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Found 65 results
  1. News Article
    Only two mental health trusts are known to be using the advice and guidance (A&G) system, and it should be used “much more broadly” in the sector, Rebecca Gray told HSJ. A&G was introduced under the last government, but the current administration is pressing for a big expansion this year, introducing payments to GP practices each time they use it from this month. Ms Gray, who joined Confed earlier this year from the Maudsley Charity, said it was a good policy but so far was mainly focused on physical health, and she wanted to work with the network’s trust members to expand it. Mental health is largely not covered by the main referral-to-treatment waiting list, nor the government’s headline target to reduce RTT waits to less than 18 weeks. Data on MH waits is poor, but it suggests tens of thousands of children and adults are waiting longer than two years. Ms Gray said: ”Mental health services can and should play a crucial role in these kinds of initiatives. We know that mental ill health is placing a huge demand on GPs and their teams. This can not only be difficult for services to manage but frustrating for patients, who can often be left facing long waits to get the support they need if their condition is not best managed in primary care.” She said GPs should be incentivised to “reach out to specialist mental health teams to support people more quickly [which] could help tackle these issues before they get worse”. Read full story (paywalled) Source: HSJ, 22 April 2025
  2. Content Article
    The government priority is to return to the 18-week referral to treatment (RTT) standard through reforming elective care by March 2029. In support of this, NHS England has published a plan for reforming elective care for patients, setting out 4 key priority areas. Care in the right place is one of the 4 areas, which includes Advice and Guidance (A&G) services and clinical triage of referrals. Advice and Guidance aims to ensure patients receive optimal care, as quickly as possible, in the most appropriate care setting while upholding patients’ rights to choice. The Enhanced Service Specification sets out the requirements for payment of pre- referral Advice and Guidance requests. There is considerable variation in how Advice and Guidance is applied, delivered and monitored. It is important to manage patient demand, so a higher degree of rigour and standardisation is needed. This framework has been created as a tool to support ICBs to ensure Advice and Guidance is implemented effectively. This approach will enable them to embed Advice and Guidance in their leadership, culture, operational processes and build on existing good practice in line with NHS IMPACT. The framework has been co-produced, including input from a focus group of NHS colleagues from regions, ICBs, primary care and secondary care providers.
  3. Content Article
    More information about "Patients Association: Getting the most out of your appointments"
    The Patients Association have launched a new animation and guide to help you feel more prepared and confident when managing your care. They cover what to do before, during, and after appointments, with tips on communicating with healthcare professionals, sharing important information, and avoiding issues. These resources were co-designed with patients from diverse backgrounds to ensure they’re practical and useful.
  4. News Article
    The father of a seven-week-old boy who died after being breastfed in a baby carrier is calling for increased safety standards around baby slings. James Alderman, who was known as Jimmy, was being breastfed "hands-free" within a baby carrier worn by his mother while she moved around their home. Jimmy's father, George Alderman, told Sky News: "Baby slings are sold as being a lifesaver, allowing you to get on with your business while your baby's safe and close to you, but in this instance, we had our baby close, but not safe." The inquest into his death heard Jimmy was in an unsafe position too far down the sling. Mr Alderman said that while much of the available advice around slings focused on them not being too tight, few people were aware of the danger of the sling not being tight enough, and so allowing the baby to slump. Explaining what medical experts think happened to Jimmy, he said: "After he'd been feeding, he fell asleep and then he slumped forwards. Then, because his head was covered and he had his chin against his chest, he was facing downwards. "Nothing was covering his face, but because of the position he was in, that meant that not enough oxygen was going into his lungs because he was small and not fully developed, and that's why he stopped breathing." Mr Alderman said that while many brands of baby carriers said they were safe for breastfeeding, the lack of advice around how to safely do it meant that parents were "left to work it out by themselves". Read full story Source: Sky News, 30 December 2024
  5. Content Article
    Baby Jimmy was being breastfed within a baby carrier worn by his mother. After 5 minutes she found that he was collapsed and although immediate resuscitation was commenced he died 3 days later on 11 October 2023 in St George’s Hospital. Jimmy died because his airway was occluded as he was not held in a safe position while within the sling. There is insufficient information available from any source to inform parents of safe positioning of young babies within carriers and in particular in relation to breastfeeding.  It was accepted that the sling was being worn snugly, not tightly, and although she could see his face when she looked down, the TICKS acronym was not met by his position within the sling as Jimmy was too far down. The TICKS acronym was prepared by the (now disbanded) UK consortium of sling retailers and manufacturers tight in view at all times close enough to kiss keep chin off the chest supported back. There appeared to be no advice in the literature regarding the risk of baby slumping and the risk therefore of suffocation, particularly if baby is under the age of 4 months, and no advice that breastfeeding “hands free” a young baby is unsafe, due to the risk of suffocation and not being able to meet every aspect of TICKS. There appeared to be no helpful visual images of “safe” versus “unsafe” sling/carrier postures. Evidence was given by the witnesses assisting the inquest that public information, readily available, not too complex but consistent in message would be welcomed to advise and instruct. Matters of concern There is very little information available to inform parents of safety and positioning advice of young babies in carriers/slings and in particular nothing in relation to breastfeeding in carriers/slings This is notwithstanding a significant increase over recent years in the use of such equipment. The question of whether it is safe to breastfeed “hands free” is not addressed or referred to in the public domain or manufacturers literature. The NHS available literature provides no guidance or advice. The only current “tips” are provided on the National Childbirth Trust (NCT) website but these are in fact unhelpful Young babies are at risk of suffocation. Consideration should be given to industry standards to promote the safe use of slings/carriers, to warn users of the risks and whether any such standards should be voluntary or mandatory.
  6. Content Article
    More information about "Reducing the risk of self-harm in inpatient mental health settings"
    This blog explores the ever-present risk of self-harm in inpatient mental health settings and looks at ways to reduce this risk.  Inpatient mental healthcare is intended to offer refuge. In theory, these are places where an individual in (mental health) crisis can step out of the chaos and venture into a structured environment that’s designed to stabilise and guide them back to balance. But for those struggling with self-harm, the reality of inpatient care is often far more complex: rules intended to keep these patients safe may suddenly become triggers. Research studies are unanimous: patients who rely on self-harm as a way to manage the intensity of their feelings can find inpatient spaces challenging. Deprived of a familiar coping mechanism, they might feel isolated or even punished (a situation that prompts an escalation of distress rather than relief). This paradox—the push and pull between patient safety and autonomy, control and compassion—makes managing self-harm in inpatient mental health settings a hefty ordeal. Self-harm in inpatient treatment: what do the studies reveal? One research study published in the Journal of Psychiatric and Mental Health Nursing has, among other results, concluded that, for some patients, the inpatient environment temporarily reduces the incidence of self-harm simply by making it physically more challenging to do so. Yet, the study underlines this sense of enforced security is fragile. For patients who have come to rely on self-harm as a form of release, removing that outlet without addressing the underlying pain can magnify feelings of helplessness. That also makes things difficult for the staff: they’re aware that while restrictions can reduce harm, they also risk pushing patients into more dangerous or desperate forms of self-harm. How to reduce the risk of self-harm in inpatient mental health settings Reducing self-harm risk in inpatient mental health settings requires a shift away from containment and toward a model that promotes healing through connection, trust and empowerment. Build authentic trust Safety isn’t simply about restrictions or even vigilance. Safety, in a setting meant for healing, is about creating trust. A staff member trained to listen without judgment and to approach the patient with calmness and empathy is often the first line of defence against self-harm. When patients feel they can freely communicate about their urges without the discouraging fear of punishment, it can reduce the compulsion to self-harm in secrecy. Offer practical coping tools Patients who self-harm typically do so because it serves as a reliable, although harmful, way to manage emotions they simply can’t handle. In an inpatient setting, replacing self-harm with skills like grounding techniques, mindful breathing, meditation or yoga, and keeping an everyday diary can be more than helpful. Introducing these skills as an alternative to self-harm will require time, practice and encouragement. Staff who guide patients through these techniques will be an important link; they’ll help patients see and feel that self-control, and not self-harm, is achievable. Provide plenty of safe outlets Patients frequently injure themselves because they don't have safe ways to express the overwhelming emotions they're experiencing. Establishing specific areas and times for patients to express themselves via art, journaling or group conversations provides a healthy means of processing challenging emotions. These kinds of therapeutic channels can lessen the urge for self-harm as a release mechanism while also making patients feel heard and understood. Collaborative care Involving patients in creating their treatment plans can foster a profound sense of agency they feel they lack. When patients participate in defining their goals and strategies, they are more likely to engage meaningfully with their treatment. Collaborative care doesn’t just manage symptoms—it affirms the patient’s role in their recovery. By involving patients as partners, we validate their insight and resilience, helping to counteract feelings of powerlessness that can trigger self-harming behaviours. Support staff resilience Working in mental healthcare, especially in crisis settings, demands both emotional endurance and self-care. In facilities where staff face constant pressure to prevent self-harm, the emotional toll can lead to burnout. A burnt-out staff member may unintentionally create a tense atmosphere that patients can sense. Facilities that invest in support systems—counselling, peer supervision or regular team check-ins—enable staff to maintain the compassion and resilience needed to connect with patients. When staff feel cared for, they can care more effectively, healing the inpatient environment. Conclusions Inpatient mental health settings face an immense challenge: to protect individuals from self-harm while also supporting the emotional work that is essential to recovery. Research underscores that while restrictions on self-harm may reduce immediate risk, they cannot address the pain that drives these behaviours. Without a shift in approach, the risk of self-harm in inpatient mental health settings remains. A treatment model that combines empathy with skill-building, collaborative care and staff support creates a space where healing can occur on a deeper level.
  7. Content Article
    Search engines often serve as a primary resource for patients to obtain drug information. However, the search engine market is rapidly changing due to the introduction of artificial intelligence (AI)-powered chatbots. The consequences for medication safety when patients interact with chatbots remain largely unexplored. This study explored the quality and potential safety concerns of answers provided by an AI-powered chatbot integrated within a search engine. The study found that AI-powered chatbots are capable of providing overall complete and accurate patient drug information. Yet, experts deemed a considerable number of answers incorrect or potentially harmful. Furthermore, complexity of chatbot answers may limit patient understanding. Hence, healthcare professionals should be cautious in recommending AI-powered search engines until more precise and reliable alternatives are available.
  8. Content Article
    The Maternity Survey 2022, run by Ipsos on behalf of the Care Quality Commission, looked at the experiences of women and other pregnant people who had a live birth in early 2022. In this article Anita Jefferson from Ipsos looks at the results of this and considers what they tell us about experiences of maternity services. Results from the Maternity Survey 2022 that this article highlights includes: Across the maternity pathway there has been a decline in the proportion of respondents who say they can always get help when they need it. Related to the availability of staff, the provision of information and advice has also dropped. While most (82%) respondents felt they were given appropriate advice and support at the start of their labour, this is a drop from 88% in 2019 and 84% in 2021. Almost a quarter of women and people who had given birth (23%) felt that when they raised a concern during labour and birth, it was not taken seriously. There are some areas of care that have seen an upward trend across the years. One of these is the experience of discharge from hospital, where around two-thirds of women and other people who had given birth report no delay to their discharge (62%, up from 56% in 2019). The results show an improved experience around support for mental health across the maternity pathway.
  9. Content Article
    Whole-body bathing or showering with a skin antiseptic to prevent surgical site infections (SSI) is a usual practice before surgery in settings where it is affordable. The aim is to make the skin as clean as possible by removing transient flora and some resident flora. Several organisations have issued recommendations regarding preoperative bathing. The care bundles proposed by the United Kingdom (UK) High impact intervention initiative and Health Protection Scotland recommend bathing with soap prior to surgery. The Royal College of Surgeons of Ireland recommends bathing on the day of surgery or before the procedure with soap . The USA Institute of Healthcare Improvement bundle for hip and knee arthroplasty recommends preoperative bathing with CHG soap. Finally, the UK-based National Institute for Health and Care Excellence (NICE) guidelines recommend bathing to reduce the microbial load, but not necessarily SSI. In addition, NICE states that the use of antiseptics is inconclusive in preventing SSI and that soap should be used. The purpose of this systematic review is to assess the effectiveness of preoperative bathing or showering with antiseptic compared to plain soap and to determine if these agents should be recommended for surgical patients to prevent SSI.
  10. Content Article
    More information about "The Family Oops and Burns First Aid eBook"
    'The Family Oops and Burns First Aid' is a free children's book written by Kristina Stiles, beautifully illustrated by Jill Latter, created to support children and their families learning about burns prevention and first aid principles together. The book describes an accident prone family who are not burns aware, who have to go to school to learn about burn safety and first aid principles within the home. The book is aimed at KS1 children and their families, and is available as hard copy book by request from Children's Burns Trust and also as an audio/video book via YouTube.
  11. News Article
    National leaders are looking to greatly reduce the number of direct hospital referrals made by GPs, by insisting that they first discuss cases with hospital consultants. The approach – known as “advice and guidance” or “A&G” – involves GPs sending a patient’s details to a consultant who specialises in their condition before making a referral. The consultant then advises on the best course of action. “A&G’ has been voluntarily adopted by many health systems, but HSJ has now learnt that a move to significantly increase its use of it is being discussed as part of a new national strategy for outpatient services, due to be published by December. Theresa Barnes, outpatients lead at the Royal College of Physicians, is part of a group of clinicians helping to develop the strategy in partnership with NHS England, and said there is a case for A&G to be used “in preference” to direct referrals in a vast number of cases where it is clinically appropriate. She told HSJ: “I think there should be a push to use advice and guidance in preference to direct referrals, so we can maximise that pre-referral interaction and deliver as much care as close to patients’ homes as they can get it and without the delay of potentially waiting for a secondary care appointment.” Read full story (paywalled) Source: HSJ, 20 September 2023
  12. News Article
    YouTube has launched a verification system for healthcare workers in the UK as it battles disinformation online. In 2022, health videos were viewed more than three billion times in the UK alone on the video-sharing platform. Doctors, nurses and psychologists have been applying for the scheme since June and must meet rigorous criteria set by the tech giant to be eligible. Successful applicants will have a badge under their name identifying them as a genuine, licensed healthcare worker. But YouTubers have warned the system is only meant for education purposes, not to replace medical advice from your GP. Vishaal Virani, who leads health content for YouTube, said it was important simply due to the sheer number of people accessing healthcare information on the video-sharing platform. "Whether we like it or not, whether we want it or not, whether the health industry is pushing for it or not, people are accessing health information online," he told the BBC. "We need to do as good a job as possible to bring rigour to the content that they are subsequently consuming when they do start their care journey online." Read full story Source: BBC News, 8 September 2023
  13. Content Article
    Patients benefit from guideline-based preventive, chronic disease, and acute care, but many do not receive it. A limitation to providing high-quality care is insufficient time for primary care providers (PCPs). The aim of this study was to quantify the time needed to provide preventive care, chronic disease care, and acute care for a nationally representative adult patient panel by a PCP alone, and by a PCP as part of a team-based care model. The authors concluded that PCPs do not have enough time to provide the guideline-recommended primary care. With team-based care the time requirements would decrease by over half, but still be excessive.
  14. Event
    This conference focuses on prehabilitation – Principles and practice, and will provide a practical guide to delivering an effective prehabilitation programme, ensuring patients are fit and optimised for surgery/treatment. This is even more important in light of the Covid-19 pandemic and lockdowns which have had a negative effect on many individual’s health and fitness levels, and currently high waiting lists could be used as preparation time to ensure the best outcomes. The conference will look at preoperative/pre treatment optimisation of patients fitness and wellbeing through exercise, nutrition and psychological support. This conference will enable you to: Network with colleagues who are working to deliver effective prehabilitation for surgery/treatment. Reflect on a patient lived experience to understand how to engage patients in prehab programmes. Learn from outstanding practice in implementing a prehabilitation programme. Embed virtual prehabilitation into your programme during and beyond Covid-19. Demonstrate a business case for prehabilitation and ensure prehab services continue through and beyond the pandemic. Reflect on national developments and learning. Improve the way we support patients to prepare themselves, physically and emotionally for surgery/treatment. Develop your skills in Behaviour Change and Motivational Interviewing.. Embed virtual prehabilitation into your programme during and beyond Covid-19. Learn from case studies. Understand how you can improve emotional and psychological support. Explore the role of prehabilitation in older people. Work with patients to improve nutrition. Ensure you are up to date with the latest evidence. Self assess and reflect on your own practice. Supports CPD professional development and acts as revalidation evidence. This course provides 5 Hrs training for CPD subject to peer group approval for revalidation purposes. Register
  15. News Article
    There will be no national mandate for GPs to use advice and guidance in a certain number of cases, NHS England has told Pulse. National medical directors for primary and secondary care said that formalised pathways should be developed ‘locally’, and decisions should be based on an area’s population. In September, it was reported that NHS England’s upcoming outpatients strategy would further increase the use of advice and guidance (A&G) before GP referrals are accepted, with the RCGP then "voicing concerns" about this proposal. However, when asked about the reports that this would be mandated, Dr Stella Vig, national medical director for secondary care and clinical director for elective care, said she ‘doesn’t know’ where that came from, and ‘doesn’t recognise’ those comments. NHS England also released guidance clarifying the medico-legal risks and clinical responsibility for clinicians using A&G or referral assessment services (RAS), which is now available on the NHS Futures website. The guidance said that these forms of specialist advice are "expanding rapidly" as a result of improvements to digital services. On legal issues, it said liability ‘will be determined on a case by case basis’ but that GPs could be liable if "all relevant clinical information is not provided" when sending an A&G request. But specialists at hospitals would be accountable if they send back advice to the GP which is ‘not clinically appropriate’ or if they ‘refuse to accept a patient’. On turnaround times, NHS England has said that ‘local variables will ultimately dictate the agreed response times’ for hospital teams dealing with A&G – but the guidance recommends that the response time "should not exceed 10 working days for routine requests". Read full story Source: Pulse, 30 November 2023
  16. News Article
    The NHS 111 service has permanently stopped nurses and other healthcare professionals in a clinical division handling calls with people suspected of having COVID-19 after an audit of recorded calls found more than 60% were not safe. The audit was triggered in July after many of the medical professionals recruited to work in that clinical division of the 111 service sounded the alarm, saying they did not feel “properly skilled and competent” to fulfil such a critical role. An investigation was launched into several individual cases after the initial review found that assurances could not be given “in regard to the safety of these calls”, according to an email, seen by the Guardian, from the clinical assurance director of the National Covid-19 Pandemic Response Service. In a further email on 14 August, she told staff that after listening to a “significant number” of calls “so far over 60% … have not passed the criteria demonstrating a safe call”. A number of “clinical incidents” were being investigated, she said, because some calls “may have resulted in harm”. One case had been “escalated as a serious untoward incident with potential harm to the patient”. NHS England declined to answer questions about any aspect of these apparent safety failings, saying it was the responsibility of the South Central ambulance service (SCAS), which set up a section of NHS 111 called the Covid-19 Clinical Assessment Service (CCAS). Read full story Source: The Guardian, 1 October 2020
  17. News Article
    Hundreds of people believe the 111 helpline failed their relatives. Now the Guardian reports that they are demanding a full inquiry into the service. When the coronavirus outbreak hit in March, the NHS feared hospitals could be overwhelmed and so patients with suspected symptoms were directed to call the designated 111 helpline. Call volumes were massive and waiting times were often over an hour. The Guardian’s David Conn has spent months talking to bereaved relatives about that difficult time and during his conversations he found many were deeply unhappy about the service they felt had been provided by the 111 helpline. Lena Vincent’s partner Patrick McManus died from the virus in April following a short period in hospital. He had called 111 three times and had not been advised to seek further medical help. Lena tells Anushka she wants to know who is accountable for the service. Listen to the podcast Source: The Guardian, 28 September 2020
  18. News Article
    Nurses and non-medical staff have been stopped from taking patient calls to the NHS coronavirus helpline amid concerns over the safety of their advice. An audit of calls to the telephone assessment service found more than half were potentially unsafe for patients, according to a leaked email shared with The Independent. At least one patient may have come to harm as a result of the way their assessment was handled. The COVID-19 Clinical Assessment Service (CCAS) is a branch of the NHS 111 phone line and is designed to assess patients showing signs of coronavirus to determine whether they need to be taken to hospital or seen by a GP. The helpline was set up at the start of the pandemic to divert patients with symptoms to a phone-based triage to relieve pressure on GPs and prevent them from turning up at surgeries and spreading the virus. GPs, nurses and allied health professionals (AHPs) such as paramedics and physiotherapists were recruited to speak to patients after they were flagged by NHS 111 call handlers. The use of non-medical staff was first paused in July amid concerns about the quality of call handling. Now it has emerged much wider safety issues have surfaced. Read full story Source: The Independent, 18 August 2020
  19. News Article
    A key element in the new covid-19 response service run by NHS 111 urgently needs more doctors, NHS England has said. The national covid-19 clinical assessment service, or CCAS, serves a cohort of patients with coronavirus symptoms deemed by 111 as needing a clinical assessment over the phone or online. An email to GPs from NHSE’s primary care directors on Friday evening said: “We urgently need more GPs help to staff this service, especially as covid-19 cases increase over coming days, because of your expertise and experience.” Read full story Source: HSJ, 6 April 2020
  20. News Article
    The rapid spread of coronavirus has given the NHS a “kick forward” in the need to accelerate technology and ensure staff are digitally prepared, a GP has said. Neil Paul, a Digital Health columnist and GP in Ashfields, said the need to reduce face-to-face appointments to prevent the potential transmission of Covid-19 has forced the NHS, particularly in primary care, to adopt already available technologies. He said practices “still in the stone ages” and “technophobes” were less prepared for the current situation, but that it would force them to move into the digital age. “It’s absolutely made my surgery go ‘right, how do we do online consults’. I think it actually has given people a real kick forward,” he told Digital Health News. “I think in six months’ time my surgery might be very different in that actually we will be doing a lot of online and telephone consults where previously we may have been a bit reluctant." GP practices across the country have been advised to assess patients online or via telephone and video appointments to mitigate the potential spread of coronavirus. In a letter to GPs last week, NHS England urged Britain’s 7,000 GP surgeries to reduce face-to-face appoints for patients displaying symptoms of Covid-19. The preemptive move means millions of patients will now be triaged online, via telephone or video and contacted via text messaging services. Read full story Source: Digital Health News, 13 March 2020
  21. News Article
    Regional NHS leaders in England have been ordered to immediately organise a primary care management service to care for covid-19 patients who “do not require immediate admission” to hospital. In a letter sent on 8 March, seen by The BMJ, NHS England and NHS Improvement’s strategic incident director for coronavirus, Keith Willett, has ordered regional primary care and public health directors to set up a 24 hour, seven day a week service to manage patients in the community. This service should be delivered by an out-of-hours provider, and every part of England must be covered by Tuesday 10 March, the letter said. The service will be used to manage patients who are deemed well enough to be isolated at home, with active monitoring for people who are at high risk of developing severe illness, and advice to those not deemed high risk on what to do if their illness deteriorates. The letter advises that patients “remain in isolation until 5 days after resolution of symptoms, unless [they are a] healthcare worker or work with high risk groups, in which case require one negative sample 5 days after resolution of symptoms before return to work.” People with mild illness and not in a high risk group will be told to isolate themselves at home and will be given health advice on how to identify deterioration. All patients managed at home will be given a phone number to call if they feel more unwell. The letter said that the community service should be provided by a nurse and GP team and that all clinical information should be recorded and transferred to the patient’s general practice. Providers must also provide regular situation reports, including confirmed numbers of patients cared for under the service, numbers of patients who deteriorate, and numbers of patients admitted to and discharged from the service. Read full story Source: BMJ, 9 March 2020
  22. Content Article
    These documents are for bereaved families and aim to explain what happens after a bereavement. They include information about how to comment on the care a loved one received and what happens if a death will be looked into by a coroner.
  23. Content Article
    This article from Healthwatch outlines the communications patients should expect from their healthcare provider while they are waiting for treatment. It also describes how healthcare staff should involve patients in shared decision-making about their care and communicate clearly, personally and transparently.
  24. Content Article
    In this article, Robert Greene, Founder and President of HungerNdThirst Foundation, explains why patient advocacy is a vital aspect during the entire clinical trial process. He discusses how a patient advocates help patients communicate with their healthcare providers in order to make an informed decision about their health care, the positives and negatives of participating in clinical trials and how building trust and collaboration between patients, patient advocates, other stakeholders, and clinical trial professionals is important.
  25. Content Article
    This article describes the importance of an advocate that provide independent support in health and care. An advocate can provide practical advice whilst also ensuring all the rules are being followed and help navigate a patient through the healthcare system. The article also explains how to find an advocate and the different types of support available.

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