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Found 146 results
  1. News Article
    More than 100 families looking after severely disabled adults and children outside hospital, have told the BBC that the NHS is failing to provide enough vital support. The NHS says help is based on individual needs and guidelines ensure consistency across England and Wales. However, some families describe the system as adversarial. Only those living outside hospital with life-limiting conditions, or at risk of severe harm if they don't have significant support, get this help from the NHS. It is provided through a scheme called Continuing Healthcare (CHC) for adults, and its equivalent for under-18s, Children and Young People's Continuing Care. Cases in England are decided by NHS Integrated Care Boards (ICBs) - panels responsible for planning local health and care services. In Wales, they are overseen by local health boards. The BBC has heard from 105 families who described serious concerns with how the two schemes are working - with most calling for reform. One young man with 24-hour needs hasn't received any CHC help despite being eligible since February 2023 - his parents, who first applied for support on his behalf nearly two years ago, currently provide round-the-clock care Another family were told overnight care for their teenage child - who is non-verbal, has severe mobility issues and requires 24/7 support - would be reduced from seven down to three nights a week, without a reason being given. Read full story Source: BBC News, 14 February 2024
  2. Content Article
    The aim of this study, published in the BMJ, was to evaluate whether a structured online supervised group physical and mental health rehabilitation programme can improve health related quality of life compared with usual care in adults with Long Covid.  Best practice usual care was a single online session of advice and support with a trained practitioner. The REGAIN intervention was delivered online over eight weeks and consisted of weekly home based, live, supervised, group exercise and psychological support sessions. The authors concluded that in adults with Long Covid, an online, home based, supervised, group physical and mental health rehabilitation programme was clinically effective at improving health related quality of life at 3 and 12 months compared with usual care.
  3. News Article
    Lawyers and charities tell of mothers told to ‘labour at home as long as they can’, dangerously few midwives and ‘lies’ during natal care. As Rozelle Bosch approached her due date she had every reason to expect a healthy baby. Neither she, her husband nor the midwives knew that the child was in the breech position at 30 weeks. When her waters broke a fortnight early, Bosch and her husband, Eckhardt, both first-time parents, had been reassured by NHS Lanarkshire that all was well and that the mother was “low risk”. They were sent home from Wishaw hospital and told to monitor conditions until the pregnancy became “active”. Shortly before 11pm on 1 July 2021, her husband called an ambulance saying that Bosch was in labour and was giving birth. Bosch was in an upstairs bedroom on her knees and paramedics noted that “the baby was pink”. They soon asked the control room for a doctor or midwife to attend but none were available. By the time the ambulance took the family to hospital, the baby had turned blue. Within two days, baby Mirabelle had died. She had become trapped with only her feet and calves delivered while the couple were still at home. A post-mortem has found that Mirabelle suffered oxygen deprivation to the brain from “head entrapment” during delivery. Last month, her father explained to a fatal accident inquiry (FAI) at Glasgow sheriff court: “We were told Rozelle was healthy and Mirabelle was healthy. I think this was a lie and the consequences have me standing here today.” The way that the tragedy unfolded is striking, not just because of the devastating consequences, but because it is not an entirely isolated case. The same FAI is examining the deaths of two other newborns, Ellie McCormick and Leo Lamont, who also died in NHS Lanarkshire less than a month apart in 2019. Experts say it is rare for the Crown and Procurator Fiscal Service to group investigations in this way. Darren Deery, the McCormicks’ lawyer and a medical negligence specialist with Drummond Miller, said he had noticed a “considerable increase” in parents contacting the law firm in the past three years. Read full story (paywalled) Source: The Times, 11 February 2024
  4. News Article
    Doctors have warned of the risks of “freebirthing” – where a woman gives birth without the help of a medic or midwife. Unassisted births, or “freebirths”, are thought to have been on the increase since the start of the Covid pandemic, when people may have been worried about attending hospitals and home births were suspended in many areas. The practice is not illegal and women have the right to decline any care during their pregnancy and delivery. Some women hire a doula to support them during birth. The Royal College of Obstetricians and Gynaecologists (RCOG) said women should be supported to have the birth they choose, but “safety is paramount” and families need to be aware of the risks of going it alone. The Nursing and Midwifery Council (NMC) said it is in the early stages of collaboration with the Chief Midwifery Officer’s teams, the Royal College of Midwives (RCM) and the Department of Health to better understand professional concerns about freebirthing and what organisations may need to do. Its statement on unassisted births supports women’s choice, but notes that “midwives are understandably concerned about women giving birth at home without assistance, as it brings with it increased risks to both the mother and baby”. It also states that women need to be informed that a midwife may not be available to be sent out to their home during labour if they change their mind and wish to have help. Read full story Source: The Independent, 8 February 2024
  5. News Article
    Harold Chugg spent much of early 2023 in a hospital bed because of worsening heart failure. During his most recent admission in June, the 75-year-old received several blood transfusions, which led to fluid accumulating in his lungs and tissues. Ordinarily, he would have remained in hospital for further days or weeks while the medical team got his fluid retention under control. But Harold was offered an alternative: admission to a virtual ward where he would be closely monitored in the comfort of his own home. Armed with a computer tablet, a Bluetooth-enabled blood pressure cuff and weighing scales, Harold returned to his farm near Chulmleigh in north Devon and logged his own symptoms and measurements daily, which were reviewed by a specialist nurse in another part of the county. Virtual wards provide hospital-level care in people’s homes through the use of apps, wearables and daily “virtual ward rounds” by medical staff, who review patient data and follow up with telephone calls or home visits where necessary. More than 10,000 such beds are already available across England and at least a further 15,000 are planned. Scotland, Wales and Northern Ireland are also funding their expansion. But while proponents claim patients in virtual wards recover at the same rate or faster than those treated in hospital, and that the wards’ provision can help cut waiting lists and costs, some worry that their rapid expansion could place additional strain on patients and caregivers while distracting from the need to invest in emergency care. “Virtual wards, if they deliver hospital-level processes of care, are just one part of the solution, not a panacea,” said Dr Tim Cooksley, a recent ex-president of the Society for Acute Medicine. Read full story Source: The Guardian, 7 February 2024
  6. Content Article
    This article in the Nursing Times explores reflective practice in community nursing, focusing on a stressful incident in which a patient who had not been contactable during a home visit was later found to have died. The article emphasises the necessity of structured reflection, utilising Rolfe’s reflective model, to explore nurses’ feelings. It delves into the model’s stages, its impact on critical thinking and guiding reflection through questions, and highlights the importance of reflective practice, emphasising its role in learning, professional development and improving patient outcomes. The article concludes by showcasing the successful implementation of a new model and its positive impact on patient safety in home visits, providing a structured approach for nurses and health professionals.
  7. Content Article
    Children are more than twice as likely as adults to experience a medication error at home. In this interview for the journal Patient Safety, Dr Kathleen Walsh, paediatrician at Boston Children’s Hospital, discusses why that is the case and provides some tips to keep children—and adults—safe.
  8. News Article
    Almost one in four people have bought medicine online or at a pharmacy to treat their illness after failing to see a GP face to face, according to a UK survey underlining the rise of do-it-yourself treatment. Nearly one in five (19%) have gone to A&E seeking urgent medical treatment for the same reason, the research commissioned by the Liberal Democrats shows. One in six (16%) people agreed when asked by the pollsters Savanta ComRes if the difficulty of getting an in-person family doctor appointment meant they had “carried out medical treatment on yourself or asked somebody else who is not a medical professional to do so”. Ed Davey, the leader of the Liberal Democrats, said delays and difficulty in accessing GP appointments constituted a national scandal, and face-to-face GP appointments had become “almost extinct” in some areas of the country. He said: “We now have the devastating situation where people are left treating themselves or even self-prescribing medication because they can’t see their local GP.” Dr Richard Van Mellaerts, the deputy chair of the British Medical Association’s GP committee in England, said: “While self-care and consulting other services such as pharmacies and NHS 111 will often be the right thing to do for many minor health conditions, it is worrying if patients feel forced into inappropriate courses of action because they are struggling to book an appointment for an issue that requires the attention of a GP or a member of practice staff.” Read full story Source: The Guardian, 2 January 2024
  9. Content Article
    With around half a million people receiving homecare medicines services at a cost that is likely to be between £3billion and £4billion each year, there are questions over what the NHS is getting for its money and how governance and accountability within the system could be improved. This article outlines an investigation by The Pharmaceutical Journal that has revealed hundreds of patient safety incidents caused by problematic homecare medicines services.
  10. Content Article
    In this blog, Angela Osei, associate director, NICE implementation support, sets out to understand some of the challenges, benefits and considerations of setting up and running a virtual ward, from the perspective of teams on the front lines.
  11. News Article
    Private healthcare companies are harming NHS patients in their own homes by failing to deliver vital medicines, and then escaping censure amid an alarming lack of oversight by ministers and regulators, members of the House of Lords have warned. More than 500,000 patients and their families rely on private companies paid by the NHS to deliver essential medical supplies, drugs and healthcare to their homes. The homecare medicines services sector is estimated to be worth billions of pounds. A report by the Lords public services committee says patients are being harmed due to “real and serious problems” with the services provided by for-profit companies. The absence of a single person or organisation with overall control or oversight of the sector means poor performance is going unchecked, it says. “There are serious problems with the way services are provided,” the Lords report says. “Some patients are experiencing delays, receiving the wrong medicine or not being taught how to administer their medicine. [This] can have serious impacts on patients’ health, sometimes requiring hospital care. This leaves NHS staff either firefighting the problems caused by problems in homecare medicines services, or working on the assumption that those services will fail.” Read full story Source: The Guardian, 16 November 2023
  12. Content Article
    Homecare medicines services deliver medicines and provide medicine-related care to patients in their homes, for example, teaching them to self-inject, and delivering medicine that might need special transport. In this report, the House of Lords Public Services Committee highlights concerns about multiple reports of delays and errors by homecare providers, resulting in patients receiving care later than scheduled. The report states that this key service is not working the way it should and, in some cases, is causing patients serious harm.
  13. News Article
    Two-thirds of patient safety incidents recorded during hospital trusts’ monthly reporting period for homecare medicine provision were for services provided by the company Sciensus, an investigation by The Pharmaceutical Journal has revealed. In response to a freedom of information request sent to 131 hospital trusts in England in August 2023, 32 trusts recorded 417 patient safety incidents during their most recent monthly reporting period, which ranged from May to July 2023. Some 66% of these incidents (277) related to services delivered by homecare provider Sciensus, despite providing medicines to fewer than half (44%) of the 96,849 patients covered in the data. The findings come after the House of Lords Public Services Committee opened an inquiry into homecare medicines services in May 2023 following press reports of complaints from patient organisations and others about the service provided. The inquiry heard evidence from patient groups, regulators, homecare companies and the government during the summer and the committee will publish its report on 16 November 2023. Sciensus was previously known as Healthcare at Home and is one of the UK’s largest homecare companies. The data also uncovered that Sciensus was a poor performer on “failed” deliveries, defined as those that did not arrive on the scheduled day. Read full story Source: The Pharmaceutical Journal, 9 November 2023
  14. Content Article
    This report provides a comprehensive analysis of the adult social care workforce in England and the characteristics of the 1.52 million people working in it. Topics covered include: recent trends in workforce supply and demand, employment overview, recruitment and retention, demographics, pay, qualification rates, and future workforce projections.
  15. Content Article
    The National Wound Care Strategy Programme, the AHSN Network’s Transforming Wound Care programme, and the Patient Experience Network have created a new resource to teach patients how to take a photograph of their wound to empower them to take an active role in their healthcare. Developed for patients by patients, based on experience and medical information, the resource provides hints and tips on best practice with taking wound photographs, including the mechanics of getting the best possible photograph and what photographs should and should not include to assist healthcare providers in providing the best possible care.
  16. Content Article
    '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.
  17. News Article
    Almost 900,000 older people are admitted to hospital every year as an emergency because the NHS is failing to keep them healthy at home, Age UK has warned. A major lack of services outside hospitals means elderly people are also suffering avoidable harm, such as falls and urinary tract infections, the charity said. In a new report it urges NHS bosses to push through huge changes to how the “hospital-oriented” service operates and establish “home first” as the principle of where care is provided. Doing so would reduce the strain on overcrowded hospitals and leave the NHS better set up to respond to the increase in the number of over-65s and especially over-85s, Age UK said. Its report, on the state of health and care of older people in England, concluded that “our health and care system is struggling, and too often failing, to meet the needs of our growing older population.” Read full story Source: The Guardian, 11 July 2023
  18. News Article
    GPs should offer all patients presenting with signs of colorectal cancer a faecal immunochemical test (FIT) to reduce the waiting times for a colonoscopy, the National Institute for Health and Care Excellence (NICE) has recommended in draft guidance. The current NICE recommendation is to offer FIT to people presenting to primary care with low risk symptoms suggestive of colorectal cancer, while people with high risk symptoms should be immediately referred to the suspected cancer pathway. However, patients often have lengthy waiting times for colonoscopy because of limited capacity. NICE estimates that the recommendation should lead to 50% fewer referrals for urgent colonoscopies being made by GPs each year. Read full story (paywalled) Source: BMJ, 5 July 2023
  19. News Article
    Tens of thousands of children will be treated in “virtual wards” to free hospital beds for more critically ill patients under new NHS plans. The Hospital at Home service will be expanded to include paediatric care in every region of England this month, the health service announced. As part of the service, clinical teams review patients daily and can provide treatments including blood tests, prescribe medicines or administer fluids through a drip. Ward rounds can include home visits or a video call, and many services use technology such as apps and wearable devices to monitor recovery. Professor Simon Kenny, the NHS’s national clinical director for children and young people, said: “The introduction of paediatric virtual wards means children can receive clinical care from home, surrounded by family and an environment they and their parents would rather they be — with nurses and doctors just a call away.” Read full story (paywalled) Source: The Times. 5 July 2023
  20. News Article
    The NHS is on trajectory to fall short of a flagship pledge to have around 24,000 “virtual ward beds” in place by December 2023, internal data has revealed. NHS England’s figures from March, seen by HSJ, suggest the system is instead more likely to have created around 18,500 virtual beds by the 2023 deadline. Senior clinicians, including the Royal College of Physicians and the Society of Acute Medicine, have recently raised concerns about the speed and timing of the roll-out and staffing implications. And now fresh concerns are also being raised about the programme following publication of a new academic study which suggests virtual wards set up by the NHS during Covid made little impact on length of stay or readmissions rates. Alison Leary, professor of healthcare and workforce modelling, London South Bank University, was one of the first senior leaders to publicly voice concerns about the NHS’s virtual wards programme. Professor Leary told HSJ: “I am not surprised [systems are falling] short. Since Elaine [Elaine Maxwell, visiting professor, London South Bank University] and I published our piece in HSJ, I have been contacted by several clinicians who have serious concerns over virtual wards and staffing them.” Read full story (paywalled) Source: HSJ, 31 March 2022
  21. News Article
    NHS chiefs have issued an extraordinary plea for families to help them discharge loved ones even if they are Covid-19 positive as the health service faces a “perfect storm” fuelled by heavy demand, severe staff shortages and soaring Covid cases. Hospitals and ambulance services across England are under “enormous strain”, health leaders have warned, after NHS trusts covering millions of patients declared critical incidents or issued stark warnings to residents. Dr Layla McCay, director of policy at the NHS Confederation, which represents the whole healthcare system, said the situation had become so serious that “all parts” of the health service were now becoming “weighed down”. This will have a “direct knock-on effect” on the ability of staff to tackle the care backlog, she added, as well as the current provision of urgent and emergency care. On Wednesday evening, the crisis became so acute in Hampshire and the Isle of Wight that its chief medical officer urged relatives of patients well enough to be discharged to collect them immediately – even if they were still testing positive for coronavirus. Dr Derek Sandeman, of the Hampshire and Isle of Wight Integrated Care System, revealed that almost every hospital in the two counties was full, and said the number of people with Covid-19 being cared for in hospitals across the area was 650 – more than 2.5 times higher than in early January. He added that 2,800 staff working for local NHS organisations were off sick, half of which absences were due to Covid-19. “With staff sickness rates well above average, rising cases of Covid-19 and very high numbers of people needing treatment, we face a perfect storm – but there are some very specific ways in which people can help the frontline NHS and care teams,” said Sandeman. Read full story Source: The Guardian, 6 April 2022
  22. News Article
    Amazon, eBay and Wish have stopped stocking some monitors that let people keep track of their blood oxygen levels after an investigation found they were not fit to be sold. The online marketplaces removed a number of pulse oxygen testing devices known as oximeters from sale after being alerted to flaws identified by the consumer organisation Which? Pulse oximeters have boomed in popularity as a result of Covid, with millions of people keeping one at home so they can quickly assess if their blood oxygen level has fallen worryingly low – a condition known as “silent hypoxia” – which is a common side-effect of the disease. Some of the devices were not legally fit to be sold in the UK, did not carry the CE quality Kitemark or wrongly claimed that they had been approved by the NHS. The Department of Health and Social Care (DHSC) said it would look into the unauthorised use of the health service’s iconic blue and white branding on the devices. It made clear that “the NHS does not approve or endorse any medical devices, including oximeters”. “The department strictly controls the NHS identity and takes unauthorised use or adaptation of the NHS logo and the letters ‘NHS’ very seriously”, a DHSC spokesperson said. Which? said that 11 of the cheap pulse oximeters it bought from those websites failed to comply with UK and European Union law when it examined them closely. “It is very concerning that our investigation found these medical devices for sale without the required safety markings or brazenly claiming to be approved by the NHS, and the biggest online marketplaces were not picking up on these red flags”, said Natalie Hitchens, the consumer group’s head of home products and services. Read full story Source: The Guardian, 26 March 2022
  23. News Article
    Midwife-supported homebirths will not be re-introduced in Guernsey after their suspension due to coronavirus. The committee for health and social care explained it is difficult for a small team to accommodate the births. It said that if the service was reinstated, it may impact deliveries on Loveridge Ward in Princess Elizabeth Hospital. A spokesperson said they were "very sorry" to parents who wanted to give birth at home. The committee said homebirths rely on a demanding on-call commitment from community midwives on top of their contracted hours. To facilitate a birth at home, two of the five midwives are required to be on-call for 24 hours a day, for up to five weeks at a time. Deputy Tina Bury, vice president of the committee for health and social care, said: "The midwifery team is small and it was simply not sustainable or safe in the long-term to provide the kind of on-call cover needed to support homebirths. Read full story Source: BBC News, 5 March 2022
  24. News Article
    The NHS plans to treat up to 25,000 hospital patients at home in “virtual wards” to help clear the backlog caused by the pandemic, the “living with Covid” plan has revealed. Patients will be offered acute clinical care at home, including remote monitoring and treatment, as an alternative to hospital stays. Consultants or GPs will review patients daily via digital platforms and phone calls. In some cases, patients will be provided with a wearable device to continuously monitor and report their vital signs. The NHS has set a national target of 40 to 50 virtual beds per 100,000 population, which equates to about 25,000 beds across England, according to the “living with Covid” plan published this week. The document said: “The use of ‘virtual wards’ and ‘hospital at home’ models of care have ensured that patients can be safely cared for in their own homes and that additional bed capacity can be freed up in hospitals.” Commenting on the initial rollout of virtual wards, Dr Tim Cooksley, the president of the Society for Acute Medicine, warned a “hasty” rollout could risk patient safety. He said: “Virtual wards do have the potential to be a model of the future. However, it is essential they are appropriately planned, resourced and staffed so they simply cannot be seen as a short-term mitigation measure which can be hastily rolled out mid-pandemic. Incorrect implementation could risk patient safety and significantly impact clinician and patient confidence.” Read full story (paywalled) Source: The Telegraph, 22 February 2022
  25. News Article
    A digital NHS Health Check is to be rolled out across England from next spring, the government has announced, in an attempt to alleviate the pressure on GP surgeries. The initiative will deliver 1m checks in the first four years, according to the Department for Health and Social Care (DHSC). Tens of thousands of cases of hypertension are expected to be identified and hundreds of strokes and heart attacks prevented. Patients will be able to access the check via a mobile phone, tablet or computer, the DHSC said. Participants will complete an online questionnaire, enter height, weight, and the results of a cholesterol test which they can carry out at home. They will also be asked to have their blood pressure checked at a pharmacy. The results, which will be available online, will direct people to personalised advice. Referrals to GPs will only be made if further tests and treatment are needed. Professor Sir Nilesh Samani, medical director at the British Heart Foundation, said: “This initiative will help to reach more people and encourage them to get their blood pressure and cholesterol levels checked so that, where necessary, healthcare professionals can work with them to manage their condition. “This could play an important role in helping people live healthier for longer and saving lives in the coming years, while reducing pressure on the NHS.” Read full story Source: The Guardian, 28 June 2023
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