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Found 82 results
  1. Content Article
    This state-of-the-nation report from the National Hip Fracture Database (NHFD) focuses on the period from 1 January to 31 December 2022. It shows that the number of people who died in the month following a hip fracture now stands at 6.2%; down from 10.9% in 2007, when the NHFD was set up. However, the report also finds that it took longer for patients to reach a ward where a hip fracture team can work together (where there is the best chance of recovery) in 2022. It also states that fewer patients received prompt surgery to repair their broken hip by the day after they presented to hospital. There was an improvement in how many people with hip fracture received bone strengthening medicines to avoid future fractures in 2022, but some hospitals continue to report that none of their patients receive such treatment.
  2. Content Article
    Despite their widespread use, the impact of commissioners’ policies for body mass index (BMI) for access to elective surgery is not clear. Policy use varies by locality, and there are concerns that these policies may worsen health inequalities. This study in BMC Medicine aimed to assess the impact of policies for BMI on access to hip replacement surgery in England. The authors used National Joint Registry data for 480,364 patients who had primary hip replacement surgery in England between January 2009 and December 2019. They found that rates of surgery fell after localities introduced policies restricting access to surgery based on BMI, whereas rates rose in localities with no policy. Localities with BMI policies have higher proportions of independently funded surgery and more affluent patients receiving surgery, indicating increasing health inequalities, and policies enforcing extra waiting time before surgery were associated with worsening mean pre-operative symptom scores and rising obesity. The authors recommend that BMI policies involving extra waiting time or mandatory BMI thresholds are no longer used to reduce access to hip replacement surgery.
  3. News Article
    "Seeing how much pain she's in is killing me," the mother of a woman waiting four years for a hip operation has said. It is only by screaming that Marie Morgan, from Carmarthenshire, can express her level of suffering. The 30-year-old, who has multiple brain conditions, can speak only a few words and needs round-the-clock care. "Her hip is out and is rubbing against bone... there's no socket there," Marie's mother Sandra said. "She can't travel because every time I move her she's screaming in pain. Marie has cerebral palsy, severe epilepsy and fluid on the brain and the constant agony caused by the wait has meant these conditions, including her seizures, have become "horrendous". Sandra said: "She used to be so happy, we used to go to the pool, play music... Now she's gone downhill. I don't think she can last much longer to be honest with you." Marie, from Penygroes, is on a waiting list to have surgery in Morriston Hospital, Swansea. Her mother said staff have told her she is considered to be high priority, but despite her best efforts, she is still in the dark about when the operation will happen. "They said because of Covid they weren't operating, now they say it's staff shortages so it's something all the time. "I feel I'm knocking my head against a wall. It's not fair, she's only 30 and suffering the way she is." Swansea Bay Health Board said it hoped to tackle the backlog by increasing capacity at one of its hospitals. Read full story Source: BBC News, 17 February 2022
  4. News Article
    Barts Health NHS Trust has been told to take action to prevent future deaths after an elderly woman was unlawfully killed at one of its hospitals. East London acting senior coroner Graeme Irvine sent a report to the trust in which he raised concerns over the death of 78-year-old Surekha Shivalkar in 2018. The report follows an inquest into Mrs Shivalkar's death, which reached a narrative conclusion incorporating a finding of unlawful killing. A Barts spokesperson said the trust had made a number of changes after carrying out an investigation. Mrs Shivalkar underwent hip replacement revision surgery at Newham Hospital on September 28, 2018 in a procedure estimated to last between four and five hours, the coroner wrote. She had a number of serious conditions, including ischaemic heart disease, osteoporosis and chronic obstructive pulmonary disorder. But Mr Irvine said an inaccurate risk of death of less than 5% was given, as no formal risk assessment tool was used. The surgery took longer than seven and a half hours, during which time Mr Irvine said Mrs Shivalkar sustained a "prolonged and dangerous" period of hypotension, or low blood pressure. He said the anaesthetist failed to communicate this to the surgical team and agreed to prolong surgery at the six hour point. Mr Irvine said: "Poor communication between the orthopaedic surgical team and the anaesthetist during surgery led to a collective failure to identify a critically ill patient." Read full story Source: Newham Recorder, 17 January 2022
  5. News Article
    Suicidal thoughts are three times as common in those living with a spinal cord injury in the UK, according to new research And yet, it’s estimated that only one third of people living with a spinal cord injury (SCI) are getting access to mental health support, and of those, 68% do not feel that support services available are able to meet their needs. These alarming statistics are taken from a new report, ‘It’s not just physical’ which was presented to parliament yesterday (17 November). The report shines a light on the mental health problems faced by people with spinal cord injuries in the UK today. It's calling on the NHS, government and other health policy makers to provide better mental health support services for people with spinal cord injuries – and their unpaid carers – as a matter of urgency. Nik Hartley, Spinal Injuries Association CEO said: “We are at risk of failing thousands of people in the UK living with a spinal cord injury. Our new report highlights that psychological damage caused by a SCI is, at best, considered as an afterthought, and at worst, completely ignored by the medical profession. We need urgent action and for services to be sufficiently specialised to support the thousands of people living with this type of injury before it is too late.” Read full story Source: Spinal Injuries Association, 17 November 2021
  6. News Article
    Labour is demanding new investment for the NHS as part of the government’s spending review next week, after analysis shows hundreds of thousands of patients are waiting for life-changing operations. The party’s shadow health secretary, Jonathan Ashworth, will challenge Matt Hancock in Parliament on today over the latest NHS data, which reveal almost 500,000 patients are waiting for surgery on their hips, knees and other bones. Last week, NHS England published new data showing more than 1.7 million people were waiting longer than the NHS target of 18-weeks for treatment. The target was last met in February 2016. An analysis of NHS England data reveal which specialities have been hardest hit by the growing backlog of operations, which has soared since the first wave of coronavirus caused widespread hospital cancellations earlier this year. There were 4.3 million patients on NHS waiting lists for hospital treatments in September. Labour said this included 477,250 waiting for trauma and orthopaedic surgery, with 252,247 patients waiting over 18 weeks. The next worst specialty was ophthalmology, which treats eye disorders, with 444,828 patients on waiting lists, 233,425 of whom have waited more than 18 weeks. There were six figure waiting lists over 18 weeks for other specialties including gynaecology, urology, general surgery, and ear, nose and throat patients. Read full story Source: 17 November 2020
  7. News Article
    Several patients were harmed after leaders at an acute trust failed to act on multiple concerns being raised about a surgeon, documents obtained by HSJ suggest. The documents reveal a catalogue of governance and safety concerns over the trauma and orthopaedics department at University Hospitals of Morecambe Bay Foundation Trust in the last three years. They include an external review which described the process for investigating clinical incidents as akin to “marking your own homework” and found the T&O department at Royal Lancaster Infirmary driven by “internecine squabbles”. It comes as the trust, which is widely known for a patient safety scandal within its maternity department, also faces a major investigation into whistleblowing concerns over its urology services. Read full story (paywalled) Source: HSJ, 17 November 2020
  8. News Article
    Regulators have sent an improvement director into a North West acute trust amid multiple allegations of poor care and ‘cover up’ across different specialties. University Hospitals of Morecambe Bay Foundation Trust, which spent 18 months in special measures midway through the last decade, is again now the subject of significant regulatory intervention from NHS England. The regulator has appointed Simon Bennett as a board-level improvement director, which comes after he undertook a similar assignment at the struggling Stockport FT. It comes amid ongoing external investigations into the trust’s urology and trauma and orthopaedics specialties, where serious allegations have been made about attempts to cover up poor care. The trust has a troubled history of care failings and regulatory intervention, including a major maternity scandal which culminated in the Kirkup Inquiry in the first half of the 2010s, and being placed in special measures in 2014. It was widely recognised that positive progress was subsequently made to implement the inquiry recommendations and improve services, which culminated in the trust exiting special measures in late 2015, and being rated “good” by the CQC in early 2017. However, the recent allegations and investigations have again brought regulatory intervention. Read full story (paywalled) Source: HSJ, 20 April 2021
  9. News Article
    The Covid pandemic is casting a wide shadow over the nation’s health, according to new data revealing a dramatic drop in urgent referrals for suspected cancers in England, and a plummeting quality of life among patients awaiting hip and knee surgery in the UK. The crisis has caused huge disruption to healthcare services: in November NHS England revealed that the number of people waiting more than a year for surgery had reached its highest level since 2008, while patients have reported that their procedures, from cancer surgery to hip replacements, have been repeatedly cancelled. It has also been linked to a fall in MRI and CT scans, while among other consequences breast screening programmes were paused last year. Experts have warned the pandemic may also have led to people avoiding GPs and hospitals, meaning they may have missed out on crucial care. Now an analysis of NHS England data by Cancer Research UK has found that the number of people urgently referred for suspected lung cancer fell by 34% between March 2020 and January 2021 compared with the same time period in 2019/2020 – adjusted for working days. That, they say, equates to about 20,300 fewer people being urgently referred. Declines were also found for other suspected cancers including urological cancer and gynaecological cancer, with about 51,000 fewer patients urgently referred for the former, a 25% drop, and 19,800 fewer patients urgently referred for the latter, a 10% drop, compared with the year before. Read full story Source: The Guardian, 24 March 2021
  10. News Article
    NHS England has ordered an independent review into patient safety and governance concerns at an acute trust which had been resisting calls to take this step, HSJ has learned. The intervention at University Hospitals of Morecambe Bay Foundation Trust comes after pressure from staff and local MPs, who believe more extensive investigation is required into cases of patient harm within the trauma and orthopaedics division. The broad issues were first revealed by HSJ in November, with documents suggesting several patients were harmed after leaders failed to act on multiple concerns being raised about a surgeon. The trust has already commissioned one external review. This reported last year and found the service to be riven by “internecine squabbles”. However, the review was overseen by trust executives and the terms of reference were focused on incident reporting and culture within the department. It is understood that some consultants have since been pushing for further investigation into specific cases where patients were harmed, as well as concerns that managers or clinicians who were accused of failing to tackle the issues have since been promoted to more senior positions. Read full story (paywalled) Source: HSJ, 2 March 2021
  11. News Article
    The use of opioids for pain relief soared during the pandemic as some patients waited longer for surgery, according to new research. The University of Aberdeen team focused on more than 450 patients due to have hip or knee replacement surgery. They said waiting times for these procedures increased by an average of 90 days and that the numbers of patients using opioids while waiting for surgery increased by 40% compared to pre-pandemic levels. The research, published in the BMJ Quality and Safety, looked at data collected from 452 NHS patients from the north east of Scotland. The university's Luke Farrow, who led the research, said alternative ways of managing severe arthritis pain needed to be found "urgently" for those waiting for this kind of surgery. Read full story Source: BBC News, 15 November 2021
  12. News Article
    "Bodies would have been piling up" if the Covid vaccine had not been available, the director of intensive care at Belfast City Hospital has said. Dr George Gardiner, a consultant, also said his biggest fear would be having to stop routine cancer surgery. He has called for an end to "tribal politics" in Northern Ireland to allow transformation of the health service, so that cancer and coronavirus can be tackled in tandem. He said the system was currently "one step from chaos" and warned hospitals will not cope with winter if Covid numbers continue to rise. "We need to get everyone who can take a vaccine to take it now before the winter pressures are on us," Dr Gardiner added. "The cancer surgery that we are doing at the minute is life saving. A few more Covid admissions, which could be prevented, will cause us to stop operating because we simply haven't got the capacity to do both." Read full story Source: BBC News, 7 September 2021
  13. Event
    The Professional Records Standard Body (PRSB) are holding a workshop on 4 March to help us develop a shared decision-making standard, so that individuals can be more involved in the decisions that affect their health, care and wellbeing. The online workshop will bring together health and care professionals, patients and system vendors to focus on different topics including diabetes and other long-term conditions, mental health, child health, gynaecology, colorectal cancer, genetic conditions, multi-medications and orthopaedics. We will be asking questions about the way information about treatment and care options are discussed and decisions recorded. This would include consent for treatment, when it is agreed, and any pre-operative assessments and requirements. By standardising the process, it will ensure that information can be shared consistently using any digital systems. If you’re interested in getting involved in the project, please contact info@theprsb.org
  14. Content Article
    Through the National Joint Registry (NJR) Surgeon and Hospital Profile service you can find information about: Consultant surgeons who carry out hip, knee, ankle, elbow and shoulder joint replacement surgery in England, Wales, Northern Ireland, the Isle of Man and Guernsey. Hospitals where those joint replacement operations are carried out. For each consultant surgeon listed, you will find information about their practice including how many hip, knee, ankle, elbow or shoulder procedures they have carried out since 2018. For hip and knee consultant surgeons, there is also information about mortality in the first 90-days after surgery. For hip surgeons only, there is information about the use of ODEP-rated implants as a proportion of total practice.
  15. Content Article
    The National Joint Registry records, monitors, analyses and reports on performance outcomes in joint replacement surgery in a continuous drive to improve service quality and enable research analysis, to ultimately improve patient outcomes.
  16. Content Article
    This tool is easy to use and will help you better understand your own risks and benefits of having hip or knee joint replacement surgery. It has been designed using the National Joint Registry (NJR) information from people just like you who have chosen to have their procedure outcome details recorded on the registry. You may wish to take a printout of your results to use in your medical consultation.
  17. Content Article
    This guide by the Royal College of Physicians explains what a hip fracture is and answers questions about how patients will be cared for before and after a hip operation. It is written for patients and their families and carers. The guide covers aspects of hip fracture care such as: pain relief memory problems who should be involved in your care how soon an operation should take place eating and drinking bladder problems rehabilitation and physiotherapy following surgery when you will be able to go home future falls prevention bone strengthening medication
  18. Content Article
    Fracture liaison services (FLSs) check if people who have recently broken a bone after falling from a standing height or less (a fragility fracture) might also have osteoporosis – a disease that weakens bones. They then advise on treatments to reduce the risk of another fracture, helping to improve patient outcomes. The Royal College of Physicians (RCP) estimates that at least 90,000 patients in England and Wales who should have anti-osteoporosis therapy are not receiving it. This guide by the RCP's Fracture Liaison Service Database (FLS-DB) aims to help patients and their families and carers understand what to expect following a fragility fracture. It outlines three key findings and the actions that individuals can take to ensure they receive the care and treatment they need from health services.
  19. Content Article
    The National Audit of Inpatient Falls (NAIF) has published its latest report into the care given to patients who fell while they were in hospital and sustained a hip fracture. Based on data from 1,394 patients in 2021, the report presents information on post-fall management and tracks performance against National Institute for Health and Care Excellence (NICE) Quality Standard 86, which includes checking the patient for injury before moving, using safe lifting equipment and prompt medical assessment after the fall.
  20. Content Article
    This article tells the story of Rod, who underwent a dorsal column stimulator implant for chronic pain in 2007. However, following surgery Rod realised something was wrong, and X-rays confirmed that the surgeon had applied the electrodes to the wrong side of his body, resulting in the need for several follow-up surgeries. This left Rod's chronic pain untreated, as well as giving Rod scarring, additional pain and mental stress. He has been unable to gain any financial compensation or admission of liability from the NHS Trust that made the error.
  21. Content Article
    This video summarises the story of Heather, who has cauda equina syndrome and suffered permanent damage as a result of negligent hospital treatment.
  22. Content Article
    Surgical site infections continue to represent a costly complication of spine surgery. Studies show that surgical smoke can contain infectious agents, and smoke evacuation systems have demonstrated effective removal of these particles from the operative field. Kreuger et al. reviewed the literature on surgical smoke and to study the effect of a smoke evacuation system on the rate of surgical site infections (SSIs) after spine surgery.
  23. Content Article
    This is a story of a patient in whom the emergency department missed the same diagnosis twice, four years apart. The first occasion (prior to his diagnosis of ankylosing spondylitis) was understandable. The second was not. As a result of this case, the hospital have changed their x-ray policy for non-traumatic back pain. They also want to share key learning points (the majority of which were due to lack of awareness about a relatively rare condition and its complications) as widely as possible, to help others avoid the same errors.  This reflective learning features guest educator, Mr Gareth Dwyer (the patient).
  24. Content Article
    Toolkit to improve safety in ambulatory surgery centres helps ambulatory surgery centres in the US make care safer for their patients. Ambulatory surgery centres can use the toolkit to help prevent surgical site infections and other complications and improve safety culture in their facilities.
  25. Content Article
    This report is the Healthcare Safety Investigation Branch (HSIB) first complete investigation which relates to the implantation of the wrong prostheses (artificial body parts) during joint replacement surgery — a surgical never event. A never event is a serious incident that is entirely preventable.
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