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Found 211 results
  1. News Article
    A trust is reviewing more than 100,000 patients on its outpatient lists, after concerns emerged that some had ‘been lost whilst on hold’ for follow-up appointments. A report from Buckinghamshire Healthcare Trust, leaked to HSJ, found 116,575 patient records without a scheduled follow-up after an outpatient consultation, with more than half of those left inappropriately without action, some dating back a decade. The review was triggered after staff spotted cases in which patients had been “lost whilst on hold”, the report said. The trust this week told HSJ that, since the initial discovery in the summer of last year, it had been validating the lists and reduced the number of outstanding records to 47,778. It aims to complete the reviews in the next two months. It told HSJ it had undertaken a harm review and found no “systemic harm”. Concerns have been raised over several years about the extent of overdue and unreviewed patients on follow-up lists, and the potential for them to deteriorate and come to harm. There are no national figures monitoring the patients, many of whom have long-term health needs. Read full story (paywalled) Source: HSJ, 15 December 2023
  2. Content Article
    Healthcare Inspectorate Wales (HIW) is the independent inspectorate of the NHS and regulator of independent healthcare in Wales. The findings of their Annual report outline the sustained pressure on healthcare services across Wales, highlighting risks relating to emergency care, staffing concerns, poor patient flow and the accessibility of appointments. It sets out how the HIW carried out their functions across Wales, seeking assurance on the quality and safety of healthcare through a range of activities. This includes inspections and review work in the NHS, and regulatory assurance work in the independent healthcare sector. The report provides a summary of what HW's work has found, the main challenges within healthcare across Wales, and HIW's view on areas of national and local concern.
  3. Content Article
    Patient-initiated follow up (PIFU) is an appointment process that helps hospitals manage capacity and puts patients in control of making appointments, when they need them. In traditional care models, patients who have had treatment or surgery, or suffer with chronic conditions are provided with a set care plan and offered scheduled follow-up appointments either conducted in person, or remotely. PIFU offers an alternative way of organising planned follow-up care for patients following their elective procedures, rather than automatically being scheduled for appointments. This aims to give greater control to patients over the timing of their follow-up appointment based on their health status needs, helping patients save time, money and the inconvenience of travelling to pre-arranged appointments they may not need.
  4. News Article
    GP appointments over the phone or online risk harming patients, a new study published in the BMJ has found. An analysis of remote NHS doctor consultations between 2020 and 2023 found that “deaths and serious harms” had occurred because of wrong or missed diagnoses and delayed referrals. Distracted receptionists were also found to be responsible for deaths after they failed to call patients back. The report, led by the University of Oxford, suggested doctors should stop giving phone appointments to the elderly, people who are deaf, or technophobes. As many as a third of GP appointments are now virtual after face-to-face appointments slumped to less than half during the pandemic. Restoring access to face-to-face appointments has been a priority of multiple health secretaries, with Steve Barclay last year promising to name and shame GPs who did not see patients in person. Patient groups said the study was likely to be “just the tip of the iceberg” given the “potential for tragic misdiagnoses because of the limitations of online or telephone consultations”. Read full story (paywalled) Source: The Telegraph, 29 November 2023
  5. Content Article
    Triage and clinical consultations increasingly occur remotely. In this study, published in BMJ Quality & Safety, Payne et al. aimed to learn why safety incidents occur in remote encounters and how to prevent them. They found that rare safety incidents (involving death or serious harm) in remote encounters can be traced back to various clinical, communicative, technical and logistical causes. Telephone and video encounters in general practice are occurring in a high-risk (extremely busy and sometimes understaffed) context in which remote workflows may not be optimised. Front-line staff use creativity and judgement to help make care safer. As remote modalities become mainstreamed in primary care, staff should be trained in the upstream causes of safety incidents and how they can be mitigated. The subtle and creative ways in which front-line staff already contribute to safety culture should be recognised and supported.
  6. News Article
    One in 10 people attempting to contact their GP practice do not manage to get in contact, while a further 6% are only told to try again another day, according to new official survey findings commissioned by the government. The Office for National Statistics has been quietly carrying out the new regular GP access survey since the spring after ministers said they wanted to monitor the impact of their primary care recovery plan. After a sign of slight improvement in the summer, the latest survey results – for October – show no significant change since May. It also found, as did previous rounds, that of those who had tried to contact a GP practice in the past month, 10 per cent said they could not do so (see chart below, ‘Contact with GP practice’). Of those who did make contact, a further 6 per cent reported they were told to try again another day (see chart below, ‘Next step after contact’). The government and NHS England have made it a high priority in recovery plans that patients should no longer be asked to call back another day to book an appointment and should know “on the day” how their request will be managed, which may mean being advised to use a different service. Read full story (paywalled) Source: HSJ, 9 November 2023
  7. Content Article
    People with chronic pain need personalised care – an approach offering patients choice and control over their mental and physical health, basing care on what matters to them personally, and focusing on individual strengths and needs. People in this position need someone to listen and acknowledge that these symptoms are real, not all in their head. They need someone to explain their chronic pain and other symptoms, but also someone for everything else too. As well as medical care, people need time and emotional care. But how on earth can this be achieved in UK primary care in 2023? Is this really the role of a modern GP? Even if it was how can it now be in our over-stretched, fragmented, target-driven services? In North-West London, Selena Stellman and Benjamin Ellis have tested a personalised care model to improve the care offered to patients with fibromyalgia and high impact chronic pain. In this opinion piece in BJGP Life, they discuss the two key changes in their approach.
  8. Content Article
    Patient initiated follow up and remote clinical reviews show promise in alleviating capacity issues and ensuring timely care, with positive patient feedback and early intervention benefits Media interest regularly reports on the three headline performance measures of the NHS; 18-week target, cancer wait targets, and four hour waits in emergency departments. There is, however, another large group of patients that we do not have any targets for and receive no media attention, who Peter Towers, NHS service manager, has termed the “fourth group”. These are the patients who have started their treatment but cannot be discharged back to primary care as they require continued secondary outpatient care.
  9. News Article
    NHS England plans to reduce follow-up appointments is leading to patient safety risks and causing waiting lists to grow, an acute trust has warned. The NHSE plans were set out in the 2023-24 planning guidance which says trusts must cut outpatient follow-ups by 25% against 2019-20 levels by March, to increase capacity for new patients. But North Cumbria Integrated Care Foundation Trust has raised concerns that adhering to the policy will “exacerbate” its follow-up backlogs, warning that the delays “potentially… pose a risk of harm to patients whose condition may deteriorate when follow-up is late”. NHS Confederation told HSJ it thought the policy “has risks” because it could mean that patients needing follow-ups will wait for longer, although the organisation also saw benefits. It said hospital leaders had “mixed feelings” about the policy. The Patients Association also raised concerns that cancelling follow-ups for some patients “will exacerbate health inequalities”. Read full story (paywalled) Source: HSJ, 12 October 2023
  10. News Article
    The NHS in England is facing mounting pressure amid a surge in patients attending A&E departments with minor ailments, health bosses have said. Emergency departments, which are designed for serious injuries and life-threatening emergencies only, are seeing an increase in people attending with sore throats, insomnia, coughs and earache. Data analysed by the Press Association news agency also shows more people going to A&E with complaints such as hiccups, nasal congestion, backache and nausea. Cases where sore throat was the chief complaint rose by 77% between 2021-22 and 2022-23, from 191,900 cases to 340,441. Patients going to A&E with coughs rose by 47%, from 219,388 to 322,500, while attendances for nosebleeds rose by a fifth, from 47,285 cases to 56,546. Miriam Deakin, the director of policy and strategy at NHS Providers, said: “The rise in A&E admissions is piling even more pressure on to an already stretched NHS. Persistent strain on primary care services, including GPs and dentists, means patients often resort to A&E when they cannot access timely care elsewhere. “Minor ailments such as coughs, earache, fever, nausea and hiccups can and should be managed through more appropriate services such as pharmacies and NHS 111 online. This could ease pressure on emergency departments, whose priority is to deliver urgent care for those most in need. Boosting capacity of staff, beds and equipment in these settings would also significantly help. However, this requires proper funding and support from the government.” Read full story Source: The Guardian, 10 October 2023
  11. Content Article
    Urgent funding is required to clear waiting list backlogs and drive Northern Ireland's long-term healthcare transformation, the Northern Ireland Audit Office has said in a new report which outlines the health service's "critical situation" after almost a decade of worsening waiting lists for elective care. The NI Audit Office looked at waiting list data from 2014 to 2023. It found the number of patients waiting for elective care has risen by 452,000 during that nine-year period. The Audit Office also said: "Available information suggests waiting list performance levels are significantly worse in Northern Ireland compared with the other UK regions."
  12. Content Article
    The adoption of virtual consultations, catalysed by the COVID-19 pandemic, has transformed the delivery of primary care services. Owing to their rapid global proliferation, there is a need to comprehensively evaluate the impact of virtual consultations on all aspects of care quality. This study aims to evaluate the impact of virtual consultations on the quality of primary care. It found that virtual consultations may be as effective as face-to-face care and have a potentially positive impact on the efficiency and timeliness of care; however, there is a considerable lack of evidence on the impacts on patient safety, equity, and patient-centeredness, highlighting areas where future research efforts should be devoted. Capitalising on real-world data, as well as clinical trials, is crucial to ensure that the use of virtual consultations is tailored according to patient needs and is inclusive of the intended end users. Data collection methods that are bespoke to the primary care context and account for patient characteristics are necessary to generate a stronger evidence base to inform future virtual care policies.
  13. Content Article
    In February 2022, NHS England published its Delivery Plan for Tackling the Covid-19 Backlog of Elective Care, aiming for an unprecedented 30% rise in elective activity by 2024-25. In an effort to cut waiting times and the number of people waiting for first appointments, the plan set an improbably ambitious target of reducing follow-up outpatient visits by 25% by March 2023 from 2019-20, to leave more capacity for first appointments. All first appointment waits of over 52 weeks were to be abolished by 2025. In this BMJ opinion piece, David Oliver looks at why the targets are unlikely to be met.
  14. News Article
    The cost of living squeeze is a significant factor in some stillbirths, according to case reviews carried out in one of England’s most deprived areas. The review was undertaken in Bradford last year, and concluded: ”the current financial crisis is impacting on the ability of some women to attend essential antenatal appointments”. Missing these appointments was a factor in a range of maternity safety events, including stillbirths, it said. The researchers are now calling for new national funding to help ensure expectant parents do not miss important appointments because they cannot afford to attend. The research findings include: ‘Did not attend’ rates increased due to lack of funds for transport to antenatal appointments; “Lack of credit on phones prevented communication between women and maternity services, for example, making [them] unable to rearrange scans or appointments”; Wide spread incidence of “digital poverty, [for example] a lady with type 1 [diabetes] was unable to monitor her glycaemic control over night due to only having one phone charger in the house”; and “Families with babies on a neonatal unit going without food in order to finance transport to and from the unit.” Read full story (paywalled) Source: HSJ, 25 August 2023
  15. News Article
    A trust has had to re-examine the cases of more than 31,000 patients after they were automatically and wrongly discharged from its care because they did not have another appointment within the next six months. Dartford and Gravesham Trust in Kent has revealed that soaring waiting times post-covid meant patients who needed follow-up appointments were not offered them within six months, which before covid was a very unusual occurrence. When they passed six months, they were dropped off waiting lists altogether, due to a feature in the trust’s patient administration system designed to ensure outdated pathways are closed. It is a common feature in many such systems, HSJ was told. The trust has now “validated” more than 31,000 patients who have been in contact with it since 1 September 2021. So far, it said, it had not found evidence of harm, although some people have been recalled for clinical review or investigation, and a small number are still to be seen. Read full story (paywalled) Source: HSJ, 22 August 2023
  16. News Article
    Patients at all general practices across England will soon benefit from new digital phone lines designed to make booking GP appointments easier. Backed by a £240 million investment, more than 1,000 practices have signed up to make the switch from analogue systems - which can leave patients on hold and struggling to book an appointment - to modern, easy-to-use digital telephones designed to make sure people can receive the care they need when they need it. It is expected every practice in the country will have the new system in place by the end of this financial year, helping put an end to the 8am rush - a key pillar of the Prime Minister’s primary care recovery plan to improve patient access to care. Patients will be able to contact their general practice more easily and quickly - and find out exactly how their request will be handled on the day they call, rather than being told to call back later, as the government and NHS England deliver on the promises made in the primary care recovery plan announced in May. If their need is urgent, they will be assessed and given appointments on the same day. If it is not urgent, appointments should be offered within 2 weeks, or patients will be referred to NHS 111 or a local pharmacy. The upgraded system will bring an end to the engaged tone, see care navigators direct calls to the right professional, and the use of online systems will provide more options and help those who prefer to call to get through. Read press release Source: Department of Health and Social Care, 18 August 2023
  17. Content Article
    Many patients struggle to book a GP appointment in England. Once people have been successful in getting a booking to see their doctor, however, how long are they having to wait for their appointment? Charlotte Paddison looks at the latest data to reveal the answer – and argues that quick access to GP appointments is not the only factor to consider.
  18. News Article
    Patients in all but one integrated care system found it more difficult to contact their GP practice by phone this year compared to last year. GP patient survey data, published this month, showed the proportion of patients who found it “very” or “fairly easy” to get through by phone had fallen across almost every ICS by as much as seven percentage points. The measure fell nationally from 53 to 50%. The drop in performance comes as NHS England and the government ramp up focus on ease and speed of access to GPs as part of the primary care recovery plan, published in May. An NHSE spokesperson said: ”Despite GP teams experiencing record demand for their services, with half a million more appointments delivered every week compared to before the pandemic, the GP survey found that the majority of patients have a good overall experience at their GP practice. “However, the NHS recognises more action is needed to improve access for patients, which is why it published a recovery plan in May.” Read full story (paywalled) Source: HSJ, 31 July 2023
  19. Content Article
    Having patients actively engaged in their care helps healthcare professionals develop more accurate, timely diagnoses. To help encourage this engagement, the Society to Improve Diagnosis in Medicine (SIDM) has developed the Patient's Toolkit, a resource for patients, by patients. Preparing ahead of time for medical appointments allows patients to think about concerns, symptoms, and other important information that healthcare professionals will need from you, and what you want to get out of the conversation during your visit. SIDM's toolkit was designed for patients visiting their healthcare provider to help tell their story clearly. Patients can follow a set of prompts and questions posed in the toolkit to help encourage participation and partnership with medical professionals. Prepare for you next appointment, map your symptoms, account for medications, and plan your next steps with the Patient's Toolkit.
  20. News Article
    NHS trusts across England are scrambling to trace thousands of children for urgent hearing tests amid fears that cases of infant deafness may have been missed for years. An internal NHS report has exposed poor-quality testing within paediatric audiology departments at five hospitals and warned of systemic failings. At another NHS trust, almost 1,500 children were found to have missed out on appointments dating back to 2012. Vital quality inspections of departments checking infants for hearing loss were stopped ten years ago. Whistleblowers who previously worked for the NHS’s newborn hearing screening programme have revealed that concerns were raised shortly before they were told to stop carrying out checks. They say that thousands of children may have been mistreated for deafness and hearing loss in the past decade. Read full story (paywalled) Source: The Times, 25 June 2023
  21. News Article
    Patients who fail to turn up for surgical day case procedures are costing the health service thousands of pounds. It is a problem across Northern Ireland's five health trusts. Over a 10-month period in the South Eastern area 14,000 patients did not attend or cancelled review appointments on the day they were due to turn up. Assistant Director of Elective Surgery at the South Eastern Trust Christine Allam said it was "frustrating". The South Eastern trust review showed between April 2022 and January 2023, 7,755 people did not attend or cancelled new outpatient appointments on the day. During the same period, 14,003 or 10% of patients didn't show for review appointments. Ms Allam said the situation was "frustrating for those patients who are waiting to be seen". "Those slots where people don't turn up are lost capacity because we haven't been given notice - and this only lengthens the waiting lists," she added. It is a problem that all health trusts are experiencing. Read full story Source: BBC News, 24 May 2023
  22. Content Article
    Hospitals can significantly elevate patient satisfaction and enhance the delivery of healthcare services by incorporating best practices from adjacent and non-adjacent sectors. Chetan Trivedi explores several solutions, from multiple sectors, that can serve as a blueprint for hospitals across every key step of the patient journey, spanning from admission to discharge.
  23. Content Article
    This webinar shares the findings of a co-production project in Nottingham and Nottinghamshire Integrated Care Board (ICB) to remove barriers to shared decision making. The partners in the project were the ICB’s Personalised Care Team, the My Life Choices lived experience panel, the Patient Information Forum (PIF) and the Patients Association. Over the course of six co-production meetings, they developed simple resources to support patients and professionals to have better shared decision making conversations. Speakers discuss practical solutions to help patients and professionals get the most from limited appointment times which can be applied nationally.
  24. News Article
    ICBs should ensure there are ‘formal escalation routes’ in place for GPs after 25 daily clinical contacts, the BMA has said in new guidance. From next week (15 May), GP practices are contractually required to offer an ‘appropriate response’ to patients the first time they get in contact, by offering them an appointment or redirection, rather than asking them to call back at a different time. While GP leaders warned this would lead to increased pressure on NHS 111 and A&E, NHS England attempted to clarify in this week’s recovery plan that GPs should only redirect patients in ‘exceptional circumstances’. It also said practices should inform their ICB on each such occasion. However, conflicting BMA guidance has now been published, warning that practices attempting to adhere to the new requirement ‘may do so at the expense of clinician wellbeing and patient safety’. It reiterates the GP Committee for England’s safe working guidance recommending that clinicians have no more than 25 clinical contacts per day because anything beyond this "can lead to decision fatigue, clinical errors and patient harm, and clinician burn out". Read full story Source: Pulse, 11 May 2023
  25. News Article
    Delayed health checks among people with diabetes may have contributed to 7,000 more deaths than usual in England last year, a charity report suggests. The routine checks help cut the risk of serious complications like amputations and heart attacks. Diabetes UK says too many people are still being "left to go it alone" when managing their challenging condition. There are more than five million people in the UK living with diabetes, but around 1.9 million missed out on routine vital checks in 2021-22, Diabetes UK says. Disruption to care during the pandemic is likely to be a factor in the current backlog, which may be leading to higher numbers of deaths than usual in people with diabetes, it says. Between January and March 2023, for example, there were 1,461 excess deaths involving diabetes - three times higher than during the same period last year. "Urgent action is needed to reverse this trend and support everyone living with diabetes to live well with the condition," the report says. Read full story Source: BBC News, 10 May 2023
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