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Event
The Patients Association: Get involved – diagnostic tests and results
Patient Safety Learning posted a calendar event in Community Calendar
untilAre you a patient who has been waiting to receive a diagnosis or test results during the last six months? This includes, but is not limited to, CT scans, MRI scans, and endoscopy and dermatology procedures. Has the COVID-19 pandemic affected your service? Would you like to help to improve the patient experience of waiting for a diagnosis? The Patients Association is holding an online Zoom patient group discussion on this topic on Tuesday 27th October, 2.00-4.00pm, and we are seeking patients to take part. An £80 incentive payment will be offered in Amazon vouchers and places are limited. Participants will be chosen on the basis of suitability to ensure the group is representative of a wide variety of backgrounds and experiences. Please fill in the registration form https://www.surveymonkey.co.uk/r/CRNMC2T if you are interested. -
Content ArticleWithin the letter Jeremy Hunt calls for: Recognition that many Long COVID patients were not hospitalised. Guidance on treatment, management of symptoms and on rehabilitation support to 111 and 119 advisers, GPs and all clinical staff in frontline services and is essential for the delivery of quality care, and to end the dismissive attitudes reported by far too many people with Long COVID when they attempt to access health services. A multi-disciplinary Long Covid taskforce, including researchers, professional bodies, and representatives of peer-led groups, to address the urgent needs of people living with persistent, ongoing symptoms of COVID-19. An update on plans for further research into the symptoms of Long COVID patients. Research to include: the natural history of COVID-19, risk factors and potential causes of Long COVID, exercise and Long COVID, diagnostic reliability, viraemia and ongoing or intermittent infectivity, impact of SARS-CoV-2 on different organs and therapeutic options for people with Long COVID Information about the timeline for commissioning these clinics and the time it will take to scale up and reach everyone who requires this service. NHS Long COVID clinics to be inclusive of quality mental health services. Clarity regarding how Long COVID patients will be involved in the development of health promotion and public health programmes, to help tackle the stigma and discrimination that many (people with Long COVID), experience, and address the complexity and uncertainty of current public health information. Greater Awareness-raising around the risk to young people of acquiring Long COVID. (In regard to healthcare workers) – protection of full pay, and guidance to line managers on how to handle absences and phased returns, support and advice for handling relapses and to flex to respond to the lived experience of those with this complex and evolving condition.
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Community PostI've been posting advice to patients advising them to personally follow up on referrals. Good advice I believe, which could save lives. I'm interested in people's views on this. This is the message I'm sharing: **Important message for patients relating to clinical referrals in England** We need a specific effort to ensure ALL referrals are followed up. Some are getting 'lost'. I urge all patients to check your referral has been received, ensure your GP and the clinical team you have been referred to have the referral. Make sure you have a copy yourself too. Things are difficult and we accept there are waits. Having information on the progress of your referral, and an assurance that is is being clinically prioritised is vital. If patients are fully informed and assured of the progress of their referrals in real-time it could save time and effort in fielding enquiries and prevent them going missing or 'falling into a black hole', which is a reality for some people. It would also prevent clinical priorities being missed. Maybe this is happening, and patients are being kept fully informed in real-time of the progress of their referrals. It would be good to hear examples of best practice.
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News ArticlePeople awaiting a CT or MRI scan will be able to have one on the high street under NHS plans to improve access to diagnostic tests. NHS England plans to set up a network of new “one-stop shops” where patients will be able to have scans closer to home rather than having to go hospital. They are intended to reduce the risk of patients getting COVID-19 in hospital and speed up the time it takes to undergo diagnostic testing by having more capacity. NHS England’s governing board approved a plan on Thursday by Prof Sir Mike Richards to create “community diagnostic hubs across the country over the next few years”. It is part of a planned “radical overhaul” in the way patients access a range of diagnostic tests, screening appointments and other services. The hubs, which would open six days a week, may also perform blood tests, lung function checks and endoscopies, in which a camera is put down the throat. The new facilities would be sited in disused shops or in shopping centres. They are part of the NHS’s drive to make it easier for people to be tested without having to go to hospital, amid concern that reluctance to do so is part of the reason fewer people are undergoing cancer screening. It is already undertaking lung cancer tests in 10 mobile centres that are parked at supermarkets and shopping centres. Bigger hubs could also offer mammograms, eye health checks, scans for pregnant women, hearing tests and gynaecological services. Hospital bosses welcomed the plan, which they said should reduce waiting times. Miriam Deakin, the director of policy and strategy at NHS Providers, which represents NHS trusts, said: “Doing these checks in the community rather than in hospital could support trusts as they grapple with a second wave of Covid-19, winter pressures and tackling backlogs of care.” Read full story Source: The Guardian, 1 October 2020
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Leaked data gives first view of growing cancer waiting list post covid peak
Patient Safety Learning posted a news article in News
Official data from mid-September shows that nearly 6,400 people had waited more than 100 days following a referral to cancer services. The leaked data reveals for the first time the length of the cancer waiting list in the wake of the first pandemic peak, during which much diagnostic and elective cancer care was paused. The list consists of those waiting for a test, the outcome of a test, or for treatment. NHS England and Improvement only publish waiting times for patients who have been treated – not the number still waiting – so this information has been secret. The data, obtained from official emails seen by HSJ, showed the total number of people on the cancer waiting list grew substantially, from 50,000 to around 58,000, between the start of August and the middle of September. Of the 6,400 people recorded to be waiting more than 104 days on 13 September, 472 had a “decision to treat classification”, meaning they have cancer and are awaiting treatment. NHS England has said reducing the cancer waiting list would be overseen by a national “taskforce”, which is being chaired by national director for cancer Peter Johnson. Experts have warned the delays already stored up in the system could cost tens of thousands of lives as patients go undiagnosed or have their diagnosis and treatment later than they otherwise would. HSJ asked NHS England if harm reviews had been carried out for those on the waiting list and whether it had discovered if those waiting longer than104 days had been harmed, but did not receive an answer. Read full story (paywalled) Source: HSJ, 29 September 2020 -
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News ArticleInquest finds Susan Warby, 57, received insulin she did not need after blood test mistakes. Hospital errors contributed to her death five weeks after bowel surgery, an inquest into her death has concluded. Susan Warby, 57, who died at West Suffolk hospital in Bury St Edmunds, was incorrectly given glucose instead of saline through an arterial line that remained in place for 36 hours and resulted in inaccurate blood test readings. She was subsequently given insulin she did not need, causing bouts of extremely low blood sugar (hypoglycemia) and the development of “a brain injury of uncertain severity”, recorded Suffolk’s senior coroner, Nigel Parsley. Speaking after the inquest was adjourned in January, Susan's husband, Jon Warby, said he was “knocked sideways completely” when he received an anonymous letter two months after her death highlighting blunders in her treatment. Doctors at the hospital were reportedly asked for fingerprints as part of the hospital’s investigation into the letter, a move described by a Unison trade union official as a “witch-hunt” designed to identify the whistleblower. Following January’s adjournment, Parsley instructed an independent expert to review the care that Warby received. Warby’s medical cause of death was recorded as multi-organ failure, with contributory causes including septicaemia, pneumonia and perforated diverticular disease, affecting the bowel. Recording a narrative conclusion, Parsley wrote: “Susan Warby died as the result of the progression of a naturally occurring illness, contributed to by unnecessary insulin treatment caused by erroneous blood test results. This, in combination with her other comorbidities, reduced her physiological reserves to fight her naturally occurring illness.” Jon Warby said in a statement: “The past two years have been incredibly difficult since losing Sue, and it is still a real struggle to come to terms with her no longer being here. The inquest has been a highly distressing time for our family, having to relive how Sue died, but we are grateful that it is over and we now have some answers as to what happened." “After learning of the errors in Sue’s care, I wanted to know how these occurred and what action was being taken to prevent any similar incidents in the future. The trust has now made a number of changes which I am pleased about.” Read full story Source: The Guardian, 7 September 2020
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Hospital has 'closed its doors' to patients, LMC warns NHS England
Patient Safety Learning posted a news article in News
GP leaders have written to NHS England to demand that an NHS hospital trust urgently restores routine referrals as it has 'closed its doors' to some patients, ‘destabilising’ practices in the process. Oxfordshire LMC said local GPs are ‘concerned and angry’ about the ‘ongoing closure’ to routine referrals across multiple ‘high-demand’ specialties by Oxford University Hospital Foundation Trust, while warning GPs are also being asked to carry out tests that should be done in hospital. A ‘significant’ number of specialties are affected, including ENT, general gynaecology, dermatology, ophthalmology, endoscopy and urology, as well as plastics and maxillofacial, it added. The hospital trust said it had remained open for urgent and emergency care and was accepting clinically urgent and suspected cancer referrals, while reinstating services to support 'the vast majority' of routine referrals. But Oxfordshire LMC has this week written to NHS England and the council of governors at OUHFT to demand that there are ‘no further delays’ in restoring the services amid concerns of ‘patient harm’. It said: ‘The LMC believes the continuing closure of some specialty services to routine referrals is now so serious for patients that it has taken a decision to formally raise the concerns of Oxfordshire’s GPs with NHS England.’ Read full story Source: Pulse, 13 August 2020 -
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News ArticleA sponge-on-a-string pill test could transform the way oesophageal cancer is diagnosed, researchers say. The method can identify 10 times more people with Barrett’s oesophagus than the usual GP route, scientists say. The test, which can be carried out by a nurse in the GP surgery, is also better at picking up abnormal cells and potentially early-stage cancer. Barrett’s oesophagus is a condition that can lead to oesophageal cancer, cancer of the food pipe, in a small number of people. Normally it is diagnosed in hospital by endoscopy, which involves passing a camera down into the stomach, following a GP referral for long-standing heartburn symptoms. The cytosponge test, developed by researchers at the University of Cambridge, is a small pill with a thread attached that the patient swallows. It expands into a small sponge when it reaches the stomach, and is then quickly pulled back up the throat by a nurse, collecting cells from the oesophagus for analysis. The pill is a quick, simple and well tolerated test that can be performed in a GP surgery and helps tell doctors who needs an endoscopy. In turn, this could prevent many people from having potentially unnecessary endoscopies. Scientists say that as well as better detection, the test means cancer patients can benefit from kinder treatment options if their cancer is caught early enough. Read full story Source: The Independent, 1 August 2020
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Winter warning as 35,000 respiratory diagnoses delayed due to pandemic
Patient Safety Learning posted a news article in News
Patients with respiratory disease have been overlooked during the COVID-19 pandemic, with the NHS storing up problems for the winter months, a group of experts including the Royal College of General Practitioners (RCGP) has warned. Analysis by the 34-member Taskforce for Lung Health showed that referrals for lung conditions fell by 70% in April, with two-in-five (39%) of CCGs seeing no appointment bookings for respiratory conditions for the whole of May. On average, the group calculated a weekly average of 3,399 lung patients missing out on urgent and routine referrals during the COVID-19 lockdown, amounting to a total of at least 34,780 people, based on NHS England data. This was blamed in part on a general reduction in routine procedures during the pandemic, which will have affected all disease areas, but also the limitations on clinicians including GPs to carry out spirometry due to the risk of COVID-19 infection spread. But the taskforce - which includes the RCGP and the Primary Care Respiratory Society, as well as the Royal College of Physicians and Asthma UK - is now calling on NHS England to urgently restore services to pre-pandemic levels to tackle the backlog of lung patients requiring support. It said that failure to do so risked causing the premature death of patients who require urgent diagnosis as well as overwhelming the NHS during the winter season, when respiratory symptoms worsen. Read full story Source: Pulse, 9 July 2020 -
News ArticleUrgent cancer referrals were "inappropriately" rejected by hospitals during the coronavirus lockdown without tests being carried out, GPs have said. Cancer Research UK said the findings from a survey of more than 1,000 GPs were "alarming", warning that patients whose lives may be at risk were being left "in limbo". Family doctors were surveyed in June and asked what had happened to patients they had referred to hospitals for tests in the month to that point because cancer was suspected. A quarter of GPs said urgent referrals had been inappropriately turned down by hospitals more often than had been the case before the pandemic. Four in 10 said that, when tests were refused, patients had been left without proper checks to see whether their case could safely be left without investigation. Read full story (paywalled) Source: The Telegraph, 8 July 2020
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Cancer patients missed out on tests during lockdown, NHS England figures show
Patient Safety Learning posted a news article in News
Huge numbers of people with suspected cancer were not referred to hospital for urgent checks or did not have a test during the first month of the lockdown, prompting fears that late diagnosis of the disease will reduce some patients’ chances of survival. Unprecedented numbers of cancer patients missed out on vital treatments, diagnostic tests and outpatient appointments as the pandemic unfolded, NHS England data shows. Macmillan Cancer Support estimates that 210,000 people should have entered the system this month. That means roughly 130,000 people who would ordinarily be referred to a consultant have not been. About 7% of these patients would usually require cancer treatment, meaning approximately 9,000 people might not have had their cancer diagnosed in April. The organisation said that around 2,500 people who should have been referred for their first treatment after a cancer diagnosis will not have received that treatment. Read full story Source: The Guardian, 11 June 2020 -
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Cancer survivor urges people not to ignore symptoms and get checked by GP
Patient Safety Learning posted a news article in News
A Nottingham mum recovering from breast cancer surgery said she 'hates to think' what could have happened, if she had let the cancer go undetected. Claire Knee, 45 of Beeston, was diagnosed with breast cancer in March shortly before lockdown measures were introduced. Having felt slightly off and noticing lumps in her breast, she was encouraged to contact her GP who referred her for tests. After a serious of diagnostic tests at Nottingham City Hospital's Breast Institute, specialists confirmed the presence of a tumour in the early stages. Surgeons successfully removed the tumour from her right breast amid the pandemic and Claire has been recommended some follow up treatment. She now wants to share her experience of seeking help and getting treatment to advise others who may be showing signs of cancer but are too scared to contact their GP. "Looking back I just think that if I hadn’t made the call to my GP I would be walking around with undetected breast cancer, which could still be growing now. I would urge anyone in similar circumstances to contact their GP and get checked - even if it’s just for peace of mind.” Read full story Source: Nottinghamshire Live, 4 May -
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Millions of patients 'avoiding calls to GP' during COVID-19 pandemic
Patient Safety Learning posted a news article in News
Four in ten people are not seeking help from their GP because they are afraid to be a burden on the NHS during the pandemic, polling by NHS England reveals. The findings – from a survey of 1,000 people – are the latest in a wave of evidence that fewer people are seeking care for illnesses other than those related to coronavirus during the pandemic. GP online reported on 20 April that data collected by the RCGP showed a 25% reduction in routine clinical activity in general practice, and figures from Public Health England (PHE) and the British Heart Foundation show that A&E attendances overall and patients going to hospital for heart attacks are down 50%. Warnings that patients' reluctance to come forward could put them at risk come as leading charities warned that suspension of some routine GP services during the pandemic could also lead to a 'future crisis' if control of conditions such as asthma and COPD deteriorate. Professor Carrie MacEwen, chair of the Academy of Medical Royal Colleges, said: 'We are very concerned that patients may not be accessing the NHS for care because they either don’t want to be a burden or because they are fearful about catching the virus. 'Everyone should know that the NHS is still open for business and it is vitally important that if people have serious conditions or concerns they seek help. This campaign is an important step in ensuring that people are encouraged to get the care they need when they need it.' Read full story Source: GP online, 25 April 2020 -
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Content ArticleThis guidance recommends the following: Suspend initiation of new treatment cycles, including ovulation induction, intrauterine inseminations (IUIs), in vitro fertilisation (IVF) including retrievals and frozen embryo transfers, as well as non-urgent gamete cryopreservation. Strongly consider cancellation of all embryo transfers whether fresh or frozen. Continue to care for patients who are currently “in-cycle” or who require urgent stimulation and cryopreservation. Suspend elective surgeries and non-urgent diagnostic procedures. Minimise in-person interactions and increase utilisation of telehealth. Note: This guidance will be revisited periodically as the pandemic evolves, but no later than March 30, 2020, with the aim of resuming usual patient care as soon and as safely as possible.
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News ArticlePrime Minister Boris Johnson has announced plans to test more people for coronavirus. At the moment only people in hospital are being routinely tested, so if you have symptoms and you are not sure if you have the virus, you may well never know. As of 18 March, 56,221 people in the UK had been tested for coronavirus. The number of tests has been rising from just over 1,000 a day at the end of February, when testing began, to more than 6,000 per day by mid-March. The government plans to increase this to 10,000 a day initially, with a goal of reaching 25,000 tests a day. But it has been criticised by some experts for not testing widely enough, and people have been complaining online about not having access to tests despite having symptoms. Public Health England says it will do some surveillance testing on a local level if clusters of cases are identified, using a network of 100 designated GP surgeries. This is to try to get a sense of how many milder cases there are in the community that do not result in hospitalisation. But the UK is not currently doing any mass surveillance testing or actively tracing people who have come into contact with known cases The Director General of the World Health Organization (WHO), Tedros Adhanom Ghebreyesus, said he had a "simple message" for all countries: "Test, test, test." He added: "We cannot stop this pandemic if we do not know who is infected." The UK's chief scientific officer Sir Patrick Vallance told a group of MPs that "we simply don't have mass testing available for the population now", and that "when you only have capacity to do a certain number of tests" you have to prioritise the most vulnerable groups. Read full story Source: BBC News, 19 March 2020
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