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Found 1,299 results
  1. News Article
    More than one in five patients at some hospitals are leaving accident and emergency departments before completing treatment, and in some cases before being seen for assessment at all, with the rate across England trebling since before the pandemic. Experts told the Observer that the increase was probably driven by a combination of long A&E waiting times and by difficulties accessing NHS facilities such as GPs, community health services and NHS 111. The figures apply to patients who left A&E before an initial assessment; after an assessment but before treatment started; or before treatment was completed. They include patients who left to find treatment elsewhere. David Maguire, a senior analyst with the King’s Fund health thinktank, linked the rise to patients having difficulty accessing other parts of the NHS and going to A&E instead. “We’re probably talking about things that won’t require an admission, but it’s important that you get seen by someone,” he said. “So for example, somebody’s got a chest pain, somebody’s got some sort of adverse indication that you would want to seek attention for. It’s a perfectly rational thing to do. But it’s a struggle to access at other points [in the NHS], so you default towards A&E.” He added that staff shortages and social care capacity were also contributing factors. “I think it’s a lot of the NHS not functioning properly. Pre-pandemic, there was a certain amount of flex in the system – even with the problems that we were seeing around performance – that meant you could come to A&E with some of these issues. That flex in the system has gone – the capacity has been absorbed by other issues.” Read full story Source: The Observer, 21 May 2022
  2. Content Article
    This report published by the National Confidential Enquiry into Patient Outcome and Death (NCEPOD) looked to identify and explore remediable factors in the clinical and organisation of the physical healthcare provided to adult patients admitted to a mental health inpatient setting.  The report suggests that a physical healthcare plan should be developed when patients are admitted to a mental health inpatient setting. Other key messages aimed at improving care include calls to: formalise clinical networks/pathways between mental health and physical health care; involve patients and their carers in their physical health care, and use admission as an opportunity to assess and involve patients in their general health, and include mental health and physical health conditions on electronic patient records.
  3. Content Article
    This video is based on research interviews with acute medical patients and examines how staff and patients in hospital can create safe care together. It includes quotes from real-life patient experiences and highlights the importance of listening to and reassuring patients, and involving them in their care.
  4. News Article
    NHS prescription charges in England are to be frozen for the first time in 12 years, the government has confirmed. Single prescription charges, which the Department of Health said would normally rise "in line with inflation", will remain at £9.35 until next year. Health Secretary Sajid Javid said freezing the costs would "put money back in people's pockets". Faith Angwet, a single mother of two, said she had to choose between paying for prescriptions to treat for her high blood pressure, or using that money to feed her children. She said the price freeze "won't go far" because "it's not necessarily the outgoings affecting me, everything is going up in price and I'm not able to afford everything I use to be, including my prescription". Claire Anderson, of the Royal Pharmaceutical Society, said people who do not qualify for free prescriptions because of their income, age, or medication type, often had to make decisions about which medicines they need. "Those medicines are prescribed for a reason because that patient needs that treatment," she told the BBC. And Laura Cockram, chairwoman of the Prescription Charges Coalition, who welcomed the freeze, said the government should review the list of those who qualified for free prescriptions. She said the prescription exemption charge list was put together more than 50 years ago, when conditions like HIV "didn't even exist" and at a time there "weren't life saving treatments for things like asthma, Parkinson's and MS". Read full story Source: BBC News, 16 May 2022
  5. Content Article
    Every year, thousands of emergency department (ED) visits result in patients being discharged with oral antibiotic prescriptions. Published studies that assess the appropriateness of these antibiotic regimens are limited. The purpose of this study from Bauman et al. was to examine the appropriateness of antibiotic prescriptions written for patients discharged from a community hospital’s ED. A total of 76% of the prescribed antibiotics were appropriate, 16% were inappropriate, and the remaining 8% were not assessable. Duration was the most common reason for a regimen to not be optimal. The most frequently inappropriately prescribed antibiotics included cephalexin (but it is noted cephalexin was included in almost half of the antibiotic regimens in this study), clindamycin, and azithromycin. Infections that were most frequently treated inappropriately were skin and soft tissue infections, dental infections, and sinusitis. 
  6. Content Article
    Lisa Drake, an NHS ex General Practice Manager now working in a digital advisory role, shares some of the missed opportunities for digital ways of working she witnessed when she was a patient herself.
  7. Content Article
    Call 4 Concern is a patient safety initiative enabling patients and families to call for immediate help and advice when they feel concerned that they are not receiving adequate clinical attention. Here is the University Hospitals Dorset Trust's leaflet.
  8. News Article
    A website that tells patients how long they are likely to wait for NHS treatment will be made available in Scotland this summer. Humza Yousaf, the Scottish health secretary, said people queuing for tests and procedures and their doctors would be able to access information about any delays in their area using the software. Many patients living in pain are waiting years to have common operations such as hip and knee replacements. In theory, the SNP guarantee hospital treatment within 12 weeks of patients joining the waiting list, but this law was broken extensively before the pandemic and has now been breached hundreds of thousands of times. One orthopaedic surgeon, who did not wish to be named, said he was operating on patients whose joints had entirely collapsed after a two-year wait for a limb replacement made their case an emergency. Other patients who did not reach crisis faced even longer delays, he said. Dr Sandesh Gulhane, a GP and health spokesman for the Scottish Conservative Party, asked Yousaf, during a meeting of the Scottish Parliament’s health committee yesterday: “Why can’t we have in the future, in the [recovery] plan, indicative waiting times which are relatively live so we can all go on a website and see how long we need to wait.” Yousaf said it was fair for patients and NHS staff to expect to have information on waiting times, and that a website to provide this was being developed. “We are working closely with Public Health Scotland, we are working closely with boards to develop the infrastructure in order to collate and publish this data,” he said. “It’s an ambition of ours to have that available in a way that is easy to find, easy to understand, both for the patient but for the health professional too.” Read full story (paywalled) Source: The Times, 11 May 2022
  9. News Article
    The latest batch of hospital patient safety ratings from America's Leapfrog Group shows a general decline among “several” hospital safety measures concurrent with the onset of the COVID-19 pandemic, according to the healthcare safety watchdog. Released Tuesday, the scores are accompanied by a report from Leapfrog that highlights a “significant” decline in the experiences of adult inpatients at acute care hospitals during the pandemic, with many areas “already in dire need” prior to the pandemic deteriorating even further. “The healthcare workforce has faced unprecedented levels of pressure during the pandemic, and as a result, patients' experience with their care appears to have suffered,” Leah Binder, president and CEO of the Leapfrog Group, said in a statement. Leapfrog’s twice-annual reports assess more than 30 patient safety measures and component measures compiled from the Centers for Medicare & Medicaid Services (CMS) and Leapfrog’s hospital surveys between July 2018 and March 2021. The most recent release assigns letter grades to nearly 3,000 US general hospitals and is the second collection of scores to incorporate safety and experience data from the COVID-19 pandemic. Read full story Source: Fierce Healthcare, 10 May 2022
  10. News Article
    A chief executive has described her ‘considerable regret’ that growing difficulty in discharging patients has resulted in nearly half of her trust’s inpatients being clinically ready to leave. Debbie Richards, who leads Cornwall Partnership Foundation Trust, a community and mental health provider, highlighted the issue at the trust’s board meeting last month, amid a “dearth of adult social care provision” across the country. In her update to the board, Ms Richards said delays in finding onward care for patients awaiting discharge meant “almost 50 per cent of our community hospital beds are occupied by patients who have no medical need to be in hospital”. In her report to the board, Ms Richards said: “Despite having over 5,000 care home beds in Cornwall, the majority of these are full, or care home providers are unable to offer beds because of a lack of staffing. “Where there is capacity, this tends to be for lower-level residential beds where unfortunately there is much less demand.” Siobhan Melia, chair of the NHS Community Network and CEO of Sussex Community FT, said the “dearth of adult social care provision” was the biggest limiting factor in discharging delayed patients home, followed by high staff vacancies and sickness absence." She called for a national long-term funding settlement for social care and reform of the sector to address the key challenges. Read full story (paywalled) Source: HSJ, 10 May 2022
  11. News Article
    Hundreds of severely mentally ill prisoners in urgent need of hospital treatment are being left in prison cells due to bed shortages in secure NHS psychiatric units, an investigation has discovered. Freedom of information (FoI) responses from 22 NHS trusts reveal for the first time that just over half of the 5,403 prisoners in England assessed by prison-based psychiatrists to require hospitalisation were not transferred between 2016 and 2021 – an 81% increase on the number of prisoners denied a transfer in the previous five years. In some areas, the majority of mentally ill prisoners were not admitted, which could be the result of long delays or a trust refusing to take certain patients. Norfolk and Suffolk NHS foundation trust, which was rated inadequate by the Care Quality Commission last month, only admitted 16 of 41 prisoners referred in 2021. Essex Partnership University NHS foundation trust only admitted 24 of 57 prisoners referred in 2021. Lancashire and South Cumbria NHS foundation trust only accepted 18 of the 38 prisoners referred in 2021. Peter Dawson, the director of the Prison Reform Trust, said the figures unearthed by the investigation suggested hundreds of very ill people were being denied the treatment they needed. “It is shocking that a growing number of people are not getting the transfer to hospital that clinicians say is essential for their mental health,” he said. “Instead they are languishing in often overcrowded and dilapidated prisons. It is cruel and guarantees people will leave prison in a worse state than when they came in, with every likelihood that the behaviour that originally led to their arrest and conviction will continue.” Read full story Source: The Guardian, 10 May 2022
  12. Content Article
    In the 2017 Health Survey for England, 34% of adults reported experiencing chronic pain. The survey found that 5.5 million people (12%) are affected by high-impact pain that prevents them from enjoying social, family and recreational activities, and from working, including carrying out household tasks. This document sets out what the Arthritis and Musculoskeletal Alliance (ARMA) believes should be available in every area for people living with long term pain. It covers four areas: Underpinning framework Treatment for underlying conditions Services for people living with chronic pain Prevention and inequalities
  13. News Article
    People in England are struggling to get dental treatment, as dentists close to new NHS patients, a watchdog says. Healthwatch England, the NHS body representing patients, said the problem was made worse by the rising cost of living and needed "urgent attention". It said some people were living in pain, unable to speak or eat properly, because they could not find treatment. And it warned the poorest were suffering most as they were least able to afford to pay for private dentistry. Healthwatch England said the issue was creating a two-tier system - dividing the rich and the poor - and called on the government to take action. "There is now a deepening crisis," said Louise Ansari, of Healthwatch England. "With millions of households bearing the brunt of the escalating living costs, private treatment is simply not an option - and even NHS charges can be a challenge. "This needs urgent attention." Read full story Source: BBC News, 9 May 2022
  14. News Article
    GPs face “appalling and systemic” racism from patients and colleagues, a leaked NHS report has revealed. The first Health Education England report for London of its kind says racism and discrimination are widespread within primary care across the capital, and GPs in other parts of the country have raised similar concerns. Doctors speaking with The Independent have told stories of being called derogatory and racist names, of staff leaving due to the bigotry they’ve faced, and of patients asking to see a “white” or “English” GP. Senior GPs have warned patients will ultimately suffer as a result, as experienced doctors leave practices to avoid such abuse. Professor Simon Gregory, deputy medical director for Health Education England, said: “There is considerable evidence that the UK is systemically racist, and that the NHS is a systemically racist workplace. “This report is shocking evidence of terrible, indeed appalling, levels of discrimination across protected characteristics and with much intersectionality, but especially shocking levels of racial discrimination.” “The awful and painful narratives of so many colleagues over so many years cannot be ignored but thanks to London’s primary care educational leaders we now have firm evidence. Evidence that cannot be ignored.” Read full story Source: The Independent, 4 May 2022
  15. Content Article
    In this BMJ article, Caitríona Cox and Zoë Fritz argue that outdated medical language that casts doubt, belittles, or blames patients jeopardises the therapeutic relationship and is overdue for change.
  16. News Article
    A record 2.7 million people were referred for cancer checks in the last year, NHS England has said. It comes after figures suggested the Covid pandemic saw numbers dramatically decline in 2020. But at least 30,000 people are still waiting to start treatment. Charities have welcomed the increase in referrals but warned of the "devastating" impact the pandemic has had on cancer care. Referrals for suspected cancer remain at about 16% higher than pre-pandemic levels and rose overall from 2.4 million to 2,65m in the past 12 months. Dame Cally Palmer, national cancer director for NHS England, said there were still 30,000 people who had not started treatment due to the pandemic but that the new figures suggested some progress. She said: "We are going further and faster than ever before in our ambitions to diagnose more cancers at an earlier stage so that we can save more lives." It is "vital that we keep these referral rates high", she added. Read full story Source: BBC News, 2 May 2022
  17. Content Article
    In this blog, a woman who has suffered from severe pain and complications for 17 years due to transvaginal mesh shares her experience. She talks about how the device has changed her life, how her symptoms have been repeatedly dismissed by surgeons, and the variation she has witnessed between different specialist mesh centres.
  18. Content Article
    Nearly half of all adults and approximately 8% of children (aged 5-17) worldwide have a chronic condition. Yet, studies have consistently shown that adherence to medication is poor; estimates range from under 80% to under 50%, with an average of 50%. There could be a considerable improvement in health outcomes (and consequently longevity), not only by developing new drugs, but by helping people adhere to existing treatment regimens that have already been researched, tested and prescribed for them. But adherence isn’t usually prioritised by governments, health providers or healthcare professionals (HCPs). Adherence isn’t measured at a national level for any disease, apart from in Sweden where hypertension is recorded. And as governments don’t prioritise adherence, health providers aren’t measured or incentivised for improving it, meaning HCPs may not have the time and resources (or reminders) to focus on it during consultations.  This report from the International Longevity Centre-UK (ILC) makes a series of recommendations.
  19. Content Article
    Operations can have cognitive side-effects, particularly in the over-65s but also in the very young. How can science minimise the danger?
  20. Content Article
    There has been an increasing trend in commercially available diagnostic tests for food allergy and intolerance, but many of these tests lack an evidence base. In this article, Philippe Bégin from the University of Montreal describes the risks involved with using unproven diagnostic tests for food allergies and intolerances. He highlights that alongside their high cost, they may lead to false diagnoses, with associated anxiety and unnecessary strict avoidance diets. They may also lead truly allergic people to believe they are not allergic to certain foods, which could cause them to eat a food that gives them a life-threatening reaction. He also provides a list of tests that are offered to consumers, but that are unproven and should be avoided.
  21. News Article
    Three in four GPs have reported facing increasing patient abuse last year, according to a major survey by a medical defence organisation. The Medical and Dental Defence Union of Scotland (MDDUS) surveyed almost 2,000 members across the UK, including 668 GPs, about their experiences last year compared with 2020. It revealed that 76% of GPs reported an increase in verbal abuse from patients towards them and their practice staff. Half of these (38%) said this had ‘significantly increased’ and the other half that it had ‘somewhat increased’ throughout 2021. Female GPs were more likely to face verbal abuse or aggression than their male counterparts, with 81% reporting an increase in this compared with 72% of their male colleagues. The survey found that this has led to a ‘huge increase in work-related stress’, MDDUS said. Among GPs who experienced verbal abuse or aggression in the workplace, 83% said they felt ‘more stressed’ than they did in 2020. MDDUS chief executive Chris Kenny said: ‘The pandemic has stretched our healthcare professionals to the limit. For those at the very frontline, it is clear now that the levels of stress have reached an almost unsustainable point. ‘GPs urgently need recognition, reassurance and realism to support them so they can reset their relationship with patients.’ Read full story Source: Pulse, 22 April 2022
  22. News Article
    A trust has discovered 1,800 patients who were removed by mistake from its elective waiting list. Barking, Havering and Redbridge University Hospitals Trust chief executive Matthew Trainer wrote to colleagues in the east London health system today to “apologise for the stress this will have caused those experiencing a delay”. Of the 1,800 patients involved, 600 have been waiting more than a year and roughly 200 have been waiting for more than two years. Mr Trainer’s note explained: “The patients have been waiting to see our specialists in routine clinics in gynaecology, neurology, neurosurgery and ophthalmology.” It continued: “As we have been working through our waiting lists, we have discovered a problem with one of them that was used to deal with the backlog created by the pandemic. “It contained routine referrals that were submitted by GPs who wanted their patients to be seen by a specialist, but for whom there were no appointments available due to covid-19. Unfortunately, these patients were removed automatically from this list before they had been seen.” Read full story (paywalled) Source: HSJ, 26 April 2022
  23. News Article
    Relatives of intensive care Covid patients were left traumatised by being banned from visiting their seriously ill loved ones during the pandemic, a study has found. Researchers found two-thirds of family members of patients in intensive care were still suffering high levels of symptoms of post traumatic stress disorder (PTSD) three months after their relative was admitted. Symptoms of PTSD include flashbacks, nightmares and physical sensations such as pain, sweating, feeling sick or trembling. Before the Covid pandemic, symptoms of PTSD in family members of intensive care patients were between 15 and 30 per cent, depending on the condition. The team from the University of Colorado School of Medicine said visitation restrictions may have inadvertently generated a secondary public health crisis of stress-related disorders in family members of Covid patients. At the height of the pandemic, hospitals across Britain restricted access to patients, with many people forced to say goodbye to dying loved ones over Skype, or behind screens or windows. Even as late as last winter, a Telegraph investigation showed that a quarter of trusts were still imposing restrictions on visitors. The findings suggest that the rates of PTSD may be higher in relatives than in patients. A previous study by Imperial College and the University of Southampton found that only one-third of patients on ventilators suffer symptoms. Read full story (paywalled) Source: The Telegraph, 25 April 2022
  24. Content Article
    Dr Roberta Heale, Associate Editor of Evidence-Based Nursing, speaks to Dr Elaine Maxwell, Nurse and author of two National Institute for Health Research reviews on evidence on Long COVID in this BMJ Talk Medicine podcast. They discuss the variance in reported Long COVID statistics, the impact of vaccinations, symptoms, and research efforts.
  25. Content Article
    In 2016, the Centers for Disease Control and Prevention published prescribing guidelines for opioids. Though intended to encourage best practices in opioid prescribing, these guidelines fueled providers’ fears of opioids and led to many clinicians abandoning patients who relied on opioids for pain relief. In this article, Antje M. Barreveld reflects on the harms he may have caused by underprescribing these drugs, not overprescribing them.
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