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Found 270 results
  1. News Article
    Older people are routinely enduring hidden waits of several months to get essential care and support, according to new figures obtained from government. Waiting time figures for adult social care are not routinely published in England, but last summer the Department of Health and Social Care collected the information from councils for the first time in at least a decade. They have been released to HSJ after a freedom of information appeal, and show average waits of up to 149 days (about five months) in Bath and North East Somerset, with 25 councils (30% of the 85 councils which supplied this information) reporting waits of two months or more. Some people will be waiting much longer than the averages reported. Across the 85 councils which reported average waits, the average of those figures was around 50 days. But the figures released to HSJ show huge variation – with three councils reporting waits of less than 10 days – although this is partly due to recording differences. The lack of clear figures, and absence of national waiting time measures and standards for adult social care, in contrast to the many targets and published figures in the NHS, and has sparked calls for that to be changed. Sir David Pearson, a former integrated care system chair and director of adult social care, who led the government’s Covid-19 care taskforce in the wake of the disaster in care homes in spring 2020, said: “One way of ensuring public confidence is a timely response to need. “Being clearer about a small number of standards and measures would help to achieve this. Of course it has to be associated with the right funding and reform, including supporting the social care workforce”. Read full story (paywalled) Source: HSJ, 25 March 2024
  2. News Article
    The Royal College of Paediatrics and Child Health has called on the UK government not to wait until after the upcoming general election to approve an infant immunisation programme against respiratory syncytial virus (RSV), so that babies can be protected next winter. In June 2023 the Joint Committee on Vaccinations and Immunisations (JCVI) recommended developing an RSV immunisation programme for infants and for older adults.1 It issued a fuller statement reiterating the advice in September 2023.2 But the government has yet to make a final decision on rolling out an RSV immunisation programme. A letter signed by more than 2000 paediatricians and healthcare professionals says that the sooner a full RSV vaccination programme is implemented the more effective it will be and that it “could save child health services reaching breaking point.” Read full story (paywalled) Source: BMJ, 20 March 2024
  3. Content Article
    Older people’s mental health has long been overlooked and poor mental health is often dismissed by health professionals as an ‘inevitable’ part of getting older. And despite NHS Talking Therapies having higher than average recovery rates among the over-65s, this service is less likely to be offered to older people. Commissioned by Age UK, this briefing from the Centre for Mental Health summarises evidence about the mental health of older people in England. It finds that ageist attitudes underpin a system that discriminates against older people, while fatalistic assumptions about what people can expect for their mental health in later life undermine the provision of effective support to promote wellbeing, prevent mental ill health and treat mental health difficulties. The briefing finds that while older people may possess many protective factors for good mental health, they face numerous risk factors, including poorer physical health, reduced mobility and, for some, poverty and racism. Tackling the risk factors and boosting protective factors can increase wellbeing in later life and either prevent or stop the escalation of mental health problems.
  4. News Article
    Doctors made do-not-resuscitate orders for elderly and disabled patients during the pandemic without the knowledge of their families, breaching their human rights, a parliamentary watchdog has said. In a new report on breaches of the orders during the pandemic, the Parliamentary Health Service Ombudsman (PHSO) found failings from at least 13 patient complaints. The research, carried out with the charity Dignity in Dying, found “unacceptable” failures in how end-of-life care conversations are held, and in particular with elderly and disabled patients. Following a review of complaints in 2019 and 2020 the PHSO found evidence in some cases that doctors did not even inform the patient or their family that a notice had been made and so breached their human rights. The report calls for health services in Britain to improve the approach by medics in talking about death and end-of-life care. In examples of cases reviewed, the PHSO revealed the story of 58-year-old Sonia Deleon who had schizophrenia and learning disabilities and a notice which was wrongly applied during the pandemic. In 2020, she was admitted to Southend University Hospital after contracting Covid-19 at age 58. On three occasions a notice was made but her family were never informed. Following Sonia’s death her family found out the reasons given by doctors for the DNAR which “included frailty, having a learning disability, poor physiological reserve, schizophrenia and being dependent for daily activities.” Sonia’s sister Sally-Rose Cyrille said: “I was devastated, shocked and angry. The fact that multiple notices had been placed in Sone’s file without consultation with us, without our knowledge, it was like being hit with a sledgehammer. Read full story Source: The Independent, 14 March 2024
  5. Content Article
    A change in how British people and health professionals talk about death is needed to avoid delays in crucial conversations about end-of-life care, resulting in traumatic consequences for patients and their families, the Parliamentary and Health Service Ombudsman (PHSO) has warned. In a new report, End of life care: improving ‘do not attempt CPR’ conversations for everyone, PHSO has called for urgent improvements to the process and communication surrounding do not attempt cardiopulmonary resuscitation (DNACPR), so doctors, patients, and their loved ones can make informed choices about their care.
  6. News Article
    Distressed elderly patients are being “treated like animals” and left begging for care as NHS staff struggle to cope with overwhelmed wards and an ever-increasing ageing population, an investigation by The Independent has revealed. Scores of families have come forward to share harrowing allegations of neglect as one top doctor warns that elderly people are receiving care “well below the standards they should expect” – including long waits in waiting rooms and “degrading” corridor care. In one shocking case, a 96-year-old patient admitted to the hospital with a urinary tract infection (UTI) was allegedly left semi-naked and delirious in his hospital bed – before choking on vomit after being sedated without his family’s permission, his daughter told The Independent. Another patient, 99, was traumatised after being left in a bed next to the body of a dead woman. The investigation was sparked by the horrific story of 73 year old Martin Wild who was left so desperate for pain medication he was forced to call 999 from his hospital bed. It comes as analysis by the Independent shows the government was warned three times last year by coroners over the increasing risk to elderly patients’ lives amid fears they are not being “effectively safeguarded”. Read full story Source: The Independent, 11 March 2024
  7. Content Article
    About 1 in 5 people who have had chickenpox develop shingles, predominantly those who are over 70. However, uptake rates of the shingles vaccine are falling in London and across England. The purpose of this toolkit is to help GPs better protect their patients by suggesting ways to improve uptake of the shingles vaccine. These suggestions are based on best practice and evidence and have been shown to work with little or no cost to practices.
  8. Content Article
    Decisions to admit older, frail patients to critical care must pay particular attention to quality of life and the potential burden of care on patients. This burden may extend beyond surviving a critical illness. These decisions are not easy and require careful thought, clinical judgment, and communication write Daniele Bryden and colleagues in this BMJ opinion piece. 
  9. Content Article
    In my 15 years focusing on developing drink thickening solutions for dysphagia patients, the intersection of dysphagia management and patient safety has become increasingly apparent. Dysphagia, or difficulty swallowing, presents not only as a significant health challenge but also as a critical patient safety issue. The condition's underdiagnosis, particularly in vulnerable populations, heightens the risk of severe complications, including choking, aspiration pneumonia, dehydration and the profound fear of choking that can lead to malnutrition.
  10. Content Article
    This article outlines a recent improvement put in place by a ward at Sir Robert Peel Community Hospital, part of University Hospitals of Derby and Burton NHS Foundation Trust. The team won an award for implementing learning following a patient fall to help drastically reduce the frequency of incidents and improving patient safety.
  11. 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. 
  12. Content Article
    The first UK geriatric oncology service at a tertiary cancer centre was established at the Royal Marsden Hospital in London. Its purpose is to conduct comprehensive geriatric assessments of patients with cancer on order to make referrals to multidisciplinary care. This descriptive study aimed to track its progress. It found that the service made a median of three referrals for each patient, most commonly to physiotherapy and occupational therapy. The frequency of referrals indicates that there is a high level of unmet need in older patients with cancer.
  13. Content Article
    In 2021 in New South Wales (NSW) there were 41,619 people over 65 who were hospitalised due to a fall at home or in the community. This number increased by 60% in a decade from 25,982 in 2010 and the incidence of falls is set to increase further as the population ages. In 2021 the cost to the NSW health system from falls by older people in the community was around $752 million. These costs are projected to grow to $1.09 billion by 2041 – the result of around 60,300 hospitalised falls projected for that year. There is robust evidence that falls can be prevented. Fall prevention is a complex area as there are multiple risk factors that may contribute as to why a person may fall. A systems thinking approach acknowledges the complexity of fall prevention, seeks to understand the interactions between components, and identifies what interventions work best.
  14. Content Article
    This cross-sectional study in JAMIA Open aimed to identify concerns, barriers and facilitators impacting the use of patient portals by older patients, as well as desired features in future updates. The authors held two focus group discussions culminating in an anonymous survey completed by women who were 65 years and older receiving urogynaecology care in Northwest Ohio. The authors concluded that the lack of age-aligned medical access software and products may lead to worsening digital exclusion and disparities in healthcare. Portal application developers and healthcare systems must advance efforts that consider the needs of those who are older when designing patient portals.
  15. News Article
    Thousands more elderly people will be stuck in hospital over Christmas because of junior doctors’ strikes, Age UK has warned. The charity is among several who have said the timing of the strikes, which begin at 7am on Wednesday means it will be “extremely difficult to ensure safe and effective care” during them. Age UK is one of five organisations raising fears over patient safety and making a plea to the British Medical Association (BMA) and Victoria Atkins, the Health Secretary, for a resolution to the dispute. Junior doctors’ walkouts are due to last until Saturday, with their longest strike to come early in the new year, while flu, norovirus and Covid hospitalisations are rising. In a joint letter with the NHS Confederation, Patients Association, National Voices and Healthwatch , Age UK said strike action in the days ahead could leave thousands of patients stranded in hospital for want of staff to get them discharged. The latest figures show 13,000 such cases in hospitals despite being medically fit for discharge. The charities said the withdrawal of almost half the medical workforce in England would mean the most vulnerable are left “bearing the brunt” of the pay dispute. “Our concern is that, despite the best efforts of hard-working NHS staff, it will be extremely difficult to ensure safe and effective care during this period for all patients that need it.” Read full story (paywalled) Source: The Telegraph, 20 December 2023
  16. Content Article
    As part of the Care Quality Commission's (CQC's) commitment to person-centric care, they have worked with the University of Bedfordshire to produce guidance for care home managers and members of the public on the availability and management of alcohol in care homes.   This guidance focuses on both the benefits of having alcohol available to care home residents who want it, as well as how to mitigate potential risks.   The University of Bedfordshire spoke to residents, their family members, care home managers and CQC inspectors, and captured their expectations and requirements on how alcohol is managed in care settings.  
  17. News Article
    Patients needing emergency treatment are becoming sicker in A&E as hospitals struggle to free up enough beds, top doctors have warned. Dr Adrian Boyle, president of the Royal College of Emergency Medicine (RCEM), told The Independent that elderly patients are waiting so long for treatment in A&E that they’re developing bed sores and delirium. Another senior NHS doctor, Dr Vicky Price, who is president-elect of the Society for Acute Medicine, warned that corridor care is now “routine practice” with the situation only set to worsen as A&E departments come under increasing pressure. Their comments highlight the ongoing chaos in emergency medicine, as strikes take place during the most difficult time of the year. The chief executive of the NHS, Amanda Pritchard, said on Thursday that last winter was the worst she’d ever seen for the health service, warning that strikes by junior doctors will only make the situation harder for hospitals this year The warnings come as the latest NHS data shows that the prime minister, Rishi Sunak, could fail in his promise to deliver 5,000 more acute hospital beds to the NHS this month. Current data shows that the NHS is falling short of the target by just under 1,200 beds, with 97,818 against a target of 99,000. Read full story Source: The Independent, 10 November 2023
  18. Content Article
    This report published by the National Audit of Inpatient Falls (NAIF) includes information on multi-factorial risk assessments and post fall management, and contains five recommendations as well as resources to support improvement.
  19. Content Article
    This blog calls for action on the careful review of established pain medication when a patient is admitted to hospital. Richard describes the experience of two elderly patients who suffered pain due to their long term medication being stopped when they were admitted to hospital. Pain control needs must not be ignored or undermined, there needs to be carer and patient involvement and their consent, and alternative pain control must be considered.
  20. Content Article
    The Greater Manchester Major Trauma Network recognise that many older patients self-present to emergency departments and the ‘Meet Harry’ infographic was produced as an aide memoire to triage nurses and clinicians to assist in assessment. You can view the ‘Meet Harry’ infographic by clicking on the image or download it from the attachment below.
  21. News Article
    The UK faces an ageing crisis and healthcare must step in, England's chief medical officer, Prof Sir Chris Whitty, warns in his annual report. People are living longer but some spend many of their later years in bad health - and that has to change, he said. Based on projections, the elderly boom will be in rural, largely coastal, areas and these places are often poor cousins when it comes to provision. In deprived regions, age-related issues emerge 10 years earlier, on average. "We've really got to get serious about the areas of the country where ageing is happening very fast, and we've got to do it now. "It's possible to compress the period of time that people spend in ill health...because otherwise we will end up with large numbers of people leading much more dependent lives." Providing services and environments suitable for older adults in these areas is an absolute priority, the report says. Read full story Source: BBC News, 10 November 2023
  22. Content Article
    Chief Medical Officer Professor Chris Whitty's annual report recommends actions to improve quality of life for older adults and prioritise areas with the fastest growth in older people.
  23. News Article
    A rise in hip fractures last year could be a symptom of a wider increase in general physical deconditioning in older and vulnerable people following the pandemic, senior clinicians have warned. Around 72,000 hip fractures were recorded in 2022 compared to 66,000 in 2020 and 67,000 in 2021, according to the 2023 National Hip Fracture Database report, published this month. The report, published by the Royal College of Physicians, said: “These additional hip fractures happened despite a fall in the size of the ‘at risk’ older population over the preceding three years, as a result of Covid-19-related mortality among older people and those living in care homes.” “Our casemix run chart shows a slight increase in the proportion of hip fractures occurring in people aged under 80. “This is perhaps an early indication of Public Health England’s [now the UK Health Security Agency] predictions that physical deconditioning and increased risk of falling due to the pandemic may lead to an increase in the number of people who are at risk of fragility fracture.” Read full story (paywalled) Source: HSJ. 25 September 2023
  24. Content Article
    The number of older people having surgery is increasing. However, older patients are more likely to have complications after surgery than younger patients as they often have multiple health conditions and age-related problems such as frailty and a decline in mental ability. These factors increase the risk of surgery and can hinder recovery. Surgical pre-assessment usually focuses on the patient’s physical fitness for surgery, not the broader range of health-related factors that are important to consider in older patients. The Perioperative care for Older People undergoing Surgery (POPS) model was developed to provide a holistic assessment of an older person’s medical, physiological and functional condition prior to surgery. The assessment is then used to inform interventions that can reduce the risk of complications. The POPS model is increasingly being implemented across the English and Welsh NHS, but there are often challenges in introducing these new ways of providing care that need to be better understood. This independent study, led by THIS Institute Fellow Professor Justin Waring, outlines the key activities and strategies that are needed for the POPS model to be successfully implemented and become part of routine practice in a hospital.
  25. Content Article
    Monitoring and responding to deterioration in social care settings is critical to providing safe, effective and responsive care. Front-line staff are pivotal for highlighting change to wider teams and managing low to medium risk individuals in their place of residence. However, there is a core set of principles that most systems use which may not be used by non-clinical staff in residential settings. This case study explores an intervention to empower non-clinical staff to take observations. The Whzan blue box contains a digital tablet and equipment to take temperature, pulse, oxygen saturation levels and blood pressure measurements. Staff were trained and supported on site to use the system and set up a digital platform to share measurements with wider teams. Staff fed back that they felt empowered and able to better engage in conversation with health care professionals, highlighting the importance of having a common language. This case study was submitted to the Care Quality Commission (CQC) by North East and North Cumbria ICB.
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