Tag: NHS

Winter pressures on health and social care

Health Secretary Michael Matheson met frontline A&E staff at the Royal Alexandra Hospital (RAH) in Paisley today to see first-hand how services are coping with peak winter demand.

Mr Matheson thanked teams for their ongoing efforts and met RAH staff working to keep the flow of patients moving through the hospital to help reduce pressures building up in the emergency department, and avoid people being delayed in hospital longer than necessary.  

With hospitals across the country remaining extremely busy, Mr Matheson thanked the public for continuing to do their part to help ease pressure on A&E by considering if their condition is an emergency before attending.

Mr Matheson said: “Our health and care services are now dealing with peak winter demand. There is no doubt the situation remains very challenging so I am extremely grateful to all our highly skilled and committed NHS and social care staff for their continued hard work and dedication.

“The public have really played their part so far, by considering whether their condition is an emergency before going to A&E. To help relieve pressure on services it’s vital everyone continues to do that. Local GPs and pharmacies can be contacted during the day for non-critical care, NHS 24 is also available on 111 for non-emergencies, and the NHS Inform website is an invaluable resource.

“However, let me be clear – urgent care will always be available for those who need it. If someone needs emergency care they should call 999 or go straight to A&E.

“The NHS 24 service dealt with significant demand over Christmas and New Year and, although very challenging, the system handled the large volume of calls very well, which was down to all those involved in the implementation of months of pre-winter planning, which started in spring, to ensure services were available to those in need.

“I am especially grateful to those across health and social care who sacrificed their time and worked over the bank holidays.”

Mr Matheson remains under investigation by the Scottish Parliament’s Corporate Body over his explanation of £11,000 data roaming costs on his parliamentary i-Pad incurred during a family holiday.

NHS Greater Greater Glasgow & Clyde launches Home for Lunch initiative

As winter poses increasing demand on our healthcare system, NHSGGC is encouraging family members to help get their loved ones ‘Home for Lunch’. 
 
Almost all patients that are ready to go home are discharged on the same day, but a number remain in hospital causing flow issues throughout the health care system. 
 
Doctors are reminding families of patients who are ready to be discharged to help make the required arrangements to get them back to their own home or care setting, at the earliest opportunity. 
NHS Greater Glasgow and Clyde ward staff and discharge teams work in parallel to create pathways for families to ensure that, when their loved ones are healthy enough to return home, they are supported in doing so.
 
As part of NHSGGC’s ABC winter campaign, the health board are attempting to ease pressure on our services and staff from the emergency department, through to patients being discharged. 
 
Dr Scott Davidson, Deputy Medical Director for Acute Services, said: “Winter places increasing demands on our health care services and families play an important role in helping to ease those pressures. 
 
“Our staff are working extremely hard to ensure we provide the best possible care for our patients and we are looking for your help to get loved ones home at the earliest opportunity. 
 
“We do not want patients spending any longer than they need to within our hospitals and want people to be in the comfort of their own home, without the risks associated with lengthy hospital stays. 
 
“I would like to thank families and members of the public who are doing their best to support our patients and staff as we continue to tackle winter pressures.” 

NHS: Right Care, Right Place

If you’re looking for health advice this Hogmanay, please read this important information: 📢

The 111 service is very busy today with almost 5000 calls already. This may mean a longer wait than usual for calls to be answered. Some mobile providers disconnect calls due to network capacity demand.

Here’s what you can do to help yourself, save time and help us care for those in the most need first.

💊If your call is related to medicines please visit https://nhs24.info/accessing-medicines

Whether it is prescribed or non-prescribed medication, our guide to accessing medication can save you time. You might not need to call 111.

🤧If you need general advice about seasonal ailments remember we have a lot of information on NHS inform, including a range of symptom checkers which you can use to help you decide what to do next: https://nhs24.info/symptom-checkers

📱The NHS 24 Online app also has handy health advice and can help you source your nearest open healthcare services, including pharmacies. The app is free to download on both iOS and Android devices. https://nhs24.info/NHS-24-Online

✔️By using NHS resources wisely, we can keep well and get the care we need quickly, safely and as close to home as possible.

Find out more about how to access the #RightCareRightPlace:

https://nhs24.info/RightCareRightPlace

If you are using a mobile phone to call please switch to WiFi calling and ensure your device is charged. This should help to prevent your call being disconnected by a network provider.

NHS 24’s staff are working exceptionally hard to answer as many calls as we can, quickly and safely. Please be patient and we will answer. If you can try the above options first, it could save you time. We want to help you get the right care, in the right place. 💙

RCEM: ‘We must not normalise crisis’

Accident and Emergency

‘We must not normalise crisis or celebrate small improvements – our patients and our members deserve more.’ That is the response of the Royal College of Emergency Medicine to the latest A&E performance data.

Yesterday (14 December 2023) two sets of data published by NHS England, have been released: the latest Urgent and Emergency Care (UEC) Daily Situation Reports 2023-24 (also known as Winter Sitrep); and monthly A&E performance figures for November 2023.

While there have been some small signs of improvement in certain areas the overall situation remails extremely challenging with A&E departments declaring critical incidents this week, clinicians describing things as the worst they have experienced and ambulance chiefs expressing serious concerns about the pressure their service is under.

The most recent Winter UEC Sitrep data which covers the period 4-10 December 2023 paints a worrying picture with bed occupancy running dangerously high at almost 95% (the level considered ‘safe‘ is 85%) and two-thirds of ambulances not meeting the 15-minute target to hand over patients.

There was a small uplift in the number of beds available within hospitals, but these do not appear to have helped to ease pressure elsewhere in the system, and there remain thousands of patients, who are well enough to go home, but have not been discharged – occupying beds which are needed for other people.

The November performance data reveals that last month more than 144,000 people who visited an A&E within the month were there for more than 12 hours – the target is four hours.

Reacting to these figures, Dr Adrian Boyle, President of the Royal College of Emergency Medicine, said: “While the data suggest a marginal improvement compared to last year, it’s just deja-vu and we must not allow this permacrisis to become accepted as ‘normal’.

“Ambulances are queueing outside A&Es, Trusts are declaring critical incidents, patients are facing dangerously long waits in overcrowded and uncomfortable A&Es. Conditions are intense and difficult for staff, and the experience of patients is distressing and undignified.

“Clinicians are doing their very best, despite the circumstances, to deliver optimal and compassionate care, and mitigate any potential risks to patients but it is taking its toll on them too.

“It is welcome to see small increases in bed numbers, but it is not enough and patients continue to endure long waits.

“Significant and urgent action is required now to address these issues – this is what our members and their patients need and deserve.”

Data in detail:

The latest Urgent and Emergency Care Winter sitrep data for week ending 10 December (week 4 of publication for 2023/24) published today by NHS England show:

  • Bed occupancy levels at Trusts with a major A&E (Type 1 acute Trust) was 94.9%.
  • There were 99,497 beds open at Trusts with a major A&E, 1,521 more than the same week last year.
  • The Government promised that by winter 2023/24 there would be 5,000 more beds open when compared to October 2022 (97,287). For this week, there was an increase of 2,210 Type 1 beds compared with October 2022.
  • On average, one third of ambulance handovers involved a delay of over 30 minutes, while only one third of patients arriving at A&E were handed over within 15 minutes as per national guidance.
  • On average, 46,929 patients occupied a bed for more than seven days at a Trust with a major A&E.
  • On average, 384 beds were general and acute beds were occupied by patients with flu.
  • On average, 12,927 patients remained in hospital while no longer who were ready to be discharged.
  • There was an average of 49,020 daily staff absences at Trusts with a major A&E.
  • This is 7,547 fewer than the same week last year.

Published today (14 December 2023) by NHS England, the latest A&E performance figures for November 2023 show:

  • There were 1,385,701 attendances to major A&Es (Type 1 EDs) in November 2023.
    This is a 1.97% decrease compared with the previous month.
  • In November 2023, 144,085 patients waited 12-hours or more from their time of arrival. This accounts for 10.9% of all major A&E attendances in November. This means that more than one in 10 patients waited 12-hours or more.
  • The four-hour target at major A&Es stood at 55.4%, this is the fourth worst four-hour performance on record and the lowest so far in 2023.The aggregate four-hour target stood at 69.7%, the lowest so far in 2023. This is 6.3 percentage points lower than the Government’s intermediary threshold target of 76% to be hit by March 2024.
  • 42,854 patients waited 12 hours or more from decision to admit (DTA) to admission. This is a 4% decrease when compared to the previous month. It is a 13.2% increase when compared with November 2022.
  • Beds data for October 2023 show bed occupancy stood at 94.8%.
  • Data show there were 98,844 Type 1 General & Acute beds available.  This is an increase of 1,473 beds from October 2023 (97,371). And an increase of 1,636 beds from November 2022 (97,208).
  • Since it was announced in January 2023 that 5,000 new beds would be made available by winter 2023/24 compared with October 2022 (when there was 97,287 beds available), there has been an increase of 1,557 beds.
  • There were 396,755 emergency admissions at major A&Es. This is a 1.19% decrease since the previous month (401,523). This is the second highest number of admissions so far in 2023.

Health and Social Care Secretary sets out priorities for system in England

Victoria Atkins aims to make health and social care system faster, simpler and fairer for patients

  • Health and Social Care Secretary sets out intention to make the system faster, simpler and fairer for patients
  • Victoria Atkins thanks staff for a week of delivery, in which two manifesto commitments were met

Health and Social Care Secretary Victoria Atkins has thanked health, social care and research staff for delivering on patients’ priorities, as she set out her commitment to make the health and social care system faster, simpler and fairer for patients.

The Secretary of State has paid tribute to NHS, social care and research staff for their hard work in a week the government delivered 50,000 additional nurses, delivered 50 million more GP appointments – both manifesto commitments – and rolled out lifesaving HIV opt-out testing to 46 areas across England.

Her words came days after pharmacies across the country began offering new contraceptive services and additional blood pressure checks, and after a breakthrough in talks to end consultant strikes, which saw the British Medical Association Consultants committee agree to put an offer on contract reform to its members.

Health and Social Care Secretary, Victoria Atkins, said: “Since joining the department, I have been bowled over by the way health and social care staff just keep on delivering for patients. The important milestones we’ve reached this week – reaching 50,000 additional nurses and 50 million more GP appointments – demonstrate real progress. 

“I have spent the past few weeks meeting doctors, nurses, GPs, pharmacists and other health workers and heard wonderful stories about how they have gone above and beyond to deliver outstanding care for patients and cut waiting lists.

“But I have also heard about their frustrations and where they feel they are not able to deliver the best possible care or where prevention or early intervention could have made a real difference. That is why I am committed to making health and social care services faster, simpler and fairer.

“We face a difficult winter ahead. And though our early winter planning is seeing some results we know there is much more to do. But having seen what our excellent staff can do I am confident that with the government’s support we can continue to deliver for patients over the coming months.”

The Health and Social Care Secretary has committed to making health and social care services:

  • Faster for patients, by making it easier to get treatment locally, improving A&E performance and cutting waiting lists
  • Simpler for patients, with joined up, integrated care, and simpler for staff, by reducing bureaucracy and giving them the latest technology to free up their time to care for patients
  • Fairer, ensuring children are protected from health harms, that health outcomes are not determined by where you live, that government supports older people to maintain their independence for longer, and that government delivers a more productive NHS that is fairer for taxpayers.

She added that she would continue to work with the NHS to manage the ongoing winter pressures. The government prepared for winter earlier than ever before and data released by the NHS on Thursday shows the government is making good progress.

Compared to the same time last year, ambulance handover delays have fallen by 28%, thousands more 111 calls are being answered within 60 seconds, and there were nearly 1,500 more hospital beds available.

The Secretary of State said: “We face a difficult winter ahead. And though our early winter planning is seeing some results we know there is much more to do.

“But having seen what our excellent staff can do I am confident that with the government’s support we can continue to deliver for patients over the coming months.”

The Health and Social Care Secretary was appointed on 13 November. She has now set out her priorities in a week in which the government and NHS hit a number of major delivery milestones:

  • NHS England data published on Thursday showed there were 51,245 additional nurses in September 2023 compared to 2019 – hitting the government’s manifesto commitment to recruit an additional 50,000 nurses six months early.
  • NHS England data also showed that for the year to October 2023, there were 51 million additional general practice appointments delivered when compared to October 2019, meeting another manifesto commitment.
  • On Monday the government announced that it had put forward an offer that will modernise the consultant contract and reform consultants’ pay structure, paving the way to end consultant strikes. The British Medical Association and Hospital Consultants and Specialists Association will put the deal to their memberships in the coming weeks. 
  • On Wednesday the Secretary of State announced funding for a research project to evaluate the rollout of the hugely successful HIV opt-out testing programme to 46 new sites across England.
  • On Friday 1 December pharmacies across England began offering the new contraceptive services announced recently as part of Pharmacy First. This is part of the NHS and government’s Primary Care Recovery Plan, announced by the head of the NHS and the Prime Minister in May, which committed to making it quicker and easier for millions of people to access healthcare on their high street.

RCEM Scotland calls for urgent increase in bed numbers amid warning of ‘devastating winter’

Latest data show that more than 4,000 patients faced 12-hour delays in Scottish A&Es as RCEM calls on the Scottish government to increase bed numbers and avoid ‘devastating winter’.

Monthly A&E performance figures for Scotland for September 2023 published by the Scottish government show:

  • In September 2023, there were 113,864 attendances at major A&Es in Scotland.
  • 66.50 % of patients were seen within four-hours at major A&Es (Type 1 EDs)
    • 38,114 (33.5%) patients waited over four-hours in major Emergency Departments, this is a 1.7% increase from the previous month and a 2.3% decrease from September 2022.
    • This is a decrease of 1.4 percentage points from the previous month.
    • The number waiting more than four-hours has increased by 145.5% compared with September 2019 (15,526).
  • 11,788 (10.4%) patients waited eight-hours or more in an Emergency Department
    • This is an increase of 1.1 percentage points from the previous month, and a 1.5 percentage point decrease compared with September 2022.
    • The number waiting more than eight-hours has increased by more than eight times (701%) compared with September 2019 (1471).
  • 4263 (3.7%) patients waited more than 12-hours before being seen, admitted, discharged, or transferred.
    • This figure has increased by 0.4 percentage points from the previous month. And has decreased by 1 percentage point compared with September 2022.
    • The number waiting more than 12-hours has increased by 14 times (1307%) compared with 2019 (303).
  • There were 1,811 beds occupied due to delayed discharges, the second most for any September on record.

Commenting on these data, RCEM Scotland Vice President, Dr John-Paul Loughrey said: “As we head into winter, we expect many people to attend A&Es with a multitude of conditions and illnesses, and many of them will require admission to hospital for further care.

“It is vital that with this clear expectation comes the necessary winter planning to resource A&Es, and support both clinicians and their patients through the colder months.

“We are concerned that the Scottish government’s winter plan fell short of delivering what is needed ahead of what will likely be a difficult period for emergency care.

“We desperately need to see an increase in bed numbers. This will help to reduce the dangerously high levels of bed occupancy, reduce long and dangerous delays in A&Es, and help to ensure patients are admitted to a bed more promptly.

“We continue to engage with the Cabinet Secretary and his team in good faith and raise the concerns of our members.

“To avoid what could be a devastating winter, we again urge the Scottish government to heed our calls to adopt our priorities to #ResuscitateEmergencyCare.”

The data come as figures obtained through Freedom of Information requests revealed that nearly 4,000 people faced 24 hour waits in Scotland A&Es in the six months up to June this year.

As Dr Loughrey said: “24 hours in A&E belongs on TV, not in daily reality for patients and staff”.

British Psychological Society: Access to mental health and wellbeing support for NHS and social care staff has become a national lottery

Access to staff mental health and wellbeing services has become a postcode lottery for NHS and social care workers, after funding was cut for the NHS Staff Mental Health and Wellbeing Hubs in March this year.

This World Mental Health Day, the British Psychological Society (BPS) is calling for all NHS and social care staff to have equal access to dedicated evidence-based mental health and wellbeing support at work, wherever they live in the country. 

With 17 hubs already closed or closing across England*, struggling staff in those areas are unable to access the dedicated support that’s still provided in localities that have retained a hub.

And, despite a limited injection of short term funding from NHS England to provide one hub per NHS region, which would offer a drastically reduced service for vast catchment areas, this arrangement is yet to be operational.

Some hubs report not having received this vital funding.

With less than six months of this financial year remaining, time is running out for staff who need to access help now. Yet, the need for dedicated mental health support for health and care staff could not be more stark.

The latest NHS statistics show anxiety, stress, depression, or other psychiatric illnesses was the most reported reason for sickness absence in May 2023, accounting for over 502,570 full time equivalent days lost and 26.4 per cent of all sickness absence.

Last year, more than 6 million full time equivalent days were lost in the NHS for mental health reasons. 

The BPS’s own research found mental health, stress, and work-related stress was behind nearly one-third(30 per cent or 500,021 FTE days)* of social care staff sickness absence in 114 councils in England last year.

With the NHS Workforce Plan placing responsibility for investment in staff mental health and wellbeing provision with integrated care systems from April 2024, local health and care leaders will make crucial decisions about their staff mental health and wellbeing services, including the hubs, in the next few months.

To date, just one integrated care board has confirmed continued long term funding for its dedicated staff mental health and wellbeing service, and 41 boards are yet to make a decision about the future of their provision from April 2024.

The BPS is urging health and care leaders to make funding for staff mental health and wellbeing support a key long-term priority in their budgets.

Dr Roman Raczka, BPS President-Elect and chair of the Division of Clinical Psychology, said: “NHS and social care staff have the right to be cared for by their employer, as they care for us.

“If and when they need help with their mental health, they have a right to parity of access to the same support services as their colleagues in a neighbouring area.

“The NHS and local authorities have a duty of care to their employees, and it simply isn’t good enough that where you live and work should have a bearing on the level of mental health support on offer if you’re struggling.”

This year’s theme for World Mental Health Day is ‘Mental health is a universal human right’.

Government and NHS to help tackle killer heart condition

Health and Social Care Secretary Steve Barclay has announced measures to tackle aortic dissection, a heart condition that kills 2,000 people every year

  • Aortic dissection takes the lives of 2,000 people a year in Britain
  • Government and NHS England to look at ways to tackle condition
  • Health Secretary pledges to build on strong work already being done

Secretary of State for Health and Social Care, Steve Barclay, has unveiled measures to tackle aortic dissection, a life-threatening heart condition that kills 2,000 people every year.

Speaking at a research event to mark Aortic Dissection Awareness Day, the Health Secretary announced the formation of an NHS working group that will bring together clinical experts and charities, to improve diagnosis and treatment of the condition.

The group will review the whole patient experience when it comes to aortic dissections, and pinpoint opportunities for future improvement, including the potential benefits of genetic testing.

Secretary of State for Health and Social Care, Steve Barclay said: “Aortic dissection can be a devastating condition and every year it takes the lives of more people than die on our roads, yet awareness is low. Changing that will save lives.

“Developing a holistic approach, from identifying those potentially at risk to providing first class follow-up care, will be life-changing for patients and I’m delighted to be able to build on the good work we’re already doing in this area.

“I also want to pay tribute to the tireless work of my colleague Pauline Latham whose campaigning to improve aortic dissection care has kept this issue on the agenda.”

The Health Secretary has asked for the working group to report back with options within six months, and aortic dissection charities will input into the work.

Pauline Latham MP, who tragically lost her son to an undiagnosed aortic dissection in 2018, has been a leading voice in campaigning to improve the lives of sufferers and their families, and met with the Secretary of State earlier this year to discuss ways to improve aortic dissection care.

Pauline Latham MP said: “In the wake of losing my son Ben to a missed diagnosis of aortic dissection, I couldn’t sit back and let other families suffer the way we have. That’s why Graham Cooper, Catherine Fowler and I started The Aortic Dissection Charitable Trust.

“We’ve been pushing hard – asking tough questions in Parliament, meeting with health ministers, and I’m thrilled to say, we have NHS England and the Department for Health and Social Care on board.

“This will bring in standardised care, genetic screening, and specialised nurses to not only save lives but improve quality of life for everyone affected by this condition. It’s our heartfelt mission to turn tragedy into a safer future for all.”

The announcement builds on the progress made on aortic dissection in recent years. NHS England adjusted 111 and 999’s triage systems to better recognise chest pains caused by aortic dissections and is rolling out the Aortic Dissection Acute Toolkit across the regions to speed up diagnosis and improve patient outcomes, while The Royal College of Emergency Medicine has also published a best-practice guide to improve diagnosis in emergency departments.

The Department of Health and Social Care is also funding dedicated research into aortic dissection through the National Institute for Health and Care Research, as part of an annual £50 million investment in cardiovascular disease research.

Researchers are developing a tool to help people at genetic risk of aortic dissection decide if they want screening and, if necessary, preventative treatment and this is just one of the many exciting research projects under way across the country.

The remit of the working group will be to:

  • continue to monitor and support the implementation of the acute Aortic Dissection toolkit which has already been produced by NHS England and is currently being rolled out to NHS providers
  • review the whole aortic dissection patient pathway and identify areas for improvement including the elective pathway
  • explore the evidence and options for genetic screening including potential cohorts for screening
  • scope the clinical skills and workforce requirements to support aortic dissection pathway improvement