Dying patients waiting hours for pain relief in NHS funding shortfall (The Guardian: 14 March 2017)
Dying patients are waiting up to eight hours to receive pain relief because of cuts to district nursing services during the NHS’s unprecedented budget squeeze, a new report has revealed.
Severe financial pressures on the NHS are leading to longer waits for treatment and a short-sighted and growing rationing of care that is storing up problems for the future, according to a study by the King’s Fund health thinktank.
The report quotes one unnamed manager of a hospice saying: “The district nurses working at night are not able to give effective response times; you can wait up to eight hours … for patients experiencing pain and discomfort in the last two to three days of their life, it has a massive impact. It’s a frightening time for patients.”
The King’s Fund research has found that district nursing and sexual health services are among the areas of care most affected by six years of the NHS in England receiving annual budget increases of 1.2%, far less than its historic average of 3.7% rises.
It highlights how the diminishing number of district nurses are struggling to give patients prompt high-quality care because they are increasingly overworked.
The need to balance budgets and the smaller numbers of district nurses are prompting some NHS bodies to restrict their eligibility criteria for patients seeking help, refusing it for those with serious mobility problems unless they are completely housebound.
“We heard some examples of providers attempting to limit access. This was mainly through tightening referral criteria, particularly in relation to patients being ‘housebound’. Increasingly, if patients are able to visit their general practice (even if doing so is challenging), they will not be eligible to receive care from district nurses,” the report states....read more
Thousands attempt suicide while on NHS waiting list for psychological help (The Independent: 16 September 2014)
Thousands of people have attempted suicide while on an NHS waiting list for psychological treatment, according to a comprehensive new study of mental health services in England.
In the latest evidence of a hidden mental health crisis, a coalition of leading charities and medical professionals report that one in 10 patients are waiting for more than a year just to be assessed for treatment, and one in six made an attempt on their life while on a waiting list.
GPs report a “huge rise” in the number of mental health conditions, which has coincided with cuts to mental health services and psychotherapy posts in many parts of the country.
The consequent delays in accessing treatment can be disastrous for patients, the report from the We Need to Talk coalition warns. In a survey of 2,000 patients, one in six said they had attempted suicide while waiting for treatment, four in 10 said they had self-harmed, and two thirds said their condition had deteriorated before they had a chance to see a mental health professional.
The report, which focuses on referrals for treatment under Improving Access to Psychological Therapies (IAPT) programme, also reveals stark variations in the number of patients being referred and treated on time in different parts of England.
IAPT services, which include talking therapies such as cognitive behavioural therapy (CBT) and counselling, which are predominantly for patients suffering with anxiety and depression, provide vital early intervention which are intended to prevent a crisis, such as a suicide attempt, further down the line.
Most NHS areas saw between 1,000 and 3,000 IAPT referrals in the last quarter of 2013/14 – but in some areas there were fewer than 100, suggesting that many patients are not being referred for the help they need. There was also significant variation in the length of time patients had to wait for specialist treatment.Pressure on IAPT services represents just one symptom of a wider crisis in mental health care. Services have been disproportionately cut in many areas as commissioners attempt to balance the books during the longest funding squeeze in NHS history. Since 2012, the equivalent of more than 200 full-time mental health doctor posts have been cut, along with 3,600 nursing posts.
Key cancer waiting time targets missed (The Telegraph: 29 August 2014)
Thousands of women with symptoms of breast cancer are being forced to wait before seeing a specialist after the NHS admitted it is breaching a key target for the first time.
Cancer patients are also having to wait too long before starting treatment as a second target is being breached for the second quarter in a row, statistics have revealed.
Critics say the failure to meet the targets show the NHS is struggling to cope with the growing pressure that rising numbers of cancer patients and better screening is placing on the health service.
Two-thirds of Britons with depression get no treatment (The Guardian: 13 August 2014)
Less than a third of people with common mental health problems get any treatment at all – a situation the nation would not tolerate if they had cancer, according to the incoming president of the Royal College of Psychiatrists.
While the health secretary, Jeremy Hunt, has pledged to deliver "parity of esteem" for mental and physical health services, the treatment gap is now so huge that it may prove impossible to bridge in the current financial climate, said Professor Simon Wessely of King's College London in his first interview since election to the post.
"People are still routinely waiting for – well, we don't really know, but certainly more than 18 weeks, possibly up to two years, for their treatment and that is routine in some parts of the country. Some children aren't getting any treatment at all – literally none. That's what's happening. So although we have the aspiration, the gap is now so big and yet there is no more money," he said.
Welsh ambulance response time target missed in June (BBC News: 30 July 2014)
Welsh ambulances have again missed their target of reaching 65% of life-threatening incidents in eight minutes.
The figure for June was 53%, down from 54.1% in May and 62.6% in June 2013.
The Welsh government said the results were "disappointing" as the health minister wanted month-on-month improvements.
Plaid Cymru said there was "no excuse for this continuing failure" to hit the target while the Welsh Liberal Democrats said it was a "huge concern".
There were 35,570 emergency calls, of which 14,167 were Category A and of these 53% of responses arrived within eight minutes.
Ambulance crews arrived at the scene of Category A calls within 30 minutes in 96.7% of cases.
Welsh Conservatives shadow health minister Darren Millar: "An immediate medical response to a heart attack, stroke or serious accident can make the difference between life and death."
The Welsh government spokeswoman added: "Information we've received from the Welsh Ambulance Service for July to date shows there has been a marked improvement in the eight-minute response time performance and an overall reduction in the number of long handover delays at hospitals."
Call to review waiting times for routine surgery (BBC News: 10 July 2014)
A re-think is needed on the waiting time target for routine operations as 18 weeks is too long for some patients, the new leader of UK surgeons says. Royal College of Surgeons president Clare Marx says the "one size fits all" approach needs reviewing.
The Patients Association has backed the call for a debate, saying it is unfair to apply waiting times rigidly. But health officials say the 18-week target will not be changed and that fewer patients face very long waits.
The target is the period between a patient being referred by their GP and beginning their treatment. In most cases that should be no more than 18 weeks. A similar target is in place in Scotland, while in Wales it is 26 weeks.
But in an exclusive interview with the BBC, Ms Marx says there are people, such as those needing a gallbladder operation, for whom the current waiting times are too long.
NHS facing summer crisis as A&E performance deteriorates, says Labour (The Guardian: 10 June 2014)
An unexpected summer crisis is developing in the NHS, with performance in accident and emergency departments deteriorating, bucking the normal trend of waiting times being worse in winter than summer, according to the Labour party.
The figures show a record number of patients attending hospital A&E departments in any one week and a record number then admitted to hospital wards. The figures show a total of 296,667 going to A&E in the last week of May, again raising questions about the adequacy of GP services. Of these 77,745 were admitted to hospital.
A&E departments are supposed to see, treat, and admit or discharge 95% of patients within four hours of arrival at hospital, but in the last four weeks the number of patients waiting more than four hours has ranged from 22,231 a week to 24,503.
Woman brain damaged after ambulance delay awarded £5m (BBC News: 17 June 2014)
A scientist who was left brain damaged after waiting more than 100 minutes for an ambulance has been awarded a compensation package worth £5m.
Caren Paterson, 36, collapsed at her home in Islington, north London, in 2007, and her boyfriend called 999. But the address was flagged as high risk and the crew waited just 100m away waiting for a police escort.
The London Ambulance Service offered "sincere apologies" to Ms Paterson, who worked as a genetic scientist.
She eventually suffered a cardiac arrest, five minutes before police and an ambulance team arrived. It left Ms Paterson, who worked at King's College London, with chronic amnesia, confusion and disorientation with the result she will never work again and needs 24-hour care for the rest of her life.
Lawyer John Davis, representing the family, said the delay was because the address in Hargrave Road was inexplicably flagged as being on the "high risk" register, and the ambulance crew was told to wait for the police.
There were no officers available at the time and, despite two more 999 calls, the emergency medical team waited.
Derriford Hospital apologises for backlog on CT scans (BBC News: 12 June 2014)
One in six patients currently on the waiting list for a CT scan at a Devon hospital have gone over the required waiting time.
A cancer patient from Plymouth faced a three-month wait for a vital CT scan due to an appointment backlog at Derriford Hospital.
Daniel Pearce had two operations to remove tumours and should have a CT scan every six months.
Plymouth Hospitals NHS Trust apologised for any distress the wait is causing.
Mr Pearce was due to have a scan in June, but due to an increasing backlog he was told he may have to wait until September.
Mr Pearce said: "There isn't an excuse for this...We need to know when I'm going to get that scan and when everyone else is going to get theirs.
NHS patients not treated fast enough, say MSPs (BBC News: 3 June 2014)
Concerns have been raised by MSPs that NHS patients in Scotland are not getting hospital treatment fast enough.
Hugh Henry, convener of Holyrood's audit committee, said the health service was failing to meet the legal 12-week treatment guarantee.
The Labour MSP said the Scottish government must outline how the target would be met.
Health Secretary Alex Neil said the health service was "consistently close" to hitting it 100% of the time.
Mr Henry's comments came following an audit committee assessment of an investigation into NHS performance by the public spending watchdog, Audit Scotland, which called for more support to help the health service meet its targets.
Mr Henry said the cross-party committee recognised that there had been waiting time improvements, and that 100% compliance of the target would be difficult to achieve.
Worries in Scotland as more NHS patients miss 18-week waiting time target (BBC News: 27 May 2014)
Fewer patients are being treated by the NHS within the Scottish government's target of 18 weeks after they've been referred by their GP. For the first time since the system was introduced, the proportion has fallen below 90 per cent. The worst-performing health board is Forth Valley, with only 80.8 per cent of patients starting their treatment within the target period. Across Scotland as a whole, the figure for March is 89.6 per cent. That compares to 90.8 per cent in December 2013.
As well as Forth Valley, the other NHS boards which did not meet the target were Grampian, Lothian and Western Isles.NHS Highland - which recently switched to a new patient management system - submitted an estimated number which will be revised when the next figures are released.
Mr Findlay said the figures showed the NHS was "breaking under pressure" and should be reason enough for Health Secretary Alex Neil to stand down. He added: "Unfortunately for both patients and staff, Alex Neil will never accept responsibility for what is happening under his watch."
NHS admission over chronic pain treatment waiting times (BBC News: 6 May 2014)
A patient has forced NHS Scotland to admit that waiting times for chronic pain treatment are even longer than previously reported.
A report released last week revealed that some patients were waiting up to two years to see a specialist.
After it emerged one patient waited two and a half years to see a psychologist, NHS Forth Valley said there had been an "administrative error" in the report.
The board is investigating the mistake and working to reduce waiting times.
The originally reported mean waiting time to see a psychologist through NHS Forth Valley, 36 weeks, was half that of the actual figure, 78 weeks.
The health board has insisted they sent the correct information to Healthcare Improvement Scotland, but the published error was only brought to light after a complaint from patient Kenny Boyle.
Mr Boyle injured his back playing sports 15 years ago while living in London, and said that when he moved back home to Alloa seven years ago he hoped to receive similar care in Scotland to that in the capital.
However, the 46-year-old found himself on a waiting list for several years, and was thus shocked to read that NHS Forth Valley had listed average waiting times in the Healthcare Improvement Scotland report.
NHS hospitals failing to meet targets on treatment waiting times (The Guardian: 20 March 2014)
Patients are waiting too long for surgery, treatment in A&E and vital diagnostic tests at growing numbers of hospitals, NHS figures show. In all 2.9m people were waiting for treatment in January, up by 362,000 from the 2.538m seen in the same month in 2013, and 326,000 more than the 2.574m who were on the list for treatment when the coalition took over in May 2010. That is the highest total recorded in January since records began in 2007-08 and the first time January's total has been more than December's.
The number of patients in England in January who had not been treated within the 18-week target enshrined in the NHS constitution hit 189,179, some 45,438 higher than the same month in 2013, though fewer than in May 2010. In addition, both mean and median waiting times are now the highest since early 2008.
The TDA said that the ongoing squeeze on NHS budgets meant that "the challenge of maintaining national standards is harder than at any point in recent history", though the sector had performed well in difficult circumstances this winter.
Jamie Reed, the shadow health minister, highlighted the lengthening waiting list for operations as "a worrying sign of what lies ahead for patients as NHS lists reach their longest in years."
Waiting times soar for life-saving tests in Scotland (The Scotsman: 16 March 2014)
The number of NHS patients in Scotland waiting more than a month for potentially life-saving tests has soared dramatically in the past year. Figures reveal the number of patients on the waiting list for vital diagnostic tests that can pick up serious diseases including cancer has soared by 15 per cent in a year, from 41,340 to 47,248. The number waiting more than four weeks has risen from 4,785 to 6,252. There is also huge discrepancy across the country. In some areas nobody is waiting longer than four weeks, whilst thousands are in others.
The figures are the latest waiting times crisis to hit the NHS in a matter of weeks. Last month, it emerged bed blocking by elderly patients waiting for a care home place or assessment had increased by 165 per cent. The figures, released yesterday, revealed more than 11,000 people waiting more than 12 weeks for a new hospital appointment – up from 5,678 at the end of December 2012 and 5,579 at the end of 2011. Waiting times in accident and emergency departments, while better than during last winter’s crisis, are still among the worst recorded with 93.5 per cent of patients dealt with within four hours. Some health boards are still not treating patients within 12 weeks of doctors agreeing a care plan, despite this guarantee being enshrined in law. A total of 1,371 Scots waited more than 12 weeks for hospital treatment.
BBC Documentary finds hospital discharge delays 'cost NHS £100m a year' (Health Service Journal: 17 March 2014)
Delays in discharging patients from hospital while they are waiting for social care to be arranged are costing the NHS in England about £100m each year, a documentary claims. The documentary makers who blame the strains on the NHS for the discharge delays, spent a week filming at the emergency department of University Hospital of North Tees in Stockton, Teesside, where staff also spoke of the pressures of meeting “unachievable” targets to see patients within four hours,.
Panorama calculated the £100m figure for the discharge delay costs using NHS England data from 245 trusts over the past two years. Clifford Mann, president of the College of Emergency Medicine, which represents A&E doctors nationally, said that recruiting and retaining enough emergency staff is a huge problem all over the country. “My real fear if we don’t do something about recruitment and retention in emergency medicine is that you will turn up in an ambulance to an emergency department and there will be no doctors there to see you.”
Ambulances taking longer to reach stroke and heart attack victims (The Guardian: 31 January 2014)
Ambulances are taking longer to reach patients with life-threatening conditions after receiving a 999 call, NHS performance data reveals. In some parts of England ambulances are taking almost two minutes longer than two years ago to get to patients who have suffered a stroke or heart attack or been stabbed, for example. Response times deteriorated in nine of the 11 regional NHS ambulance services between December 2011 and December last year, the latest performance figures published by NHS England show. A spokeswoman for NHS England, which seeks to improve care for patients, said it could not comment on ambulance performance before it took over responsibility for the NHS last April. But she added that performance had improved with seven services, and worsened with only four, since December 2012. However, she added that: "As eight out of 11 ambulance trusts have not met the standard this month there is clearly more work to be done to make sure people get a consistent, high quality service."
NHS hospitals face record levels of 'bed blocking' (The Guardian: 25 January 2014)
Hospitals are facing growing "bed blocking" as they try to deal with an increase in the number of patients needing to be admitted as emergencies this winter. New NHS figures show the total number of bed days lost because of "delayed transfers of care" – usually caused because social care support is not available to allow a fit patient to return home – hit 70,124 last month, the highest December total since the NHS started recording the figures in 2010. Andrew Gwynne, the shadow health minister, said the figures were "truly sad and a direct result of this government's brutal cuts to social care".
Rationing of care as NHS struggles to save £20bn (The Guardian: 5 December 2013)
NHS cuts: Half of mental health patients wait over three months for treatment (Yahoo News: 28 November 2013)
Half a million Londoners on waiting lists for NHS surgery (Evening Standard: 23 September 2013)
More than double the number of NHS trusts failing to meet A&E targets (Independent Sunday: 22 September 2013)
1 in 3 patients face A&E delays under closure plans (The Daily Mail: 3 August 2013)