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News ArticleAll vulnerable people will have been offered a coronavirus vaccination by “late spring” the head of NHS England has said as he warned the health service was “back in the eye of the storm.” In a New Year message, Sir Simon Stevens described 2020 as the “toughest year” and he paid tribute to nurses, doctors, therapists and other NHS staff including hospital cleaners, carers and volunteers as well as care home staff. Sir Simon visited a new vaccination centre on Monday saying: “We think that by late spring with vaccine supplies continuing to come on stream we will have been able to offer all vulnerable people across this country Covid vaccination. That perhaps provides the biggest chink of hope for the year ahead.” His comments came as the NHS in London was said to be “teetering on the edge” as latest data showed the numbers of hospital admissions in the capital jumped more than 200 per cent since the end of lockdown on 2 December. Read full story Source: The Independent, 29 December 2020
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News ArticleCases of anorexia and other eating disorders have quadrupled in some areas during the coronavirus pandemic, doctors say. The Royal College of Paediatrics and Child Health (RCPCH) issued an alert to parents, saying the Christmas and new year period can be stressful for young people who struggle with disordered eating. That comes on top of massive disruption to schooling and other areas of life due to Covid-19 which has led to a loss of physical and social activity, plus money worries and bereavement for some. “In our tier 4 under 13s mental health inpatient unit we have seen a three- to fourfold increase in children referred to our service with eating disorders, and they are just the tip of the iceberg.” Dr Nancy Bostock, a consultant in Cambridge, said in a statement provided by the college. Read full story Source: The Independent, 29 December 2020
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News ArticleHealth workers are "back in the eye of the storm" as coronavirus cases continue to rise, NHS England's chief executive Simon Stevens has said. It has been the "toughest year" for the NHS, which has treated 200,000 severely ill Covid-19 patients, he added. Hospitals in England are currently treating more Covid patients than at the peak of the first wave in April. A government scientific adviser has warned national restrictions are needed to prevent a "catastrophe". On Monday, a record 41,385 new Covid cases were reported in the UK, though it is thought the infection rate was higher during spring when testing was much more limited. NHS England said 20,426 people were being treated for the virus in hospitals in England on Monday, which is higher than the previous peak of about 19,000 in April. Read full story Source: BBC News, 29 December 2020
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News ArticleNew planning guidance asks local NHS organisations to prepare for a major waiting-list catch-up by seeking “top quartile performance in productivity”, but also to “safely mobilise all… available surge capacity over the coming weeks” as the service battles rising covid levels “in almost all parts of the country”. An end-of-year planning letter was issued by NHS England to local NHS chief executives last night. It warns: “With covid-19 inpatient numbers rising in almost all parts of the country, and the new risk presented by the variant strain of the virus, you should continue to plan on the basis that we will remain in a level 4 incident for at least the rest of this financial year and NHS trusts should continue to safely mobilise all of their available surge capacity over the coming weeks. “This should include maximising use of the independent sector, providing mutual aid, making use of specialist hospitals and hubs to protect urgent cancer and elective activity and planning for use of funded additional facilities such as the Nightingale hospitals, Seacole services and other community capacity.” Read full story (paywalled) Source: HSJ, 24 December 2020
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News ArticleNHS England has told hospitals to begin planning for the use of Nightingale Hospitals as the numbers of coronavirus patients in hospitals is expected to surge in coming weeks. In a letter sent on Wednesday night hospitals were told to activate all of their emergency capacity to cope with the expected pressures over the coming weeks. This is likely to mean the mass redeployment of staff and designating wards, surgical theatres and recovery areas as makeshift intensive care units for patients. NHS England did not explain how the Nightingale Hospitals would be staffed if the decision was made to activate them. Read full story Source: The Independent, 24 December 2020
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News ArticleThere are 14 hospital trusts on course to have at least a third of their beds filled by covid patients on New Year’s Eve. HSJ analysed current occupancy and growth at each general acute trust in the seven days to 21 December. Projecting the same rate of growth forward, the number of trusts with at least a third of their bedbase likely to be taken by covid patients would increase from 5 at present to 14. Three of the four acute trusts in Kent are projected to have covid bed occupancy of over 40%. Another two trusts are in areas covered by tier two restrictions. They are Queen Elizabeth in Norfolk, and Countess of Chester. A third, East Sussex, has one of its two general hospitals in “tier four” (St Leonards), and the other in Eastbourne, which is outside the Sussex “tier four” zone. There are also 27 trusts not in tier four areas which had more than 50 covid patients on 21 December, and where the number of covid patients grew by at least 20 per cent in that week. These include Liverpool University Hospitals and Sheffield Teaching Hospitals. HSJ last week projected that, if trends continued, English hospitals would have just short of 19,000 covid patients on New Year’s Eve in total — almost exactly the same as the 12 April first wave peak. Current projections put that number at over 20,000. Read full story (paywalled) Source: HSJ, 23 December 2020
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News Article
NHS leaders raise concerns over pace of Covid vaccine rollout
Patient Safety Learning posted a news article in News
NHS leaders have raised concerns about the rollout of the coronavirus vaccine, with more than half of hospital trusts and two-thirds of GPs yet to receive supplies amid growing alarm over the new fast-spreading variant. Dr Richard Vautrey, the chair of the British Medical Association’s GP committee, urged the government to speed up delivery of the Pfizer/BioNTech vaccine in order to save lives. Experts also demanded greater transparency from ministers on how many doses are available. Vautrey said: “We need millions of doses to be made available as soon as possible – urgently – because it’s the number one priority for GP practices, our patients and the nation, especially given the new mutant strain. “GPs who haven’t got it yet are frustrated because they want to be getting on and vaccinating their patients as well. Their frustration is understandable. They want to protect their patients, especially their vulnerable patients, as quickly as possible.” Read full story Source: The Guardian, 22 December 2020 -
EventuntilSir Robert Francis QC, Retired Barrister (specialising in medical law) and Queen’s Counsel. Before his retirement from full-time practice earlier this year, Sir Robert sat as a Recorder (part-time Crown Court judge) and as a Deputy High Court Judge. Sir Robert will be joining Professor Roger Kirby (RSM President) for an interesting discussion on his wide-ranging legal career, including previous inquiries such as the Freedom to Speak Up Review. He will also be talking about patient quality and care in the UK, and his view on the COVID-19 pandemic. Register
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News Article
Doctors and nurses at London’s frontline hospital denied coronavirus vaccine
Patient Safety Learning posted a news article in News
Doctors and nurses on the front line of the fight against coronavirus at the Royal London Hospital – which has the largest number of Covid patients in the capital – have been denied the Pfizer vaccine, The Independent has learnt. Hospital bosses at Barts Health Trust have written to staff today expressing their frustration over the decisions by NHS England, which meant the northeast of London – where the rate of infections and hospitalisations are worst – has not been given access to any vaccines. The Independent has learned that staff from the Royal London booked appointments to be vaccinated at University College London, but they were turned away because the vaccinations had been earmarked for NHS staff from University College London Hospital Trust. The trust’s chief medical officer wrote to senior doctors on Monday warning them the crisis facing the hospital would get worse before it gets better. Professor Alistair Chesser told staff: “It has been frustrating to see the vaccine delivered to other trusts and to GP surgeries but not to us in the last few days given the pressure we are under. Please be assured we are lobbying for our staff and our patients at the very highest levels and will not let this rest.” Read full story Source: The Independent, 22 December 2020 -
News Article
Thousands of clinically vulnerable patients in tier 4 areas told to stay indoors
Patient Safety Learning posted a news article in News
Thousands of people who are at extreme risk from the coronavirus and live in tier 4 areas have been told to stay indoors at all times unless they are exercising or have medical appointments. The Department of Health and Social Care (DHSC) issued new advice on Monday warning people classed as “clinically extremely vulnerable” to stay home, in a bid to protect them from the new, more infectious strain of COVID-19. Those affected have been told not to leave their homes even if they cannot work remotely. The government said residents could be eligible for statutory sick pay, employment support allowance, or universal credit as well as the coronavirus job retention scheme. The DHSC said the high-risk group should stay at home as much as possible. Children who have been advised to shield should not attend school, the department added. Read full story Source: The Independent, 21 December 2020 -
News Article
Cancer care under threat as NHS loses covid private sector back-up
Patient Safety Learning posted a news article in News
Cancer surgery in London is under threat as rising covid admissions put pressure on services that no longer have back-up capacity from the independent sector, HSJ has learned. Research by HSJ has discovered that NHS England ended contracts with HCA, The London Clinic and the Cromwell Hospital at the end of August, after concerns about underutilisation. Under the previous deal with the private sector, rules were in place to make sure low-priority private patients were not treated ahead of NHS patients who needed surgery urgently. HCA and The Cromwell have confirmed the contracts were ended in August and were not renewed. The London Clinic did not respond to a request for comment. As of 19 December, there were 2,909 covid inpatients being treated in London hospitals, a rise of 39% over the previous seven days. Barts Health Trust and Barking, Havering and Redbridge University Trust in the east of the city are under particular pressure. Should the number of covid patients reach a level that requires the capital to instigate surge protocols, theatre space set aside for cancer operations is likely to be commandeered. Under this scenario, the NHS in the capital would no longer have the option to transfer cancer patients to private facilities as it did during the first wave of the pandemic. A senior London-based source said: “This is a real and imminent threat to London’s ability to perform cancer surgery." Read full story (paywalled) Source: HSJ, 21 December 2020 -
Content ArticleThe COVID-19 pandemic is compromising the nation's health - in the short and long term. It's widening existing inequalities, with some groups hit harder than others. As part of the Health Foundation COVID-19 impact inquiry, we spoke to to three people from across the UK to hear about their experiences of the pandemic. Nathaniel, Bethan and Joe share how COVID-19 and measures to control the virus have affected different aspects of their lives including work, access to health care services and mental health. They also reflect on what they think we can learn from the pandemic, to give everybody the same opportunities for health and wellbeing - now and in the future.
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Content Article
Channel 4: Surviving Covid (26 November 2020)
Patient Safety Learning posted an article in Coronavirus (COVID-19)
Four patients lie in comas in the Intensive Care Unit (ICU) at King's College Hospital in south London in March 2020. Each one has been struck down by COVID-19 during Britain's first surge. This intimate, feature-length observational documentary follows their stories - and their families' stories - over six months. -
Content ArticleThe British Society for Immunology (BSI) has created two video question and answer sessions about vaccines for COVID-19. They took vaccine questions and concerns from the public on their Instagram channel and put them to expert immunology scientists, Dr Megan MacLeod and Prof Sheena Cruickshank. In the videos, Megan and Sheena answer these questions and explore the details of when vaccines may become available, who will receive the vaccines, how long immunity might last to a vaccine, how herd immunity can protect us and lots more. It’s important to understand and address vaccine concerns that are prominent in public discussion and may lead to hesitancy to vaccination. By answering your vaccine questions, the BSI hopes to provide expert information to help everyone make informed decisions about vaccines and their health. Follow the link below to watch the videos.
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News Article
Pressure on hospitals 'at a really dangerous point'
Patient Safety Learning posted a news article in News
Nearly 90% of hospital beds in England are full as hospitals try to cope with the demands of Covid in addition to normal winter pressures. Ambulances queuing to offload patients, staff sickness and a lack of beds mean hospitals are "at a really dangerous point", say emergency doctors. This could result in some trusts facing the decision to stop non-Covid work. Rises in hospital admissions are particularly affecting areas in the south. The percentage of NHS hospital beds which are occupied is increasing and has reached almost 89% in England for the week ending December 13. This is the highest occupancy rate so far this year - it's still lower than the same time last year, although the extra burden of Covid is likely to make hospitals feel they are much busier. A safe level for bed occupancy is below 90% but nearly half of NHS trusts report a figure currently higher than this - the largest proportion this season. Read full story Source: BBC News, 19 December 2020 -
News Article
Covid infections caught in hospital rise by a third in one week
Patient Safety Learning posted a news article in News
The number of people likely to have caught COVID-19 in NHS hospitals in England has risen by more than a third in the last week. The 35% rise in probable hospital-acquired COVID-19 from 6 to 13 December is the highest weekly increase since 30 October, HSJ analysis of NHS England data reveals. Hospital-acquired infections are rising across areas such as London, the South East, and South West, and also at some hospitals in the North East, Yorkshire and the Midlands. At some trusts, the weekly total of likely hospital-acquired COVID-19 infections has more than doubled since last week. Read full story (paywalled) Source: HSJ, 18 December 2020 -
News Article
Shortages of staff and equipment weigh on doctors’ decisions, survey reveals
Patient Safety Learning posted a news article in News
Staff shortages and a lack of equipment are affecting the day-to-day decisions about patient care by doctors and nurses, a new YouGov survey has revealed. The representative survey of NHS clinicians revealed more than half, 54%, admitted that factors such as a lack of staff played a role in their decisions about patients beyond what was in their best interests. Almost a third of staff, 31%, said staffing levels were the top factor affecting decisions about patients. A fifth said the availability of services such as key tests were a significant factor; 16% cited a lack of equipment; and 12% cited beds. 10% of clinicians said a fear of being sued was part of their decision-making. YouGov carried out the research for JMW Solicitors and weighted the responses to be representative of the NHS workforce population. It also revealed more than two-fifths of clinicians, 42%, believe a “blame culture” in the NHS plays a top role in preventing staff admitting to mistakes in care. In maternity services specifically, 68% of nurses and midwives said at least one factor other than what was in patients’ best interest played a role in their decisions. Read full story Source: The Independent, 20 December 2020 -
Content ArticleUniversity College London (UCL) Hospitals have produced this joint guide with Performing Medicine for using personal protective equipment (PPE) informed by insights from actors used to wearing restrictive costumes. Although healthcare workers wearing PPE have an entirely different purpose and are working in an intensely emotional and demanding context, actors have useful, practical advice to share about challenges such as orientation, communication and movement in challenging clothing and equipment. Performing Medicine has been providing courses for healthcare professionals for over 15 years. They draw on arts-based approaches and methods to teach skills relevant to clinical practice.
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News Article
Long Covid: Hospital patients to get checks at six weeks
Patient Safety Learning posted a news article in News
Patients in hospital with coronavirus should be offered a follow-up six weeks later to check for "long Covid" symptoms, doctors are being advised. The guidance, drawn up by health officials across the UK, says the long-term effects can be "significant". They identified 28 of the most common symptoms, from breathlessness and dizziness to chest pain. Mental health problems including depression, anxiety and struggling to think clearly, have also been reported. "Because this is a new condition, there is still much that we don't know about it," said Paul Chrisp of the National Institute for Health and Care Excellence, which produces health guidance. The NHS has opened 69 specialist clinics across England to offer rehabilitation to people recovering from the disease. Read full story Source: BBC News, 18 December 2020 -
News ArticleA major London trust’s critical care staff have urged leaders to review elective work targets amid serious concerns over workload, safe staffing and burnout, HSJ has learned. In a letter to Guy’s and St Thomas’ Foundation Trust’s board, staff represented by trade union Unite said they had “repeatedly” raised concerns about the provider’s approach to elective work, as well as winter pressures and second wave planning, and the implications this has had for “the health, safety and wellbeing of both staff and patients”. The letter — which was also addressed to the trust’s health and safety committee and has been seen by HSJ — said: “Our primary concern is that the trust’s endeavours, and understandable need to square these circles, may be unrealistic given the current pressures on staffing and the high rates of sickness and burnout the trust is continuing to experience. “This is especially in critical care, where we are concerned this may compromise patient safety and is already damaging staff wellbeing and morale.” Read full story (paywalled) Source: HSJ, 18 December 2020
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News ArticleLondon’s hospitals are already beginning to run out of critical care beds ahead of the Christmas relaxation of rules – which is expected to increase cases further, a leaked NHS briefing has warned. The update on the situation in the capital comes as major hospitals have already started to cancel operations for other patients in order to find enough staff to deal with the rise in patients as NHS trusts open up extra surge capacity. More operations are expected to be cancelled in hospitals across London, with staff warned they could be redeployed at short notice. On Wednesday, there were a total of 2,289 coronavirus patients in London hospitals, an increase of 2 per cent on the day before. But the numbers of coronavirus patients in critical care beds jumped 8.6% in a single day, increasing from 302 to 345 patients on Wednesday, while an additional 900 people who have tested positive were receiving oxygen. Across London, there were just 49 adult critical care beds available on Wednesday. In total there were 904 beds occupied, 328 by patients with COVID-19. This meant the capital’s total critical care bed occupancy rate was almost 95%. Although the number of patients is much lower than it was the first wave, many hospitals are still treating routine and non-Covid patients – meaning they are struggling to staff critical wards and keep other services running. A briefing for NHS managers warned them: “A reduction of elective [routine] activity is likely to be needed in line with increasing acute activity.” Read full story Source: The Independent, 17 December 2020
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Content Article
The Long Covid Forum 2020 video (12 December 2020)
Patient Safety Learning posted an article in Patient recovery
Coverage from the Long Covid Forum 2020, in association with ISARIC and GLOPID-R LongCovid.org. -
News Article
Major trust diverts ambulances and cancels electives after covid surge
Patient Safety Learning posted a news article in News
One of England’s largest hospital trusts has been forced to divert ambulances and cancel operations, after seeing a very steep increase in covid-19 admissions over the past week. Whipps Cross Hospital in north east London, part of Barts Health Trust, declared a critical incident over the weekend, the trust has confirmed. The trust has also declared a “high pressure phase” of covid response. A well placed source said Whipps Cross had been forced to divert ambulances in recent days, because of pressure on its emergency services, while a message to staff said it was deferring some planned operations, along with other steps aimed at protecting safety. It is also understood to be attempting to further speed up discharges from hospital. Read full story (paywalled) Source: HSJ, 16 December 2020 -
News ArticleResearch by a group of doctors has found ‘major deficiencies’ around infection control within hospitals in the North West region. The study looked at trusts’ adherence to Public Health England guidance around limiting the spread of COVID-19 within orthopaedic services. The study found patients were routinely being allocated to hospital beds before they had been confirmed as covid-negative, “thus allowing spread of COVID-19 not only between patients but also between nursing and medical staff”. Fewer than half of patients were nursed with the appropriate screens in place, while it was uncommon for doctors to be tested regularly. Separate statistics published by NHS England suggest almost 20 per cent of new covid cases in North West hospitals from August to December were likely to be nosocomial, meaning they were acquired on the wards. This was a higher proportion than any other region. Read full story Source: HSJ (paywalled), 16 December 2020
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News Article
Pregnant women allowed support of partners during birth
Patient Safety Learning posted a news article in News
Pregnant women should be allowed to have one person alongside them during scans, appointments, labour and birth, under new NHS guidance sent to trusts in England. The chosen person should be regarded as "an integral part of both the woman and baby's care" - not just a visitor. Previously, individual hospitals could draw up their own rules on partners being present. This meant many women were left to give birth alone. The guidance says pregnant women "value the support from a partner, relative, friend or other person through pregnancy and childbirth, as it facilitates emotional wellbeing". Women should therefore have access to support "at all times during their maternity journey". And trusts should make it easy for this to happen, while keeping the risk of coronavirus transmission within NHS maternity services as low as possible. Read full story Source: BBC News, 16 December 2020
