This website is intended for healthcare professionals only.
Take a look at a selection of our recent media coverage:
10th February 2025
With Great Western Hospitals NHS Foundation Trust recently receiving recognition from NHS England as an exemplar site for sustainability in infection prevention and control, Katherine Price finds out what initiatives they implemented, how clinical staff got involved and how other hospitals and Trusts can take inspiration to achieve their own sustainability goals.
From floods in Spain to wildfires in Los Angeles, healthcare professionals globally are continuing to see the devastating impacts of climate change first hand, and the UK is no exception.
While many individuals are identifying ways to reduce the environmental impact of their clinical practice and driving change, the NHS in England recognised the need for formal, integrated processes to meet its net zero by 2045 target.
Following discussions with NHS England, Great Western Hospitals (GWH) NHS Foundation Trust in Swindon became the pilot site for an exemplar sustainability project. It received around £2,000 towards a four-month programme of initiatives and to create a replicable model, including governance and reporting structures, for sustainability quality improvement.
A clinical sustainability group – chaired by Graham Pike, associate director of nursing and infection prevention and control and clinical sustainability lead – was established in January 2024 to oversee progress. The group included representatives from infection prevention and control (IPC), sustainability, quality improvement, facilities management, pharmacy and procurement.
Following the successful pilot, GWH became the first organisation recognised by NHS England as an exemplar site for sustainability in IPC practices.
As IPC touches all areas of practice, it is ‘crucial to optimise sustainable practice’ in this area, says Rachel McLean, sustainable quality improvement programme lead at the Centre for Sustainable Healthcare.
Many practices in hospitals are driven by fear or risk of infection, and Graham says this includes ‘the products we use, the procedures we do, the way we do them and how we dispose of things’. And while sometimes those risks are real, if the rationale and evidence are lacking, there may be opportunities to identify and adopt more sustainable practices without compromising patient care.
As part of its efforts in the pilot project, GWH implemented a series of 11 initiatives that other hospitals around the UK and beyond can take inspiration from to make strides towards their own sustainability goals, of which three had a particularly big impact.
Many UK hospitals change patient bedsheets daily. Although regular linen changes are important for IPC, evidence supporting the daily changing of unsoiled sheets is lacking. ‘This is a really good example of “we do it this way because we’ve always done it this way”, and how we need to review everything we do – can we do it less, can we do it differently?’ says Graham.
A proposal to move to twice-weekly linen changes – excepting specified circumstances – was approved by the Trust’s infection control group, received positive feedback from the public and now is being trialled.
Reducing glove use was a priority, which saw GWH adopt the Intensive Care Society’s Gloves Off in Critical Care campaign.
‘There’s plenty of evidence out there that the unnecessary use of gloves, as well as being a waste and costing money, increases the risk of infection,’ says Graham. Posters showing when and when not to wear gloves were displayed by patient bedspaces and emails, articles and a webinar on glove use were shared among to team members.
Subsequently, the percentage of staff observed performing a procedure where inappropriate use of gloves risked cross-contamination fell from 63% to 20%. Hand washing observed before glove application improved from 15% to 70% of cases, and hand washing after glove removal increased from 20% to 90%.
Procurement data showed a 22% reduction in glove use over three months that, if sustained, would lead to a £1,382 annual saving for the hospital and prevent 1.6 tonnes of CO2e emissions.
GWH’s emergency department (ED) also set about working towards the Royal College of Emergency Medicine’s GreenED sustainability accreditation. ‘There were challenges on that – how do you release the staff to do the project and how do you fund [it]?’ says Graham. Pilot funding helped pay for the registration fee and staff time – and GWH became one of the first five GreenED accredited sites in the UK, and one of just two to achieve silver.
This scheme specifically encourages reduced cannulation and, after developing and displaying clear cannulation criteria, GWH saw a 29% reduction over three months. Since the pilot, this has continued to a 40% reduction – approximately the same amount of CO2e as nine flights between London and New York.
There can be a perceived conflict between IPC and sustainability, and Graham says existing case studies were a valuable resource to allay anxiety, for example when shifting to use reusable theatre caps.
‘Data demonstrating the potential or actual impact of improvement is important,’ explains Rachel. ‘If you don’t fully understand the problem beforehand and have baseline data, you won’t be able to show you have improved care later. Utilising existing case studies which demonstrate tangible benefits – for example, carbon and cost savings – can build trust that similar initiatives will be successful in another setting.’
She also suggests tailored messaging highlighting the range of benefits, including time savings, and, of course, improvement in patient outcomes.
Generally, it was straightforward to achieve buy-in for the project from colleagues across all departments and seniority, Graham recalls, partly because there is increasing concern about the effects of climate change.
‘There are a lot of staff out there who are worried,’ he says. ‘They see the waste that’s generated by healthcare every day and people are increasingly aware of climate change.’
Graham recommends working with managers to identify team members keen to drive sustainability projects within their departments. Two intensive care nurses at GWH led the Gloves Off project, for example. Already frustrated by glove waste in their unit, the project empowered them to implement and drive change, and Graham says they ‘did a cracking job of engaging the rest of the team’.
Rachel adds that collaboration ensures staff ‘feel ownership over an improvement and that changes are made in a way that best embeds them into the existing workflow and everyday systems’.
Following completion of the pilot at GWH, trials continue, initiatives are being rolled out, more sustainability groups have been established across the hospital. Sights are also set on GreenED gold accreditation.
Every project created a ripple of discussion and action, says Graham, and funding staff time to focus on sustainability identified significant cost savings as well as opportunities to reduce environmental impact, highlighting an important return on investment.
Formalising the relationship between IPC and sustainability also ensured projects progressed more quickly and consistently, resulting in an exemplar site project report that can be adapted to service, resource and patient need.
18th November 2024
Fixing the working relationship with primary care is one the key priorities for secondary care providers, who must not rely on GPs to do so, NHS England’s chief executive has said.
Addressing the NHS Providers conference in Liverpool last week, Amanda Pritchard went as far as listing this as one of five key priorities for secondary care managers.
The other priorities were living within their financial means and making resources go as far as possible; embedding continuous improvement into strategies; maintaining quality and safety; and making the most of opportunities flowing from ability to act as ‘one NHS‘, such as the Federated Data Platform.
According to Ms Pritchard, realisation of the Government’s ‘neighbourhood health service’ plan will rely on improving the interface between primary and secondary care. Speaking to a room full of NHS managers, she noted that ‘frustrations can run both ways’ but warned that ‘relying on GPs to solve it won’t work and it’s not fair’.
Ms Pritchard said: ‘We have to make this work better for all parties, because it’s patients who suffer when it doesn’t. So we’re working on this centrally; looking particularly at streamlining referrals. But it’s about much more than that.
‘Patients unable to get information from hospitals, pushing them to GPs. Clinics asking GPs to refer to other clinics, to chase test results ordered by the clinic.’
She called on all providers to ‘commit to this now’ and said this is ‘particularly important as a first step to make integrated neighbourhood teams and neighbourhood services work’, as they rely on ‘well-functioning’ relationships.
Speaking at the same conference, health secretary Wes Streeting said realising the new neighbourhood health service should be the key focus of integrated care boards (ICBs) going forward.
His speech focused on a number of reforms focused on provider performance, including trust league tables, but he also said ICBs would be measured on their ability to deliver neighbourhood services.
Suggesting ICBs are unclear on their ‘purpose’, he said: ‘I want ICBs to focus on their job as strategic commissioners and be responsible for one big thing: the development of a new Neighbourhood Health Service.
‘It will focus on building up community and primary care services with the explicit aim of keeping patients healthy and out of hospital, with care closer to home and in the home.’
Those ICBs making the most progress towards this goal should ‘enjoy greater freedom and flexibility’, the health secretary said.
Earlier this year, a survey run by Hospital Healthcare Europe and its sister titles revealed that the primary-secondary care interface is not effective at ensuring efficient continuity of patient care between settings.
In June, NHS England asked integrated care boards (ICBs) to act as ‘referees’ to resolve ‘tension’ between primary and secondary care around workload and referrals.
And in April, hospital Trusts were informed by NHS England of a requirement to have ‘a designated lead for the primary-secondary care interface’ and ICBs were tasked with regularly reviewing this progress.
A version of this article was originally published by our sister publication Pulse.
14th March 2024
Artificial intelligence (AI) software that aims to reduce missed appointments is being rolled out to 10 NHS trusts in England following a ‘successful’ pilot.
The tool predicts likely missed appointments through algorithms and anonymised data and details the reasons why this might be the case using external insights, such as the weather, traffic or jobs.
Appointments can then be rearranged for better times, for example it will give evening or weekend slots to those less able to take time off in the day. It also offers ‘back-up’ bookings to maximise efficiency.
In a six-month pilot of the technology at Mid and South Essex Foundation Trust, there was a 30% drop in non-attendance, with 377 DNAs prevented and an additional 1,910 patients seen.
NHS England said this tool, developed by Deep Medical, has the potential to save £27.5m a year for a trust of 1.2 million people and can help to bring down long waiting lists.
Dr Vin Diwakar, national director for transformation at NHS England, said: ‘Not only can these technologies help to free up doctors’ time to treat more patients and reduce waiting times for planned care, it means a significant amount of money can be invested in frontline care rather than lost to missed appointments.
‘And the work being done across the country through these AI pilots shows that initiatives like this can deliver results in a short period of time, while also supporting patients to take control over their own care and help to better understand and reduce health inequalities.’
Charlotte Williams, chief strategy and improvement officer at Mid and South Essex NHS Foundation Trust, said: ‘Embracing new technologies is something the trust is passionate about, it also supports better access for people who are disabled and for working women, as a working mum I know how sometimes it can be hard to juggle work and childcare as well as managing your own health needs.’
Eight million outpatient appointments were not attended across NHS England in 2022/23, which equates to 6.4%, according to NHS figures. The highest proportion of missed appointments were physiotherapy (11%), cardiology (8.9%) and ophthalmology (8.8%).
A version of this article was originally published by our sister publication Healthcare Leader.
13th March 2024
By some indices, the NHS workforce appears to be recovering from the impact of the Covid-19 pandemic, according to the newly-released NHS Staff Survey 2023, but concerns were raised over issues with sexual harassment identified in a new survey question.
Across England, over half of the 700,000 surveyed staff (55.17%) reported that they now look forward to going to work – the best result since 2020.
Some 69.02% reported being enthusiastic about their job, which was, again, the best result since 2020 but remains around six percentage points lower than in 2019. Enthusiasm amongst medical and dental staff increased following four consecutive years of decline on this measure, the results showed.
When it came to the issue of wellbeing, staff reported experiencing less pressure at work than before, with the work pressure sub-score having improved in 2023 after a sharp decline between 2020 and 2021 and little change in 2022.
A total of 46.71% said they were able to meet all the conflicting demands on their time at work, however this remained lower for medical and dental staff (34.44%) than for many other staff groups and over 12 percentage points lower than the average.
Professor Em Wilkinson-Brice, director for staff experience and leadership development at NHS England said: ‘It is really encouraging that the experience of NHS staff at work improved over the past year, even as they faced near record levels of pressure including the busiest summer recorded in A&E, as well as managing the disruption of industrial action.‘
And Dr Navina Evans, chief workforce, training and education officer at NHS England, said: ‘While there is still more to do, it is good news that less than 12 months on from the publication of the NHS Long Term Workforce Plan staff are happier at work than last year thanks to initiatives such as flexible working hours, clinical support squads to help menopausal women at work, and human resources stay advocates.‘
However, Dr Emma Runswick, deputy chair of the British Medical Association council, noted that ‘while there have been some small positive changes made in certain aspects from staff shortages to time pressures, it’s imperative to differentiate between “improvements” and what is deemed as satisfactory or acceptable’.
The NHS Staff Survey arrives at a time of ongoing workforce shortages, mounting pressures and widespread dissatisfaction with pay.
While satisfaction with pay recovered to levels similar to 2021 across a number of staff groups, the survey found only 32.05% of medical and dental staff were satisfied with their pay. This adds to the persistent decline over the last three years and is 23 percentage points lower than in 2020.
Dr Runswick said: ‘The vast majority of medical and dental staff (68%) are dissatisfied with their pay, all while clearly struggling with unacceptable workloads, unreasonable time pressures, and inadequate resources.
‘The Government must recognise the urgent need for fair pay and systemic improvements to support and prioritise the wellbeing of our invaluable healthcare workforce.’
The survey results also revealed widespread reports of discrimination and sexual harassment by patients and colleagues.
Discrimination hit a record high, with one in 12 staff (8.48%) having reported facing discrimination from patients, service users, their relatives or other members of the public, up from 7.20% in 2019. This rose to 9.07% for people who reported personally experiencing discrimination from managers, team leaders or colleagues, up from 7.68% in 2019.
However, overall, staff were reportedly increasingly likely to feel their organisation respects individual differences such as cultures, working styles, backgrounds and ideas (70.63%). This measure is up two percentage points since 2021.
This was the first time the NHS Staff Survey ran a question on sexual harassment, and the results showed that 8.67% of staff said they had faced sexual harassment from patients, patients’ relatives, or other members of the public within the last year.
In fact, more than 58,000 NHS staff reported experiencing ‘unacceptable’ levels of unwanted sexual behaviour from the public.
The survey also found 3.84% of staff faced unwanted sexual behaviour from staff or colleagues.
Commenting that these figures are very distressing, Dr Evans said: ‘Such conduct should not be tolerated in the NHS. That is why the NHS launched its first ever Sexual Safety charter last year which provides clear commitments to improve reporting on unacceptable behaviour, as well as appointing more than 300 domestic abuse and sexual violence leads who will review and improve trust policies for reporting of sexual harassment.
Medical leaders condemned the survey findings on sexual harassment. Dr Adrian Boyle, president of the Royal College of Emergency Medicine, said: ‘Discrimination or abuse of any kind must not be tolerated – anywhere, ever. Everyone has a responsibility to call it out.
‘Such behaviour is abhorrent and in a clinical setting, utterly disrespectful to our hardworking NHS staff and to patients receiving or waiting for medical attention. Staff are most effective when they feel psychologically safe in a workplace.
‘NHS staff cannot walk away when someone needs help – being harassed or feeling vulnerable should never be considered “part of the job”.’
Professor Vivien Lees, vice president of the Royal College of Surgeons of England (RCS England) and lead on sexual misconduct, said: ‘Gathering this data is an important step as it gives us a better picture of the scale of the problem.
‘It is essential that staff members feel empowered to report instances of misconduct without fear of reprisal or negative impact on their career progression. They also need to feel confident that reports will be believed.’
She added: ‘RCS England is committed to a zero-tolerance approach to sexual misconduct, and we will actively work to eradicate this behaviour in surgery and healthcare.’
Coinciding with the publication of the NHS Staff Survey, the Royal College of Physicians and Surgeons of Glasgow launched its 10-point action plan aimed at tackling sexual misconduct in healthcare.
5th February 2024
Both the global cancer burden and inequity in cancer and palliative care services are growing across the world, according to new figures released by the World Health Organization (WHO).
Published to coincide with World Cancer Day (4 February 2024), the survey undertaken by the WHO’s cancer agency, the International Agency for Research on Cancer (IARC), shows a growing need for more cancer-related health services worldwide.
Over 35 million new cancer cases are predicted in 2050, a 77% increase from the estimated 20 million cases in 2022, the IARC said.
This ’rapidly growing global cancer burden’ reflects population ageing and growth, as well as changes to people’s exposure to risk factors such as tobacco, alcohol, obesity and air pollution, it added.
The figures show that 10 types of cancer collectively comprise around two-thirds of new cases and deaths globally. Lung cancer is the most commonly occurring cancer worldwide, followed by female breast cancer and colorectal cancer.
In 2022, there were an estimated 20 million new cancer cases and 9.7 million deaths, with lung cancer accounting for 2.5 million or 12.4% of the total new cases.
Female breast cancer ranked second with 11.6% of new cases, followed by colorectal cancer, which accounted for 9.6% of new cases. Prostate cancer and stomach cancers were the next two most common, respectively.
Lung cancer was also the leading cause of cancer death, accounting for nearly a fifth of the total cancer deaths, followed by colorectal cancer 9.3% of deaths and liver cancer 7.8% of deaths.
Differences were seen between sexes, with breast cancer being the most commonly diagnosed cancer and leading cause of cancer death amongst women, whereas it was lung cancer for men.
Prostate and colorectal cancers were found to be the second and third most commonly occurring cancers for men, with liver and colorectal cancers second and third most common causes of cancer death.
For women, lung and colorectal cancer were second and third for both the number of new cases and of deaths.
Lung cancer’s re-emergence as the most common cancer is likely related to persistent tobacco use in Asia, the IARC said.
The figures also show that a majority of countries do not adequately finance priority cancer and palliative care services.
Only 39% of participating countries covered the basics of cancer management as part of their funded core health services for all citizens, and only 28% of participating countries additionally covered care for people who require palliative care.
In areas where patients are underserved in relation to cancer treatments, rates of cancer are higher, highlighting a growing inequity in cancer services worldwide.
Dr Panagiota Mitrou, director of research, policy and innovation at the World Cancer Research Fund, stated that the UK Government needs to prioritise cancer care in light of the increasing number of global cases.
She said: ‘These new estimates show the increased burden that cancer will have in the years to come. UK Governments’ failure to prioritise prevention and address key cancer risk factors like smoking, unhealthy diets, obesity, alcohol and physical inactivity has, in part, widened health inequalities. We know around 40% of cancer cases could be prevented.’
She added: ‘Now is the time to turn the tide by implementing policies that enable people to live healthier lives by reducing their exposure to risk factors and prioritising a national cancer plan which includes better screening and early detection.’
The WHO figures come as NHS England announces the launch of a national gene testing programme to identify cancer risk for people with the BRCA gene.
The BRCA refers to two genes, BRCA1 and BRCA2, which repair DNA damage and help to protect against cancer. If one of the genes is faulty, this can increase a person’s chance of getting cancer significantly.
People with Jewish ancestry are around six times more likely to carry such genetic faults than the rest of the population and are therefore at increased risk of developing some cancers.
Through genetic testing, the NHS plans to identify people carrying faults in the BRCA gene to ensure those affected have access to early surveillance and prevention services.
People with at least one Jewish grandparent can register for a saliva test kit, and following the success of the pilot programme, it is expected that the national roll-out will see around 30,000 people tested over the next two years.
Commenting on the programme, Peter Johnson, national clinical director for cancer at NHS England, said: ‘BRCA testing for the people most at risk has the potential to save lives by allowing them to take steps to reduce the chance of cancers developing or making sure that any cancer can be detected as early as possible, with those at increased risk able to take advantage of surveillance and prevention programmes with their health teams.’
A version of this article was originally published by our sister publication Nursing in Practice.
16th January 2024
A new platform allowing recently retired consultants who still hold a license to return to the NHS in a more flexible capacity has been launched by NHS England as part of a range of measures to bring down the elective care backlog.
The NHS Emeritus pilot scheme will run for a year across England and it is expected Emeritus consultants will be able to start carrying out appointments from February 2023.
This will follow a full registration process, which includes pre-employment checks and face-to-face interviews with NHS Professionals.
Once registered, a cloud-based platform will link Emeritus consultants with secondary care providers who upload the activity they would like supported. This could range from outpatient appointments, specialist advice requests and education and training support.
The Emeritus consultants can then express their interest in undertaking the specific work listed, and providers will choose the consultant whose skillset and availability best matches the appointments they need covered.
Appointments would be scheduled and arranged with patients in the normal way and carried out in-person or remotely, if clinically appropriate.
This means Emeritus consultants could be based anywhere in England and support hospitals in areas with workforces shortages in a particular specialty or a higher demand for services, or more remote areas where travel is difficult for patients.
The platform aims to provide trusts with an alternative to using agency staff, while allowing experienced specialists who are nearing retirement but want to keep working in the NHS longer, or recently-retired consultants who want to re-join, with an easy route back in with more flexibility.
Stella Vig, NHS national clinical director for elective care, said: ‘The NHS prides itself on its hard-working and committed staff, and it is often the most experienced and knowledgeable clinicians who are lost to the NHS once they retire, even though they still have a lot more they can give to benefit patients.
‘Many have said they want to be able to keep giving back to the health service once they have retired, but in a more flexible way – through the NHS Emeritus initiative, we can provide an opportunity for consultants to continue to work in the NHS in a way that fits in with their life and schedule, and ensures the NHS can still benefit from their skills and knowledge, whether that be through providing training and education, or continuing to see patients and help add much-needed capacity as we work toward our aims of bringing down the longest waits for elective care.’
Consultant urologist Simon Williams is currently employed by University Hospitals of Derby and Burton, and going through the final stages of the registration process for the Emeritus scheme ahead of retiring soon.
He said: ‘Having spent 32 years working in the NHS I have built up a wealth of experience and skills. NHS Emeritus is a great way to continue to share that and still see patients, but in a more flexible way.
‘The programme will enable me to help trusts across the country using remote consultations, not just those in my local area, which could really help free up capacity for their consultants to see more patients in-person and help bring down some of the longer waits for routine appointments.’
Dr Sarah Clarke, president of the Royal College of Physicians, said: ‘At a time when the NHS is facing unprecedented demands, paving a way for our recently retired experienced doctors to be able to contribute their skills again as emeritus consultants is a very welcome step forward.
‘As outlined in RCP’s Later Careers Guidance, we know that more than a third of physicians who are not yet retired say they want to retire early, but almost 60% of physicians would delay retirement if they could work flexibly or reduce their hours, highlighting that integrated flexible working would greatly improve retention.
‘We will closely follow the Emeritus pilot and very much hope that it offers a flexible opportunity for experienced physicians to once again provide vital care for their patients while importantly reducing waiting lists.’
If the pilot is successful, the scheme has the potential to be expended to cover other work areas, the NHS said.
Ms Vig added: ‘It’s a simple concept, but one that we hope will benefit everyone taking part – and we envisage that this is just the beginning, with the potential to broaden NHS Emeritus out to a wider cohort and to include different types of work in the future, which could benefit thousands of patients across the country.’
The new tool is one initiative being rolled out to help deliver the NHS Elective Recovery Plan and to cut the longest waits for routine care.
Recent research has suggested that the NHS must treat 10% more non-urgent hospital cases a month to reverse the increasing waiting list for elective care.
NHS trusts and integrated care boards must work to reduce elective long-waits and meet cancer 62-day backlog targets following this month’s strike action, NHS England has said.
In a letter addressed to chief executives and directors, NHS England outlined its expectations following the disruption caused by the junior doctors’ strike held in January.
It said that trusts will likely face a combination of pressures including seasonal Covid and flu presentations, cold weather-related presentations, staff sickness and the need to reschedule patients’ cancelled appointments.
NHS England urged trusts to ‘continue to prioritise the safety of patients’, including urgent planned surgery and other treatment for time-sensitive conditions, particularly fast progressing cancers.
It said the priorities from January to March remain for:
The latest round of junior doctor strikes lasted for 144 hours from 7am on 3 January to 7am on 9 January as part of their ongoing salary dispute.
NHS data showed that more than 113,700 inpatient and outpatient appointments due to be held during the strike had to be rescheduled.
Since strikes began, the cumulative total of acute inpatient and outpatient appointments rescheduled is now 1,333,221, according to NHS England.
As these latest NHS priorities were shared, a new study suggested that the NHS must treat 10% more non-urgent hospital cases a month to reverse the increasing waiting list for elective care.
Even if system capacity were to increase by 30% – as NHS England’s target sets out – it would still take ‘several years’ to clear the backlog, researchers from Universities of Edinburgh and Strathclyde said.
Published in The Lancet, the research paper estimated there were 10.2 million fewer referrals made to elective care between the beginning of the Covid-19 pandemic and October 2022.
It also highlighted that the NHS waiting list for elective treatment increased between January 2012 and 2020 suggesting ‘a gradual service decline’ even before the pandemic.
The researchers concluded that even if the 30% increase in capacity is achieved during the next three years, ‘several years (beyond the end of 2025) will be needed for the backlog to clear.’
They added: ’Our study emphasises the need to improve healthcare system resilience to ensure that the effects of any future emergencies on the provision of routine care are minimised.’
The most recent NHS England data revealed that the Covid-19 backlog has fallen for two months in a row, dropping by 95,000 individual pathways from 7.7 million in October to 7.6 million in November.
NHS England said this was due to NHS staff delivering more than 1.63 million treatments in November – the highest monthly activity on record and around 150,000 more than the same month before the pandemic.
1st December 2023
The number of patients in hospital with norovirus is triple that of this time last year and is adding to mounting winter pressures, NHS England figures show.
Surveillance data also shows so far in the 2023/24 season, the cumulative number of norovirus cases is 9% higher than the five-year average.
The increased rate is mostly accounted for by unusually high activity earlier in the season, according to a report from the UK Health Security Agency with data up to 19 November.
The data shows that cases had been increasing over the previous two weeks, but remain within the range of what might be seen for the time of year.
Overall, an average of 351 people were in hospital with diarrhoea and vomiting symptoms every day last week compared to 126 in the same week last year, NHS England said.
There were also 13 children with the virus in hospital each day, compared to an average of just three for the same period in 2022.
Laboratory reports for rotavirus are also showing an increase with cumulative figures for the 2023/24 season 25% higher than the average for the past five years.
The figures suggest that winter pressures may be mounting on the NHS with adult bed occupancy already running at more than 95% and 1,200 more patients admitted than the end of November last year.
And problems with discharging patients from hospital into social and community care settings are continuing to have a ‘considerable impact’ with more than 12,600 adult beds a day occupied by people ready for discharge – one in seven of the total, the NHS said.
NHS England national medical director, Professor Sir Stephen Powis, said: ‘We all know somebody who has had some kind of nasty winter virus in the last few weeks and today’s data shows this is starting to trickle through to hospital admissions, with a much higher volume of norovirus cases compared to last year, and the continued impact of infections like flu and respiratory syncytial virus in children on hospital capacity – all likely to be exacerbated by this week’s cold weather.‘
He added that staff were working hard to prepare for winter and there had been a significant reduction in ambulance handover delays. He also urged people to get their Covid and flu vaccines if they were eligible.
However, he concluded: ‘The demand on hospitals and staff is high, with more than 1,200 extra patients in hospital compared to last year, and we know that is likely to grow considerably before Christmas.’
A version of this story was originally published by our sister publication Pulse.
3rd November 2023
A single, national standardised early warning system for paediatric teams in hospital settings is being rolled out by the NHS in England as a way of ensuring deterioration in a child’s condition is detected and escalated quickly.
Available from today (3 November), the new inpatient Paediatric Early Warning System (PEWS) chart allows paediatricians to measure things like blood pressure, heart rate, oxygen levels and levels of consciousness. The system tracks any changes and has different scores representing the level of concern.
If a parent or carer raises a concern that their child is getting ill or sicker than the score shows, this will immediately escalate the child’s care regardless of other clinical observations.
Unlike the similar universal system currently in place for adults, there are four separate charts for different age ranges, including 0-11 months, one to four years, five to 12 years, and those aged 13 and over.
The ultimate aim of the PEWS is to improve working methods and safety to support better health outcomes.
It is part of the System-wide Paediatric Observations Tracking (SPOT) programme, led by NHS England in collaboration and endorsement from the Royal College of Paediatrics and Child Health (RCPCH) and the Royal College of Nursing (RCN).
The partnership has been developing PEWS for three years, with pilots running across 15 sites demonstrating clear benefits for both patients and staff.
Updates to the system – such as those based on any guidance from Martha’s Rule, which gives families and patients the right to a second medical assessment – will continue to be implemented as required.
Professor Sir Stephen Powis, NHS national medical director, said: ‘We know that nobody can spot the signs of a child getting sicker better than their parents, which is why we have ensured that the concerns of families and carers are right at the heart of this new system with immediate escalation in a child’s care if they raise concerns and plans to incorporate the right to a second opinion as the system develops further.’
The NHS will develop and circulate a leaflet and video content for parents to explain how to communicate concerns to healthcare staff and encourage them to escalate if needed.
Dr Mike Mckean, vice president for policy, at the RCPCH, said: ‘The National PEWS chart is an extremely important new tool that will support all paediatricians and wider child health teams to spot deterioration in children in hospital. Alongside training and resources, it will help teams across the country improve patient safety, efficacy and quality of care.
‘The SPOT programme builds on systems already in place in many trusts and has the many advantages of becoming a national system. I’d strongly encourage all paediatricians to look at the chart and consider what they need to do to smoothly transition towards integration and embedding the National PEWS into their trusts.’
Standardised tools and e-learning for using national PEWS charts in a range of health settings are in development.
In 2023/24 trusts are expected to appoint an education/implementation lead who will begin to support their trust to roll out the national PEWS.
Plans are in place to expand the system to emergency departments as well as mental health, ambulance and community services in due course. It is also hoped that the national PEWS chart will become the standard of care in England, meaning all medical and nursing students will receive instruction on its use during their training.
1st November 2023
Around 400,000 patients who have been waiting the longest for elective treatment will be offered the opportunity to travel to a different hospital to be treated sooner, NHS England has said.
Any patient who has been waiting longer than 40 weeks for treatment and who does not have an appointment within the next eight weeks will be contacted by their hospital.
It comes after analysis by the Health Foundation indicated that the waiting list for elective NHS care will peak at eight million next summer if current trends continue, regardless of whether NHS strike action continues.
Patients contacted by their hospital will be asked to specify how far they are willing to travel, with the NHS then identifying alternative hospitals with capacity.
NHS England said in some cases the request will be uploaded to the NHS’s Digital Mutual Aid System – its hospital matching platform – to see if NHS or independent sector providers elsewhere in the country can provide their care.
Patients will remain on the waiting list for their home hospital until there is confirmation that their full care pathway has been moved to another provider. If no alternative is found within eight weeks they will retain their position on their current waiting list.
The NHS estimated that approximately 400,000 patients – or 5% of the overall waiting list – meet the criteria and will be contacted by their hospital.
This system is made possible, the NHS said, thanks to ‘the hard work of NHS staff‘ as well as innovations such as ‘surgical hubs, community diagnostic centres, and the use of robots and AI to speed up surgery and other treatments‘.
NHS chief executive Amanda Pritchard said: ‘Despite pressure and the huge disruption caused by strikes, NHS staff have made great progress in reducing the longest waits for patients. This new step to offer NHS patients who have been waiting the longest the opportunity to consider travelling for treatment is just another example of how we are introducing new approaches to reduce how long patients wait, while improving the choice and control they have over their own care.
‘Giving this extra option to these patients also demonstrates the clear benefits of a single national health service, with staff able to share capacity right across the country.
‘So, whether a patient’s care moves to the next town or somewhere further away, it is absolutely right that we make the most of available capacity across the country to continue to reduce the backlogs that have inevitably built up due to the pandemic and provide the best possible service for patients.’
Louise Ansari, chief executive of Healthwatch England, welcomed the news but said: ‘We’re now calling on NHS England and integrated care boards to work together to ensure everyone choosing to travel for faster treatment is given support, including with the costs of transport and accommodation – as described in the Elective Recovery Plan. Otherwise, this option risks deepening health inequalities by only providing solutions to people who can afford to contribute towards the additional costs of travel.‘
A version of this story was originally published by our sister publication Healthcare Leader.
IMPORTANT LINKS
MORE FROM COGORA
© Cogora 2025
Cogora Limited. 1 Giltspur Street, London EC1A 9DD
Registered in the United Kingdom. Reg. No. 2147432
