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Found 767 results
  1. 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?
  2. News Article
    NHS waiting lists will take more than three years to be reduced to pre-pandemic levels, according to a new analysis. Despite recent reductions in the waiting list in England, the Institute for Fiscal Studies (IFS) think tank said that it is “unlikely that waiting lists will reach pre-pandemic levels” by December 2027 – even under a “best-case scenario”. The latest figures show that the waiting list for routine hospital treatment in England has fallen for the third month in a row. An estimated 7.6 million treatments were waiting to be carried out at the end of December, relating to 6.37 million patients, down slightly from 7.61 million treatments and 6.39 million patients at the end of November, according to NHS England figures. Cutting NHS waiting lists is one of Prime Minister Rishi Sunak’s top priorities. However, the PM admitted earlier this month he would not meet his promise to reduce waiting lists. However, the new IFS analysis highlights how the NHS waiting list was already growing before the pandemic, but it rose “rapidly” during the crisis. The IFS report suggests a range of scenarios about how the waiting list could look in December 2024. Under a “more pessimistic scenario”, waiting lists will remain at the same elevated level while an “optimistic scenario” would see them fall to 5.2 million by December 2027.
  3. Content Article
    This Institute for Fiscal Studies briefing, outlines what has happened to NHS waiting lists (in England, given that health is a devolved responsibility) over the last 17 years – the period for which consistent data are available – and present new scenarios of what could happen to waiting lists over the years to come. It focuses on the elective waiting list – the list of people waiting for pre-planned hospital treatment and outpatient appointments. This is what most people mean when they talk about NHS waiting lists, but it also considers a range of other NHS waiting lists and waiting times. Alongside this report, IFD has updated their interactive online tool that allows you to produce waiting list scenarios under your own assumptions.
  4. News Article
    Long A&E waits have got worse at more than one in five acute trusts, despite an improving trend nationally. Around 30 acute trusts have reported an increase in long accident and emergency waits, bucking the national trend. According to data covering the nine months to December, the proportion of waits more than 12 hours from time of arrival has improved to 6.3%, down from 8% during the same period in 2022. However, 28 out of 119 acute trusts reported a rise of up to 3 percentage points. HSJ’s analysis, which used published and unpublished data, showed 11 of these trusts had worsened despite improving their headline performance against the four-hour target. Adrian Boyle, of the Royal College of Emergency Medicine, said the emphasis on the four-hour target “incentivises focus on the people who are being sent home, and takes effort and attention away from the people who are being admitted to hospital”. He added: “The harms of long waits are greatest for people being admitted to hospital. We are disappointed by the current lack of focus in the planning guidance to help our most vulnerable patients.” Read full story (paywalled) Source: HSJ, 27 February 2024
  5. Content Article
    Eating Disorders Awareness Week takes place 26 February - 3 March 2024 Eating disorders are complex mental health conditions that affect an estimated 1.25 million people in the UK. There are many unhelpful myths about who eating disorders affect, what the symptoms are and how to support people in recovery. Alongside a current lack of appropriately trained staff and capacity in mental health services, this can make it challenging for people with eating disorders to access the help and support they need. Patient Safety Learning has pulled together ten useful resources shared on the hub to help healthcare professionals, friends and family support people with eating disorders. They include awareness-raising articles, practical tips for patients and their loved ones, and clinical guidance for primary, secondary and mental health providers.
  6. News Article
    Health systems will be asked to deliver the same amount of elective activity next year as they were tasked with completing in 2023-24, HSJ understands. Local leaders have been issued with varying interim targets for 2024-25 that produce an average national threshold of 7% more activity than pre-covid levels, on a value-weighted basis. It means the target for the current year has effectively been rolled over into next, suggesting the elective recovery is a year behind schedule. Even if systems hit their thresholds next year, they will still fall well short of the central target set out in the elective recovery plan in 2022. Recent weeks have seen other elective ambitions ditched or watered down, including the prime minister’s headline pledge to bring the overall waiting list down. It is likely a result of the government accepting it cannot push more elective activity due to ongoing strikes and overspending. Read full story (paywalled) Source: HSJ, 27 February 2024
  7. 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
  8. Content Article
    The Scottish Government needs to develop a clear national strategy for health and social care to address the pressures on services, says a review by Audit Scotland. Significant changes are needed to ensure the financial sustainability of Scotland's health service. Growing demand, operational challenges and increasing costs have added to the financial pressures the NHS was already facing. Its longer-term affordability is at risk without reform.
  9. News Article
    Scotland's NHS is unable to meet the growing demand for health services, a spending watchdog has warned. A review by Audit Scotland said the increased pressure on the NHS was now having a direct impact on patient safety and experience. The watchdog also claimed there was no "overall vision" for the future of the health service. The annual report on the state of Scotland's health service highlighted that the NHS was facing soaring costs, patients were waiting longer to be seen and there were not enough staff. Stephen Boyle, Auditor General for Scotland, said this had "added to the financial pressures on the NHS and, without reform, its longer-term affordability". He added: "Without change, there is a risk Scotland's NHS will take up an ever-growing chunk of the Scottish budget. And that means less money for other vital public services. "To deliver effective reform the Scottish government needs to lead on the development of a clear national strategy for health and social care. "It should include investment in measures that address the causes of ill-health, reducing long-term demand on the NHS." Read full story Source: BBC News, 22 February 2024
  10. News Article
    Patients are facing delays stuck on hidden waiting lists that do not show up in the official figures in England, a BBC News investigation reveals. The published waiting list stands at 7.6 million - but the true scale of the backlog is thought to be much higher. This is because patients needing ongoing care are not automatically included in those figures - even if they face major delays. NHS England said hospitals should be monitoring and counting such cases. But BBC News found evidence suggesting this is not always the case. The problem affects patients receiving ongoing care, as well as those removed from waiting lists even before starting treatment. BBC News has spoken to patients waiting months and even years for vital treatment, such as cancer care, spinal treatment and others at risk of going blind because of deteriorating eyesight. Hospitals are meant to return patients facing unnecessary delays to the waiting list to ensure they are counted in the backlog figures. But of 30 NHS trusts asked by BBC News how regularly this was happening, only three could provide figures. Karen Hyde, from Insource, a company that helps hospitals manage waiting lists, said the guidance was "commonly ignored". "This is a huge issue. The NHS does not incentivise hospitals to keep a close eye on these patients. "We know there are long waits for those on the waiting list. For those not on the official waiting list, it is likely to be even worse - but the figures are not published." Read full story Source: BBC News, 19 February 2024
  11. Content Article
    This is an independent review commissioned by NHS England, chaired by Siobhan Melia, Chief Executive, Sussex Community NHS Foundation Trust, to support the improvement of the culture within the ambulance service. The review considers the prevailing culture within ambulance trusts in England. It considers the core factors impacting cultural norms and offers actionable recommendations for improvement. Based on insights from key stakeholders, this review has identified six key recommendations to improve the culture in ambulance trusts.
  12. News Article
    The number of patients waiting more than 12 hours for a bed on a ward after being seen in A&E in England was 19 times higher this winter than it was before the pandemic, figures show. There were nearly 100,000 12-hour waits in December and January - compared with slightly more than 5,000 in 2019-20. A decade ago these waits were virtually unheard of - in the four winters up to 2013-14 there were fewer than 100. The King's Fund said long delays were at risk of becoming normalised. It said the pressures this winter had received little attention compared with last winter, despite no significant improvement in performance. During December 2023 and January 2024, 98,300 patients waited more than 12 hours for a bed on a ward after A&E doctors took the decision to admit them. The Northern Ireland branch of the Royal College of Emergency Medicine (RCEM) said the pressures were "unsurmountable" and it was having a detrimental impact on patients. Read full story Source: BBC News, 15 February 2024
  13. News Article
    The family of a man who needlessly died after a 12-hour delay in surgery have called for changes at a troubled NHS trust as regulators expressed alarm about patient safety and waiting times. The Care Quality Commission (CQC) upgraded the surgery department at the Royal Sussex county hospital in Brighton from “inadequate” to “requires improvement” at a time when it is at the centre of a police investigation into dozens of patient deaths, allegations of negligence and cover-up. In their report, the regulator expressed concern about already long and lengthening waiting times, repeated cancelled operations and staff shortages that could compromise safety. The inspection report comes as the Guardian can reveal the trust apologised and settled with the family of Ralph Sims, who died aged 65 after heart surgery in April 2019 when doctors failed to act appropriately to a drop in his blood pressure. Sims, who was a keen runner, suffered a drop in blood pressure and developed an irregular heart rhythm eight hours after surgery to replace an aortic valve at the hospital. An internal investigation into Sims’ treatment acknowledged that hospital staff failed to “recognise the significance of the fall in blood pressure”. University Hospitals Sussex NHS foundation trust, which runs the hospital, accepted that the father of three should have returned to surgery to identify the cause of his deterioration. Instead, medics decided that he should be observed overnight. Due to another emergency case, an angiogram was not carried out on Sims until just before noon the following day – 12 hours after the drop in pressure. The delay caused irreversible – and avoidable – heart muscle damage, leading to his death five weeks later. The family said: It added: “Whilst the trust has apologised to our family it feels hollow. Ralph’s death was entirely unnecessary, and despite the issues in his care, it took the trust several years to apologise.” Read full story Source: The Guardian, 14 February 2024
  14. News Article
    England’s largest hospital trust has written to GPs warning their patients face 15-week waits for routine MRIs, ultrasound and CT scans. Guy’s and St Thomas’ Foundation Trust in central London said it was prioritising suspected cancer and other “urgent cases”, meaning “unfortunately waiting times for routine patients are now an average of 15-16 weeks for an appointment against a target of six weeks”. This is much worse than national averages, which December figures showed were 3.2 weeks, 2.5 weeks and 3.3 weeks for MRI, CT and ultrasound waits respectively. It its letter to GPs in Lambeth and Southwark – its main patches – GSTT said: “Current imaging referral demand outstrips capacity, despite these services consistently delivering near 120 per cent levels of activity compared to 2019-20. “The radiology service is exploring multiple routes to increase imaging capacity, including increased weekend working, insourcing and outsourcing contracts, but there is still a significant shortfall of slots every week.” In particular, it said primary care staff should expect long waits for the reporting of routine MRI scans. Read full story (paywalled) Source: HSJ, 13 February 2024
  15. News Article
    NHS England is in negotiations with ministers to formally push back the target to eliminate 65-week waiters, HSJ has learned. Discussions about the target are on-going as part of negotiations around the delayed 2024-25 planning guidance. It has been clear for months the March deadline to virtually eliminate 65-week waiters would be missed. It has emerged some trusts with the largest waiting lists already appear to be working to a September deadline. The news follows prime minister Rishi Sunak being forced to finally admit this week that his flagship NHS pledge from last January, that the waiting list would be falling by this year, had failed. This was something NHS bosses have warned of since summer. Read full story (paywalled) Source: HSJ, 9 February 2024Choose Single File...
  16. News Article
    An investigation has been launched after a woman died days after being found unconscious underneath her coat while waiting in A&E for seven hours. The 39-year-old woman is understood to have first attended A&E at Queen’s Medical Centre in Nottingham on the evening of 19 January complaining of a severe headache. She was triaged and then observed by nurses three times. Her case was escalated but she was not seen by a doctor before being discovered. When the woman was called to see a doctor, she did not respond. It was assumed that she had left A&E because she had waited so long. She was discovered and transferred to intensive care but died three days later on 22 January. A source familiar with the hospital told LBC, which first reported the incident, that the A&E department could have up to 80 patients waiting at a single time and that wait times could be as long as 14 hours. Dr Keith Girling, the medical director at Nottingham university hospitals NHS trust, said: “I offer my sincere condolences to the family at this difficult time. An investigation, which will involve the family, will now take place and until this has been concluded, we are unable to comment further.” Read full story Source: The Guardian, 10 February 2024
  17. News Article
    The number of patients waiting more than 12 hours in A&E hit a record in January of almost 180,000 people. Worsening pressures on A&E come as prime minister Rishi Sunak has officially missed his pledge, made in January last year, to cut the NHS waiting list. NHS England began publishing previously-hidden data on patients waiting 12 hours or more last year, after reports by The Independent. The latest figures for January show 178,000 people were waiting this long to be seen, treated or discharged after arriving from A&E – a record since February 2023 when the data was first published. In that month, 128,580 people waited more than 12 hours, and in December there were 156,000. The number waiting at least four hours from the decision to admit to actual admission has also risen, from 148,282 in December to 158,721 last month – the second-highest figure on record. Dr Tim Cooksley, past president of the Society for Acute Medicine, warned: “Degrading corridor care and prolonged waits causing significant harm is tragically and increasingly the expected state in urgent and emergency care.” Read full story Source: The Independent, 8 February 2024
  18. News Article
    Cancer waiting times for 2023 in England were the worst on record, a BBC News analysis has revealed. Only 64.1% of patients started treatment within 62 days of cancer being suspected, meaning nearly 100,000 waited longer than they should for life-saving care. The waits have worsened every year for the past 11. Macmillan Cancer Support chief executive Gemma Peters called the figures "shocking". "This marks a new low and highlights the desperate situation for people living with cancer," she said. "Behind the figures are real lives being turned upside down, with thousands of people waiting far too long to find out if they have cancer and to begin their treatment, causing additional anxiety at what is already a very difficult time. "With over three million people in the UK living with cancer and an ageing population, this is only set to rise." The records go back to 2010, shortly after the cancer target was introduced. However, improvements have been made over the course of 2023 in how quickly patients are diagnosed with 72% told whether they have cancer or not within 28 days of an urgent referral. Read full story Source: BBC News, 8 February 2024
  19. News Article
    Next week’s launch of the ‘Wayfinder’ waiting time information service on the NHS App will give patients “disingenuous” and “misleading” information about how long they can expect to wait for care, senior figures close to the project have warned. Briefing documents seen by HSJ show the figure displayed to patients will be a mean average of wait times taken from the Waiting List Minimum Data Set and the My Planned Care site. However, it was originally intended that the metric displayed would be the time waited by 92% of relevant patients. This is more commonly known as the “9 out of 10” measure. Mean waits are likely to be about “half the typical waiting time” measured under the 9 out of 10 metric, according to the waiting list experts consulted by HSJ. Ahead of The Wayfinder service’s launch on Tuesday, NHS trusts and integrated care boards have been sent comprehensive information on how to publicise it, including a “lines to take” briefing in case of media inquiries. This mentions the use of an “average” time but does not provider any justification for this approach. HSJ’s source said the mean average metric was “the worst one to choose” as it would be providing patients with “disingenuous” information that will leave them disappointed. They added that the 92nd percentile metric would be a “far more realistic” measure “for a greater number of people”. They concluded that “using an average” would create false expectations “because in reality nobody will be seen in the amount of time it is saying on the app.” Read full story (paywalled) Source: HSJ, 26 January 2024
  20. News Article
    Rishi Sunak has admitted the government has failed on a pledge to cut NHS waiting lists in England. The prime minister said the government had "not made enough progress" but that industrial action in the health service "has had an impact". Mr Sunak made the comments in an interview with TalkTV. Cutting NHS waiting lists is one of five priorities Mr Sunak set out in January 2023, along with measures on the economy and illegal immigration. At the time he said "NHS waiting lists will fall and people will get the care they need more quickly" but did not set a timeframe for achieving that. Asked if his government has failed to achieve that pledge, Mr Sunak said: "Yes, we have." The prime minister continued: "What I would say to people is that we've invested record amounts in the NHS - more doctors, more nurses, more scanners. "All these things mean the NHS is doing more than it ever has but industrial action has had an impact." Read full story Source: BBC News, 5 February 2024
  21. News Article
    Hospitals are being pressured to shift their resources to treating patients with less serious conditions to meet a “politically motivated” target, according to multiple senior sources. The pressure appears to be coming through NHS England’s regional teams, with local sources saying they are being told to focus energies on patients in their emergency departments who do not need to be admitted to a ward. These cases are typically faster to deal with, and therefore shifting resources to this cohort could significantly improve performance against the four-hour target. However, experts in emergency care repeatedly warn that admitted patients are the most likely to suffer long waits and harm. The NHS has been tasked with lifting performance against the four-hour target to 76% in 2023-24, but has failed to meet that in any month this year. Performance in December was 69%. Some trust leaders told HSJ they would ignore the instructions, saying they would continue to focus resources on reducing the longest waits. One chief executive in the north of England said: “It’s a complete nonsense and just politically motivated. We’re getting a very clear message to hit 76 per cent which is hugely problematic because it will drive non patient focussed behaviour. We have said ‘no, we are focussing on long waiters and ambulance delays’… in other words doing the right thing for patients.” Read full story (paywalled) Source: HSJ, 5 February 2024
  22. Content Article
    Set up in January 2023, the Times Health Commission was a year-long projected established to consider the future of health and social care in England in the light of the pandemic, the growing pressure on budgets, the A&E crisis, rising waiting lists, health inequalities, obesity and the ageing population. Its recommendations are intended to be pragmatic, practical, deliverable and able to be potentially taken up by any political party or government, present or future. 
  23. News Article
    Paramedics are "watching their patients die in the back of ambulances because they can't get them into A&E", according to the health union, Unison. It was commenting on data showing 2,750 hours were lost by ambulance crews waiting to hand over patients at Hull Royal Infirmary in October 2023. One crew was stuck outside A&E for 10 hours and 27 minutes. Hull University Teaching Hospitals said it was "confident" a new urgent treatment centre on the hospital site would "improve overall waiting times" and lost ambulance hours had "reduced notably" this month. The figures, obtained by the BBC through a freedom of information request, showed on 9 October 2023 ambulance crews lost 144 hours and 18 minutes, the equivalent to one crew being out of action for six full days and nights. Megan Ollerhead, Unison's ambulance lead in Yorkshire, said paramedics were "literally watching their patients die in the back of these ambulances because they can't get into A and E." "I talk to a lot of the people who receive the 999 calls in the control rooms and they're just listening to people begging for ambulances and they know there are none to send." Read full story Source: BBC News, 26 January 2024
  24. News Article
    One in 20 patients has to wait at least four weeks to see a GP at a time when funding for family doctor services is falling, NHS figures show. In November 2023, 1.5m appointments in England at a GP surgery took place four weeks or more after they were booked, 4.8% of the 31.9m held that month. In one in six appointments, 5.4m (17.3%), the patient was forced to wait at least two weeks after booking it to see a GP, practice nurse or other health professional. “Millions of people are being left anxious or waiting in pain because they can’t get an appointment with their GP,” said Ed Davey, the leader of the Liberal Democrats, who highlighted the latest evidence underlining the long delays that many patients face to see a GP. “Staggering” numbers of patients now have to wait a long time, he said. GP leaders blamed the situation on the widespread shortage of family doctors, which they said was making it impossible to keep up with the rising demand for appointments. Burnout due to intense workloads is prompting more GPs to work part time. Read full story Source: The Guardian, 22 January 2024
  25. Content Article
    Meeting cancer performance targets is a challenge for many trusts with waiting times for diagnosis and treatment growing since the pandemic. But this is a worrying time for patients as well, and they would welcome quicker turnaround of results and diagnosis. Cutting time out of this pathway would benefit everyone but are there ways to do this which do not compromise patient safety? An HSJ webinar, in association with SS&C Blue Prism, addressed this important question and tried to find ways trusts could reduce waiting times.
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