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Found 36 results
  1. Content Article
    This constructive commentary reflects on two recent related publications, the Healthcare Safety Investigation Branch (HSIB) report, Variations in the delivery of palliative care services to adults, and an article from Sarcoma UK, Family insights from Dermot’s experience of sarcoma care. Drawing from these publications, Richard, brother-in-law of Dermot, gives a family perspective, calling for a more open discussion around how we can improve palliative care and sarcoma services, and why we must listen and act upon family and patient experience and insight.
  2. Content Article
    'Gridlock' of patients in urgent and emergency care is often attributed to a lack of onward capacity for people leaving hospital, leading to delayed discharges that back up the system. But does this explanation often favoured by government and policy makers tell the whole story? The Nuffield Trust's Quality Watch investigates whether the pattern is visible in patient journeys through urgent and emergency care at the integrated care system level.
  3. News Article
    Many vulnerable patients are struggling to access covid treatments after commissioning responsibility switched to integrated care boards this week, charities have warned. Approximately two million vulnerable patients must now contact local services themselves to access treatments designed to combat covid infections, such as the antivirals Paxlovid and Sotrovimab. Integrated care boards are expected to coordinate and fund “equitable” access. Prior to 27 June, identification of patients and the delivery of treatment was coordinated nationally under pandemic arrangements. However, a group of 20 patient charities have written to Steve Barclay warning that most ICBs have not drawn up plans to deliver this new responsibility, leaving patients and primary care clinicians unclear on how to access the treatments. “Despite continually raising our concerns with those carrying out the planning, implementation, and communication of this [policy], we now find that we are in exactly the position we warned against,” they said. Read full story (paywalled) Source: HSJ, 3 July 2023
  4. News Article
    The number of patients unable to get a hospital appointment after being referred by their GP is up more than 50% in two years amid the record NHS backlog, official data show. NHS Digital figures show no appointments were immediately available for 2.3 million referrals made in the first six months of this year – up 51% on the same period in 2020. Appointment slot issues occur when a patient is referred by their GP through the NHS e-Referral Service but no appointment is available to book. The referral is then forwarded or deferred to a patient’s chosen provider, but if an appointment is not made within 180 days it will automatically be removed from the system, according to NHS Digital. Patient safety campaigners have said the scale of the problem must be “urgently investigated” by NHS England to ensure the safety of patients is not being compromised while they wait for appointments. Helen Hughes, the chief executive of the Patient Safety Learning charity, said: “We have significant concerns about the safety of patients who are facing increasingly long waits for treatment, particularly those on high priority cancer pathways and urgent referrals.” She said patients needed to be assured that they will “not be lost in a failing, complex system”, adding: “We believe that NHS England needs to urgently investigate, quantify the scale of the problem and take action if we are to prevent these capacity and system issues resulting in avoidable harm for patients.” Some GPs told Patient Safety Learning they had experienced difficulties getting referrals accepted. One GP, based in the North East, said: “There is an ever-creeping transfer of management of complex conditions from secondary to primary care, without adequate training or resources to manage this safely.” Read full story (paywalled) Source: The Telegraph, 7 August 2022 You may also be interested in Patient Safety Learning's blog: Rejected outpatient referrals are putting patients at risk and increasing workload pressure on GPs
  5. News Article
    A call to NHS 111 was abandoned every 10 seconds between 2020 and 2021, figures show. Millions of callers to the helpline hung up at a time when demand for the NHS was at its highest. In 2020, 2,490,663 calls were abandoned, while in 2021 this figure increased to 3,531,186. And 1,174,159 gave up on the line from January to May this year. Callers in Devon take an average of 11 minutes to get through to the NHS 111 service, according to Liberal Democrat research. Daisy Cooper, Lib Dem spokeswoman for health and social care, said: "Ambulance services are being stretched to breaking point, hospitals are reaching full capacity and now people cannot get through to NHS 111. We have called on this government time and time again to get a grip on this issue by recruiting more NHS 111 call handlers now." "The longer they delay, the longer they are leaving people in pain and distress." Helen Hughes, of the Patient Safety Learning charity, said: "These figures represent a serious safety concern. Each call is a potential missed opportunity for patients to receive timely medical advice that may prevent future harm." "With the ongoing severe pressures faced by ambulance services and hospitals this summer, patients are increasingly being signposted to NHS 111 for advice on non-life threatening conditions." "However, it can only relieve the pressure on other areas of the health service if NHS 111 has the capacity and resources to meet rising demand. The NHS leadership needs to urgently assess the reasons for this high number of abandoned calls." Read full story Source: Express, 31 July 2022
  6. News Article
    Monkeypox is continuing to spread in the UK, with current efforts insufficient to curb the outbreak, experts have warned as a whistleblower claimed there were serious flaws in the support given to those who think they have been exposed. According to the UK Health Security Agency (UKHSA), there have been 1,552 confirmed cases of monkeypox in the UK related to the outbreak as of 7 July. “[There is] no evidence that current strategies are likely to bring this to an end anytime soon,” said Paul Hunter, a professor in medicine at the University of East Anglia, although he noted that while total case numbers were continuing to rise, the rate of new infections may have plateaued. The concerns came as a whistleblower working on a UKHSA monkeypox inquiries line said it had numerous issues, including offering little support for people who are not confirmed contacts of cases – i.e. somebody whose name has been provided to contact tracers by a person with monkeypox. The Guardian has seen scripts that show even if someone calls because they are worried they may have had a contact with a confirmed case, they are told their risk is very low if they have not been formally identified as a contact. The whistleblower said that made little sense when a caller has said a sexual partner has monkeypox symptoms. In addition, the whistleblower said call handlers were not allowed to suggest callers contact a sexual health clinic unless sexual health was brought up by the caller, They added that some clinics had turned off their phone lines. The UKHSA has rejected the claims, saying the phone line is an additional service to provide non-clinical advice to members of the public. Read full story Source: The Guardian, 11 July 2022
  7. News Article
    Hundreds of thousands of older people in England are having to endure chronic pain, anxiety and unmet support needs owing to the worsening shortage of social care staff and care home beds. Age UK has said older people with chronic conditions such as diabetes, high blood pressure and heart failure are increasingly struggling with living in their own homes because of a lack of help with everyday tasks such as getting out of bed, dressing and eating. The decline in the amount of support and care provided to older people is piling pressure on families and carers and leaving the NHS in constant crisis mode, contributing heavily to ambulance queues outside A&E departments, the charity said in a new report It warned that there would be a repeat of the NHS crisis this winter – in which rising numbers of elderly people have been unnecessarily stuck in hospital because of an acute lack of social care – without a shift to preventing unnecessary admissions. Read full story Source: The Guardian, 17 February 2023
  8. News Article
    Two-thirds of GPs feel ‘advice and guidance’ is preventing patients who really need a referral to secondary care from getting one, according to the findings of a snapshot survey of Pulse readers. Advice and guidance (A&G) services, which involve GPs accessing specialist advice before making a referral, have become a major part of NHS England’s plans for clearing the pandemic backlog. But of the 366 GP survey respondents in England who said they had used advice and guidance, 68% said they felt the pathway is blocking necessary referrals. The survey also found that of those 366 GPs who had used A&G services: Around half (49%) said A&G was reducing referrals; More than three-quarters (78%) said it was increasing their workload; Just over half (60%) said it was requiring them to work beyond their competence; Two-thirds (68%) said A&G was resulting in patients complaining because their wish to see a consultant had been diverted. One GP who wished to remain anonymous commented: "An increasing number of referrals are being rejected for secondary care service pressure reasons rather than clinical need. [This] often duplicates GP admin work as we need to re-refer, rewriting the referral and/or enclosing further information or tests results in order to get a referral accepted." Read full story Source: Pulse, 25 January 2023 Further reading on the hub: Rejected outpatient referrals are putting patients at risk and increasing workload pressure on GPs Patient referrals and waiting lists: A ticking time bomb A child left waiting for ‘urgent’ surgery, a blog by Clare Rayner
  9. News Article
    More than two million patients each year have to make four or more repeat visits to their GP before they get a referral, a patient watchdog has warned. Patient safety campaigners said people faced waits of “weeks, months or even years” before officially joining NHS waiting lists, and that their health and wellbeing was suffering as a result. They warned it would also add to pressure on other services such as A&E departments. Research by Healthwatch England revealed what the patient watchdog called a “hidden waiting list”. “People wait for a GP appointment; they wait for their GP to tell them they will be referred; they wait for the hospital to confirm that referral; and then they join a hospital waiting list,” it said. “NHS statistics monitor only the hospital waiting list, leaving the steps between getting a GP referral and a letter confirming a hospital appointment as a dangerous ‘blind spot’ for the NHS and patients.” Read full story (paywalled) Source: The Times, 11 April 2023
  10. News Article
    Patients contacting NHS 111 in England are having to wait so long for medical help that they are abandoning millions of calls, with 3.6m ditched in the past 12 months, official figures reveal. The national helpline service is supposed to make it quicker and easier for patients to get the right advice or treatment they need, either for their physical or mental health. It is billed as being open 24 hours a day, seven days a week. However, analysis by the House of Commons Library, commissioned by the Liberal Democrats, shows callers are waiting so long to speak to someone that nearly one in five give up. In 2022, 3,682,516 calls to NHS 111 were abandoned. MPs said the “dire” figures exposed how the NHS had reached “breaking point” after years of “neglect and underfunding” by the government. The data suggests that, on average, more than 10,000 callers hang up every day without receiving medical advice or treatment. As well as being distressing for those who are unwell, abandoned NHS 111 calls pose a risk to patient safety. The problem also increases pressure on other urgent care services as people seek care elsewhere. Read full story Source: The Guardian, 10 April 2023
  11. Content Article
    A new in-depth report from the Charity Age UK, ‘Fixing the Foundations’, reveals how our under-funded and overstretched NHS and social care system is struggling and sometimes failing to cope with the needs of older people.  The report provides a first-hand account of older people’s difficulties in getting the good, joined up health and social care they need to manage at home, leaving them at risk of crisis which often results in being admitted to hospital. Yet the evidence is clear that with the right care at the right time many of these admissions could have been avoided. The report also includes perspectives from professionals and unpaid carers. It also shows how living with multiple long-term health conditions, as a significant proportion of older people do, including more than two-thirds of those aged over 85, makes it especially hard to navigate health services which are still usually organised around individual illnesses and diseases. Meanwhile social care was often inadequate or absent in these older people’s lives. Age UK estimates that astonishingly, over 1.6 million older people have some level of fundamental care and support need, such as help to get dressed, washed or getting out of bed, that is not being fully addressed.
  12. Content Article
    In this blog Patient Safety Learning considers the impact on patient safety of the shortage of hospital beds facing the NHS this winter. It focuses on two specific issues stemming from this, the increasing numbers of patients being cared for in corridors and other non-clinical areas, and current proposals to reduce the number of patients waiting to be discharged.
  13. Content Article
    Patients are facing increased delays at almost every stage of their NHS treatment, as the health system struggles to find the resources to deal with demand. The latest data shows waiting lists across England have surpassed record highs every month for two years running, one of many major challenges currently facing the NHS. But what impact does this have on ordinary people trying to access the NHS in 2022? Through a combination of interviews with health professionals and analysis of official data, the Guardian has plotted the journeys of four fictional patients through their NHS journey and how waiting times have changed at each stage of their treatment and recovery.
  14. Content Article
    Paul Batalden is the host of "The Power of Coproduction". Prepared as a pediatric physician, he has been an international architect, teacher, and advocate for the improvement of healthcare services for five decades. His current focus is the coproduction of healthcare services.
  15. Content Article
    The Patients Association has been working with NHS England to look at how to improve GP referrals of patients to hospital. The goal was to look at ways specialists could support GPs so they could reduce the number of outpatient appointments patients have to attend, without compromising care. This report includes an overview of the patient panel workshops, key themes and findings from the workshops, and a set of recommendations.
  16. News Article
    The aftercare of COVID-19 patients will have significant financial implications for ‘understaffed’ community services, NHS England has been warned. This month the national commissioner released guidance for the care of patients once they have recovered from an immediate covid infection and been discharged from hospital. It said community health services will need to provide “ongoing health support that rehabilitates [covid patients] both physically and mentally”. The document said this would result in increased demand for home oxygen services, pulmonary rehabilitation, diagnostics and for many therapies such as speech and language, occupational, physio, dieticians and mental health support. One GP heavily involved in community rehab told HSJ: “There is a lot detailed information about what people might experience in recovery, but it doesn’t say what should actually happen. “We have seen people discharged from hospital that don’t know anything about their follow-up and the community [health sector] hasn’t got any instructions of what they should be doing or what services have even reopened. This guidance needs to go a step further and rapidly say what is expected so local commissioners can put that in place.” Read full story Source: HSJ, 10 June 2020
  17. Content Article
    Intrahospital transport is a common occurrence for many hospitalised patients. Critically ill children are an especially vulnerable population who experience preventable adverse events at least once a week, on average. Transporting these patients throughout the hospital introduces additional hazards and increases the risk of adverse events. The transport process can be decomposed into a series of steps, each incurring specific risk. These risks are numerous and few of these risks are specific to the transport process. There is a paucity of literature available on paediatric intrahospital transport and related adverse events. Elliot et al. recently reviewed the Wake Up Safe database, a paediatric anesthesia quality improvement initiative across member institutions to disseminate information on best practices, for paediatric perioperative adverse events associated with anaesthesia-directed transport. The authors present several examples of airway and respiratory events taken from the database and discuss the complexity of the transport process.
  18. Content Article
    Hospitals can significantly elevate patient satisfaction and enhance the delivery of healthcare services by incorporating best practices from adjacent and non-adjacent sectors. Chetan Trivedi explores several solutions, from multiple sectors, that can serve as a blueprint for hospitals across every key step of the patient journey, spanning from admission to discharge.
  19. News Article
    Patients will receive better, more joined-up care under new plans announced to improve the links between health and social care. The integration white paper sets out a vision for an integrated NHS and adult social care sector which will better serve patients and staff. Despite the best efforts of staff, the current system means that too often patients find themselves having to navigate complex and disjointed systems. Those with multiple conditions can be left feeling frustrated at having to repeatedly explain their needs to multiple people in different organisations, while others can end up facing delayed discharge because the NHS and local authorities are working to different priorities in a way that is not as joined up as it could be. The white paper sets out some of the ways health and care systems will draw on the resources and skills across the NHS and local government to better meet the needs of communities, reduce waiting lists and help level up healthcare across the country. Health and Social Care Secretary Sajid Javid said: "Better integration is vital to stop people falling into the gaps between health and social care. Ensuring our health and care systems work in unison will mean we can support hardworking staff, provide better care to patients and deliver value for the taxpayer." "Our Integration white paper is part of our wider plans to reform and recover the health and social care system, ensuring everyone gets the treatment and care they need, when and where they need it." The plans set out in the white paper will ensure care is more personalised and accessible and remove the burdens on patients. Better information sharing will mean people will no longer have to remember key facts such as dates of diagnosis or medicines prescribed, taking pressure off patients to coordinate their own care. Local health services will be tailored to the specific needs of the community to ensure the right services are available. This could mean for example more diabetes clinics in areas with higher obesity, or additional support for people to stop smoking in communities where there are higher numbers of smokers. The integration white paper is the next step in delivering the government’s promise of a health and social care system fit for the future. It builds on both the Health and Social Care Bill and the People at the Heart of Care white paper which set out a 10-year vision for social care funded through the Health and Care Levy, and follows the delivery plan for tackling the COVID-19 backlog of elective care. Dedicated plans to tackle health disparities are set to be published in due course. Read press release Source: Gov.uk, 9 February 2022
  20. News Article
    The government has been warned that changes to covid-related infection prevention and control guidance will not enable a ‘rapid’ increase in the NHS’ capacity to tackle the elective care backlog and could pose significant ‘risks’. Trust leaders have been told they no longer have to segregate patients into separate pathways according to “high”, “medium”, or “low” risk of covid-19 in updated IPC guidance issued by the Department of Health and Social Care, NHS England and UK Health Security Agency. Following this guidance means the treatment of every patient without symptoms of a respiratory illness will be subject to the same precautions – such as one, rather than two, metre physical distancing. This, in theory, could create more capacity to treat larger numbers of patients. A subsequent letter from NHS England highlighting the changes said: ”This guidance supports efficient delivery of NHS services to meet wider patient needs, via the return to pre-COVID-19 social distancing and standard IPC measures for patients who do not have infectious respiratory diseases.” However, NHS Providers chief executive Chris Hopson told HSJ that many trusts are currently losing between 10 and 20% of their capacity due to “essential” IPC measures, and would not be able to abandon this approach quickly. He said: “There is a conception in some people in central government’s minds that by having got this guidance changed, we are now going to see a rapid recovery of activity levels and we’ll be able to more successfully manage the infection risk. That’s what people need to be realistic about – there is a risk here." Read full story Source: HSJ, 29 November 2021
  21. Event
    Unsafe medication practices and medication errors are a leading cause of injury and avoidable harm in health care systems across the world. WHO Patient Safety Flagship has initiated a series of monthly webinars on the topic of “WHO Global Patient Safety Challenge: Medication Without Harm”,. The main objective of the webinar series is support implementation of this WHO Global Patient Safety Challenge: Medication Without Harm at the country level. Considering the huge burden of medication-related harm, Medication Safety has also been selected as the theme for World Patient Safety Day 2022. With each transition of care (as patients move between health providers and settings), patients are vulnerable to changes, including changes in their healthcare team, health status, and medications. Discrepancies and miscommunication are common and lead to serious medication errors, especially during hospital admission and discharge. Countries and organizations need to optimise patient safety as patients navigate the healthcare system by setting long-term leadership commitment, defining goals to improve medication safety at transition points of care, developing a strategic plan with short- and long-term objectives, and establishing structures to ensure goals are achieved. At this webinar, you will be introduced to the WHO technical report on “Medication Safety in Transitions of Care,” including the key strategies for improving medication safety during transitions of care. Register
  22. Event
    From the perspective of a service user, interactions with health and social care are often exceedingly difficult to navigate. The NHS’s traditional to approach to managing patient pathways has involved letters, appointments at set times, and stress for an individual needing to communicate that a planned consultation is no longer needed – or is needed more urgently. Knowing which service to access, and how to do so swiftly, can be particularly challenging. All this is inefficient and can lead to poor patient experience. As the service seeks to manage the backlog of care, and to meet the continuing demands of an unpredictable pandemic, that becomes particularly problematic. So how might healthcare organisations help move from patients who are passive participants in pathways to active partners, able to regularly communicate as their needs change? How might self-referrals and patient initiated follow up processes be more widely rolled out? What unpinning technology would be needed to make such a shift? This HSJ webinar, run in association with Salesforce, will bring together a small panel to discuss these issues. Register
  23. Content Article
    Lisa Drake, an NHS ex General Practice Manager now working in a digital advisory role, shares some of the missed opportunities for digital ways of working she witnessed when she was a patient herself.
  24. Event
    Over the last twenty years in particular, the NHS has been focusing on how to create better care pathways that improve patient outcomes. Improving care pathways has a positive impact on clinical outcomes, cost reduction, patient satisfaction, teamwork and process outcomes, but COVID-19 has created a significant disconnect in these pathways meaning patients are either not entering them or not flowing through them as smoothly as they need to. The administrative elements of managing patients through pathways are significant and, at a time when the NHS is experiencing workforce shortages, routinely take staff away from caring for and reassuring patients. At this King's Fund event, decision points within pathways will be explored and how digital technology can transform how pathways operate, enabling clinicians to better understand where each patient is on the pathway, what they are waiting for and what needs to happen next. Learn how to improve pathway ‘hand-offs’ and administration, to free up time for staff to care for patients in a more personalised way. The event will include examples of how industry and the NHS can come together to build smarter pathways, using technology to augment the expertise of caregivers. Register for free
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