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Found 2,335 results
  1. News Article
    Health workers are "back in the eye of the storm" as coronavirus cases continue to rise, NHS England's chief executive Simon Stevens has said. It has been the "toughest year" for the NHS, which has treated 200,000 severely ill Covid-19 patients, he added. Hospitals in England are currently treating more Covid patients than at the peak of the first wave in April. A government scientific adviser has warned national restrictions are needed to prevent a "catastrophe". On Monday, a record 41,385 new Covid cases were reported in the UK, though it is thought the infection rate was higher during spring when testing was much more limited. NHS England said 20,426 people were being treated for the virus in hospitals in England on Monday, which is higher than the previous peak of about 19,000 in April. Read full story Source: BBC News, 29 December 2020
  2. 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
  3. News Article
    NHS England has told hospitals to begin planning for the use of Nightingale Hospitals as the numbers of coronavirus patients in hospitals is expected to surge in coming weeks. In a letter sent on Wednesday night hospitals were told to activate all of their emergency capacity to cope with the expected pressures over the coming weeks. This is likely to mean the mass redeployment of staff and designating wards, surgical theatres and recovery areas as makeshift intensive care units for patients. NHS England did not explain how the Nightingale Hospitals would be staffed if the decision was made to activate them. Read full story Source: The Independent, 24 December 2020
  4. News Article
    NHS leaders have raised concerns about the rollout of the coronavirus vaccine, with more than half of hospital trusts and two-thirds of GPs yet to receive supplies amid growing alarm over the new fast-spreading variant. Dr Richard Vautrey, the chair of the British Medical Association’s GP committee, urged the government to speed up delivery of the Pfizer/BioNTech vaccine in order to save lives. Experts also demanded greater transparency from ministers on how many doses are available. Vautrey said: “We need millions of doses to be made available as soon as possible – urgently – because it’s the number one priority for GP practices, our patients and the nation, especially given the new mutant strain. “GPs who haven’t got it yet are frustrated because they want to be getting on and vaccinating their patients as well. Their frustration is understandable. They want to protect their patients, especially their vulnerable patients, as quickly as possible.” Read full story Source: The Guardian, 22 December 2020
  5. News Article
    There are 14 hospital trusts on course to have at least a third of their beds filled by covid patients on New Year’s Eve. HSJ analysed current occupancy and growth at each general acute trust in the seven days to 21 December. Projecting the same rate of growth forward, the number of trusts with at least a third of their bedbase likely to be taken by covid patients would increase from 5 at present to 14. Three of the four acute trusts in Kent are projected to have covid bed occupancy of over 40%. Another two trusts are in areas covered by tier two restrictions. They are Queen Elizabeth in Norfolk, and Countess of Chester. A third, East Sussex, has one of its two general hospitals in “tier four” (St Leonards), and the other in Eastbourne, which is outside the Sussex “tier four” zone. There are also 27 trusts not in tier four areas which had more than 50 covid patients on 21 December, and where the number of covid patients grew by at least 20 per cent in that week. These include Liverpool University Hospitals and Sheffield Teaching Hospitals. HSJ last week projected that, if trends continued, English hospitals would have just short of 19,000 covid patients on New Year’s Eve in total — almost exactly the same as the 12 April first wave peak. Current projections put that number at over 20,000. Read full story (paywalled) Source: HSJ, 23 December 2020
  6. News Article
    Doctors and nurses on the front line of the fight against coronavirus at the Royal London Hospital – which has the largest number of Covid patients in the capital – have been denied the Pfizer vaccine, The Independent has learnt. Hospital bosses at Barts Health Trust have written to staff today expressing their frustration over the decisions by NHS England, which meant the northeast of London – where the rate of infections and hospitalisations are worst – has not been given access to any vaccines. The Independent has learned that staff from the Royal London booked appointments to be vaccinated at University College London, but they were turned away because the vaccinations had been earmarked for NHS staff from University College London Hospital Trust. The trust’s chief medical officer wrote to senior doctors on Monday warning them the crisis facing the hospital would get worse before it gets better. Professor Alistair Chesser told staff: “It has been frustrating to see the vaccine delivered to other trusts and to GP surgeries but not to us in the last few days given the pressure we are under. Please be assured we are lobbying for our staff and our patients at the very highest levels and will not let this rest.” Read full story Source: The Independent, 22 December 2020
  7. News Article
    Thousands of people who are at extreme risk from the coronavirus and live in tier 4 areas have been told to stay indoors at all times unless they are exercising or have medical appointments. The Department of Health and Social Care (DHSC) issued new advice on Monday warning people classed as “clinically extremely vulnerable” to stay home, in a bid to protect them from the new, more infectious strain of COVID-19. Those affected have been told not to leave their homes even if they cannot work remotely. The government said residents could be eligible for statutory sick pay, employment support allowance, or universal credit as well as the coronavirus job retention scheme. The DHSC said the high-risk group should stay at home as much as possible. Children who have been advised to shield should not attend school, the department added. Read full story Source: The Independent, 21 December 2020
  8. 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
  9. 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
  10. News Article
    Staff shortages and a lack of equipment are affecting the day-to-day decisions about patient care by doctors and nurses, a new YouGov survey has revealed. The representative survey of NHS clinicians revealed more than half, 54%, admitted that factors such as a lack of staff played a role in their decisions about patients beyond what was in their best interests. Almost a third of staff, 31%, said staffing levels were the top factor affecting decisions about patients. A fifth said the availability of services such as key tests were a significant factor; 16% cited a lack of equipment; and 12% cited beds. 10% of clinicians said a fear of being sued was part of their decision-making. YouGov carried out the research for JMW Solicitors and weighted the responses to be representative of the NHS workforce population. It also revealed more than two-fifths of clinicians, 42%, believe a “blame culture” in the NHS plays a top role in preventing staff admitting to mistakes in care. In maternity services specifically, 68% of nurses and midwives said at least one factor other than what was in patients’ best interest played a role in their decisions. Read full story Source: The Independent, 20 December 2020
  11. News Article
    Layla Moran, Lib Dem MP for Oxford West and Abingdon and Chair of the APPG on Coronavirus, has secured the first Commons debate on Long Covid on Thursday 7 January following cross-party support. The Backbench Business Committee granted the application by Layla Moran, co-sponsored by Dr Dan Poulter MP (Con) and Andrew Gwynne MP (Lab) and supported by many others. Layla said that the debate “is long overdue” and called on “those with lived experience and clinical experience to tell us your stories” in advance of the debate. Layla Moran said: “I’m pleased that we’ve been able to secure this important debate on Long Covid, which is long overdue. The APPG on Coronavirus, which I chair, has submitted recommendations to the Government on this, and the debate will give us the opportunity to hold them to account and represent our constituents suffering from it." “What’s really important now is that as many MPs as possible take part in the debate, so we can give this the profile it deserves and give the Government the opportunity to listen and respond to our concerns. Thank you to my cross-party colleagues for supporting this. I’m calling on those with lived experience and clinical experience to tell us your stories between now and the 7 January. This is a crucial opportunity.” Read full story Source: Liberal Democrats, 19 December 2020
  12. News Article
    The number of people likely to have caught COVID-19 in NHS hospitals in England has risen by more than a third in the last week. The 35% rise in probable hospital-acquired COVID-19 from 6 to 13 December is the highest weekly increase since 30 October, HSJ analysis of NHS England data reveals. Hospital-acquired infections are rising across areas such as London, the South East, and South West, and also at some hospitals in the North East, Yorkshire and the Midlands. At some trusts, the weekly total of likely hospital-acquired COVID-19 infections has more than doubled since last week. Read full story (paywalled) Source: HSJ, 18 December 2020
  13. News Article
    Women are undergoing “painful and distressing” diagnostic tests as doctors use the COVID-19 pandemic as an excuse not to offer them their choice of pain relief, HSJ has been told. At least 70 women who have had hysteroscopies this year in English NHS hospitals said they were left in extreme pain following the procedures, with many suffering trauma for several days, according to a survey by the Campaign Against Painful Hysteroscopies group. Some women claimed doctors used COVID-19 as an “excuse” not to offer sedation or general anaesthetic. Others said they were offered an inpatient appointment with general anaesthetic, but were also told it would be a long wait and would likely be cancelled due to covid pressures. Women also said they were told an outpatient procedure would reduce the time spent in hospital and consequently reduce the risk of contracting covid. The only pain relief on offer was often just ibuprofen and some women said facilities like recovery rooms were unavailable. The vast majority of the women surveyed — more than 90% — said they were traumatised for a day or longer by the pain from the procedure, A RCOG spokeswoman said: “We are concerned to hear that women are going through painful and distressing hysteroscopy procedures and that they feel COVID-19 is being used as an excuse not to offer a choice of anaesthetic." “The covid-19 pandemic has put incredible strain on the health services, and the risk of transmission of the virus has meant they’ve had to adapt their procedures. Whilst all women should be offered a choice of anaesthesia and treatment settings for hysteroscopic procedures, an outpatient setting avoids hospital admission and reduces the risk of exposure to the virus." “The RCOG guidance on this is very clear — all pain relief options should be discussed with women, as well as the risks and benefits of each. Women should be given the choice of a local or general anaesthetic. If the procedure is still too painful, no matter what anaesthetic options are chosen, it must be stopped and a further discussion of pain relief options should then take place. It’s vital that women are listened to and their choice is fully supported.” Read full story Source: HSJ, 21 December 2020
  14. News Article
    Patients in hospital with coronavirus should be offered a follow-up six weeks later to check for "long Covid" symptoms, doctors are being advised. The guidance, drawn up by health officials across the UK, says the long-term effects can be "significant". They identified 28 of the most common symptoms, from breathlessness and dizziness to chest pain. Mental health problems including depression, anxiety and struggling to think clearly, have also been reported. "Because this is a new condition, there is still much that we don't know about it," said Paul Chrisp of the National Institute for Health and Care Excellence, which produces health guidance. The NHS has opened 69 specialist clinics across England to offer rehabilitation to people recovering from the disease. Read full story Source: BBC News, 18 December 2020
  15. 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
  16. 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
  17. 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
  18. News Article
    Research by a group of doctors has found ‘major deficiencies’ around infection control within hospitals in the North West region. The study looked at trusts’ adherence to Public Health England guidance around limiting the spread of COVID-19 within orthopaedic services. The study found patients were routinely being allocated to hospital beds before they had been confirmed as covid-negative, “thus allowing spread of COVID-19 not only between patients but also between nursing and medical staff”. Fewer than half of patients were nursed with the appropriate screens in place, while it was uncommon for doctors to be tested regularly. Separate statistics published by NHS England suggest almost 20 per cent of new covid cases in North West hospitals from August to December were likely to be nosocomial, meaning they were acquired on the wards. This was a higher proportion than any other region. Read full story Source: HSJ (paywalled), 16 December 2020
  19. News Article
    Pregnant women should be allowed to have one person alongside them during scans, appointments, labour and birth, under new NHS guidance sent to trusts in England. The chosen person should be regarded as "an integral part of both the woman and baby's care" - not just a visitor. Previously, individual hospitals could draw up their own rules on partners being present. This meant many women were left to give birth alone. The guidance says pregnant women "value the support from a partner, relative, friend or other person through pregnancy and childbirth, as it facilitates emotional wellbeing". Women should therefore have access to support "at all times during their maternity journey". And trusts should make it easy for this to happen, while keeping the risk of coronavirus transmission within NHS maternity services as low as possible. Read full story Source: BBC News, 16 December 2020
  20. 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
  21. News Article
    The government’s plan to allow up to three households to mix at Christmas is a “major error that will cost many lives” and should be stopped, the editors of two leading medical journals have said. In a rare joint editorial, the editors of the British Medical Journal and Health Service Journal have said the government’s plan to relax coronavirus restrictions for five days between 23 and 27 December is a serious “blunder” that will put more pressure on the NHS and cause thousands of operations to be cancelled. The article published jointly on Tuesday says: “The government was too slow to introduce restrictions in the spring and again in the autumn. It should now reverse its rash decision to allow household mixing and instead extend the tiers over the five-day Christmas period in order to bring numbers down in the advance of a likely third wave.” Read full story Source: The Independent, 15 December 2020
  22. News Article
    Throughout the pandemic, people with learning disabilities and autism have consistently been let down. A lack of clear, easy-to-understand guidance, unequal access to care and illegal “do not resuscitate” instructions have exacerbated the inequalities many people have long faced. It is crucial we do not forget those who have constantly been at the back of the queue: people with learning disabilities and autism. The impact cannot be ignored: research shows that 76% of people with learning disabilities feel they do not matter to the government, compared with the general public, during the pandemic. And data shows the danger of contracting COVID-19 for people with learning disabilities and autism is much higher than for the wider population. Public Health England has said the registered COVID-19 death rate for people with learning disabilities in England is more than four times times higher than the general population. But experts estimate the true rate is likely to be even higher, since not all deaths of people with learning disabilities are registered in the databases used to collate the findings. The reasons the pandemic has impacted people with learning disabilities so disproportionately are systemic, and a result of inequalities in healthcare services experienced for generations. Yes, some individuals are more clinically vulnerable, on account of the co-morbidities and complications associated with their learning disability. For many people, however, poorer outcomes after contracting the virus are due to non-clinical issues and inequalities in accessing healthcare services. This is inexcusable. The government must prioritise vaccinations for the 1.5 million people with learning disabilities and 700,000 with autism. Putting this long-overlooked group at the top of the vaccine queue would help address the systemic health inequalities learning disabled people face. Read full story Source: The Guardian, 15 December 2020
  23. News Article
    Trusts’ infection control measures will be put under greater scrutiny by the Care Quality Commission (CQC), HSJ has been told. In an effort to cut hospital-acquired COVID-19, the CQC will carry out focused inspections which will assess “in more detail the leadership and delivery of infection prevention control”. According to NHS England/Improvement figures, around 9% of covid inpatients definitely caught the virus in hospital. However, the number could be higher as NHSE/I figures — released on Friday — showed 21% of COVID-19 patients in hospitals were “probably” acquired in hospitals. HSJ understands the CQC plans to carry out up to 20 infection control focused inspections in the early part of 2021. The CQC told HSJ it is reviewing local nosocomial infection rates on a weekly basis, using the data alongside “wider intelligence” from other sources to monitor trusts’ risk, with inspections carried out at providers where specific concerns are picked up. Read full story (paywalled) Source: HSJ, 14 December 2020
  24. News Article
    Health checks should be offered to people from black, Asian and minority ethnic backgrounds from the age of 25, a report has recommended. MPs examined the disproportionate impact of the Covid pandemic on people from black and Asian backgrounds. They said NHS checks, currently available to 40-70-year-olds in England, could pick up conditions which are linked to severe coronavirus. The role of inequalities in employment and housing was also emphasised. The report, produced by the Women and Equalities Committee, said the government should act to tackle these wider causes of poor health. The committee heard evidence during the course of its investigation that showed 63% of healthcare workers who died after contracting the virus had come from black, Asian or other ethnic minority backgrounds. And during the first peak of the virus, data from the Intensive Care National Audit and Research Centre showed 34% of coronavirus patients in ICUs were from an ethnic minority background, whereas they made up 12% of viral pneumonia admissions. Office for National Statistics (ONS) data has also shown that black people were almost twice as likely to die from Covid-19 as white people, with those of Bangladeshi and Pakistani ethnicity about 1.7 times as likely. The report raised concerns the pandemic was entrenching "existing health inequalities". Read full story Source: BBC News, 15December 2020
  25. News Article
    Pre-existing social inequalities contributed to the UK recording the highest death rates from Covid in Europe, a leading authority on public health has said, warning that many children’s lives would be permanently blighted if the problem is not tackled. Sir Michael Marmot, known for his landmark work on the social determinants of health, argued in a new report that families at the bottom of the social and economic scale were missing out before the pandemic, and were now suffering even more, losing health, jobs, lives and educational opportunities. In the report, Build Back Fairer, Marmot said these social inequalities must be addressed whatever the cost and it was not enough to revert to how things before the pandemic. “We can’t afford not to do it,” he said. Read full story Source: The Guardian, 15 December 2020
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