Jump to content

Search the hub

Showing results for tags 'Follow up'.

More search options

  • Search By Tags

    Start to type the tag you want to use, then select from the list.

  • Search By Author

Content Type


Forums

  • All
    • Commissioning, service provision and innovation in health and care
    • Coronavirus (COVID-19)
    • Culture
    • Digital health and care service provision
    • Improving patient safety
    • Investigations, risk management and legal issues
    • Leadership for patient safety
    • Organisations linked to patient safety (UK and beyond)
    • Patient engagement
    • Patient safety in health and care
    • Patient Safety Learning
    • Professionalising patient safety
    • Research, data and insight
    • Miscellaneous

Categories

  • Commissioning, service provision and innovation in health and care
    • Commissioning and funding patient safety
    • Health records and plans
    • Innovation programmes in health and care
    • Climate change/sustainability
  • Coronavirus (COVID-19)
    • Blogs
    • Data, research and statistics
    • Frontline insights during the pandemic
    • Good practice and useful resources
    • Guidance
    • Mental health
    • Exit strategies
    • Patient recovery
    • Questions around Government governance
  • Culture
    • Bullying and fear
    • Good practice
    • Occupational health and safety
    • Safety culture programmes
    • Second victim
    • Speak Up Guardians
    • Staff safety
    • Whistle blowing
  • Digital health and care service provision
    • Artificial Intelligence
    • Apps for health and care
    • Teleservices
    • Other health and care software
    • Digital health regulatory bodies/standards/guidance
  • Improving patient safety
    • Clinical governance and audits
    • Design for safety
    • Disasters averted/near misses
    • Equipment and facilities
    • Error traps
    • Health inequalities
    • Human factors (improving human performance in care delivery)
    • Improving systems of care
    • Implementation of improvements
    • International development and humanitarian
    • Patient Safety Alerts
    • Safety stories
    • Stories from the front line
    • Transformative Simulation
    • Workforce and resources
  • Investigations, risk management and legal issues
    • Investigations and complaints
    • Risk management and legal issues
  • Leadership for patient safety
    • Business case for patient safety
    • Boards
    • Clinical leadership
    • Exec teams
    • Inquiries
    • International reports
    • National/Governmental
    • Patient Safety Commissioner
    • Quality and safety reports
    • Techniques
    • Other
  • Organisations linked to patient safety (UK and beyond)
    • Government and ALB direction and guidance
    • International patient safety
    • Regulators and their regulations
  • Patient engagement
    • Consent and privacy
    • Harmed care patient pathways/post-incident pathways
    • How to engage for patient safety
    • Keeping patients safe
    • Patient-centred care
    • Patient Safety Partners
    • Patient stories
  • Patient safety in health and care
    • Care settings
    • Conditions
    • Diagnosis
    • High risk areas
    • Learning disabilities
    • Medication
    • Mental health
    • Men's health
    • Patient management
    • Social care
    • Transitions of care
    • Women's health
  • Patient Safety Learning
    • Patient Safety Learning documents
    • Patient Safety Standards
    • 2-minute Tuesdays
    • Patient Safety Learning Annual Conference 2019
    • Patient Safety Learning Annual Conference 2018
    • Patient Safety Learning Awards 2019
    • Patient Safety Learning Interviews
    • Patient Safety Learning webinars
  • Professionalising patient safety
    • Accreditation for patient safety
    • Competency framework
    • Medical students
    • Patient safety standards
    • Training & education
  • Research, data and insight
  • Miscellaneous

News

  • News

Find results in...

Find results that contain...


Date Created

  • Start
    End

Last updated

  • Start
    End

Filter by number of...

Joined

  • Start

    End

Group

First name

Last name

Country

About me

Organisation

Role

Found 65 results
  1. Content Article
    More information about "Ensuring patients feel informed, listened to and supported long after the headlines disappear"
    John Bradley Williamson was a spinal surgeon whose work later became the subject of investigations and reviews following concerns raised by former patients regarding surgical outcomes and complications. Many of his patients experienced long-term health problems, additional corrective surgeries, chronic pain, and lasting physical and psychological harm. The case has since received national media attention and prompted wider discussions around patient safety, oversight, follow-up care and how concerns are communicated to patients. Simon Wainwright, a former patient affected by the spinal surgery carried out by John Bradley Williamson, has lived with the long-term complications that have required multiple corrective operations across several hospitals. Simon reflects on the gap between the recommendations made in investigation reports and the realities patients face, and how patients like himself are often left to navigate the long-lasting complications largely on their own.  Over the years, there have been formal reviews and reports into what happened to patients operated on by consultant spinal surgeon John Bradley Williamson, and many recommendations made.[1][2][3] Although these processes are important, there remains a gap between the recommendations written in these reports and the reality patients continue to experience years later. Although there are processes described on paper that sound reassuring, many patients still feel they are left to navigate ongoing complications, uncertainty and fragmented care largely on their own. One example of this is the concept of a “patient-initiated review.” A patient-initiated review essentially means that patients themselves are expected to come forward if they have concerns about the care or surgery they received. In theory, this sounds positive—giving patients the opportunity to come forward if they have concerns, ask questions or seek reassessment. However, in practice, it raises an important question: how will patients even know this option exists? Many patients are not routinely followed up long-term, may have moved areas or may not realise that the symptoms they are living with could be connected to a previous surgery. By relying on patients to initiate this themselves, without proactive communication and outreach, there is a real risk that affected patients remain unaware that support or review pathways are available to them at all. There is often an assumption that primary care services will help identify and support these patients, but the reality is more complicated. GPs may not have access to a patient’s complete historical surgical information, particularly when treatment occurred many years ago or across multiple hospitals. This means some patients can easily fall through gaps in the system unless there is a coordinated and proactive approach. For patients like me, the impact is not limited to a single procedure. It is ongoing—affecting physical health, independence, mental wellbeing, family life, the ability to work and live normally, and confidence in the healthcare system itself. In my own experience, the consequences did not end after the original surgery. I have required multiple corrective operations across different hospitals and continue to live with the long-term physical and emotional effects. What has been difficult at times is feeling that patients are expected to coordinate much of this themselves; patients are often left chasing information rather than being actively supported through the process. I would like to see genuine commitment to patient safety and learning, with communication clear, proactive and accessible. Patients should not have to discover reviews through the media, search online for information themselves, or rely on chance conversations to understand what support may be available to them. Affected patients should be directly contacted wherever possible, given clear information in accessible language, and offered appropriate long-term clinical and psychological support. This is not just about past events – it is about ensuring that patients are not left behind in the process of reviewing and learning from them. Real accountability is not just about producing reports. It is about ensuring patients feel informed, listened to and supported long after the headlines disappear. References tps://www.northerncarealliance.nhs.uk/about-us/nca-independent-report-previous-management-concerns-regarding-consultant-spinal-surgeon?q=%2Fabout-us%2Fnca-independent-report-previous-management-concerns-regarding-consultant-spinal-surgeon https://www.northerncarealliance.nhs.uk/application/files/5516/8985/5202/SPSLBR_Report_Final_060623_redacted.pdf Spinal-diagnostic-Final-report.pdf
  2. News Article
    Women experiencing miscarriage are facing additional trauma and distress due to a significant lack of adequate follow-up care, a new report has revealed. One patient described her experience as "dehumanising", while others reported feeling dismissed and traumatised by the current system. Research by the Miscarriage Association, which underpins the report, found that nearly two-thirds of women felt their follow-up care was insufficient. Furthermore, more than four in 10 of those who sought mental health support after losing their baby did not receive it. The new report urges immediate action to make comprehensive follow-up care a routine part of miscarriage management. Some 65% of women in the study said they did not have adequate follow-up care, while 42% said they did not receive treatment for mental health symptoms following their miscarriage. Many women felt they were sent home with little or no guidance, or with conflicting advice, according to the Miscarriage Association. Some reported insensitive wording from healthcare professionals, with one woman claiming she was told her baby “had been put in the incinerator with the rest of the medical waste” whilst recovering from a ruptured ectopic pregnancy. Read full story Source: The Independent, 9 March 2026
  3. Content Article
    An estimated one in four pregnancies in the UK ends in loss. Yet many women and their partners still face gaps in care, understanding and recognition at one of the most vulnerable moments in their lives. To better understand these experiences, the Miscarriage Association carried out a national survey exploring the experience of miscarriage across healthcare settings, workplaces and personal relationships. More than 1,000 people affected by pre-24-week pregnancy loss shared their experiences, providing a detailed picture of how miscarriage is currently experienced across the UK. Their responses highlight important gaps in care, support and awareness — and the changes needed to ensure no one faces pregnancy loss without the compassion and support they deserve. Experiences of miscarriage care varied significantly across the UK. While some respondents described compassionate and supportive healthcare professionals, many reported gaps in information, follow-up care and access to appropriate services. Common themes included: Lack of clear information about miscarriage and treatment options. Inconsistent access to scans, investigations and Early Pregnancy Units (EPUs). Miscommunication or conflicting advice. Little or no follow-up care after pregnancy loss. For many respondents, the absence of follow-up support left them feeling isolated and uncertain about both their physical recovery and emotional wellbeing.
  4. Content Article
    The NHS in England has introduced various innovations to keep up with the growing demand for elective care, one of which is patient-initiated follow-up (PIFU). This evaluation sought to understand staff experiences of implementing PIFU. The authors of this study conducted a rapid qualitative service evaluation between June 2022 and July 2023, based on semi-structured interviews with operational/managerial and clinical NHS staff from five English NHS Trusts, and an online workshop with 21 additional members of staff from the English NHS. The study found that implementation of PIFU affected staff roles, workload, and job satisfaction. Levels of PIFU uptake, and experience with similar models, affected the extent to which participants experienced the impact of PIFU. How PIFU was implemented varied. Some staff saw changes in their role because of new administrative demands, safety-netting procedures (such as proactive measures by specialty teams to mitigate the risk of patients not initiating appointments when necessary), and selection of suitable patients. PIFU was felt by some staff to increase, and by others to decrease, workload. PIFU affected intensity of work, interrelated with other factors such as the size of waiting lists, and conditions experienced by patients. Whether staff were satisfied with PIFU related to its impact on their role and workload. Satisfaction was also affected by whether staff believed PIFU delivered benefits for patients, and by the aims they felt were driving rollout.
  5. News Article
    A troubled NHS trust has apologised to the family of a man who died after a series of potentially fatal delays to treat a tumour, in a case that is being investigated by police as possible corporate manslaughter. Richard Harris, 71, died last July after a series of errors in the neurosurgery department at the Royal Sussex County hospital in Brighton, which is part of University Hospitals Sussex NHS foundation trust (UHSussex). The trust admitted that Harris was “lost to follow-up” when the hospital repeatedly failed to monitor a tumour in his nervous system, or operate on it, as doctors recommended. An internal review of Harris’s care found that doctors failed to arrange a routine MRI scan for him when he was first urgently referred to neurosurgery in 2017. Harris, who was fit and a regular swimmer, only received a scan when he contacted the department again in 2019. The scan picked up a benign schwannoma tumour, which a multidisciplinary team concluded would require regular monitoring, every six months. They also said “surgical intervention should be advised”, the review found. But no surgery was arranged. And the required follow-up scans were postponed and cancelled at a time when internal whistleblowers expressed alarm about high cancellation rates, and repeated and allegedly dangerous failures to follow up patients under the trust’s care. Eventually Harris was referred to neurosurgery early last year suffering with acute pain. He had to wait weeks to be seen, despite repeatedly pleading with his consultant in emails complaining of “red-hot poker pain” that was “scaring me to death”. There were yet further delays in arranging MRI scans, the review found. Months later, the tumour was assessed to be cancerous and inoperable. Harris was discharged to hospice care and died a few weeks later. Sussex police have confirmed to Harris’s family that his death is being investigated as possible corporate manslaughter, as part of its expanding Operation Bramber investigation. Read full story Source: The Guardian, 1 April 2025
  6. Content Article
    The extent to which postintensive care unit (ICU) clinics may improve patient safety for those discharged after receiving intensive care remains unclear. This observational cohort study from Karlick et al., conducted at an academic, tertiary care medical centre, used qualitative survey data analysed via conventional content analysis to describe patient safety threats encountered in the post-ICU clinic. For 83 included patients, safety threats were identified for 60 patients resulting in 96 separate safety threats. These were categorised into 7 themes: medication errors (27%); inadequate medical follow-up (25%); inadequate patient support (16%); high-risk behaviours (5%); medical complications (5%); equipment/supplies failures (4%); and other (18%). Of the 96 safety threats, 41% were preventable, 27% ameliorable, and 32% were neither preventable nor ameliorable. Nearly 3 out of 4 patients within a post-ICU clinic had an identifiable safety threat. Medication errors and delayed medical follow-up were the most common safety threats identified; most were either preventable or ameliorable.
  7. Content Article
    Patient-initiated follow up (PIFU) is an appointment process that helps hospitals manage capacity and puts patients in control of making appointments, when they need them. In traditional care models, patients who have had treatment or surgery, or suffer with chronic conditions are provided with a set care plan and offered scheduled follow-up appointments either conducted in person, or remotely. PIFU offers an alternative way of organising planned follow-up care for patients following their elective procedures, rather than automatically being scheduled for appointments. This aims to give greater control to patients over the timing of their follow-up appointment based on their health status needs, helping patients save time, money and the inconvenience of travelling to pre-arranged appointments they may not need.
  8. Content Article
    New research from Healthwatch reveals worrying problems with hospital discharge arrangements. Many people told us they are not given the right support or information when being discharged from hospital. Read on about their experiences and Health Watch's calls to action. Key findings Over half, 59%, of people said the hospital discharge team didn't ask if they needed support in getting transport to the place they were discharged to, contrary to government guidance People discharged either in the early hours, before 9 am, or late, after 6 pm, were significantly less likely to be asked if they needed transport. Over half, 51%, of people weren’t given contact information for further help or advice when leaving the hospital, contrary to government guidance Nearly a third, 32%, felt unprepared at discharge. Carers were more likely than patients to say they didn't feel prepared at discharge (44% of carers, 25% of patients). Over one in ten, 11%, had to wait over 12 hours after being told they were well enough to leave the hospital. Over one in five, 24% reported an excellent hospital discharge experience, with 37% reporting either a mixed or neutral. Healthwatch are calling for: The Government to update its hospital discharge and community support guidance. It must include new minimum standards on transport waiting times and post-discharge contact times. Integrated Care Boards (ICBs) to be consistent in implementing the latest hospital discharge guidance, including: Supporting people to make informed choices by providing contact information and advice and asking about transport home; Better signposting to support services, including voluntary organisations and services that support unpaid carers; Dedicated staff who will make travel arrangements; Points of contact for people to use if their condition gets worse; Greater involvement of family and carers in decisions about people discharge. Urgent government reform of the social care system to ensure councils and providers have the staff, skills, and resources to support people to live independently, including reablement support at home or in residential care following discharge from the hospital. ICBs to focus on workforce solutions in secondary care, including a review of staff retention policies and the development of plans to increase the capacity of administrative staff in local NHS trusts. Admin staff should act as points of contact for those coming into and leaving the hospital and support the work of 'transfer of care' hubs NHS Digital to capture and report data on deterioration in health at seven and 30 days after discharge, to understand where discharge processes are not always working for patients. This includes collecting data on emergency readmissions, death after discharge, and contact with another health service about the same condition.
  9. Content Article
    Patient initiated follow up and remote clinical reviews show promise in alleviating capacity issues and ensuring timely care, with positive patient feedback and early intervention benefits Media interest regularly reports on the three headline performance measures of the NHS; 18-week target, cancer wait targets, and four hour waits in emergency departments. There is, however, another large group of patients that we do not have any targets for and receive no media attention, who Peter Towers, NHS service manager, has termed the “fourth group”. These are the patients who have started their treatment but cannot be discharged back to primary care as they require continued secondary outpatient care.
  10. Content Article
    Incident investigation remains a cornerstone of patient safety management and improvement, with recommendations meant to drive action and improvement. However, there is little empirical evidence about how—in real-world hospital settings—recommendations are generated or judged for effectiveness. This scoping review from Lea et al. looks at what approaches to incident investigation are used before the generation of recommendations, what are the processes for generating recommendations after a patient safety incident investigation, what are the number and types of recommendations proposed and what criteria are used, by hospitals or study authors, to assess the quality or strength of recommendations made. The authors concluded that despite the ubiquity of incident investigation, there is a surprising lack of evidence concerning how recommendation generation is or should be undertaken. Little evidence is presented to show that investigations or recommendations result in improved care quality or safety. They suggest that although incident investigations remain foundational to patient safety, more enquiry is needed about how this important work is actually achieved and whether it can contribute to improving quality of care.
  11. News Article
    Patients are being left feeling “confused and neglected” by not being told who to contact about their future care when they are discharged from hospital, an NHS watchdog has said. Research by Healthwatch England has found that 51% of people are not being given details when they leave of which services they can turn to for help and advice while they are recovering. The NHS was risking patients having to be readmitted as medical emergencies and hospital beds becoming even more scarce by failing to adhere to its own guidelines on discharge, it said. “While our findings show some positive examples, it’s alarming that guidance on safe discharge from the hospital is routinely not being followed,” said Louise Ansari, the patient champion’s chief executive. Healthwatch asked 583 people and their carers how their discharge had gone. Read full story Source: The Guardian, 19 November 2023
  12. News Article
    Three patients have died after being given a bowel test by a doctor who failed to ensure treatment needed was carried out, a health board has said. NHS Greater Glasgow and Clyde (NHSGGC) said three more patients suffered harm. The six patients were identified in a clinical review the health board carried out of 2,700 people the consultant carried out a colonoscopy on between 2020 and 2022. The consultant, who has not been named, was suspended in November 2022 and has since left the health board. NHSGGC deputy medical director Professor Colin McKay said: “We would like to offer our sincere apologies to patients who were not followed up appropriately and our condolences to the families of those patients who have died." “Our investigations found that the doctor did not consistently follow up the results of investigations that had been completed or requested and therefore missed the opportunity for patients to be treated, including a number of patients who went on to develop malignancy." Read full story Source: The Independent, 11 October 2023
  13. News Article
    NHS England plans to reduce follow-up appointments is leading to patient safety risks and causing waiting lists to grow, an acute trust has warned. The NHSE plans were set out in the 2023-24 planning guidance which says trusts must cut outpatient follow-ups by 25% against 2019-20 levels by March, to increase capacity for new patients. But North Cumbria Integrated Care Foundation Trust has raised concerns that adhering to the policy will “exacerbate” its follow-up backlogs, warning that the delays “potentially… pose a risk of harm to patients whose condition may deteriorate when follow-up is late”. NHS Confederation told HSJ it thought the policy “has risks” because it could mean that patients needing follow-ups will wait for longer, although the organisation also saw benefits. It said hospital leaders had “mixed feelings” about the policy. The Patients Association also raised concerns that cancelling follow-ups for some patients “will exacerbate health inequalities”. Read full story (paywalled) Source: HSJ, 12 October 2023
  14. Content Article
    This Healthcare Safety Investigation Branch (HSIB) investigation focuses on the systems used by healthcare providers to book patient appointments for clinical investigations, such as diagnostic tests and scans. ‘Clinical investigation booking systems’ are used throughout the NHS to support the delivery of patient care. Healthcare services use paper-based or fully electronic systems, or a combination of the two (hybrid systems), to communicate to patients the time, date and location of their appointment. These systems also produce information for patients about actions they need to take to prepare for their appointment. Written patient communication is a key output of clinical investigation booking systems. This investigation examines the safety implications of patient communications, produced by booking systems, that do not account for the needs of the patient. In addition, it looks at why patients are ‘lost to follow-up’ after an appointment is cancelled, rescheduled or not attended. Lost to follow-up is the term used to describe a patient who does not return for planned appointments (whether for continued care or evaluations) or is no longer being tracked in the healthcare system when they should be. The reference event for this investigation was a child of Romanian ethnicity who was referred for an MRI scan, which required a general anaesthetic. The scan was booked, and a letter was sent to the child’s parents including the appointment details and pre-appointment instructions. The Trust’s booking system was only able to produce appointment letters in English, and there were no Trust processes or policies to routinely translate written appointment information. The family recognised key details in the written information, including the time, date and location of the scan. However, they were not able to understand the instructions about the child not eating or drinking (fasting) for a certain amount of time before the scan. When the family attended the appointment for the scan, the child had eaten. This meant the MRI scan could not be completed and it was therefore cancelled. When the scan was finally carried out cancer was diagnosed. The child received treatment, but sadly the disease progressed and they were placed on a palliative care pathway and died. Findings Written communications to patients about radiology appointments are routinely sent in English only. Healthcare staff expect that written appointment information will be translated by a patient’s friend or family member. NHS England standards do not require written appointment information to begiven in any non-English language, other than for people with a disability. Confusion about the requirements for appointments can result in delayed care and additional costs if appointments need to be rebooked. The language needs of patients are not always clearly understood. There is differing national guidance as to whether written communication needs should be recorded. The national NHS system that holds patient information and populates it into many trust systems (the Personal Demographics Service) can store information on patients’ preferred written communication methods. However, this information is often not entered into the system. Administrative staff are not routinely involved in assessing and testing electronic booking systems before they are implemented. Recommendations HSIB recommends that NHS England develops and implements a standard for healthcare providers on supplying written appointment information in languages other than English. Safety observations It may be beneficial for NHS care providers to explore options for the translation of written appointment communications, including pre-attendance guidance, for patients whose preferred written language is not English. Safety actions It may be beneficial if the ‘preferred written communication method’ field of the Personal Demographics Service system is completed for patients who require written communications in a language other than English. It may be beneficial if NHS trusts identify mechanisms to appreciate the language needs of their patient demographic and adjust the written communications accordingly. It may be beneficial to clarify the roles and functions of national organisations in supporting the health inequalities landscape. It may be beneficial for NHS healthcare providers to incorporate the NHS Service Standard into agreements with third-party developers of electronic clinical investigation booking systems.
  15. News Article
    NHS England is looking to ditch a key elective target that aimed to deliver large reductions in follow-up appointments, HSJ has learned. Senior sources privately admit progress has not been made against the target to cut the volume of the most common type of outpatient follow-up by 25 per cent target. This is supported by publicly available data. While this only gives a partial picture, the data suggests the volumes have actually increased compared to pre-covid levels. The volume-based target is widely viewed as unrealistic and senior figures told HSJ it had also “masked” some genuine progress trusts have made in reforming outpatient services and reducing less productive appointments. Sources familiar with discussions said having a volume-based target to reduce a subset of patients while trying to increase overall activity volumes had been logistically complex. NHSE is instead pushing for a new “ratio-based” target which sources said would be a better measure to reduce the least productive types of outpatient follow-ups and be a fairer measure of progress. Read full story (paywalled) Source: HSJ, 26 February 2024
  16. News Article
    A prostate cancer patient went a year without a check-up because his referral to a consultant was lost. An inquest into the death of Thomas Ithell also heard that when the error was spotted it was not recorded because staff at Wrexham Maelor Hospital were too busy. The 77-year-old from Wrexham died in November 2022 after being admitted to hospital with shortness of breath. Assistant Coroner for North Wales East and Central, Kate Robertson, has submitted a Prevention of Future Deaths report to the health board in relation to Mr Ithell's case. As well as concerns over the lack of an investigation, she also questioned how the patient's follow-up appointment was missed. "There have been no assurances as to what, if any, changes and learning have been identified other than a tracking system for PSA monitoring," she wrote, referring to a type of blood test that helps diagnose prostate cancer. She was also concerned to learn that the hospital's Datix system - used for reporting incidents such as Mr Ithell's - had been described as "not user-friendly". Time constraints also sometimes prevented staff from completing these reports, thereby failing to trigger subsequent investigations by the board, the assistant coroner added. "I remain incredibly concerned that where matters are not raised in accordance with internal health board processes that assurances given to me in previous Prevention of Future Deaths reports cannot be supported," Ms Robertson added. Read full story Source: BBC News, 27 January 2024
  17. News Article
    Campaigners have said that more lives would be lost unless mental health services were reformed. Figures show 120 people each year are killed by people with mental illnesses. Julian Hendy, whose father was killed by a psychotic man with a long history of mental ill health 17 years ago, said health professionals must be “more assertive” and work better with other agencies such as the police. Valdo Calocane, who was sentenced on Thursday to an indefinite hospital order after being convicted of manslaughter of three people in Nottingham, had fallen off the radar of mental health services, which allowed him to avoid taking his medicine. Hendy accused Nottinghamshire Healthcare NHS Foundation Trust, which was responsible for Calocane’s care, of “washing their hands” of him. He said: “It’s not responsible and it’s not safe. It doesn’t look after people properly … That hasn’t helped him at all, or protected his rights at all, because he has now committed this terrible offence.” Read full story (paywalled) Source: The Times, 26 January 2024
  18. News Article
    NHS England’s drive to encourage patient-initiated appointments is only having a marginal impact on reducing overall outpatient follow-ups, a major study suggests. NHS England currently has a target to have 5% of outpatients on patient-initiated follow-up pathways, and hopes this can be increased substantially in future years. The headline finding in a study by the Nuffield Trust think tank, which analysed almost 60 million cases, was that for every 5% on PIFU pathways, this roughly corresponded to 2% fewer outpatient follow-up attendances overall. It suggests PIFU implementation would need to be dramatically expanded to get anywhere close to a 25% reduction in total follow-up activity, which NHSE had previously targeted by March 2023. As previously reported, there has been little to no reduction so far. Chris Sherlaw-Johnson, senior fellow at the Nuffield Trust, said: “As few patients are currently on PIFU pathways at present, it’s not going to have that noticeable impact on the overall number of follow ups.” He also stressed it was not clear whether the reduction was caused by the genuine elimination of unnecessary follow-ups or if patients were not returning for care despite needing it. Read full story (paywalled) Source: HSJ, 25 January 2024
  19. News Article
    A trust is reviewing more than 100,000 patients on its outpatient lists, after concerns emerged that some had ‘been lost whilst on hold’ for follow-up appointments. A report from Buckinghamshire Healthcare Trust, leaked to HSJ, found 116,575 patient records without a scheduled follow-up after an outpatient consultation, with more than half of those left inappropriately without action, some dating back a decade. The review was triggered after staff spotted cases in which patients had been “lost whilst on hold”, the report said. The trust this week told HSJ that, since the initial discovery in the summer of last year, it had been validating the lists and reduced the number of outstanding records to 47,778. It aims to complete the reviews in the next two months. It told HSJ it had undertaken a harm review and found no “systemic harm”. Concerns have been raised over several years about the extent of overdue and unreviewed patients on follow-up lists, and the potential for them to deteriorate and come to harm. There are no national figures monitoring the patients, many of whom have long-term health needs. Read full story (paywalled) Source: HSJ, 15 December 2023
  20. News Article
    Campaigners have written to the chief constables of Norfolk and Suffolk to request an investigation into thousands of mental health deaths in those areas. They say coroners are raising safety issues but no improvements are being made. A report by independent auditors found as many as 8,440 patients had died unexpectedly over three years. Norfolk and Suffolk NHS Foundation Trust said it had started a review of patient deaths. Coroners worried about the risk of future deaths highlight unsafe practices in prevention of future deaths reports (PFDs). And authorities are required by law to respond with an action plan within 56 days. The Norfolk and Suffolk trust said it had responded to all PFDs and was working to ensure recommendations and actions were implemented. But Mark Harrison, from the Campaign to Save Mental Health Services in Norfolk and Suffolk, said: "There's a criminal case to answer. And we want the police to investigate, where the same mistakes have been repeated time and time again." He said coroners were repeatedly warning of risks such as delays to treatment, lack of patient follow-ups, chaotic record keeping and disorganised communication between teams. Mr Harrison said: "The mental health trust always responds saying they've learned lessons, they are changing policy and practices. "But then what we're seeing in analysing the orders from the coroner are repeat circumstances where other people have died in similar circumstances to a previous prevention-of-future-deaths notice." Read full story Source: BBC News, 12 December 2023
  21. News Article
    Trusts are being encouraged to adopt a system in which patients initiate follow up appointments by the lastest guidance from NHS England designed to help the NHS recover from the covid crisis. It is hoped the approach can reduce unnecessary demand and therefore help trusts cut waiting lists that have soared as a result of the restrictions placed on hospital activity during the pandemic. Under 'patient initiated follow up' (PIFU) patients decide when they require follow up appointments. They are given guidance as to what symptoms and other factors they should take into account when deciding if a follow up appointment is necessary. PIFU is already used by some trusts, but it has not yet become widely adopted. The plan to increase PIFUs was set out in a guidance published today designed to underpin the “phase three letter” sent out to NHS leaders last week. The guidance, Implementing phase 3 of the NHS response to COVID-19 pandemic , says “individual services should develop their own guidance, criteria and protocols on when to use PIFUs”. The document also sets out some overarching principles. It says services will be rated against the following headline metrics: “total number and proportion of patients on the PIFU pathway; patient outcomes, e.g. recovery rates, relapse rates; waiting times; and DNA rates”. Read full story (paywalled) Source: HSJ, 7 August 2020
  22. 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
  23. Content Article
    Missed or failure to follow up on test results threatens patient safety. This qualitative study from Dahm et al. used volunteers to explore consumer perspectives related to test result management. Participants identified several challenges that patients experience with test-results management, including systems-level factors related to the emergency department and patient-level factors impacting understanding of test results.
  24. Content Article
    The Healthcare Safety Investigation Branch (HSIB) have identified a safety risk involving outpatient follow-up appointments which are intended but not booked after an inpatient stay. If a patient does not receive their intended follow-up appointment, it could lead to patient harm owing to delayed or absent clinical care and treatment. The investigation was launched after HSIB identified an event where a patient was discharged from hospital on two separate occasions with a plan to follow-up in outpatient clinics. Neither of the outpatient appointments were made. HSIB recommendations HSIB recommends that NHS England and NHS Improvement develops standards and an operating framework that describes the assurance required for all outpatient appointment booking processes, including after an inpatient stay. The assurance should include feedback mechanisms which provide safeguards that intended outpatient appointments are booked. Ideally, solutions will use technology and automation to create resilience and efficiency so that there is less reliance on staff vigilance. HSIB recommends that NHSX’s What Good Looks Like programme includes a requirement for organisations to be responsive to HSIB reports and recommendations within the ‘Safe Practice’ section of its guidance.
  25. News Article
    Nearly 35,000 patients are overdue a follow-up appointment at North Lincolnshire and Goole Foundation Trust, HSJ has learned. Almost 20% of the 34,938 follow-up appointments are in ophthalmology. A paper from the trust’s November board meeting said the “backlog of follow-up appointments… clearly remains a risk”. The report also said the service was failing some of the quality guidelines set out by the National Institute for Health and Care Excellence (NICE). The trust told HSJ it had introduced a clinical harm review process last year to address the backlog. It has reviewed “more than 5,000 patients”, out of the 34,938 cases to date, according to Chief Operating Officer Shaun Stacey. He said the trust had initially identified 83 patients who could have come to “potential harm”. Read full story Source: HSJ, 28 January 2020

© 2026 Patient Safety Learning. All rights reserved.

Patient Safety Learning is registered as a charity with the Charity Commission Registration number 1180689.

×
  • Create New...

Important Information

We have placed cookies on your device to help make this website better. You can adjust your cookie settings, otherwise we'll assume you're okay to continue.