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Found 448 results
  1. News Article
    There has been a 27% rise in people dying while in treatment for drug and alcohol addiction during the pandemic, an official report shows. Changes to support and reduced access to healthcare during lockdowns are likely to have been factors, it says. Between April 2020 and March 2021, 3,726 people died while in contact with drug and alcohol services - up from 2,929 the year before. The figures, published by the Office for Health Improvement and Disparities, for England, show a small 2% rise in the overall numbers of adults receiving help for drug and alcohol problems from 2020 to 2021. Out of more than a quarter of a million people affected, more than half were in treatment for problems with opiates - medicines to treat pain - and a quarter with alcohol problems. The proportion of deaths in treatment for alcohol addiction rose by 44% to 1,064 and for opiate addiction by 20% to 2,418. UKAT, a group providing residential detox treatment, said a "concerning" number of services closed their doors to addicts during the pandemic. "But drug and alcohol treatment is critical care intervention and cannot be simply put on pause," said Nuno Albuquerque, head of treatment for the group. "It cannot be a coincidence that more people have subsequently lost their lives when they were in fact trying to save it." Read full story Source: BBC News, 25 November 2021
  2. News Article
    Soaring numbers of women are being diagnosed with advanced breast cancer, undermining their chances of survival, because of Covid’s disruption of NHS care, a charity has warned. The number of women being diagnosed with the disease at stage 4 is as much as 48% higher in some months than expected, with the pandemic to blame, says Macmillan Cancer Support. At the same time, fewer women are being confirmed as having breast cancer at stage 1, when their chances of responding well to treatment and living longer are much higher. Macmillan estimates that there is now a backlog of 47,300 people across the UK who have not yet been diagnosed with some form of cancer, as a direct result of Covid. They include people who could not access care in the usual way because many NHS services were scaled back, and also those who were too scared to seek help or did not want to add to the pressure the health service was already under. None have had a confirmed diagnosis of cancer, though some may be undergoing tests or screening. Steven McIntosh, Executive Director of Advocacy and Communications at Macmillan Cancer Support, says: “Nearly two years into the pandemic, there is still a mountain of almost 50,000 people who are missing a cancer diagnosis. Thousands more are already facing delays and disruption as they go through treatment. While hard-working healthcare professionals continue to do all they can to diagnose and treat patients on time, they are fighting an uphill battle. Cancer patients are stuck, waiting in a system that doesn’t have the capacity to treat them fast enough, let alone deal with the backlog of thousands who have yet to come forward.” “The Government has promised an NHS Elective Recovery Plan. This must show how it will tackle spiralling pressures on cancer services. It has never been more crucial to boost NHS capacity to treat and support everybody with cancer, so people receive the critical care they need now and in the years to come.” Read full story Source: The Guardian, 26 November 2021
  3. News Article
    Health experts have raised the alarm over “serious” delays in diagnosing children and young people with cancer, as a study reveals the number found to have the disease during the pandemic fell by almost a fifth. The University of Oxford found a “substantial reduction in childhood, teenage and young adult cancer detection” in England last year. The research, being presented on Friday at the National Cancer Research Institute (NCRI) festival, showed a 17% drop in cases diagnosed in the under-25s last year compared with previous years. The impact of Covid on adults with cancer is well known. However, previously little has been known about the toll on younger patients. As well as the fall in the overall numbers of children diagnosed with cancer, researchers found that even those whose cancer was spotted last year were more likely to have been diagnosed only after being admitted to intensive care. That suggests long delays in accessing care may have made them much sicker, experts say. Read full story Source: The Guardian, 12 November 2021
  4. News Article
    A global threat in the form of a measles outbreak is mounting as more than 22 million infants missed their first vaccine dose for the disease in 2020, warned the world’s top health agencies. The World Health Organization (WHO) and the US Centres for Disease Control (CDC), in a joint statement on Wednesday, said the number represents the largest increase in missed vaccinations in two decades. The 22-million figure is three million more than in 2019, “creating dangerous conditions for outbreaks to occur,” according to the agencies. The surveillance of measles cases deteriorated because of the coronavirus pandemic, which resulted in a reported dip in cases by more than 80%t in 2020, the statement said. Measles is one of the most contagious viruses to date. It kills more than 60,000 people a year, mostly young children. But at the same time, the disease is entirely preventable through vaccinations, which have averted more than 30 million deaths from the disease globally. “Large numbers of unvaccinated children, outbreaks of measles, and disease detection and diagnostics diverted to support Covid-19 responses are factors that increase the likelihood of measles-related deaths and serious complications in children,” said Kevin Cain, the CDC’s global immunisation director. Read full story Source: The Independent, 11 November 2021
  5. News Article
    Long waiting times in emergency departments are becoming normal, with some patients spending days in A&E wards before they can be moved into other hospital beds, emergency physicians have warned. Leaders of the Royal College of Emergency Medicine (RCEM) and the Society for Acute Medicine (SAM) said that some hospitals had effectively run out of space, meaning patients could not receive the right care until a bed became free. NHS figures for September show that 5,025 patients waited for more than 12 hours to be admitted to hospital in England. That is only 1% of the 506,916 admitted via A&Es, but it is more than 10 times as many as the 458 waiting more than 12 hours in September 2019 and nearly twice as many as the January peak of 2,847. Scientists at the Zoe Covid study said last week that UK cases of coronavirus may have peaked. But the React study at Imperial College found that the R number was between 0.9 and 1.1 with Covid cases at their highest levels. Pressures on hospitals have prompted the Royal College of Nursing to call for a return to compulsory mask-wearing, while Sadiq Khan, the mayor of London, said that ministers should reimpose a legal obligation to wear masks on public transport, allowing police to enforce the law. Read full story Source: The Guardian, 7 November 2021
  6. News Article
    Bed occupancy in England’s hospitals has already reached normal peak winter levels, NHS leaders have warned. While modelling suggests that the rise in Covid infection levels appears to have stalled for now, the chief executive of NHS Providers has stressed that bed occupancy levels at acute hospitals are already at 94-96%, an “unprecedented” situation not normally seen until the middle of winter. It comes as long waiting times in England’s emergency departments are becoming normal, with the number of patients waiting for more than 12 hours increasing tenfold since 2019. Meanwhile, the NHS is undergoing a mounting workforce crisis and an enormous backlog of routine treatments that have built up over the pandemic. Six healthcare workers describe to the The Guardian the pressures they are facing at the moment, highlighting staff shortages, rising wait times and abuse toward NHS workers. Read full story Source: The Guardian, 8 November 2021
  7. News Article
    Inside the emergency department at Sparrow Hospital in Lansing, Michigan, staff members are struggling to care for patients showing up much sicker than they’ve ever seen. Tiffani Dusang, the ER’s nursing director, practically vibrates with pent-up anxiety, looking at patients lying on a long line of stretchers pushed up against the beige walls of the hospital hallways. “It’s hard to watch,” she said. But there’s nothing she can do. The ER’s 72 rooms are already filled. “I always feel very, very bad when I walk down the hallway and see that people are in pain, or needing to sleep, or needing quiet. But they have to be in the hallway with, as you can see, 10 or 15 people walking by every minute,” Dusang said. The scene is a stark contrast to where this US emergency department — and thousands of others — were at the start of the pandemic. Except for initial hot spots like New York City, in spring 2020 many ERs across the country were often eerily empty. Terrified of contracting covid-19, people who were sick with other things did their best to stay away from hospitals. Visits to emergency rooms dropped to half their typical levels, according to the Epic Health Research Network, and didn’t fully rebound until this summer. But now, they’re too full. Even in parts of the country where covid isn’t overwhelming the health system, patients are showing up to the ER sicker than before the pandemic, their diseases more advanced and in need of more complicated care. Read full story Source: Kaiser Health News, 29 October 2021
  8. News Article
    Planned operations including ”priority two” procedures were postponed at short notice at one of England’s largest hospital trusts earlier this week due to rising covid compounding other operational pressures, HSJ understands. Several sources said Leeds Teaching Hospitals Trust cancelled the large majority of elective operations scheduled for Tuesday 2 November due to rising occupancy in intensive care and throughout the trust, particularly linked to increasing numbers of covid patients. The postponed operations included ‘priority two’ cases, which must be undertaken within one month to avoid further harm and deterioration, a well placed source told HSJ. The trust said it did not, however, cancel ‘priority one’ urgent operations, which must be performed within 72 hours. It said most elective operations resumed on Wednesday as pressure had “eased a little” since Tuesday. Some daycase surgery was also postponed, it said, as areas had to be repurposed for emergency care. One concerned family member of a Leeds patient whose operation was cancelled, who contacted HSJ, said: ”My relative is on the cardiology list and might not be fit enough for the op if there are further delays — that could be fatal.” Read full story (paywalled) Source: HSJ, 4 November 2021
  9. News Article
    About 1,600 fewer people than expected were diagnosed with the three most common cancers during the first nine months of the Covid pandemic. Public Health Scotland (PHS) has attempted to work out how restrictions put in place at the start of coronavirus affected diagnosis of the disease. The statistics show that breast cancer diagnosis was down by 19%, bowel cancer by 25% and lung cancer by 9%. The data also showed cancer was not being diagnosed at the earliest stages. This is when treatment is most successful. Cancer Research UK called for urgent action to prevent progress on cancer survival going backwards. David Ferguson, from Cancer Research UK in Scotland, said the PHS report reinforced fears that opportunities to diagnose cancer at an early stage were missed during the pandemic. He said: "Urgent action is needed. Cancer survival wasn't good enough before the pandemic. Too many people are waiting far too long for diagnosis and treatment so this must be addressed." He called for a "road map" to tackle staff shortages and backlogs. "If swift action isn't taken, our fear is that cancer survival in Scotland could go backwards," he said. Read full story Source: BBC News, 3 November 2021
  10. News Article
    Some trusts in London and the South East are closing standalone birth centres and warning they cannot support home births because of high levels of demand for ambulance services from covid patients. Women in East Sussex who planned to give birth at Eastbourne District General Hospital and Crowborough Birth Centre have been told they need to go to other units. Both Eastbourne and Crowborough have standalone midwife-led units and women who have a difficult labour would need to be transferred by ambulance to another hospital. Both East Sussex Healthcare Trust and Maidstone and Tunbridge Wells Trust, which run the services, cited pressure on the ambulance services as the reason for the closures. The trusts, both of which are served by South East Coast Ambulance Service Foundation Trust, have also suspended support for home births. Services are continuing at a similar birthing unit at Maidstone Hospital, with private ambulances transferring women to Tunbridge Wells Hospital if needed. However, Maidstone and Tunbridge Wells Trust has posted on Facebook to warn women the situation may change and it is monitoring ambulance response times to determine “the safety of our out of hospital birthing choices”. Read full story (paywalled) Source: HSJ, 6 January 2021
  11. News Article
    Hundreds of people a day across London are waiting hours for an emergency ambulance to get to them, as paramedics warn that patients are dying as a result of delays. Patients in emergency calls classified as category two, such as those involving a suspected stroke or chest pains, should be seen by paramedics within an average of 18 minutes but are being forced in some cases to wait up to 10 hours. Even life-threatening calls where patients are in cardiac arrest and should be reached within seven minutes have experienced delays, with data suggesting one such call was waiting 20 minutes on Monday. Internal data shared with The Independent shows that London Ambulance Service is holding hundreds of open 999 calls for hours at a time with the service’s boss acknowledging in an email to staff that the service is struggling to maintain standards. Experts warned that the problems in the capital were reflected in ambulance services across the country. One paramedic told The Independent: “Patients desperately requiring ambulances aren’t getting them and, anecdotally, people are deteriorating and dying whilst waiting. Our poor dispatchers have to stare at screens of held calls, working out who gets the next available resource and who waits, suffers or dies.” Read full story Source: The Independent, 5 January 2021
  12. News Article
    Potentially life-saving cancer operations have been put on hold at a major London NHS trust because of the number of beds taken by Covid patients. King's College Hospital Trust has cancelled all "Priority 2" operations - those doctors judge need to be carried out within 28 days. Cancer Research UK said such cancellations did not appear to be widespread across the country. And surgery has not been stopped on the same scale as during the first wave. Rebecca Thomas, who has had her bowel cancer surgery at King's College Hospital "cancelled indefinitely", told the BBC she felt like she had been left "in limbo". Until she has surgery her tumour cannot be studied to see how aggressive it is, and so she won't know until then how significant this wait will turn out to be. A spokesperson for the Trust, which mainly serves patients in south London, said: "Due to the large increase in patients being admitted with COVID-19, including those requiring intensive care, we have taken the difficult decision to postpone all elective procedures, with the exception of cases where a delay would cause immediate harm. "A small number of cancer patients due to be operated on this week have had their surgery postponed, with patients being kept under close review by senior doctors." Read full story Source: 5 January 2021
  13. News Article
    NHS leaders are holding fresh talks with private healthcare groups to try to secure surgery for urgent cancer patients in London, as the covid-19 second wave causes hospitals in the capital to make widespread cancellations, HSJ understands. In recent weeks, pivotal independent sector providers have declined to do the procedures for the payments on offer. In the spring covid peak, the NHS block-booked private capacity in London, but now only small, spot contracts are in place for this work. Under the previous deal, rules meant low-priority private patients could not be treated ahead of NHS patients who needed surgery urgently. But now providers can prioritise their private patients as they see fit. HSJ understands NHS England, under pressure from the Treasury, was not willing to pay the prices asked by the three private providers. As London NHS hospitals continue to fill with covid patients, particularly in critical care, they are able to do few cancer procedures beyond the most urgent category, P1, and are suspending many procedures in the lower categories, including P2, sources said. P2 is defined as patients who need treatment within four weeks. One senior clinical manager in the city told HSJ on Monday: “Cancellations [are] rife. We have stopped almost all operating in our elective hub apart from P1 [patients assessed as needing surgery within three days]. “The independent sector has not opened up capacity and lifestyle operations [are] still planned [in private hospitals].” Read full story (paywalled) Source: HSJ, 5 January 2021
  14. News Article
    Very long waits for emergency hospital care have surged in London since mid December, due to a rapid rise in COVID-19 admissions combined with limited capacity, according to figures leaked to HSJ. Data sent to HSJ indicates that December will set a new record high nationally for the number of 12-hour “trolley waits”. This is when there are 12 hours or longer from the decision is made to admit a patient from the emergency department to hospital, to when they are actually admitted to a bed. It adds to fears about what will happen if rising covid occupancy — which has left some hospitals running out of staff and acute beds, and intensive care well over normal capacity — combines with potential additional winter demand in coming weeks. Several senior hospital managers in areas heavily affected by covid said there were two main factors. One is shortage of beds and operational issues: there are about 6,300 fewer general and acute beds open nationally this winter, due to infection prevention measures. The beds that remain have to be split between covid positive and negative, often taking time to convert more. Two sources said bed shortages were exacerbated by problems with discharge, particularly of covid patients who no longer need acute care, including “local authorities taking their eye off the ball on designated settings and covid-positive pathways”, according to one. And another reason behind delays is waiting for covid test results before admitting patients. Read full story (paywalled) Source: HSJ, 4 January 2021
  15. News Article
    Twenty-three hospital trusts had more than a third of their core bedbase occupied by COVID-19 patients on Tuesday, and occupancy is still rising at all but one. Three trusts (North Middlesex in north London, as well as Medway and Dartford and Gravesham in Kent) had more than half of general and acute beds occupied by patients who had the virus, and others were not far behind. Several trusts saw their covid occupancy share up by more than 10 percentage points in a week — a rate of growth which would soon see them entirely filled by covid patients, a situation with radical consequences for emergency hospital care in those areas. London as a whole had a third of these beds occupied by patients with COVID-19. HSJ has analysed data published for the first time by NHS England last night. The data concerns the status of adult general and acute beds, which make up the large majority of the acute bedbase. They do not include intensive care, which is also now under huge pressure in London, the south east and the east of England. Most hospitals in these areas are stretching IC capacity above normal levels. Such high covid occupancy in both intensive care and the core bedbase is putting severe strain on hospitals’ ability to treat other patients. Most or all of the trusts under the greatest pressure have now cancelled routine planned surgery, and many are struggling with crowding, delays getting patients into and out of emergency departments due to the space available, and a lack of staff. Read full story (paywalled) Source: HSJ, 1 January 2021
  16. News Article
    Elderly people who suffer falls are having to wait up to six hours for an ambulance because of rising Covid pressures, a medical body has warned. The delays are due to paramedics having to prioritise 999 calls from people suffering from coronavirus related breathing difficulties. Read full story (paywalled) Source: The Telegraph, 1 January 2021
  17. News Article
    A major incident has been declared in Essex amid fears the number of COVID-19 cases could overwhelm the county's health services. The Essex Resilience Forum (ERF) said "growing demand" was putting stress on hospitals and social care settings. On Tuesday Mid and South Essex NHS Trust placed all three of its hospitals on critical alert. All of Essex is in tier four and the south of the county has some of the worst-affected districts in England. Essex Police Chief Constable BJ Harrington, who is co-chairman of the ERF, said declaring a major incident allowed it "to seek further support from the government to address the severe pressures which the health system is under". The forum said the number of patients being treated for Covid in the county had exceeded the levels seen at the peak of the first wave and "these levels are likely to increase further in the coming days". The ERF - comprised of health services, blue light responders and councils - said issues included "critical care and bed capacity, staff sickness/self-isolation levels and the system's ability to discharge patients quickly into safe environments". Mr Harrington urged the public to continue only dialling 999 or attending A&E in an emergency. Read full story Source: BBC News, 30 December 2020
  18. News Article
    Cases of anorexia and other eating disorders have quadrupled in some areas during the coronavirus pandemic, doctors say. The Royal College of Paediatrics and Child Health (RCPCH) issued an alert to parents, saying the Christmas and new year period can be stressful for young people who struggle with disordered eating. That comes on top of massive disruption to schooling and other areas of life due to Covid-19 which has led to a loss of physical and social activity, plus money worries and bereavement for some. “In our tier 4 under 13s mental health inpatient unit we have seen a three- to fourfold increase in children referred to our service with eating disorders, and they are just the tip of the iceberg.” Dr Nancy Bostock, a consultant in Cambridge, said in a statement provided by the college. Read full story Source: The Independent, 29 December 2020
  19. News Article
    New planning guidance asks local NHS organisations to prepare for a major waiting-list catch-up by seeking “top quartile performance in productivity”, but also to “safely mobilise all… available surge capacity over the coming weeks” as the service battles rising covid levels “in almost all parts of the country”. An end-of-year planning letter was issued by NHS England to local NHS chief executives last night. It warns: “With covid-19 inpatient numbers rising in almost all parts of the country, and the new risk presented by the variant strain of the virus, you should continue to plan on the basis that we will remain in a level 4 incident for at least the rest of this financial year and NHS trusts should continue to safely mobilise all of their available surge capacity over the coming weeks. “This should include maximising use of the independent sector, providing mutual aid, making use of specialist hospitals and hubs to protect urgent cancer and elective activity and planning for use of funded additional facilities such as the Nightingale hospitals, Seacole services and other community capacity.” Read full story (paywalled) Source: HSJ, 24 December 2020
  20. News Article
    Cancer surgery in London is under threat as rising covid admissions put pressure on services that no longer have back-up capacity from the independent sector, HSJ has learned. Research by HSJ has discovered that NHS England ended contracts with HCA, The London Clinic and the Cromwell Hospital at the end of August, after concerns about underutilisation. Under the previous deal with the private sector, rules were in place to make sure low-priority private patients were not treated ahead of NHS patients who needed surgery urgently. HCA and The Cromwell have confirmed the contracts were ended in August and were not renewed. The London Clinic did not respond to a request for comment. As of 19 December, there were 2,909 covid inpatients being treated in London hospitals, a rise of 39% over the previous seven days. Barts Health Trust and Barking, Havering and Redbridge University Trust in the east of the city are under particular pressure. Should the number of covid patients reach a level that requires the capital to instigate surge protocols, theatre space set aside for cancer operations is likely to be commandeered. Under this scenario, the NHS in the capital would no longer have the option to transfer cancer patients to private facilities as it did during the first wave of the pandemic. A senior London-based source said: “This is a real and imminent threat to London’s ability to perform cancer surgery." Read full story (paywalled) Source: HSJ, 21 December 2020
  21. News Article
    Nearly 90% of hospital beds in England are full as hospitals try to cope with the demands of Covid in addition to normal winter pressures. Ambulances queuing to offload patients, staff sickness and a lack of beds mean hospitals are "at a really dangerous point", say emergency doctors. This could result in some trusts facing the decision to stop non-Covid work. Rises in hospital admissions are particularly affecting areas in the south. The percentage of NHS hospital beds which are occupied is increasing and has reached almost 89% in England for the week ending December 13. This is the highest occupancy rate so far this year - it's still lower than the same time last year, although the extra burden of Covid is likely to make hospitals feel they are much busier. A safe level for bed occupancy is below 90% but nearly half of NHS trusts report a figure currently higher than this - the largest proportion this season. Read full story Source: BBC News, 19 December 2020
  22. News Article
    A major London trust’s critical care staff have urged leaders to review elective work targets amid serious concerns over workload, safe staffing and burnout, HSJ has learned. In a letter to Guy’s and St Thomas’ Foundation Trust’s board, staff represented by trade union Unite said they had “repeatedly” raised concerns about the provider’s approach to elective work, as well as winter pressures and second wave planning, and the implications this has had for “the health, safety and wellbeing of both staff and patients”. The letter — which was also addressed to the trust’s health and safety committee and has been seen by HSJ — said: “Our primary concern is that the trust’s endeavours, and understandable need to square these circles, may be unrealistic given the current pressures on staffing and the high rates of sickness and burnout the trust is continuing to experience. “This is especially in critical care, where we are concerned this may compromise patient safety and is already damaging staff wellbeing and morale.” Read full story (paywalled) Source: HSJ, 18 December 2020
  23. News Article
    London’s hospitals are already beginning to run out of critical care beds ahead of the Christmas relaxation of rules – which is expected to increase cases further, a leaked NHS briefing has warned. The update on the situation in the capital comes as major hospitals have already started to cancel operations for other patients in order to find enough staff to deal with the rise in patients as NHS trusts open up extra surge capacity. More operations are expected to be cancelled in hospitals across London, with staff warned they could be redeployed at short notice. On Wednesday, there were a total of 2,289 coronavirus patients in London hospitals, an increase of 2 per cent on the day before. But the numbers of coronavirus patients in critical care beds jumped 8.6% in a single day, increasing from 302 to 345 patients on Wednesday, while an additional 900 people who have tested positive were receiving oxygen. Across London, there were just 49 adult critical care beds available on Wednesday. In total there were 904 beds occupied, 328 by patients with COVID-19. This meant the capital’s total critical care bed occupancy rate was almost 95%. Although the number of patients is much lower than it was the first wave, many hospitals are still treating routine and non-Covid patients – meaning they are struggling to staff critical wards and keep other services running. A briefing for NHS managers warned them: “A reduction of elective [routine] activity is likely to be needed in line with increasing acute activity.” Read full story Source: The Independent, 17 December 2020
  24. News Article
    One of England’s largest hospital trusts has been forced to divert ambulances and cancel operations, after seeing a very steep increase in covid-19 admissions over the past week. Whipps Cross Hospital in north east London, part of Barts Health Trust, declared a critical incident over the weekend, the trust has confirmed. The trust has also declared a “high pressure phase” of covid response. A well placed source said Whipps Cross had been forced to divert ambulances in recent days, because of pressure on its emergency services, while a message to staff said it was deferring some planned operations, along with other steps aimed at protecting safety. It is also understood to be attempting to further speed up discharges from hospital. Read full story (paywalled) Source: HSJ, 16 December 2020
  25. News Article
    The waiting list for cancer patients has almost doubled over the last seven months, according to internal NHS data which has never been made public. A slide set seen by HSJ suggests the total number of patients waiting for cancer treatment on the 62-day pathway has increased from around 90,000 in mid-May, to around 160,000 at the start of December. However, the data suggests the NHS has made good progress in treating patients waiting the longest. Read full story (paywalled) Source: HSJ, 15 December 2020
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