high expected uptake of the jabs. Read full story Source: The Guardian, 18 January 2021
  7. Content Article
    Dr Iram Sattar is a GP and Trustee for the Muslim Women's Network UK. In this short video, she answers questions surrounding the newly established COVID-19 vaccine. This video is available in English, Urdu and Bengali. Watch in English Watch in Bengali Watch in Urdu
  8. News Article
    A London hospital is being forced to send patients back to ambulances for treatment due to an ‘overwhelming’ number of Covid patients on ICU wards, according to a frontline doctor. The medic, who asked to remain anonymous, said A&E staff are "running" into waiting ambulances to treat patients there until space becomes available. He said: "It’s not the fault of the staff, but the sheer numbers are so unprecedented and being full like this means that you just have to do your best to adapt. But it’s not the standard (of care) I signed up to." "It’s extremely stressful for us to be doing our best but knowing that significant patient harm is happening because there isn’t space and the patient load is too high." He raised concerns that "significant patient harm" was occurring due to a lack of beds available and the emergency system means medics are limited in the care they can provide. Read full story Source: The Metro, 14 January 2021
  9. News Article
    The growth in covid positive hospital patients is rapidly slowing in every English region and appears to have stopped in the south east. The weekly increase in covid inpatients across England fell to 8% yesterday, the first time it had dropped to single figures since 12 December. A week earlier, on 10 January, the growth rate stood at 23%. There are now 33,352 covid hospital patients in English hospitals, an increase of 2,594 in the last seven days. The previous week had seen a rise of 5,801. The weekly growth rate of covid positive hospital patients in the seven English regions currently ranges from 26% in the south west to zero in the south east. In every region, the growth rate is seven to 20 percentage points lower than recorded on 10 January. London’s weekly growth rate is now three per cent and the east’s is 2%. There has been no substantive change in the south east total in the past week. It is likely covid patients will be seen to have peaked in these three regions between 13 to 15 January. The slowing in the growth of national covid patient numbers means the total is likely to peak during the next seven days at a level lower than many had feared and expected. HSJ has seen internal NHS England projections from last week that saw growth continuing into February and total covid patient numbers rising well above 40,000, this now seem very unlikely. Read full story Source: HSJ, 18 January 2021
  10. News Article
    Emergency legislation is needed to protect doctors and nurses from “inappropriate” legal action over critical Covid treatment decisions made amid the pressures of the pandemic, health organisations have argued. A coalition of health bodies has written to Matt Hancock, the health secretary, calling for the law to be updated so medical workers do not feel “vulnerable to the risk of prosecution for unlawful killing” when treating coronavirus patients “in circumstances beyond their control”. The letter, coordinated by the Medical Protection Society (MPS), states there are no legal safeguards for coronavirus-related issues such as when there are “surges in demand for resources that temporarily exceed supply”. The coalition, which includes the British Medical Association and Doctors’ Association UK, wrote: “With the chief medical officers now determining that there is a material risk of the NHS being overwhelmed within weeks, our members are worried that not only do they face being put in this position but also that they could subsequently be vulnerable to a criminal investigation by the police. “There is no national guidance, backed up by a clear statement of law, on when life-sustaining treatment can be lawfully withheld or withdrawn from a patient in order for it to benefit a different patient, and if so under what conditions. The first concern of a doctor is their patients and providing the highest standard of care at all times.” Read full story Source: The Guardian, 16 January 2021
  11. News Article
    Advisers from the Scientific Advisory Group for Emergencies (Sage) have raised fresh concerns over Covid vaccine uptake among black, Asian and minority ethnic communities (BAME) as research showed up to 72% of black people said they were unlikely to have the jab. Historical issues of unethical healthcare research, and structural and institutional racism and discrimination, are key reasons for lower levels of trust in the vaccination programme, a report from Sage said. The figures come from the UK Household Longitudinal Study, which conducts annual interviews to gain a long-term perspective on British people’s lives. In late November, the researchers contacted 12,035 participants to investigate the prevalence of coronavirus vaccine hesitancy in the UK, and whether certain subgroups were more likely to be affected by it. Overall, the study found high levels of willingness to be vaccinated, with 82% of people saying they were likely or very likely to have the jab – rising to 96% among people over the age of 75. Women, younger people and those with lower levels of education were less willing, but hesitancy was particularly high among people from black groups, where 72% said they were unlikely or very unlikely to be vaccinated. Among Pakistani and Bangladeshi groups this figure was 42%. Eastern European groups were also less willing. “Trust is particularly important for black communities that have low trust in healthcare organisations and research findings due to historical issues of unethical healthcare research,” said the Sage experts. “Trust is also undermined by structural and institutional racism and discrimination. Minority ethnic groups have historically been underrepresented within health research, including vaccines trials, which can influence trust in a particular vaccine being perceived as appropriate and safe, and concerns that immunisation research is not ethnically heterogenous.” Read full story Source: The Guardian, 16 January 2021
  12. Content Article
    In this opinion piece for the British Medical Journal, David Oliver, consultant in geriatrics and acute general medicine, highlights the high rates of COVID-19 infection that have been acquired in hospital. David looks at an example in the US where rigid infection control measures have been implemented with success, arguing that more needs to be done to challenge and address these worrying statistics here in the UK.
  13. Content Article
    The Health Innovation Network's Patient Safety and Experience team have been working with behavioural insights specialists to create materials based on a behavioural science approach to support frontline health and care staff to prioritise their physical health and emotional wellbeing needs that may have been neglected due to the impact of COVID-19. The campaign takes a peer to peer approach since it was found staff can struggle to identify signs of stress in themselves and are better at spotting this within colleagues.
  14. Content Article
    ‘Health systems recovery’ is a term used to describe the process of restoring and improving the functions of a health system that have been exposed to a shock or public health emergency, such as natural disaster, conflict, or a disease outbreak. This paper from Matthew Neilson and Sheila Leatherman discusses what quality in recovery look like.
  15. Content Article
    This is the second part of webinar three in a series designed to help the NHS respond to the Covid-19 pandemic, hosted by the Faculty of Clinical Informatics. It is hosted by Sebastian Alexander, Founding Fellow of the FCI, NHS Digital, Safety, SME Apps Programme, and features presentations on the work of the National Pathology Xchange and The National Pathology Programme.
  16. Content Article
    This is the first part of webinar three in a series designed to help the NHS respond to the Covid-19 pandemic, hosted by the Faculty of Clinical Informatics. It is hosted by Sebastian Alexander, Founding Fellow of the FCI, NHS Digital, Safety, SME Apps Programme, and features presentations on the NHS Digital Apps and Wearables Programme and the Kryptowire app assessment.
  17. News Article
    Covid outbreaks in care homes have more than trebled in a month. Figures show that infection levels are now similar to the peak of the first wave, with last week having the second highest weekly total since records began in April. Senior figures said the numbers were "shocking" and warned: "Care homes cannot be neglected again". Ministers have pledged that all care home residents would be vaccinated by the end of this month. But The Telegraph has been told the care home rollout was taking longer than officials had anticipated. The new figures come after The Telegraph revealed the Government is proposing to send hospital patients into care homes without tests, despite being warned that was responsible for driving up cases in the first wave. Read full story Source: The Telegraph, 14 January 2021
  18. News Article
    The Healthcare Safety Investigation Branch (HSIB) have launched a national investigation into the provision of piped oxygen gas supplies to hospitals. During the COVID-19 pandemic there has been an increased demand for oxygen gas on hospital wards, with more patients needing oxygen therapy. Insufficient oxygen supply to seriously ill patients can have very severe consequences, including death. The investigation is examining a major incident that took place at an acute hospital. Demands on their oxygen supply led to patients being diverted to other hospitals. In addition, patients were also transferred between clinical environments. As part of HSIB's final investigation report, they will make safety recommendations to the appropriate national bodies in order to improve patient safety. Read full story Source: HSIB, 15 January 2021
  19. News Article
    Boris Johnson’s plans to test millions of schoolchildren for coronavirus every week appear to be in disarray after the UK regulator refused to formally approve the daily testing of pupils in England, the Guardian has learned. The Medicines and Healthcare products Regulatory Agency (MHRA) told the government on Tuesday it had not authorised the daily use of 30-minute tests due to concerns that they give people false reassurance if they test negative. This could lead to pupils staying in school and potentially spreading the virus when they should be self-isolating. The regulator’s decision undermines a key element of the government’s strategy to bring the pandemic under control – and is bound to raise fresh questions about the tests, and the safety of the schools that have been asked to use them. Prof Jon Deeks, a biostatistician of the University of Birmingham and Royal Statistical Society, described the use of rapid tests in this context as “ridiculous and dangerous” and welcomed the MHRA’s stance. He said: “It is really important that we have confidence in the safety and effectiveness of tests for Covid-19 and all other diseases - this is the responsibility of our regulator. “This clarification of the unsuitability of lateral flow tests for saying people are not infected with SARS-CoV-2 from the MHRA demonstrates that they are taking their responsibility seriously to ensure that tests are used in a safe way." Read full story Source: The Guardian, 14 January 2021
  20. News Article
    Fake news is likely to be causing some people from the UK's South Asian communities to reject the Covid vaccine, a doctor has warned. Dr Harpreet Sood, who is leading an NHS anti-disinformation drive, said it was "a big concern" and officials were working "to correct so much fake news". He said language and cultural barriers played a part in the false information. Dr Sood, from NHS England, said officials were working with South Asian role models, influencers, community leaders and religious leaders to help debunk myths about the vaccine. Much of the disinformation surrounds the contents of the vaccine. He said: "We need to be clear and make people realise there is no meat in the vaccine, there is no pork in the vaccine, it has been accepted and endorsed by all the religious leaders and councils and faith communities." "We're trying to find role models and influencers and also thinking about ordinary citizens who need to be quick with this information so that they can all support one another because ultimately everyone is a role model to everyone", he added. Dr Samara Afzal has been vaccinating people in Dudley, West Midlands. She said: "We've been calling all patients and booking them in for vaccines but the admin staff say when they call a lot of the South Asian patients they decline and refuse to have the vaccination. "Also talking to friends and family have found the same. I've had friends calling me telling me to convince their parents or their grandparents to have the vaccination because other family members have convinced them not to have it". Read full story Source: BBC News, 15 January 2021
  21. News Article
    Nearly a quarter of a million people have been waiting more than a year for operations and other hospital procedures, HSJ has learned. Official NHS England data for November, released on Thursday, showed 192,000 patients had been waiting for treatment for more than a year. However, figures leaked to HSJ of weekly data up to 3 January showed a steep increase to 223,000 patients — the highest reported so far throughout the COVID-19 pandemic and before. According to the leak, just under 4.2 million people are waiting for treatment, of which year-long waiters comprise 5.4%. The data also showed 175 patients across England had waited more than two years for treatment. In February, before the pandemic, 1,613 patients were waiting more than a year — meaning there has been a 138-fold increase. Read full story (paywalled) Source: HSJ, 15 January 2021
  22. Content Article
    Based on the experiences of hospital trusts that performed well during the early phase of the pandemic, the guidance shares successful innovations and practices which others can utilise and adopt. Drawing on the Getting It Right First Time (GIRFT) programme’s data-driven methodology and the wealth of experience of its national clinical leads, the advice covers infection prevention and control, emergency medicine, critical care, anaesthesia, acute and general medicine, respiratory medicine, diabetes care, and geriatric medicine and community care, as well as looking at cross-cutting themes such as trust leadership and management, research and clinical coding. The guide, Clinical practice guide for improving the management of adult COVID-19 patients in secondary care, is reviewed and endorsed by 12 key professional societies.
  23. News Article
    Younger people who think they are “invincible” need to be aware of the shocking life-changing reality of long Covid, according to health professionals who are living with the condition. Long Covid, also known as post-Covid syndrome, is used to describe the effects of COVID-19 that continue for weeks or months beyond the initial illness. Speaking at the All-Party Parliamentary Group (APPG) on Coronavirus, Dr Nathalie MacDermott, 38, said neurologists believe Covid has damaged her spinal cord and she can only walk about 200 metres without some form of assistance. She said the damage has affected her bladder and bowel too, causing urinary tract infections, and she gets pain in her arms and has weakness in her grip. Dr MacDermott, a clinical doctor sub-specialising in paediatric infectious diseases in the NHS, told MPs there needs to be “better recognition” from employers that long Covid is a “genuine condition” and that people may need to be off work for a significant period of time. She added: “And I think we need better recognition in the public, particularly the younger public who think that they’re invincible. “I’m 38 and I wonder if I’ll ever be able to walk properly without crutches again. Will this continue to get worse? Will I end up in a wheelchair?” Read full story Source: 12 January 2021, Lancashire Post
  24. News Article
    More than one in 10 hospital nurses are now off work in areas hard-hit by covid, according to internal data leaked to HSJ. The data shows the toal absence rate among acute trust nurses has risen steadily over the last month. Nationally the total absence rate among acute trust nurses was 9.7% as of Monday, up from around 7% at the start of December, pushed up by rapidly rising absences due to covid. These make up more than half of total absences, and have now hit rates last seen in early May. Senior NHS sources said staff absences are severely compounding operational pressures in the hardest hit regions, limiting hospitals’ capacity to operate more than is suggested in official bed capacity figures. The highest rate was in the East of England where 11.4% of nurses off work, with coronavirus accounting for 7.5%. This is likely to mask even higher rates in particular hospitals, services and wards. Read full story Source: HSJ, 14 January 2021
  25. Content Article
    This report from the Healthcare Safety Investigation Branch (HSIB) outlines the most important factors for supporting staff in the wake of safety incidents, against the backdrop of the COVID-19 pandemic. The report reinforces the importance of effective staff support for those suffering high levels of psychological harm, as it has a direct impact on patient care. While focusing on patient safety incidents overall, the report also provides valuable insight that could help organisations develop their own programmes of support for any situation. The report features a first-hand account from a junior doctor which charts the impact that a patient safety incident had on his life and his experiences of support. Excerpts from the story emphasise the importance of creating a ‘normalised’ culture around accessing support.
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