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Found 32 results
  1. Content Article
    In this episode of the Medicine and the Machine podcast, Scottish GP Gavin Francis talks about the need to reconsider the importance of convalescence. He discusses the role of GPs in supporting patients through recovery after a hospital admission or period of illness and talks about a lack of awareness of the principles of convalescence amongst patients.
  2. Content Article
    The transition from hospital to home is a vulnerable time as patients may have changes in medications or care needs, or difficulties accessing follow up with an outpatient provider. Authors conducted a prospective intervention study of children with medical complexity discharged at a children’s hospital from April 2018 to March 2020. To reduce adverse events (AE), rehospitalizations, and emergency department visits, this hospital developed a structured discharge bundle based on the I-PASS tool used for inpatient handoffs. AE, rehospitalisations, and emergency department visits were all reduced following implementation of the I-PASS bundle.
  3. News Article
    Hospital staff have to complete 50 separate steps on average to discharge a patient, it has emerged, as the NHS grapples with a bed-blocking crisis. On average, around 14,000 patients deemed fit to leave hospital are stuck in beds every day, according to the latest official figures. The congestion is helping to fuel the backlog in accident and emergency (A&E) departments, where more than 55,000 patients waited 12 hours or longer last month. Steve Barclay, Health Secretary, announced an additional £250 million in funding last week to buy up care beds to help discharge thousands of patients. But doctors, social care experts and families have warned discharges are being delayed by NHS “bureaucracy” and excessive form filling. Dr Matt Kneale, co-chair of the Doctors’ Association UK and a junior doctor in Manchester, said patients are held up by “numerous bottlenecks” before being sent home. “While social care shortages are the predominant issue, smaller factors stack up to create a big problem,” he told The Telegraph. Many hospitals have limits on the times their pharmacies are open, he explained, meaning patients can often be stuck on the ward all day, or an extra night, waiting for their medication. Read full story (paywalled) Source: The Telegraph, 15 January 2023
  4. News Article
    The “social prescribing” of gardening, singing and art classes is a waste of NHS money, a study suggests. Experts found that sending patients to community activity groups had “little to no impact” on improving health or reducing demand on GP services. The research calls into question a major drive from the NHS and Department of Health to increase social prescribing as a solution to the shortage of doctors and medical staff. In 2019 the NHS set a target of referring 900,000 patients for such activities via their GP surgeries within five years. Projects receiving government funding include football to support mental health, art for dementia, community gardening and singing classes to help patients to recover from Covid. However, the study, published in the journal BMJ Open, said there was “scant evidence” to support the mass rollout of so-called “social prescribing link workers”. Read full story (paywalled) Source: The Times, 18 October 2022
  5. Content Article
    Improving medication safety during transitions of care is an international healthcare priority. While existing research reveals that medication-related incidents and associated harms may be common following hospital discharge, there is limited information about their nature and contributory factors at a national level which is crucial to inform improvement strategy. This study in the journal Therapeutic Advances in Drug Safety aimed to characterise the nature and contributory factors of medication-related incidents during transitions of care from secondary to primary care. The authors found several themes for future research that could support the development of interventions, including: commonly observed medication classes older adults increase patient engagements improve shared care agreements for medication monitoring post hospital discharge.
  6. News Article
    Hundreds of NHS patients have received personal, specialised care thanks to a new service set up during the coronavirus pandemic. Stroke Connect, a partnership with the NHS and the Stroke Association provides stroke survivors with support and advice in the early days following hospital discharge, without having to leave the house. Experts have said that the new offer is providing a ‘lifeline’ during the pandemic and has helped more than 500 people to rebuild their lives after having a stroke since it launched last month. Patients are contacted for an initial call within a few days of discharge from hospital, from a trained ‘Stroke Association Connector’, an expert in supporting people after stroke. The connector provides reassurance, support with immediate concerns and links the stroke survivor to support they can access in the long-term as part of their recovery journey as well as signposting them to other sources of support. A further call is offered within the month to check in on the stroke survivor’s progress and identify any further support needed. The new service complements existing rehabilitation services and ‘life after stroke’ care, which has continued throughout the pandemic. Read full story Source: NHS England, 31 August 2020
  7. News Article
    Problems with hospital discharges in England, highlighted in the largest annual patient survey, reinforce the need for greater integration between health and social care, the sector regulator has said. The Care Quality Commission inpatient survey found that a majority of patients were positive about their hospital care but a significant minority experienced problems on discharge. A third of respondents who were frail said the care and support they expected when they left hospital was not available when they needed it. Three in 10 frail people said they had not had discussions with staff about the need for further health and social care services they might require post-discharge. Four in 10 of all patients surveyed left hospital without printed or written information about what they should or should not do after discharge, and the same proportion said their discharge was delayed. Read full story Source: The Guardian, 2 July 2020
  8. News Article
    Tens of thousands of people will need to be recalled to hospital after a serious OVID-19 infection to check if they have been left with permanent lung damage, doctors have told the BBC. Experts are concerned a significant proportion could be left with lung scarring, known as pulmonary fibrosis. The condition is irreversible and symptoms can include severe shortness of breath, coughing and fatigue. Research into the prevalence of lung damage caused by COVID-19 is still at a very early stage. It's thought those with a mild form of the disease are unlikely to suffer permanent damage. But those in hospital, and particularly those in intensive care or with a severe infection, are more vulnerable to complications. In a study from China, published in March, 66 of 70 patients still had some level of lung damage after being discharged from hospital. Radiologists in the UK say, based on the early results of follow-up scans, they are concerned about the long term-effects of a serious infection. Prof Gisli Jenkins, of the National Institute for Health Research, is running assessment clinics for those discharged from hospital with COVID-19. He said: "My real concern is that never before in our lifetime have so many people been subject to the same lung injury at the same time." NHS England has said it is planning to open a number of specialist COVID-19 rehabilitation centres to help patients recover from long-term effects, including possible lung damage. Read full story Source: BBC News, 24 June 2020
  9. Content Article
    Access outline their virtual ward offer and 10 case studies from NHS trusts and other organisations from which they present findings as testimony, to show the impact of virtual wards on the NHS’ ability to provide care.
  10. News Article
    Serious patient safety and wellbeing concerns about the latest hospital discharge guidance have been raised to HSJ by senior clinicians and charities. Senior geriatricians warned that the guidance could prompt an increase in “urgent readmissions”, “permanent disability” and “excess mortality”, while charities said families could be left with “unsustainable caring responsibilities” because of the new rules. The government guidance, Hospital Discharge Service: policy and operating model, published in August, said clinicians should consider discharging patients when they were “medically optimised” rather than “medically fit”. It said 95% of these patients would return straight home with additional social care and rehabilitation support if needed. Many of the concerns raised surround the retention of the “criteria to reside”. This was originally agreed in March when there was a push from NHS England to free up acute beds over fears hospitals would become overwhelmed with covid admissions as the pandemic hit the UK. The criteria has, however, been maintained in the new guidance, despite a significant fall in infections and deaths from the virus. Rachel Power, chief executive of The Patients Association charity, warned: “This guidance makes it clear that the NHS is still having to take drastic emergency action in the face of covid-19, that will continue to take a heavy toll on patients. It is clear that many patients will be rushed home who would normally have had a longer period of hospital care.” Read full story (paywalled) Source: HSJ, 8 September 2020
  11. Content Article
    The Quality Network for Inpatient Working Age Mental Health Services (QNWA) based within the Royal College of Psychiatrists' Centre for Quality Improvement are pleased to announce the publication of their 8th edition standards. Since the publication of the first edition standards in 2006, the Network has grown to include over 140 members from the NHS and private sector. This new edition of standards aims to reflect the changes in working practices and legislation over the last two years in addition to placing greater emphasis on equality, diversity and inclusion as well as sustainability in inpatient mental health services. The eighth edition standards have been drawn from key documents and expert consensus and have been subject to extensive consultation with professional groups involved in the provision of inpatient mental health services, and with people and carers who have used services in the past.
  12. Content Article
    When leaving hospital with medicines, there can be a lot of information to take in. This checklist designed by the Royal College of Physicians (RCP) Quality Improvement and Patient Safety (QIPS) is designed to help patients and their carers use medications safely when they leave hospital. It includes: Questions to consider before you leave hospital Questions to consider when you’ve left hospital Further useful resources Medicines safety and governance pharmacist Jen Flatman has written a blog about how the checklist was developed.
  13. Content Article
    In this blog, Jen Flatman, medicines safety and governance pharmacist, discusses a resource to support people to continue to use their medicines safely once they leave hospital. The medicines safety checklist was designed by patients and carers, for patients and carers, helping bridge the transition between hospital and the next destination. The points on the checklist are designed to act as a prompt, ensuring individuals are aware of key information to continue to use their medicines safely. They also act as a reminder to the reader to ask questions if they are unsure about anything.
  14. Content Article
    Transitions of care between hospital departments are necessary, but they may disrupt care coordination, such as discharge planning. Family carers often serve as liaisons between the patient and healthcare professionals, but they frequently experience exclusion from care planning during intrahospital transfers (IHTs). This has the potential to decrease their awareness of patients’ clinical status, postdischarge needs and carer preparation. This study aimed to explore family carers’ perceptions about IHTs, patient and carer ratings of patient discharge readiness and carer self-perception of preparation to engage in at home care.
  15. Content Article
    This review explores the benefits of multidisciplinary team working to support people having surgery and the factors that may help and hinder its development and sustainability. Perioperative care is the integrated multidisciplinary care of patients from the moment surgery is contemplated through to full recovery. Multidisciplinary working, whereby professionals from different specialties and sectors work together to support someone along their journey, is a foundation of perioperative care. The Centre for Perioperative Care (CPOC) wanted to explore the benefits of, and barriers and enabler to, multidisciplinary team working. The rapid review summarises learning from 236 UK and international studies about this. About 13% of the studies were from the UK. To identify relevant research, 14 bibliographic databases were searched and screened more than 18,000 articles available as of June 2020.  
  16. Content Article
    This document from the Department of Health and Social Care (DHSC) sets out how health and care systems can ensure that people: are discharged safely from hospital to the most appropriate place. continue to receive the care and support they need after they leave hospital. It replaces ‘Coronavirus (COVID-19) hospital discharge service requirements’ published on 19 March 2020.
  17. Content Article
    This survey looks at the experiences of people who stayed at least one night in hospital as an inpatient. People were eligible to take part in the survey if they stayed in hospital for at least one night during November 2021 and were aged 16 years or over at the time of their stay.
  18. Content Article
    HomeLink Healthcare (HLHC) has been providing clinical care in the home with Norfolk and Norwich University Hospitals NHS Foundation Trust (NNUHT) since January 2019, to release in-patient bed capacity and improve patient choice. The two organisations have co-created the service, NNUH at Home, creating additional capacity and promoting improvements in patient flow from hospital to home. A key feature of NNUH at Home is that it compliments and integrates with existing services, rather than replicating those already in place.
  19. Content Article
    Medicines reconciliation and medication reviews play an integral part in medicine optimisation. Medicines reconciliation is the process of accurately listing a person’s medicines. This could be when they're admitted into a service or when their treatment changes. It involves recording a current list of medicines, including over-the-counter and complementary medicines. Then, the list is compared with the medicines the person is actually using. It involves recognising and resolving any discrepancies and documenting any changes. The medicines reconciliation process will vary depending on the care setting that the person has moved into (or from). Trained and competent staff should carry out the medicines reconciliation. They should consult with a health professional. Ideally, this should be the person’s GP, nurse or pharmacist.
  20. Content Article
    Patient Safety Learning speaks to sepsis survivor, Dave Carson, and his wife, Margaret Carson, who tell us how things have improved and what more still needs to be done for sepsis.
  21. Content Article
    Sepsis is the immune system’s overreaction to an infection. Normally, our immune system helps fight infections – but sometimes it attacks our body’s own organs and tissues. We do not yet know why the body reacts this way, which is what makes sepsis so dangerous; if Sepsis isn’t treated immediately, it can result in organ failure and death. Yet with early diagnosis, it can be treated with antibiotics.
  22. Content Article
    Frimley Health NHS Foundation Trust have devised a patient leaflet to help patients play a role in their safety while at the hospital. 
  23. Content Article
    Interesting article, by the Patient Safety Network, around how patients can be involved in the solution and the cause of some patient safety incidents.
  24. Content Article
    Rehabilitation is fast becoming the new priority in dealing with the impact of this pandemic and is crucial for people recovering from COVID-19 infection.The Royal College of Occupational Therapists (RCOT) have published three guides to support people to manage post-viral fatigue and conserve their energy as they recover from COVID-19. These guides are endorsed by the Intensive Care Society.Practical advice for people who have been treated in hospitalPractical advice for people who have recovered at home’Practical advice for people during and after having COVID-19.You can download the guides via the link below.
  25. Content Article
    The National Falls Prevention Coordination Group has identified resources to address Covid-19 related falls and fracture issues including advice for patients on keeping active following hospital discharge. The advice leaflet has been designed for patients who are discharged home with no community rehabilitation and can be download via the Chartered Society of Physiotherapy link below. It explains why muscle wasting occurs with prolonged bed rest or inactivity and why it is important to be active when discharged home from hospital. 
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