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Found 91 results
  1. News Article
    NHS England has found that one in five GP surgeries – and more than two-fifths in some regions – were built more than 75 years ago, and is concerned a lack of space will stop it meeting targets to train more GPs, HSJ has learned. An internal NHSE document seen by HSJ reveals a major audit it commissioned in 2019 – but has not made public – found 20 per cent of 8,900 buildings examined were built before 1948. The figure rises to more than 40 per cent of practices in London, HSJ understands. These practices are likely to be in converted houses, normally owned by GP partners, with very limited space and little scope for expansion. The NHSE slides which include the figure warn the “limited [GP] estate” means there is “strain on existing capacity and meeting current training needs is challenging”. HSJ understands officials are concerned poor estates and lack of space will restrict the big expansion of GP training planned under the NHS long-term workforce plan. Other fears relate to poor tech and the shortage of experienced staff to supervise trainees. NHSE said in a statement: “NHS England has asked every ICS to review their infrastructure to assess which buildings they need to expand and reconfigure to manage additional workforce over the next 10 years.” Read full story (paywalled) Source: HSJ, 9 May 2024
  2. News Article
    An ambulance trust is having to protect its staff from the effects of fumes – including potential cancer risk – as they are spending so long in their vehicles outside hospitals. South Western Ambulance Service Foundation Trust (SWASFT) has carried out a risk assessment of the impact of diesel engine emissions after following concerns from staff, many of whom are spending hours waiting to handover on each shift. The region has faced the worst handover delays to emergency departments in recent years. Ambulance engines normally have to be kept on while waiting, to keep essential equipment running, and sometimes for warmth. But with queues of a dozen or more ambulances at times, staff and patients can be exposed to substantial emissions for long periods. The trust’s risk assessment – which has been seen by HSJ – warns exposure to diesel emissions is associated with eye and upper respiratory tract irritation, while prolonged exposure can lead to coughing, increased sputum production and breathlessness. There is also “epidemiological evidence which indicates that sustained occupational exposure to diesel engine exhaust emissions may result in an increase in the risk of lung cancer”. It gives a risk rating of 20 – one of the highest possible – which, under the trust’s policies, indicates “activities must not proceed” until mitigations are in place. Read full story (paywalled) Source: HSJ, 27 March 2024
  3. Content Article
    Making hospitals more conducive to high quality sleep might benefit patient experience and wellbeing, and could perhaps even lead to reduced length of stay. Sleep is known to be closely connected to physical and mental health, and yet hospital environments are far from conducive to high quality rest. Noise, light, disturbances for treatment or tests, other patients, staff noise and temperature can all reduce the odds of a good night’s sleep. Overnight observations can also be extremely disruptive. At some trusts, efforts are being made to address this situation. The ultimate aim? Not only to improve the patient experience, but to potentially the speed with which they heal–so reducing the likes of length of stay. Others, meanwhile, are exploring whether supporting better sleep could even reduce the need for hospital admission in the first place.
  4. Content Article
    Great Ormond Street Hospital NHS Foundation Trust is one of the world’s leading children’s hospitals, receiving 242,694 outpatient visits and 42,112 inpatient visits every year (figures from 2021/22). This paper seeks to provide an overview of the safety systems and processes Great Ormond Street Hospital has in place to keep patients, staff, and healthcare environments safe.
  5. Content Article
    This study in the American Journal of Surgery aimed to understand the impact of operating room temperature and humidity on surgical site infection (SSI). The authors found that large deviations in operating theatre temperature and humidity do not increase the risk of SSI.
  6. News Article
    Liquid bleach does not kill off a hospital superbug that can cause fatal infections, researchers have found. Clostridium difficile, also known as C diff, is a type of bacteria found in the human gut. While it can coexist alongside other bacteria without problem, a disruption to gut flora can allow C diff to flourish, leading to bowel problems including diarrhoea and colitis. Severe infections can kill, with 1,910 people known to have died within 30 days of an infection in England during financial year 2021-2022. Those at greater risk of C diff infections include people aged over 65, those who are in hospital, people with a weakened immune system and people taking antibiotics, with some individuals experiencing repeated infections. According to government guidance, updated in 2019, chlorine-containing cleaning agents with at least 1,000 ppm available chlorine should be used as a disinfectant to tackle C diff. But researchers say it is unlikely be sufficient, with their experiments suggesting that even at high concentrations, sodium hypochlorite – a common type of bleach – is no better than water at doing the job. “With antimicrobial resistance increasing, people need to recognise that overuse of biocides can cause tolerance in certain microbes, and we’re seeing that definitely with chlorine and C diff,” said Dr Tina Joshi, co-author of the research, from the University of Plymouth. While chlorine-based chemicals used to be effective at killing such bacteria, that no longer appears to be the case, she said. “The UK doesn’t seem to have any written new gold standard for C diff disinfection. And I think that needs to change immediately,” she said. Read full story Source: The Guardian, 22 November 2023
  7. Content Article
    The climate and ecological crises are both driven by human activities. They each have catastrophic implications for human health and their strong interconnection creates a vicious circle where each is reinforced by the other. A stable natural environment is critical for limiting global warming and achieving the UN’s Sustainable Development Goals (SDGs). Conversely, the loss of biodiversity is a major threat to human, animal, and environmental health. In order to mitigate harm and maximise the co-benefits of action, it is important that policies tackle both climate change and biodiversity loss together. This policy report by the UK Health Alliance on Climate Change, describes the impacts of biodiversity loss on land and oceans for human health and puts forward recommendations to reduce biodiversity loss, restore nature, and achieve climate goals for the benefit of health.
  8. News Article
    A patient was left traumatised when his body caught on fire halfway through surgery - leaving his insides scorched. Mark, 52, went to hospital for a routine abscess removal - but woke up to the news that a freak accident in theatre had sparked an horrific blaze. A diathermy machine, used to stop bleeding, caused a swab to catch fire - before flames burnt their way through his exposed flesh, Mark explained. It took over a year for Mark - not his real name - to recover from his dreadful injuries - and the emotional scarring it caused. Between 2008 and 2018, 37 cases were acknowledged by NHS trusts across Britain. But from 2009 to 2019, it has paid out nearly £14 million in compensation settlements and legal fees. Fires such as these are often fuelled by leaking oxygen - and are caused by faulty machinery or sparking equipment. Campaigners are concerned that UK hospitals are lagging behind other countries in recording surgical fires and introducing protocols to reduce both their frequency and severity. Theatre scrub nurse Kathy Nabbie has spent the past five years trying to make colleagues more aware of the threat of surgical fires. In 2017 - after hearing how a woman in Oregon, USA, had suffered severe burns when her face was set alight in surgery - she made a simple safety checklist. Her Fire Risk Assessment tool allowed colleagues to check for the presence of elements that together might cause a fire to break out. But senior staff failed to implement the initiative and - when a surgical fire actually took place three months later - Kathy learned that her laminated checklist had simply been put in a drawer. “I couldn’t believe it,” she said. “After that they did start using it, but why on earth should it have taken an actual fire to persuade them?” Read full story Source: The Sun, 7 April 2022 Further reading What can we do to improve safety in the theatre? Reflections from theatre nurse Kathy Nabbie How I raised awareness of fires in the operating theatre - Kathy Nabbie
  9. News Article
    United Lincolnshire Hospitals NHS Trust has been ordered to pay a total of £111,204 in fines and legal costs after pleading guilty to failing to provide safe care and treatment to an elderly patient, causing them avoidable harm, following a sentencing hearing on Friday, 25 March at Boston Magistrates’ Court. The case was taken by the Care Quality Commission (CQC) under regulations 12 and 22 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The case against United Lincolnshire Hospitals NHS Trust involved the care of an elderly patient, Iris Longmate, who was admitted to the Greetwell Ward at Lincoln County Hospital on 20 February 2019. On March 3, 2019 Iris fainted and fell unsupervised from a commode, and was found face down on the floor in her room. Iris sustained spinal injuries and a cut to the head as a result of the fall, but then also suffered significant burns to her thigh and left arm as a result of being pressed against a radiator whilst being assessed by staff following the fall. Iris was subsequently transferred to Queens Medical Centre for assessment and treatment. She sadly contracted pneumonia in hospital and died on March 14, 2019. United Lincolnshire Hospitals NHS Trust pleaded guilty to a single offence of failure to provide safe care and treatment causing avoidable harm to Iris, for which the trust was fined £100,000. The court also ordered the trust to pay £170 victim surcharge and £11,034 costs to the CQC. The trust was found to not have taken all reasonable steps to ensure that safe care and treatment was provided, resulting in avoidable harm to Iris. In pleading guilty to the offence of causing avoidable harm to Iris, the trust also acknowledged that other patients on the Greetwell Ward had also been exposed to a significant risk of avoidable harm. Fiona Allinson, CQC’s deputy chief inspector of hospitals, said: "This death is a tragedy. My thoughts are with the family and others grieving for their loss." "People have the right to safe care and treatment, so it’s unacceptable that patient safety was not well managed by United Lincolnshire Hospitals NHS Trust," she said. "Had the trust addressed the issues with the exposed heating pipes before Iris fell, she wouldn’t have suffered such awful burns injuries." Read full story Source: Medscape, 2 April 2022
  10. News Article
    Patients visiting Wales' newest emergency department were likely to have been put at risk of harm due to the lack of processes and systems in place, inspectors found. Healthcare Inspectorate Wales (HIW) carried out an unannounced inspection of The Grange University Hospital in Cwmbran between 1 and 3 November last year and published its findings on 29 March. On the day of their arrival inspectors said The Grange was at full capacity with no empty beds in A&E or in the hospital in general. Despite the best efforts of staff who were "working hard under pressure" the report stated the emergency department had several issues which could have compromised the privacy and dignity of patients. This included problems with the physical environment of the waiting room, which was described as a "major cause of anxiety" for visitors, as well as with the flow of patients through the hospital in general. It found that patients were not triaged and medically managed in A&E in a timely fashion with many being placed on uncomfortable chairs or in corridors for hours on end. Between 1 April 2021 and 1 November 2021, the average waiting time in the department was six hours and seven minutes. The report said some issues required immediate action including the fact patients in the waiting area were often left to "deteriorate without being overseen". There were also infection control failures which could have led to the cross-contamination of Covid-19. "We were not assured that all the processes and systems in place were sufficient to ensure that patients consistently received an acceptable standard of safe and effective care," the report stated. Read full story Source: Wales Online, 1 April 2022
  11. News Article
    Every year, air pollution causes up to 36,000 deaths in the UK.  The World Health Organization and the UK Government recognise that air pollution is the largest environmental health risk we face today. Millions of people around the world breathe polluted air that puts their respiratory and cardiovascular health, and in some cases even their lives, at risk. Phasing out fossil fuels would be a major step in protecting health for current and future generations. More than a thousand health professionals have already endorsed the call for a treaty. Add your name to endorse the call for a treaty. Next week, the Global Climate and Health Alliance are planning a major press launch of the health community's letter calling for a Fossil Fuel Non-Proliferation Treaty and want to secure as many signatures as possible. They are encouraging healthcare professionals to help to build momentum by inviting two—or more—of your health colleagues to sign the health letter before the launch on 14 September. Invite your colleagues to sign the health letter By clicking the link above, you'll be taken to a form where you can send a short note of invitation to a colleague to sign the letter. They will be sent your note, as well as a link to some additional information about the Fossil Fuel Non-Proliferation Treaty. The form can only send one email at a time, but you use the form as many times as you wish.
  12. News Article
    A senior NHS leader has warned of a “life-threatening” situation in which clinically vulnerable people are being admitted to hospital after having their energy supplies disconnected. Sam Allen, chief executive of North East and North Cumbria Integrated Care Board (ICB), has written to Ofgem today to raise “serious concerns” that vulnerable people have seen their electricity or gas services disconnected as a result of non-payment. In the letter, which the ICB has published on its website, Ms Allen said the impact of energy supplies being cut off “will be life threatening for some people” and place additional demand on already stretched health and social care services. She wrote: “It has come to light that we are starting to see examples where clinically vulnerable people have been disconnected from their home energy supply which has then led to a hospital admission. “This is impacting on people who live independently at home, with the support from our community health services team and are reliant on using electric devices for survival. “An example of this is oxygen; and there will be many other examples. There is also a similar concern for clinically vulnerable people with mental health needs who may find themselves without energy supply. “Put simply, the impact of having their energy supply terminated will be life threatening for some people as well as placing additional demands on already stretched health and social care services.” Read full story (paywalled) Source: HSJ, 5 September 2022
  13. News Article
    Half of healthcare facilities worldwide lack basic hygiene services with water and soap or alcohol-based hand rub where patients receive care and at toilets in these facilities, according to a new report by WHO and UNICEF. Around 3.85 billion people use these facilities, putting them at greater risk of infection, including 688 million people who receive care at facilities with no hygiene services at all. “Hygiene facilities and practices in health care settings are non-negotiable. Their improvement is essential to pandemic recovery, prevention and preparedness. Hygiene in health care facilities cannot be secured without increasing investments in basic measures, which include safe water, clean toilets, and safely managed health care waste,” said Dr Maria Neira, WHO Director, Department of Environment, Climate Change and Health. “I encourage Member States to step up their efforts to implement their 2019 World Health Assembly commitment to strengthen water, sanitation and hygiene (WASH) services in health care facilities, and to monitor these efforts.” The latest report, “Progress on WASH in health care facilities 2000–2021: special focus on WASH and infection prevention and control”, has for the first time established this global baseline on hygiene services – which assessed access at points of care as well as toilets – as more countries than ever report on critical elements of WASH services in their hospitals and other health centres. For hygiene, data are now available for 40 countries, representing 35% of the world’s population, up from 21 countries in 2020 and 14 in 2019. The newly established global estimate reveals a clearer and more alarming picture of the state of hygiene in health care facilities. Though 68% of health care facilities had hygiene facilities at points of care, and 65% had handwashing facilities with water and soap at toilets, only 51% had both and therefore met the criteria for basic hygiene services. Furthermore, 1 in 11 (9%) of health care facilities globally have neither. “If health care providers don’t have access to a hygiene service, patients don’t have a health care facility,” said Kelly Ann Naylor, UNICEF Director of WASH and Climate, Environment, Energy, and Disaster Risk Reduction (CEED). “Hospitals and clinics without safe water and basic hygiene and sanitation services are a potential death trap for pregnant mothers, newborns, and children. Every year, around 670,000 newborns lose their lives to sepsis. This is a travesty – even more so as their deaths are preventable.” Read full story Source: WHO, 30 August 2022
  14. News Article
    Two new London hospitals will not open until 2027 at the earliest, the BBC has been told. In 2019, the government pledged to build a new hospital in Sutton and another at Whipps Cross in east London. The St Helier complex in Sutton in south London dates back to the 1930s and much of the Epsom site is about 40 years old. But Dr Ruth Charlton, chief medical officer at Epsom and St Helier Hospital, said: "Our working conditions... are not fit for 21st century healthcare. We really feel that our patients and or staff deserve facilities that would allow them to deliver the quality of healthcare that we all wish to receive." A Department of Health and Social Care spokesperson said: "We have committed to deliver 40 new hospitals by 2030, backed by an initial £3.7bn. We are working closely with all the schemes in the programme and providing funding to develop their plans - final funding allocations are only confirmed once business cases have been fully reviewed and agreed. By taking a more centralised approach, we will reduce the overall time taken to build the hospitals and provide better value for money for the taxpayer." Read full story Source: BBC News (25 August 2022)
  15. News Article
    An unfortunate series of events involving a magnetic resonance imaging (MRI) machine led to the death of a man at a hospital in India. Rajesh Maruti Maru, a 32-year-old, was thrust into the MRI machine while he was visiting an elderly relative at the BYL Nair Charitable Hospital in Mumbai, India. As the Hindustan Times reports, the man was apparently told by a junior member of staff to carry a metal cylinder of liquid oxygen into a room containing an MRI machine. Unbeknownst to everyone, the MRI machine was turned on. This caused Maru to be suddenly jolted pulled towards the machine, causing the oxygen tank to rupture and leak. The man later died after inhaling large amounts of oxygen. His body also bled heavily as a result of the accident. "When we [the hospital staff] told him that metallic things aren't allowed inside an MRI room, he said 'sab chalta hai, hamara roz ka kaam hai' [it's fine, we do it every day]. He also said that the machine was switched off. The doctor, as well as the technician, didn't say anything,” Harish Solanki, Maru's relative, told NDTV. "It's because of their carelessness that Rajesh died," Solanki added. Police are currently examining the CCTV footage of the incident and have arrested at least two members of hospital staff for the negligence. The local government has also awarded the man's family 500,000 rupees ($7,855) in compensation. Read full story Source: IFL Science, 29 January 2018
  16. News Article
    Hospitals in England have recorded more than 450 sewage leaks in the last 12 months, data shows, putting patients and staff in danger and prompting warnings that the NHS estate is “falling apart” after a decade of underinvestment. Freedom of information requests to NHS trusts by the Liberal Democrats found alarming examples of sewage leaking on to cancer wards, maternity units and A&E departments. The investigation also uncovered multiple cases of urine and faeces flowing into hospital rooms and on to general wards. Health officials called the revelations shocking. In some instances, sewage leaks made entire hospital departments unsafe for patients and led to staff struggling to work because they felt nauseous and had headaches. Ed Davey, the Liberal Democrat leader, said: “This is a national scandal. Our country’s hospitals are falling apart after years of underinvestment and neglect. Patients should not be treated in these conditions and heroic nurses should not have the indignity of mopping up foul sewage.” “At every turn, our treasured NHS is crumbling, from hospital buildings to dangerous ambulance wait times. The government needs to find urgent funds to fix hospitals overflowing with sewage. Patient and staff safety is a risk if ministers fail to act,” he said. Read full story Source: The Guardian, 17 February 2023
  17. Content Article
    A significant amount of professional time is wasted during a medical ward round retrieving patient notes from the ward trolley. If the efficiency of this non-clinical, non-functional interaction could be improved it would save time, maintain continuity and have financial implications. One identified constraint was the structure of the traditional ward trolley; a stationary filing tray with vertical sleeves. During ward round, time is spent returning and retrieving each patients notes from outside the patient bay and additional time may be wasted if the notes are misplaced or in use elsewhere. To resolve this, the ‘Vista 90’ trolley with horizontal, transparent trays, is portable and has an ergonomic writing surface was selected as a potential second generation replacement. An assessment of the impact of the Vista 90 trolley over the traditional trolley in the clinical setting was carried out on Erringham (medical) Ward, Worthing Hospital, West Sussex Hospital Trust, UK. This was by way of qualitative analysis performed by semi-structured interview of 12 doctors and other healthcare professionals who regularly interacted with the Vista 90 and traditional trolley in December 2012. The audit found that those interviewed preferred using the Vista 90 trolley over its predecessor as it improved the efficiency of the ward round and subsequent clinical work. It’s mobility allowed it to be easily transported with the ward round, reducing disruption during a consultation and between consecutives ones. The ergonomic writing surface was noted to improve legibility of documentation due to greater comfort and if placed appropriately, did not interfere with the doctor-patient interaction. The financial savings of this greater efficiency was found to be of significance and justify the cost of the Vista 90 within two weeks.
  18. Content Article
    Dr Gordon Caldwell shares how he changed his whole approach to ward rounds after seeing spaghetti maps of where a nurse walked during a shift. He cut down walking distance on rounds by creating a mobile office on wheels out of an old electricians trolley. See also: Making the ward a more efficient place: a qualitative evaluation of the impact of the Vista 90 trolley  
  19. Content Article
    Air pollution is an issue that affects us all; it is associated with impacts on lung development in children, heart disease, stroke, cancer, exacerbation of asthma, increased mortality and other health issues. This year’s Chief Medical Officer's report lays out the scale of the challenge of reducing air pollution and the substantial progress that has been made. It highlights achievable solutions across different sectors and makes the case that we need to continue to be active in reducing outdoor air pollution.
  20. Content Article
    This case study describes the project that won the 'Future-proofing Healthcare 2022' category in the Healthcare Quality Improvement Partnership's (HQIP's) Clinical Audit Heroes Awards. The Sustainable Respiratory Care Audit team at Newcastle Hospitals NHS Foundation Trust was recognised for its work improving care for individual patients while also reducing the environmental impacts of healthcare. Their nomination detailed how the project provided a structure for the audit of patients’ techniques, preferences and knowledge about inhalers, and the need for a clinical review—interventions that can reduce the carbon footprint of healthcare while improving the quality of care.
  21. News Article
    Trusts need hundreds of millions of pounds to remediate dangerous roofs. A series of freedom of information requests submitted by New Civil Engineer has revealed five of the worst affected trusts have applied for £331.9m of additional funding to be spent on fixing reinforced autoclaved aerated concrete planks during the next three years. In response to NCE’s freedom of information investigation, Liberal Democrat deputy leader and health spokesperson Daisy Cooper said “patients are paying the price for years of neglect” by successive governments. “It is truly shocking that patients are being treated in crumbling buildings that could be at risk of collapse. The NHS is crying out for the funds to fix creaking roofs so that patients can be treated safely. The public needs to know that the funds to fix this are on the way as soon as possible.” Read full story Source: HSJ, 17 October 2022
  22. Content Article
    Because hospitals exist for a long time and are expensive to build and to operate, it is crucial to use the abundant, available empirical evidence to guide design. “Evidence-based design” has documented how to make hospitals safer and less stressful. This article, published in The Conversation, looks at the challenges involved.
  23. Content Article
    In April 2002, St Joseph’s Community Hospital of West Bend, a member of SynergyHealth, brought together leaders in healthcare and systems engineering to develop a set of safety-driven facility design recommendations and principles that would guide the design of a new hospital facility focused on patient safety. By introducing safety-driven innovations into the facility design process, environmental designers and healthcare leaders will be able to make significant contributions to patient safety. Request permission to view the resource in full via the link below.
  24. News Article
    Doctors are prescribing heating to patients with conditions that get worse in the cold as part of a health trial. The Warm Home Prescription pilot paid to heat the homes of 28 low-income patients to avoid the cost of hospital care if they became more ill. Michelle Davis, who has arthritis and serious pulmonary illness, had her energy bills paid for and said the difference was "mind-blowing". "When the weather turns cold, I tend to seize up," she told the BBC. "It's very painful, my joints ache and my bones are like hot pokers." In 2020 Ms Davis spent most of the winter in bed, trying to keep warm and was admitted to hospital with pneumonia and pleurisy. But not in winter 2021. "You're not stuck in bed, you're not going to hospital, my children were able to have a life, they were able to go out and play and get cold," she said. Academics estimate that cold homes cost NHS England £860m a year and that 10,000 people die every year due a cold home. But that research was completed before the current cost of living crisis took hold. This first trial achieved such good results, that it's being expanded to 150 households in NHS Gloucestershire's area, plus about 1,000 in Aberdeen and Teesside. Dr Matt Lipson helped design the pilot programme and feels like this preventative step is a no-brainer for the health service. "If we buy the energy people need but can't afford, they can keep warm at home and stay out of hospital," he said. "That would target support to where it's needed, save money overall and take pressure off the health service." The change in patients was swift: "The NHS were telling us they were seeing a benefit much more quickly than pills and potions," Dr Lipson added. "It was taking days, not weeks and months." Read full story Source: BBC News, 22 November 2022
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