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This week's Friday Five: 23/12/22

UK hospices predict staff cuts and bed closures as energy bills increase

Hospice charities which provide end of life services in partnership with the NHS have said that they face shutting beds and firing staff due to energy bills heavily impacting upon their daily running costs. They have also warned that many patients who opt for palliative care in the home are failing to maintain care standards as increasing central heating and electricity costs mean they can no longer afford the electrical medical equipment required in their care.

Hospices, which rely on charitable donations to fund around three quarters of their running costs, have reported facing 350% increases in energy bills to meet their gas and electricity needs. They are now facing what is described as "the perfect storm" as these higher running costs occur at a time in which public fundraising methods have decreased but demand for services have increased.

Toby Porter, Chief Executive of Hospice UK has urged the government to extend the business support scheme ending on the 31st of March to ensure that hospices are guaranteed continued financial support.

He said: "Hospices are a critical partner to the health system … If rising energy costs impact their ability to continue those services, then this will have a knock-on effect on to the already overstretched NHS."

Read more at the Guardian

NHS prepares for increased patient influx following ambulance strikes

The NHS is preparing for an increase in patients between now and Christmas after thousands of people avoided seeking medical treatment following the Wednesday strikes by ambulance workers. An increase which senior doctors have warned comes at a time when the NHS is already struggling to cope due to hospitals reducing their services in preparation for the Christmas period.

On Wednesday as thousands of ambulance workers and paramedics in England and Wales went on strike 8 out of 10 ambulance trusts in England reported critical incidents following increased pressure on resources. During this time health officials warned the public to avoid risky behaviours/activities which could leave them struggling to receive timely medical attention. The public were also warned to not call 999 unless life-threatening care was required. It is believed that the public adhered to this advice as on Wednesday 999 calls fell by 25% and A&E attendances were reduced.

However, Dr Adrian Boyle, president of the Royal College of Emergency Medicine warned that there are likely to be a negative consequences following these changes.

He said: "We have anxieties about people not seeking help when they should. We saw this in lockdown. We are particularly concerned about a rebound effect, which means things could be much worse in the days to come.”

Read more at the Guardian

Patients requiring emergency care spending an additional day in congested hospitals

On average, patients are now spending an additional day in hospital during emergency admissions compared to pre-covid times.

The research, which comes from an HSJ analysis of unpublished hospital data, had several key findings including:

  • In the first 8 months of 2022 the average length of stay for emergency admission was 8.4 days compared to 7.4 days in the first 8 months of 2019 - signalling a 14% increase.

  • If this years length of stay had been the same as 2019 it would have saved 3.6 million days of inpatient hospital care.

  • The number of long-staying emergency patients requiring intensive care from staff has increased from pre-covid times. There is a 7% increase for patients staying two weeks or more and a 10% increase for patients staying over three-weeks. An increase which represents a likely side-effect of overwhelmed NHS services.

Similar reports from NHS England support the findings highlighted by HSJ, estimating non-elective length of stay has increased by around 15% since pre-covid times. Julian Kelly, NHS England's Chief Financial Officer emphasised that there are several steps which need to be taken to prevent this emergency care overspill.

He said: “I think the answers lie in discharge, decongest [hospitals], and the investment we are putting in to protect [elective] capacity. We can see that where people are running green [protected elective] sites, they are managing to get through more.”

Read more at HSJ

New cancer mRNA vaccine is trialled

Researchers at Moderna and MSD have completed a trial of personalised cancer vaccines which utilise the same messenger RNA (mRNA) technology used in the covid vaccines. Doctors hope that the development of these vaccines will lead to new treatment approaches to target skin, bowel and other types of cancer.

The trial was part of a 157 patient melanoma study which found a 44% reduction in mortality rates/skin cancer progression in patients taking Keytruda if they had the mRNA-4157/V940 vaccine. While the findings from this study have not yet been independently analysed the trial remains significant as it marks the first randomised trial testing an mRNA therapeutic in people with cancer.

While there is currently no pricing information available, as this treatment will involve researchers tailoring vaccines to match each patient's cancer it is anticipated to be very expensive. It is expected that more trials will be conducted to examine this treatment method with other pharmaceutical companies running similar studies using this mRNA technology. Professor Alan Melcher from the Institute of Cancer Research discussed the implications of this research.

He said: "There's no question, this is very exciting. These results show the feasibility of making and delivering personalised vaccines to treat cancer, and that the vaccine can add benefit to current treatments."

Read more at BBC News

Quote of the week

On Twitter Health Secretary Steve Barclay controversially discussed the impact of Wednesday's industrial action which saw ambulance workers striking over poor working conditions and pay.

He said: "Ambulance workers do invaluable work & unions have decided to strike to cause maximum disruption, inevitably impacting care. Patient safety is my number one priority and the government & NHS colleagues have been working to protect safe staffing levels."

Read more at the Telegraph

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