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Found 2,345 results
  1. Content Article
    As the UK’s vaccination programme against COVID-19 escalates, Helen Buckingham takes a closer look at the main issues for the NHS during its biggest ever vaccine campaign. 
  2. Content Article
    In response to the coronavirus disease of 2019 (COVID-19) pandemic, healthcare systems worldwide have stepped up their infection prevention and control efforts in order to reduce the spread of the infection. Behaviours, such as hand hygiene, screening and cohorting of patients, and the appropriate use of antibiotics have long been recommended in surgery, but their implementation has often been patchy. The current crisis presents an opportunity to learn about how to improve infection prevention and control and surveillance (IPCS) behaviours. The improvements made were mainly informal, quick and stemming from the frontline rather than originating from formal organisational structures. This paper from Toccafondi et al. aims to illustrate how adopting a human factors and ergonomics perspective can provide insights into how clinical work systems have been adapted and reconfigured in order to keep patients and staff safe.
  3. Content Article
    As the UK emerges from the COVID-19 pandemic ‘Build Back Better’ has become the mantra. Important, but we need to Build Back Fairer. The levels of social, environmental and economic inequality in society are damaging health and wellbeing. The aim of this report from the Institute of Health Equity is three-fold: To examine inequalities in COVID-19 mortality. Focus is on inequalities in mortality among members of BAME groups and among certain occupations, alongside continued attention to the socioeconomic gradient in health – the more deprived the area, the worse COVID-19 mortality tends to be. To show the effects that the pandemic, and the societal response to contain the pandemic, have had on social and economic inequalities, their effects on mental and physical health, and their likely effects on health inequalities in the future. To make recommendations on what needs to be done.
  4. News Article
    Throughout the pandemic, people with learning disabilities and autism have consistently been let down. A lack of clear, easy-to-understand guidance, unequal access to care and illegal “do not resuscitate” instructions have exacerbated the inequalities many people have long faced. It is crucial we do not forget those who have constantly been at the back of the queue: people with learning disabilities and autism. The impact cannot be ignored: research shows that 76% of people with learning disabilities feel they do not matter to the government, compared with the general public, during the pandemic. And data shows the danger of contracting COVID-19 for people with learning disabilities and autism is much higher than for the wider population. Public Health England has said the registered COVID-19 death rate for people with learning disabilities in England is more than four times times higher than the general population. But experts estimate the true rate is likely to be even higher, since not all deaths of people with learning disabilities are registered in the databases used to collate the findings. The reasons the pandemic has impacted people with learning disabilities so disproportionately are systemic, and a result of inequalities in healthcare services experienced for generations. Yes, some individuals are more clinically vulnerable, on account of the co-morbidities and complications associated with their learning disability. For many people, however, poorer outcomes after contracting the virus are due to non-clinical issues and inequalities in accessing healthcare services. This is inexcusable. The government must prioritise vaccinations for the 1.5 million people with learning disabilities and 700,000 with autism. Putting this long-overlooked group at the top of the vaccine queue would help address the systemic health inequalities learning disabled people face. Read full story Source: The Guardian, 15 December 2020
  5. News Article
    Pre-existing social inequalities contributed to the UK recording the highest death rates from Covid in Europe, a leading authority on public health has said, warning that many children’s lives would be permanently blighted if the problem is not tackled. Sir Michael Marmot, known for his landmark work on the social determinants of health, argued in a new report that families at the bottom of the social and economic scale were missing out before the pandemic, and were now suffering even more, losing health, jobs, lives and educational opportunities. In the report, Build Back Fairer, Marmot said these social inequalities must be addressed whatever the cost and it was not enough to revert to how things before the pandemic. “We can’t afford not to do it,” he said. Read full story Source: The Guardian, 15 December 2020
  6. News Article
    A new variant of coronavirus has been found which is growing faster in some parts of England, MPs have been told. Health Secretary Matt Hancock said at least 60 different local authorities had recorded Covid infections caused by the new variant. He said the World Health Organization had been notified and UK scientists were doing detailed studies. He said there was "nothing to suggest" it caused worse disease or that vaccines would no longer work. Read full story Source: BBC News, 14 December 2020
  7. News Article
    Health checks should be offered to people from black, Asian and minority ethnic backgrounds from the age of 25, a report has recommended. MPs examined the disproportionate impact of the Covid pandemic on people from black and Asian backgrounds. They said NHS checks, currently available to 40-70-year-olds in England, could pick up conditions which are linked to severe coronavirus. The role of inequalities in employment and housing was also emphasised. The report, produced by the Women and Equalities Committee, said the government should act to tackle these wider causes of poor health. The committee heard evidence during the course of its investigation that showed 63% of healthcare workers who died after contracting the virus had come from black, Asian or other ethnic minority backgrounds. And during the first peak of the virus, data from the Intensive Care National Audit and Research Centre showed 34% of coronavirus patients in ICUs were from an ethnic minority background, whereas they made up 12% of viral pneumonia admissions. Office for National Statistics (ONS) data has also shown that black people were almost twice as likely to die from Covid-19 as white people, with those of Bangladeshi and Pakistani ethnicity about 1.7 times as likely. The report raised concerns the pandemic was entrenching "existing health inequalities". Read full story Source: BBC News, 15December 2020
  8. Content Article
    Although most majority of COVID-19 cases are mild, some patients with initial mild to moderate forms of COVID-19, complain of persistent or resurgent symptoms. The aim of this study from Salmon-Deron et al. was to describe the clinical, biological and imaging profile of such patients in order to suggest a classification of the symptoms and raise hypotheses about their pathophysiology.
  9. Content Article
    Multiorgan symptoms after COVID-19 are being reported by increasing numbers of patients. They range from cough and shortness of breath, to fatigue, headache, palpitations, chest pain, joint pain, physical limitations, depression, and insomnia, and affect people of varying ages. At the Lancet–Chinese Academy of Medical Sciences conference on Nov 23, Bin Cao presented data (in press at The Lancet) on the long-term consequences of COVID-19 for patients in Wuhan, and warned that dysfunctions and complications could persist in some discharged patients for at least 6 months. So-called long COVID is a burgeoning health concern and action is needed now to address it.
  10. News Article
    There are not enough nurses to safely care for patients in the UK, according to the body that represents the profession, and many of those who are working are suffering from anxiety and burnout after a gruelling nine months treating Covid patients. A year after the prime minister pledged during the 2019 election campaign to add 50,000 nurses to the NHS, the Royal College of Nursing has accused Boris Johnson of being “disingenuous” for claiming the government is meeting this 2025 target. Johnson claimed last week that the government had “14,800 of the 50,000 nurses already” during prime minister’s questions in the Commons. Yet the latest NHS figures show there were 36,655 vacancies for nursing staff in England in September, with the worst shortages affecting mental health care and acute hospitals. Staff in some intensive care units (ICUs) have quit since the pandemic, with those whom the Observer spoke to choosing to work instead in supermarkets or as dog-walkers. Dame Donna Kinnair, the RCN’s chief executive and general secretary, said: “The simple, inescapable truth is that we do not have enough nursing staff in the UK to safely care for patients in hospitals, clinics, their own homes or anywhere else.” She said that even before the pandemic, “heavy demand” was rising faster than the “modest increases” in staff numbers. Read full story Source: The Guardian, 12 December 2020
  11. News Article
    England’s test and trace service is being sub-contracted to a myriad of private companies employing inexperienced contact tracers under pressure to meet targets, a Guardian investigation has found. Under a complex system, firms are being paid to carry out work under the government’s £22bn test and trace programme. Serco, the outsourcing firm, is being paid up to £400m for its work on test and trace, but it has subcontracted a bulk of contact tracing to 21 other companies. Contact tracers working for these companies told the Guardian they had received little training, with one saying they were doing sensitive work while sitting beside colleagues making sales calls for gambling websites. One contact-tracer, earning £8.72 an hour, said he was having to interview extremely vulnerable people in a “target driven” office that encouraged staff to make 20 calls a day, despite NHS guidance saying each call should take 45 to 60 minutes. Another call centre worker, who had no experience in healthcare or emotional support, said she suffered a nervous breakdown during an online tutorial about phoning the loved ones of coronavirus victims in order to trace their final movements. Read full story Source: The Guardian, 14 December 2020
  12. News Article
    Coronavirus vaccinations at GP practices will now take ‘twice as long’ after regulators announced new rules just days before the jabs are rolled out across primary care. The Medicines and Healthcare products Regulatory Agency announced patients would have to be observed for 15 minutes after they received the vaccine. This came after two people had severe allergic reactions to the Pfizer/BioNTech vaccine. Primary care directors told HSJ the change means they have had to overhaul plans in their primary care networks and, in some areas, the vaccine programme will be “unfeasibly challenging” to deliver. Sources told HSJ workforce plans are being overhauled, while vaccines risk being wasted because of the additional time constraints. There have been claims some practices may drop the vaccination programme altogether, as they lack capacity to carry out 15-minute observations for each patient. One primary care director, who spoke to HSJ anonymously, said: “For us, we now need additional space for an observation area. It also makes it more difficult to efficiently flow through the vaccines as the actual vaccination process might take a few minutes, but the through flow of patients will be limited by the 15-minute wait.” They added: “The vaccine now taking at least twice as long to do creates logistical problems. Not insurmountable but there nonetheless." Read full story (paywalled) Source: HSJ, 11 December 2020
  13. Content Article
    Following Jeremy Hunt’s appointment as chancellor, HSJ is now hosting the Patient Safety Watch newsletter, written by Patient Safety Watch trustee James Titcombe.  Read the latest newsletter: Patient Safety Watch: What can be done to improve duty of candour?
  14. News Article
    The number of COVID-19 infections likely to have been acquired in hospital are rising again for the first time in three weeks and their proportion of all cases has reached record levels for the second wave, HSJ can reveal. NHS England data covering the week to 6 December (the latest available) shows 1,787 COVID-19 cases were acquired in-hospital – a rise of almost 14% on the week before. The number of hospital-acquired, or “nosocomial”, infections had been falling since the week to 15 November, when 1,794 were recorded. This week, hospital acquired covid infections amounted to 21% of the 8,337 new cases which were recorded in hospitals – the highest proportion in the second wave. On 6 December alone, 24% of infections had probably been acquired in hospital rather than the community. Read full story (paywalled) Source: HSJ, 11 December 2020
  15. News Article
    NHS patients in rural areas of England face extra long waits for treatment, according to a study. The Nuffield Trust think-tank says urban areas benefited most from measures put in place to help the NHS cope with the coronavirus pandemic. Researchers found rural hospitals now faced an uphill challenge when it came to restoring services to normal. NHS England says that funding reflects the higher costs of delivering care in rural communities. The Nuffield Trust report says while the number of Covid cases in rural areas was lower than in big urban centres, the pandemic's impact on services has been much greater. It says the coronavirus crisis highlighted pre-existing problems facing rural trusts. For example, it can be hard to recruit and retain doctors and nurses who are willing to work in smaller hospitals, which means trusts rely more heavily on expensive agency staff to fill gaps in rotas. This, in turn, has a detrimental effect on the finances of hospital trusts which struggle to balance the books. In addition, rural trusts often have only a limited capacity to treat any extra patients as they are often already very busy. Read full story Source: BBC News, 11 December 2020
  16. News Article
    A prominent feminist campaigner and writer has described in devastating detail how she was left feeling “humiliated and alone” as she was forced to deal with a miscarriage without her partner. Caroline Criado Perez, the author of Invisible Women, called on NHS trusts to allow partners to attend medical appointments, scans and emergencies in maternity services, because the refusal to do so was “traumatising an already traumatised woman”. She added: “It needs to stop, now.” At the start of the coronavirus crisis, the majority of NHS trusts began preventing partners from accompanying pregnant women to the majority of maternity appointments, and reports suggest this is still the case in many areas. In September the Guardian revealed that three-quarters of NHS trusts were not allowing birth partners to support women throughout their whole labour, despite being told by the NHS and Boris Johnson to urgently change the rules on visiting. According to a November survey by the campaign group Pregnant Then Screwed (PTS), 82% of respondents said their local hospital had restrictions in place (for labour or scans), while 90% said that these restrictions were having a negative impact on their mental health. Read full story Source: The Guardian, 9 December 2020
  17. News Article
    One in 10 staff at some Welsh health boards are off sick or self-isolating, BBC Wales has been told. The NHS Confederation said staffing problems were having a "huge impact". It said the overall NHS Wales absence rate was between 8% and 9%, but some services have up to half their staff absent. Monthly absence rates in December are usually about 5%, but Aneurin Bevan, Cwm Taf Morgannwg and Betsi Cadwaladr health boards have rates of about 10%. Welsh NHS Confederation director Darren Hughes told Wales Live the NHS was in "the same storm but different parts will definitely be in different boats", with absence rates higher in areas hit hardest by coronavirus. Read full story Source: BBC News, 10 December 2020
  18. Content Article
    Managing infection control is essential to prevent the spread of coronavirus (COVID-19) for your setting or service. As care providers, you are likely to be providing essential care and support to people, which will often require close contact. This quick guide from the Social Care Institute for Excellence sets out best practice for care providers to remain safe and prevent COVID-19 from spreading.
  19. News Article
    Coronavirus has not caused an increase in stillbirths despite fears it could do so, Government data suggests. The Office for National Statistics (ONS) published data on Monday showing that the stillbirth rate decreased from 4.0 stillbirths per 1,000 total births in 2019, to 3.9 in the first three quarters (January to September) of 2020, in line with the long-term trend. The data comes amid fears that coronavirus can impact pregnancy and the stillbirth rate. Read full story Source: The Telegraph, 8 December 2020
  20. News Article
    Dialysis patients who must travel to hospital are nearly four times as likely to die of covid than those aged over 80, but so far have not been prioritised for receiving vaccination, HSJ has learned. UK Renal Registry data shows that, from March to November 2020, 3.3% of all in-centre haemodialysis patients have died from covid (662 deaths out of a population of 20,000). This figure compares to a death rate of approximately 0.7% in all those aged over 80 and 1.8% in over 90s. Although the government classifies dialysis patients as clinically extremely vulnerable to COVID-19, not all patients are able to receive dialysis at home and those receiving inpatient treatment still need to travel to dialysis clinics, either in main hospital buildings or smaller satellite clinics, three times a week. At present the Joint Committee on Vaccine and Immunisation COVID-19 vaccine prioritisation list ranks all dialysis patients at priority level four, alongside all other shielding patients and those aged over 70. Priority one covers all care home residents and staff, while priority two covers all over 80s and frontline health workers. The Renal Association wrote to Public Health England and JCVI over the weekend to ask for a change in vaccine prioritisation but, at the time of writing, has not received a response. Read full story (paywalled) Source: HSJ, 9 December 2020
  21. News Article
    All non-urgent elective operations are being postponed for at least two weeks in a health system still seeing significant and growing pressure from coronavirus. The four acute trusts in Kent and Medway will still carry out cancer and urgent electives, but other work is being postponed. Relatively few elective operations are usually carried out around Christmas and New Year, meaning the county is likely to see little or no elective work for the next four weeks. In a covid update bulletin issued last night, the Kent and Medway Clinical Commissioning Group acknowledged the pressure hospitals across its area were under but stressed cancer and other urgent operations would go ahead. It added: “However, we are now pausing non-urgent elective services. This will allow staff to move to support the increased number of covid-19 patients. “Initially this will be for a two-week period. We will keep this under weekly review and will contact individual patients where appointments need to be rescheduled.” Read full story (paywalled) Source: HSJ, 8 December 2020
  22. Content Article
    How are we ensuring that patient and staff safety is being prioritised during the pandemic? Watch the recording of the 'Leadership for patient safety during COVID-19' webinar that took place on 7 December 2020.
  23. News Article
    A 90-year-old woman has become the first patient in the world to receive the Pfizer Covid-19 vaccine after its approval in the UK, where the NHS has launched its biggest vaccine campaign. Margaret Keenan received the jab at about 6.45am in Coventry, marking the start of a historic mass vaccination programme. The vaccines will be administered at 50 hospital hubs around the country, with patients aged 80 and over who are either already attending hospital as an outpatient or are being discharged home after a hospital stay, being first in line. Read full story Source: The Guardian, 8 November 2020
  24. Content Article
    The COGER study is collecting data to gain insight into the course of functional and medical recovery in older people affected by COVID-19 participating in rehabilitation across Europe.
  25. News Article
    Concern is growing that NHS hospitals may face a third wave of the coronavirus pandemic with a much higher level of covid-positive inpatients than at the beginning of the second wave. This raises the prospect of the service being overwhelmed during the January-February “winter pressures” period and having to once again halt elective and non-urgent work in many areas. HSJ understands national NHS leaders are concerned that anything over 5,000 covid patients in hospital by the year end would leave the service vulnerable to being overwhelmed. Their concerns are based on the fact that the second wave added 13,000 hospitalised covid patients at peak. During the first wave, covid hospitalisation peaked at just over 17,000, and in order to prepare for it the NHS cancelled most elective and non-urgent work. Read full story Source: HSJ, 7 December 2020
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