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News ArticleAt the age of 49, Sarah Fisher feels her life is on a knife-edge. She had a heart attack during lockdown and has subsequently been diagnosed with heart failure. In July, she was told she needed to have an implantable cardioverter defibrillator (ICD) fitted, which can shock the heart back into rhythm when it detects a potential cardiac arrest. But 12 weeks on, she is still waiting. "I could have a cardiac arrest at any point," Sarah says. "It is awful not knowing what is going to happen. "I am on the urgent list – but the infection rates are rising and the clinics are closing." "I don't know when I will get it. "There are so many people in my position – we don't have Covid but our lives are at risk too. We are the forgotten victims of this pandemic." British Heart Foundation analysis of Office for National Statistics data for England and Wales found almost 800 extra deaths from heart disease among under-65s from March to July - 15% more than would be expected. The rate of death was highest during the full lockdown - but, worryingly, the trend continued afterwards. The charity blames delays in people seeking care, as well as reduced access to routine tests and treatments. And NHS England figures show a sharp rise in the numbers waiting over six weeks for a whole range of key tests, including echocardiograms for hearts. Read full story Source: BBC News, 15 October 2020
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Content Article
NHS e-Review platform
Patient Safety Learning posted an article in Regulatory bodies/standards/guidance
Key aims Reassure patients they have not been forgotten during the coronavirus pandemic. Establish the patient's wishes regarding treatment. Good communication with patient and GP. Produce a validated waiting list that allows operating lists to run effectively. All Trusts are required to complete a clinical validation of patients on an admitted patient care pathway by 23 October, and for it to be captured in NHS e-Review. Trusts will be required to identify four user groups for the system; a user to upload patients to the system, an administrator, a super user to upload and download waiting lists and the outcomes from clinical reviews, and a clinical reviewer who is responsible for reviewing a cohort of patients within a specialty. Letter to healthcare providers and bodies Video software overview -
News ArticleThe numbers waiting over a year for hospital treatment have hit a 12-year high in England as hospitals struggle to get services back to normal. Nearly 2m patients have been waiting more than the target time of 18 weeks for routine care with 111,000 left for over a year, NHS England figures show. The numbers starting cancer treatment and getting urgent checks are also below the levels seen a year ago. But NHS England said "progress" was being made. It pointed out more patients were starting to be seen - although there are now warnings service may have to be cut back on again as admissions for Covid continue to rise. About 500 patients a day are being admitted to hospital with the disease - double the number two weeks ago. Health Secretary Matt Hancock said the UK was in a "perilous" position and the ability of the NHS to see non-Covid patients was under threat. Health minister Nadine Dorries predicted within 10 days hospitals would be a "critical" point. Read full story Source: BBC News, 8 October 2020
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News ArticleThere could be a "tsunami" of cancelled operations this winter as the NHS copes with rising numbers of coronavirus patients, leading surgeons are warning. Members of the Royal College of Surgeons of England say they doubt the NHS can meet targets to restore surgery back to near pre-pandemic levels. Planned procedures such as hip replacements were paused to free up beds during lockdown in the spring. And hospitals have since been dealing with a backlog. In July, NHS England boss Sir Simon Stevens told trusts hospitals should by September 2020 be performing at least 80% of their September 2019 rates of: overnight planned procedures outpatient or day-case procedures And by October, this proportion should rise to 90%. But data suggests more than two million people have been waiting longer than 18 weeks for routine operations, with 83,000 waiting more than a year - up from 2,000 before the pandemic. Read full story Source: BBC News, 6 October 2020
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News Article
The mystery of the capital’s ‘high-volume’ treatment centres
Patient Safety Learning posted a news article in News
Next Thursday we’ll see more waiting list data released. What is contained in it is probably why Sir David Sloman’s office has taken nearly a month to not answer this question: Your letter to system leaders said you would “eliminate” 52-week waits, by when? The regional director’s office could not answer, nor could it reveal which hospitals were going to be the high-volume centre to burn through the lists in the six major specialities. There are a couple of likely reasons for their not being able to say when the long waiters would be eliminated. NHSI/E’s phase three letter set “mad” targets that don’t feel very real to many on the ground. I/E central will know this and have their own reasons for setting stretching-to-the-point-of-snapping targets, but trusts don’t really want to be held to submitting impossible commitments then being chastised for missing them (management teams have been moved on for this kind of thing in less fraught times). The second reason is that the picture is likely to be scary and also to have an impact on the ongoing three-way negotiation between the NHS, the independent sector - which will be hosting a lot of this work - and the workforce that will actually do it in both places. There is even less transparency than usual from the regional director’s office and I/E generally when asked anything at all about how effectively private sector facilities are being used, or how much it is costing. Much more surprising is the fact that Sir David’s office cannot yet name where each of the ICS’s six high-volume centres will be. Read full story (paywalled) Source: HSJ, 1 October 2020 -
Community PostI've been posting advice to patients advising them to personally follow up on referrals. Good advice I believe, which could save lives. I'm interested in people's views on this. This is the message I'm sharing: **Important message for patients relating to clinical referrals in England** We need a specific effort to ensure ALL referrals are followed up. Some are getting 'lost'. I urge all patients to check your referral has been received, ensure your GP and the clinical team you have been referred to have the referral. Make sure you have a copy yourself too. Things are difficult and we accept there are waits. Having information on the progress of your referral, and an assurance that is is being clinically prioritised is vital. If patients are fully informed and assured of the progress of their referrals in real-time it could save time and effort in fielding enquiries and prevent them going missing or 'falling into a black hole', which is a reality for some people. It would also prevent clinical priorities being missed. Maybe this is happening, and patients are being kept fully informed in real-time of the progress of their referrals. It would be good to hear examples of best practice.
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News ArticleAlmost one million women in the UK have missed vital breast screening due to coronavirus, a leading charity has estimated. Breast screening programmes were paused in March as the NHS focused resources on tackling the pandemic. Breast Cancer Now calculates that around 8,600 women who have not had a scan have undetected breast cancer. The scanning programme is running again, but social distancing measures have reduced capacity. Combined with the significant backlog of women waiting for a scan, and more women starting to come forward with concerns about possible symptoms, the charity warns the service is under intense pressure. Breast cancer diagnosed at a later stage can be harder to treat. Breast Cancer Now estimates that a total of 986,000 women across the UK missed their mammograms due to breast screening programmes being paused. The estimate is based on the average number of women screened per month, and the approximate length of time the screening programme was suspended, in each part of the UK. This breaks down to almost 838,000 women in England, 78,000 in Scotland, 48,000 in Wales and 23,000 in Northern Ireland. The charity is calling for an action plan and new resources to tackle the problem. Baroness Delyth Morgan, Breast Cancer Now chief executive, said: "That nearly one million women across the UK were caught up in the backlog waiting for breast screening is cause for grave concern. "Mammograms are a key tool in the early detection of breast cancer, which is critical to stopping women dying from the disease. "We understand that the breast screening programme was paused out of necessity due to the global Covid-19 pandemic, but we must now press play to ensure that all women can access breast screening, and we cannot afford for the programme to be paused again." Read full story Source: BBC News, 30 September 2020 Breast Cancer Now press release
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Content ArticleOn 1 October 2020, the Health and Social Care Select Committee published its inquiry report into ‘Delivering core NHS and care services during the pandemic and beyond’.[1] [2] Patient Safety Learning contributed to this inquiry earlier in the year with two formal submissions of evidence. The first focused on hospital discharge arrangements, in a joint submission with CECOPS.[3] In the second we looked at the impact of COVID-19 on patient safety, specifically considering non-COVIDcare and treatment.[4] For the latter, our insights on this were partly informed by a webinar we held with patients, healthcare professionals and patient safety experts.[5] We welcome the publication of today’s report, which sets out recommendations in five different areas where action is needed to ensure the safe and effective provision of health and social care services both during and after the pandemic. Communication with patients The report recognises the importance of clear communications with patients during the pandemic. It acknowledges that there have been shortcomings in this area, stating that: “… the patient experience for some has been unacceptably poor, leaving them feeling like they have been left in 'limbo' or 'in the lurch'. Unnecessary anxiety and stress has been caused to those patients due to poor communication not just from their local hospital about the scheduling of appointments or access to treatments, but from national bodies, and on key items of guidance such as on shielding.” The Committee calls on the NHS to review the guidance they provide to trusts on how to communicate with patients about treatment changes and medical guidance in the event of a further spike in COVID-19 cases. We agree with this recommendation and reflected concerns about this issue in our submission to the inquiry. We also believe the NHS needs to consider how it communicates with patients who are impacted by the pandemic backlog of treatment and care. There needs to be honest and transparent conversations with patients about how this may affect their personal circumstances. Managing the backlog of care and treatment Recognising the serious challenge that the NHS now faces in managing waiting times and a backlog of appointments resulting from the pandemic, the report considers this in more detail in the areas of elective surgery, mental health, cancer and dental services. This was also an area of focus in our submission to the inquiry, where we highlighted other areas of concern such as chronic disease management and postnatal support.[4] We have also subsequently looked in more detail at the backlog in elective surgery and the patient safety implications of this.[6] We welcome the Committee’s recommendations that the Department of Health and Social Care and NHS should set out plans to address the backlog, along with steps that will be taken in future to manage the overall level of demand across health services. Patient Safety Learning believes that a strategy is needed to tackle the demand on NHS services in a systemic way; a published strategy that will help to ensure that decisions regarding the priority of cases are made transparently and with patient safety at the forefront. Staff access to Personal Protective Equipment (PPE) and routine testing Another area of focus in the report is the protection of staff from infection during the pandemic. The Committee asks for assurances about future supplies of PPE and presses for routine staff testing of staff in health and social care. We completely agree on the importance of this issue and in our recent work for World Patient Safety Day made the case for staff safety being intrinsically linked with patient safety.[7] In terms of physical safety during the pandemic, the case for this is clear – ensuring sufficient suitable PPE is available and that staff have access to testing is essential in both limiting the risk of passing on infection to patients as well as protecting staff themselves. We also note that in discussing PPE requirements the report refers to a specific issue around problems with fitting PPE, particularly for staff from some ethnic groups. We note the Royal College of Nursing has called for equality impact assessments on PPE and fit testing and we think that this should form part of the Department of Health and Social Care response to this report. Burnout and staff wellbeing The report notes the significant impact that the pandemic has had on both the mental and physical wellbeing of staff, advising that the Committee also has launched a separate inquiry on this, 'Workforce burnout and resilience in the NHS and social care'. This is also an area we highlighted in our submission to the inquiry and we have been sharing and highlighting staff perspectives on this during the pandemic on the hub.[8] We are also using the hub to share and publicise tools to help support staff through this period, such as a set of wellbeing resources from the Scottish Patient Safety Programme. We welcome the report’s call on NHS to set out in more detail the steps it will take “to support the mental and physical wellbeing of all staff and a plan to deal with the specific issue of sustained workplace pressure due to the current pandemic and backlog associated with the coronavirus”. Learning lessons from the pandemic The final section of the report considers the fundamental changes that have been ushered into health and social care services by the pandemic, looking in more detail at the 111 dial service, technology and digital innovations, and the independent sector. It calls on the Department of Health and Social Care and the NHS to assess the effectiveness of such changes while also noting the need to “ensure patients’ wellbeing is not jeopardised by the risk of being digitally excluded from accessing medical treatment and advice”. Patient Safety Learning welcomes these recommendations. As we noted in our response to the inquiry, the pandemic has created the opportunity for innovations in health and social care that we should seize upon to improve future services. We also believe that this presents an opportunity to design new models of care and delivery with patient safety and staff safety at their core. References Health and Social Care Select Committee, Delivering core NHS and care services during the pandemic and beyond, 1 October 2020. UK Parliament, Delivering Core NHS and Care Services during the Pandemic and Beyond, Last Accessed 30 September 2020. Patient Safety Learning and CECOPS, Hospital Discharge Arrangements, 7 May 2020. Patient Safety Learning, Response to the Health and Social Care Select Committee Inquiry: Delivering Core NHS and Care Services during the Pandemic and Beyond, 8 May 2020. Patient Safety Learning, Your voice matters: how it is shaping out work in non Covid-19 care and patient and staff safety, 14 May 2020. Patient Safety Learning, The return of elective surgery and implications for patient safety, 15 June 2020. Patient Safety Learning, Why is staff safety a patient safety issue?, 3 September 2020. Claire Cox, “I know this is burnout. I didn’t want it to be. But it is.”, Patient Safety Learning’s the hub, 11 June 2020.
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Content Article
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News ArticlePeople awaiting a CT or MRI scan will be able to have one on the high street under NHS plans to improve access to diagnostic tests. NHS England plans to set up a network of new “one-stop shops” where patients will be able to have scans closer to home rather than having to go hospital. They are intended to reduce the risk of patients getting COVID-19 in hospital and speed up the time it takes to undergo diagnostic testing by having more capacity. NHS England’s governing board approved a plan on Thursday by Prof Sir Mike Richards to create “community diagnostic hubs across the country over the next few years”. It is part of a planned “radical overhaul” in the way patients access a range of diagnostic tests, screening appointments and other services. The hubs, which would open six days a week, may also perform blood tests, lung function checks and endoscopies, in which a camera is put down the throat. The new facilities would be sited in disused shops or in shopping centres. They are part of the NHS’s drive to make it easier for people to be tested without having to go to hospital, amid concern that reluctance to do so is part of the reason fewer people are undergoing cancer screening. It is already undertaking lung cancer tests in 10 mobile centres that are parked at supermarkets and shopping centres. Bigger hubs could also offer mammograms, eye health checks, scans for pregnant women, hearing tests and gynaecological services. Hospital bosses welcomed the plan, which they said should reduce waiting times. Miriam Deakin, the director of policy and strategy at NHS Providers, which represents NHS trusts, said: “Doing these checks in the community rather than in hospital could support trusts as they grapple with a second wave of Covid-19, winter pressures and tackling backlogs of care.” Read full story Source: The Guardian, 1 October 2020
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News Article
Leaked data gives first view of growing cancer waiting list post covid peak
Patient Safety Learning posted a news article in News
Official data from mid-September shows that nearly 6,400 people had waited more than 100 days following a referral to cancer services. The leaked data reveals for the first time the length of the cancer waiting list in the wake of the first pandemic peak, during which much diagnostic and elective cancer care was paused. The list consists of those waiting for a test, the outcome of a test, or for treatment. NHS England and Improvement only publish waiting times for patients who have been treated – not the number still waiting – so this information has been secret. The data, obtained from official emails seen by HSJ, showed the total number of people on the cancer waiting list grew substantially, from 50,000 to around 58,000, between the start of August and the middle of September. Of the 6,400 people recorded to be waiting more than 104 days on 13 September, 472 had a “decision to treat classification”, meaning they have cancer and are awaiting treatment. NHS England has said reducing the cancer waiting list would be overseen by a national “taskforce”, which is being chaired by national director for cancer Peter Johnson. Experts have warned the delays already stored up in the system could cost tens of thousands of lives as patients go undiagnosed or have their diagnosis and treatment later than they otherwise would. HSJ asked NHS England if harm reviews had been carried out for those on the waiting list and whether it had discovered if those waiting longer than104 days had been harmed, but did not receive an answer. Read full story (paywalled) Source: HSJ, 29 September 2020 -
News Article
Coronavirus: NHS faces pandemic 'triple whammy' this winter
Patient Safety Learning posted a news article in News
The NHS is facing a "triple whammy" of rising COVID-19 cases, a major backlog in treatment and reduced capacity due to infection-control measures, according to health bosses. The NHS Confederation report on the English NHS said more investment was desperately needed. The NHS bosses also called on ministers to be "honest and realistic" about waiting lists for treatment. It comes despite the government promising an extra £3bn this winter. That money - announced over the summer - was intended to help hospitals cope with the extra-infection control measures required and to pay for patients to be treated privately for routine treatment, such as knee and hip replacements. But hospitals are still performing only half the number of routine operations they normally would. Two million patients have already waited longer than 18 weeks for treatment, the highest number since records began, in 2007. And services in other areas, such as cancer care, are running at about three-quarters capacity. Of the more than 250 bosses who responded to the confederation's survey: fewer than one in 10 said the current level of funding allowed them to deliver safe and effective care nearly nine in 10 said a lack of funding would be a significant barrier to achieving waiting-time targets for everything from mental-health care to cancer treatment and routine operations. Read full story Source: BBC News, 29 September 2020 -
News ArticleMore than 1,500 breast cancer patients in UK face long waits to have reconstructive surgery after hospitals could not operate on them during the pandemic because they were tackling COVID-19. The women are facing delays of “many months, possibly years” because the NHS has such a big backlog of cases to get through, according to research by the charity Breast Cancer Now. When the lockdown began in March the NHS stopped performing breast reconstructions for women seeking one after a mastectomy as part of its wider suspension of care. That was because so many operating theatres were being used as overflow intensive care units and because doctors and hospital bosses feared that patients coming into hospital might catch Covid. The NHS started doing them again in July, but not everywhere and not in the same numbers as before. “We are deeply concerned by our finding that over 1,500 breast cancer patients may now face lengthy and extremely upsetting delays for reconstructive surgery,” said Delyth Morgan, the chief executive of Breast Cancer Now. “This will leave many women who want to have reconstruction with one breast, no breasts or asymmetric breasts for months, possibly even years.” Lady Morgan said: “Reconstructive surgery is an essential part of recovery after breast cancer for those who choose it. “Women with breast cancer have told us these delays are causing them huge anxiety, low self-esteem and damaged body confidence, and all at a time when the Covid-19 pandemic has denied them access to face to face support from healthcare professionals and charities.” Read full story Source: The Guardian, 18 September 2020
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Content ArticleThe webinar took place on Wednesday 16 September but if you missed it, you can watch the recording below. To receive information about future webinars please register with the hub for free or you can follow us on Twitter @ptsafetylearn. To find out more about this issue, please read Patient Safety Learning's blog: Patient safety on the frontline: Responding to the treatment backlog safely
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EventA record excess of four million people are now awaiting hospital treatment in England. This number includes more than 83,000 who have been waiting more than a year. On Thursday 17 September, RSM President Professor Roger Kirby will interview Professor Derek Alderson, immediate past President of the Royal College of Surgeons, Ben Challacombe, Consultant Urological Surgeon at Guy’s and St Thomas’ and Hannah Warren, Specialist Registrar at King’s College Hospital to discuss the impact of the COVID-19 pandemic on surgeons, surgery and surgical waiting lists. In addition, the panel will discuss whether the mass testing proposed by the Prime Minister in his “Operation Moonshot” initiative could help to resolve the situation. The webinar will include plenty of opportunities for questions. Registration
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Content ArticleBacklog of care and treatment COVID-19 has placed the health and social care system under unprecedented pressure this year. To meet the demand created by the pandemic, a range of non COVID care and treatment was postponed at the peak of the crisis to free up capacity of the NHS. These decisions have created a long-term challenge, with a significant backlog in treatment and care.[1] Postponing all non-urgent elective operations for a period of three months is estimated as resulting in more than half a million cancelled procedures.[2] This, alongside other challenges to restoring services following the peak in the pandemic, could result in the waiting list reaching 10 million by the end of 2020.[3] Impact on patients The delays in treatment resulting from this backlog will have a significant impact of patients’ quality of life and, in some case, their survival. For those managing chronic diseases, such as arthritis, long delays in fairly common surgeries (for instance knee replacements) can reduce functional capacity gain and lead to increased pain and disability.[4] Meanwhile, a recent study looking at delayed diagnosis and cancelled treatment for cancer cases during the pandemic suggested that this could result in “anywhere between 7,000 and 35,000 additional deaths from the disease over the coming year”.[5] In addition to those waiting to be referred for treatment, there is also the issue of high numbers of patients waiting on follow-up appointment. Clinicians have expressed concerns about the clinical risk to those facing delays on their follow-up outpatient lists, particularly because the scale of this is hard to gauge due to there being “no official, verified data on follow up appointments”.[6] Addressing the backlog safely In its recent ‘Third Phase’ response guidance, the NHS identified one of its three key priorities as “accelerating the return to near-normal levels of non-COVID health services, making full use of the capacity available in the ‘window of opportunity’ between now and winter”.[7] As we do this, it is vital that patient safety considerations are placed at the heart of this process, as the NHS seeks to address the backlog of cases while also meeting regular demand for services. Key points to consider include: How are organisations tackling the treatment backlog? How is access to treatment and care being prioritised? What are the risks to patient safety, and are these being addressed? Who will ensure that patients’ needs are considered, and who will provide information to manage patients’ expectations? Should cases where surgery delays lead to significant health issues, or even death, be considered as serious incidents? Do we have adequate data about the backlog so we can quantify the problem and manage waiting lists, whether referral to treatment or follow-up appointments? Find out more - join the webinar Are you interested in hearing more about these issues? The webinar is scheduled for 11.00am (BST) on Wednesday 16 September and you can sign up here. References Patient Safety Learning, Response to the Health and Social Care Select Committee Inquiry: Delivering Core NHS and Care Services during the Pandemic and Beyond, 8 May 2020; Patient Safety Learning, The return of elective surgery and implications for patient safety, 15 June 2020. Estimates on this figure vary between around 516,000 at the lower end of the scale (University of Birmingham, COVID-19 disruption will lead to 28 million surgeries cancelled worldwide, 15 May 2020) to potentially as high as 749,248 (Alexander Fowler et al, Resource requirements for reintroducing elective surgery in England during the COVID-19 pandemic: a modelling study, medRxiv, 2020). NHS Confederation, Public reassurance needed on slow road to recovery for the NHS, 10 June 2020. Versus Arthritis, Written evidence submitted by Versus Arthritis (DEL0173), May 2020. Health Data Research UK, The Big C isn’t COVID-19 – it’s cancer, 25 August 2020. Health Service Journal, Recovery watch: the NHS' biggest restoration challenge, 2 September 2020. NHS England and NHS Improvement, Third phase of NHS response to Covid-19, 31 July 2020.
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News Article
Plans for 150 new diagnostic hubs to cut rising waits
Patient Safety Learning posted a news article in News
Plans for up to 150 new community diagnostic hubs to tackle the NHS’ ballooning diagnostic waiting lists are included in NHS England ‘blue print plans’ leaked to HSJ. The document pointed out the hubs “were highlighted in the phase 3 letter [from Sir Simon Stevens] and will be recommended as part of new service models for diagnostics in the forthcoming [Sir Mike] Richards’ Review of Diagnostics Capacity”. It said “at least 150 community diagnostic hubs should be established in the first instance (broadly equivalent to the number of acute hospitals)” although it appears many of these may be temporary facilities. The phase 3 letter said systems should mange the “immediate growth in people requiring cancer diagnosis and/or treatment returning to the service by… the development of community diagnostic hubs” among other measures The Richards review was commissioned by NHS England in 2019 as it had long been recognised that England has one of the lowest levels in Europe of diagnostic equipment as well as a shortage in facilities and staff. Last month think-tanks warned of significant worsening of cancer outcomes because of the backlog in diagnosis and treatment created by a fall in referrals during the pandemic..." Read full story (paywalled) Source: HSJ, 4 September 2020 -
News ArticleHospitals are not equipped to deal with the surge in screenings and tests as the health service restarts care – leaving patients facing delays in diagnosis and treatment for conditions including cancer, according to medical leaders. As the NHS tries to recover from the worst of the coronavirus crisis, more than a million laboratory samples from cancer screening services are expected in pathology labs, while as many as 850,000 delayed CT and MRI scans need to be carried out. But 97% of labs do not have enough pathologists to carry out the work – with staff already working unpaid hours to tackle the existing backlog – while the number of radiology posts nationally would need to be increased by a third to deal with the rise, experts say. Precautions to protect against the spread of coronavirus also limits the number of scans that can be carried out. The royal colleges of pathologists and radiologists warned that cancers would go undiagnosed and treatments for all patients across the NHS could be further delayed as a result. Read full story Source: The Independent, 27 August 2020
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News Article
Trust declares critical incident over ‘relentless demand’
Clive Flashman posted a news article in News
Gloucestershire Hospitals FT declares critical incident after ‘relentless demand’ on emergency care Pressure comes two months after trust downgraded one of its A&Es ‘Tired’ staff warned a ’Herculean effort’ is needed to reset emergency system NHS 111 cited as pinch point A trust has declared a critical incident after experiencing “relentless demand” on urgent and emergency care, months after downgrading one of its emergency departments. The internal critical incident was raised by Gloucestershire Hospitals Foundation Trust yesterday. An internal memo said the previous three days “have seen unprecedented demand fall on the Gloucestershire urgent and emergency care system”. Clinicians have been told that early discharges need to be identified on both its Cheltenham General and Gloucestershire Royal hospital sites, to try to free up bed-space, and that all non-essential meetings, besides those at executive level, should be cancelled. The incident comes after the trust decided in June to downgrade the A&E department at Cheltenham General to a minor injuries unit, operating from 8am to 8pm. Previously, the unit offered a full A&E service between 8am and 8pm, with a “nurse-led” minor injuries service outside these hours. The problems appear to be unrelated to covid-19, although infection control measures are known to have reduced capacity in many A&Es and wards. HSJ understands that local managers believe NHS 111, run by Care UK Health Care, has been a particular cause of the problems in recent days, because it has not been directing enough people to alternative services; as well as workforce pressures and the hot weather. Read full (paywalled) article here in the HSJ. -
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News Article
The NHS’ approach to waiting list management needs urgent reform
Patient Safety Learning posted a news article in News
Waiting lists for treatment in 2019 were at record levels, with the proportion of patients waiting less than 18 weeks for treatment at its lowest level in a decade. Cancer waiting times were the worst on record, with 73% of trusts not meeting the 62-day cancer target. Waiting for diagnostic tests was at the highest level since 2008: 4.2% of patients were waiting over six weeks against a target of less than 1%. On 17 March 2020, NHS England and NHS Improvement asked trusts to postpone all non-urgent elective operations to free up as much inpatient and critical care capacity as possible. At this point, there were 4.43 million people on waiting lists for consultant-led elective treatment. It is imperative that we open a national debate on what the NHS can deliver in a resource-constrained environment. To translate into action, this must involve patients, clinicians, system and regional leaders, the public and politicians. Such a debate is long overdue: current methods for prioritising elective care, such as referral to treatment or the 62-day cancer standard, are no longer fit for purpose. Read full story (paywalled) Source: HSJ, 14 July 2020 -
News Article
NHS patients in England face longest waits on record for surgery and cancer care
Patient Safety Learning posted a news article in News
Far fewer people are having surgery or cancer treatment because COVID-19 has disrupted NHS services so dramatically, and those who do are facing the longest waits on record. NHS figures reveal huge falls in the number of patients who have been going into hospital for a range of vital care in England since the pandemic began in March, prompting fears that their health will have worsened because diseases and conditions went untreated. Patients have been unable to access a wide range of normal care since non-COVID-19 services were suspended in hospitals in March so the NHS could focus on treating the disease. Many patients were also afraid to go into hospital in case they became infected, which contributed to a fall in treatment volumes. Tim Gardner, a senior policy fellow at the Health Foundation thinktank, said: “The dramatic falls in people visiting A&E, urgent referrals for suspected cancer and routine hospital procedures during lockdown are all growing evidence that more people are going without the care they need for serious health conditions." “Early diagnosis and prompt treatment of cancer is crucial to saving lives, and delays in referrals and treatment during the pandemic are likely to mean more people are diagnosed later when their illness is further advanced and harder to treat.” Read full story Source: Guardian, 9 July 2020 -
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News ArticleWaiting times for tests and treatment not related to COVID-19 are likely to increase significantly in the second half of 2020 because of the fallout from the pandemic, the head of NHS England has acknowledged. Giving evidence to the Commons health select committee on 30 June, NHS England’s chief executive Simon Stevens said that contrary to some commentary, the NHS’s overall waiting list actually dropped by over half a million people between February and April 2020 because fewer people were coming forward for treatment. But, he added, “As referrals return we expect that will go up significantly over the second half of the year.” Stevens said that there were 725 000 fewer elective admissions to NHS hospitals during March and April, but that number has begun to recover significantly. “As we speak, we think we’re now somewhere north of 55% of pre-covid-19 elective activity levels,” he said. He added that he hoped the NHS would return to around three quarters of normal activity levels by July or August. Stevens told MPs that the NHS would pursue a range of measures to increase capacity over the coming months, including extending the deal with the private sector to use its facilities, and repurposing some of the Nightingale hospitals for diagnostic testing. Read full story Source: BMJ, 1 July 2020
