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Found 1,298 results
  1. News Article
    Two-thirds of GPs feel ‘advice and guidance’ is preventing patients who really need a referral to secondary care from getting one, according to the findings of a snapshot survey of Pulse readers. Advice and guidance (A&G) services, which involve GPs accessing specialist advice before making a referral, have become a major part of NHS England’s plans for clearing the pandemic backlog. But of the 366 GP survey respondents in England who said they had used advice and guidance, 68% said they felt the pathway is blocking necessary referrals. The survey also found that of those 366 GPs who had used A&G services: Around half (49%) said A&G was reducing referrals; More than three-quarters (78%) said it was increasing their workload; Just over half (60%) said it was requiring them to work beyond their competence; Two-thirds (68%) said A&G was resulting in patients complaining because their wish to see a consultant had been diverted. One GP who wished to remain anonymous commented: "An increasing number of referrals are being rejected for secondary care service pressure reasons rather than clinical need. [This] often duplicates GP admin work as we need to re-refer, rewriting the referral and/or enclosing further information or tests results in order to get a referral accepted." Read full story Source: Pulse, 25 January 2023 Further reading on the hub: Rejected outpatient referrals are putting patients at risk and increasing workload pressure on GPs Patient referrals and waiting lists: A ticking time bomb A child left waiting for ‘urgent’ surgery, a blog by Clare Rayner
  2. Content Article
    This download A4 Easy Read booklet from Jo's Cervical Cancer Trust uses simple language and pictures to talk about smear tests. It explains what a smear test is and has tips to make it better for you. It also has a list of words you might hear. Please note this edition of the Easy Read booklet has not been updated with HPV primary screening, but the information and tips about cervical screening are correct. 
  3. News Article
    Being placed on immunotherapy to treat Stage 4 cancer was a life-saver for Imogen Llewellyn. Three years on, the 34-year-old is currently cancer-free, but said if it was not for specialist doctors, the side effects could have killed her. The Royal College of Physicians (RCP) claims Wales needs more oncology experts in A&E to recognise and treat emergencies. The Welsh government said all acute hospitals were expected to have an acute oncology service. The RCP report wants investment in emergency cancer care because of the sheer volume of patients who need urgent care during their treatment. With about a fifth of acute hospital beds occupied by people who have a cancer-related problems, they add that about a third of admissions could be avoided if same-day care were more widely available in Wales - which in turn would relieve pressure on hospitals. Dr Hilary Williams, consultant oncologist and Wales Cancer Network lead for acute oncology, said: "Wherever a patient lives in Wales, they should be able to access excellent acute oncology services. "When people think about cancer treatment, they might think about undergoing surgery or receiving chemotherapy, radiotherapy or immunotherapy in an organised way, perhaps during weekday hours in a specialist centre. But what happens when an emergency arises?" Read full story Source: BBC News, 24 January 2023
  4. News Article
    A mental health trust has spent millions this year on places in “bed and breakfast” accommodation in order to discharge inpatients, HSJ has learned. South London and Maudsley Foundation Trust, which serves four London boroughs, confirmed to HSJ it had spent £3.1m since April for a range of basic bed and breakfast places, and spaces with a specialist housing association, to ease its bed shortage pressures. The trust told HSJ clinicians were often reluctant to discharge patients to street homelessness, and that people with mental health problems can be more challenging to find accommodation for. The trust’s chief executive officer David Bradley told HSJ system leaders had been asked to think “innovatively” about how to mitigate discharge problems. B&Bs are generally a cheaper and more appropriate alternative to a £500 a night mental health hospital bed for people who don’t need acute treatment and have no housing, he said. Read full story Source: HSJ, 24 January 2023
  5. News Article
    A record 350,000 patients waited more than 12 hours to be admitted to hospital from A&E last year, according to figures that raise fears about unsafe care as the NHS faces further waves of strike action. The figures, uncovered in an analysis by the Liberal Democrats, show a steep rise in delays since 2015, when just 1,306 patients waited 12 hours. Senior doctors described the situation as “unbearable” for patients and staff, ahead of a strike in which thousands of ambulance workers will walk out across England and Wales on Monday. The Liberal Democrat leader, Ed Davey, warned that frequent and lengthy delays in emergency medicine are “needlessly costing lives of patients” and said that the government is in “total denial” about the scale of the problem facing hospitals, social care and GP services. “The failure of the Conservative government to grip this crisis is simply unforgivable,” he said. “Instead they have shamefully allowed the situation to go from bad to worse through years of neglect and failure.” Read full story Source: The Guardian, 23 January 2023
  6. News Article
    A growing number of patients deemed to require a hospital admission are waiting so long in A&E that they end up being discharged before being admitted to a ward, HSJ has been told. A senior emergency clinician, who has delivered improvement support to multiple emergency departments across the NHS, said such cases have become a regular occurrence – describing it as a “terrible experience” for some patients. The clinician, who asked not to be named, said: “I suspect every ED in the country are having patients who are spending 24 to 48 hours in ED under the care of a specialist, that in a better time they would have gone onto a ward. That’s happening every day in every department. “If you have been seen by the ED crew and referred to the medics who say ‘you need to be admitted to hospital’, the chances are that they are sick enough that they really do need that bed. “It’s a terrible experience [for the patients]. EDs are busy, noisy and crowded. This is not the place where, if you were feeling ill, to get better in a calm, relaxing area. This idea that somehow it’s OK because these people are not that sick, it’s pretty poor. “It feels very much like battlefield medicine – slap a patch on and try and get them back into battle as quickly as possible. It shouldn’t be the way with civilian healthcare.” Read full story (paywalled) Source: HSJ, 23 January 2023
  7. News Article
    An NHS trust has introduced pharmacy changes to help patients who are medically fit to leave hospital sooner. Gloucestershire Hospitals NHS Foundation Trust is focusing on getting TTOs (drugs To Take Out) to the pharmacy by 13:00 GMT each day. It says this reduces the length of stay for patients by several hours and can release up to 20 beds a day. "That's 20 people not waiting in the emergency department," said medical director, Professor Mark Pietroni. The plan has been called 'Early Meds to Release Beds' by the trust. Patients whose TTOs are with the pharmacy by 13:00 GMT are usually discharged about four hours later. Read full story Source: BBC News, 20 January 2023
  8. News Article
    The percentage of Americans reporting they or a family member postponed medical treatment in 2022 due to cost rose 12 points in one year, to 38%, the highest in Gallup’s 22-year trend. The latest double-digit increase in delaying medical treatment came on the heels of two consecutive 26% readings during the COVID-19 pandemic that were the lowest since 2004. The previous high point in the trend was 33% in 2014 and 2019. An average 29% of U.S. adults reported putting off medical treatment because of cost between 2001 and 2021. Americans were more than twice as likely to report the delayed treatment in their family was for a serious rather than a nonserious condition in 2022. In all, 27% said the treatment was for a “very” or “somewhat” serious condition or illness, while 11% said it was “not very” or “not at all” serious. Lower-income adults, younger adults and women in the U.S. have consistently been more likely than their counterparts to say they or a family member have delayed care for a serious medical condition. In 2022, Americans with an annual household income under $40,000 were nearly twice as likely as those with an income of $100,000 or more to say someone in their family delayed medical care for a serious condition (34% vs. 18%, respectively). Those with an income between $40,000 and less than $100,000 were similar to those in the lowest income group when it comes to postponing care, with 29% doing so. Read full story Source: Gallup News, 17 January 2023
  9. Content Article
    This blog by Brita Lundberg of Lundberg Health Advocates looks at how healthcare providers can sometimes blame the patient for their condition, errors in treatment and communication issues. She looks at the role that language used in medical settings and historical views of the medical profession have on the tendency to blame patients, and highlights how the issue is also present in wider society. She offers three potential steps to help tackle patient-blaming: Recognise the problem, as it is difficult if not impossible to solve a problem until one recognises that it exists. Families, friends and clinicians should start with the assumption that the patient is correct and question others, particularly any in authority. All of us can be much too quick to dismiss patients’ concerns and to reassure them. It’s a bad habit. Instead–it is prudent never to eliminate any diagnosis, particularly one suggested by the patient, until all the supporting and contradictory evidence for each is carefully considered. Listen–that terribly overused and so little practiced—word. Listening instead of interrupting right away not only helps preserve the flow of the narrative but also gives us time to think about what is being said, and time to formulate a more considered response.
  10. Content Article
    Sarah Woolf shares the impact her cancer treatment had on her mental health and describes why it is important to see each patient as a whole person, understanding that their body has meaning for them
  11. News Article
    Visiting times have been extended at Dorset's hospitals during strike action so relatives and friends of patients can help. Times at general inpatient wards have been altered to be between 10:00 and 20:00 GMT on Wednesday and Thursday. Hospital bosses said help at mealtimes, for example, would allow nursing staff to focus on clinical care. All wards "will be safely staffed during the industrial action", the hospitals said. The UHD trust said: "If you wish to help your loved one at mealtimes or with any personal care, please do so - just let a member of the ward team know." Read full story Source: BBC News, 18 January 2023
  12. News Article
    GPs whose patients want to stop taking antidepressants should reduce the dose of their medication in stages to lower the risk and severity of withdrawal symptoms, the medicines watchdog has said. About one in six (16%) adult Britons experience moderate to severe depression, according to the Office for National Statistics. In England alone, 21.4m antidepressant drugs were prescribed between July and September 2022, according to the NHS Business Services Authority. A new draft quality standard for the care of adults with depression from the National Institute for Health and Care Excellence (NICE) – the first update in 11 years – includes specific guidance to help adults come off antidepressant medication permanently. NICE’s independent advisory committee, which includes experts in treating adults with depression, recommends the staged withdrawal of antidepressants in patients who want to stop taking the drugs. A staggered reduction of medicine, known as tapering, helps to reduce withdrawal effects and long-term dependence on the medication, according to Nice. The committee said primary care and mental health professionals should follow the NICE guideline recommendations on stopping antidepressant medication, including agreeing with their patient whether it is right for them to stop taking the medication and, if so, the speed and duration of withdrawal from it. Read full story Source: The Guardian, 17 January 2023
  13. Content Article
    With the NHS under relentless pressure this winter and as records keep getting broken for all the wrong reasons, Helen Buckingham takes a closer look at why hospitals are so full, and emphasises the importance of supporting and helping the health service’s staff.
  14. News Article
    Hospital staff have to complete 50 separate steps on average to discharge a patient, it has emerged, as the NHS grapples with a bed-blocking crisis. On average, around 14,000 patients deemed fit to leave hospital are stuck in beds every day, according to the latest official figures. The congestion is helping to fuel the backlog in accident and emergency (A&E) departments, where more than 55,000 patients waited 12 hours or longer last month. Steve Barclay, Health Secretary, announced an additional £250 million in funding last week to buy up care beds to help discharge thousands of patients. But doctors, social care experts and families have warned discharges are being delayed by NHS “bureaucracy” and excessive form filling. Dr Matt Kneale, co-chair of the Doctors’ Association UK and a junior doctor in Manchester, said patients are held up by “numerous bottlenecks” before being sent home. “While social care shortages are the predominant issue, smaller factors stack up to create a big problem,” he told The Telegraph. Many hospitals have limits on the times their pharmacies are open, he explained, meaning patients can often be stuck on the ward all day, or an extra night, waiting for their medication. Read full story (paywalled) Source: The Telegraph, 15 January 2023
  15. Content Article
    This document is Solent NHS Trust's engagement and inclusion strategy, which outlines the Trust's vision to health and reduce inequalities in the community it serves. Developed in partnership with local people, it describes the Trust's commitment to bring together three key things that help improve health: Diversity and inclusion–applying a positive approach to improving access, experience and outcomes for all. People participation–putting people central to decision making at all stages, phases and levels of their health care and healthcare provision as a whole. Community engagement–understanding what our local community does best, what they may need some help from us with and what we need to focus our expertise and energies on.
  16. Content Article
    In this letter to Steve Barclay MP, Secretary of State for Health and Social Care, the chair and chief executive of the Patients Association, Sir Robert Francis and Rachel Power, raised their concerns about how the Government is dealing with the growing crisis in health and social care. The letter asked him to declare a national incident in the NHS and to publish solutions to the current crisis, developed with patients and carers. The letter also asked the Minister to publish the long-term workforce plan and includes an offer from the Patients Association to work with the Department for Health and Social Care (DHSC).
  17. Content Article
    Dr Henrietta Hughes, England's Patient Safety Commissioner, discusses how the experiences of people from Black and minority ethnic groups has worsened since the pandemic and how this has impacted on patient safety, in a blog for the NHS Race & Health Observatory.
  18. News Article
    A senior doctor has told Scottish ministers to drop “patient-blaming language” over “unnecessary attendances” at emergency departments. Lailah Peel, the deputy chairwoman of the British Medical Association in Scotland, said the phrase suggested that patients were responsible for the problems and showed a misunderstanding of the issues. Patients have waited 30 hours for beds in overcrowded A&E units while ambulances have queued outside hospitals waiting to hand over patients to overstretched staff. Sturgeon, announcing measures to ease the strain, said: “To reduce the pressures in hospital and the knock-on impacts at the front door we need to do more firstly to avoid unnecessary attendances at hospital and second to speed up the discharge of patients from hospital.” Read full story (paywalled) Source: The Times, 12 January 2023
  19. Content Article
    This is part of our series of Patient Safety Spotlight interviews, where we talk to people working for patient safety about their role and what motivates them. Ian talks to us about rebuilding patient trust in the healthcare system, how the Private Healthcare Information Network (PHIN) is helping to improve decision making for patients in the private sector, and why recognising the link between physical and mental health is vital to patient safety.
  20. Content Article
    This document summarises the current landscape of virtual wards from the perspective of healthcare for older people, and provides advice to those looking to set up such services for older people living with frailty.
  21. Content Article
    We know that NHS organisations may sometimes need to reorganise their services to consider how they can best deliver care to patients. This can mean there is a need to repurpose existing environments, for example hospital wards or clinical areas. Staff may also be redeployed to deal with surges in demand when the pressure on the system is at its greatest. We commonly see this during winter, with ‘winter pressures’ wards, but we have also seen this become more common during other times of the year as the NHS deals with the lasting impact of coronavirus (COVID-19) and staff shortages in some key areas. It’s important that the NHS has this ability to adapt to try and make sure it can deliver the best and safest care to as many patients as possible. The ability to flex in this way helps to keep the NHS operating when it is at its busiest and makes sure that patients can still access appropriate care. Scott Hislop, the Healthcare Safety Investigation Branch (HSIB) Principal National Investigator, looks at the challenges faced by the NHS when flexing to meet demands and how to mitigate potential risks to patient safety.
  22. News Article
    More and more older people are being “warehoused” in inappropriate care beds, condemned unnecessarily to long-term care, and “lost” to health and care services, due to the rush to discharge from full hospitals and a lack of community rehab services, leaders have warned. Several senior figures in community and social care have raised the issue with HSJ, warning it has been a growing concern over the past 18 months of severe system pressure following on from acute covid peaks. The Health and Safety Investigation Branch has also raised the issue, telling HSJ inappropriate care placements are leading to harm and readmissions, while a major accountability gap remained over the safety of discharges. The average length of hospital stay has increased compared to pre-Covid, with a big jump in those staying more than three weeks. Many in the NHS put this down to a lack of social care capacity meaning more medically fit people are stuck in hospital. Senior staff in community health and social care services told HSJ hospitals were increasingly demanding rapid discharges, often as part of “surge” measures when they are very full and under pressure to reduce ambulance queues. Homecare cannot be organised, and with suitable step-down and care beds also full, trusts are instead “spot purchasing” space in unsuitable homes which may be a long journey from the person’s home area, and in a different council area. Read full story (paywalled) Source: HSJ, 5 January 2023 Further reading HSIB interim bulletin - Harm caused by delays in transferring patients to the right place of care
  23. News Article
    NHS hospitals are discharging patients into a hotel in a bid to ease demand for beds. Bristol, North Somerset and South Gloucestershire trusts are using the hotel for patients who no longer need urgent treatment but need social care. The Integrated Care Board (ICB) for the three trusts has booked the "hotel care facility" for up to 30 patients. A spokesperson for the ICB said care services were "under significant pressure". "This temporary care facility delivered at a local hotel will help us to improve the flow of patients through our hospitals by ensuring more people can be discharged as soon as they are medically fit to leave hospital," they said. The hotel care facility was introduced in late November 2022 and will run until the end of March. It is being provided by CQC-registered homecare company Abicare. The service is being delivered by live-in care workers on a 24/7 basis with visiting clinical teams providing rehabilitation and primary care support, the ICB said. Nadra Ahmed OBE, chair of the National Care Association (NCA), told BBC Radio 4 Today she is concerned about the quality of care in a hotel setting. "This is a short-term solution- what we really need is a robust, sustainable and well-invested social care sector," she said. Read full story Source: BBC News, 5 January 2022
  24. Content Article
    In this blog for the Citizens Commission on Human Rights, Jane London shares her account of how electroconvulsive therapy (ECT) has affected her life since early adulthood, resulting in severe memory loss and heart problems. Jane shares how her physical medical problems including appendicitis and a severe heart attack were put down to depression, and how she was nearly forced to have ECT against her will in England in 1966. When her abusive marriage ended in 1968 and Jane returned to Australia her mother insisted she have ECT, despite her depression being temporary and related to her marriage ending. After 14 treatments, Jane left the treatment facility and received talking therapy to help her recover. Jane talks about the dramatic adverse effect ECT has had on the rest of her adult life.
  25. News Article
    A man turned up to an accident and emergency department in the Midlands complaining about ear wax on the day a hospital declared a critical incident, a nurse who works there has said. Lesley Meaney, a sister at University Hospitals of North Midlands (UNHM), said the patient presented to A&E with “no pain, no discomfort, just eat war wax!” Earlier on 30 December officials at the trust declared a critical incident, citing “extremely high demand for all of our services.” The disclosure by Ms Meaney underlines the scale of the challenge facing the NHS and staff working in hospitals across the country. Writing on Twitter, Ms Meaney added: “Seriously what is up with the general population? A major incident declared, ambulances queuing, and you decide to come to the emergency department on New Year’s Eve with ear wax.” Dr Matthew Lewis, medical director at UNHM, said: “The accident & emergency departments at UHNM are some of the busiest in the country so we would urge the public to only come to our Emergency Departments if it’s for serious, life-threatening conditions that need immediate medical attention, such as persistent severe chest pain, loss of consciousness, acute confusion, severe blood loss, serious burns, broken bones, suspected stroke. Read full story Source: The Independent, 4 January 2023
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