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Take a look at a selection of our recent media coverage:

Latest junior doctor strike action begins as the NHS faces ‘most difficult start to year’

3rd January 2024

Junior doctors will strike for six days this week, marking the longest consecutive strike action taken in NHS history.

As a result, NHS England has warned it could be ‘one of the most difficult starts to the year‘ the health service has ever experienced with this latest strike action exacerbating pressures caused by seasonal illnesses and staff absence. 

Health leaders have also said trusts will be ‘skating on the thinnest of ice’ and that patient safety will be put at serious risk.

The strike began at 7am on Wednesday 3 January and will end at 7am on Tuesday 9 January – a total of 144 hours of uninterrupted stoppages.

The NHS Confederation highlighted that this will lead to thin rotas and local services being placed in highly vulnerable positions.

Rising levels of flu, norovirus and Covid-19 in hospitals combined with higher staff absences due to Covid will also heighten the risk, it said.

Hospitals will prioritise urgent and emergency cases as consultants cover striking junior doctors – the most recent period of action resulted in ‘thousands’ of postponed appointments. 

Despite pressures, NHSE has encouraged people to continue using 111 online, GP services, and A&E in emergency situations.

NHS England’s national medical director Professor Sir Stephen Powis said: ‘This January could be one of the most difficult starts to the year the NHS has ever faced.’

Despite ‘extensive preparations’, he warned that NHS staff are starting the new year ‘on the back foot’, and the industrial action ‘will continue to have a serious impact in the weeks after’.

In the week to 24 December 2023, there were an average of 942 patients with flu in hospital each day, including 48 in critical care. That is almost six times higher than the 160 patients the previous month and over double the 402 from the week before.

An average of 452 patients were in hospital with norovirus each day, which is 61% higher than the 281 patients the same week in 2022.

There were also 3,620 patients with Covid in hospital on 24 Dec, up 59% from 2,275 the month before.

Strike recall for major incidents

Junior doctors voted for these strike dates at the start of December, along with three strike days in the run up to Christmas, after rejecting the Government’s pay offer – this followed five weeks of ‘intense negotiations’.

BMA junior doctors committee co-chairs Dr Robert Laurenson and Dr Vivek Trivedi said: ’We spent the holiday period hoping we would get the “final offer“ that the health secretary had promised us last year.

’Sadly, we have received no such offer despite repeatedly saying we would meet for talks any time over Christmas. We will continue to offer to meet throughout these coming strikes. All we need is a credible offer we can put to members and we can call off these strikes.’

The British Medical Association (BMA) and the Government were unable to agree to national derogations for the January strikes, but there is an agreement in place whereby junior doctors can be recalled for major incidents and extreme circumstances.

The Confederation said NHS leaders are calling on the BMA to respond to requests for junior doctors to be recalled and for the judgement of senior managers to be trusted when they say they need urgent cover.

Matthew Taylor, chief executive of the NHS Confederation said: ‘Many NHS trusts will have thin rotas and will be in a highly vulnerable position as they enter what is widely regarded as the busiest week of the year for local NHS services. Parts of the NHS will be skating on very thin ice, and they will need the BMA to back any recall requests for junior doctors when services find themselves under extreme pressure.’

He added: ‘To face almost 150 hours of continuous stoppages is a serious and unprecedented risk – and one that NHS leaders and their staff have never experienced before. The good news is that the NHS has again prepared extensively and has had to become adept at planning for strikes.

‘While they will again do all they can to mitigate the risks, especially for patients needing emergency care, they have again been left with no choice but to schedule in less activity in anticipation of the strikes. That means more delays for patients who have faced lengthy waits for routine treatment.’

In October, NHS England formally warned the BMA about the ‘cumulative’ impact of the doctor strikes which were causing ‘significant disruption and risk to patients’.

In November, the BMA and Hospital Consultants and Specialists Association (HCSA) reached an agreement in principle on a pay offer of 4.95% that could bring an end to consultant strike action.

A recent Health Foundation report found that the NHS waiting list will reach a high of eight million in the summer of 2024 if current trends continue, regardless of strike action.

Earlier norovirus outbreak adding to winter pressures on hospitals, NHS England warns

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.

NHS leaders may be forced to cut services without extra funding, NHS Confederation warns

26th October 2023

NHS leaders in England will be forced to choose which services must be cut unless the Government provides extra funding to cover the rising cost of industrial action, among other cost pressures, the NHS Confederation has said.

Strike action in England is estimated to have cost the NHS £1.4bn, compounding financial pressure brought by rising drug prices and continuing healthcare costs.

Both consultants and junior doctors took part in joint strike action last month for the first time in history.

With further strikes this winter set to push the cost higher, health leaders are already considering which services must be cut, operating under the expectation that they will need to reduce costs further, the NHS Confederation warned.

This would include restricting the number of extra beds they open this winter to manage expected higher demand, putting the NHS’ winter plan to introduce 5,000 more beds at risk of failure.

Leaders have also warned that progress on waiting lists may stall, anticipating that the NHS will miss Prime Minister Rishi Sunak’s pledge to reduce the size of the waiting list by March 2024.

That waiting list stood at 7.2 million when the pledge was made in January this year, but has grown by around 100,000 a month to 7.75 million.

Last week, it was reported that the Government has agreed to meet with the BMA Consultants Committee in the hope to find a resolution to the current pay dispute.

NHS Confederation chief executive Matthew Taylor said that both health leaders and health secretary Steve Barclay know the Government must ‘make an urgent decision on whether to cover the unplanned costs of strike action’ and other higher costs.

He added: ‘NHS leaders tell me that they are already having to take difficult choices every day on which services to cut back as they are not expecting any extra money to make up for the shortfall caused by the strikes, higher drug prices and pay costs being higher than the funding allocated at the start of the year. This will make an already difficult winter even harder to get through and we need the Government to face up to this risk.’

Responding to the Confederation’s statement, BMA council chair Professor Phil Banfield said that striking workers ‘are not to blame for the current financial crisis’ in the NHS, adding that it has been ‘years in the making’.

He said: ‘This is not about short-term solutions, but about long-term investment. Credible pay offers to bring about an end to disputes with doctors will help to ensure a more sustainable medical workforce.

‘It is crucial that the NHS has enough funding this winter and beyond so that instead of facing an “impossible choice“ about what care it can deliver, NHS leaders can feel confident about delivering the PM’s promise to the people about the future of our health service.’

A version of this story was originally published by our sister publication Healthcare Leader.

NHS England bosses join calls for Government to resume strike talks as winter pressures loom

5th October 2023

‘Serious discussions’ must resume between the Government and doctors to end strike action ahead of winter, NHS England bosses said today.

At this afternoon’s board meeting, NHS England chair Richard Meddings stressed that winter pressures ‘impossible to manage’ if also impacted by strike action.

And chief executive Amanda Pritchard noted talks between the Government and doctors needed to urgently resume.

Following months of strike action, consultants and junior doctors have jointly been striking for three full days this week, with ‘Christmas Day’-level cover.

Mr Meddings told the board that it is ‘simply not sustainable to continue to operate with this amount of disruption’.

He said: ‘There’s simply not enough staff on “Christmas Day cover” days to complete the usual tasks while also dealing with business-as-usual levels of demand.

‘It would be impossible to manage this coming into the winter period. But we will continue of course to do all we can to keep caring for patients, putting them first but we urgently need to see a clear path to resolution and for all parties to work together to do the right thing by patients and to find an agreement to this dispute.’

Ms Pritchard said that the focus of NHS England’s discussions with both unions and Government regarding the strike action continues to be patient safety.

She added: ‘We all want to see serious discussions resume between unions and Government and with winter approaching that cannot happen soon enough.’

The Department of Health and Social Care declined to comment and instead pointed towards a previous statement.

This saw health secretary Steve Barclay urging unions ‘to end their relentless strike action’ and argued that doctors ‘have received a fair and reasonable pay rise – as recommended by the independent pay review body, which we’ve accepted in full’. 

The BMA has repeatedly asked the Government to return to the negotiating table, with consultants saying this week that they are willing to involve reconciliation service ACAS and revive strike action discussions.

Yesterday NHS England told the British Medical Association (BMA) in a formal warning letter that ‘cumulative’ impact of doctor strikes are now causing ‘significant disruption and risk to patients’.

However the BMA argued that patient safety is being put at risk due to strike planning failures by NHS England.

BMA council chair Professor Phil Banfield said that the union has always been open to discussing ways to maintain patient safety.

BMA Cymru Wales has announced it will ballot junior doctors in Wales for strike action for six weeks from the 6 November. If successful, it will lead to a 72-hour full walk-out by participating junior doctors in Wales.

This comes following ’the Welsh Government’s failure to make any effort to restore junior doctors’ pay, which has left BMA Cymru Wales with no choice but to enter a trade dispute and ballot for strike action’, it said.

A version of this story was originally published by our sister publication Pulse.

‘Care traffic control centres’ among measures to speed up hospital discharge in England this winter

28th July 2023

NHS England has announced plans to help speed up patients’ discharge this winter, including additional ambulance hours, extra beds and new ‘care traffic control centres’, to ‘boost capacity and resilience’ across the NHS.

A nationwide rollout of ‘care traffic control centres’ will provide ‘one stop’ for staff to locate and co-ordinate the best and quickest discharge options for patients, according to NHS England.

The centres are expected to bring together teams from across NHS, social care, housing and voluntary services in one place to help ‘make live decisions and offer patients everything they need in one place’.

Around a quarter of local areas currently offer this service 12 hours a day, seven days a week, and this is set to expand to every area of the country by winter, NHS England said.

The commissioner expects a third of patients to be discharged using this model by December, drawing information from electronic patient records to track patients and link up with housing services.

Effective discharge systems

Chelsea and Westminster Hospital NHS Foundation Trust has been able to speed up and improve staff rounds and discharge patients more easily using the Timely Care Hub, where staff can track tasks and patient statuses live, and check information like anticipated discharge date and pathways. In future, the Trust will also be able to use the Timely Care Hub to check outstanding risk assessments for things like falls, infection control and pain assessment.

North Tees and Hartlepool NHS Foundation Trust also has a new system which operates in a dedicated control room and tracks patients from admission through their hospital journey, highlighting in real-time any issues that could delay their discharge once they are medically ready to leave. Following a successful pilot, this system is now being rolled out around the country by NHS England.

The NHS will also be announcing a new scheme to encourage local teams to ‘overachieve’ on performance measures with financial incentives provided for these areas.

Winter preparations have been well underway since the publication of the NHS Urgent and Emergency Care Recovery Plan, NHS England said.

Bracing for high levels of respiratory illnesses

The NHS has also outlined how it is bracing for another winter facing the possibility of higher than usual levels of respiratory illness including Covid, flu and respiratory syncytial virus.

The use of Acute Respiratory Hubs, for urgent, same-day face-to-face assessment for conditions like Covid, flu and RSV, will also be expanded to be available in every part of the country.

Australia, whose activity often predicts what the NHS in England is likely to see in winter, is experiencing one of the biggest flu seasons on record with children particularly affected, making up four in five of flu-related hospital admissions, NHS England said.

Hospitals are putting more beds in place for patients and are on track to hit 5,000 additional ‘core’ permanent general and acute beds.

Plans will also be put in place to ‘strengthen ambulance response to mental health calls, to raise the profile of all-age 24/7 urgent mental health helplines’ and to avoid long lengths of stay in mental health inpatient settings.

‘Put the NHS on the front foot‘

Sarah-Jane Marsh, NHS national director of urgent and emergency care, said: ‘Ahead of winter we will not only have more ambulances and beds in place, but we will also be continuing to work more closely as an entire NHS and social care system, increasing the capacity of community services that help keep patients safe at home.

‘We will continue to build on this progress and do everything we can to put the NHS on the front foot ahead of what has the potential to be another challenging winter with covid and flu.’  

Dr Vin Diwakar, NHS medical director for transformation, said: ‘The rapid expansion of ‘care traffic control centres‘, means patients can be more easily discharged with the right support when medically fit to leave hospital with the latest information available to staff in one spot – this is both better for patients and for the NHS.’

A version of this article was originally published by our sister publication Pulse.

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