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Found 2,339 results
  1. Content Article
    A group of doctors who have chronic COVID-19 symptoms have been digesting information on social media platforms from thousands of individuals in the UK and worldwide affected by covid symptoms for 16 weeks or more. Some of these symptoms and patients’ experiences have been summarised in a video “Message in a bottle—long covid SOS.” The announcement of an NHS portal for patients who have been admitted to hospital or dealt with the illness at home is a welcome signal that the problems of long standing covid symptoms are starting to be recognised. In this BMJ article, the authors explore these patients' experiences and urge that the new NHS portal should be co-created with by patients with COVID-19 and carers. There needs to be some bidirectionality in the creation of this service and subsequent research to avoid institutional “top down” blind spots about the condition.
  2. News Article
    A wide disparity in coronavirus mortality rates has emerged in English hospitals, with data seen by the Guardian showing that one hospital trust in south-west England had a death rate from the disease of 80% while in one London trust it was just 12.5%. The figures, which NHS England has compiled but never published, show the age-standardised mortality rates that all of the country’s 135 acute hospital trusts have recorded during the pandemic. Doctors regard age as the single biggest predictor or risk factor for dying from COVID-19. They cover the period from the start of the coronavirus crisis in March, through its peak in late March and April, up until 15 May, by which time 42,850 (85%) of the 50,219 deaths so far in all settings had occurred in England and Wales. It is the first such data to emerge about how many people have lived or died in each trust after being treated there because they had been left critically ill by the disease. They are based on patients who were treated in an intensive care or high-dependency unit or on a ward. Senior doctors said the dramatic gap in death rates of 67.5 percentage points between the trusts with the highest and lowest rates was notable and may mean that some hospitals needed to learn lessons from others. Read full story Source: Guardian, 14 June 2020
  3. Content Article
    Over 300 health and social care staff died in the UK during the first COVID‐19 wave. There are concerns regarding infection risks but there has been very little discussion or research on personal protective equipment (PPE) design. To understand how PPE changes clinical tasks, Hignett et al. conducted an online survey between (via Twitter, LinkedIn, etc.) 4 April and 8 May 2020, when there was a peak of 33,173 deaths. They focused on human factor/ergonomic issues to avoid preconception bias about availability to ask with regard to fit and comfort, reading and operating equipment, hearing and communicating, reaching and moving, and dexterity to use touch screens, press buttons, open vials/taps and use syringes.
  4. Content Article
    Safety of patients and surgical teams is paramount when undertaking elective surgery in the initial recovery phase from COVID-19. This tool from the Royal College of Surgeons of England lists key considerations to minimise risks of patients and surgical teams contracting COVID-19 in the hospital.
  5. Content Article
    Hospitals are currently planning to resume or expand surgical services that were cancelled during the recent COVID-19 crisis. While emergency surgery will need to continue to be performed within current restrictions, other operations might now be feasible as resources become available. The following checklist from the Royal College of Surgeons of England introduces some of the main criteria that should be taken into account in the initial stages of resuming planned surgery.
  6. News Article
    Some NHS trusts in England are yet to complete /cOVID-19 risk assessments for their staff from ethnic minority groups more than two months after the NHS first told them to do so, an investigation by The BMJ has found. On 29 April NHS England’s chief executive, Simon Stevens, wrote to all NHS leaders telling them to carry out risk assessments and make “appropriate arrangements” to protect ethnic minority staff, amid growing evidence that they were at greater risk of contracting and dying from COVID-19. However, The BMJ asked England’s 140 acute care trusts for details of risk assessments they had carried out and what subsequent actions they had put in place. Seventy trusts responded. Of these, 27 (39%) said that assessments were yet to be completed for all ethnic minority staff, and 43 (61%) indicated that assessments had been completed. But the other 70 trusts were unable to provide a response within the 20 day deadline, citing “unprecedented challenges” posed by the COVID-19 pandemic, so it is not known what stage they are at in risk assessing staff. Commenting on The BMJ’s findings, Chaand Nagpaul, the BMA’s chair of council, said, “Clearly, we know that a significant number of doctors have not been risk assessed. It is a shame that it has taken so long, because the risk assessments and mitigations would have been most useful and impactful during the peak of the virus.” Doctors’ leaders have suggested that systemic race inequalities in the workplace may have exacerbated delays in risk assessing staff. Nagpaul said, “The BMA survey found that doctors from a BAME [black, Asian, and minority ethnic] background felt under more pressure to see patients without adequate protection. So it does beg the question of whether there’s also been this added factor of BAME healthcare staff feeling unable to demand their right to being assessed and protected." “This is something the NHS needs to tackle. This is an issue that predates covid. It’s vital that we have an NHS where anyone is able to voice their concerns. No one should have to suffer or have fear in silence.” Read full story Source: The BMJ, 10 July 2020
  7. News Article
    A former senior NHS official plans to sue the organisation after he had to pay a private hospital £20,000 for potentially life-saving cancer surgery because NHS care was suspended due to COVID-19. Rob McMahon, 68, decided to seek private treatment after Worcestershire Acute Hospitals NHS trust told him that he would have to wait much longer than usual for a biopsy. He was diagnosed with prostate cancer after an MRI scan on 19 March, four days before the lockdown began. McMahon was due to see a consultant urologist on 27 March but that was changed to a telephone consultation and then did not take place for almost two weeks. “At that appointment, the consultant said: ‘Don’t worry, these things are slow-growing. You’ll have a biopsy but not for two or three months.’ I thought, ‘that’s a long time’, so decided to see another consultant privately for a second opinion.” A PET-CT scan confirmed that he had a large tumour on both lobes of the prostate and a biopsy showed the cancer was at risk of breaking out of the prostate capsule and spreading into his body. He then paid to undergo a radical prostatectomy at a private Spire hospital. “This is care that I should have had on the NHS, not something that I should have had to pay for myself. I had an aggressive cancer. I needed urgent treatment – there was no time to waste,”, he said. “With the pandemic, he added, “it was almost like a veil came down over the NHS. He worked for the NHS for 17 years as a manager in hospitals in London, Birmingham and Redditch, Worcestershire, and was the chief executive of an NHS primary care trust in Leicester.” Mary Smith of Novum Law, McMahon’s solicitors, said: “Unfortunately, Rob’s story is one of many we are hearing about from cancer patients who have been seriously affected by the disruption to oncology services as a result of COVID-19." Read full story Source: The Guardian, 11 July 2020
  8. News Article
    Coronavirus patients have continued to suffer from fatigue, breathlessness and forgetfulness more than 100 days after contracting the bug. Many COVID-19 survivors have found that they are not back to normal months after they tested positive. Louise Nicholls, from Litherland in Liverpool, is one of those people who found themselves suffering from curious symptoms long after she should have been back to normal. She was told she had coronavirus by her doctor on 1 April having gone in search of medical help after suffering from a number of respiratory symptoms. "I was trying to do my workouts and I was getting really short of breath," Louise said. "I couldn't put my finger on what was going on but it got worse every day. My chest started getting tighter and my lungs were burning. I didn't have a cough or a fever but I had shortness of breath and I was waking up with night sweats." Louise said her symptoms were dismissed as anxiety by those around her at first, but when her symptoms got worse she phoned the doctor who said it sounded like coronavirus. Louise said: "My doctor said it sounds like covid. She said 'you're young and fit, you'll be over it in a few weeks' and sent me on my way." Louise's breathing continued to get worse and she was given a steroid inhaler, which she is still taking today. Although Louise feels much better than she did at one time, she is still struggling with her breathing today and is continuing to use her inhaler. She said: "I feel much better than I was but I can't push myself too much... My chest feels tight if I don't take my inhaler every day." Read full story Source: Mirror, 12 July 2020
  9. News Article
    Doctors may be missing signs of serious and potentially fatal brain disorders triggered by coronavirus, as they emerge in mildly affected or recovering patients, scientists have warned. Neurologists are on Wednesday publishing details of more than 40 UK COVID-19 patients whose complications ranged from brain inflammation and delirium to nerve damage and stroke. In some cases, the neurological problem was the patient’s first and main symptom. The cases, published in the journal Brain, revealed a rise in a life-threatening condition called acute disseminated encephalomyelitis (Adem), as the first wave of infections swept through Britain. At UCL’s Institute of Neurology, Adem cases rose from one a month before the pandemic to two or three per week in April and May. One woman, who was 59, died of the complication. “We’re seeing things in the way Covid-19 affects the brain that we haven’t seen before with other viruses,” said Michael Zandi, a senior author on the study and a consultant at the institute and University College London Hospitals NHS foundation trust. “What we’ve seen with some of these Adem patients, and in other patients, is you can have severe neurology, you can be quite sick, but actually have trivial lung disease,” he added. Read full story Source: The Guardian, 8 July 2020
  10. Content Article
    Early clinical experiences have demonstrated the wide spectrum of COVID-19 presentations, including various reports of atypical presentations of COVID-19 and possible mimic conditions. This article, published in the BMJ, summarises the current evidence surrounding atypical presentations of COVID-19 including neurological, cardiovascular, gastrointestinal, otorhinolaryngology and geriatric features. 
  11. Content Article
    This short film was created by patients who are experiencing long-lasting and debilitating symptoms of COVID-19, to raise awareness of their ongoing issues, also known as 'Long COVID'.
  12. Content Article
    The study by Traverse aimed to explore the knock-on effects of coronavirus for health and wellbeing in the UK by understanding the experiences of people whose care has been disrupted. It is based on interviews with 12 people in the week beginning 20th April, just after the second 3-week lockdown period was announced in the UK.
  13. Content Article
    This Royal College of General Practitioners (RCGP) report calls on the four governments of the UK to each produce a comprehensive plan to support GPs in managing the longer-term effects of COVID-19 in the community.
  14. News Article
    Far fewer people are having surgery or cancer treatment because COVID-19 has disrupted NHS services so dramatically, and those who do are facing the longest waits on record. NHS figures reveal huge falls in the number of patients who have been going into hospital for a range of vital care in England since the pandemic began in March, prompting fears that their health will have worsened because diseases and conditions went untreated. Patients have been unable to access a wide range of normal care since non-COVID-19 services were suspended in hospitals in March so the NHS could focus on treating the disease. Many patients were also afraid to go into hospital in case they became infected, which contributed to a fall in treatment volumes. Tim Gardner, a senior policy fellow at the Health Foundation thinktank, said: “The dramatic falls in people visiting A&E, urgent referrals for suspected cancer and routine hospital procedures during lockdown are all growing evidence that more people are going without the care they need for serious health conditions." “Early diagnosis and prompt treatment of cancer is crucial to saving lives, and delays in referrals and treatment during the pandemic are likely to mean more people are diagnosed later when their illness is further advanced and harder to treat.” Read full story Source: Guardian, 9 July 2020
  15. Content Article
    In this blog, intensive care doctor Jake Suett draws on his personal journey and that of others to highlight the prolonged and frightening symptoms many patients with confirmed or suspected COVID-19 are experiencing. Jake outlines his concerns and sets out recommendations for future action to address the needs of these 'Long COVID' patients. Included is an example letter that can be adapted by others to call on MPs to raise awareness of those suffering persisting symptoms of COVID-19. 
  16. Event
    until
    The number one focus in the world right now is health care and the critical need to bring greater efficiency to treating patients. During the COVID-19 pandemic, vast amounts of information are rapidly cross-crossing the globe. Governments, health systems, and research communities in the European region are looking to learn as much as possible from each other, as quickly as possible, about the nature of COVID-19 and the most effective interventions for preventing and treating it. We cannot afford to ignore the clear signs pointing to a new future of increased care needs, labour shortages, and operational strain. From COVID-19 to general routine care, we must act now to ensure that no patient waits for the care they need. For health care professionals looking to structure their leadership plans around lessons learned in the field comes the 'Hospital Flow in the UK: During and Beyond COVID-19'. In this online course from the Institute for Healthcare Improvement (IHI), health care leaders address challenges and share successes, best practices, and strategies to effectively advance the long-term goal of improving community health in a post-COVID world. Experts will discuss noteworthy global challenges and responses to COVID-19, specifically focusing on efforts in the United Kingdom (UK) to monitor and quickly improve treatment for patients across the care continuum. Further information and registration
  17. News Article
    Patients with respiratory disease have been overlooked during the COVID-19 pandemic, with the NHS storing up problems for the winter months, a group of experts including the Royal College of General Practitioners (RCGP) has warned. Analysis by the 34-member Taskforce for Lung Health showed that referrals for lung conditions fell by 70% in April, with two-in-five (39%) of CCGs seeing no appointment bookings for respiratory conditions for the whole of May. On average, the group calculated a weekly average of 3,399 lung patients missing out on urgent and routine referrals during the COVID-19 lockdown, amounting to a total of at least 34,780 people, based on NHS England data. This was blamed in part on a general reduction in routine procedures during the pandemic, which will have affected all disease areas, but also the limitations on clinicians including GPs to carry out spirometry due to the risk of COVID-19 infection spread. But the taskforce - which includes the RCGP and the Primary Care Respiratory Society, as well as the Royal College of Physicians and Asthma UK - is now calling on NHS England to urgently restore services to pre-pandemic levels to tackle the backlog of lung patients requiring support. It said that failure to do so risked causing the premature death of patients who require urgent diagnosis as well as overwhelming the NHS during the winter season, when respiratory symptoms worsen. Read full story Source: Pulse, 9 July 2020
  18. Content Article
    This interactive webinar was part of the world tour series designed by the World Health Organization's Patients for Patient Safety (PFPS) Global Network and hosted by Patients for Patient Safety Canada, the patient-led program of the Canadian Patient Safety Institute, a WHO Collaborating Centre on Patient Safety and Patient Engagement. Watch on demand and download slides from the webinar.
  19. News Article
    Health leaders have called for the routine recording of ethnicity and faith during the registration of deaths to help fight COVID-19, but the government appears to have rejected the idea. Leaders at West Yorkshire and Harrogate Health and Care Partnership, the second largest integrated care system in England, wrote to registrar general Abi Tierney last month and said the lack of routine collection and analysis of this data “means there is a structural barrier to understanding of inequalities in mortality”. The Home Office replied and said it is considering “a range of reliable and proportionate ways to collect the necessary information”. But HSJ understands the Home Office has indicated no immediate action will be taken on the issue. The letter said: “This absence has undoubtedly led to delays in identifying the inequalities of COVID-19 mortality and means that we remain unclear about the disparities in deaths outside of hospital. These delays have risked contributing to further loss of life in our places in recent weeks, as we have not had robust data to enable us to address impacts at sufficient pace as we have been dealing with this crisis.” Read full story (paywalled) Source: HSJ, 8 July 2020
  20. News Article
    CAP-COVID are conducting essential research on how the COVID-19 pandemic affects pregnant women and their babies. If you are a pregnant woman at any stage of pregnancy, you can take part in the study. This includes whether you have just had a positive pregnancy test (even if you are unsure what to do about your pregnancy), whether you are in the middle of pregnancy, or you are about to have your baby. Take part
  21. News Article
    The Public Accounts Committee has given the Department of Health and Social Care two months to report back with a plan to ensure personal protective equipment (PPE) provision during a second COVID-19 spike. The influential group of MPs said they were 'extremely concerned' by PPE shortages faced by NHS and care workers during the first wave of the pandemic in the UK. According to the DHSC it never ran out of stock of PPE but rather Covid-19 had 'put supply chains and distribution networks under unprecedented strain', posing challenges with ensuring the right equipment was at the right place at the right time. BMA council chair Dr Chaand Nagpaul said: 'We may be past the first peak of this virus, but we should be under no illusion that the demand for PPE is over – especially as the NHS begins to manage the huge backlog of demand caused by the pandemic, all under tighter infection control measures.' In light of the threat of a second wave of Covid-19 doctors and colleagues 'need cast-iron guarantees from Government that the failures of the past months will not be repeated, that there will be enough of the right PPE and that it will be properly tested, quality-controlled and safe to use', Dr Nagpaul added. Read full story Source: Pulse, 8 July 2020
  22. Content Article
    Lesley Flatley, reflects on some of the challenges and key learnings from leading in isolation, as a manager in an independent care home, during the pandemic. "Our experiences of the pandemic so far have been extremely challenging, but we must continue to improve and build on new ways of working to ensure that staff and residents are supported."
  23. Content Article
    In this interview, Dr Jake Suett talks about his experience of persisting and debilitating symptoms after he was suspected to have contracted COVID-19. Additional reading: Patient safety concerns for Long COVID patients (6 July 2020) Press release: Patient Safety Learning calls for urgent action to ensure Long COVID patients are heard and supported (6 July 2020) My experience of suspected 'Long COVID' (6 July 2020) Dismissed, unsupported and misdiagnosed: Interview with a COVID-19 ‘long-hauler’
  24. Content Article
    An increasing number of people with confirmed or suspected COVID-19 are continuing to struggle with prolonged, debilitating and sometimes severe symptoms months later.[1] Many were never admitted to hospital and have instead been trying to manage their symptoms and recovery at home. These patients are sometimes referred to as the ‘long-haulers’ or described as having ‘post-acute’, ‘chronic’ or ‘long-term’ COVID-19. Here, we will use the term ‘Long COVID’. With social distancing restrictions still in place, patients in the UK and across the world have been turning to social media support networks[2] to connect with others who are experiencing similar challenges. These patients have raised very credible concerns about the care they are receiving[3] and the uncertainties they face. Their concerns are revealing many implications for patient safety. We have recently shared on the hub the story of Dr Jake Suett[4], one of the many people experiencing symptoms of Long COVID. When we conclude this article, we will return to his story and highlight the changes that he is calling for. However, first, we will focus on the patient safety aspects of Long COVID, highlighting key areas of concern and action needed (a full list of actions can be found summarised here).
  25. Content Article
    Weeks and months after having a confirmed or suspected Covid-19 infection, many people are finding they still haven’t fully recovered. Emerging reports describe lingering symptoms ranging from fatigue and brain-fog to breathlessness and tingling toes. So why does Covid-19 cause lasting health problems? In this podcast, Ian Sample discusses some of the possible explanations with Prof Danny Altmann, and finds out how patients might be helped in the future.
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