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Found 29 results
  1. 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
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    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
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    The Norfolk and Norwich University Hospital introduced NNUH at Home in January 2019 as part of a pilot project. NNUH is working in partnership with HomeLink Healthcare to deliver this service, which will benefit patients by supporting them to leave hospital as soon as they are clinically stable. Some clinically selected patients are able to go home to recover for the last few days of their acute episode of care. These patients remain under the care of the hospital and will be supported at home with bespoke care services such as therapy, nursing care, personal care and IV antibiotics. Patients are able to complete the remainder of their care in the comfort of their own homes, with the full support of their medical consultant and the NNUH and HomeLink teams. The NNUH at Home team comprises of nurses, physiotherapists, occupational therapists and Healthcare Support Workers. Patients transferred to the NNUH at Home service will remain under the care of their hospital consultant until they are formally discharged by the hospital to their GP at the end of their agreed length of stay. NNUH at Home will complements existing NHS community services.
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    This is a template that can be used by health professionals carrying out medicines reconciliation.
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    View video (3:23 )
  14. Content Article
    The challenge Some patients leaving hospital need advice and support to help them take their medicines correctly and safely. Around 60 per cent of patients have three or more changes made to their medicines during their stay in hospital, and only 10 per cent of older patients are discharged with the same medication they were taking before they went into hospital. In some cases, errors or unintentional changes to a patient’s medication can occur because of miscommunication. This can lead to patients becoming unwell and being readmitted to hospital, causing unnecessary distress to the patient and placing an avoidable burden on NHS resources. It is estimated that 6.5 per cent of emergency admissions are a result of adverse drug reactions, of which it is estimated that 72 per cent are avoidable. Actions taken In 2016, NHS England in Cheshire and Merseyside, in partnership with the Innovation Agency, received funding from NHS England to support the implementation of systems enabling the transfer of care from hospitals to community pharmacies. Soon afterwards, the initiative was adopted nationally by all Academic Health Science Networks and is one of the AHSN Network’s key innovation programmes. A secure digital system enables a hospital’s pharmacy team to inform the patient’s local pharmacy of the patient’s medicines on discharge, so the pharmacist can follow up with advice and services. Impacts Of all referrals from hospitals to community pharmacies through Transfer of Care Around Medicines, around 40 per cent require follow-up action from the pharmacist. It is estimated that for every 10 completed referrals, eight avoidable bed days are saved for the NHS. As of March 2019, Transfer of Care Around Medicines in Cheshire and Merseyside has been implemented in 10 trusts, including 11 hospitals, two mental health trusts and all 635 community pharmacies in the region – the fastest adoption and widest spread of the initiative in any region in England. There have been 14,853 referrals to community pharmacists at March 2019, of which 6,224 have been completed with further actions from the pharmacist, resulting in calculated savings of 5,103 bed days, or £9.5 million, to the NHS as well as improved patient safety and quality of care. Testimonial Una Harding, pharmacist at Day Lewis Pharmacy in Aintree, said: “We now get notifications on our system on a daily basis, it’s a platform we use every day. New discharges or referrals are the first thing you see when you log on. If we see a patient has recently been in hospital we can make a note to speak to them about their medication when they next come in." "Patients now understand we can deliver more for them. There’s a culture now where people are realising that their GP doesn’t always have to be the first port of call. They know now that if they come into the pharmacy we can talk to them about the changes to their medication." "It’s fabulous. Finally we’re getting more information so we can make more clinical decisions without having to hunt for information from different sources.” Hassan Argomandkhah, Chair of Pharmacy Local Professional Network NHS England Cheshire and Merseyside, said: “What started as an idea – we’ve managed to achieve it, and even if we’ve made just one small change in the quality of life of one patient in the past two years it’s been well worth it. None of this would have happened without the dedication of the pharmacists and their teams – whether in NHS England, in the community pharmacies, or in the hospital pharmacy teams – and all the other ancillary staff surrounding them. Without that support and encouragement we wouldn’t have achieved this.”
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    This is an interview with sepsis survivor Julia, who gives insight into her own personal battle with the condition.
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  19. 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
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    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
  21. 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
  22. 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
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    This report teases out the ‘ingredients’ for successful team working at system, organisational, team and individual level. In the COVID-era, multidisciplinary perioperative teams can be at the front and centre of supporting staff to deliver the best possible care. Key messages Our review found that multidisciplinary working is worth prioritising. There is evidence that in some cases multidisciplinary working can: speed access to surgery, if that is an appropriate treatment option improve people’s clinical outcomes, such as reducing complications after surgery reduce the cost of surgical care by helping people leave hospital earlier However, these benefits are not always apparent. More work is needed to explore which types of multidisciplinary working are most effective and what infrastructure and resources are needed to strengthen and sustain multidisciplinary care around the time of surgery.
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    Key findings Feeling safe from risk Most patients (83%) said they felt safe from the risk of catching coronavirus in hospital: those diagnosed while in hospital felt least safe (68%) compared with those who did not receive a coronavirus diagnosis (84%). Confidence and trust in staff Over 8 in ten people surveyed (83%) said they ‘always’ had confidence and trust in the staff treating them: 77% said they were involved ‘a great deal’ or ‘a fair amount’ in the decisions made about their treatment 70% felt they ‘always’ received enough emotional support from staff during their stay. Overall experiences Patients with a coronavirus diagnosis reported poorer experiences than people who did not have the virus. Particularly in relation to discharge and accessing support after leaving hospital. Leaving hospital Around a third of people with coronavirus (32%) did not know what would happen next with their care when leaving hospital. This compared with 18% of people without coronavirus. Three in 10 (29%) diagnosed with coronavirus felt help from health and social care services would have been ‘useful’ after leaving hospital but did not get any. Cleanliness The majority of respondents (80%) said that their room or ward was ‘very clean’. Most also recalled seeing a range of infection control measures. This included staff wearing personal protective equipment (PPE), handwashing, and cleaning of surfaces. But fewer people saw social distancing measures such as markers on the floor or signage. Keeping in touch with family and friends Seventy-five per cent of people said they were 'often' able to keep in touch with their family and friends during the pandemic. But, 13% said they did not receive the help they needed to do so. Older patients, patients with a sensory impairment and people with a learning disability, a mental health condition or neurological condition were less likely to feel they were able to keep in touch with family and friends. Communicating with staff Certain groups of patients found communicating with staff who were wearing PPE especially difficult. Those aged 85 and over were less likely to always understand what they were being told. As were: patients with Autism, dementia or Alzheimer’s disease patients who were deaf or hard of hearing patients with Learning Disabilities.
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