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Showing results for tags 'Lack of resources'.
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News Article
'I'm terrified of food - but I can't get specialist eating disorder treatment'
Patient Safety Learning posted a news article in News
A woman whose wait for a diagnosis of a lesser known eating disorder left her feeling like a "problem that cannot be solved" has called for reform of how the condition is treated by Northern Ireland's health service. Sinead Quinn, from Londonderry, said binge eating compulsions had made her "a prisoner in her own home, afraid of food and afraid of herself". Binge Eating Disorder (BED) is not currently treated by eating disorder services in Northern Ireland - patients are instead referred to general mental health services. The Department of Health said regional adult eating disorder services were commissioned to treat anorexia, bulimia and atypical presentations of these conditions. BED is the second most common eating disorder in the UK, after atypical eating disorders, according to UK health assessment body NICE, external. The Department of Health said it did not collate data on how many people in Northern Ireland are living with BED. It also said there was no current review of the way the condition is treated. Experts say specialist care within the health service is urgently needed to help people get a formal diagnosis and recover from BED. Prof Laura McGowan, from the Centre for Public Health at Queen's University, hopes the recently announced roll-out of a regional obesity management service for Northern Ireland would include screening of eating disorders like BED. "BED is simply not widely recognised and the services for it not widely commissioned," she said. "For BED patients, especially those living with obesity, there is such an unmet need." Read full story Source: BBC News, 5 June 2025- Posted
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- Eating disorder
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News Article
Nearly £450m is being invested in the NHS in England to cut hospital waiting times and tackle persistently failing trusts, the health secretary has announced. Wes Streeting says his NHS reforms aim to deliver around 40 new centres to fast-track treatment for patients, up to 15 mental health crisis assessment units and almost 500 new ambulances. It is part of an attempt to shift patients away from A&E and avoid unnecessary hospital admissions. "No patient should ever be left waiting for hours in hospital corridors or for an ambulance which ought to arrive in minutes," said Mr Streeting. "The package of investment and reforms we are announcing today will help the NHS treat more patients in the community, so they don't end up stuck on trolleys in A&E," he added. In an example of the challenge facing the health secretary, Sky News on Wednesday revealed the scale of England's mental health crisis, exacerbated by a shortage of specialist beds and an overwhelmed social care network. The new Urgent and Emergency Care Plan for England says more needs to be done to drive down long waits, cut delayed discharges and improve care for patients. Read full story Source: Sky News, 6 June 2025 Related reading on the hub: How corridor care in the NHS is affecting safety culture: A blog by Claire Cox My experience of the 'Wait 45' policy - Florence in the Machine A silent safety scandal: A nurse’s first-hand account of a corridor nursing shift- Posted
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- Hospital corridor
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Content Article
NHS England: Urgent and emergency care plan 2025/26
Patient Safety Learning posted an article in NHS England
This report sets out how the NHS will resuscitate urgent and emergency care, with a focus on getting patients out of corridors, keeping more ambulances on the road, and enable those ready to leave hospital to do so as soon as possible. Summary of actions and impact for patients and carers Focus as a whole system on achieving improvements that will have the biggest impact on urgent and emergency care services this winter By the year-end, with improvement over winter, we expect to: Reduce ambulance wait times for Category 2 patients – such as those with a stroke, heart attack, sepsis or major trauma – by over 14% (from 35 to 30 minutes). Eradicate last winter’s lengthy ambulance handover delays by meeting the maximum 45-minute ambulance handover time standard, helping get 550,000 more ambulances back on the road for patients. Ensure a minimum of 78% of patients who attend A&E (up from the current 75%) are admitted, transferred or discharged within 4 hours, meaning over 800,000 people a year will receive more timely care. Reduce the number of patients waiting over 12 hours for admission or discharge from an emergency department compared to 2024/25, so this occurs less than 10% of the time. This will improve patient safety for the 1.7 million attendances a year that currently exceed this timeframe. Tackle the delays in patients waiting to be discharged – starting with the nearly 30,000 patients a year staying 21 days over their discharge-ready-date, saving up to half a million bed days annually. Increase the number of children seen within 4 hours, resulting in thousands of children every month receiving more timely care than in 2024/25. Develop and test winter plans, making sure they achieve a significant increase in urgent care services provided outside hospital compared to last winter Improve vaccination rates for frontline staff towards the pre-pandemic uptake level of 2018/19. This means that in 2025/26, we aim to improve uptake by at least 5 percentage points. Increase the number of patients receiving urgent care in primary, community and mental health settings, including the number of people seen by Urgent Community Response teams and cared for in virtual wards. Meet the maximum 45-minute ambulance handover time standard. Improve flow through hospitals, with a particular focus on reducing patients waiting over 12 hours, and making progress on eliminating corridor care. Set local performance targets by pathway to improve patient discharge times, and eliminate internal discharge delays of more than 48 hours in all settings. Reduce length of stay for patients who need an overnight emergency admission. This is currently nearly a day longer than in 2019 (0.9 days) and needs to be reduced by at least 0.4 days . Reduce the number of patients who remain in an emergency department for over 24 hours while awaiting a mental health admission. This will provide faster care for thousands of people in crisis every month. National improvement resource and additional capital investment is simplified and aligned to supporting systems where it can make the biggest difference Allocating over £370 million of capital investment to support: Around 40 new same day emergency care centres and urgent treatment centres. Mental health crisis assessment centres and additional mental health inpatient capacity to reduce the number of mental health patients having to seek treatment in emergency departments. Expansion of the Connected Care Records for ambulance services, giving paramedics access to the patient summary (including recent treatment history) from different NHS services, enabling better patient care and avoiding unnecessary admissions.- Posted
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- Emergency medicine
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News Article
'I will fade away without vital pancreas medication'
Patient Safety Learning posted a news article in News
A Kent man who has had three-quarters of his pancreas removed says he will "fade away" without a medication that there has been a nationwide shortage of since 2024. Paul Elcombe, from Hartley, takes Creon three times a day, after major surgery three years ago left him no longer able to create enough enzymes to break down food. As it stands, he has three and a half weeks worth of tablets left, having only had one prescription filled this year. He said: "You need it to survive, without it [Creon] your body can't break down the food...it's as important as insulin is to a diabetic." The nationwide shortage, which the Department of Health and Social Care (DHSC) says is a "European-wide" supply issue, has forced the 63-year-old and his wife to spend time travelling to different pharmacies in a bid to get the medication. He said: "I know it sounds dramatic, but without it you will just fade away...it's very scary." Read full story Source: BBC News, 5 June 2025- Posted
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Content Article
This report from the National Federation of Women’s Institutes looks at the ways in which the UK dentistry crisis disproportionately affects women, based on a survey that obtained over 960 responses. The central theme of the report is that dental health is a feminist issue. This is partly a matter of biology: for example, in pregnant women, hormonal changes can lead to gingivitis – an inflammation of the gums. It is also because women take a disproportionate amount of the caring responsibility for children and ageing parents. The report states that with NHS dental appointments becoming harder to obtain, women are bearing financial, temporal, physical, and mental health burdens for not only themselves but also their loved ones. Pregnant women and children are entitled to free NHS dental healthcare. But survey respondents reported being unable to find a dentist taking NHS patients to treat them. So some women are turning to private dentistry but are then finding that they are required to pay high bills. The report makes the point that the lack of available NHS dental healthcare, and the financial burden of private dental care, forces women to choose between their own health and the well-being of their families, further exacerbating inequalities in access to dental healthcare.- Posted
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- Dentist
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News Article
"We've got two," explains Emer Szczygiel, emergency department head of nursing at King George Hospital, as she walks inside a pastel coloured room. On one wall, there's floral wallpaper. It is scored through with a graffiti scrawl. The words must have been scratched out with fingernails. There are no other implements in here. Patients being held in this secure room would have been searched to make sure they are not carrying anything they can use to harm themselves - or others. "So this is one of two rooms that when we were undergoing our works, we recognised, about three years ago, mental health was causing us more of an issue, so we've had two rooms purpose built," Emer says. "They're as compliant as we can get them with a mental health room - they're ligature light, as opposed to ligature free. They're under 24-hour CCTV surveillance." There are two doors, both heavily reinforced. One can be used by staff to make an emergency escape if they are under any threat. What is unusual about these rooms is that they are built right inside a busy accident and emergency department. The doors are just feet away from a nurse's station, where medical staff are trying to deal with acute ED (emergency department) attendances. On a fairly quiet Wednesday morning, the ED team is already managing five mental health patients. One, a diminutive South Asian woman, is screaming hysterically. She is clearly very agitated and becoming more distressed by the minute. Despite her size, she is surrounded by at least five security guards. She has been here for 12 hours and wants to leave, but can't as she's being held under the Mental Capacity Act. Her frustration boils over as she pushes against the chests of the security guards who encircle her. "We see about 150 to 200 patients a day through this emergency department, but we're getting on average about 15 to 20 mental health presentations to the department," Emer explains. "Some of these patients can be really difficult to manage and really complex." "If a patient's in crisis and wants to harm themselves, there's lots of things in this area that you can harm yourself with," the nurse adds. "It's trying to balance that risk and make sure every emergency department in the country is deemed a place of safety. But there is a lot of risk that comes with emergency departments, because they're not purposeful for mental health patients." Read full story Source: Sky News, 4 June 2025- Posted
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- Mental health
- Emergency medicine
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News Article
People 'dying in pain due to end-of-life care gaps'
Patient Safety Learning posted a news article in News
Marie Curie said one in five hospital beds in Wales were occupied by people in the last year of their lives and "bold, radical" action was needed for services which were at "breaking point". One family said they had to fight to ensure their 85-year-old father could die peacefully at home rather than in a hospital ward. The Welsh government said it provided more than £16m a year to ensure people had access to the best possible end-of-life care. Marie Curie said gaps in care meant "too many people are spending their final days isolated, in pain, and struggling to make ends meet". "End-of-life care in Wales is at breaking point," said Senior Policy Manager Natasha Davies. "Services and staff are struggling to deliver the care people need, when and where they need it. There is an urgent need for change." The charity recognised while hospital was the best place for many palliative care patients, better community and out-of-hours care would allow people to be cared for in their homes. "It also means having meaningful conversations with dying people about their care preferences, so their wishes are heard and respected," added Ms Davies. The Welsh government said good palliative and end-of-life care could make a "huge difference" to helping people die with dignity. Read full story Source: BBC News, 2 June 2025- Posted
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- Wales
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Content Article
In recent years we have become familiar with the idea of “dental deserts” – areas of the country where it is impossible to get basic dental treatment on the NHS. The situation was already bad five years ago when, pre-pandemic, only half of the adult population (49%) had access to an NHS dentist. Covid accelerated the decline and now only 4 in 10 have access. This report, from the House of Commons Committee of Public Accounts. explains that in 2024 the then government launched a dental recovery plan. There were three main goals: to deliver an additional 1.5 million courses of treatment in 2024–25, to improve children’s oral health through the Smile for Life programme, and to introduce measures to support the dental workforce. The Committee’s judgement on the plan is blunt. They say that it has “comprehensively failed to deliver improvements in access to NHS dentistry”. One consequence is that “the most vulnerable patients continue to suffer the most from long–standing failures in the system”. The underlying cause, according to the Committee, was that “The modelling that underpinned the dental recovery plan was flawed, and even if the plan had performed in line with expectations it was never actually ambitious enough to meet its stated aim of ensuring that everyone who needs to see an NHS dentist would be able to".- Posted
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News Article
‘No staffing growth’ policy implicated in patient’s death
Patient Safety Learning posted a news article in News
Repeated refusals by NHS England to fund extra staff was a key factor in a patient’s death, a coroner has said. The coroner warned that year-long delays to follow-up appointments at the Robert Jones and Agnes Hunt Orthopaedic Hospital Foundation Trust were a factor in the death of Peter Anzani, a spinal injury patient who died from a blood clot in November last year. NHS England turned down two requests to fund extra staff at the trust due to national policy and “a funding shortage”, a recent prevention of future deaths report has said. That’s despite RJAH struggling with patient demand and staffing shortages, leading to longer waits for reviews and treatments, according to the report. Adam Hodson, the coroner for Birmingham and Solihull, said in the report sent to NHSE and the hospital: “It is obvious that where patients are waiting for longer than is reasonable or necessary for treatment or reviews, there is a real risk of deaths occurring. No patient should be waiting longer than absolutely necessary for treatment.” He added: “It is concerning to hear that the trust do not appear to be being adequately supported financially by NHS England, and do not currently appear to be able to address their workplace staffing issues without additional financial support (which does not appear to be forthcoming).” Read full story (paywalled) Source: HSJ, 22 May 2025- Posted
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Content Article
US foreign aid plays a critical role in tackling poverty, hunger, and inequality worldwide, which is why the Trump administration’s recent cuts to foreign development assistance were met with public outrage and pushback from development and humanitarian organisations, including Oxfam. Despite widespread public support for US-funded foreign aid, Secretary of State Marco Rubio cut more than 80% of US Agency for International Development (USAID) programmes, which provide humanitarian and development assistance worldwide to people in some of the worst global crises. The effect of these cuts on people is dire: At least 23 million children stand to lose access to education, and as many as 95 million people would lose access to basic healthcare, potentially leading to more than 3 million preventable deaths per year. Oxfam has responded to the attacks on USAID by joining other humanitarian groups in a lawsuit to defend USAID and US foreign assistance, which is ongoing. So what does the Trump administration's decision to eliminate so much foreign aid mean, what impact could it have around the world, and why is it critical for the government to reverse this decision? Oxfam answers all of these questions and more.- Posted
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News Article
‘My son is falling through the cracks of the child mental health system’
Patient Safety Learning posted a news article in News
A six-year wait for ADHD treatment on the NHS highlights a growing crisis. One mother tells of her frustrations: I wasn’t surprised by the children’s commissioner report out today, calling for urgent action to tackle waiting lists in mental health care for children. Ten years ago, I received a call from my son's reception teacher. They asked me to come in and said he was showing some developmental delays, and autistic traits. Within six months my son, who is now 15, was diagnosed with autism and ADD (attention deficit disorder) and medicated. Fast forward to his younger brother, and he has been languishing on a waiting list for six years. The school referred him to CAMHS (child and adolescent mental health services) to be assessed for ADHD in November 2021. The school could see how much I was struggling and sent CAMHS an email each week asking where he was on the waiting list. Despite this, it took until October 2024 for him to be diagnosed with ADHD. By then he was in secondary school. Something Rachel de Souza, the children’s commissioner for England, said really stuck out to me. She said: “The numbers in this report are staggering — but these are not numbers, these are real children.” Read full story (paywalled) Source: The Times, 19 May 2025 -
Content Article
This report describes children’s access to mental health services in England during the 2023-24 financial year, based on new analysis of NHS England data. Demand continues to grow for Children and Young People’s Mental Health Services (CYPMHS, commonly known as CAMHS) , with the number of children with active referrals increasing by nearly 10,000 since last year to 958,200. Compared to last year, there have been some areas of progress: fewer children’s referrals are being closed before treatment, and investment in CYPMHS has increased in real terms and when adjusted for inflation. However, figures continue to highlight some concerning trends: Many children were still experiencing long waits to access mental health services, and the number of children with active referrals who were still waiting for treatment to begin at the end of the year has increased by almost 50,000 children from 270,300 in 2022-23 to 320,000 in 2023- 24. Almost half of those referred for being ‘in crisis’ have their referrals closed or were still waiting for their second contact at the end of the year. There has been an uptick in children being referred for suspected and diagnosed neurodevelopmental conditions; these conditions are associated with some of the longest waits. The accessibility of mental health services in England continues to vary widely from one ICB area to another, leading to a postcode lottery in children’s access to suitable support for their mental health conditions.- Posted
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- Mental health - CAMHS
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Content Article
My experience of the 'Wait 45' policy
Anonymous posted an article in Florence in the Machine
The images on the left highlight the increased delays in ambulance responses and the potentially catastrophic consequences. Equally, the panic-inducing headlines of measures brought in to resolve the crisis. I work on the healthcare frontline and I’d like to share my experience of the 'Wait 45' policy in my trust and the impact it is having. Implementation of a new policy In December 2024, all ambulance trusts in England were told to implement a new policy, ‘Release to Respond’, also known as the ‘Wait 45’ policy, which means ambulances will only wait at Emergency Departments (ED) for 45 minutes before patients are left and the crews make their way to the next call. This was initiated following increasing waits for crews to handover patients to the ED. These waits were not inconsiderable periods of time, with many reports of crews spending their entire shift parked outside the ED with just one patient. This has resulted in some appalling headlines—for example, elderly people being left waiting for up to 15 hours for an ambulance to arrive and people having cardiac arrests where ambulances are not available to respond. Based on this, the adoption of the ’Release to Respond' policy makes sense. However, the introduction of this policy has been met with some scepticism and equally horrendous headlines about patients being dumped while crews run. The policy states that crews will not dump and run, and that handovers will be given, and patients will be placed on a chair, trolley or wheelchair in a dedicated space. But this policy is another example of not identifying the whole problem and bringing in a measure that only addresses the needs of one part of the healthcare system, while making it considerably worse for other parts! What is the point of an integrated care system (ICS) and board (ICB) if they do not look at an integrated intervention to address this situation? What is the reality of the ’Wait 45’ policy? The Wait 45 policy in my trust has completely changed the way the ED manages patients. Corridor care is a term used to describe the practice of providing medical attention to patients in hallways or other non-designated clinical areas due to overcrowding or resource shortages. It used to be that corridor care was for patients who had been seen, had a plan and who were either waiting to go home or for a bed on a ward. Now, in my trust, the corridor is for undifferentiated patients (patients who present with symptoms that have not yet been diagnosed or categorised) that come in directly from the ambulances. This has increased the risk to patients and staff. The corridor is used as soon as the department is full and then, only when the corridor is full to capacity, does the Wait 45 policy get initiated. At this point it is almost guaranteed that the corridor will need additional staffing from somewhere, while the first crew need to wait their 45 minutes—the hospital now has 45 minutes to find these additional staff otherwise the nurse: patient ratio increases in the corridor. The ratios of nurse to patients differs depending on the area of the hospital: in major treatment areas it is 1:4 but in the corridor it is 1:6; however, there is no upper limit of patients in the corridor and staff are often moved from other in-patient areas to work in the ED where they are invariably working in the corridor. These nurses will not have a ED background and will find it challenging and may miss the subtle signs that an experienced ED nurse may spot. There is often a lack of support for nurses in the corridor, leaving additional staff having to rely on their previous experience and judgement to guide them on what needs to be done. Handover criteria not being met Ambulance trust and the acute trust staff should at handover discuss the criteria for placing patients in a corridor—i.e., patients are supposed to be independent, able to move themselves to the toilet, be clinically stable and not have an infectious presentation However, in my experience this criteria is often not followed, as highlighted in the following examples I have seen and heard: Suspected neutropenic patients placed in the corridor. These patients have a low neutrophil count (a type of white blood cell) and are more vulnerable to infections. The concern for those on immunosuppressants seems to be non-existent now; there was a significant concern during the Covid-19 pandemic, but now being immunosuppressed is met with a tut, roll of the eyes and a shrug of the shoulders. It rarely features in handovers. Ambulance crews handing over patients that needed a hoist transfer at their nursing home; it is clearly not appropriate to care for these patients in a corridor where they should be mobile to use bedpans or commodes. Elderly patients who have fallen—either with significant trauma or with no apparent injuries—placed in the corridor. One patient had pain in their neck and received a trauma CT scan in the corridor—surely this patient should not have been in a corridor in the first place! Patients with diarrhoea and vomiting placed in the corridor, sometimes next to the neutropenic patients. Those with significant respiratory symptoms suggestive of influenza or Covid-19 placed in the corridor, despite the known risks to those that are in the corridor with them. I have even had a patient with a Glasgow Coma Scale of 10 (this is a tool that healthcare providers use to measure decreases in consciousness) handed over to the corridor… Wouldn’t resuscitation be a better location for them? Unintended consequences It is easy to understand why ‘Release to Respond’ policies are needed. With no external pressure, it appeared that many trusts lacked the willingness to investigate changes to reduce the overcrowding in the ED. However, while I recognise that the ambulance trusts need to have their staff available and not tied up at hospitals, this is making the ED unsafe. Another unintended consequence of these policies is that the working relationships between the ED nurses and the ambulance crews has deteriorated. I have noticed an increasing lack of willingness to help each other and incivility is growing. Asking simple questions results in dirty looks and aggressive questioning about ’who are you‘. The natural feeling is now one of defence, protecting each other against comments, pulling back into areas of comfort and knowledge. The standard replies are now ‘no’ and a feeling that this is not my problem or my fault. Unilateral measures that do not address the whole problem I cannot help but think implementing a unilateral solution like the ‘Release to Respond’ policy is based entirely on ‘work as imagined’ and benefits only one part of a highly complex area. It places additional burdens on already overstretched resources. The worst of which is that EDs are still seen as being made of elastic, with the ability to continually expand even when the evidence shows every hospital is beyond capacity every day of the year! When I first heard about ICSs and ICBs, I really hoped we would start to see a time of collaboration, working together to solve some of the issues within healthcare. Sadly, there does not yet seem to have been a change. In fact, it feels very much that we renamed but stayed the same. Probably, because all that has happened since the ICSs were introduced is restructuring after restructuring. They are not being allowed to work. Please, don’t get me wrong. I can see why these policies are in place. If I called an ambulance, I would like it to be available to respond and unfortunately currently they are not and have not been for a while. But I cannot help but think that until the ICS and regional NHS organisations take ownership of these problems, and all the stakeholders are represented at the table to analyse, design, implement and, most important of all, EVALUATE an intervention, we are condemned to keep implementing unilateral measures that do not address the whole problem. Further reading on the hub The crisis of corridor care in the NHS: patient safety concerns and incident reporting A silent safety scandal: A nurse’s first-hand account of a corridor nursing shift A nurse's response to the NHSE guidance on their principles for providing safe and good quality care in temporary escalation spaces How corridor care in the NHS is affecting safety culture: A blog by Claire Cox Share your insights Do you have experience of corridor care either as a patient or a healthcare professional? What impact have you seen on patient safety? You can comment below (sign up here for free first) or email the editorial team at [email protected]- Posted
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Content Article
The fundamental importance of having enough registered nurses present to deliver care is well supported by evidence. Lower registered nurse staffing levels are associated with higher risks to patients and poorer quality care. Here is the Royal College of Nursing's position statement on registered nurse staffing levels for patient safety.- Posted
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News Article
NHS gave private firms record £216m to examine X-rays in 2024
Patient Safety Learning posted a news article in News
The NHS handed private firms a record £216m last year to examine X-rays and scans because hospitals have too few radiologists. The amount of money NHS organisations across the UK are paying companies to interpret scans has doubled in five years as demand rises for diagnostic tests. Despite the growth in privatisation, the NHS in England failed to read 976,000 X-rays and CT and MRI scan results within its one-month target – the highest number ever. Scans play a crucial role in telling doctors if a patient has cancer or a broken bone, for example. The Royal College of Radiologists (RCR), which collated the figures from doctors across the UK, said the £216m given to private firms in 2024 was “a false economy” which it blamed on the NHS’s failure to recruit enough specialists to read all the scans patients have in its hospitals. The college said the growing outsourcing of scan analysis risked creating “a vicious cycle” in which NHS radiology services were increasingly weakened and its doctors drawn to private work. Dr Katharine Halliday, the RCR’s president, said: “The current sticking plaster approach to managing excess demand in radiology is unsustainable and certainly isn’t working for patients, who face agonising waits for answers about their health. “It is a false economy to be spending over £200m of NHS funds outsourcing radiology work to private companies, and evidence of our failure to train and retain the amount of NHS radiologists we need.” Read full story Source: The Guardian, 15 May 2025- Posted
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News Article
Trust admits it ‘cannot safely run’ maternity service
Patient Safety Learning posted a news article in News
A trust is set to close one of its birthing units for at least six months after admitting it “cannot safely run” the service. Somerset Foundation Trust will temporarily close the maternity unit at Yeovil District Hospital “for an initial period of six months” from next week, amid significant gaps in medical staffing. The trust has said it “cannot safely run” the special care baby unit, which provides dedicated support for premature newborns, nor “safely provide care during labour and birth”. The closure follows concerns being raised by the Care Quality Commission. The regulator rated maternity services at Yeovil “inadequate” last year and also issued a warning notice in January after finding its paediatric care “requires significant improvement”. The CQC said the service did not have enough medical staff or emergency equipment to keep babies safe, and found not all staff followed infection control procedures. Dr Iles added that senior paediatricians from Somerset FT’s Musgrove Park Hospital are helping to ensure paediatric inpatient and outpatient services at Yeovil remain open, including obstetric and midwifery antenatal clinics, scanning, antenatal screening services, and home births. But she added: “We cannot care for any newborns who require care in a special care baby unit or safely provide care during labour and birth at the Yeovil maternity unit. “We are committed to providing safe, high quality, and sustainable services for those who need them, but we must address these concerns and need the time and space to do this. I apologise again to anyone who is affected by these changes.” Read full story (paywalled) Source: HSJ, 15 May 2025 -
News Article
The UK's top A&E doctor has accused the government of “neglecting the oldest and sickest patients” as figures suggest a record 320 people a week may have died needlessly in A&E last year due to waits for hospital beds. Dr Adrian Boyle, the Royal College of Emergency Medicine president, has warned that current government policy on A&E is focused on cutting waits for “cut fingers and sprained ankles” while neglecting older people, who are most likely to die and spend days on trollies. The Royal College of Emergency Medicine (RCEM) estimates there were more than 16,600 deaths of patients linked to long waits for a bed, an increase of a fifth on 2023 and a record since new A&E data has been published. The figures come after the NHS’s target to see 95% of patients within four hours was cut to 78% for 2025/26. There is no national target for the number of people waiting 12 hours, the length of time linked to excess emergency care deaths, but last year more than 1.7 million patients waited 12 hours or more to be admitted, discharged or transferred from A&E. Dr Boyle said the figures were “the equivalent of two aeroplanes crashing every week” and were devastating for families. Read full story Source: The Independent, 15 May 2025- Posted
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News Article
Thousands of people in a mental health crisis are enduring waits of up to three days in A&E before they get a bed, with conditions “close to torture” for those in such a distressed state. At one hospital, some patients have become so upset at the delays in being admitted that they have left and tried to kill themselves nearby, leading nurses and the fire brigade to follow in an attempt to stop them. A&E staff are so busy dealing with patients seeking help with physical health emergencies that security guards rather than nurses sometimes end up looking after mental health patients. The findings are included in research by the Royal College of Nursing. Its leader, Prof Nicola Ranger, called the long waits facing those in serious mental ill health, and the difficulties faced by A&E staff seeking to care for them, “a scandal in plain sight”. The RCN’s research into “prolonged and degrading” long stays in A&E also disclosed that: Some trusts that previously had no long waits for mental health patients now have hundreds. The number of people seeking help at A&E for mental health emergencies is rising steadily and reached 216,182 last year. The recruitment of mental health nurses has lagged far behind the rise in demand. The number of beds in mental health units has fallen by 3,699 since 2014. Rachelle McCarthy, a senior charge nurse at Nottingham university hospitals NHS trust, said: “It is not uncommon for patients with severe mental ill health to wait three days. Many become distressed and I totally understand why. I think if I was sat in an A&E department for three days waiting for a bed I would be distressed too.” Read full story Source: The Guardian, 13 May 2025- Posted
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- Mental health
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News Article
Vulnerable patients at a struggling A&E died or needed intensive care after their needs “were not met” while being cared for in corridors and waiting areas, inspectors have warned after an unannounced inspection. The Care Quality Commission has raised concerns about how some of the “most vulnerable patients” were being treated in temporary escalation spaces at the Royal Cornwall Hospital in Truro, according to a document published in board papers this month. NHSE has said systems should “consider reporting the number of patients” in temporary escalation spaces, which include corridors or makeshift wards. Its guidance followed the broadcast of a Channel 4 documentary that included scenes of patients being neglected in corridors in the Royal Shrewsbury Hospital. Published CQC reports have since raised concerns about corridor care, but senior figures told HSJ the findings at the Royal Cornwall were among the most severe of this kind. The inspectors said one 96-year-old woman in a temporary escalation space died following a fall and staff “were unaware of the risk of falls due to lack of verbal handover”. Another patient “with a history of delirium” suffered a fractured collarbone from a fall in the same area of the hospital. In another case, an incontinent patient was transferred to a “fit to sit” area but by the end of the day “had deteriorated and was in intensive care”. The CQC’s letter said: “We were concerned the most vulnerable patients were not having their needs met when cared for in a temporary escalation space. “We weren’t assured that every ward is accounting for additional patients in the temporary escalation areas in terms of staffing numbers and skill mix.” Read full story (paywalled) Source: HSJ, 13 May 2025 Further reading on the hub: Corridor care: are the health and safety risks being addressed? The crisis of corridor care in the NHS: patient safety concerns and incident reporting A nurse's response to the NHSE guidance on their principles for providing safe and good quality care in temporary escalation spaces- Posted
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- Hospital corridor
- Patient death
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News Article
Hospitals in England reducing staff and services as part of NHS ‘financial reset’
Patient Safety Learning posted a news article in News
Hospitals in England are cutting staff, closing services and planning to ration care in order to make “eye-watering” savings demanded by NHS bosses. Rehabilitation centres face being shut, talking therapies services cut and beds for end-of-life care reduced as part of efforts by England’s 215 NHS trusts to comply with a “financial reset”. Sir Jim Mackey, NHS England’s new chief executive, has ordered them to make unprecedented savings during 2025-26 to avoid a projected £6.6bn deficit becoming a reality. But trust bosses are warning that delivering what for some equates to 12% of their entire budget in “efficiency savings” will affect patients and waiting times. “These [savings targets] are at eye-wateringly high levels”, said Saffron Cordery, the interim chief executive of NHS Providers, which represents trusts. “It’s going to be extremely challenging.” Trusts have to make, in some cases, deep cuts in order to stay in the black this year, despite the government having given the NHS an extra £22bn for last year and this one. A survey it conducted among trust leaders found that diabetes services for young people and hospital at-home-style “virtual wards” were among the areas of care likely to be scaled back. Trusts are planning to shrink their workforce by up to 1,500 posts each to save money, even though they fear that could damage the quality or safety of care provided. Read full story Source: The Guardian, 9 May 2025- Posted
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- Funding
- Workforce management
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News Article
More than 1m older people in England waited over 12 hours in A&E last year
Patient Safety Learning posted a news article in News
More than 1 million older people a year in England are forced to wait longer than 12 hours in A&E, with many having to endure “degrading and dehumanising” corridor waits on trolleys. The number aged 60 and over waiting more than 12 hours to be transferred, admitted or discharged increased to 1.15 million in 2024, up from 991,068 in 2023. The figure was 305,619 in 2019, according to data obtained by the Royal College of Emergency Medicine (RCEM) under freedom of information laws. A report by the RCEM also found the risk of a 12-hour wait in an emergency department in England increased with the age of the patient. People aged 60 to 69 had a 15% chance of waiting 12 hours or more. For those aged 90 and over, the likelihood rose to 33%. “The healthcare system is failing our most vulnerable patients – more than a million last year,” said Dr Adrian Boyle, the president of the RCEM. “These people are our parents, grandparents, great-grandparents. “They aren’t receiving the level of care they need, as they endure the longest stays in our emergency departments, often suffering degrading and dehumanising corridor care. It’s an alarming threat to patient safety. We know long stays are dangerous, especially for those who are elderly, and puts people’s lives at risk.” As well as long waits, the RCEM report found many older people were missing out on vital checks in A&E. Of patients aged over 75, only 16% were screened for delirium – a reversible condition linked to an increased risk of death. Fewer than half (48%) of patients were screened for their risk of falls. Read full story Source: The Guardian, 6 May 2025- Posted
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- Older People (over 65)
- Accident and Emergency
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Content Article
More than a million older people faced waits of 12 hours or more in A&Es in England last year – and shockingly, the older a person is, the more likely they are to experience a long stay in the emergency department – new data from the Royal College of Emergency Medicine (RCEM) reveals.It comes as the College publishes a new report looking at the care older people receive in emergency departments.The research, titled ‘Care of Older People 2023-24’, is part of the College’s clinical Quality Improvement Programme which aims to improve the care of patients attending Emergency Departments. This interim report reflects the findings of the second year of the three-year programme. Across the UK, 149 Emergency Departments submitted 24, 865 patient cases from 4 October 2023 – 3 October 2024. A key finding was that among patients over the age of 75, there was insufficient screening for three common conditions which primarily affect this age group: Only 16% of patients were screened for delirium – a reversible condition which can be associated with mortality, characterised by a sudden change in mental function.On average less than half (48%) had screening to assess the risk of falling.An average of 56% underwent screening for general frailty – which if detected can trigger early intervention and support in hospital and in the community.Despite a year-on-year improvement from 2023, these patients are enduring the longest waits in A&Es and are bearing the brunt of an Urgent and Emergency Care system in crisis. Older people are often more likely to suffer with complicated or multiple health issues. This, combined with the wider issues related to a shortage of in-patient beds, mean they can often end up enduring extreme long waits in A&E – often on trolleys in corridors.- Posted
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- Older People (over 65)
- Accident and Emergency
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News Article
Urgent care worse than pre-pandemic, think tank says
Patient Safety Learning posted a news article in News
A leading health think tank says urgent and emergency care in England is performing "far worse" than before the pandemic. The Health Foundation argues that the NHS was "in distress" this winter with A&E waiting times reaching a record high. The group says it would be wrong just to blame relatively high levels of flu. The government is due to publish an urgent and emergency care plan soon. The Department for Health and Social Care said that hospitals were "feeling the strain" but that it was taking "decisive action" to prevent winter crises. The Health Foundation report on the recent winter says that the number of people waiting 12 hours or more in A&E after a decision to admit to a ward was the highest since modern records began. It topped 60,000 in January, or 11% of emergency admissions. The report says that a familiar problem remains as acute as ever – delays discharging patients from hospital who are fit to leave. This, it says, made bottlenecks worse in A&E and for ambulances trying to hand over patients and that delays for those handovers were worse than in previous winters. Read full story Source: BBC News, 28 April 2025- Posted
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- Organisational Performance
- Lack of resources
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Content Article
The health service in England has endured a punishing winter. Stark warnings about a potential ‘quad-demic’, the ‘busiest year on record’ for A&E and ambulance services, and ’jampacked’ hospitals prompted comparisons with the COVID-19 pandemic. But how bad was winter 2024/25? The Health Foundation present analysis of routinely collected and publicly available data on health service performance and the possible contributing factors. Key points: This winter saw the NHS in distress. Only 73% of A&E patients were treated within 4 hours, similar to the last two winters, and far below the 95% constitutional standard. The number of people experiencing 12-hour waits before admission reached a new record high. Numbers of A&E diverts and ambulance handover delays were worse than over previous winters. Looking at operational performance, winter pressures and other factors, the analysis explores the extent to which disruptions to urgent and emergency care were caused by higher than usual levels of winter illnesses and/or systemic weaknesses within the NHS. Levels of flu and diarrhoea and vomiting were higher than usual. Hospital admissions for flu reached a similar peak to winter 2022/23 but took longer to fall, leading to a 50% higher total number of flu bed days. However, hospital admissions for RSV were similar to previous winters, while admissions for COVID-19 remained low. Winter A&E attendances have risen steadily each year. However, slightly fewer patients attended major A&E departments in winter 2024/25 than in 2023/24, and emergency hospital admissions fell slightly. This suggests the NHS struggled to cope with a small increase in demand from patients needing emergency hospitalisation, while also expanding elective activity in line with government commitments to improve elective performance. Bed occupancy during winter has been rising for the last 15 years, exceeding the NHS 92% threshold for the first time in winter 2017/18, highlighting a system at its limits. Since COVID-19, a substantial increase in delayed discharges is likely to have obstructed the flow of patients out of hospitals, worsening bottlenecks upstream in the care pathway from A&E into wards and from ambulances into A&E. Overall, the conditions this winter, while severe, were similar to those in recent years and not far above what the NHS can normally expect. Attributing operational problems to external factors such as winter illnesses and higher demand risks offering false comfort about the resilience of the health service. The shows the health service performing far worse than before the pandemic and reporting record or near-record levels of operational problems across urgent and emergency care. Ahead of the government’s forthcoming Urgent and Emergency Care Plan, this raises key questions about what might be behind some of the underlying issues contributing to what has now become an annual winter crisis.- Posted
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- Organisational Performance
- Long waiting list
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Content Article
In a blog earlier this year, Patient Safety Learning’s Associate Director Claire Cox looked at how corridor care within the NHS is affecting safety culture and examined its implications for both healthcare professionals and patients. In this new blog, she turns her attention to the associated health and safety risks, questioning whether these are being properly addressed. Claire draws out key areas for consideration and suggests practical measures that can help protect patient safety in such challenging working environments. In recent years, corridor care has become an unfortunate reality in many NHS hospitals across the UK. With hospitals operating over capacity, patients are often treated in corridors due to a lack of available beds. While this practice may provide temporary relief in overcrowded healthcare settings, it also introduces significant health and safety risks for patients, staff and visitors. What is corridor care? Corridor care is a term used to describe the practice of providing medical attention to patients in hallways or other non-designated clinical areas due to overcrowding or resource shortages. This is typically due to emergency departments being overwhelmed or a shortage of inpatient beds. Corridor care is no longer an exception—it has become the norm in many hospitals. A new report published in January by the Royal College of Nursing illustrated the prevalence of this, sharing the experiences of more than 5,000 nursing staff on corridor care in the UK.[1] [2] In February, the Royal College of Physicians published a snap survey of its members highlighting the prevalence of corridor care, with 78% of respondents having provided care in a temporary environment in the previous month.[3] Key health and safety risks of corridor care When speaking about the impact of corridor care, understandably our initial focus tends to be on its direct impact on the care of the patient and the staff member providing that care. However, a somewhat overlooked aspect of this is how it can impact on the wider health and safety of those working in, or using, healthcare facilities. This can manifest itself in a number of different ways: Infection control risks Corridors lack the necessary infection control measures—for example, hand washing facilities and appropriate waste disposal, including sharps—which increases the risk of hospital-acquired infections, such as MRSA and Clostridium difficile.[4] The inability to maintain appropriate isolation for infectious patients poses a serious public health concern.[5] Delayed emergency response Corridors are not equipped for life-saving interventions in emergencies. Delayed access to equipment, medication and clinical teams in a corridor setting can increase mortality and morbidity.[6] A lack of emergency call bell alarms may incur delays in receiving appropriate emergency help. Swift transfer of unwell patients is often made challenging due to obstacles obstructing a usually clear path. Emergency teams may find it difficult to locate the unwell patient in a corridor as there may be numerous ‘temporary escalation’ areas within the department. Obstruction and fire safety hazards Corridors crowded with trolleys, equipment and patients create obstructions that can impede fire evacuation routes. Fire doors may be left open to accommodate trolleys, compromising compartmentalisation and increasing the spread of fire and smoke. NHS Trusts are legally required under the Regulatory Reform (Fire Safety) Order 2005 to ensure that escape routes remain unobstructed, which is often compromised by corridor care.[7] The London Fire Brigade recently highlighted these issues with their local hospitals, citing concerns about obstruction of fire escape routes, increased fire load in circulation spaces and delayed evacuation times in the event of an emergency.[8] Manual handling and staff safety Healthcare staff face increased manual handling risks while manoeuvring equipment and providing care in narrow corridors. This can lead to musculoskeletal disorders and workplace injuries, further exacerbating staff shortages.[9] The question is, are these risks being addressed? Risk assessments: A key to mitigation While some NHS Trusts have implemented risk assessment templates for corridor care, these are not yet standardised across the system. The Health and Safety Executive (HSE) recommends that risk assessments for corridor care include: infection control protocols fire safety compliance manual handling risk reduction patient privacy and dignity measures emergency response protocols.[9] What about fire safety? Fire safety is one of the most pressing concerns associated with corridor care. Under the Regulatory Reform (Fire Safety) Order 2005, NHS Trusts are required to ensure that: Escape routes remain clear at all times. Adequate fire risk assessments are conducted and updated regularly. Staff are trained in evacuation procedures, especially in high-risk areas like corridors.[7] Are Trusts compliant? While most Trusts have fire risk assessments in place, reports from the Care Quality Commission (CQC) indicate that compliance varies across the country. Some hospitals have been flagged for failing to adequately mitigate the fire risks associated with corridor care.[10] What measures can we take to protect patient safety? The below points offer some practical health and safety measures that can be put in place to help reduce risk: Fire risk management: Regular audits to ensure corridors are not overcrowded and escape routes remain clear. Patient identification and monitoring: Implementing digital systems to track patient location and their condition when placed in corridors. Enhanced infection control: Providing hand hygiene stations and maintaining isolation protocols even in corridor settings. Staff training and awareness: Ensuring staff are trained in dynamic risk assessments and evacuation procedures. Establishing escalation protocols: Creating clear guidelines on when to escalate corridor care situations to prevent patient harm. The need for systemic change Corridor care is a symptom of a healthcare system under immense pressure. While temporary risk mitigation measures can improve safety, long-term solutions require increased capacity, better resource allocation and investment in community-based care to prevent unnecessary admissions. If the current trend continues, addressing health and safety risks associated with corridor care must become a top priority to protect both patients and healthcare staff. Call to action Do you work in healthcare or health and safety? Your expertise can make a real difference! Share your corridor care risk assessments with Patient Safety Learning to help identify risks, prevent harm and improve outcomes for patients. Comment below (sign up first for free) or email [email protected]. References Royal College of Nursing. On the frontline of the UK’s corridor care crisis, 16 January 2025. Patient Safety Learning. Response to RCN report: On the frontline of the UK’s corridor care crisis, 17 January 2025. Royal College of Physicians. Doctors confirm ‘corridor care’ crisis as 80% forced to treat patients in unsafe spaces, 26 February 2025. National Institute for Health and Care Excellence (NICE). Infection Prevention and Control Quality Standard, 2014. London: NICE. Public Health England. Guidelines on Infection Prevention and Control, 2019. London: PHE. Royal College of Emergency Medicine (RCEM), 2021. Crowding and its Consequences: Policy Brief. London: RCEM. HM Government, 2005. The Regulatory Reform (Fire Safety) Order 2005. London: The Stationery Office. London Fire Brigade. Letter to Trusts to review your Fire Risk Assessments, 17 February 2025. Health and Safety Executive (HSE). Manual Handling Operations Regulations 1992 (as amended), September 2016. London: HSE. Care Quality Commission (CQC). State of Care Report, September 2021. London: CQC. Related reading on the hub: How corridor care in the NHS is affecting safety culture: A blog by Claire Cox The crisis of corridor care in the NHS: patient safety concerns and incident reporting Response to RCN report: On the frontline of the UK’s corridor care crisis A nurse's response to the NHSE guidance on their principles for providing safe and good quality care in temporary escalation spaces A silent safety scandal: A nurse’s first-hand account of a corridor nursing shift- Posted
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- Hospital corridor
- Health and safety
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