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Found 152 results
  1. News Article
    A large-scale trial of a new treatment it is hoped will help stop COVID-19 patients from developing severe illness has begun in the UK. The first patient received the treatment at Hull Royal Infirmary on Tuesday afternoon. It involves inhaling a protein called interferon beta which the body produces when it gets a viral infection. The hope is it will stimulate the immune system, priming cells to be ready to fight off viruses. Early findings suggested the treatment cut the odds of a COVID-19 patient in hospital developing severe disease - such as requiring ventilation - by almost 80%. It was developed at Southampton University Hospital and is being produced by the Southampton-based biotech company, Synairgen. Read full story Source: BBC News, 13 January 2021
  2. News Article
    More than 1,000 people needing urgent cancer surgery in London have no date for their treatment, HSJ can reveal. A document leaked to HSJ showed that, at the end of last week, more than 1,000 of London’s cancer surgery patients without an appointment date were defined as P2 (priority two), meaning they needed to be seen within four weeks or risk their condition worsening. The report seen by HSJ also showed more than 300 P2 patients had their surgery postponed in the past week, a statistic NHS England London has so far refused to disclose. Hospitals in the capital are facing their highest-ever COVID-19 occupancy rates, with surgical lists at many trusts being cancelled. Meanwhile, a separate NHSE London document reported in the press this week revealed: “Most NHS Green sites [those cancer surgery sites intended to be covid-free to avoid risk to very frail patients] are now compromised with only a limited number of cases being undertaken in NHS sites this week”. The papers also said the current plans to increase indepedent sector capacity usage were “insufficient to offset the NHS shortfall”, and noted there was a two week lead-in time to move patients into private hospitals “based on clinical rotas, theatre bookings, [and] patient isolation”. Read full story (paywalled) Source: HSJ, 12 January 2021
  3. News Article
    Two more life-saving drugs have been found that can cut deaths by a quarter in patients who are sickest with Covid. The anti-inflammatory medications, given via a drip, save an extra life for every 12 treated, say researchers who have carried out a trial in NHS intensive care units. Supplies are already available across the UK so they can be used immediately to save hundreds of lives, say experts. The UK government is working closely with the manufacturer, to ensure the drugs - tocilizumab and sarilumab - continue to be available to UK patients. As well as saving more lives, the treatments speed up patients' recovery and reduce the length of time that critically-ill patients need to spend in intensive care by about a week. Both appear to work equally well and add to the benefit already found with a cheap steroid drug called dexamethasone. Read full story Source: BBC News, 7 January 2021
  4. News Article
    An experimental treatment involving stem cells from umbilical cords could significantly reduce deaths and quicken recovery time for patients suffering the most severe form of COVID-19, a study suggests. US researchers reported a 91% survival rate in seriously ill patients given the stem cell infusion, compared to 42% in a second group who did not receive the treatment. Researchers said the treatment also appeared to be safe, with no serious adverse reactions reported. Read full story Source: The Independent, 5 January 2021
  5. Content Article
    Content includes: What is neonatal herpes? What is the herpes simplex virus? How can a baby catch herpes? What are the signs & symptoms of neonatal herpes? How do I know if my baby has an infection? What is the treatment for neonatal herpes? What can I do to prevent my baby from getting neonatal herpes? I am pregnant or breastfeeding, how can I protect my baby? I have a cold sore, what should I do to make sure I don't pass the virus to a baby? How do I wash my hands properly to help keep babies safe? Follow the link below to Kit Tarka Foundation's website, to find out more.
  6. Content Article
    This guideline includes recommendations on: identifying people with ongoing symptomatic COVID-19 or post-COVID-19 syndrome assessing people with new or ongoing symptoms after acute COVID-19 investigations and referral planning care management follow-up and monitoring sharing information and continuity of care service organisation. Who is it for? Health and care practitioners Health and care staff involved in planning and delivering services Commissioners.
  7. Content Article
    Azithromycin is an antibiotic known for its anti-inflammatory properties which is already used to treat chronic inflammatory lung disease, or chest infections such as pneumonia. Inflammation, caused by an overly-active immune response, is a key feature of severe COVID-19. Azithromycin was considered a potential treatment for COVID-19 and investigated through an arm of the RECOVERY trial to assess whether the drug had a meaningful benefit amongst hospitalised patients with COVID-19. A preliminary analysis of the data has shown no meaningful clinical benefit of azithromycin in the hospitalised COVID-19 patients randomised to this treatment arm. The data showed no significant difference in the primary endpoint of 28-day mortality (19% azithromycin vs. 19% usual care). While researchers found no evidence of beneficial effects on the risk of progression to mechanical ventilation or length of hospital stay. The results were consistent in different subgroups of patients. However it is not possible to make conclusions about the effectiveness of azithromycin in patients in the community.
  8. News Article
    All non-urgent elective operations are being postponed for at least two weeks in a health system still seeing significant and growing pressure from coronavirus. The four acute trusts in Kent and Medway will still carry out cancer and urgent electives, but other work is being postponed. Relatively few elective operations are usually carried out around Christmas and New Year, meaning the county is likely to see little or no elective work for the next four weeks. In a covid update bulletin issued last night, the Kent and Medway Clinical Commissioning Group acknowledged the pressure hospitals across its area were under but stressed cancer and other urgent operations would go ahead. It added: “However, we are now pausing non-urgent elective services. This will allow staff to move to support the increased number of covid-19 patients. “Initially this will be for a two-week period. We will keep this under weekly review and will contact individual patients where appointments need to be rescheduled.” Read full story (paywalled) Source: HSJ, 8 December 2020
  9. News Article
    The NIHR-supported PRINCIPLE trial is to start investigating the inhaled corticosteroid budesonide to find out if it can help treat COVID-19 in patients who aren’t in hospital. Led by the University of Oxford, the PRINCIPLE is the UK’s national platform trial for COVID-19 treatments that can be taken at home. It is evaluating treatments that can help people aged over 50 recover quickly from COVID-19 illness and prevent the need for hospital admission. The study, funded by NIHR and UK Research and Innovation (UKRI) has so far recruited more than 2100 volunteers from across the UK with support from NIHR’s Clinical Research Network. Inhaled budesonide is often used to treat asthma and chronic obstructive pulmonary disease, with no serious side-effects associated with short-term use. In some patients with COVID-19, the body’s immune response to the virus can cause high levels of inflammation that can damage cells in the airways and lungs. Inhaling budesonide into the airways targets anti-inflammatory treatment where it is needed most, and can potentially minimise any lung damage that might otherwise be caused by the virus. Patients taking part in the study will be randomly assigned to receive an inhaler in the post, alongside the usual care from their clinician. They will be asked to inhale two puffs twice a day for 14 days with each puff providing a 400 microgram dose of budesonide. They will be followed up for 28 days and will be compared with participants who have been assigned to receive the usual standard-of-care only. Read full story Source: National Institute for Health Research, 27 November 2020
  10. News Article
    A woman has become blind after her monthly eye injections were delayed for four months during lockdown. Helen Jeremy, 73, said everything she enjoyed doing has "gone out of the window" after losing her eyesight. She has glaucoma and was diagnosed with age-related macular degeneration four years ago. Monthly injections controlled the condition and meant she could still drive and play the piano. However, her appointments were cancelled when the pandemic struck and her eyesight deteriorated. "I was panicking. It was terrifying. Because I'm a widow I'm on my own and it was awful," she said. "Suddenly my eyesight was basically gone. By the time of my next appointment I was told there was no point in going on with these injections because the damage had been done to the back of my eye." Thousands more people in Wales are at risk of "irreversible sight loss" because of treatment delays, RNIB Cymru warns. The Welsh Government said health boards are working to increase services. Read full story Source: BBC News, 27 November 2020
  11. Content Article
    Detailed results from the report show: - The regions that have seen the sharpest decline in the number of people referred for routine elective care during the first 8 months of the year are London (37% reduction as compared to 2019), North West (35% reduction) and South East (35% reduction). The South West saw the smallest reduction in the number of people referred for elective care compared to 2019 (29%). The North East and Yorkshire saw a 34% reduction and Midlands and East of England both had a 33% reduction. - Those regions that experienced the lowest rates of COVID-19 during the first wave, namely the South West and East of England, are also those that have made the most progress in reopening elective care services. While there are currently only limited signs that more treatment is being postponed in the regions hardest hit by COVID-19, this may change in the future. - Referrals to clinical areas have declined as follows: oral surgery (43% lower than in 2019, representing 177,591 fewer people) trauma and orthopaedics (42% lower, representing 622,593 fewer people). This includes surgery for hip and knee replacements ophthalmology (41% lower, representing 531,660 fewer people). This includes cataract operations thoracic medicine (29%, or 98,546 fewer people) cardiothoracic surgery (29%, or 7,889 fewer people) neurosurgery (29% lower, or 23,872 fewer people); urology (28% lower, representing 186,119 fewer people).
  12. News Article
    A new NHS treatment programme targeting young people with eating disorders has been launched amid a rise in numbers needing treatment during the coronavirus pandemic. Recent NHS data showed record numbers of children and young people are currently being treated across England for eating disorders while waiting times in some places are dangerously long. On Monday, children’s charity NSPCC warned that counselling sessions for eating and body image disorders rose by 32% after lockdown was introduced in March. The new scaling up of intervention services for those with eating disorders such as anorexia and bulimia will mean young people can gain access to rapid specialist NHS treatment across England. The service will be rolled out to 18 sites, building on a successful trial model at King's College London, where one patient described the treatment as the “gold standard” of care. Nadine Dorries, Minister for Health, said: “Eating disorders can have a devastating impact on individuals and their families – and can very sadly be fatal. I am committed to ensuring young people have access to the services and treatment they need which can ultimately save lives." Read full story Source: The Independent, 10 November 2020
  13. News Article
    Several NHS trusts are offering a ‘treatment’ for birth trauma which uses a technique which lies outside national guidelines and which is criticised by specialists as potentially causing ‘more harm than good’. The ‘Rewind’ technique is promoted as a fast treatment for post-natal post-traumatic stress disorder (PTSD) – also known as birth trauma - which involves the “reprocessing” of painful memories. HSJ has learned of several trusts, including East and North Herts Trust, Chelsea and Westminster Hospital Foundation Trust and James Paget University Hospital FT, where the therapy is being offered. It is thought there are other trusts which are providing it or have explored it. Typically, it is provided by midwives who have undergone training in the technique. But Nick Grey, a clinical psychologist who was on the National Institute for Health and Care Excellence panel which looked at PTSD, said it was “absolutely clear cut” that it was bad practice to offer the technique as a branded therapy for PTSD, although he said it could be embedded as part of other treatments. He told HSJ: “It should not be offered to mothers with PTSD… they are being done a disservice if they are not given evidence-based treatment. There is no evidence that this [provides] treatment for sub-clinical PTSD or trauma,” he said. Read full story (paywalled) Source: HSJ, 11 November 2020
  14. News Article
    Cancer patients have had surgery cancelled because of coronavirus for the first time as pressure mounts on hospitals from the second wave, The Independent has learnt. Nottingham University Hospitals Trust has confirmed it had to postpone the operations because of the number of patients needing intensive care beds. While hospitals across the north of England have been forced to start cancelling routine operations in the last 10 days, maintaining cancer and emergency surgery had been a red line for bosses given the risk to patients from any delays. Cancer Research UK said it was “extremely concerning” that some operations had been postponed and called for urgent action and investment to make sure treatments were not curtailed further. In a statement to The Independent, Nottingham University Hospitals medical director Keith Girling said: “We’ve had to make the extremely difficult decision to postpone operations for four of our cancer/pre-cancer patients this week due to pressure on our intensive care units from both Covid-19 and non-covid related emergencies." “We expect to treat one of the postponed patients next week, and we’re in contact with the others to arrange a new date, which will be imminent. This delay, however short, will be incredibly hard for the patients and their families, and I’m truly sorry for any distress this will have caused. Read full story Source: The Independent, 27 October 2020
  15. News Article
    NHS bosses have denied claims that thousands of frail elderly people were denied potentially life-saving care at the peak of the pandemic in order to stop the health service being overrun. NHS England took the unusual step on Sunday of issuing a 12-page rebuttal to allegations in the Sunday Times that patients deemed unlikely to survive were “written off” by being refused intensive care. Prof Stephen Powis, NHS England’s national medical director, said: “These untrue claims will be deeply offensive to NHS doctors, nurses, therapists and paramedics, who have together cared for more than 110,000 severely ill hospitalised Covid-19 patients during the first wave of the pandemic, as they continue to do today." “The Sunday Times’ assertions are simply not borne out by the facts. It was older patients who disproportionately received NHS care. Over two-thirds of our COVID-19 inpatients were aged over 65. “The NHS repeatedly instructed staff that no patient who could benefit from treatment should be denied it and, thanks to people following government guidance, even at the height of the pandemic there was no shortage of ventilators and intensive care.” The newspaper claimed the high coronavirus infection rate in the UK before lockdown began on 23 March and the NHS’s limited supply of mechanical ventilators going into the pandemic meant that “the government, the NHS and many doctors were forced into taking controversial decisions – choosing which lives to save, which patients to treat and who to prioritise – in order to protect hospitals”. The Sunday Times said its claims were the result of a three-month investigation that involved speaking to more than 50 sources in the NHS and the government about the health service’s response to the pandemic. Read full story Source: The Guardian, 25 October 2020
  16. News Article
    Concerns are growing that long NHS waiting times caused by the coronavirus crisis are exacerbating pre-existing health inequalities and creating a “two-tier” system, as more people turn to the private sector for quicker treatment. As leading doctors warn mass cancellations of NHS operations in England are inevitable this winter after waiting times reached the highest levels on record this summer, data shows a rise in the number of people self-funding treatment or investing in private health insurance. “COVID-19 has not impacted everyone equally, and there is clearly a risk that the backlog in routine hospital treatment is going to add to those inequalities if some people are able to get treatment faster because they’re able to pay,” said Tim Gardner, from the Health Foundation thinktank. As the NHS heads into winter and a growing second wave of the virus, experts stressed the need to help those affected by the backlog now. “There is a need to prioritise the most urgent cases, but simply because someone’s case isn’t urgent doesn’t mean it’s not important. It doesn’t mean that people aren’t waiting in pain and discomfort, or waiting anxiously for a diagnosis,” said Gardner. “We think it’s incumbent on the health service to make the best possible use of the capacity it’s got. But also it needs to make sure it’s supporting people while they’re waiting. We just can’t have people left in limbo.” Read full story Source: The Guardian, 27 October 2020
  17. Content Article
    I believe all clinicians should read this latest report. There is so much to be learned and so many changes in clinical practice that can be made right away. Since 2018, I have been teaching using Oliver's tragic story to promote reflection on best practice in prescribing and in implementing the Mental Capacity Act. I could write a lot here; however, I believe this is a report all clinicians, and especially all prescribers, need to read in full. A summary of how I see this (or indeed how any individual sees it) it will not be adequate.
  18. News Article
    n the day Boris Johnson was admitted to hospital with COVID-19, Vivien Morrison received a phone call from a doctor at East Surrey Hospital in Redhill. Stricken by the virus, her father, Raymond Austin, had taken a decisive turn for the worse. The spritely grandfather, who still worked as a computer analyst at the age of 82, was not expected to survive the day. His oxygen levels had fallen to 70% rather than the normally healthy levels of at least 94%. Vivien says she was told by the doctor that her father would not be given intensive care treatment or mechanical ventilation because he “ticked too many boxes” under the guidelines the hospital was using. While ministers delayed lockdown, soaring cases were putting immense pressure on hospitals. This investigation from The Times shows officials devised a brutal ‘triage tool’ to keep the elderly and frail away. Read full story (paywalled) Source: The Sunday Times, 25 October 2020)
  19. Content Article
    The HSIB investigation focused on what happens after thrombolysis treatment is given and how venous thromboembolism (VTE) risk is managed as patients recover. They identified issues such as a low rate of intermittent pneumatic compression (IPCs) being fitted despite their success in improving the survival rates of those who are not mobile after a stroke and their recommendation by NICE guidelines. As the investigation progressed, HSIB identified missed opportunities throughout the whole process of care. There is a lack of a national, stroke-specific assessment for VTE that considers the patient’s specific circumstances or determines the level of risk the patient has of blood clots forming. Even if an assessment identifies IPC as a treatment, the case examined in this report reflected a wider picture of confusion over how the devices are recorded i.e. on the patient’s chart and who then is responsible for fitting. The findings also show that national guidelines do not require a follow-up assessment or a check that the VTE preventative measure is in place. Safety recommendation As a result of the national investigation, HSIB have made one safety recommendation to facilitate the development of a stroke specific assessment, a system for the associated treatment to be recorded using a tool to ensure that the relevant information is documented and, importantly, reviewed. Dr Stephen Drage, HSIB Director of Investigations and intensive care unit consultant, said: “The time after a patient is admitted and treated for a stroke is incredibly precarious. It is important that any safety risks in the care process are mitigated to prevent life-threatening blood clots forming to give patients the best chance of making a full recovery. “A number of barriers to the most effective aftercare emerged through our investigation and the safety issues impact not only all specialist units but any wards where stroke recovery takes place in the NHS. The recommendation we have made is aimed at ensuring that VTE risk is managed in a targeted way that ensures that patients are getting the right treatment at the right time.”
  20. Content Article
    Speaking at the NHS Providers conference today Sir Simon Stevens, Chief Executive of the NHS, announced that £10 million will be invested into additional local funding "to help kick start and designate Long Covid clinics in every area across England".[1] Patient safety concerns for Long COVID patients Long Covid patients are people with confirmed or suspected Covid-19 who continue to struggle with prolonged, debilitating and sometimes severe symptoms months later.[2] Many were never admitted to hospital and have instead been trying to manage their symptoms and recovery at home. At Patient Safety Learning we have seen growing evidence that there are many patients suffering from long-lasting symptoms of Covid-19 who are feeling abandoned, confused and without support. We have featured patient insights of this on the hub, our platform for patient safety, such as the experiences of Barbara Melville and Dr Jake Suett.[3] Informed by patients we have also been highlighting the patient safety issues arising from this.[4] In September we heard from many Long Covid patients who have expressed confusion about access post-Covid support clinics. This followed comments from the Health Secretary Matt Hancock MP at the Health and Social Care Select Committee in which he suggested this support was already available.[5] We wrote to Simon Stevens calling on the NHS to publish details of post-Covid support clinics and confirm the timeframe for the implementation of Phase 2 of the ‘Your Covid Recovery’ support portal.[6] Reflections on today’s announcement The NHS announcement today sets out a five-part package of support people living with Long Covid: 1. New guidance commissioned by NHS England from NICE by the end of October on the medical ‘case definition’ of Long Covid. This will include patients who have had Covid who may not have had a hospital admission or a previous positive test. It will be followed by evidence-based NICE clinical guidelines in November on the support that Long Covid patients should receive, enabling NHS doctors, therapists and staff to provide a clear and personalised treatment plan. This will include education materials for GPs and other health professionals to help them refer and signpost patients to the right support. We welcome this measure and plans to update guidance so that it includes patients who may not have had a hospital admission or a previous positive test. We have heard from patients who have expressed their frustrations around the lack of clinical recognition of their illness, exacerbated by receiving a negative test result. This new guidance should enable health care providers in primary and secondary care to properly capture information about patients that have Long Covid. This should help to create a better understanding of how many patients are experiencing this disease and the services they are receiving. It will also be essential to ensure that service providers are appropriately funded to support these patients. 2. The ‘Your Covid Recovery’ – an online rehab service to provide personalised support to patients. Over 100,000 people have used the online hub since it launched in July, which gives people general information and advice on living with long Covid. Phase 2 of the digital platform being developed this Autumn by the University of Leicester will see people able to access a tailored rehabilitation plan. This will enable patients to set goals for their mental and physical health, provide peer to peer support through social community forums, offer an ‘ask the expert’ facility for patients to contact their local rehab service, and allow patients to be monitored by their local rehab teams to ensure that they are on track with their care. This service will be available to anyone suffering symptoms that are likely due to COVID-19, regardless of location or whether they have spent time in hospital. It is most likely that patients will access the service through their GP, but they could also be referred through another healthcare professional following assessment. From our conversations with patients and community support groups, we are aware that concerns remain about the availability of support for those who have been managing their symptoms at home. Patients have highlighted that much of the ‘Your Covid Recovery’ site focuses only on those patients who have been in hospital. It is essential that patients that are living in the community with Long Covid can access advice and guidance specific to their needs. We are concerned that access to information and advice is only accessible through GPs or another healthcare professional following assessment. We need to ensure that this referral route does not become a barrier to Long Covid patients having the information and advice they need. 3. Designated Long Covid clinics, as announced today. This will involve each part of the country designating expert one-stop services in line with an agreed national specification. Post-Covid services will provide joined up care for physical and mental health, with patients having access to: – A physical assessment, which will include diagnostic testing, to identify any potential chronic health issues. – A cognitive assessment, to assess any potential memory, attention, and concentration problems. – A psychological assessment, to see if someone is suffering potentially from depression, anxiety, PTSD, or another mental health condition. Patients could also then be referred from designated clinics into specialist lung disease services, sleep clinics, cardiac services, rehabilitation services, or signposted into IAPT and other mental health services. We welcome this commitment to a one-stop shop approach to support for Long COVID patients. It is important that we recognise that patients may need to access a wide range of services and that patients who are unwell should not have to move between different clinical specialities to get diagnosis and treatment related to their personal needs. The £10m initial investment is to be welcomed as is the national specification; it is important that we do not have a postcode lottery of services. As the infection rate increases, so will the number of patients with Long Covid. The investment in services will need to match patient need, both initial assessment and diagnosis and access to specialist treatment, support services and ongoing rehabilitation. We also note that these appear to be England-only measures and would be keen to clarify what steps are being put in place to support patients in the other three nations of the UK. 4. NIHR-funded research on Long Covid which is working with 10,000 patients to better understand the condition and refine appropriate treatment. This is welcomed and should inform the development of clinical pathways and best practice guidelines. 5. The NHS’s support will be overseen by a new NHS England Long Covid taskforce which will include long Covid patients, medical specialists and researchers. This is a new disease and we do not yet understand how best to support patients with Long Covid. We believe that a multi-disciplinary task force that engages and welcomes patients' insights is essential. What are your thoughts? Further to our initial reflections on this, we would be keen to hear from people living with Long Covid on their thoughts on this announcement. Please share your thoughts with us on the support that is needed on our patient safety platform, the hub. References NHS England and NHS Improvement, NHS To Offer ‘Long Covid’ Sufferers Help at Specialist Centres, 7 October 2020. The symptoms for those with Long COVID vary greatly but many are experiencing rashes, shortness of breath, neurological and gastrointestinal problems, abnormal temperatures, cardiac symptoms, and extreme fatigue. Barbara Melville, Dismissed, unsupported and misdiagnosed: Interview with a COVID-19 ‘long-hauler’, Patient Safety Learning’s the hub, 24 June 2020; Dr Jake Suett, My experience of suspected ‘Long COVID’, Patient Safety Learning’s the hub, 10 July 2020. Patient Safety Learning, Patient safety concerns for Long COVID patients, 6 July 2020. Rt Hon. Matt Hancock MP commented in a select committee that “The NHS set up Long COVID clinics and announced them in July. I am concerned by reports this morning from the Royal College of GPs that not all GPs know how to ensure that people can get into those services. That is something I will take up with the NHS and that I am sure we will be able to resolve”. Health and Social Care Committee, Oral evidence: Social care: funding and workforce, HC 206, 8 September 2020. Patient Safety Learning, Clarity needed on post-COVID clinics: Patient Safety Learning's letter to NHS leader, 11 September 2020.
  21. News Article
    Much has been said about the delays to patient care during the first wave of COVID-19, but the full picture has been hard to pin down as statistics come in different forms and are released gradually. However, one recently-published poll performed by Ipsos Mori, with more than 2,000 UK adults aged between 18-75, revealed two-thirds of people who needed treatment for new or recently changed conditions had their care cancelled or delayed during March and July. The poll also revealed three-quarters of people missed out on routine treatment in the same timeframe. It is believed to be the hitherto largest patient-focused survey exploring the impact of the pandemic on non-COVID-19 care during its first peak. It found that – of the people who needed treatment for a new or changed condition – 23% chose to cancel their treatment while 42% had their treatment cancelled or delayed by their healthcare provider. Within the group of people requiring care for an ongoing problem, 31% of patients delayed or cancelled their treatment. Mark Davies, chief medical officer at IBM – which commissioned the poll – told HSJ the number of people with new or recently changed conditions choosing to cancel or delay their care was “really worrying”. “This survey backs up the anecdotal evidence we hear about people being worried about going into hospital during the pandemic,” he said. “It is striking that the proportion of this group of patients who did not get treatment is roughly similar to the proportion of patients requiring treatment for an ongoing health problem who cancelled or delayed their care." He said he would have expected the former group – those with new or changed conditions – to be more anxious to get treated, and warned of a “backlog of unmet need that is only going to emerge in the next few months”. Read full story (paywalled) Source: HSJ, 6 October 2020