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Showing results for tags 'Secondary impact'.
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News Article
Doctor: We're getting self-harming 10-year-olds in A&E
Patient Safety Learning posted a news article in News
The pandemic has had a deep impact on children, who are arriving in A&E in greater numbers and at younger ages after self-harming or taking overdoses, writes Dr John Wright of Bradford Royal Infirmary. Children are a lost tribe in the pandemic. While they remain (for the most part) perplexingly immune to the health consequences of COVID-19, their lives and daily routines have been turned upside down. From surveys and interviews carried out for the Born in Bradford study, we know that they are anxious, isolated and bored, and we see the tip of this iceberg of mental ill health in the hospital. Children in mental health crisis used to be brought to A&E about twice a week. Since the summer it's been more like once or twice a day. Some as young as 10 have cut themselves, taken overdoses, or tried to asphyxiate themselves. There was even one child aged eight. Lockdown "massively exacerbates any pre-existing mental health issues - fears, anxieties, feelings of disconnection and isolation," says A&E consultant Dave Greenhorn. Read full story Source: BBC News, 2 February 2021 -
News ArticleMaternity staff are facing extreme burnout during the pandemic as staff shortages and longer, busier shift patterns lead to the workforce becoming increasingly overwhelmed, healthcare leaders warned. Senior figures working in pregnancy services told The Independent healthcare professionals are working longer hours, covering extra shifts around the clock, and spending more time on call to compensate for increasing numbers of employees taking time off work after getting coronavirus. Staff say stress-related absences have reached “worryingly” high levels, with junior doctors and midwives “thrown into the deep end” due to having to fill in for colleagues. Professionals argued the coronavirus crisis will lead to a rise in doctors, nurses and midwives suffering post-traumatic stress disorder (PTSD) and other mental health issues – raising concerns staff exhaustion could curb patient safety and standards of care. Read full story Source: The Independent, 31 January 2021
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News Article
Urgent children’s ops routinely cancelled due to covid pressure
Patient Safety Learning posted a news article in News
Dozens and potentially hundreds of urgent operations for children have been cancelled during the third wave of the covid pandemic, HSJ can reveal. There are also concerns that national guidance for prioritising surgery “disadvantages” young people. Several well placed sources told HSJ that urgent operations for children have been delayed in recent weeks because of covid pressures. This is because of a combination of staff being diverted to help with adults sick with covid, and space in children’s facilities — including intensive care — being taken over for adult covid care, as well as other staff being absent due to covid. The royal college of surgeons has told HSJ that urgent children’s operations “are increasingly being cancelled around the country”. Dozens and potentially hundreds of children’s operations rated as priority two — those which are urgent and should be carried out within a month — have been cancelled and delayed in recent weeks in the capital, according to several well placed sources. This is alongside potentially thousands of priority three operations being cancelled, which are those needing to be carried out within three months. Read full story Source: HSJ, 31 January 2021 -
News Article
‘Catastrophic’ threat to cancer ops at England’s third largest hospital trust
Patient Safety Learning posted a news article in News
Cancer services at large hospital trust have been at ‘catastrophic’ risk of being overwhelmed, after two of its hospital sites had to suspend life-saving cancer surgeries in the last month due to COVID-19. In its latest board papers Mid and South Essex Foundation Trust rated the “cancellation of cancer elective activity” at its highest risk level of 25 – which based on their own risk-scoring key is “catastrophic”. It said the expected consequences at this risk level include “permanent disability or death, serious irreversible health effects” and an “unacceptable… quality of service”. The trust runs three general acute hospitals in the county. Its 2,000 plus beds make it the third largest trust in England after University Hospitals Birmingham FT and Leeds Teaching Hospitals. The same board papers, dated 28 January, said cancer surgery at Southend University Hospital, one of three hospital sites run by the trust, “ceased on 24 December”. At a second hospital site, Mid Essex Hospital covid “hit hard just before Christmas” and elective work was “dramatically impacted with short period of life and limb only carried out on site”. This meant all P2 cancer surgery — which requires treatment in less than four weeks — did not take place. Both hospital sites said they hoped the independent sector could help them restart cancer surgeries this month with a focus on “long waiting and clinical urgent patients”. It is not clear how much capacity the sector has to work through waiting lists and the board papers said “some of this capacity may be reduced” because of recent changes to a new national contract for the independent sector. Read full story (paywalled) Source: HSJ, 29 January 2021 -
News Article
Cancer operations down 800 in first two weeks of January
Patient Safety Learning posted a news article in News
There were 800 fewer cancer surgeries in the first two weeks of January than usually take place during the period, according to provisional data seen by HSJ. The bulk of this reduction came in London and the surrounding counties such as Essex, Bedfordshire, and Surrey. London and the south east have been severely hit by coronavirus pressures, causing widely reported mass cancellations of non-urgent elective surgery. However, the impact on cancer cases has, so far, been less clear. NHS England has insisted in the last week that urgent cancer cases should be given the same priority as coronavirus patients. Read full story (paywalled) Source: HSJ, 25 January 2021 -
News Article
Ambulance service facing 'terrifying' levels of risk, says trust chief
Patient Safety Learning posted a news article in News
The chief executive of a small acute trust has described the “terrifying situation” faced by ambulance crews and hospital staff in trying to provide adequate emergency care as coronavirus threatens to overwhelm the local NHS services. Susan Gilby, of Countess of Chester Hospital Foundation Trust, told HSJ staff are seeing “tragic and potentially avoidable” instances where patients with COVID-19 have reached the emergency department too late. She suggested this is due to a combination of patients waiting too long to call 999, and then having to wait long periods for an ambulance to arrive. Cheshire has been among the hardest hit areas in England during this third wave of coronavirus, with all four of its acute hospitals having very high covid occupancy rates. Dr Gilby, a former critical care consultant, said her trust has been at around 60 per cent covid occupancy for the last fortnight, which has made her increasingly fearful of the difficulties in admitting patients through the emergency department due to a lack of beds. This can then cause knock-on delays for patients arriving in ambulances, and ties those ambulance crews up for long periods, preventing them from responding to further 999 calls. She said ambulance turnaround times had been relatively good at the Countess of Chester, but she had spoken to paramedics handing over patients who were “really struggling” to get to people quickly enough. Read full story (paywalled) Source: HSJ, 22 January 2021 -
News ArticleSmear-test delays during lockdown have prompted calls for home-screening kits. Cervical cancer screening has restarted across the UK - but some women say they will not attend their appointments for fear of catching Covid. Jo's Cervical Cancer Trust is urging "faster action" on home tests for HPV, which causes 99% of cervical cancers. An NHS official said GP practices should continue screening throughout lockdown, and "anyone invited for a cervical smear test should attend". Cancer Research UK said it was not yet known how effective and accurate self-sampling could be in cervical screening. A survey by gynaecological cancer charity the Eve Appeal indicates nearly one in three missed smear tests are the result of people being "put off" by coronavirus. And a Jo's Cervical Cancer Trust survey during the pandemic suggests the same proportion would prefer to take their own human-papillomavirus (HPV) test rather than go to a GP. Acting chief executive Rebecca Shoosmith said coronavirus had added "more barriers" to going for a smear test. "Sadly those who found it difficult before are likely to be no closer to getting tested," she said. "Self-sampling would be a game-changer." Both charities emphasise smear tests are for "women and anyone with a cervix" and transgender and non-binary people may have additional barriers to going. Jo's Cervical Cancer Trust said DIY tests could also help people who had been sexually assaulted and those with disabilities or from backgrounds where smear tests were taboo. Read full story Source: BBC News, 21 January 2021
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News Article
Covid: 'Sharp drop' in heart-attack hospital admissions
Patient Safety Learning posted a news article in News
There has been a sharp drop in the number of patients admitted to hospitals in England with heart attacks or heart failure in recent months, research reveals. Experts are worried that people who need urgent medical help are not seeking it. This was also the case during the first wave of the pandemic. The researchers included 66 hospitals in the study and compared daily admission rates in the year before the pandemic with those during the first and second waves in England, up to 17 November. During the first lockdown, daily admissions for heart attacks or heart failure decreased by more than 50%. They went up again in the summer, as coronavirus rates decreased in the UK and the NHS became less busy with the virus. From October, when coronavirus cases were rising again, heart admissions began to drop - by between 35% and 41% compared with pre-pandemic data, according to the study published in the Journal of the American College of Cardiology. Researcher Prof Chris Gale, from Leeds University, said: "Medical emergencies do not stop in a pandemic. I am afraid that we are seeing a re-run of one of the preventable tragedies of the first wave - people were either too afraid to go to hospital for fear of contracting COVIDd-19 or were not referred for treatment." "The message to patients needs to be clear. If they experience symptoms of a heart attack or acute heart failure, they need to attend hospital." Read full story Source: BBC News, 20 January 2021 -
News ArticleNHS bosses have instructed hospitals to keep performing urgent cancer surgery despite Covid pressures, after a growing number cancelled procedures because they did not have enough intensive care beds or available staff. They have told England’s regional directors of cancer to ensure treatment of people who need cancer surgery within four weeks gets the same priority as care of patients who have Covid. The move was unveiled in a letter, obtained by HSJ, sent last Friday by Amanda Pritchard, the chief operating officer at NHS England and NHS Improvement. It was also signed by Cally Palmer, the NHS’s national cancer director, and Prof Peter Johnson, a highly respected specialist who is the NHS’s national clinical director for cancer. They have acted after unease among cancer specialists that growing numbers of hospitals, including all those in London, had cancelled urgent operations. Hospitals have felt obliged to do so either because they did not have enough intensive care beds for patients who might need one after their cancer procedure or because surgical staff had been repurposed to help care for Covid patients. Doctors voiced alarm at the scale of recent postponements of what the NHS classes as “priority two” operations. That means they should be done within 28 days to ensure that someone with cancer does not see their disease spread or become inoperable because it was delayed. More than 1,000 cancer patients in London are now waiting to have “priority two” or “P2” urgent surgery, but none have been given a new date for when it will happen, HSJ reported last week. Read full story Source: The Guardian, 18 January 2021
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News ArticleNearly a quarter of a million people have been waiting more than a year for operations and other hospital procedures, HSJ has learned. Official NHS England data for November, released on Thursday, showed 192,000 patients had been waiting for treatment for more than a year. However, figures leaked to HSJ of weekly data up to 3 January showed a steep increase to 223,000 patients — the highest reported so far throughout the COVID-19 pandemic and before. According to the leak, just under 4.2 million people are waiting for treatment, of which year-long waiters comprise 5.4%. The data also showed 175 patients across England had waited more than two years for treatment. In February, before the pandemic, 1,613 patients were waiting more than a year — meaning there has been a 138-fold increase. Read full story (paywalled) Source: HSJ, 15 January 2021
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News ArticlePatients are missing out on potentially life-saving organ transplant surgery because hospital intensive care beds are filled by coronavirus patients, The Independent has learnt. Major organ transplant centres in London, as well as the Queen Elizabeth Hospital in Birmingham and Addenbrooke’s Hospital in Cambridge, have been forced to close their doors to transplant cases because of a lack of beds, the increased risk to patients, and the need to redeploy doctors and nurses to the coronavirus front line. The impact on organ transplant services follows hundreds of urgent cancer operations being delayed in London and across the country, as NHS trusts run out of spare beds to treat non-Covid patients. Most routine operations have also been stopped in the hardest-hit areas. Teacher Shona McFadyen was diagnosed with liver cancer in December 2018 and needs an urgent liver transplant at the Queen Elizabeth Hospital in Birmingham. She has already waited 22 months for her surgery. She told The Independent: “It’s not the hospital’s fault. I get that. But it just adds to the feeling of hopelessness and it feels like as patients we have been forgotten about. It is life and death for us.” Read full story Source: The Independent, 13 January 2021
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News ArticleMore than 1,000 people needing urgent cancer surgery in London have no date for their treatment, HSJ can reveal. A document leaked to HSJ showed that, at the end of last week, more than 1,000 of London’s cancer surgery patients without an appointment date were defined as P2 (priority two), meaning they needed to be seen within four weeks or risk their condition worsening. The report seen by HSJ also showed more than 300 P2 patients had their surgery postponed in the past week, a statistic NHS England London has so far refused to disclose. Hospitals in the capital are facing their highest-ever COVID-19 occupancy rates, with surgical lists at many trusts being cancelled. Meanwhile, a separate NHSE London document reported in the press this week revealed: “Most NHS Green sites [those cancer surgery sites intended to be covid-free to avoid risk to very frail patients] are now compromised with only a limited number of cases being undertaken in NHS sites this week”. The papers also said the current plans to increase indepedent sector capacity usage were “insufficient to offset the NHS shortfall”, and noted there was a two week lead-in time to move patients into private hospitals “based on clinical rotas, theatre bookings, [and] patient isolation”. Read full story (paywalled) Source: HSJ, 12 January 2021
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News ArticleThousands of women have had abortions after falling pregnant while having difficulties accessing contraception during the pandemic, healthcare providers have warned. Sexual health clinics have been forced to shut or run reduced services while staff are transferred to work with Covid patients or have to self-isolate – with the profound disruption leaving many women unable to access their usual methods of contraception. Many women are struggling to get the most effective long-acting contraceptive choices of a coil or an implant due to these requiring face-to-face appointments which have largely been suspended as consultations are carried out remotely via phone or video call to curb the spread of COVID-19. British Pregnancy Advisory Service, the UK's largest abortion provider, told The Independent they provided the progestogen-only contraceptive pill to almost 10,000 women undergoing an abortion between May and October last year. Katherine O’Brien, a spokesperson for the service, said: “Many of these women will have fallen pregnant after struggling to access contraception, so there really is a huge unmet need for contraceptive services which will only worsen as lockdown and Covid continues. “We routinely hear from women during the pandemic who simply can’t access their regular method of contraception because of clinics closing or staff being deployed elsewhere or staff self-isolating.” Read full story Source: The Independent, 9 January 2021
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News Article
Dozens of hospitals hit dangerous bed occupancy levels
Patient Safety Learning posted a news article in News
Dozens of acute trusts have operated at very high levels of bed occupancy in the past month, as they deal with a surge in non-covid patients with thousands fewer beds than normal. At one point in May, 49 general acute trusts out of 145 — the most since before covid — operated at occupancy of 95 per cent or more in adult acute beds. Up to eight trusts at a time were operating at 99 or 100% occupancy during May, according to analysis of published data. NHS England, prior to covid, told trusts to keep occupancy below 92%, and others believe even this is dangerously high, although trusts do often exceed it during winter. Trusts are seeing the largest numbers of non-covid emergency patients since at least winter 2019-20; and are also trying to return as many planned operations as possible. They are doing so with thousands fewer beds than normal, due to measures to deal with ongoing covid patients without further outbreaks of the virus in hospital. Read full story (paywalled) Source: HSJ, 8 June 2021 -
News Article
People in England ‘face three-year waits for dentist appointments’
Patient Safety Learning posted a news article in News
People are being told to wait until 2024 for dentist appointments while others are being removed from their practice lists for not making appointments sooner, according to a damning report into the state of dentistry. Dental surgeries have reported that they have thousands of people on their waiting lists, while patients are unable to access care after ringing round numerous dental surgeries, a watchdog has warned. Delays have resulted in the worsening of painful symptoms and in one instance even led to a patient needing hospital treatment after overdosing on painkillers, it said. But Healthwatch England said that some people are being offered swift private care as an alternative at the same dental practice, with some patients reporting that they felt pressured to pay for their treatment. Some practices appeared to be prioritising private care, it added. Read full story Source: The Guardian, 24 May 2021 -
News ArticleAlmost 7,000 junior doctors who treated patients during the Covid pandemic are at risk of falling behind with their training, potentially causing staffing shortages and costing taxpayers a potential £260m. The worst-case scenario estimate of the impact of the pandemic on frontline medics has prompted ministers to inject an extra £30m to try to help doctors finish training so they can progress their careers. Ensuring medics progress into their next roles is viewed as crucial to ensuring the health service has the doctors it needs to try and reduce the massive waiting list for operations caused by the pandemic. Read full story Source: The Independent, 20 May 2021
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News ArticleMonica Evans's initial misdiagnosis could have proved life-threatening – and she is just one of many to have suffered during pandemic. Since The Telegraph began reporting on the struggles of patients around the country to access GP services during the pandemic, they have been inundated with messages and letters. There have been multiple stories of serious misdiagnoses made after telephone consultations with doctors that took place in lieu of face-to-face assessments; of interminable waits to get through to practices on jammed phone lines; and of lengthy delays while worried patients have waited for referrals to be made. Those who shared their experiences have also shared their fury, frustration, fear and dismay. Some who could afford to have felt they had no option but to turn to private healthcare, unable to obtain the help they needed from an NHS struggling with Covid and all its knock-on effects. Others have been left with nowhere to turn. GPs have spoken, too, about their dissatisfaction with a system that has discouraged face-to-face consultations. Amid an outpouring of anger from both patients and doctors, NHS England yesterday rowed back on plans for "total triage" of patients to keep them out of surgeries whenever possible. But for many the damage has already been done. Read full story (paywalled) Source: The Telegraph, 13 May 2021
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EventuntilThe Healthier Nation Index (HNI) is Nuffield Health’s annual survey of the nation’s physical and mental health. The HNI aims to understand how people are feeling, how they are managing their own physical and mental health, and explore some of the factors that are impacting the health of the nation. This session run by Public Policy Projects will explore the findings of the HNI and provide useful insights into the issues policymakers and stakeholders within the health sector should be focusing on as we move on from the pandemic and into the ‘levelling up’ landscape. The findings of this year’s HNI survey show the long-term impact of the pandemic on the nation’s physical and mental health, including how waiting times and the elective care backlog are having a detrimental effect on people’s wellbeing, as well as changing traditional models of healthcare. As we emerge from the pandemic, what lessons can be learned? How can we rebuild the nation’s health? Discussion points 1. What role can prevention and interventions outside the hospital setting play in relieving pressure? The HNI adds to a growing body of evidence which demonstrates that people are finding it difficult to access health services. What role can prevention and interventions outside the hospital setting play in relieving pressure on an overburdened NHS and tackle the elective care backlog? 2. What is the effect of the pandemic on how people use the NHS? What impact are long NHS waiting lists having on mental and physical health? Has the pandemic changed the way that people seek health advice and access healthcare? 3. How can we address health inequalities? How can we widen access to healthcare? Are the ‘Levelling Up’ health missions the right ones to improve the health of under-served populations? 4. What are the opportunities of Integrated Care Systems and Partnerships? As the fledgling bodies are brought into statutory footing in July 2022, what should the new structures be focusing on? Register for this webinar
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EventIn November 2021, the Chancellor announced £5.9 billion in funding to help the UK's health and social care system address the backlog and provide much-needed support to NHS staff and patients. But how are healthcare professionals addressing the NHS backlog for 2022/23? Whilst the future pattern of COVID-19 transmission and the resulting demands on the NHS are unknown, there is an urgent need to increase NHS capacity and resilience to deliver safe, high-quality services that meet the full range of people's health and care needs. Here at National Health Executive, we will be hosting our first online event of the year, NHE365 NHS backlog, on February 17th, 2022. This event will investigate how the NHS will continue to rise to the challenges of restoring services, meeting new care demands, and reducing care backlogs caused by the pandemic. Register
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Content ArticleThis blog by doctors Clare Rayner and Amali Lokugamage argues that Long Covid rehabilitation needs a wider focus that goes beyond a purely biomedical paradigm to include complementary therapies and methods. The authors—who have both lived with Long Covid for more than two years—argue that although patients were the first to raise concerns about Long Covid, describe its symptoms and patterns and even research the condition, their narratives and voices are not being included in approaches to treatment. While the biomedical evidence surrounding Long Covid is currently limited, they highlight that there is much valuable lived-experience to be found in patient support and campaign groups, and that patients' knowledge should be drawn on to shape policy and guidance about the condition.
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Content ArticleThis article in The BMJ examines the risks and benefits of current prostate cancer screening methods in the UK. It highlights issues that prevent early diagnosis including great variation in how prostate cancers behave and the poor performance of prostate specific antigen (PSA) testing in identifying disease that requires treatment. As a result of the limited benefits of screening for prostate cancer, routine screening is not recommended by the UK’s National Screening Committee or the US Preventive Service Task Force. The authors highlight that a bid by NHS England to find an estimated 14,000 men who have not yet started treatment for prostate cancer due to the pandemic, seems to contradict this recommendation. The NHS campaign warns that people shouldn’t wait for symptoms and encourages men to use a risk checker which informs patients of risk factors including family history, age and ethnicity. The authors express concern that the campaign implies there is great benefit in detecting asymptomatic disease, which could lead people to believe that the NHS is promoting screening. They argue that the NHS needs to be clearer and more consistent in its messaging, making sure that information aimed at the public emphasises that although PSA testing is available on request for men older than 50, it is not currently recommended, and why.
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Content ArticleThe Office for Health Improvement and Disparities, part of the UK Government Department of Health and Social Care, highlighted an emerging signal of increased non-COVID-19-related deaths in England between July and October, 2021, with a potentially disproportionate higher increase in people with diabetes. Valabhji et al. aimed to substantiate and quantify this apparent excess mortality, and to investigate the association between diabetes routine care delivery and non-COVID-19-related-mortality in people with diabetes before and after the onset of the pandemic. They examined whether completion of eight diabetes care processes in each of the two years before the index mortality year was associated with non-COVID-19-related death. Results of the study show an increased risk of mortality in those who did not receive all eight care processes in one or both of the previous two years. These results provide evidence that the increased rate of non-COVID-19-related mortality in people with diabetes in England observed between 3 July and 15 October 2021 is associated with a reduction in completion of routine diabetes care processes following the pandemic onset in 2020.
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Content ArticleThe Covid-19 pandemic has had a profound impact on patient safety, revealing a range of challenges across all healthcare systems, at all levels and in all settings. At the Health Plus Care conference on the 18 May 2022, Patient Safety Learning's CEO Helen Hughes, in a keynote speech, reflected on the impact of the pandemic on patient safety and work being undertaken by the World Health Organization to assess this. See attached her presentation slides.
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Content ArticleThis qualitative descriptive study in the journal BMC Nursing aimed to analyse the experiences of patients with type 2 diabetes during the stay-at-home order in place during the first wave of the Covid-19 pandemic. It looked at the experiences of ten patients with type 2 diabetes living in Catalonia and identified the strategies and resources they used to manage their care. The study found that many people with type 2 diabetes reported effective self-care during confinement and were able to adapt well using the resources available, without face-to-face contact with primary care health staff.
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Content Article
Can the NHS live with Covid? (Independent, 3 May 2022)
Patient Safety Learning posted an article in Exit strategies
Across the NHS, from routine care to emergency treatment, health leaders tell Rebecca Thomas in this special Independent report that pressure brought on by the pandemic has become unsustainable – with patients’ lives on the line as a result
