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Found 100 results
  1. Content Article
    Between April 2008 to March 2017, procedure data from the UK NHS confirmed that 100,516 patients had a mid-urethral tape procedure, while only 1195 patients had a non-tape SUI procedure. Although the 2013 national guideline from The National Institute for Health and Care Excellence (NICE) recommended that tape and non-tape SUI procedures be offered equally, 84 mesh tape procedures were performed for every 1 non-tape procedure over the 10-year period. Hundreds of patients recently engaged in litigation on the basis of lack of informed consent, particularly in offering alternatives to the mesh tape option. Little is known, however, about how patients choose among different treatment options for SUI and there are no validated patient decision aids (PDAs) in this context. PDAs have been shown to increase patient knowledge, clarity about their own values and accuracy of risk perceptions regarding various management options. Women considering SUI surgery require up-to-date information on all common and available surgical procedures as well as support in their decision-making, tailored to their values and needs. Agur et al. on behalf of the NHS Ayrshire & Arran Continence Multidisciplinary Team designed and developed a novel SUI surgery patient decision aid (SUI-PDA) to help women in making a choice of treatment based on their own individual values. This study reports the development and validation of SUI-PDA as well as the initial evaluation of its usefulness in clinical practice for women considering SUI surgery.
  2. News Article
    A former senior NHS official plans to sue the organisation after he had to pay a private hospital £20,000 for potentially life-saving cancer surgery because NHS care was suspended due to COVID-19. Rob McMahon, 68, decided to seek private treatment after Worcestershire Acute Hospitals NHS trust told him that he would have to wait much longer than usual for a biopsy. He was diagnosed with prostate cancer after an MRI scan on 19 March, four days before the lockdown began. McMahon was due to see a consultant urologist on 27 March but that was changed to a telephone consultation and then did not take place for almost two weeks. “At that appointment, the consultant said: ‘Don’t worry, these things are slow-growing. You’ll have a biopsy but not for two or three months.’ I thought, ‘that’s a long time’, so decided to see another consultant privately for a second opinion.” A PET-CT scan confirmed that he had a large tumour on both lobes of the prostate and a biopsy showed the cancer was at risk of breaking out of the prostate capsule and spreading into his body. He then paid to undergo a radical prostatectomy at a private Spire hospital. “This is care that I should have had on the NHS, not something that I should have had to pay for myself. I had an aggressive cancer. I needed urgent treatment – there was no time to waste,”, he said. “With the pandemic, he added, “it was almost like a veil came down over the NHS. He worked for the NHS for 17 years as a manager in hospitals in London, Birmingham and Redditch, Worcestershire, and was the chief executive of an NHS primary care trust in Leicester.” Mary Smith of Novum Law, McMahon’s solicitors, said: “Unfortunately, Rob’s story is one of many we are hearing about from cancer patients who have been seriously affected by the disruption to oncology services as a result of COVID-19." Read full story Source: The Guardian, 11 July 2020
  3. Content Article
    We need to listen to patients and commission research COVID-19 is a new virus and there is currently little understanding about long-term impacts[5] and why some people seem to recover quickly while others are left very unwell for months.[6] Prolonged symptoms vary greatly[7] but many are experiencing rashes, shortness of breath, neurological and gastrointestinal problems, abnormal temperatures, cardiac symptoms and extreme fatigue. Recent studies indicate COVID-19 can cause organ damage even where patients have been asymptomatic.[8] Research into the Long COVID cohort of patients is needed as a high priority. Without this, we won’t be able to assess the impact on patients, identify the causes and develop treatments with appropriate advice and support. This knowledge gap deserves immediate attention so that we can better understand how and why the virus has presented itself differently in these patients, many of whom are young and were previously fit and healthy.[9] Thousands of patients are reporting their experiences through social and mainstream media. Patients need to be assured that they are being listened to and that their insights and symptoms are being captured to better understand this disease. Without engaging with patients who are living through this, it will be impossible to gain the full picture and know how best to provide care and keep them safe. Call for action: There needs to be a scientific and global approach to the study of patients undergoing prolonged COVID-19 symptoms to understand the numbers affected, the causes, how long they remain contagious and to investigate possible treatments. Patients must be encouraged to speak up via their GPs, researchers and social media, and they must be listened to. Where patients are dissatisfied with the services and the support they are receiving, they should be encouraged to share this insight through online reporting and, if needed, the NHS complaints process. The Department of Health and Social Care should establish a Long COVID patient advisory group to inform the design of new services, support, research and patient communication. Urgent need for COVID-19 recovery guidance and support For ensuring an effective recovery from serious illnesses such as COVID-19, the importance of rehabilitation to long-term mental and physical health is widely recognised.[10] However, access to quality rehabilitation varies across the UK[11] and, during the pandemic, post COVID-19 support and rehabilitation have focused on the acutely unwell who have spent time in hospital.[12] Patient Safety Learning has heard testimonials from people with COVID-19 who are struggling to recover and have been unable to access support.[13] Although there has been an increase in guidance available for people recovering from COVID-19[14], these have in the main been designed for patients who have been acutely unwell and in hospital. If patients who are managing their illness and recovery from home don’t also receive the care and support they need, they face an increased risk that their physical and mental health outcomes could be adversely affected, limiting their future quality of life.[15] On 5 July 2020 it was announced that NHS England is launching a new service for people with on-going health problems after having COVID-19. "Your Covid Recovery" is an online portal for people in England to access tutorials, contact healthcare workers and track their progress. It is launching later this month and, ‘later in the summer’, tailored rehabilitation will also be offered to those who qualify, following an assessment (up to a maximum of 12 weeks).[16] Call for action: The development of national guidance co-produced with people who have lived experience of Long COVID, and the immediate and consistent application of this guidance. Quality rehabilitation support for Long COVID patients, whether they have confirmed or suspected COVID-19. Services to be provided for as long as people need them, wherever they live in the UK. The psychological impact of Long COVID on patients, with or without a formal diagnosis People who are experiencing prolonged symptoms of COVID-19 are telling us of the negative impact on their mental health and wellbeing.[17] We are hearing of huge variations in the care and advice these patients are being offered when accessing GP services. Many feel that they have been dismissed under catch-all diagnoses or made to question what they are feeling in their own bodies.[18] Frustrations around lack of clinical recognition for their illness is often exacerbated by receiving a negative test result. There is emerging evidence of the problematic nature of COVID-19 and antibody testing to accurately determine whether someone has or hasn’t been infected with COVID-19.[19] ‘False negatives’ can occur for a number of reasons including the challenging process of sample collection[20], the patient’s stage of illness and the failure rates of the tests themselves. Relapses seem common and many people are understandably worried that they may never return to their state of health pre-COVID. It may be that some of these patients are at the beginning of chronic illness, requiring appropriate physical and psychological support.[21] Are these patients’ experiences being believed by the healthcare system? If not, and this results in lack of access to support, then those experiencing long-term symptoms from COVID-19 are potentially at higher risk of developing mental health issues such as depression.[22] Call for action: Patients recovering from suspected Long COVID should be given the same support, regardless of whether they have had COVID-19 confirmed by a test result or not. Appropriate psychological support needs to be available to help patients come to terms with the impact of long-term illness. We need to learn whether unconscious bias about chronic illness is affecting professionals’ decision-making and patients’ access to services. If so, guidance, advice, training and support should be provided. Are serious conditions being overlooked? There is a risk that patients who are suspected or confirmed to have had COVID-19 may not have ‘red-flag’ symptoms (indicative of serious conditions) investigated in the way they would have done pre-pandemic[23], their symptoms instead being attributed to COVID-19. Many members of COVID-19 support groups report having to fight for referrals to rule out other pathologies. This is particularly worrying for people who have a history of cancer or other hereditary illnesses in their family. Their concern is that potential delays to diagnosis and treatment could have an adverse effect on a patient’s health outcomes.[24] Call for action: ‘Red flag’ symptoms that may be indicative of other conditions should be appropriately investigated in Long COVID patients. A second pair of ears Patients with prolonged symptoms are often experiencing what they describe as ‘brain-fog’[25], difficulties with memory or finding the right words, for example. Patient Safety Learning is hearing from those who have expressed a need to have another person attend their appointments to help communicate and to help them process everything in relation to their care. Due to concerns around infection control during the pandemic, such support isn’t always allowed, so there is a risk that patients could be left confused and overwhelmed, unable to engage actively in their care. This could significantly compromise their ability to keep themselves safe.[26] If this is recognised as an issue for those with prolonged COVID-19 symptoms, steps could be taken to ensure they are able to access support in the same way as those with other conditions that result in cognitive impairment. Call for action: Reasonable adjustments should be considered to allow a companion to accompany patients with debilitating symptoms (including ‘brain-fog’) to appointments, or to speak with a clinician over the phone. Health inequalities We now know from recent research that people from Black and Ethnic Minority backgrounds and people who live in deprived areas have been disproportionately affected by COVID-19.[27] There is a significant amount of research looking at the difficulties people from ethnic minority backgrounds and deprived areas face with regard to accessing health services. The concern is that inequalities have the potential to widen if people with Long COVID are not appropriately supported. Call for action: Long COVID patients should be included in research and action being taken to address health inequalities and COVID-19. Rehabilitation outcomes should be monitored and reported so that learning can be captured and so that any emerging inequalities in access to services are identified and addressed quickly. Next steps Patient Safety Learning is calling for the safety of Long COVID patients to be considered as a matter of urgency. Our Chief Executive Helen Hughes comments: "It is understandable that the initial focus of care during the COVID-19 pandemic has been on acutely unwell and hospitalised patients. However, there is growing evidence that there are many patients recovering in the community with long-lasting symptoms who are feeling abandoned, confused and without support. We must take action to better understand the needs of these patients and provide them with safe and effective care for as long as they need." Patient Safety Learning is also supporting the broader calls for action by Dr Jake Suett, set out in his blog post on the hub. These call on Government, public health bodies, healthcare systems, sciences and society to take the following actions: Establish a scientific approach to the study of patients undergoing prolonged COVID-19 symptoms (ensuring the cohort that was not hospitalised and has persisting symptoms is also captured in this data). This needs to include epidemiological, mechanistic and treatment studies. The Long-term Impact of Infection with Novel Coronavirus (LIINC) study[28] being carried out at University of California San Francisco is a good example of the type of study required for capturing objective data on the full spectrum of COVID-19 disease, including in those individuals with a prolonged illness. Maintain an open-minded approach to the underlying pathophysiology of the condition and avoid labelling it with existing names until there is sufficient evidence to make these statements. Include Long COVID patients in the study design stages. Raise awareness amongst health professionals and make arrangements so that treatable pathology is investigated and ruled out. Provide information and guidelines on how to manage long-term COVID19. Raise awareness amongst employers. Consider the medical, psychological and financial support that may be required by these patients. When considering measures to ease the lock down, include a consideration of the risk of exposing additional people to prolonged COVID-19 symptoms and long-term health consequences. Ensure and clarify that the plans announced on 5 July 2020 for research and rehabilitation by NHS England do not inappropriately exclude those who have not required hospital admission, and do not exclude those who have been unable to access testing early on, or in whom a false negative test is suspected. It is important that similar services are available throughout the UK. We will continue to use the hub to highlight patients’ experiences and concerns about this issue. We will also be working with others to seek support for these actions and raise awareness of the patient safety implications of Long COVID with policymakers in Government and the health and social care system. References [1] Forbes, Report Suggests Some ‘Mildly Symptomatic’ COVID-19 Patients Endure Serious Long-Term Effects, 13 June 2020. https://www.forbes.com/sites/joshuacohen/2020/06/13/report-suggests-some-mildly-symptomatic-COVID-19-patients-endure-serious-long-term-effects/#216f1aa35979; COVID Symptom Study, How long does COVID last?, 8 June 2020. https://COVID.joinzoe.com/post/COVID-long-term; Huffington Post, ‘Long COVID’ – The Under-The-Radar Coronavirus Cases Exhausting Thousands, 2 June 2020. https://www.huffingtonpost.co.uk/entry/what-is-long-COVID-and-how-many-people-are-suffering_uk_5efb3487c5b612083c52d91d?guccounter=1; The Independent, ‘The fatigue has lasted for months and months’: Meet the ‘long haulers’ living with the long-term impact of COVID-19, 12 June 2020. https://www.independent.co.uk/life-style/health-and-families/coronavirus-long-tail-patients-symptoms-lockdown-a9563681.html [2] Facebook, Long COVID Support Group, Last Accessed 3 July 2020. https://www.facebook.com/groups/longCOVID; Facebook, Positive Path Of Wellness – (COVID UK Long Haulers), Last Accessed 3 July 2020. https://www.facebook.com/groups/1190419557970588; Coronavirus – Survivors Group – COVID-19, Last Accessed 3 July 2020. https://www.facebook.com/groups/CVsurvivors [3] Asthma UK, “We have been totally abandoned” people left struggling for weeks as they recover from COVID at home, Last Accessed 3 July 2020. https://www.asthma.org.uk/about/media/news/post-COVID-abandoned/ [4] Dr Jake Suett, My experience of suspected 'Long COVID', Patient Safety Learning's the hub, 6 July 2020. https://www.pslhub.org/learn/coronavirus-covid19/273_blogs/my-experience-of-suspected-long-covid-r2547/ [5] The Guardian, The coronavirus ‘long-haulers’ show how little we still know, 28 June 2020. https://www.theguardian.com/commentisfree/2020/jun/28/coronavirus-long-haulers-infectious-disease-testing; BBC News, Coronavirus: Calls for awareness of long-term effects, 19 June 2020. https://www.bbc.co.uk/news/uk-england-south-yorkshire-53084368 [6] BBC News, Coronavirus doctor’s diary: Why does COVID-19 make some health young people really sick?, 31 May 2020. https://www.bbc.co.uk/news/health-52853647 [7] The Independent, Coronavirus: Lesser-known symptoms that could be linked to COVID-19, 1 June 2020. https://www.independent.co.uk/life-style/health-and-families/coronavirus-symptoms-loss-smell-taste-delirium-COVID-toe-syndrome-a9520051.html [8] Quan-Xin Long et al, Clinical and immunological assessment of asymptomatic SARS-CoV-2 infections, Nature Medicine, 18 June 2020. https://www.nature.com/articles/s41591-020-0965-6.pdf [9] NewsLetter, A ‘fit and healthy’ 25 year old COVID-19 patient is urging young people to take coronavirus seriously, 31 March 2020. https://www.newsletter.co.uk/read-this/fit-and-healthy-25-year-old-COVID-19-patient-urging-young-people-take-coronavirus-seriously-2523383 [10] Chartered Society of Physiotherapy, The importance of community rehabilitation, Last Accessed 3 July 2020. https://www.csp.org.uk/professional-clinical/improvement-innovation/community-rehabilitation/importance-community [11] Chartered Society of Physiotherapy, Rebab Matters, Last Accessed 3 July 2020. https://www.csp.org.uk/campaigns-influencing/campaigns/rehab-matters [12] NHS England, After-care needs of inpatients recovering from COVID-19, 5 June 2020. https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/06/C0388-after-care-needs-of-inpatients-recovering-from-COVID-19-5-june-2020-1.pdf [13] Barbara Melville, Dismissed, unsupported and misdiagnosed: Interview with a COVID-19 ‘long-hauler’, Patient Safety Learning’s the hub, 24 June 2020. https://www.pslhub.org/learn/coronavirus-COVID19/patient-recovery/resources-for-patients/dismissed-unsupported-and-misdiagnosed-interview-with-a-COVID-19-%E2%80%98long-hauler%E2%80%99-r2461/ [14] Patient Safety Learning’s the hub, Resources for patients, Last Accessed 3 July 2020. https://www.pslhub.org/learn/coronavirus-COVID19/patient-recovery/resources-for-patients/ [15] Health Awareness, Rehabilitation: making quality of life better for patients, 14 August 2019. https://www.healthawareness.co.uk/rehabilitation/rehabilitation-making-quality-of-life-better-for-patients/# [16] NHS England and NHS Improvement, NHS to launch ground breaking online COVID-19 rehab service, 5 July 2020. https://www.england.nhs.uk/2020/07/nhs-to-launch-ground-breaking-online-covid-19-rehab-service/ [17] CTV News, ‘Great medical mystery’ as COVID-19 ‘long-haulers’ complain of months-long symptoms, Last Updated 19 June 2020. https://www.ctvnews.ca/health/great-medical-mystery-as-COVID-19-long-haulers-complain-of-months-long-symptoms-1.4981669; Anonymous, ‘False negative’ and the impact on my mental health, Patient Safety Learning’s the hub, 22 May 2020. https://www.pslhub.org/learn/coronavirus-COVID19/273_blogs/false-negative-and-the-impact-on-my-mental-health-r2297/ [18] Barbara Melville, Dismissed, unsupported and misdiagnosed: Interview with a COVID-19 ‘long-hauler’, Patient Safety Learning’s the hub, 24 June 2020. https://www.pslhub.org/learn/coronavirus-COVID19/patient-recovery/resources-for-patients/dismissed-unsupported-and-misdiagnosed-interview-with-a-COVID-19-%E2%80%98long-hauler%E2%80%99-r2461/ [19] Financial Times, COVID-19 antibody test raise doubts over accuracy and utility, study finds, 26 June 2020. https://www.ft.com/content/dc4b97a9-d869-40bc-950a-60f9f383bed0; The Guardian, Doctors condemn secrecy over false negative COVID-19 tests, 25 May 2020. https://www.theguardian.com/world/2020/may/25/doctors-condemn-secrecy-over-false-negative-COVID-19-tests [20] Patient Safety Learning, COVID-19 tests: The safety implications of false negatives, Patient Safety Learning’s the hub, 22 May 2020. https://www.pslhub.org/learn/coronavirus-COVID19/273_blogs/COVID-19-tests-the-safety-implications-of-false-negatives-r2309/ [21] Psychology Today, Chronic Illness, Last Accessed 3 July 2020. https://www.psychologytoday.com/us/basics/chronic-illness [22] National Institute of Mental Health, Chronic Illness & Mental Health, Last Accessed 2 July 2020. https://www.nimh.nih.gov/health/publications/chronic-illness-mental-health/index.shtml [23] Dr Jake Suett, My experience of suspected 'Long COVID', Patient Safety Learning's the hub, 6 July 2020. https://www.pslhub.org/learn/coronavirus-covid19/273_blogs/my-experience-of-suspected-long-covid-r2547/ [24] The Guardian, Thousands of cancer patients could die early due to coronavirus delays, study finds, 20 May 2020. https://www.theguardian.com/society/2020/may/20/thousands-of-cancer-patients-could-die-early-due-to-coronavirus-delays-study-finds [25] Daily Mail, How coronavirus can attack the brain: From exhaustion and depression to even DEMENTIA symptoms… the effects COVID-19 can have on one of our most vital organs, 16 June 2020. https://www.dailymail.co.uk/health/article-8424649/How-coronavirus-attack-brain.html [26] Sign up to Safety Patient Engagement in Patient Safety Group, Patient Engagement in Patient Safety: A Framework for the NHS, May 2016. https://www.england.nhs.uk/signuptosafety/wp-content/uploads/sites/16/2016/05/pe-ps-framwrk-apr-16.pdf [27] Public Health England, Disparities in the risk and outcomes of COVID-19, June 2020. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/892085/disparities_review.pdf [28] Long-term impact of Infection with Novel Coronavirus, Study Information, Last Accessed 6 July 2020. https://www.liincstudy.org/en/study-information
  4. Content Article
    The goal of the NPSIF is to improve patient safety at all levels of healthcare across all modalities of healthcare provision, including prevention, diagnosis, treatment and follow up within overall context of improving quality of care and progressing towards UHC (Universal Health Coverage) in the coming decade. The scope of patient safety applies to all national programmes and envisages collaboration of wide range of national international stakeholders both within and outside health sector. NPSIF applies to national and sub-national levels as well as to public and private sectors. Objectives: Strategic Objective 1: To improve structural systems to support quality and efficiency of healthcare and place patient safety at the core at national, subnational and healthcare facility levels. Strategic Objective 2: To assess the nature and scale of adverse events in healthcare and establish a system of reporting and learning. Strategic Objective 3: To ensure a competent and capable workforce that is aware and sensitive to patient safety. Strategic Objective 4: To prevent and control health-care associated infections. Strategic Objective 5: To implement global patient safety campaigns and strengthening Patient Safety across all programmes. Strategic Objective 6: To strengthen capacity for and promote patient safety research.
  5. News Article
    More children died after failing to get timely medical treatment during lockdown than lost their lives because of coronavirus, new research by the Royal College of Paediatrics and Child Health (RCPCH) suggests. Six children under the age of 16 have died from COVID-19 in Britain since the pandemic began, according to the Office for National Statistics (ONS). However, seeking medical help too late was a contributory factor in the deaths of nine children in paediatric care new analysis has found, with the figure likely to be higher. A survey of 2,433 paediatricians, carried out by the RCPCH, found that one in three handling emergency admissions had dealt with children who turned up later than usual for diagnosis or treatment. Read full story (paywalled) Source: The Telegraph, 25 June 2020
  6. News Article
    Low dose dexamethasone reduces deaths in patients hospitalised with COVID-19 who need ventilation, according to preliminary results from the RECOVERY trial. The drug was also found to reduce deaths by one-fifth in other hospitalised patients receiving oxygen only, but no benefit was seen among COVID-19 patients who did not need respiratory support. The chief investigators from the University of Oxford trial said that the findings represent a “major breakthrough” which is “globally applicable” as the drug is cheap and readily available. Peter Horby, Professor of Emerging Infectious Diseases at the University of Oxford and a chief investigator on the trial, added, “This is the only drug that has so far been shown to reduce mortality, and it reduces it significantly. It is a major breakthrough.” Read full story Source: BMJ, 16 June 2020
  7. News Article
    A leading doctor has warned that trusts will struggle to get back to anything like pre-covid levels of endoscopy services and will need to prioritise which patients are diagnosed. Endoscopy procedures are part of the diagnostic and treatment pathway for many conditions, including bowel cancer and stomach ulcers. Most hospitals have not done any non-emergency procedures since the middle of March because they are aerosol generating — meaning a greater covid infection risk and need for major protective equipment. Although some areas are now starting to do more urgent and routine work, capacity is severely limited. Kevin Monahan, a consultant gastroenterologist at St Marks’s Hospital, part of London North West Healthcare Trust, and a member of the medical advisory board for Bowel Cancer UK, said the time taken for droplets to settle in rooms after a procedure can be up to an hour and three quarters, depending on how areas are ventilated. Only then can the room be cleaned and another patient seen. Dr Monahan said his trust had restarted some endoscopy work and was currently doing around 17 per cent of its pre-covid activity. “We can provide a maximum of about 20 per cent of normal activity — and that is using private facilities for NHS patients,” he said. “I am not at all confident we will be able to double what we are doing now, even in three to four months’ time." Read full story Source: HSJ, 12 June 2020
  8. News Article
    The government urgently needs to set out a plan to reduce the huge backlog of patients waiting for NHS treatments unrelated to COVID-19 in the wake of the pandemic, the BMA has said. The call came as the BMA released the results of its latest survey of over 8000 doctors. It found that more than half (3754 of 7238) were either not very confident or not confident at all that their department would be able to manage patient demand as NHS services resumed. “The government must be honest with the public about the surge to come and start meaningful conversations with frontline clinicians about how we can, together, begin to tackle the backlog,” said the BMA’s chair of council, Chaand Nagpaul. “Covid-19 has brought with it the worst health crisis in a century. The NHS must not return to its previous perilous state.” Read full story Source: BMJ, 4 June 2020
  9. News Article
    The postponement of tens of thousands of hospital procedures is putting the lives of people with long-term heart conditions at risk, according to the British Heart Foundation. The coronavirus pandemic has created a backlog which would only get larger as patients waited for care, it said. People with heart disease are at increased risk of serious illness with COVID-19, and some are shielding. The BHF estimates that 28,000 procedures have been delayed in England since the outbreak of coronavirus in the UK. These are planned hospital procedures, including the implanting of pacemakers or stents, widening blocked arteries to the heart, and tests to diagnose heart problems. People now waiting for new appointments would already have been waiting for treatment when the lockdown started, the charity said, as it urged the NHS to support people with heart conditions "in a safe way". Read full story Source: 5 June 2020
  10. News Article
    A trial has been launched in the UK to test whether ibuprofen can help with breathing difficulties in COVID-19 hospital patients. Scientists hope a modified form of the anti-inflammatory drug and painkiller will help to relieve respiratory problems in people who have more serious coronavirus symptoms but do not need intensive care unit treatment. Half the patients participating in the trial will be administered with the drug in addition to their usual care, while the other half will receive standard care to analyse the effectiveness of the treatment. Read full story Source: The Independent, 3 June 2020
  11. News Article
    The use of electroconvulsive therapy (ECT) to treat depression should be immediately suspended, a study says. ECT involves passing electric currents through a patient's brain to cause seizures or fits. Dr John Read, of the University of East London said there was "no place" for ECT in evidence-based medicine due to risks of brain damage, but the Royal College of Psychiatrists said ECT offers "life-saving treatment" and should continue in severe cases. The National Institute for Health and Care Excellence (NICE) currently recommends the use of ECT for some cases of moderate or severe depression as well as catatonia and mania. However, peer-reviewed research published in the journal Ethical Human Psychology and Psychiatry concludes "the high risk of permanent memory loss and the small mortality risk means that its use should be immediately suspended". In response to the study, the Royal College of Psychiatrists said ECT should not be suspended for "some forms of severe mental illness". Dr Rupert McShane, chair of the college's Committee on ECT and Related Treatments, said there was evidence showing "most people who receive ECT see an improvement in their condition". "For many, it can be a life-saving treatment," he said. "As with all treatments for serious medical conditions - from cancer to heart disease - there can be side-effects of differing severity, including memory loss." Read full story Source: BBC News, 3 June 2020
  12. News Article
    About 2.4 million people in the UK are waiting for cancer screening, treatment or tests, as a result of disruption to the NHS during the past 10 weeks, according to Cancer Research UK. It estimates 2.1 million have missed out on screening, while 290,000 people with suspected symptoms have not been referred for hospital tests. More than 23,000 cancers could have gone undiagnosed during lockdown. Chief executive Michelle Mitchell said COVID-19 has placed an "enormous strain on cancer services". "The NHS has had to make very hard decisions to balance risk," she said. "...there have been some difficult discussions with patients about their safety and ability to continue treatment during this time. Prompt diagnosis and treatment remain crucial to give people with cancer the greatest chances of survival and prevent the pandemic taking even more lives." To ensure no-one is put at risk from the virus now that cancer care is returning, Cancer Research UK said "frequent testing of NHS staff and patients, including those without symptoms" was vital. Read full story Source: BBC News, 1 June 2020
  13. News Article
    Dental practices in England have been told they can reopen from Monday 8 June, if they put in place appropriate safety measures. All routine dental care in England has been suspended since 25 March. The British Dental Association (BDA) has welcomed the announcement but says key questions remain. Currently, any patient with an emergency dental problem is supposed to be referred to an Urgent Dental Care (UDC) hub for treatment. In a letter to all practices, NHS England's chief dental officer, Sara Hurley, said: "Today, we are asking that all dental practices commence opening from Monday, 8 June for all face-to-face care, where practices assess that they have the necessary IPC and PPE requirements in place." The BDA said that while dentists would be relieved by the announcement, the ability of practices to reopen would depend on the availability of personal protective equipment (PPE). "It is right to allow practices to decide themselves when they are ready to open. Dentists will be keen to start providing care as soon as is safely possible, but we will need everyone to be patient as practices get up and running," said BDA chairman Mick Armstrong. Read full story Source: BBC News, 28 May 2020
  14. News Article
    Selected NHS coronavirus patients will soon be able to access an experimental treatment to speed up their recovery, with the health secretary Matt Hancock suggesting it is probably “the biggest step forward’’ in medication since the beginning of the COVID-19 crisis. The anti-viral drug remdesivir will be made available to patients meeting certain clinical criteria to support their recovery in hospital. The drug is currently undergoing clinical trials around the world, including in the UK, and peer-reviewed data showed it can shorten the time to recovery by about four days. Treatment will initially be prioritised for patients who have the greatest likelihood of deriving the most benefit, according to the Department of Health and Social Care (DHSC). Satisfied the drug can help boost recovery, the government’s Medicines and Healthcare products Regulatory Agency (MHRA) approved the use of remdesivir through its early access to medicines scheme. The experimental anti-viral drug was granted emergency authorisation to treat Covid-19 in the US by the Food and Drug Administration earlier this month. Read full story Source: The Independent, 26 May 2020
  15. News Article
    NHS England has said disabled and vulnerable patients must not be denied personalised care during the coronavirus pandemic and repeated its warning that blanket do not resuscitate orders should not be happening. In a joint statement with disabled rights campaigner and member of the House of Lords, Baroness Jane Campbell, NHS England said the COVID-19 virus and its impact on the NHS did not change the position for vulnerable patients that decisions must be made on an individualised basis. It said: “This means people making active and informed judgements about their own care and treatment, at all stages of their life, and recognises people’s autonomy, as well as their preferences, aspirations, needs and abilities. This also means ensuring reasonable adjustments are supported where necessary and reinforces that the blanket application of do not attempt resuscitation orders is totally unacceptable and must not happen.” Read full story Source: The Independent, 26 May 2020
  16. News Article
    The leader of the NHS’ pandemic testing programme has highlighted concerns about the rate of COVID-19 transmissions in hospitals, HSJ can reveal. NHS England’s patient safety director Dr Aidan Fowler told an industry webinar that he and his team “are concerned about the rates of nosocomial spread within our hospitals”. Dr Fowler leads the NHS and Public Heath England testing programme (know as “pillar one”). He said the concerns had led to a focus on discovering where transmissions of covid-19 are occurring in hospitals, and how the NHS can reduce the rate of staff and patients becoming infected while on the NHS estate. His comments come as the NHS attempts to restart the provision of routine elective care and prepares for a significant increase in emergency admissions. The NHS has been told to create separate areas for covid positive and negative patients where possible, regardless of what they are being treated for. Patients are being to self-isolate at home for two weeks before attending hospital for treatment. Read full story Source: HSJ, 18 March 2020
  17. News Article
    Trials have begun in the UK to test the effectiveness of blood plasma transfusions in treating patients suffering from COVID-19. NHS Blood and Transplant (NHSBT) have started delivering the first units of convalescent plasma, which contains the antibodies of people who have recovered from coronavirus, to hospitals in England. In total, 14 units have been supplied to Guy’s and St Thomas’ NHS Foundation Trust, Imperial College Healthcare NHS Trust and University Hospitals Birmingham NHS Foundation Trust. The first transfusions have been administered, NHSBT confirmed on Wednesday, though the efficacy of the treatment will not be known until the trial ends. Seven hospitals are currently taking part in the trials, which will assess a patient’s speed of recovery and chances of survival, with more expected to join in the coming months as the number of people eligible to donate blood plasma increases. As of Tuesday, more than 6,500 people had signed up while around 400 donations had been made. Gail Miflin, Chief Medical Officer for NHS Blood and Transplant, said: “We’re delighted the first patients are receiving convalescent plasma transfusions thanks to the generosity of our donors." Read full story Source: The Independent, 7 May 2020
  18. News Article
    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
  19. News Article
    Intensive care units across the country are running out of essentials, including anaesthetics and drugs for anxiety and blood pressure, after a “tripling of demand” sparked by the coronavirus pandemic. Six senior NHS doctors working on the front line, and drugs industry sources, say that the health service is running out of at least eight crucial drugs. Hospitals in London, Birmingham and the northwest of England have been especially badly hit. Doctors said they were being forced to use alternatives to their “drug of choice”, affecting the quality of care being provided to COVID-19 patients. They also warned that some second-choice drugs might be triggering dangerous side effects such as minor heart attacks. Ron Daniels, an intensive care consultant in the West Midlands, said the shortages had become “acute” already. “We don’t know what we’re going to run out of next week,” he said. “Safety isn’t so much the issue — it’s quality. It may be that we’re subjecting people to longer periods of ventilation than we would normally because the drugs take longer to wear off.” Daniels added that some of the “second-line drugs” being used might be challenging to a patient’s heart: “We might be causing small heart attacks or subclinical heart attacks.” Ravi Mahajan, president of the Royal College of Anaesthetists, said work was being carried out to “preserve” key drugs for those most in need. Read full story (paywalled) Source: The Times, 26 April 2020
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