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Found 2,339 results
  1. News Article
    If there is a public inquiry over the handling of the coronavirus, the provision of personal protective equipment (PPE) to front-line staff could be a major theme. The government has been put under major pressure by staff over the past four days because of delays to the delivery of vital equipment. This left them at risk as they dealt with a flood of covid-19 cases described as “all-consuming” by one hospital chief executive (while another major trust declared a critical incident). The last two weeks have prompted a mammoth effort from local and national procurement teams to make sure clinicians have the PPE they need. But, sadly, the bigger picture was what the Health Care Supply Association called a “system” failure (although it did not blame staff). Numerous trusts, some of them very large, have turned to alternative suppliers to source this vital kit, in some cases spending hundreds of thousands of pounds. The situation has apparently been so dire in recent days that, over the weekend, the HCSA asked DIY shops to donate their PPE to local trusts. Read full story (paywalled) Source: HSJ, 24 March 2020
  2. News Article
    Protection for staff, clean covid-negative wards, and enforcing social isolation are the three take home messages from Italy’s fight against COVID-19, according to rapid findings shared exclusively with HSJ. By 6 March 2020, Italy had recorded 4,636 cases and 197 deaths attributable to COVID-19. On 20 March, two weeks later, the UK announced 3,983 cases and 177 deaths due to the novel coronavirus. Models put us two weeks behind Italy and on the same trajectory. PanSurg.org, an international collaborative created at Imperial College London, organised a series of webinars to rapidly share experiences and learning around the pandemic amongst the global healthcare community. Nearly 1,000 healthcare professionals from around the world took part in these events, and several important messages emerged. 1) Protect your staff: full PPE (including, FFP3 masks) for COVID-19 suspected or COVID-19 positive areas. This is both for them and to keep your workforce numbers intact. 2) Treat everyone as if they could haveCOVID-19, as they may do and “fear the covid negative ward”. 3) Enforce social isolation and contact tracing and place a significant focus on testing. Read full story (paywalled) Source: HSJ, 25 March 2020
  3. News Article
    GP practices should review 1.5 million patients identified by NHS England as the most vulnerable to the coronavirus. NHS England will send a standard letter to these patients asking them to stay at home at all times and avoid any face-to-face contact for at least 12 weeks. GPs will be able to access a report on which patients will be contacted with specific advice, with NHS England directing GPs to review the list and provide additional support to patients. The patients, who are at ‘the highest risk of severe illness that would require hospitalisation from coronavirus’, include those who have had an organ transplant; people with specific cancers; people with severe respiratory conditions; people with rare diseases; people on immunosuppression therapies; and pregnant women with significant heart disease. In a letter to GPs, NHS England said: "We ask that you review this report for accuracy and, where any of these patients have dementia, a learning disability or autism, that you provide appropriate additional support to them to ensure they continue receiving access to care." Read full story Source: Management in Practice, 24 March 2020
  4. Content Article
    Useful up to date information from Resuscitation Council UK on COVID-19 resuscitation guidelines.
  5. News Article
    Currently we have a frightening, deadly viral pandemic, but there will another plague, one we are not hearing nearly enough about from our leaders, which will arrive in a wave just behind it, reports Paul Daley in the Guardian. There will be a pandemic of severe depression and anxiety that will sweep over the world as the unemployment rate pushes into previously unseen digits, families who’d prefer to be socially distant are thrust together and young people are denied the certainty and structure of school. We will need to support – medically, financially, emotionally and psychiatrically – those who are going to do it hardest. Psychiatric support services will need to be dramatically bolstered to fight this mental health pandemic Read full story Source: The Guardian, 24 March 2020
  6. News Article
    Details of a massive ramp-up in intensive care beds have been circulated to NHS bosses in London, amid concerns from national leaders that they are four days away from full capacity. In a call with local leaders, the NHS’ national director for mental health, Claire Murdoch, spoke about the intense pressures facing the acute system due to the coronavirus outbreak. According to several people on the call, she said London “runs out of [ICU] beds in four days” if urgent action is not taken. She also warned the need for intensive care beds will now double every three days, the sources said. The capital’s hospitals are frantically planning to try to quadruple their “surge capacity” in intensive care over the next fortnight, from around 1,000 surge beds over the weekend just passed, to more than 4,000 in two weeks’ time. Read full story Source: HSJ, 24 March 2020
  7. News Article
    Medical students who are employed in the NHS as part of efforts to swell staff numbers to tackle covid-19 should not be expected to “step up” and act outside of their competency, says the BMA in new guidance. This is the first set of guidance released by the BMA specifically for medical students, who have had placements and exams cancelled and are uncertain about how they might be employed in the NHS in the current crisis. It says that any employment should be voluntary and within the competency of the student, who should have adequate access to personal protective equipment. The BMA refers to General Medical Council guidance that states that plans are not currently in place to move provisional registration forward from the normal August date. It warns that there are concerns around the boundaries of practice and the level of supervision that students who take on roles in the NHS would have, which could lead to unsafe working practices. The BMA is in talks to negotiate a safe national contract for such roles. Read full story Source: BMJ, 24 March 2020
  8. News Article
    The government has bought 3.5 million coronavirus antibody tests — with more widespread testing of NHS workers coming “online soon”, the health secretary has said. Matt Hancock also told a press conference this evening that a new testing facility had been opened in Milton Keynes as the government aims to “ramp up” the number of antibody tests — which will determine whether people have had the virus and can therefore return to work. Mr Hancock also said the government had shipped 7.5 million pieces of personal protective equipment over the last 24 hours, following major shortages, and confirmed the conversion of east London’s Excel centre into a huge temporary hospital facility, with between 500 to 4,000 beds. Read full story Source: HSJ, 24 March 2020
  9. News Article
    A GP has criticised the practice of giving doctors surgical masks with expiry dates that have passed. Dr Kate Jack said doctors felt "like cannon fodder" after discovering the paper masks had expired in 2016. A box delivered to her Nottingham surgery had a 2021 label placed over the original date of 2016. The Department of Health and Social Care (DHSC) said equipment underwent "stringent tests" and was given a "new shelf-life" where appropriate. "I don't feel protected at the moment," said Dr Jack, a GP of 22 years. "They are really not designed for prevention of infection and are practically useless." Read full story Source: BBC News, 25 March 2020
  10. Content Article
    The president of the Vascular Society of Great Britain and Ireland, Chris Imray, has issued a letter to Vascular Society members on the COVID-19 virus and vascular surgery, offering “general principles” on vascular patients and COVID-19, elective surgery and outpatients, urgent vascular surgery, trainees, other specialities, the appropriate use of scarce resources, documentation, personal safety, mental health and burnout, research, clinical training/education, and audit. Imray stresses that “local decision making is key.
  11. News Article
    Lack of staff testing, workforce shortages and running out of personal protective equipment (PPE)are the three biggest concerns for trusts fighting the coronavirus outbreak, according to an HSJ chief executive survey conducted over the last 36 hours. Thirteen of the 34 trust chief executives who responded to the snap survey, who were from trusts across England, also warned they would run out of intensive care capacity by next week as the number of coronavirus cases continue to rise. The survey also revealed some trusts were already being forced to dilute safe staffing ratios and ration facilities. One chief warned: “We are preserving ventilation capacity by ensuring that only those who may survive are considered.” However, the majority of respondents were supportive of system leaders’ guidance so far. Several respondents praised the “impressive pace and detail of the advice." The three biggest areas of concern raised by the chiefs surveyed were: Lack of staff testing, raised by 26 of the 34 respondents (77%); Staff shortages, raised by 26 of the 34 respondents (77%); and PPE shortages, raised by 23 of the 34 respondents (68%. Read full story Source: HSJ, 24 March 2020
  12. News Article
    UK doctors fighting coronavirus still say they don't have personal protective equipment (PPE). Jon Snow spoke to Dr Jenny Vaughan, a leading member of the Doctors’ Association who have written to the government to demand better personal protective equipment for medical staff. He asked her whether the PPE equipment promised by the government was starting to reach the medical staff on the frontline, and what kinds of problems medical personnel had been encountering. Watch news story Source: Channel 4 News, 23 March 2020
  13. Content Article
    In this blog, Claire discusses the use of NEWS2 in coronavirus patients and the importance of recognising, tracking and alerting the appropriate team that your patient has an increasing oxygen demand to ensure that the risk of more people being exposed to the virus is minimal.
  14. Content Article
    This video demonstrates how to perform an intubation safely on a patient with coronavirus.
  15. Content Article
    This new guidance set out by the Department of Health and Social Care covers a variety of scenarios relating to care homes, staff, and providers who care for people in their own homes to ensure older people and those with pre-existing conditions and care needs who receive support are best protected. Elderly people and those with underlying health conditions are much more likely to develop serious complications. Anyone who is suspected of having COVID-19, with a new continuous cough or high temperature, should not visit care homes or people receiving home care, and should self-isolate at home. People receiving care will be isolated in their rooms if they have symptoms of coronavirus. To ensure they can continue to receive the care they require, care staff will use protective equipment to minimise the risk of transmission.  Building on existing strong local relationships, the NHS will work with care providers where necessary to make sure people have the best possible care and remain in the community. GPs have been asked to look at the possibilities of offering digital appointments to provide advice and guidance to patients and potentially their families. Councils have been told to map out all care and support plans to prioritise people who are at the highest risk and contact all registered providers in their local area to facilitate plans for mutual aid.
  16. News Article
    A leading NHS doctor has warned frontline medical staff dealing with Britain’s coronavirus outbreak feel like “cannon fodder” and "lambs to the slaughter". Dr Rinesh Parmar, chairman of the Doctor's Association UK, is battling the disease on an intensive care ward at a city hospital in Birmingham. The Anaesthetic Registrar begged Boris Johnson to provide better Personal Protective Equipment (PPE), describing the current crisis the "calm before the storm" Doctors and nurses fear a lack of masks, gloves, aprons and protective suits is putting them at risk as they care for patients diagnosed with Covid-19. Speaking after a night shift on the ward, Dr Parmar told The BBC's Andrew Marr Show: "We have had doctors tell us they feel like lambs to the slaughter, that they feel like cannon fodder. GPs tell us that they feel absolutely abandoned." Read full story Source: The Sun, 23 March 2020
  17. Content Article
    Governments are taking a wide range of measures in response to the COVID-19 outbreak. The Oxford COVID-19 Government Response Tracker (OxCGRT) aims to record these unfolding responses in a rigorous, consistent way across countries and across time.
  18. News Article
    The staff-to-patient ratios for intensive care are being dramatically reduced as the NHS seeks to rapidly expand its capacity to treat severely ill covid-19 patients, HSJ has learned. Acute trusts in London have been told to base their staffing models for ICU on having one critical care nurse for every six patients, supported by two non-specialist nurses and two healthcare assistants. Trusts have also been told by NHS England and NHS Improvement’s regional directorate to plan for one critical care consultant per 30 patients, supported by two middle grade doctors. The normal guidance is the consultant-to-patient ratio “should not exceed a range between 1:8-1:15”. Nicki Credland, chair of the British Association of Critical Care Nurses, confirmed the plans had been agreed today nationally. She told HSJ: “There will absolutely be a lot of concern about this in the profession, but it’s the only option we’ve got available. We simply don’t have the capacity to increase our staffing levels quickly enough." “It will dilute the standard of care but that’s absolutely better than not having enough critical care staff. There’s also a massive issue around the ability of critical care nurses not only to care for their patients but also monitor what the non-specialists in their teams are doing.” Read full story (paywalled) Source: HSJ, 24 March 2020
  19. News Article
    Delays have begun to cancer treatments, as patients are reprioritised ahead of capacity becoming overwhelmed by the coronavirus crisis. In three separate developments: A London trust announced it was cancelling chemotherapy and routine cancer operations for a fortnight due to coronavirus pressure; An NHS England covid-19 guidance document indicated palliative care cancer patients will be less likely to receive appropriate treatment; and Cancer waiting times guidance has been changed to provide for some urgent referrals for suspected cancer to be sent back to GPs without diagnosis. Read full story (paywalled) Source: HSJ, 23 March 2020
  20. News Article
    A new ventilator, a virus-killing snood and a hands-free door pull are just some of the innovations coming out of Wales to tackle coronavirus. Since the outbreak, doctors, scientists and designers have been working on ideas to stop the virus spreading. The ventilator has already successfully treated a Covid-19 patient and has been backed by the Welsh Government. Mass production of the snood-type mask is under way while a 3D design of the handle has been widely circulated. Plaid Cymru leader Adam Price, who was part of the impetus to get the ventilator into mass production, said the innovations put Wales "on the front foot" in the battle against the pandemic. "It shows that Wales, as a small nation, can get things done quickly as we face the biggest challenge of our generation," he said. Read full story Source: BBC News, 24 March 2020
  21. Content Article
    The four chief nursing officers of the UK asked all nurses who have retired from nursing in the last three years to consider re-joining the register held by the Nursing and Midwifery Council and come back into practice to help health and care services to support patients with COVID-19. In this article in the Independent, Elaine Maxwell explains why she is stepping up having left the Nursing and Midwifery Council register twelve months ago and not having worked clinically for 10 years.
  22. Content Article
    The way we treat cancer over the next few months will change enormously. Oncologists, will have to find a tenuous balance between under-treating people with cancer, resulting in more deaths from the disease in the medium to long term, and increasing deaths from Covid-19 in a vulnerable patient population. Lucy Gossage, an oncologist, discusses in the Guardian the difficult decisions that will need to be made.
  23. Content Article
    Dr Gordon Caldwell, a consultant physician, questions whether he should be ventilated if gets the coronavirus. Gordon is a 64 year old in good health. But in his blog he asks us to consider whether this would be a wise action and whether more harm than good would come from ventilating him. The process of ventilation may be the most important and dangerous fomite for the current generation of healthcare staff, but by jumping to “do it all” and “have a go” we may be shooting the human race in the foot; however well intentioned the motivation. Read Gordon's full blog in the attachment below.
  24. News Article
    The NHS must ensure that doctors have proper protective equipment, Jeremy Hunt, the former health secretary, has urged. NHS chiefs say that there are no problems with national stock levels of items including masks, gowns and gloves and that local supply issues should have been resolved over the weekend. However, hospital staff say that they are still experiencing shortages, with nurses going to DIY shops to stock up or even refusing to work without the right equipment. One London doctor said: “Every time the government is asked they say the equipment is there, and it is just not true.” Read full story (paywalled) Source: The Times, 23 March 2020
  25. Content Article
    In this thought-provoking blog, Phil discusses the implications of retired staff rejoining their registers and returning to frontline care, and how short shifts may benefit us all.
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