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Found 117 results
  1. Content Article
    Key points: The coronavirus (COVID-19) pandemic has had a profound impact on people receiving and providing social care in England. Since March, there have been more than 30,500 deaths among care home residents than we would normally expect, and a further 4,500 excess deaths among people receiving care in their own homes (domiciliary care). There has been a greater proportional increase in deaths among domiciliary care users than in care homes (225% compared to 208%). And while deaths in care homes have now returned to average levels for this time of year, the latest data (up until 19 June) shows that there have continued to be excess deaths reported among domiciliary care users.Social care workers are among the occupational groups at highest risk of COVID-19 mortality, with care home workers and home carers accounting for the highest proportion (76%) of COVID-19 deaths within this group. During March and April, there was a substantial reduction in hospital admissions among care home residents. Elective admissions reduced to 58% of the 5-year historical average and emergency admissions to 85% of the 5-year historical average. By reducing admissions, care home and NHS teams may have reduced the risk of transmission, but there may have also been an increase in unmet health needs. During March and April, discharges from hospitals to residential care homes were 75% of the historical average, while discharges from hospitals to nursing homes increased to 120% of the historical average. These difficult decisions to discharge patients were made in an urgent and uncertain context but may have played a role in transferring risk to a poorly supported social care system.
  2. News Article
    Most people in England, about 30 million, are to be offered a free flu vaccine this year, the government says. It is to prepare for a winter that could see the annual flu season coincide with a surge in coronavirus. The traditional flu programme will include all over-50s for the first time, as well anyone on the shielding list and the people they live with. Also for the first time, children in their first year of secondary school will all be offered the vaccine. Plans for Scotland, Wales and Northern Ireland have not yet been announced. Read full article here
  3. Content Article
    This report sets out to explore how antimicrobial stewardship (AMS) programmes are working to tackle antimicrobial resistance (AMR), by asking Clinical Commissioning Groups (CCGs) about their practice and experience of local stewardship. It is a follow-up to the Patients Association’s 2016 report on the same subject, and highlights some progress and areas for improvement in key areas. Using Freedom of Information Requests (FOIs), CCGs in England were asked a range of questions about their AMS programmes, relating to national guidance, toolkits and practice. The national policy and practice landscape puts AMS programmes at the heart of fighting AMR, and securing long-term quality healthcare for patients as a result. Primary care professionals are key to making these successful.
  4. News Article
    Almost half of healthcare workers at some hospitals were infected with COVID-19 during the height of the first wave, the director of a biomedical research centre has told MPs. Sir Paul Nurse, director of the Francis Crick Institute, told MPs today that COVID-19 had infected up to 45% of healthcare workers during ”the height of the pandemic” at some hospitals, according to the centre’s research. Chief medical officer Chris Whitty also told the Health and Social Care Committee that there was more evidence that COVID-19 was transmitted between staff, rather than from patients to staff, and there was “just as much risk as people being in their break rooms than on wards”. Sir Paul told MPs the Francis Crick Institute contacted Downing Street in March and wrote to health secretary Matt Hancock in April to emphasise the importance of regular systematic testing for all healthcare workers as it was “quite clear” that those without symptoms were likely to be transmitting the disease. He said hospital staff “were infecting their colleagues, they were infecting their patients, yet they were not being tested systematically.” Read full story Source: HSJ, 21 July 2020
  5. News Article
    The hospital trust which has been recording the largest number of covid deaths for several weeks has asked NHS England and NHS Improvement for help with infection control. East Kent Hospitals University Foundation Trust is also getting help from the Kent and Medway Clinical Commissioning Group, including a senior infection control and prevention nurse who is now working with the trust. It has seen persistently high numbers of covid deaths at a time when most other trusts have seen them dwindle to nothing or almost nothing. In the week to 10 July, it had 18 deaths – 9.5% of the national total. In a statement to HSJ yesterday the trust said it had “recently asked for support from NHS England and NHS Improvement to strengthen our infection prevention and control resource”. It said it had also introduced “a strict ‘front door’ policy, limiting the number of people on site, taking temperature checks before people enter the building, providing face masks and hand washing facilities”; begun testing asymptomatic staff; and regularly testing asymptomatic patients. Read full story (paywalled) Source: HSJ, 16 July 2020
  6. News Article
    Spain's large-scale study on the coronavirus indicates just 5% of its population has developed antibodies, strengthening evidence that a so-called herd immunity to COVID-19 is "unachievable," the medical journal the Lancet reported on Monday. The findings show that 95% of Spain's population remains susceptible to the virus. Herd immunity is achieved when enough of a population has become infected with a virus or bacteria – or vaccinated against it – to stop its circulation. The European Center for Disease Control told CNN that Spain's research, on a nationwide representative sample of more than 61,000 participants, appears to be the largest study to date among a dozen serological studies on the coronavirus undertaken by European nations. "In light of these findings, any proposed approach to achieve herd immunity through natural infection is not only highly unethical, but also unachievable," said the Lancet's commentary authors, Isabella Eckerle, head of the Geneva Centre for Emerging Viral Diseases, and Benjamin Meyer, a virologist at the University of Geneva. Read full story Source: CNN, 6 July 2020
  7. News Article
    The “hazardous” use of personal protective equipment (PPE) required because of COVID-19 is contributing to the spread of secondary infections in intensive care units and other hospital settings, a leading expert has told HSJ. Infection Prevention Society vice president Professor Jennie Wilson, said: “[PPE] has been used to protect the staff, but the way it has been used has increased the risk of transmission between patients. The widespread use of PPE particularly in critical care environments has exacerbated the problem (of patient to patient transmission). Unless we tackle the approach to PPE we will continue to see this major risk of transmission of infections between patients.” Professor Wilson warned this was espeically worrying as the risk includes spreading antibiotic resistant infections among ICU patients. There is increasing concern these are developing more often in covid patients due to widespread use of broad spectrum antibiotics in the early days of the pandemic, she added. Read full story (paywalled) Source: HSJ, 3 July 2020
  8. News Article
    A dramatic collapse in standards at a care home where a dozen people died from COVID-19 has been revealed by inspectors who discovered hungry and thirsty residents living with infected wounds in filthy conditions. Infection control was inadequate, residents with dementia were left only partially dressed and one family complained of finding their loved one smeared in dried faeces at Temple Court care home in Kettering, which is operated by Amicura, a branch of Minster Care which runs more than 70 homes in the UK. Amicura said the home had been “completely overwhelmed” by COVID-19 infections which it said arrived with 15 patients discharged from hospitals in the second half of March. They were overrun,” one relative told the inspectors. “They were short-staffed and then with the influx of people, they couldn’t cope.” Residents’ wounds had become necrotic and infected, requiring hospital treatment and several people had experienced falls, some of which resulted in injuries needing hospital treatment, the inspectors found. The conditions discovered by the Care Quality Commission on 12-13 May were so poor that surviving residents were moved out immediately. The CQC report into the service, published on Friday, found multiple breaches of the health and social care act. Northamptonshire police have launched an investigation to identify whether any offences may have been committed. Read full story Source: The Guardian, 26 June 2020
  9. News Article
    The government’s contact-tracing programme failed to reach almost 30% of people who tested positive for the coronavirus in England last week, the latest figures show. Only 70% of the 6,923 people who tested positive for COVID-19 during the period were reached by NHS Test and Trace staff, according to the Department of Health and Social Care. This means that 2,054 people with the virus – and potentially thousands of their close contacts – could not be traced by the new system. The fact that one in four people with the virus had not been reached since the launch was “surprising and worrying”, said Keith Neal, emeritus professor of the epidemiology of infectious diseases at the University of Nottingham. Read full story Source: The Independent, 26 June 2020
  10. News Article
    Health leaders are calling for an urgent review to determine whether the UK is properly prepared for the "real risk" of a second wave of coronavirus. In an open letter published in the BMJ, ministers were warned that urgent action would be needed to prevent further loss of life. The presidents of the Royal Colleges of Surgeons, Nursing, Physicians, and GPs all signed the letter. It comes after Boris Johnson announced sweeping changes to England's lockdown. Following the prime minister's announcement, health leaders called for a "rapid and forward-looking assessment" of how prepared the UK would be for a new outbreak of the virus. "While the future shape of the pandemic in the UK is hard to predict, the available evidence indicates that local flare-ups are increasingly likely and a second wave a real risk," they wrote in the letter. "Many elements of the infrastructure needed to contain the virus are beginning to be put in place, but substantial challenges remain." The authors of the letter, also signed by the chair of the British Medical Association, urged ministers to set up a cross-party group with a "constructive, non-partisan, four nations approach", tasked with developing practical recommendations. "The review should not be about looking back or attributing blame," they said, and instead should focus on "areas of weakness where action is needed urgently to prevent further loss of life and restore the economy as fully and as quickly as possible". Read full story Source: BBC News, 24 June 2020
  11. News Article
    Local authorities must be at the heart of contact tracing because COVID-19 is best understood as a pattern of local outbreaks rather than a national pandemic, says Sir Chris Ham and Robin Tuddenham in an HSJ article. Community testing and contact tracing represent our greatest hope for managing the risks to health of COVID-19 until a vaccine and effective treatments become available. Experts in infectious disease base their understanding of this on previous pandemics, and the experience of countries like South Korea and Germany. Work is underway at pace to resume contact tracking and tracing in England. It is understood that this programme will begin in earnest from 18 May following a pilot on the Isle of Wight. This work is a core part of Matt Hancock’s five-point plan for combating COVID-19, in support of some relaxation of lockdown anticipated soon. Whilst the pace is understandable, the methods and approach taken are top down, lack an effective role for key regional co-ordination through the Integrated Care Systems/Sustainability and Transformation Partnerships and Local Resilience Forums, and risk marginalising the essential skills of local authorities, GPs and the voluntary and community sector in place, according to Ham amd Tuddenham. Read full story Source: HSJ, 5 May 2020
  12. News Article
    Time is running out to finalise a track and trace strategy that would avoid a potential second surge in coronavirus cases, NHS leaders have said. The NHS Confederation warned of "severe" consequences to staff and patients if the right system was not established quickly and that lockdown measures should not be eased until a clear plan was in place. Contact tracing identifies those who may have come into contact with an infected person, either through an app or by phone and email, so they can avoid potentially passing the disease on. It follows the Prime Minister's pledge to introduce a "world-beating" contact tracing system in England from June. Niall Dickson, chief executive of the confederation, which represents health and care leaders, welcomed Boris Johnson's pledge made at Prime Minister's Questions on Wednesday. But in a letter to Health Secretary Matt Hancock, Mr Dickson said without a clear strategy the UK was at greater risk of a second peak of the virus. He said a strategy should have been in place sooner and if the right system was not instigated rapidly the ramifications for the NHS "could be severe". Speaking on the Today programme, Mr Dickson said: "We are absolutely clear that contact tracing is the right thing to do, it is absolutely critical, it has got to be in place to prevent any notion of a second surge if the lockdown is being further released." Read full story Source: 21 May 2020
  13. News Article
    More than 60% of new covid cases diagnosed at two hospitals in the Midlands in recent days were caught at least two weeks after the patient was admitted — suggesting there may be particular problems with the virus spreading on their wards. Northamptonshire is also still grappling with larger numbers of covid cases in hospital, in contrast to most of England. Its NHS organisations have said they do not know the cause of its ongoing problems. But the large share of cases diagnosed among patients who have been in hospital for at least 15 days – classed by NHS England as definitely “healthcare associated” – indicate that problems controlling the spread within the hospitals may be playing a significant part, rather than the outbreaks in the community. There has been major national concern about in-hospital spread of the virus in recent weeks, with the government introducing new mandatory controls on Friday. Read full story Source: HSJ, 11 June 2020
  14. Content Article
    This easy reference guide has been produced because: Some aspects of COVID-19 presentation and treatment present special challenges for safely confirming nasogastric tube position. The dense ground-glass x-ray images can make x-ray interpretation more difficult, and the increasing use of proning manoeuvres in conscious patients increases the risk of regurgitation of gastric contents into the oesophagus and aspiration into the lungs which will render pH checks less reliable. This aide-memoire is not designed to replace existing, established, NHSI compliant practice of NG confirmation. If a critical care provider is in the fortunate situation of having nursing and medical staff who have all completed local competency-based training in nasogastric tube placement confirmation aligned to local policy, they would be able to continue more complex local policies. Such policies might include specific advice indicating which critical care patients could have pH checks for initial placement confirmation, and which require x-tray confirmation, and how second-line checks should be used if first-line checks are inconclusive. However, staff returning to practice, or redeployed to critical care environments, including in Nightingale hospitals, will be helped by reminders of established safety steps in a form that can be used for all critical care patients, rather than requiring different processes for different patients. This is version 2 of the aide memoire, which includes additional advice on situations where providers can continue to safely use more complex local polices. Other changes were minor refinements of language and use of capital letters to emphasise application to checks before first use.
  15. News Article
    What will the next six months bring for the NHS? HSJ has spoken to the service’s most senior figures and makes a number of predictions. Read full story Source: HSJ, 8 June 2020
  16. News Article
    The head of NHS test and trace has refused to give MPs any data on the first six days of the new service, leading health committee chair Jeremy Hunt to warn that a lack of transparency could “destroy confidence” in its work. Baroness Dido Harding, who is leading the new effort, said she was working to validate performance data, which relies on people with COVID-19 symptoms isolating and being called by a team of tracers to identify others they have been in contact with. MPs had wanted to know how many patients had been contacted within 24 hours as well as how many were willing to share their contacts, and the compliance with self-isolation advice. But Baroness Harding said she would not share the information until the UK Statistics Authority was happy with the data and could ensure it can be trusted. The UKSA criticised the government earlier this week over its public use of test results data. Chair of the committee and former health secretary Jeremy Hunt said he was “disappointed” with her refusal and said it was hard for the committee to scrutinise services if it did not have the data, which she had been pre-warned it would ask for. Leaked information on Tuesday suggested only two-fifths of coronavirus patients and one-third of their contacts were identified and contacted by the tracing service. Read full story Source: The Independent, 3 June 2020
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