Continuing in the vein of the broad theme of BMJ’s mini-series on the NHS in 2017, BBC News is currently running a short season of news pieces on the State of the NHS (and social care).
Concentrating the Mind or Concentrating the Problem?
One sometimes wonders whether relentless coverage of operational problems and crises may inadvertently act to “talk-up” an otherwise more manageable collection of challenges, perhaps fueling the severity of the issues in question? That said, BBC journalists do strive to play a legitimate, independent and balanced role in this national conversation; any resulting reverse “Hawthorne Effect” is (one hopes) unintentional, and perhaps unavoidable.
A recent Ipsos MORI survey reflects levels of public concern about the NHS. Almost half of the British public consider the state of the NHS to be one of the biggest issues in Britain. A partly news-driven phenomenon?
Concern about the NHS jumps to the highest level since 2003: Ipsos MORI Issues Index: January 2017. London [Online]: Ipsos MORI, February 15th 2017.
The Big Picture
A brief, wide-ranging, analysis of why NHS has been hit by unrelenting pressures despite Government commitments to increasing funding.
Triggle, N. (2017). 10 charts that show why the NHS is in trouble. London: BBC Health News, February 9th 2017.
Health Secretary Jeremy Hunt has conceded that there are some instances of unacceptable standards of care / patient safety within the NHS hospitals, in England, at these difficult times. The solution(s) will involve treating more patients closer to home i.e. in the community, and better care integration.
Triggle, N. (2017). NHS Health Check: Hunt says NHS problems ‘unacceptable’. London: BBC Health News, February 10th 2017.
Pym, H. (2017). Hunt not in the mood to make excuses. London: BBC Health News, February 10th 2017.
Hospital Overcrowding / Inadequate Bed Availability
Ideally, hospitals should have no more than 85% bed occupancy, to minimise the risk of infections and delays in treatment. Patient numbers on hospital wards in England have been at unsafe levels (over 85%) in around 90% of NHS trusts this Winter.
Triggle, N. (2017). NHS Health Check: Nine in 10 hospitals ‘overcrowded’ this winter. London: BBC Health News, February 6th 2017.
The Government’s plans to treat more patients in the community using the Better Care Fund have so far not eased pressure on NHS hospitals or saved money:
Pressure on hospital beds ‘not improved by extra money’. London: BBC Health News, February 8th 2017.
Delays and Waiting Times
Delayed transfers of care worsen still further?
Triggle, N. (2017). NHS Health Check: The 10 ‘longest’ hospital delays exposed. London: BBC Health News, February 8th 2017.
An extreme case…
Webb, J. (2017). NHS care: Iris Sibley’s six-month wait to leave hospital. London: BBC Radio 4’s Today / BBC Health News, February 6th 2017.
Another anecdotal case, from Wales:
Patient waits four years to leave hospital. London: BBC News / BBC Health News, April 24th 2017.
A Scottish example:
Patient ‘waited 508 days’ for hospital discharge. Scotland: BBC Scotland News / BBC Health News, February 5th 2017.
Record numbers of patients waited more than four hours in accident and emergency units in England during January 2017:
Kirkland, F. [and] Roxby, P. (2017). NHS Health Check: A&E waits for January ‘worst ever’. London: BBC Health News, February 9th 2017.
The number of patients waiting longer than 18 weeks for non-emergency operations and treatments has increased by 163% rise since 2012.
Triggle, N. (2017). Hospital operation ‘long waiters’ rise by 163%. London: BBC Health News, February 5th 2017.
BBC News analysis of the general waiting times problem(s) for the NHS:
Pym, H. (2017). Growing waiting times threat to NHS. London: BBC Health News, February 5th 2017.
Doctors from the Royal College of Surgeons, plus other NHS consultants, associated specialists and GPs, have written letters about their concerns over cancelled non-emergency operations etc.:
NHS doctors call on prime minister to increase spending. London: BBC Health News, February 8th 2017.
Surgeons ‘kicking their heels’ as bed shortage delays operations. London: BBC Health News, February 12th 2017.
March 2017 Update on A&E Performance Target / Delays
The 95% accident and emergency target remains essential for patient safety:
Triggle, N. (2017). Hunt demands NHS hits target for A&E care. London: BBC Health News, March 9th 2017.
Steadfast refusal to fudge the issue, despite continuing problems:
Cawley, L. (2017). Four-hour accident and emergency waits rise 300% at some hospitals. London: BBC Health News, March 16th 2017.
Pym, H. (2017). Can the NHS cope better next year? London: BBC Health News, March 10th 2017.
RCEM’s Steps to Rebuilding Emergency Medicine
“The Royal College for Emergency Medicine (RCEM) says there is a large and systemic problem caused by a lack of hospital beds.”.
This relates, in part, to:
Why does winter in A&E get worse every year? London: Royal College of Emergency Medicine (RCEM), 2016.
August 2017 Update
The NHS has prepared for Winter Pressures more this year than ever before; yet it never seems to be enough. Estimates vary as to the likely extent of the problem.
Triggle, N. (2017). The worst is yet to come for the NHS – hospital chiefs. London: BBC Health News, September 3rd 2017.
England, Northern Ireland, Scotland and Wales: Brief Comparisons
All four nations in the UK have experienced essentially common challenges: rising demand, squeezed funding and an ageing population. This piece briefly reviews regional variations and commonalities:
NHS Health Check: Which part of the UK is doing the best? London: BBC Health News, February 5th 2017.
A viewpoint on the NHS of possible interest:
We must help our NHS adapt in order to keep it healthy – Professor Keith Willett. [Online]: NHS England, February 14th 2017.
Gaps in Demand and Supply Regarding Social Care
Familiar reports of shortages in the funding for social care, relative to demand from an ageing population, plus some inequities in who receives and who pays for care.
Reality Check: Who gets social care and who pays for it? London: BBC Health News, February 8th 2017.
The Local Government Association has asserted that adult social care services will continue to face cuts despite plans to raise council taxes by the full 3% this year.
Gallagher, J. (2017). Council tax to rise while services cut, says LGA. London: BBC Health News, February 20th 2017.
The German and UK health and care systems are compared briefly:
Jeffreys, B. (2017). NHS Health Check: How Germany’s healthcare system works. London: BBC Health News, February 9th 2017.
Funding and Unexpected Deaths in Mental Health Trusts
The Health Foundation estimates that mental health trusts in England have had their funding cut by £150 million over the past four years. This is a trend which the government has existing plans to correct.
Freedom of information (FOI) data from a selection of mental health trusts in England, obtained by BBC’s Panorama programme, indicate that the number of unexpected patient deaths (defined as deaths unanticipated and arising from suicide, neglect or misadventure) may have risen by roughly 50% over three years. The Department of Health believes such an apparent “increase” may be due to recent improvements in how such deaths are investigated and recorded, rather than indicating a systemic worsening problem.
Hutchinson, S. (2017). Unexpected mental health deaths up 50% in three years. London: BBC Health News, February 6th 2017.
Assaults on NHS Staff Increasing?
Frustration may be fueling at least some of the estimated 200 assaults on doctors, nurses and other NHS staff which occur in England each day. NHS Protect, the body which advises hospitals on staff safety, is to cease at the end of March 2017.
Pigott, R. (2017). NHS Health Check: ‘Most staff have been attacked’, doctor says. London: BBC Health News, February 10th 2017.
Assorted viewpoints from NHS employees and others:
NHS Health Check: Voices from the NHS frontline. London: BBC Health News, February 7th 2017.
Assorted News Stories With a More Positive Spin (Dutifully Supplied For Balance?)
NHS Health Check: Five examples of innovation in the UK. London: BBC Health News, February 10th 2017.
Price, M. (2017). The health workers that help patients stay at home. London: BBC Radio 4’s Today / BBC Health News, February 8th 2017.
Kirkland, F. (2017). NHS Health Check: How one GP practice tackled waiting times. London: BBC Radio 4’s World At One / BBC Health News, February 7th 2017.
Disrupting the Disruptors (Softly). Humour: the Ultimate Reality Check?
There may be a remedy for the possibly unduly negative recent intensive media coverage. Gentle comedy can sometimes help to defuse the sense of incipient national crisis and debunk over-blown moral panic:
Patterson, J. (2017). And finally… London [Online]: NHSNetworks, February 10th 2017.