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Content Article
In this Health Services Journal article, Alastair McLellan looks at the financial planning challenges facing Daniel Elkeles as he takes up the position of Chair of NHS England. The article suggest that NHS Providers should prioritise making the challenges facing trusts clear to the Government and NHS England. It also suggests the need for a patient approach to ensure that all parties understand the implications of financial agreements that are made.- Posted
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Rising drug costs strain NHS budgets, yet many new medicines deliver fewer health benefits than alternative interventions. A Lancet study underscores the need to reassess spending priorities and tackle inefficiencies in resource allocation for better patient outcomes, writes Steve Black in this HSJ article.- Posted
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This blog looks at what the Government's decision to launch a national conversation about the NHS—called 'Change NHS'—says about its wider health policy. Andy Cowper, Editor of health Policy Insight, highlights three key areas that the author believes the Government should focus on in order to tackle the problems facing the health service: An urgent ‘Fireman Sam’ bucket of improvements that are needed to stop things all over the English NHS being 'on fire'. Rebuilding and restoring credibility to the management systems and structures. Building the future.- Posted
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News Article
Doctors paid up to £200,000 overtime to tackle NHS backlog
Patient Safety Learning posted a news article in News
Senior doctors are charging the NHS premium rates for overtime, as pressure to cut waiting lists is allowing some to make more than £200,000 a year from additional work, a BBC News investigation has found. That is nearly double the average basic pay for a full-time consultant in England. Many of the consultants earning the most are thought to be part-time, allowing them to work significant amounts of overtime for rates exceeding £200 an hour – more than four times normal pay. In response, Health Secretary Wes Streeting told the BBC: "I don't think the rates are acceptable. Every penny that goes into the NHS needs to be well spent." But the British Medical Association (BMA), the doctors' union, pointed out the NHS would not have to rely so much on overtime were it not for staffing shortages. And hospitals said covering for strike days and sickness had also been factors. The findings come as the government invests more money in the NHS, to increase the number of appointments and operations it can offer – a key election promise made by Labour. Read full story Source: BBC News, 5 November 2024- Posted
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Community Post
This case study focuses on a North Staffordshire Combined NHS Trust project. The lead consultant for the service was concerned that the clinical pathways were not optimised and bottlenecks were delaying access, assessment and diagnosis of patients. As a result there were delays to initiating treatment. In addition to potential harm to patients this was resulting in inefficient and wasteful use of resources. Following pathway changes, value and efficiency impact was noted in the following areas: Because head CT scans are provided by a neighbouring acute trust, reducing the number of patients referred had a direct impact on service cost as well as releasing capacity in the wider system. Comparing baseline activity with the review period showed a 30% reduction in CT scan referrals and a £7,800 direct cost saving. The number of patients not attending appointments reduced from 572 in the baseline period to 379 after implementing pathway changes. While not a cash releasing saving this improved overall efficiency and productivity for the service and contributed to a reduction in overall unit price per attendance. At the start of the project, the average unit price for patients attending the memory service was £280.93. Through a combination of direct cost savings and efficiency and productivity gains arising from the revised pathway, this figure had reduced to £205.12 in the review period. Do you have a cost-saving or efficiency case study to share? What were the patient safety implications? Do you have resources or knowledge to share that can help others make positive changes? Comment below (sign in or register here for free first), or get in touch with us at [email protected] to tell your story. -
Content Article
Engagement Value Outcome (EVO) promotes collaborative working between clinical and finance teams to enhance their collective understanding of patient level costing. It provides the NHS with a framework to ensure resources are used in the most effective way possible to provide high-quality care to patients. This clinical transformation case study focuses on the North Staffordshire Combined NHS Trust EVO project. The lead consultant for the service was concerned that the clinical pathways were not optimised and bottlenecks were delaying access, assessment and diagnosis of patients. As a result there were delays to initiating treatment. In addition to potential harm to patients this was resulting in inefficient and wasteful use of resources Impact on value and efficiency While the EVO pilot framework ended after the fourth session, the trust was keen close the loop and measure the benefit of the changes made. Following pathway changes the service could see the positive impact on patient experience but needed to work with the costing team to understand the impact on activity and cost, and therefore demonstrate if there had been any realisable efficiency and productivity gains. Because head CT scans are provided by a neighbouring acute trust, reducing the number of patients referred had a direct impact on service cost as well as releasing capacity in the wider system. Comparing baseline activity with the review period showed a 30% reduction in CT scan referrals and a £7,800 direct cost saving. The number of patients not attending appointments reduced from 572 in the baseline period to 379 after implementing pathway changes. While not a cash releasing saving this improved overall efficiency and productivity for the service and contributed to a reduction in overall unit price per attendance. At the start of the project, the average unit price for patients attending the memory service was £280.93. Through a combination of direct cost savings and efficiency and productivity gains arising from the revised pathway, this figure had reduced to £205.12 in the review period. Read the full case study via the link below. -
Content Article
When many people think about NHS services they often think about clinical staff, such as doctors or nurses, and how they deliver care and interact with patients and families. However, in the context of patient safety, there is often more to see ‘behind-the-scenes’ in non-patient facing services. These services may be less visible, but they play a vital part in ensuring patient safety. Understanding the importance of these services, and how they are crucial to the ability of the NHS to operate effectively, is often underestimated. In this blog for the Healthcare Safety Investigation Branch (HSIB), National Investigators Russ Evans and Craig Hadley highlight how 'behind-the-scenes' services are crucial to help the NHS operate effectively and safely. -
Content Article
“Almost every Gynecologic surgeon I know has a story about being told that they were wasting their talent". It was this tweet from US-based gynaecology surgeon Jocelyn Fitzgerald that caught my eye a few months ago. I’m passionate about women’s health and immediately wanted to find out more about how this translated in terms of patient safety. So, in August we met, and Dr. Fitzgerald explained some of the barriers and challenges she faces in delivering safe and equitable care. Hi Dr Fitzgerald, can you tell us a bit about yourself? I am a double board-certified obstetric gynaecologist, urogynaecologist and pelvic reconstructive surgeon at Magee Women’s Hospital in Pittsburgh. My work includes pelvic floor reconstruction, including vaginal prolapse and urinary incontinence. Other gynaecology surgical specialists include; gynae oncology for cancers of the female reproductive tract, and minimally invasive gynaecology surgery for the treatment of endometriosis and fibroids. What made you want to become a gynaecology surgeon? I knew this was a field that was rife with surgical challenges and inequality – we need the most motivated surgeons and brightest minds! There is so much taboo around what we do that I knew I had to lend my voice. What sort of comments did you get personally, or hear more widely, about gynaecology surgery as a specialty when you were in training? That we are not 'real' surgeons. I've heard that so many times. This definitely had an impact on me personally. All of my peers say the same, that they were told they were wasting their surgical and medical talent by going into Gynaecology. There have even been offensive memes created by anaesthetists and shared widely that imply our specialty is less skilled when in fact sub-specialist gynaecology surgeons have low complication rates, on par or superior to those of other surgical disciplines. How does pay impact talent acquisition? If you train in urogynaecology and want to specialise in surgery you are financially disincentivised to choose the gynaecology route. In the US, we are the lowest paid surgeons in medicine.[1,2] Statistics highlight a double layer of discrimination here, with the highest paid being male clinicians who opt to specialise in urology surgery and the lowest paid being female clinicians who specialise in gynaecology surgery.[3] It feels like we are discouraged from the start to look after women. Coupled with the condescending attitudes to our specialty, poor pay leads to skilled clinicians questioning whether they are too talented to treat women and often choosing a different route. Can you tell us about how clinical services are reimbursed in the US and how this impacts gynaecology surgery? The system here uses something called ‘relative value units’ (RVUs) to determine the amount of money reimbursed to the healthcare provider or organisation for each clinical service provided. A payment formula contains three RVUs, one for physician work, one for practice expense, and one for malpractice expense. Unfortunately, the gap between reimbursement for gynaecology surgeries and other types of surgery continues to widen.[4,5] This disincentivises the recruitment of talent into this high-demand field. In a profit-driven medical environment, it also disincentivises healthcare systems from providing gynaecology surgeons with necessary resources, such as: operating room time facilities staff allocation. It is worth mentioning that only three of the 32 people on the committee that determines RVUs are women.[6] How does this lead to patient harm? This low reimbursement leads to patient harm due to long wait times for surgery, inconsistent staffing, decreased surgeon volume and worse outcomes. Lower reimbursement for gynaecology services compared to obstetrics disincentivises generalist obs/gynaes from providing gynaecology care.[7] This leads them to the majority becoming ‘low volume’ surgeons. Surgeons who operate less are less efficient and have worse outcomes; they lack dedicated teams and repetition, increasing surgery time and subsequent patient harm. Can you give an example of how this plays out for patient care? Endometriosis is a good example. It is a complex disease where tissue similar to the uterine lining is found in the abdominal cavity. It causes significant abdominal and menstrual pain, scarring, and infertility. It takes on average 7-10 years to diagnose due to the vague nature of its symptoms, association with painful menses (which are largely dismissed in emergency settings) and lack of specialist training. Endometriosis surgery is extremely complex and requires fellowship training in advanced gynaecologic Surgery. Only one code exists to reimburse for endometriosis surgery and it makes no distinction between a 20 minute laparoscopy where a lesion was briefly ‘burned’ which typically will achieve minimal benefit, and a five hour excisional procedure.[8] Reimbursement for this complex disease is so low (due to lack of complexity codes and payment) that: patients continue to see unskilled providers some US providers who do have the skills to excise endometriosis will only take cash; bankrupting desperate patients in severe pain women are more likely to face long waits for surgery and/or cancelled operations. See the documentary Below the Belt for a more detailed expose on this topic. What needs to happen to make gynaecology surgery better supported so that all patients have access to safe care? In a profit-driven system here in the US, our procedures need to be coded and reimbursed based on the worth of our skill set. Sub-specialist gynaecology surgeons complete 2-4 years of additional fellowship training in advanced procedures. This is often more than their higher-paid surgeon colleagues, for example orthopaedics, which is 5-6 years of training or Urology, which is 5 years without a fellowship. There needs to be fundamental changes to the RVU system, the involvement of the department of Health and Human Services, and legal options citing gender discrimination, though this would be challenging. Ultimately the discrimination and lack of value for gynaecology surgery is ‘baked in’ to the system and is affecting the level of care women receive. This needs to be addressed at every level to value women and their providers and prevent harm. References Wilcox L. General surgery salary report 2022: Surgeon wages up 8%. Weatherby Healthcare, 2022. Accessed online 25/09/2023. Watson KL, King LP. Double Discrimination, the Pay Gap in Gynecologic Surgery, and Its Association With Quality of Care. Obstet Gynecol. 2021;137(4):657-661. Pelley E, Carnes M. When a Specialty Becomes "Women's Work": Trends in and Implications of Specialty Gender Segregation in Medicine. Acad Med. 2020 Oct;95(10):1499-1506. Polan RM, Barber EL. Reimbursement for Female-Specific Compared With Male-Specific Procedures Over Time. Obstet Gynecol. 2021;138(6):878-883. Benoit MF, Ma JF, Upperman BA. Comparison of 2015 Medicare relative value units for gender-specific procedures: Gynecologic and gynecologic-oncologic versus urologic CPT coding. Has time healed gender-worth? Gynecol Oncol. 2017;144(2):336-342. American Medical Association. Composition of the RVS Update Committee (RUC), 2023. Accessed online 25/09/2023. Watson KL, King LP. Double Discrimination, the Pay Gap in Gynecologic Surgery, and Its Association With Quality of Care. Obstet Gynecol. 2021 Apr 1;137(4):657-661. Seckin T. Historic Update to ICD-10 Endometriosis Diagnosis Codes. Seckin Endometriosis Center, 2022. Accessed 25/09/2023. Share your views Do you work in gynaecology or women’s health in the US or another country? Have you experienced comments or barriers similar to Jocelyn? Is your area of health well resourced and funded? What needs to change to help staff provide safe and equitable care? Please comment below (sign up first for free) or get in touch with us at [email protected] to share your insights.- Posted
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Event
untilAnchor institutions are large organisations, connected to their local area, that can use their assets and resources to benefit the communities around them. Health and care organisations, as well as providing healthcare services, are well-placed to use their influence and resources to improve the social determinants of health, health outcomes and reduce health inequalities. This King's Fund event will explore what anchor institutions are, what they look like in practice and how we can embed some of those ways of working within health and care. We will look at how health and care organisations, working in partnership with other local anchor institutions, are leveraging their role as large employers and purchasers of goods and services and playing an active role in protecting the health, wellbeing and economic resilience of their local communities. Register- Posted
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News Article
NHSE orders further dilution of staffing ratios to help double ICU capacity
Patient Safety Learning posted a news article in News
NHS England has told hospitals in the Midlands to further dilute their staffing ratios so critical care capacity can be doubled, HSJ has learned. In a letter sent on 9 January to the boards of all trusts in the region, national leaders said they needed to “dilute nursing ratios beyond the current ask of 1:2” to achieve the significant increase in capacity. In November, all trusts in England were told they could dilute staffing ratios in critical care from the standard one nurse to one patient ratio, to one nurse to two patients. Informal reports from around the country suggest some trusts have already had to move beyond these ratios. The letter said trusts had already been asked to surge capacity to 150% cent of the normal baseline on 6 January, and were expected to be at 175% today. But it said some units were still not achieving this and the region was “transferring patients to other regions.” It added: “In addition to this, you need to have well developed plans in place that can be rapidly activated to surge to 200% of baseline, which may need to be enacted in the coming days. Read full story (paywalled) Source: HSJ, 11 January 2021 -
News Article
Twenty-three hospital trusts had more than a third of their core bedbase occupied by COVID-19 patients on Tuesday, and occupancy is still rising at all but one. Three trusts (North Middlesex in north London, as well as Medway and Dartford and Gravesham in Kent) had more than half of general and acute beds occupied by patients who had the virus, and others were not far behind. Several trusts saw their covid occupancy share up by more than 10 percentage points in a week — a rate of growth which would soon see them entirely filled by covid patients, a situation with radical consequences for emergency hospital care in those areas. London as a whole had a third of these beds occupied by patients with COVID-19. HSJ has analysed data published for the first time by NHS England last night. The data concerns the status of adult general and acute beds, which make up the large majority of the acute bedbase. They do not include intensive care, which is also now under huge pressure in London, the south east and the east of England. Most hospitals in these areas are stretching IC capacity above normal levels. Such high covid occupancy in both intensive care and the core bedbase is putting severe strain on hospitals’ ability to treat other patients. Most or all of the trusts under the greatest pressure have now cancelled routine planned surgery, and many are struggling with crowding, delays getting patients into and out of emergency departments due to the space available, and a lack of staff. Read full story (paywalled) Source: HSJ, 1 January 2021- Posted
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News Article
Frontline doctors have testified to deteriorating conditions in hospitals in London and the south east as the NHS deals with a surge in COVID-19 cases. Speaking to the Independent SAGE group of experts on 30 December, Jess Potter, a respiratory doctor in east London, told how she and colleagues were afraid of resources running out. “My greatest fear is having a patient that I cannot provide lifesaving treatment to,” she said. “We had one of our largest medical intakes yesterday, the vast majority with coronavirus. What do we do when we run out of resources, and who is going to provide that guidance? It will harm our patients and our staff, because we have a set of values by which we practise, and we will have to reduce the level of care we deliver.” She added, “Back in April I never saw a case where we didn’t provide a bed to a patient who needed it in intensive care, and decisions were taken as if in normal times. Now I hear from medics across the country that things are very bad, and the situation is the same as in April, if not worse. We are afraid of what will happen if we don’t act now.” Sonia Adesara, a doctor in London, spoke to Independent SAGE after a set of night shifts at her trust and told of a chronic shortage of continuous positive airway pressure (CPAP) capacity. “In the past few days, despite my hospital significantly increasing intensive and critical care capacity, our intensive care unit has been full, and there is no spare CPAP capacity. Medics are spending shifts trying to closely monitor all of our patients who are on the highest level of oxygen that we can give with a normal mask, assessing who is most unwell and unstable—and then frequently checking on patients who are on CPAP and then swapping people [around]." Read full story Source: BMJ, 31 December 2020 -
News Article
The flagship Nightingale hospital is being dismantled as medics warn that there are not enough staff to run the facilities despite the NHS being at risk of being overwhelmed by coronavirus. Amid surging virus case numbers, elective surgery is being cancelled as the number of patients in hospitals in England passes the peak of the first wave in April. Although the NHS is "struggling" to cope, the majority of the seven Nightingale hospitals, created at a cost of £220 million, have yet to start treating COVID-19 patients during the second wave. The Exeter Nightingale has been treating Covid patients since mid-November. The facility at London's Excel centre has been stripped of its beds and ventilators. The NHS has told trusts to start preparing to use the overflow facilities in the coming weeks, but bosses have failed to explain how they will be staffed. Read full story (paywalled) Source: The Telegraph, 28 December 2020 -
News Article
More than 75% of NHS midwives think staffing levels unsafe, says RCM
Patient Safety Learning posted a news article in News
More than three-quarters of midwives think staffing levels in their NHS trust or board are unsafe, according to a survey by the Royal College of Midwives (RCM). The RCM said services were at breaking point, with 42% of midwives reporting that shifts were understaffed and a third saying there were “very significant gaps” in most shifts. Midwives were under enormous pressure and had been “pushed to the edge” by the failure of successive governments to invest in maternity services, said Gill Walton, the chief executive of the RCM. “Maternity staff are exhausted, they’re demoralised and some of them are looking for the door. For the safety of every pregnant woman and every baby, this cannot be allowed to continue,” she said. “Midwives and maternity support workers come into the profession to provide safe, high-quality care. The legacy of underfunding and underinvestment is robbing them of that – and worse still, it’s putting those women and families at risk.” RCM press release Read full story Source: The Guardian, 16 November 2020 -
News Article
NHS People Plan 2020/21 response by The Health Foundation
Clive Flashman posted a news article in News
NHS People Plan provides a stop-gap but leaves glaring omissions 'Two years after it was first promised, the NHS is still waiting for a long-term workforce plan. Some of the measures announced in today’s People Plan are positive. As the plan acknowledges, it is important to learn from the impressive changes made by NHS staff during the pandemic. And improving support for people from black and minority ethnic communities – who make up one fifth of the NHS workforce – is rightly a top priority. 'But there are glaring omissions. The NHS went into the pandemic with a workforce gap of around 100,000 staff, yet the plan does not say how this will be addressed in the medium term. This is particularly concerning at a time when our recruitment of nurses from abroad has dropped dramatically. These details are missing because the NHS is still waiting on government to set out what funding will be available to expand the NHS workforce – without which the NHS cannot recruit and retain the doctors, nurses and other staff it needs. 'While this plan at least provides a stop-gap to help get the NHS through the winter, there is no equivalent plan for social care – a sector suffering from decades of political neglect and the devastating impact of COVID-19 on care users and staff. A comprehensive workforce plan for both the NHS and social care is needed now more than ever'.- Posted
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News Article
Launch of NHS People Plan (2020-21)
Clive Flashman posted a news article in News
"We are the NHS: People Plan 2020/21 – action for us all, along with Our People Promise, sets out what our NHS people can expect from their leaders and from each other. It builds on the creativity and drive shown by our NHS people in their response, to date, to the COVID-19 pandemic and the interim NHS People Plan. It focuses on how we must all continue to look after each other and foster a culture of inclusion and belonging, as well as take action to grow our workforce, train our people, and work together differently to deliver patient care. This plan sets out practical actions for employers and systems, as well as the actions that NHS England and NHS Improvement and Health Education England will take, over the remainder of 2020/21. It includes specific commitments around: Looking after our people – with quality health and wellbeing support for everyone Belonging in the NHS – with a particular focus on tackling the discrimination that some staff face New ways of working and delivering care – making effective use of the full range of our people’s skills and experience Growing for the future – how we recruit and keep our people, and welcome back colleagues who want to return The arrival of COVID-19 acted as a springboard, bringing about an incredible scale and pace of transformation, and highlighting the enormous contribution of all our NHS people. The NHS must build on this momentum and continue to transform – keeping people at the heart of all we do."- Posted
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News Article
Coronavirus: Nurses' leaders urge 'care for those who caring'
Patient Safety Learning posted a news article in News
Nurses' leaders want all healthcare employers - including the NHS - to "care for those who have been caring" during the coronavirus crisis. The Royal College of Nursing (RCN) is calling for better risk assessments; working patterns and mental health care for those on the front line. It warns many may be suffering from exhaustion, anxiety and other psychological problems. The Department of Health and Social Care said support was a "top priority". The RCN has released an eight-point plan of commitments it wants to see enforced to mark the 100 days since the World Health Organization (WHO) declared a pandemic. Amongst its suggestions are a better COVID-19 testing regime for healthcare workers and more attention paid to the risks posed to ethnic minority nurses. It says employers and ministers "must tackle the underlying causes which have contributed to worse outcomes for Bame staff". Read full story Source: BBC News, 19 June 2020 -
Content Article
While improving over time, the outcomes for lung cancer patients were already dramatically below those with other cancers before the pandemic. This report from the World Economic Forum, is designed to help governments, health systems, healthcare professionals and others to come together to: understand the effect of the pandemic on lung cancer care address the immediate impact of the pandemic on lung cancer services ensure their resilience in the longer term so that we can go further than ever before to improve patients’ outcomes.- Posted
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Content Article
Substantial evidence indicates that patient outcomes are more favourable in hospitals with better nurse staffing. One policy designed to achieve better staffing is minimum nurse-to-patient ratio mandates, but such policies have rarely been implemented or evaluated. In 2016, Queensland (Australia) implemented minimum nurse-to-patient ratios in selected hospitals. In a study published in the Lancet, McHugh et al. aimed to assess the effects of this policy on staffing levels and patient outcomes and whether both were associated.- Posted
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Amiri et al. analysed the role of nurse staffing in improving patient safety due to reducing surgical complications in member countries of Organization for Economic Co-operation and Development (OECD). They found that a higher proportion of nurses is associated with higher patient safety resulting from lower surgical complications and adverse clinical outcomes in OECD countries.- Posted
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News Article
ICUs advised how to improve staffing ratios as covid pressure eases
Patient Safety Learning posted a news article in News
Intensive care units (ICU) will be advised how to improve their staffing-to-patient ratios shortly as the number of patients admitted to hospital with COVID-19 falls across the country. In expectation that the pandemic would put intense pressures on ICUs, staff ratios were relaxed. NHS England told trusts to base their staffing models on one critical care nurse for every six ICU patients, supported by two non-specialist nurses, and one senior ICU clinician for every 30 patients, supported by two middle-grade doctors. Before the pandemic, guidance from the Faculty of Intensive Care Medicine recommended a ratio of one non-specialist nurse per patient. For senior clinicians the ratio was 1:10 New guidance, expected as early as next week, will encourage trusts to reduce the number of patients per ICU specialist nurses and senior clinicians on a localised basis as part of “transitional arrangements” aimed at moving staffing models back towards normal standards of care, HSJ has been told. The new guidance, drawn up by NHS England, the Faculty of Intensive Care Medicine and the British Association of Critical Care Nurses, will give trusts recommended staffing ratios based on the occupancy rates of their ICUs. It will tell trusts the existing ratios should be applied if their ICUs are running at four times their normal capacity. For ICUs running at double capacity, this ratio would be reduced to 1:2 for ICU nurses, and 1:15 for senior clinicians. Read full story Source: HSJ, 8 May 2020- Posted
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News Article
Intensive care staffing ratios dramatically diluted
Patient Safety Learning posted a news article in News
The staff-to-patient ratios for intensive care are being dramatically reduced as the NHS seeks to rapidly expand its capacity to treat severely ill covid-19 patients, HSJ has learned. Acute trusts in London have been told to base their staffing models for ICU on having one critical care nurse for every six patients, supported by two non-specialist nurses and two healthcare assistants. Trusts have also been told by NHS England and NHS Improvement’s regional directorate to plan for one critical care consultant per 30 patients, supported by two middle grade doctors. The normal guidance is the consultant-to-patient ratio “should not exceed a range between 1:8-1:15”. Nicki Credland, chair of the British Association of Critical Care Nurses, confirmed the plans had been agreed today nationally. She told HSJ: “There will absolutely be a lot of concern about this in the profession, but it’s the only option we’ve got available. We simply don’t have the capacity to increase our staffing levels quickly enough." “It will dilute the standard of care but that’s absolutely better than not having enough critical care staff. There’s also a massive issue around the ability of critical care nurses not only to care for their patients but also monitor what the non-specialists in their teams are doing.” Read full story (paywalled) Source: HSJ, 24 March 2020 -
News Article
Hospital’s critical care unit overwhelmed by coronavirus patients
Patient Safety Learning posted a news article in News
A major London hospital has declared a “critical incident” due to a surge in patients with coronavirus, with one senior director in the capital calling the development “petrifying”. In a message to staff, Northwick Park Hospital in Harrow said it has no critical care capacity left and has contacted neighbouring hospitals about transferring patients who need critical care to other sites. The message, sent last night and seen by HSJ, said: “I am writing to let you know that we have this evening declared a ‘critical incident’ in relation to our critical care capacity at Northwick Park Hospital. This is due to an increasing number of patients with Covid-19. “This means that we currently do not have enough space for patients requiring critical care. “As part of our system resilience plans, we have contacted our partners in the North West London sector this evening to assist with the safe transfer of patients off of the Northwick Park site” Read full story (paywalled) Source: HSJ, 20 March 2020- Posted
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News Article
NHS prepares to cancel elective ops in readiness for covid-19 surge
Patient Safety Learning posted a news article in News
System leaders are telling hospitals to prepare for a potential suspension of all non-emergency elective procedures which could last for months, as they get ready for a surge in coronavirus patients. Senior sources told HSJ NHS England had asked trusts to risk stratify elective patients in readiness for having to suspend non-emergency work to free up capacity. HSJ understands trusts have been told to firm up their plans for how they would incrementally reduce and potentially suspend non-emergency operations, while also protecting “life saving” procedures such as cancer treatment. An announcement is expected soon, with patients affected given at least 48 hours notice. It has not been decided how long it might last for, as the duration of any surge in cases and acute demand is unknown. But HSJ has been told it could stretch out for several months, with three or four months discussed, which would potentially mean tens of or even hundreds of thousands of cancelled operations. Read full story (paywalled) Source: HSJ, 12 March 2020 -
News Article
Doctors told not to fear reprisal during coronavirus outbreak
Patient Safety Learning posted a news article in News
NHS national leaders are set to reassure doctors they should not fear regulatory reprisals, within reason, if they end up working outside their areas of expertise during the coronavirus outbreak. HSJ understands the UK’s four chief medical officers and the General Medical Council are drafting a letter to be sent to all UK doctors, which will contain the reassurances, as the system braces for a sharp rise in covid-19 cases. The letter will also urge doctors to be flexible and not to resist new ways of working, with senior figures expecting many clinicians working in other specialities or locations during the outbreak. The letter will say doctors, while still expected to follow good medical practice, should not fear reprimand from their employers or national bodies such as the GMC, NHS England or other regulators. Read full story (paywalled) Source: HSJ, 11 March 2020