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Found 1,298 results
  1. Content Article
    This KevinMD podcast discusses with family physician Lisa Baron the pervasive issue of medical gaslighting, particularly in women seeking care for chronic illnesses. We’ll delve into the consequences of dismissing symptoms and the importance of validating patient concerns. We’ll also explore the role of social media in connecting patients with support and treatment options, as well as steps doctors can take to improve their bedside manner and rebuild trust with patients who have been gaslit in the past.
  2. Content Article
    With the Supreme Court having recently heard the Worcestershire appeal on local authority responsibility for section 117 aftercare, Bevan Brittan consider the current legal framework for health responsibility.
  3. Content Article
    Hospitals can significantly elevate patient satisfaction and enhance the delivery of healthcare services by incorporating best practices from adjacent and non-adjacent sectors. Chetan Trivedi explores several solutions, from multiple sectors, that can serve as a blueprint for hospitals across every key step of the patient journey, spanning from admission to discharge.
  4. Content Article
    To support patients to understand the risks of taking sodium valproate during pregnancy, NHS England has launched two new shared decision-making tools. This is part of an NHS-wide effort to reduce the use of valproate in people who can get pregnant, and to help those that do continue with valproate to prevent pregnancies.
  5. News Article
    NHS England is ‘sorry’ for backing a mental healthcare model which it now admits has caused hurt to patients, according to a leaked draft policy document. The serenity integrated mentoring model was launched in 2013 in the Isle of Wight and Hampshire. It quickly became viewed by mental health trusts as an “innovative approach” to helping support frequent users of the emergency services. A core element of the scheme involves placing a local community police officer within the healthcare team charged with supporting those patients. In 2021, the pressure group StopSIM raised concerns about the model, which included a belief that police involvement was potentially coercive, criminalised mental health crises, and could result in withholding healthcare from people, which would breach human rights legislation. The group also argued the SIM programme had not been robustly and clinically evaluated. As a result, NHSE committed to co-producing policy guidance on SIM with StopSIM. The draft document states: “NHS England did not apply sufficient scrutiny to the decision [to endorse SIM] and involve the voice of lived experience sufficiently. This compromised the safety and quality of care for service users and has caused hurt to patients. For this, NHS England is sorry.” Read full story (paywalled) Source: HSJ, 19 May 2023 Further reading on the hub: The High Intensity Network (HIN) approach and SIM model for mental health care and 'high intensity users' – what are your views?
  6. News Article
    National guidelines are needed to help maternity care professionals navigate discussions with pregnant women about past traumas, experts have said. Their study, published in the journal Plos One, also found that while talking about previously experienced traumas can be valuable, they can also trigger painful memories if not approached sensitively. The authors also raised concerns about the support available for professionals who may not feel equipped to explore challenging topics such as domestic or sexual abuse, childhood trauma and birth trauma without adequate guidelines or referral pathways. Joanne Cull, a midwife and PhD student at the University of Central Lancashire’s School of Community Health and Midwifery, who is corresponding author on the study, said: “As awareness of the long-term effects of trauma on health and wellbeing has grown, there has been a move toward asking pregnant women about previous trauma, usually at the first appointment. “No national guidance on this has been published in the UK so NHS Trusts have implemented this on a piecemeal approach.” Read full story Source: The Independent, 17 May 2023
  7. News Article
    Factors like deprivation should be considered in prioritising waiting lists, NHS England’s inequalities director has said, but in a ‘very sophisticated, thoughtful way’ alongside clinical need and waiting times. NHSE said in summer 2020 the service would “restore services inclusively”, and some systems and trusts have developed tools they say could allow them to consider factors such as deprivation, race, employment, and lifestyle risk factors, such as smoking. But the issue has been controversial. Research for University Hospitals Coventry and Warwickshire Trust, which has developed a new prioritisation system, found many members of the public are opposed to taking these factors into account. NHSE standard contract guidance for 2023-24, seemingly cautioning against such moves, said: “[The Department of Health and Social Care] asked us to make clear that providers are ‘recommended to prioritise waiting lists according to clinical need and then in chronological order from the longest waiting patient.’” Read full story (paywalled) Source: HSJ, 18 May 2023
  8. Content Article
    An NHS-Led Provider Collaborative is a group of providers of specialised mental health, learning disability and autism services who have agreed to work together to improve the care pathway for their local population. They will do this by taking responsibility for the budget and pathway for their given population. The Collaborative will be led by an NHS Provider who remains accountable to NHS England and NHS Improvement for the commissioning of high-quality, specialised services. These Collaboratives aim to ensure that people with specialist mental health, learning disability and autism needs experience high quality, specialist care, as close to home as appropriately possible. They seek to enable specialist care to be provided in the community to prevent people being in hospital if they don’t need to be, and to enable people to leave hospital when they are ready. This webpage explains the role of NHS-Led Provider Collaboratives and includes case studies that demonstrate how they are helping to transform specialised mental health services.
  9. Content Article
    Martin Hogan, Lead Professional Nurse Advocate (PNA) at Central London Community Healthcare NHS Trust, tells us about the PNA training programme and the impact and improvements it can have on both staff and patient safety. He shares his own personal development from taking the programme, how he has used the skills learnt to educate and support his colleagues, and explains why he is championing the PNA to others and has set up a network of PNAs.
  10. News Article
    The UK medical regulator has launched an investigation into a “stalker” doctor who accessed intimate details of the health history of a woman who had begun dating the doctor’s ex-boyfriend. The General Medical Council (GMC) is investigating whether the doctor – a consultant at Addenbrooke’s hospital in Cambridge – breached their professional, ethical and legal duties to protect the woman’s personal information. The victim has given the watchdog a statement detailing the consultant’s repeated violations of her medical records and documentation that shows what she did. The GMC declined to comment because it has not yet decided to open a formal disciplinary case against the consultant, who could face serious sanctions including a ban on working as a doctor. One of the GMC’s investigative officers is examining the victim’s claims and collecting evidence. The Guardian revealed how the doctor had looked at the victim’s hospital and GP records seven times last August and September, in the early stages of the woman’s relationship with a man the consultant had been involved with for several years. Read full story Source: The Guardian, 15 May 2023
  11. News Article
    A hospital trust, which has already implemented a series of safety measures to protect employees, has reported a 17% rise in incidents of abuse against staff by patients and the public in the last year. Data from the Oxford University Hospital’s clinical incident system, shared with HSJ, shows there were 1,181 cases of violence and aggression against staff in 2022, up from 1,003 in 2021. Before late 2021, the monthly incident rate very rarely hit 100, while since January 2022 it has topped 100 in seven months, including 162 and 131 incidents respectively in January and February this year. The ongoing growth is despite the trust launching a campaign, called “No Excuses”, in January 2022,. Measures include bodyworn cameras, and safety devices with alarms and positioning technology for lone workers. Read full story (paywalled) Source: HSJ, 16 May 2023
  12. News Article
    Almost a quarter of people with dementia symptoms waited more than six months before seeing a doctor, new research shows. A new survey for the Alzheimer’s Society to mark Dementia Action Week also found one in three people who notice they or a loved one has symptoms keep their fears to themselves or dismiss them as old age. Just 15% of the 1,137 people surveyed raised the issue straight away and 11% said they hadn’t raised concerns after first spotting symptoms. Kate Lee, chief executive of the Alzheimer’s Society, said: “We can’t continue to avoid the ‘d’ word – we need to face dementia head-on. “As soon as you realise something is not right, come to Alzheimer’s Society – you can use our symptoms checklist to help have that all-important first chat with your GP.” An early diagnosis is crucial to help manage symptoms, according to the charity, which has launched a new campaign called – It’s not called getting old, it’s called getting ill – to encourage people to seek support in getting a diagnosis. Read full story Source: The Independent, 15 May 2023
  13. News Article
    The confidentiality of NHS medical records has been thrown into doubt after a “stalker” hospital doctor accessed and shared highly sensitive information about a woman who had started dating her ex-boyfriend, despite not being involved in her care. The victim was left in “fear, shock and horror” when she learned that the doctor had used her hospital’s medical records system to look at the woman’s GP records and read – and share – intimate details, known only to a few people, about her and her children. “I felt violated when I learned that this woman, who I didn’t know, had managed to access on a number of occasions details of my life that I had shared with my GP and only my family and very closest friends. It was about something sensitive involving myself and my children, about a family tragedy,” the woman said. The case has prompted warnings that any doctor in England could abuse their privileged access to private medical records for personal rather than clinical reasons. Sam Smith, of the health data privacy group MedConfidential, said: “This is an utterly appalling case. It’s an individual problem that the doctor did this. But it’s a systemic problem that they could do it, and that flaws in the way the NHS’s data management systems work meant that any doctor can do something like this to any patient. Read full story Source: The Guardian, 14 May 2023
  14. Content Article
    This article looks at the experience of Tammy Dobbs, who has cerebral palsy and requires extensive support from home carers to carry out daily tasks. In 2016, Tammy's care needs were reassessed by the state of Arkansas where she lives, and the hours of support she was eligible to receive were cut in half. The change in eligibility was due to a new state-approved algorithm that had calculated her support needs in a new way, in spite of the fact that there was no change to her level of need.  The situation caused Tammy much distress and resulted in drastic life changes. The article highlights the issues associated with the use of algorithms to determine need and allocate resources in health and social care. It also raises questions about what transparency means in an automated age and highlights concerns about people’s ability to contest decisions made by machines.
  15. Content Article
    Approximately 8% of US doctors experience a malpractice claim annually. Most malpractice claims are a result of adverse events, which may or may not be a result of medical errors. However, not all medicolegal cases are the result of medical errors or negligence, but rather, may be associated with the individual nature of the patient-doctor relationship. The strength of this relationship may be partially determined by a physician’s emotional intelligence (EI), or his or her ability to monitor and regulate his or her emotions as well as the emotions of others. This review evaluates the role of EI in developing the patient-physician relationship and how EI may influence patient decisions to pursue medicolegal action.
  16. Content Article
    Five professionals explore and discuss safe patient handling. Safe patient handling is essential for encouraging mobility for the patient and maintaining their skin integrity while not forgetting the impact on the healthcare worker. Each health care specialty has differing challenges, and this podcast explores some of these and look to see if an interprofessional care approach can help drive safer care and better outcomes.
  17. News Article
    Patients, or carers of patients, who carry Emerade 300 or 500 microgram adrenaline auto-injector pens should immediately contact their GP to obtain a prescription for, and be supplied with two auto-injectors of a different brand. Pharmacists and pharmacy teams can also help with obtaining new prescriptions and dispensing of new pens. Patients or carers should then return all Emerade 300 and 500 micrograms auto-injectors to their local pharmacy. Patients should only return their Emerade pens when they have received a replacement from their pharmacy which will be an alternative brand - either EpiPen or Jext. They should ensure they know how to use the replacement pen, as each brand of pen works differently. Patients should ask their doctor, pharmacist, or nurse for help with this. Instructions are included inside the pack, along with details of the manufacturer’s website that also provides information, including videos, on how to use a new EpiPen or Jext adrenaline pen. This precautionary recall is because some 300 microgram and 500 microgram Emerade auto-injector pens may rarely fail to activate if they are dropped, meaning a dose of adrenaline would not be delivered. Premature activation has also been detected in some of the 300 microgram and 500 microgram pens after they have been dropped, meaning that a dose of adrenaline is delivered too early. The activation failure and premature activation was detected during a design assessment conducted by the manufacturer and therefore means there is a potential for some 300 microgram and 500 microgram Emerade pens to fail during use after having been dropped. Read MHRA Press Release. 9 May 2023
  18. News Article
    Knocking on doors to check on people's health and catch problems before they escalate is common practice across Brazil. But could that approach work in the UK? Comfort and Nahima are two out of four door-knockers on round Churchill Gardens, a council estate in the Pimlico neighbourhood of London, visiting residents as part of a proactive community healthcare pilot. They can help with anything from housing issues which impact health, such as overcrowding, or pick up the early signs of diabetes by chatting informally to residents about their lifestyle. These community health workers are partly funded by the local authority and partly by the NHS so they can co-ordinate between the local GP surgery and other social services. Local GP Dr Connie Junghans-Minton says the proactive approach had led to fewer requests for appointments The National Institute for Health Research helped crunch the data from the pilot. Households which had been visited regularly were 47% more likely to have received immunisations and 82% more likely to have taken up cancer screening, compared to other areas. The idea to import this model to the UK came from Dr Matthew Harris, a public health expert at Imperial College London who worked as a GP in Brazil for four years. There, community health workers have been credited with achieving a drop of 34% in cardiovascular deaths. "In Brazil they have scaled this role to such degree that they have 270,000 community health workers across the whole country, each of which looks after 150 households, visiting them at least once a month," Dr Harris said. "They've seen extraordinary outcomes in terms of population health in the last two or three decades. We think we've got a lot to learn from that." Read full story Source: BBC News, 9 May 2023
  19. Content Article
    Primary care, like many parts of the NHS and health systems globally, is under tremendous pressure – one in five people report they did not get through or get a reply when they last attempted to contact their practice. The Fuller Stocktake built a broad consensus on the vision for integrating primary care with three essential elements: streamlining access to care and advice; providing more proactive, personalised care from a multidisciplinary team of professionals; and helping people stay well for longer.  The joint NHS and Department for Health and Social Care (DHSC) plan is an important first step in delivering the vision set out in Dr Claire Fuller’s Next steps for integrating primary care.
  20. News Article
    A hospital trust has said its staff have been verbally abused when contacting some patients to postpone their appointments because of next week’s nursing strike. Oxford University Hospitals Foundation Trust posted a statement to its website yesterday, which said: “It is very regrettable that we have to report that our staff have been verbally abused when contacting some patients to postpone their appointments. We fully understand and appreciate how disappointing and frustrating any postponement is, and we only do this if we absolutely have to in order to provide safe care for all our patients. “Our staff are doing their best in challenging circumstances to make sure you are informed as soon as possible. We do not tolerate abuse of our staff and abuse will be noted and further action may be taken.” Read full story (paywalled) Source: HSJ, 27 April 2023
  21. Content Article
    This Healthcare Safety Investigation Branch (HSIB) investigation focuses on the systems used by healthcare providers to book patient appointments for clinical investigations, such as diagnostic tests and scans. ‘Clinical investigation booking systems’ are used throughout the NHS to support the delivery of patient care. Healthcare services use paper-based or fully electronic systems, or a combination of the two (hybrid systems), to communicate to patients the time, date and location of their appointment. These systems also produce information for patients about actions they need to take to prepare for their appointment. Written patient communication is a key output of clinical investigation booking systems. This investigation examines the safety implications of patient communications, produced by booking systems, that do not account for the needs of the patient. In addition, it looks at why patients are ‘lost to follow-up’ after an appointment is cancelled, rescheduled or not attended. Lost to follow-up is the term used to describe a patient who does not return for planned appointments (whether for continued care or evaluations) or is no longer being tracked in the healthcare system when they should be.
  22. Content Article
    The COVID-19 Recovery Committee has published its report on Long Covid and post-Covid syndrome, urging the Scottish Government to take action to address the stigma surrounding the condition and improve awareness among the public and healthcare professionals. The inquiry focussed on the awareness and recognition, therapy and rehabilitation, and study and research linked to Long Covid, with the Committee noting “concern” in their findings over reports of patients being unable to get the correct diagnosis and the lack of treatment for common conditions associated with the condition. The Committee said it was “deeply saddened” to learn about the stigma faced by those with lived and living experience of Long Covid, and the report highlights the impact that the lack of awareness and recognition of Long Covid can have on those with the condition.
  23. News Article
    Women in labour should be offered an alternative to an epidural spinal block injection, say new draft guidelines for the NHS. The National Institute for Health and Care Excellence (NICE) is recommending remifentanil, which is a fast-acting morphine-like drug given into a vein. Women control the medication themselves, by pressing a button to get more of the drug for pain relief. A timer ensures the user cannot administer too much of it. Women who decide to try remifentanil and do not like it could still decide to have an epidural instead if there is no medical reason why they should not. They can use gas and air, also called Entonox, which is a mix of oxygen and nitrous oxide, at the same time. NICE says having remifentanil as a treatment option has advantages - it might enable women to be more mobile than with an epidural, which makes the legs numb and weak, for example. Evidence suggests fewer epidurals might mean fewer births using instruments like forceps and ventouse vacuum suction, says NICE. Read full story Source: BBC News, 25 April 2023
  24. Content Article
    How can improvement-led delivery enhance the quality of outcomes for our patients, communities and our health and care workforce? In April 2022, Amanda Pritchard requested a review of the way in which the NHS, working in partnership, delivers effectively on its current priorities while developing the culture and capability for continuous improvement. Led by Anne Eden, NHS Regional Director South East, with a steering group chaired by Sir David Sloman, Chief Operating Officer, NHS England, the review team co-developed 10 recommendations with health and care leaders that have been consolidated into three actions.
  25. News Article
    Take-up and usage of the NHS App in England has begun to plateau, after covid drove huge growth, figures seen by HSJ suggest. This can be seen in the percentage of GP appointments booked or cancelled using the app; the number of records viewed; and the number of times it has been downloaded. Rapid uptake was driven during covid restrictions, when travel and other activities often required a covid vaccination pass. Government has said it wants the growth to continue. The number of GP appointments booked or cancelled using the app fell for a third consecutive month in March to 212,954, representing a decrease of 15% since January and 28% on October 2022, when usage peaked. The NHS app is central to government’s plan for digital health and care, published last year, billed as the “digital front door” to the NHS which would aid the recovery of services post-pandemic. Read full story (paywalled) Source: HSJ, 19 April 2023
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