Record number of urgent operations cancelled in England last year

Hospitals cancelled a record number of urgent operations last year as bed shortages left them struggling to cope with the growing number of patients needing surgery, NHS figures show.

Hospitals in England cancelled a total of 4,093 urgent procedures during 2016, which equates to 341 per month. That was 8% more than the 3,777 they had to put off in 2015 and 27% up on the 3,216 such operations they cancelled during 2014.

While some cancellations occur because of the patient’s health, the large majority are due to hospitals having too few beds, especially in intensive care or high-dependency units in which patients can recover afterwards, often because a more urgent case has arrived. A few involve staff shortages or a surgeon becoming unexpectedly unavailable.

The latest figures mean that in all 17,598 patients have had their urgent operation cancelled over the past five years, often at the last minute, despite their condition requiring surgery without delay.

Opposition parties claimed the figures, published on Friday by NHS England, showed that problems in the health service were deepening and that the government was not giving it sufficient money to keep up with the rising demand for treatment.

“Theresa May’s NHS crisis continues, and the problems are worse and more widespread than in previous years. By underfunding and overstretching the NHS, the Tories have pushed health services to the brink”, said Jonathan Ashworth, Labour’s health spokesman.

Norman Lamb, his counterpart for the Liberal Democrats, added: “The government’s stubborn refusal to give the NHS emergency funding means record numbers of operations are being cancelled as hospitals face weeks on end of intolerable pressure. This will inevitably have serious repercussions for patient care and the morale of NHS staff.”

The NHS England data shows that hospitals also cancelled 38,129 non-urgent elective operations between April and October – again, the largest-ever number for those six months.

Of those patients, 2,204 did not have their rescheduled surgery within 28 days, as the NHS Constitution says they should, in another sign of the huge pressures on the service.

However, NHS England’s latest winter situation reports data showed on Frida that hospitals came under slightly less strain last week than during the “winter crisis” that unfolded in the early weeks of January.

Overall 43 acute hospital trusts were forced to divert A&E patients to another emergency department because they could not cope with the large numbers of people needing care, down from 52 the week before. Similarly, 51 trusts declared some sort of alert during the week, down from 68 a week earlier.

A further Eleven people died from flu last week, bringing the total to 53 since the start of December, and 65 needed to be treated in an intensive care or high-dependency unit.

NHS England and Public Health England said the number of flu cases hospitalswere treating was worrying and linked to the particularly cold weather affecting much of England recently.

Record number of urgent operations cancelled in England last year

Thousands more NHS operations cancelled than figures show, report claims

Tens of thousands more operations were cancelled at the last minute in English hospitals than official figures suggest, an investigation has claimed.

About half of English NHS trusts admitted in response to Freedom of Information requests that they had cancelled nearly 42,000 operations between one and three days before patients were admitted.

It comes after official figures in May showed the number of hospital operations in England cancelled at the last minute because of a lack of staff or beds rose to 74,086, its highest in 15 years. However, that statistic only records cancellations on the day of admission.

The BBC, which carried out the investigation, says the new figures give a picture more in line with official figures published in Scotland, Wales and Northern Ireland, where the definition of last-minute cancellations is wider and is taken over several days.

FoI requests were submitted to all 156 NHS trusts in England, asking them to provide figures for operations cancelled one to three days before patients were due to be admitted. Data from the 74 trusts which replied suggested they cancelled 41,474 operations within the period.

May’s official figures marked the worst record of cancellations for the NHS in England since 2001-02, when 81,743 patients had procedures cancelled on the day they were supposed to happen. Experts warned the data was a sign of the pressures on the health service.

At the time, Clare Marx, president of the Royal College of Surgeons, said pressures on A&E units, staff shortages, and bed shortages due to a lack of social care for discharged patients were contributing to the problem.

An NHS England spokesperson said: “The proportion of patients seeing their operations cancelled at the last minute remains under 1% in spite of record numbers of operations being scheduled.

“Our national data collection rightly requires trusts to focus on monitoring the number of last-minute cancellations, as this is where the most distress is caused for patients.

“Hospitals should continue to ensure that every effort is made to reschedule cancelled operations as soon as possible.”

Thousands more NHS operations cancelled than figures show, report claims

Refugee with growing breast lump has medical transfer from Nauru cancelled

A refugee on Nauru with a growing lump in her breast has had her medical flight for treatment postponed indefinitely but has not been told why.

The 39-year-old Lebanese mother of four has had several scans over the past eight months that indicate the lump is growing, and doctors have requested she undergo a biopsy.

This week, more than a dozen refugees and asylum seekers who were scheduled to be flown to Papua New Guinea for medical treatment say they were told their flight, and their treatment, had been postponed for at least three weeks.

Related: NT royal commission ‘should also include children in immigration detention’

They were not told why their flights had been postponed but it has been reported that uncertainty over the legality of Australia’s offshore detention regime in that country has caused the flights to be abandoned.

The PNG supreme court ruled in April the Manus Island detention centre was “illegal and unconstitutional” and a decision in a second court challenge is imminent, which may further undermine Australia’s offshore regime there.

The woman on Nauru, whom the Guardian has chosen not to name, arrived in Australia in July 2013.

She first noticed a lump in her left breast about three years ago, but has developed increasing breast pain while living on Nauru, and has experienced a yellow-green discharge from her breast.

She underwent her first breast ultrasound on Nauru in late 2015. A subsequent ultrasound found two irregular masses in the woman’s left breast and confirmed at least one is growing.

Dr Paddy McLisky from Doctors 4 Refugees said a biopsy should have been arranged with some urgency at the first available opportunity.

“This is a medical scenario in which a biopsy is necessary to obtain a diagnosis and most importantly to rule out malignancy.”

McLisky said the woman did not have confidence in the Republic of Nauru hospital (RONH) to perform the biopsy safely.

“We are aware of multiple accounts that the RONH facilities are quite basic by Australian standards, and that general hygiene is a concern for refugees and asylum seekers who have attended RONH. The obvious solution is to have … [the refugee] assessed and a biopsy carried out in an appropriately resourced hospital in Australia.”

He said the woman was receiving a level of care “completely unacceptable in rural or metropolitan Australia”.

“Unfortunately, this case is only one of a multitude in which our government is falling far short of providing timely and adequate care to refugees and asylum seekers, due to political agendas.”

In response to questions from the Guardian, the department would not comment on the woman’s case specifically, but said in a statement:

“Due to unforeseen circumstances a medical transfer flight to Port Moresby scheduled for 4 August 2016 did not occur.

“The governments of Nauru and Australia are working with the government of Papua New Guinea to reschedule the transfer to Port Moresby for medical treatment as soon as possible.

“Persons scheduled for medical transfer will continue to receive medical treatment from the health services provider in Nauru.”

The department has consistently maintained that refugees and asylum seekers on Nauru and Manus Island have access to healthcare services “broadly comparable to those available within the Australian community”.

Australia has dedicated $ 26m towards upgrading Nauru’s hospital.

Meanwhile, on Australia’s other offshore detention island, Manus, refugees and asylum seekers held a late-night vigil for Pakistani refugee Kamil*, who drowned while swimming this week.

But refugees have also protested against plans by PNG authorities to bury the man on Manus Island. The detained refugees have said the man should be returned to his native Pakistan for burial, in accordance with his family’s wishes. They have even offered to sell their clothes and personal effects to fund the repatriation.

PNG authorities, after initially saying the man’s body could not be repatriated because it would cost too much, have agreed to meet with representatives of the refugees on Friday morning.

Australia funded the repatriation of two Iranian asylum seekers who died from injuries sustained while in detention on Manus: Reza Barati who was murdered by guards, and Hamid Kehazaei who died in a Brisbane hospital after his infection on Manus was inadequately treated.

However, a spokesman for the Department of Immigration and Border Protection said “funerary arrangements for refugees and transferees dying in Papua New Guinea are matters for the PNG government”.

“The department is aware that the PNG government has made contact with the deceased person’s next of kin and that local arrangements are being made for his burial.”

Iranian refugee Behrouz Boochani told the Guardian from inside the detention centre: “The Pakistani guys talked with Kamil’s family today and they do not agree to bury Kamil in Manus island. They want him sent back to Pakistan.

Related: Peter Dutton urged to ‘open his heart’ to plight of Iranian asylum seeker

“This is incredible that immigration want to bury him by force and it is immoral and inhumane. The Australian government is responsible and must send his body to Pakistan.”

Uncertainty over the future of the Manus regime has led to unrest in the detention centre compounds.

A Rohingyan refugee currently held at East Lorengau was prevented from a second suicide attempt in as many days, when fellow refugees took petrol from him. It’s understood the man had requested to return home, but because Rohingya people are not recognised as citizens by his native Myanmar he is legally stateless and cannot be returned there.

• The Guardian has chosen to publish only the man’s first name, out of concern for his family in Pakistan.

Refugee with growing breast lump has medical transfer from Nauru cancelled

Even With Cancelled Policies, Uninsured Numbers Falling Quickly

Evidence is mounting that the Cost-effective Care Act is operating to significantly reduce the quantity of uninsured Americans, despite inquiries about regardless of whether Americans had been buying policies just to exchange individuals that had been cancelled.

On leading of yet another U.S. government report Friday exhibiting far more Americans receiving coverage, especially from the Medicaid health insurance program for the bad, the latest from the Urban Institute’s Overall health Reform Monitoring Survey was clear: the “number of uninsured adults continues to fall underneath the ACA.”

However numbers vary, the Urban Institute says the variety of uninsured is down 8 million as of June.  “Though estimates of the dimension of the net acquire in coverage vary across surveys, there is constant evidence of ongoing gains in insurance coverage coverage beneath the ACA,” authors of a new Urban Institute report, linked right here, demonstrate.

The Urban Institute report, along with other folks that have been launched in recent weeks seem to undermine the argument from opponents of the law who wonder no matter whether Americans have been merely changing cancelled policies with those they were offered under the hwalth law. Numerous million Americans had their policies cancelled due to a portion of the law that calls for personal policies to have specific vital overall health rewards. (See associated gallery, also linked here)

The Urban Institute mentioned its survey didn’t account for potential other impacts that might reduced the uninsured rate such as how many young adults may well be taking benefit of a single of the law’s earliest positions enabling dependents to keep on their mothers and fathers health strategy till they are 26 years old.

But the law is doing work for youthful grownups and kids, according to a report launched Friday from Cindy Mann, deputy administrator of the Centers for Medicare &amp Medicaid Companies and Director of the Centers for Medicaid and CHIP Services.

Her report explained six.7 million more folks – an eleven.4 percent increase –  were enrolled in Medicaid applications for the poor or the Children’s Well being Insurance System as of Might 31 in contrast to “the baseline period from July though September 2013.”

The overall health law offers a money infusion of more than $ 900 billion in federal bucks from 2014 to 2022 to increase Medicaid applications for states that agreed to take advantage of the proposition.

This Medicaid funding under the Cost-effective Care Act is in contrast to past efforts to expand Medicaid in that the federal government will choose up the complete tab for the very first three many years. The state gradually has to pick up some charges in 2017 but by 2020 the federal government is even now selecting up 90 % or far more of the Medicaid tab.

It is a much greater funding proposition than the present Medicaid program that basically shares the expense among the states and the federal government. The federal government historically picks up a small much more than half of the value of Medicaid.

States usually led by Republicans that opposed this expansion haven’t seen almost the growth in Medicaid enrollment as 26 states which includes the District of Columbia that adopted and implemented the Medicaid expansion. “Enrollment in people states rose by 17 percent even though states that have not expanded reported only a 3 % enhance,” Mann wrote in her report.

When it comes to Medicaid, enrollment is expected to proceed to grow because it doesn’t have an open enrollment time period like the private coverage supplied on government run marketplaces acknowledged as exchanges. The next open enrollment period for private coverage is later this fall when a number of insurers, this kind of as Aetna (AET), UnitedHealth Group (UNH) and an array of Blue Cross and Blue Shield ideas are providing coverage in even much more markets than they did this previous open enrollment period.

In the meantime, Americans can still apply for Medicaid coverage.

“Consumers may still apply for Medicaid and CHIP coverage 12 months round and, as soon as enrolled, can use this coverage right away,” Mann explained.

Pondering how Obamacare will impact your overall health care? The Forbes eBook Inside Obamacare: The Correct For America’s Ailing Well being Care Technique answers that query and a lot more. Obtainable now at Amazon and Apple. 

Even With Cancelled Policies, Uninsured Numbers Falling Quickly

Adderall Speaking Points From My Cancelled Laura Ingraham Segment

Several of my colleagues have been aghast. “You’re going on Laura Ingraham?” They warned me I would be created a fool. Didn’t I know about her, shall we say, ideologically vehement interviews, one thing for which she is both revered or shunned based on the place one particular stands? I imagined “yeah, but still…” Soon after all the planned segment was to be on what some have labelled a rise in non-prescription Adderall use among college students. I know this to be genuinely critical, not truly conducive to partisan wrangling, and some thing about which I have something to say. Plus, the producer with whom I spoke was  collegial and intelligent. So I went all in, believing my ‘talking points” would be a match, must the need come up, for anyone’s ideological vehemence.

Sadly, they had been not a match for scheduling. A couple of hours prior to I was to go on the show I obtained an email from the producer canceling the segment, anything about breaking news. And then when it was rescheduled later in the week I was replaced by a person else. I was stunned by how disappointed I felt. Regardless of source, university college students and dad and mom need to have solid details to make great choices and remain safe. Plus, there is an urgent social need to have to talk about psychological-enhancement technologies. What we do with these emerging enhancement technologies will substantially establish what it signifies to be human as we go into the long term. Ms. Ingraham’s radio demonstrate, with its massive engaged audience, would have been a wonderful venue.

But I was bounced. And disappointment aside, I even now had a flawlessly good set of speaking factors. I did not want to toss into the trash. So, I decided to share them right here. I hope you locate them valuable. But please bear in mind, these are speaking factors for a radio interview, somewhat but not substantially embellished (with a couple of links additional in). Any a single of them could be fleshed out into a submit of its very own. But for now I will keep with the brevity of talking factors hoping that here they will still spark  useful conversation.

20mg extended release capsule of Adderall (Photo credit score: Wikipedia)

Talking Factors: Non-prescription Adderall use among school college students

• Adderall  prescribed as a treatment method for ADHD is fundamentally diverse than when it employed as a examine help.

• Calm any hysteria and hype. Stimulant meds are just the initial drips of what will be a tidal wave of meds and procedures for “brain hacking.”

• There is presently no “rise” in non-prescription Adderall use, regardless of what media shops like CNN have explained. They are just as common now as they had been ten many years in the past. Scientific studies range from about 10% to a high of about 40%.  A research completed in 2012 and just reported last week found about twenty% of college students at an Ivy League college reported non-prescription Adderall use. A DeSantis review with data collected 2005 -2006 at a massive, public southeastern research university found “34 % reported the illegal use of ADHD stimulants.”

• Concentrate on distinct message for distinct groups of students. Be clear that these kind a “message pyramid” with the prevention message on the bottom. Every single message applicable to all these above:

— College students who have not used non-prescription Adderall want a prevention message. “Don’t make a negative selection.”

—Students who use when they are in an academic bind require a danger management message. “Don’t allow a bad choice wreck your life.”

— College students who use on the border of extra, normally to compensate for too significantly partying or negative review habits, need an further get aid message. “You’re creating tons of undesirable selections, you need help making much better choices.”

— Students who are psychologically dependent or physically addicted want a clear get treatment method now message. “Your capability to make very good selections has been critically compromised. It’s time go for therapy. Select up the cellphone now and make an appointment at student well being.”

The “prevention message”

• Adderall is not a fad. Every person is not carrying out it. Customers of non-prescription Adderall considerably over-estimate fee of use. Also, users have a tendency to think it is not cheating although non-end users see it as cheating

• Adderall can kill you. It is harmful, just as unsafe and just as addictive as street drugs like coke and crystal meth. The truth that it is a prescription medicine just signifies that for some folks with a distinct issue you don’t have (ADHD), research has proven it to be risk-free and powerful. If you don’t have that issue it is just not protected.

Adderall Speaking Points From My Cancelled Laura Ingraham Segment