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Found 138 results
  1. Content Article
    Have you experienced issues getting treatment for urinary tract infections from your GP or a specialist? Please share your experiences with us in our community discussion about UTIs. Related reading Dangerous exclusions: The risk to patient safety of sex and gender bias (Patient Safety Learning, March 2021) The pain of my IUD fitting was horrific…and I’m not alone Gender bias: A threat to women’s health (August 2020) Medical trauma from IUD fitting: it’s not just five minutes of pain for five years of gain
  2. Content Article
    Key recommendations For Commissioners 1. Investment should be provided to: (a) establish prehabilitation services; (b) enable integrated Care Systems (England), Health Boards (Wales), Regional Health Boards (Scotland) and Health and Social Care Trusts (NI); and (c) expand perioperative services For NHS X 2. Ongoing work to bridge the Primary - secondary care interface should be accelerated. For primary care providers, surgeons, anaesthetists and multidisciplinary teams 3. Shared Decision Making (SDM) should be embedded throughout perioperative pathways. beginning at the earliest point where surgery is contemplated, and involving discussion between patient, surgeon, and the broader multidisciplinary team. 4. At the earliest possible point in the surgical pathway (e.g. at the point of referral from primary care, or at the first review in surgical clinic) patients should complete a screening self-assessment health questionnaire, to help shared decision making, risk prediction and optimisation. 5. Referrals from primary care to surgeons and from surgeons to Preoperative Assessment (POA) Services should detail significant medical comorbidities using a “fitness for surgery” process to enable early optimisation and review. For preoperative assessment services 6. Every patient requiring surgery and/or anaesthesia/anaesthesia-led sedation should undergo formal preoperative assessment before the day of admission. 7. Patients should be assessed for impact of comorbid conditions on functional capacity, perioperative pathways and surgical outcome. 8. Patients should be screened for cognitive impairment, psychological distress and risk of malnutrition using validated tools. For surgeons, anaesthetists and perioperative multidisciplinary teams 9. All patients being considered for surgical intervention should have their individualised risk assessed using objective measures, combined with senior, experienced clinical judgement. 10. Where possible, surgery should be avoided for 7 weeks after COVID-19 infection, or until symptoms have resolved, to avoid the higher risk of postoperative complications and death associated with earlier surgery. 11. All patients who are being considered for a surgical intervention should be screened for reduced functional capacity/physical fitness using a validated tool such as the Duke Activity Status Index (DASI). 12. All patients should be advised that improving fitness before surgery reduces risk of complications after surgery, and improves length of hospital stay, speed of recovery and quality of life. All healthcare professionals should be competent to deliver universal exercise advice to all patients following UK CMO (WHO) guidance. 13. All patients considered for a major or inpatient elective surgical intervention should be invited to attend a group ‘surgery school’, which may be in-person, via remote access or hybrid. 14. All surgical / perioperative services should have a system for active clinical surveillance of patients on waiting lists, particularly those who have been waiting for longer than 3 months. 15. Prompt preoperative assessment and optimisation, supported by agreed local pathways based on national recommendations, should be prioritised in emergency surgery. This will ensure efficient and safe care which will benefit best use of hospital resources, creating more capacity for both emergency and elective work.
  3. Content Article
    NHS 2022/2023 priorities: Invest in our workforce – with more people (for example, the additional roles in primary care, expansion of mental health and community services, and tackling substantive gaps in acute care) and new ways of working, and by strengthening the compassionate and inclusive culture needed to deliver outstanding care. Respond to COVID-19 ever more effectively – delivering the NHS COVID-19 vaccination programme and meeting the needs of patients with COVID-19. Deliver significantly more elective care to tackle the elective backlog, reduce long waits and improve performance against cancer waiting times standards. Improve the responsiveness of urgent and emergency care (UEC) and build community care capacity– keeping patients safe and offering the right care, at the right time, in the right setting. This needs to be supported by creating the equivalent of 5,000 additional beds, in particular through expansion of virtual ward models, and includes eliminating 12-hour waits in emergency departments (EDs) and minimising ambulance handover delays. Improve timely access to primary care – maximising the impact of the investment in primary medical care and primary care networks (PCNs) to expand capacity, increase the number of appointments available and drive integrated working at neighbourhood and place level. Improve mental health services and services for people with a learning disability and/or autistic people – maintaining continued growth in mental health investment to transform and expand community health services and improve access. Continue to develop our approach to population health management, prevent illhealth and address health inequalities – using data and analytics to redesign care pathways and measure outcomes with a focus on improving access and health equity for underserved communities. Exploit the potential of digital technologies to transform the delivery of care and patient outcomes – achieving a core level of digitisation in every service across systems. Make the most effective use of our resources – moving back to and beyond prepandemic levels of productivity when the context allows this. Establish ICBs and collaborative system working – working together with local authorities and other partners across their ICS to develop a five-year strategic plan for their system and places.
  4. News Article
    NHS England has set out 10 priorities for 2022-23 in its annual planning guidance. NHSE chief executive Amanda Pritchard makes clear in an introduction that many of its goals remain contingent on covid, stating: ”The objectives set out in this document are based on a scenario where covid-19 returns to a low level and we are able to make significant progress in the first part of next year.” The 10 priorities are: Workforce investment, including “strengthening the compassionate and inclusive culture needed to deliver outstanding care”. Responding to COVID-19. Delivering “significantly more elective care to tackle the elective backlog”. Improving “the responsiveness of urgent and emergency care and community care capacity.” Increasing timely access to primary care, “maximising the impact of the investment in primary medical care and primary care networks”. Maintaining “continued growth in mental health investment to transform and expand community health services and improve access”. Using data and analytics to “redesign care pathways and measure outcomes with a focus on improving access and health equity for underserved communities”. Achieving “a core level of digitisation in every service across systems”. Returning to and better “prepandemic levels of productivity”. Establishing integrated care boards and collaborative system working, and “working together with local authorities and other partners across their ICS to develop a five-year strategic plan for their system and places”. Read full story (paywalled) Source: HSJ, 24 December 2021
  5. News Article
    The national chief for the Covid vaccination programme has warned that the NHS cannot become a vaccination service every few months. Emily Lawson also told healthcare staff in a briefing on Wednesday: “I have fed back to the Department of Health yesterday that I think realistically we don’t have the capacity to do anything else new over the next two-and-a-half weeks. “And that when we plan for things and have the right lead-up to them, we deliver them more effectively, which in the end is very critical for public confidence.” Her warning comes after the government announced plans on Sunday to rapidly accelerate the national Covid vaccination programme by offering all adults a booster jab by the new year. On Monday, NHS England sent letters to hospital chiefs, GPs and local healthcare leaders setting out plans to speed up the programme, and said the first priority for primary care would be delivering vaccines. Healthcare leaders were told they could drop non-urgent care in efforts to support the vaccine drive, however specific details on what treatments can be dropped are yet to be finalised. Read full story Source: The Independent, 15 December 2021
  6. News Article
    A survey of an area’s GPs and other primary care staff found those from a minority ethnic background feel they are less involved in decision making and less respected by their colleagues, according to results shared with HSJ. The survey, instigated by GPs in Doncaster, South Yorkshire, also found more staff from a minority ethnic background said they had experienced some form of bullying or harassment, including “instances of physical violence”. The work is thought to be unusual in primary care — annual “workforce race equality standard” surveys are required by NHS England for NHS trusts and, in the past year, clinical commissioning groups, but not in primary care. The survey in October was instigated by Doncaster Primary Care BAME Network and facilitated by Doncaster clinical commissioning group. It was sent to GPs and practice staff, community pharmacy staff, and other “healthcare professionals” in primary care. There were 136 respondents. The report of the results said minority ethnic staff felt they were less able to make decisions to improve the work of primary care, less involved in decisions regarding their area of work and less respected by their colleagues compared with their white colleagues. Read full story (paywalled) Source: HSJ, 9 March 2021
  7. Content Article
    The frameworks are comprehensive and include: Comprehensive search tools to risk stratify patients – built for EMIS and SystmOne. Pathways that prioritise patients for follow up, support remote delivery of care, and identify what elements of long-term condition care can be delivered by staff such as Health Care Assistants and link workers. Scripts and protocols to guide Health Care Assistants and others in their consultations. Training for staff to deliver education, self-management support and brief interventions. Training includes health coaching and motivational interviewing. Digital and other resources that support remote management and self-management. The frameworks are being implemented by GPs across the country, helping practices to identify who needs priority care, and those whose care can safely be delayed. These frameworks are designed to be adapted to local context and preferences.
  8. Content Article
    Consider your balance between remote and face to face care – have you got it right and how might it need to change in the months to come? Think about how you are going to manage respiratory symptoms over the winter and be aware of the issues with COVID-19 in children and what to do if resuscitation is needed.Shielding is paused and is unlikely to return in the same form as at the start of the pandemic.Know about the standard operating procedure (SOP) for primary care Appraisal is restarting in a very light-touch way and there are other changes to administration.Continue to wear PPE when seeing patients face to face, and continue planning for a much bigger flu vaccination season than usual. Death certification requirements are relaxed for as long as the Coronavirus Act is in force.Look after yourself and your staff.Continue to plan ahead; this will be a marathon, not a sprint.Your core clinical skills are still important.