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Found 937 results
  1. News Article
    Local NHS organisations are facing intense “pressure” from NHS England’s national and regional teams to cut staffing numbers to improve the service’s financial outlook for 2024-25. Multiple sources have told HSJ that first draft financial returns submitted by the 42 integrated care systems indicate a combined deficit of around £6bn for the service. The £6bn figure is likely to fall substantially as NHS England meets individually with integrated care systems with the worst numbers. The need to reduce the number is prompting “horrible” conversations about service cuts, according to HSJ sources. One local leader in the South East region said the need to reduce staffing numbers constituted a “very significant part of the pushback on first-cut numbers”. A senior source in the Midlands added: “We’ve got virtually no workforce growth in our plan now… and we’ve still got a deficit. To get to breakeven we’d have to be looking at quite a significant workforce reduction.” Another leader in the South of the country said there was “big pressure” to get down to pre-pandemic staff numbers, “despite [the] increases in acuity, demand and backlogs as a consequence of covid”. Read full story (paywalled) Source: HSJ, 18 March 2024
  2. News Article
    Gripping a bag of morphine handed to him by hospital staff, Antonio sheltered at a bus stop, cold and shivering, as he tried to work out what to do. It was three days after undergoing gruelling surgery to remove his testicular cancer and the 36-year-old had been discharged from NHS care with nowhere to go. He was clutching a referral letter for the council’s housing team, given to him by hospital staff. When he arrived at the council office, he explained he had been homeless for the past few months – but was told they could not house him. “They asked me: ‘If you are in so much pain and trouble, why did they send you here?’ and I didn’t know what to say,” Antonio, whose name has been changed, tells The Independent. He was given a piece of paper with a phone number on it and told to call the next day. It was now late in the afternoon and the Salvation Army’s homeless day centre, where he would usually go for help, was closed. He had no option but to turn around and ready himself for a night on the streets. Antonio’s story is, tragically, not unique. He is one of thousands of people across England who have been discharged from NHS hospitals into homelessness in recent years, many while still battling serious health conditions. Data obtained by The Independent, in collaboration with the Salvation Army, shows at least 4,200 people were discharged from wards to “no fixed abode” in 2022/23. Read full story Source: The Independent, 17 March 2024
  3. News Article
    Staff whistleblowers have raised concerns over patient safety at one of Northern Ireland's biggest health trusts. Information received by UTV under Freedom of Information shows that most of the worries from health workers at the Belfast Health Trust relate to the Royal Victoria Hospital. Belfast Health Trust said any concerns raised by staff are investigated. The Royal College of Nursing NI was due to hold a webinar with members on Tuesday evening to discuss concerns members have about safety of patients being treated on corridors. The RCN's Rita Devlin said that the number of concerns raised with health trusts through the whistleblowing policy is only the tip of the iceberg. The concerns included unsafe staffing levels, bed shortages, boarding of patients, ED overcrowding, alleged drug dealing on a hospital site, staff sleeping on night duty, lack of mental health beds and the quality of staff training. The Belfast Trust said all staff are encouraged to make management aware of issues giving them concern through the whistleblowing process. The Trust added: "Any concern we receive is subject to a fair and proportionate process of investigation. "Whistleblowing investigations are of a fact finding nature and all relevant learning is shared as appropriate and taken forward by the Trust." Read full story Source: ITVX. 12 March 2024
  4. News Article
    At least 50,000 people will die from pancreatic cancer over the next five years unless the government gives more funding to improve how quickly the condition is diagnosed and treated, a major charity has warned. Pancreatic Cancer UK hit out at 50 years of “unacceptably slow progress” compared to other types of cancer as it warned that thousands of lives will be lost unless £35m of “urgent” investment is put towards improving survival rates of the disease. The charity predicted that pancreatic cancer – described by experts as the “quickest-killing cancer” – is expected to kill more people each year than breast cancer by 2027, which would make it the fourth-biggest cause of cancer deaths in the UK. The charity has also called for a commitment to treat everyone diagnosed with the cancer within 21 days, which it says would double the number of people getting treatment in time. Figures show that, compared to the 52.5% survival rate across the 20 most common cancers in the UK, those with pancreatic cancer have just a 7% survival rate. Around 10,500 people are diagnosed with the disease each year, with 9,558 deaths a year, according to Cancer Research UK, with more than half of people dying within three months of diagnosis. Read full story Source: The Independent, 12 March 2024
  5. News Article
    A large number of people in hospital beds waiting for onward care has forced an NHS trust to declare a critical incident to "protect patient safety". Isle of Wight NHS Trust said on Monday demand for its emergency departments was outstripping the number of free beds, leading to delays. People are being asked to collect their relatives as soon as they are ready to be discharged. In a statement, interim chief operating officer Victoria Lauchlan said: "We currently have a high number of people in hospital beds who are waiting for onward care arrangements in the community. "We are working as an island healthcare system to do everything we can to ensure we can help better support these people to be discharged home with a package of care or to care and nursing homes. "At this time we are asking people to help by collecting their relatives or friends as soon as they are ready to leave and helping with any additional care and support at home." Read full story Source: BBC News, 12 March 2024
  6. News Article
    More than 7,300 people waited longer than 24 hours for emergency treatment in Scottish hospitals last year, with the longest wait more than 122 hours. Public Health Scotland statistics obtained by Scottish Labour through freedom of information (FoI) revealed that 7,367 patients were in an emergency department for more than 24 hours before being discharged, admitted or transferred in 2023. The longest wait in A&E last year occurred at NHS Ayrshire and Arran’s University Hospital Crosshouse, where a patient waited more than 122 hours, or the equivalent of five days. Waits of more than 88 hours were recorded in NHS Borders, and 72 hours in NHS Lanarkshire. Dame Jackie Baillie, Scottish Labour’s health spokeswoman, has demanded action from Neil Gray, the health secretary. “Scotland’s A&E departments are in the grip of a deadly crisis, with lives being put on the line day in and day out,” she said. “That some people have waited days — even a working week — to be seen is dangerous and disgraceful. “Hard-pressed A&E staff are working tirelessly to look after patients, but SNP mismanagement has created a perfect storm in our hospitals. Neil Gray has inherited an NHS in deadly disarray from his colleagues. “It’s time for action to be taken now to bolster A&E departments by tackling delayed discharges and investing in primary care to avoid putting further pressure on hospital services.” Read full story (paywalled) Source: The Times, 11 March 2024
  7. News Article
    Distressed elderly patients are being “treated like animals” and left begging for care as NHS staff struggle to cope with overwhelmed wards and an ever-increasing ageing population, an investigation by The Independent has revealed. Scores of families have come forward to share harrowing allegations of neglect as one top doctor warns that elderly people are receiving care “well below the standards they should expect” – including long waits in waiting rooms and “degrading” corridor care. In one shocking case, a 96-year-old patient admitted to the hospital with a urinary tract infection (UTI) was allegedly left semi-naked and delirious in his hospital bed – before choking on vomit after being sedated without his family’s permission, his daughter told The Independent. Another patient, 99, was traumatised after being left in a bed next to the body of a dead woman. The investigation was sparked by the horrific story of 73 year old Martin Wild who was left so desperate for pain medication he was forced to call 999 from his hospital bed. It comes as analysis by the Independent shows the government was warned three times last year by coroners over the increasing risk to elderly patients’ lives amid fears they are not being “effectively safeguarded”. Read full story Source: The Independent, 11 March 2024
  8. Community Post
    Have you (or a loved one) ever been prescribed medication that you were then unable to get hold of at the pharmacy? Was there an impact on your health (physical and mental)? Were you told the reason for it not being available? Was the issue resolved? If so, how long did it take? If you are still impacted by medication supply issues, have you been told when you will be able to access them again? To help us understand how these issues impact the lives of patients and families, please share your experience and insights in the comments below. You'll need to register with the hub first, its free and easy to do. We would also like to hear from pharmacists working in community or hospital settings, and others who have insights to share on this issue. What barriers and challenges have you seen around medication availability? Is there anything that can be done to improve wider systems or processes? Please comment below or email us at content@pslhub.org
  9. News Article
    England’s NHS Ombudsman has warned that cancer patients could be put at risk because of over-stretched and exhausted health staff working in a system at breaking point and delays in diagnosis and treatment. The Parliamentary and Health Service Ombudsman (PHSO) revealed that between April 2020 and December 2023, his Office carried out 1,019 investigations related to cancer. Of those 185 were upheld or partly upheld. Issues with diagnosis and treatment were the most common cancer-related issues investigated by PHSO. These issues included treatment delays, misdiagnosis, failure to identify cancer, the mismanagement of conditions, and pain management. Complaints about cancer care also included concerns about poor communication, complaint handling, referrals, and end-of-life care. Most investigations were about lung cancer, followed by breast cancer and colorectal cancer. The Ombudsman recently closed an investigation around the death of Sandra Eastwood whose cancer was not diagnosed for almost a year after scans were not read correctly. The delay meant she missed out on the chance of treatment which has a 95% survival rate. In 2021, PHSO published a report about recurrent failings in the way X-rays and scans are reported on and followed up across the NHS service. Mr Behrens said, “What happened to Mrs Eastwood was unacceptable and her family’s grief will no doubt have been compounded by knowing that mistakes were made in her care. “Her case also shows, in the most tragic of ways, that while some progress has been made on my recommendations to improve imaging services, it is not enough and more must be done. “Government must act now to prioritise this issue and protect more patients from harm.” Read full story Source: Parliamentary Health and Health Service Ombudsman, 9 March 2024
  10. News Article
    The lives of thousands of blind and partially sighted people are being put at risk by delays in vital care that they have a legal right to after being assessed as visually impaired, according to a report. More than a quarter of English councils are leaving people who have just been diagnosed as blind waiting more than a year for vision rehabilitation assessments and potentially life-saving support, the report by the RNIB revealed. It cited the example of one person who died while waiting for council help. The Guardian can reveal that the case involved a woman from Church Stretton in Shropshire who had been waiting 18 months for an assessment when she tripped on a pothole and died later from head injuries. She had been trying to teach herself how to use a white cane, without any support or training, despite getting a certificate of visual impairment. Councils are obliged to provide such help for those coping with a recent visual impairment under the 2014 Care Act. The support involves helping people cope practically and mentally with visual impairment at a critical time after a diagnosis. The social care ombudsman recommends that councils should provide these services within 28 days of someone receiving a certificate of visual impairment. But the RNIB report, which is based on freedom of information requests to councils in England, found that 86% were missing this 28-day deadline. The report, Out of sight – The hidden scandal of vision rehabilitation warned that the delays uncovered in the figures were dangerous. Read full story Source: The Guardian, 10 March 2024
  11. Content Article
    Thousands of people with sight loss remain 'Out of Sight' in the hidden scandal of vision rehabilitation. Life changes after sight loss, sometimes overnight, often in dramatic ways. Done well, vision rehabilitation equips people with new ways to stay independent: to get out and about, adapt their work, shop and enjoy hobbies. However, the reality is stark. 86% of local authorities in England miss the 28-day recommended deadline to explore a person’s needs. Threadbare services mean people wait without the support they’re entitled to, at risk of physical accidents and injuries as well as mental health crises. The RNIB are calling on all UK political parties to commit to ensuring blind and partially sighted people get the support they need, when they need it.
  12. News Article
    It has been well-documented that Covid-19 took a devastating toll on emergency departments nationwide, revealing and exploiting the fragility of our acute-care system. Less has been written, however, about the side effects of hospitals’ attempts to recover from that era — one of the most serious of which is the proliferation of boarding. As hospitals scramble to regain their footing (and their profit margins), the financial incentive structure that undergirds US medicine has gone into overdrive. Inpatient beds that might previously have been reserved for patients who require essential care but generate very little money for the hospital, are increasingly allocated for patients undergoing more lucrative procedures. The consequences of this systemic failure cannot be overstated. Four hours is supposed to be the maximum time spent boarding in an emergency department, but recent data shows that hospitals in the US are failing to meet that goal when occupancy is high (which it routinely is). "On any given shift, hallways in the emergency department are lined with patients on stretchers. Boarding leads to a cascade of harms — including ambulances diverted to hospitals far from patients’ homes, patients charged for beds they haven’t yet occupied and overwhelmed emergency medicine personnel leaving the field because of burnout," says Hashem Zikry, an emergency medicine physician and a scholar in the National Clinician Scholars Program at UCLA. Many narratives around boarding focus on the patients themselves, shaming some for inappropriately using the emergency department. Proposed solutions include pushing patients to urgent-care centers or modifying “patient flow.” But the issues with boarding cannot be addressed with such minor tweaks. Read full story (paywalled) Source: The Washington Post, 28 February 2024
  13. Content Article
    In June 2023, the London Assembly Health Committee launched an investigation into eating disorders in London, following reports that referrals for eating disorder services have increased in recent years and performance against waiting time standards dropped during the COVID-19 pandemic. The aim of this investigation was to understand what is driving the increase in referrals, how services are responding to this additional demand and to explore people’s access to, experiences of, and outcomes from treatment services. The Committee held two formal meetings with expert guests, including clinicians, people with experience of living with an eating disorder, and representatives from the Greater London Authority and NHS England. It also held a private session with people with lived experience of being affected by an eating disorder and received 112 responses to its survey from those with experience of an eating disorder, supporting a family member or friend with an eating disorder or those working with those experiencing an eating disorder. 
  14. News Article
    A patient says he felt ignored and that NHS care was lacking after he spent 14 hours on a bed in a hospital corridor. Ivan Philpotts, 77, from Norwich, was transferred between wards at the Norfolk & Norwich University Hospital (NNUH), having contracted pneumonia. He said he was left in a bed in a corridor with no access to water, was unable to eat and that his wife was unable to visit. The hospital said it had experienced a high number of patients last week. "I felt very vulnerable," Mr Philpotts said. "Nobody seemed to be taking any notice of you and you were sitting there, people walking by you. "I was there from 8.30 in the morning until 9.10 at night before I actually got into a bay. We got no communication whatsoever." The hospital trust is one of just two in England that has been carrying out a trial of a "corridor care" scheme. The Royal College of Nursing's eastern regional director Teresa Budrey said: "We're starting to normalise it and that's not OK. "There are patients who are suffering for hours, without proper privacy or equipment and you've also got nurses dealing with an expanded number of patients. "We need government minsters and employers to come together for some bigger solutions across the system." Read full story Source: BBC News, 6 March 2024 Further reading on the hub: A silent safety scandal: A nurse’s first-hand account of a corridor nursing shift
  15. Content Article
    Elective care refers to when patients receive non-urgent treatment, normally in hospital, including, tests and scans, outpatient care, surgery and cancer treatment. The NHS is currently seeing long waiting times for some elective procedures, with the Government setting an ambition to reduce elective waiting times to less than a year by 2025. Increased waiting times mean patients have to wait longer for the care they need. This can lead to patients suffering increased pain, their condition may worsen, or they may develop other illnesses associated with the reason that they are waiting for elective care. This can cause both physical harm and mental distress to patients, their families, and carers. The Health Services Safety Investigations Body (HSSIB) Senior Safety Investigator, Neil Alexander, blogs about the challenges facing the NHS in tackling the elective care backlog and how learning from our investigation reports may be able to help the NHS rise to this challenge.
  16. News Article
    Almost 70,000 children are missing out on mental health care they should be eligible to receive as the NHS falls short of key targets, The Independent has revealed. An internal analysis, seen by The Independent, shows in England the NHS has fallen short of a target, set in 2019, for 818,000 children to receive at least one treatment session from Child and Adolescent Mental Health Services (CAMHS) in 2023. The actual number of children who received treatment in the 12 months to December was 749,833, falling short of the target by around 9%. The figures came as the government announced this week it would expand the number of early access mental health hubs for children to cover 50% of the country by 2025. However, campaigners urged ministers to commit to covering the entire country to help “turn the tide on the crisis” in children’s mental health services. The NHS analysis shows, as of December, CAMHS in the South West was furthest away from its targets with 78% of children seen out of those eligible. In London, 80% of the target was achieved and in the North West 105%. Laura Bunt, chief executive at YoungMinds, said: “Referrals to mental health services are at a record high with more young people than ever in need of support with their mental health. We know that many young people are struggling in the aftermath of the pandemic, facing intense academic pressure to catch up on lost learning, a cost of living crisis and increasing global instability. “Every young person should be able to access mental health support when they need it, but too many don’t get it until things get much worse. Services continue to be significantly underfunded and the number of young people receiving treatment falls woefully short of what is needed. To turn the tide on this crisis, the government must prioritise young people and their mental health by investing in prevention and early intervention.” Read full story Source: The Independent, 2 March 2024
  17. News Article
    A 73-year-old patient has said he was neglected at an NHS hospital and left to cry for help in "excruciating pain" during an ordeal that lasted months. Martin Wild was admitted to Salford Royal last year due to a spinal infection and claims he was denied pain relief and left lying in his own urine. Consultant Glyn Smurthwaite said Martin was "the most neglected acute patient I have ever seen". The trust that runs the hospital has apologised for failings in his care. Mr Wild came home from Salford Royal Hospital in January after an eight-month stay because of an infection following a private spinal operation. He said he was forced to phone 999 from his hospital bed when first admitted to the acute medical ward in May 2023 after struggling to get staff to give him pain relief and his Parkinson's medication. "I was left on my own in excruciating pain, with little pain relief, and I was laying on this bed for over a week before I saw a consultant." Mr Wild was discharged despite warning staff he was not well enough and no one could look after him at home, and ended up being readmitted days later via A&E. He said his poor care continued during his second stay, and Mr Wild recalled that he was shaking so much in pain that he knocked bottles of urine on to his bed after they had been left on the table with his food. Mr Wild was left lying in the urine-soaked sheets for hours before they were changed. Read full story Source: BBC News, 3 March 2023
  18. Content Article
    It is well known that the NHS is suffering from staff shortages, with 121,000 full-time equivalent (FTE) vacancies and only 26% of the workforce stating there are enough staff at their organisation. The reasons why staff are leaving are well documented (burnout, lack of work–life balance, low pay etc), and the direct impact on patients is obvious – staff shortages are one of the main reasons why there is a backlog of care. But these headlines mask nuance. They hide the areas where staff shortages are even more acute than the average, and they obscure the indirect impact on patients. Where are these areas, what are the impacts, and will the NHS Long Term Workforce Plan help?
  19. News Article
    Child and adolescent eating disorder services have never achieved NHS waiting time targets, and are not able to meet significant demand, according to analysis by the Royal College of Psychiatrists. Psychiatrists can identify and address many of the root causes of eating disorders, including neurodevelopmental conditions such as autism and ADHD. However, a current lack of capacity prevents this from happening. Due to a lack of resources, even children who meet the threshold for specialist eating disorder services are often in physical and mental health crisis by the time they are seen. Delays in treatment cause children with eating disorders physical and mental harm. NHS England set a target for 95% of children and young people with an urgent eating disorder referral to be seen within a week, and for 95% of routine referrals to be seen within four weeks. These standards have not been achieved nationwide, since they were introduced in 2021. RCPsych analysis of the latest data shows that just 63.8% of children and young people needing urgent treatment from eating disorder services were seen within one week. Only 79.4% of children and young people with a routine referral were seen within four weeks. The College also warns that there is an unacceptable gap between the number of children being referred to specialist eating disorders services, and those being seen. This is driven by a shortfall in the number of trained therapists and eating disorders psychiatrists. For Eating Disorders Awareness Week, the Royal College of Psychiatrists is calling on Government and Integrated Care Boards to invest in targeted support for children and young people to reverse this eating disorders crisis. The call is backed by the UK’s eating disorder charity Beat. Read full story Source: Royal College of Psychiatrists, 29 February 2024 Further reading on the hub: For Eating Disorders Awareness Week, Patient Safety Learning has pulled together 10 useful resources shared on the hub to help healthcare professionals, friends and family support people with eating disorders.
  20. Content Article
    When Emma Powell experienced psychosis this year, she was told to go to A&E by the mental health crisis team. But she was left waiting for a bed for three and a half days, in conditions that only made her distress worse. In this article, Emma describes several experiences of trying to access crisis care for her schizoaffective disorder. She explains the impact of long waits at A&E and how they make her condition worse, with the overcrowded and busy environment causing overstimulation, and changing staff carrying out repetitive consultations causing confusion and exhaustion.
  21. Content Article
    Salbutamol is a selective beta2-agonist providing short-acting (4-6 hour) bronchodilation with a fast onset (within 5 minutes) in reversible airways obstruction. The nebuliser liquids are licensed for use in the management of chronic bronchospasm unresponsive to conventional therapy, and in the treatment of acute severe asthma. A Medicines Supply Notification (MSN) issued on 14 February 2024, detailed a shortage of salbutamol 2.5mg/2.5ml and 5mg/2.5ml nebuliser liquid. The resolution date is to be confirmed. The supply issues have been caused by a combination of manufacturing issues resulting in increased demand on other suppliers. Terbutaline, salbutamol with ipratropium, and ipratropium nebuliser liquids remain available, however, they cannot support an increase in demand. Ventolin® (salbutamol) 5mg/ml nebuliser liquid (20ml) is out of stock until mid-April 2024 and cannot support an increased demand after this date.
  22. Content Article
    A new BMA report, “It’s broken” Doctors’ experiences on the frontline of a failing mental healthcare system", based on first-hand accounts of doctors working across the NHS, reveals a ‘broken’ system of mental health services in England. The current economic cost of mental ill health has been estimated to be over £100 billion in England alone*, but this report demonstrates that across the NHS, doctors are in an ongoing struggle to give patients the care they need because the funding is just not enough, there are not enough staff, and the infrastructure and systems are not fit for purpose. The report makes plain that without a concerted effort from central government to resource mental healthcare based on demand (which continues to grow beyond what the NHS can respond to) as well as changes in society to promote good mental health, the future looks bleak. The BMA carried out in-depth interviews with doctors across the mental health system, including those working in psychiatry, general practice, emergency medicine, and public health.
  23. Content Article
    Nicholas Gerasimidis had a history of mental illness manifesting as obsessive compulsive disorder (OCD) and anxiety. In 2022, his condition deteriorated. His GP referred him twice to the Community Mental Health Team but the referrals were rejected with medication being prescribed instead, together with advice to contact Talking Therapies.   He was taken on to CMHT workload after being assessed by the Psychiatric Liaison Team in Royal Cornwall Hospital in November 2022. The preferred course of treatment was psychological treatment in the form of Cognitive Behavioural Therapy with Exposure Response Prevention. There was a waiting list of a year. In May 2023, Mr Gerasimidis became worse. It was felt an informal admission to hospital was required but a bed was not available. He was found hanged at his home address on 3 June 2023.
  24. News Article
    The number of people in the UK who have avoidant restrictive food intake disorder (Arfid), in which those afflicted avoid many foods, has risen sevenfold in five years, figures show. The eating disorders charity Beat received 295 calls about Arfid in 2018 – comprising 2% of its 20,535 inquiries that year. However, it received 2,054 calls last year, which accounted for one in 10 of its 20,535 requests for help. Many were from children and young people or their parents. Andrew Radford, Beat’s chief executive, said: “It’s extremely worrying that there has been such a dramatic increase in those seeking support for Arfid, particularly as specialist care isn’t always readily available.” Patchy provision of NHS help meant many people were experiencing long delays before accessing support, he added. Eight in 10 eating disorder service providers did not state on their website whether or not they offered Arfid care, research by Beat found. “All too often we hear from people who have been unable to get treatment close to home or have faced waits of months or even years to get the help they need,” Radford said. Arfid is much less well-known than anorexia or bulimia. It is “an eating disorder that rarely gets the attention it deserves”. The sharp increase in cases should prompt NHS chiefs to end the postcode lottery in care for Arfid and ensure that every region of England had a team of staff fully trained to treat it, he added. “Unlike other eating disorders such as anorexia or bulimia, Arfid isn’t driven by feelings around [someone’s] weight or shape,” Radford said. “Instead, it might be due to having sensory issues around the texture or taste of certain foods, fear about eating due to distressing experiences with food, for example choking, or lack of interest in eating.” Read full story Source: The Guardian, 26 February 2024
  25. Content Article
    In this Guardian opinion piece, John Harris looks at reports of people with severe eating disorders being discharged from NHS services in the East of England. He shares the stories of several patients who are desperate to recover from their eating disorders, but have been discharged from specialist services because they are not showing progress in recovery. The article looks at the growth of a narrative that suggests some patients should not be treated if their eating disorder has reached a very severe state and highlights the way that this may be affecting practice and posing a significant risk to patient safety.
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