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Found 190 results
  1. 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
  2. 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
  3. Content Article
    In this briefing paper for the Social Market Foundation, Lord Norman Warner sets out a radical change programme that could reverse the decline in NHS services. It examines long-term issues that have been exacerbated by the impact of Brexit and the Covid-19 pandemic—the care backlog, workforce issues and loss of public confidence.
  4. Content Article
    Rates of blood testing in primary care are rising. Communicating blood test results generates significant workload for patients, GPs, and practice staff. This study from Watson et al. explored GPs’ and patients’ experience of systems of blood test communication. The study found that methods of test result communication varied between doctors and were based on habits, unwritten heuristics, and personal preferences rather than protocols. Doctors expected patients to know how to access their test results. In contrast, patients were often uncertain and used guesswork to decide when and how to access their tests. Patients and doctors generally assumed that the other party would make contact, with potential implications for patient safety. Text messaging and online methods of communication have benefits, but were perceived by some patients as ‘flippant’ or ‘confusing’. Delays and difficulties obtaining and interpreting test results can lead to anxiety and frustration for patients and has important implications for patient-centred care and patient safety.
  5. Content Article
    Cheshire and Merseyside Health and Care Partnership has published this consensus document on the interface between primary and secondary care. It aims to ensure healthcare providers ensure access to the right care to give patients the best outcomes. It contains a set of clinically-led principles to ensure pathways have a common structure of good quality, patient-centred communication. It includes a number of guiding principles that encourage staff to ensure: the patient is at the centre of decision making actions taken are completed in a timely way actions are undertaken by the most appropriate individual or team decisions and actions are understood by all.
  6. Content Article
    This is the final report of the stocktake undertaken by Dr Claire Fuller, Chief Executive-designate Surrey Heartlands Integrated Care System and GP on integrated primary care, looking at what is working well, why it’s working well and how we can accelerate the implementation of integrated primary care (incorporating the current 4 pillars of general practice, community pharmacy, dentistry and optometry) across systems.
  7. Content Article
    This animation by The King's Fund explains the changes that are happening to the way the NHS in England is organised and run. It outlines the key organisations that make up the NHS and how they can collaborate to deliver joined-up care. It describes the impact of the Health and Care Act 2022 and talks about how Integrated Care Systems foster collaboration between healthcare and other local services to improve people's experience and health outcomes.
  8. Content Article
    The UK health system is under unprecedented strain. The COVID-19 pandemic exacerbated these pressures, but it did not create them. The Academy of Medical Royal Colleges and its member organisations believe that as a country we are not facing up to the scale of the current challenges and we are not producing any coherent strategy to tackle the problems. Only when we confront these challenges will we be able to begin to fix the NHS. A combination of pressures means that the system is providing care and services which are sub-standard, threaten patient safety and fall below what should be expected in a country with the resources of the United Kingdom. If we do not act with urgency, we risk permanently normalising the unacceptable standards we now witness daily, to the detriment of us all.
  9. Content Article
    Timely written communication between primary and secondary healthcare providers is paramount to ensure effective patient care. In 2020, there was a technical issue between two interconnected electronic patient record (EPR) systems that were used by a large hospital trust and the local community partners. The trust provides healthcare to a diverse multiethnic inner-city population across three inner-city London boroughs from two extremely busy acute district general hospitals. Consequently, over a four-month period, 58,521 outpatient clinic letters were not electronically sent to general practitioners following clinic appointments. This issue affected 27.9% of the total number of outpatient clinic letters sent during this period and 42,251 individual patients. This paper from Patel et al. describes the structure, methodological process, and outcomes of the review process established to examine the harm that may have resulted due to the delay.
  10. Content Article
    This article describes perceptions of the culture of safety in paediatric primary care in the US, and evaluates whether organisational factors and staff roles are associated with these perceptions. The authors found that perceptions of the culture of safety and quality in paediatric primary care practices were generally positive, but differences in perceptions did exist based on staff role.
  11. Content Article
    In this blog, Jeremy Hunt MP, Founder of Patient Safety Watch, outlines six priorities for the new Health Secretary, Therese Coffey MP. He argues that these patient safety priorities will help reduce elective and emergency pressures and save money.
  12. 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. Sarah and Jaydee are working on an innovative project at NHS Dorset Integrated Care Board (ICB) to ensure general practice is a central part of improving patient safety across services. They talk about the value and challenges of collaborative working, how they are tailoring their offer to fit the needs of local GP practices, and making patient safety a core part of training for all healthcare professionals.
  13. Content Article
    Specialty referrals—when a clinician refers a patient to a specialist for evaluation or treatment—are on the rise in the US. Despite the introduction of electronic health records (EHRs), the referral process is often hindered by lack of clarity over roles, communication breakdowns, workloads and variations in requirements among specialists. These difficulties can lead to missed or delayed diagnoses, delays in treatment and other lapses in patient safety. This guide from the Institute for Healthcare Improvement offers recommendations that aim to help standardise how primary care practitioners activate referrals to specialists and then keep track of the information over time. It describes a nine-step, closed-loop process in which all relevant patient information is communicated to the correct person through the appropriate channels, in a timely manner.
  14. Content Article
    Each year, up to 100 million people in the US experience acute or chronic pain, mainly because of short-term illnesses, injury and medical procedures. It is therefore important that patients are offered effective treatment options to reduce symptoms and improve function. Nonopioid management is the preferred option, but there are circumstances for which short-term opioid therapy is appropriate and beneficial. Finding the balance between these approaches is an ongoing problem in the management of acute noncancer pain. This cluster randomised clinical trial featured in JAMA Health Forum, aimed to assess whether clinician-targeted interventions prevent unsafe opioid prescribing in ambulatory patients with acute noncancer pain. The authors found that the use of comparison emails decreased the proportion of patients with acute pain who had never taken opioids receiving an opioid prescription. The emails also reduced the number of patients who progressed to treatment with long-term opioid therapy or were exposed to concurrent opioid and benzodiazepine therapy. They concluded that healthcare systems could add clinician-targeted nudges to other initiatives as an efficient, scalable approach to further decrease potentially unsafe opioid prescribing.
  15. Content Article
    This editorial in BMJ Quality & Safety looks at the need for urgent improvement in the test result management and communication process in primary care. The authors highlight the inconsistency in tracking and communicating test results and look at potential solutions to reduce the patient safety risks associated with test results. They look at the evidence surrounding automated alerts built into provider IT systems and giving patient direct access to test results through apps, highlighting the growing importance of patients in safeguarding their own care through actively pursuing test results.
  16. Content Article
    This guideline from the National Institute for Health and Care Excellence (NICE) covers assessment, management and preventing recurrence for children, young people and adults who have self-harmed. It includes those with a mental health problem, neurodevelopmental disorder or learning disability and applies to all sectors that work with people who have self-harmed.
  17. Content Article
    Louise Greenwood is joined by:  Sarah Kay, GP Clinical Lead for Patient Safety at NHS Dorset Jaydee Swarbrick, Patient Safety Specialist at NHS Dorset to discuss the importance of patient safety at this time of significant pressure across the NHS. Patient safety is about maximising the things that go right and minimising the things that go wrong. It is integral to the NHS’ definition of quality in healthcare, alongside effectiveness and patient experience.
  18. Content Article
    As dentists hand back their NHS contracts in record numbers, GPs are seeing the impact on their workload and patients’ health, especially in “dental deserts,” reports Sally Howard in this BMJ article. Over one week this spring, 20 patients presented at GP Abbie Brooks’ York surgery with abscesses, dental pain, and broken teeth—demanding antibiotics and painkillers. Brooks could not prescribe because she was not indemnified to perform dental work. Many of these patients, Brooks says, were not registered with a dentist or able to find an NHS dentist, and had already been told to call 111. The NHS medical helpline had advised patients to visit emergency NHS dentists 50 miles away from Brooks’ surgery. “Vulnerable patients often can’t get to emergency dentist appointments in Bradford or Leeds for logistical or financial reasons,” she says, adding that a small proportion of patients became difficult when Brooks was unable to help. “One woman was really quite angry that I wouldn’t incise and drain her abscess,” she says. “It’s not acceptable for GPs to have to deal with this crisis not of our doing.”
  19. Content Article
    These Quality Standards have been developed by the Resuscitation Council UK. They enable healthcare organisations provide a high-quality resuscitation service, with guidance tailored for different settings including acute care, primary care, dental care, mental health units, community hospitals and in the community.
  20. Content Article
    The House of Commons Health and Social Care Select Committee has published a report highlighting the current health and social care workforce crisis in England.  The 'Workforce: recruitment, training and retention' report, which calls for a robust workforce strategy, states that within the NHS in England there’s a shortage of over 50,000 nurses and midwives, while in April this year hospital waiting lists reached an all-time high of almost 6.5 million. 
  21. Content Article
    The number of people on NHS Wales waiting lists for treatment has reached record levels. This problem has worsened since the Covid-19 pandemic, with the average wait time for treatment more than doubling since December 2019. This report by the Welsh Centre for Public Policy identifies five key areas in which policy could be developed to improve outcomes and reduce waiting times. These areas target the underlying factors causing increased waiting times, and are likely to both improve the overall performance of the health system, and to impact outcomes which matter to patients, resulting in a more patient-centred approach: Workforce capacity Digital technology Reimagining primary care Systems collaboration Follow-up care
  22. Content Article
    This Health and Social Care Select Committee report examines the pressure currently facing general practice, which is leading to low morale, GPs leaving the profession and problems recruiting new GPs. In turn, patients are increasingly dissatisfied with the level of access they receive. The root cause of the situation is that there are not enough GPs to meet the ever-increasing demands on the service, coupled with patients presenting with increasing complexity due to an ageing population. The report outlines the Committee's assessment of the key issues, including the problems with reliance on locum doctors and lack of continuity of care, and outlines what the Government should do to equip general practice for the future.
  23. Content Article
    Patient safety in ambulatory care settings is receiving increased attention. Based on interviews and focus groups with patients, providers, and staff at ten patient-centered medical homes, this qualitative study explored perceived facilitators and barriers to improving safety in ambulatory care. Participants identified several safety issues, including communication failures and challenges with medication reconciliation, and noted the importance of health information systems and dedicated resources to advance patient safety. Patients also emphasised the importance of engagement in developing safety solutions.
  24. Content Article
    Acute prescribing forms a large part of the daily workload for GP practices. Quality improvement (QI) methodology can be used to help improve prescribing processes and ensure that prescribing work is managed by the right member of your team, safely and effectively. This toolkit is designed to help primary care multidisciplinary teams, including pharmacotherapy services, safely improve their acute prescribing processes in line with the Essentials of Safe Care. An acute prescription is defined as any prescription without a serial or repeat mandate.
  25. Content Article
    This practice pointer in The BMJ provides an update on treating Long Covid in primary care and outlines how healthcare professionals might respond to questions that patients ask about the condition. The article provides information on: Definition of Long Covid Epidemiology Symptoms and case definition Questions patients ask Further resources for patients and healthcare professionals
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