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Showing results for tags 'Advice'.
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News Article
Baby sling safety warning as experts urge better guidance for new parents
Patient Safety Learning posted a news article in News
New parents require enhanced guidance on the safe use of baby slings, according to new research. Baby sleep experts at Durham University are advocating for improved education for parents, both pre-purchase and at the point of sale. A survey of 1,470 parents with infants under one year old revealed that nearly nine out of ten acquired their sling or carrier online. Of these, a mere three per cent received assistance from a virtual sales assistant or chat function, highlighting a significant gap in direct support. Researchers stress the need for more accessible and comprehensive safety information to prevent potential misuse. The survey found that even experienced parents had difficulty with positioning the baby in a sling, creating comfort for the carrier and securing the infant safely. Unsafe use of baby slings has been linked to accidental deaths from suffocation or falls. In 2023, six-week-old James Alderman died in a carrier during hands-free breastfeeding, leading a coroner to issue a warning. With incorrect sling or carrier fitting, a baby’s nose or mouth can be pressed against the parent’s body or blocked by fabric. In other cases, the baby can slump down in the carrier and their windpipe can become pinched. Read full story Source: The Independent, 4 June 2026 -
News Article
1 in 5 American adolescents have gone to an AI chatbot for mental health guidance
Patient Safety Learning posted a news article in News
Would you trust an AI chatbot to be your therapist, medical professional or confidante? New research shows that one in five American adolescents between the ages of 12-21 (around 8.2 million) are turning to Big AI’s chatbots for help with their mental health. That marks a more than 40% increase in the past year, rising from just one in eight the previous year, a 1,009-person survey from the non-profit research institute RAND found. The findings may not come as that much of a shock following the rise of chatbot use in schools and data showing that nearly half of U.S. teens used the platform multiple times each month. Still, they raise many questions about the impact of asking AI for mental health guidance. Mental health among U.S. teenagers has been at crisis levels in recent years, and suicide is the second leading cause of death for that age group, according to Johns Hopkins Medicine. AI chatbots have also been involved in investigations of the deaths of several U.S. teenagers who died by suicide, according to reports. Read full story Source: The Independent, 2 June 2026 -
News Article
Regulators demand answers on advice and guidance
Patient Safety Learning posted a news article in News
Answers are needed from NHS England and others on 11 issues to make sure its controversial expansion of advice and guidance is safe, the Care Quality Commission has declared. Advice and guidance allows GPs to seek pre-referral advice from specialist clinicians working in secondary care, and is designed in part to reduce referrals. NHS England has planned to substantially ramp up its use this year, including by making its use mandatory – rather than initial referral – in at least 10 locally-chosen specialties. This has proven controversial with many clinicians, particularly GPs. NHSE last month issued a letter seeking to clarify some aspects of the policy, including stepping back from a target that in the chosen specialties there would be a “diversion rate of at least 25 per cent by March 2027”. British Medical Association GP Committee chair Katie Bramall had also written to the Care Quality Comission in March to raise concerns express the BMA’s reservations relating to the national implementation of mandated A&G. Read full story (paywalled) Source: HSJ, 27 May 2026 -
News Article
Advice and guidance ‘adding to backlogs’, say consultants
Patient Safety Learning posted a news article in News
Many medical consultants report a “mixed” experience with the advice and guidance model, saying it is “under-resourced and adding to existing backlogs”, according to research by an integrated care board. Cheshire and Merseyside ICB surveyed around 300 GPs and medical consultants about their views on the A&G model, which NHS England has said must be significantly expanded this year. A&G allows GPs to seek pre-referral advice from specialist clinicians working in secondary care, and is designed in part to reduce referrals. The ramping up of the model in recent months has been controversial among GPs, but the ICB’s survey found 54% said A&G worked “mostly well” or “very well” for them. 36% said their experience was mixed, and 10% “bad”. However, consultants were more wary: the majority – 51% – said their experience was “mixed”; 18% said it was “bad”; while 31% said it worked “well”. The ICB’s feedback report says consultants complained about having “no job-planned time” to provide the A&G, as well as “growing volumes, limited admin support, and difficulty accessing GP records”. This was “leaving A&G under-resourced and adding to existing backlogs”. Consultants also complained of “inappropriate use”, with A&G “sometimes used by [allied health professionals], trainees, and PAs for queries that should go via a GP first”. The findings added: “Many requests lack adequate history or a clear clinical question.” Although GPs were more positive, they also highlighted problems. They said A&G responses from secondary care could be “brief, contradictory, dismissive, or written by non-consultants, with some specialties slow or unresponsive”. They also highlighted that “consultants may advise referral but cannot convert A&G directly, forcing GPs to re-refer – sometimes only to be rejected again, creating duplication and patient frustration”. Read full story (paywalled) Source: HSJ, 1 May 2026 -
Content ArticlePartnership working between Consultant Specialists and GPs is front and centre to the Government’s commitment to move patient care closer to home. Pre referral advice and guidance supports integrated care and peer to peer learning as well as service improvement. General Practices across the country already support advice and guidance pathways, which are intended to help to ensure patients receive care in the right place at the right time. However, advice and guidance pathways have workload implications for both general practice and secondary care. This document from NHS England gives more information about General Practice Requests for Advice and Guidance (A&G) pathway.
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News Article
Early care scheme could prevent thousands of miscarriages a year
Patient Safety Learning posted a news article in News
After going through two devastating miscarriages, Lisa Varey could not believe what she was thinking. She knew she would have to miscarry again before she could get the help she needed. Only when you have had three miscarriages do you normally qualify for specialist NHS help in England. One in five pregnancies end in miscarriage, most before 14 weeks. After her second miscarriage, Lisa was invited on to a pilot project at Birmingham Women and Children's Hospital, which experts believe will prevent thousands of miscarriages every year by offering earlier checks and advice. As part of the project, women who had suffered one miscarriage were given a one-to-one consultation with a specialist nurse to discuss lifestyle changes - including reducing alcohol consumption and giving up smoking - and using the hormone progesterone, which can help prevent miscarriage. After a second miscarriage, women were tested for anaemia and abnormal thyroid function, which can affect pregnancy outcomes. They were also offered early scans to reassure them the pregnancy was advancing normally. Following a third miscarriage, the pathway joins up with what the NHS currently offers - including a referral to a recurrent miscarriage clinic, further blood tests and a pelvic ultrasound. Tests showed Lisa would benefit from taking the hormone progesterone to help maintain her pregnancy and a regular aspirin tablet to increase the chances of a healthy birth. Lisa is now pregnant and in the last weeks of her second trimester. She breaks down in tears as she speaks about how much difference the project's help has made. "There's so much support for pregnant women, but it didn't always feel like there was any support for women who were no longer pregnant. We're having to go through that journey of just feeling very sad." Professor Arri Coomarasamy, head of miscarriage research at Tommy's, says the three miscarriage wait is an unacceptable anomaly. "We don't do that with any other medical condition. If somebody has a heart attack, we don't say have your third heart attack and then we will see if there is anything we can do," he says. He says the findings of the study, if rolled out across the NHS, could also save the NHS money. The pilot suggests the extra costs of staff and training are outweighed by the money saved having fewer women miscarry. Read full story Source: BBC News, 29 April 2026 -
News Article
NHSE rows back on controversial target
Patient Safety Learning posted a news article in News
NHS England has rowed back on what was widely understood to be a new target for the proportion of patients it wanted “diverted” away from waiting lists, after accusations it was rationing care. The controversy surrounds how NHS England plans to ramp up the “advice and guidance” (A&G) model, which allows GPs to seek pre-referral advice from specialist clinicians, and is designed in part to reduce referrals. NHSE guidance published just last month said it would roll out a new model involving a “single point of access” (SPoA), that would “contribute to a diversion rate of at least 25% by March 2027 for at least 10 high volume specialties” in each area. Diverted patients are those who, after the A&G process, are managed in primary or community care instead of being put on the waiting list for secondary care. The guidance was widely interpreted as a 25% diversion rate target for these cohorts of patients. This sparked concern and vocal opposition among GP leaders and patient groups, and accusations of care rationing. However, in a letter to primary care issued late on Wednesday, NHSE said: “There is no national target for specialists, trusts or general practice to divert a fixed proportion of referrals away from hospital care.” Read full story Source: HSJ, 22 April 2026 -
Content ArticleAdvice and guidance (A&G) enables dialogue between specialists and GPs before a referral is made. The aim is to ensure patients are managed in the right setting and to avoid unnecessary hospital referrals. A&G was first introduced as a formal pathway in 2015, so the concept itself is not new. However, its prominence as a policy lever is. The GP Contract 2026/27 outlines that GPs will be required to use A&G “prior to or in place of a planned care referral where clinically appropriate”. The Neighbourhood Health Framework goes further, stating an aim to achieve a “diversion rate of at least 25 per cent by March 2027 for at least 10 high-volume specialties”. This has not come without debate. Wes Streeting recently published a blog to “set out the facts” following media coverage alleging that A&G targets may lead to rationing of care. Transparency will be critical to evaluate whether increased use of A&G leads to better experiences and outcomes, says William Pett in this HSJ article.
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Content ArticleAdvice and Guidance (A&G) has been used in the NHS for years. It helps GPs get advice from specialists on a patient’s condition to decide the best course of treatment. The Department of Health and Social Care sets out the facts following media reports with a letter from the Health and Social Care Secretary Wes Streeting, published in the Daily Telegraph on 31 March.
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Content ArticleThe General Practice Requests for Advice and Guidance (A&G) is an enhanced service within the NHS that supports general practice teams to seek specialist advice from secondary care before or instead of making a planned care referral. This service is designed to support the Government's commitment to move more care from secondary into community settings. It aims to ensure patients receive care in the right place at the right time via the use of specialist advice and guidance by general practice. Participation is optional but practice that have signed up are eligible to claim payment for pre-referral A&G requests made since 1 April 2025. The Royal College of Practitioners (RCGP) proposes 6 key recommendations for the use of A&G which includes shared clinical risk between primary and secondary care and aims to ensure that advice and guidance continues as one option for clinicians within a referral process and must not be mandated. Further support for collaboration between primary and secondary care is essential to enable the backlog of care exacerbated as a result of the pandemic to be managed and streamline patient care. If work is to be transferred from secondary to primary care, via A&G, then resource (time, money and people) must follow the patient and not stay in secondary care. A&G should be optional and not mandated. Other tools to promote closer working between primary and secondary care aiming to streamline patient care are available and should be considered by providers as alternatives, allowing choice. These include direct telephone calls, emails, teledermatology and commercial apps that are able to connect primary and secondary care. Clinical care governance and risk must be shared between primary and secondary care during A&G conversations, and this must be understood by all clinicians and their patients when A&G is used. When using A&G, all clinicians must uphold the standards of good medical record keeping as per GMC advice, documenting decisions and actions, identifying who has made the decisions and is agreeing with the actions, in the patient clinical record. This should apply to both primary and secondary care and not rely solely on primary care updating the clinical records.
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Content ArticleIncreasing the amount of advice and guidance – where hospital specialists provide advice to GPs so that they can manage the patient without a referral to hospital – is a key part of ambitions to bring down NHS waiting lists. Lucina Rolewicz, Stuti Bagri and Sarah Scobie look at whether the target to increase advice and guidance is likely to be met, and what it might mean for those hopes that it will reduce waiting lists.
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Content ArticleBaby 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.
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Content Article
Reducing the risk of self-harm in inpatient mental health settings
Anonymous posted an article in Suicide and self-harm
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. -
News Article
Mental health sidelined in key waiting list policy
Patient Safety Learning posted a news article in News
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 -
Content ArticleThe 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.
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Content ArticleWhole-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.
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Content Article
The Family Oops and Burns First Aid eBook
Kristina Stiles posted an article in Recommended books and literature
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'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. -
News ArticleNational 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
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News Article
YouTube starts verifying health workers in the UK
Patient Safety Learning posted a news article in News
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 -
Content ArticlePatients 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.
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EventThis 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
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News Article
GPs will not be nationally mandated to use advice and guidance, NHSE confirms
Patient Safety Learning posted a news article in News
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 -
News ArticleThe 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
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News ArticleHundreds 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
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News ArticleNurses 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
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