Tag Archives: England

NHS England plans to cut indigestion and dandruff prescriptions

NHS England is proposing to cut free prescriptions for over-the-counter remedies such as dandruff shampoo, eye drops and indigestion tablets in an effort to make up a shortfall in its funding.

The plans, which have alarmed the Patients Association, will explore restricting prescriptions for a number of mild ailments.

Promoting the idea, NHS England revealed that it currently spends £4.5m a year on dandruff shampoos – a sum that would fund 1,200 hip replacements. It said 300 community nurses could be funded from the £7.5m spent on treatments for indigestion and heartburn.

Other readily available items such as cough mixtures, laxatives and sun creams would also be reined in, it said.

NHS England said the changes could cut costs by £136m and make money available to help with the treatment of more serious conditions.

Its chief executive, Simon Stevens, said: “This consultation gives the public the opportunity to help family doctors decide how best to deploy precious NHS resources, freeing up money from the drugs bill to reinvest in modern treatments for major conditions such as cancer, mental health and emergency care.”

The Patients Association said the plans would unnecessarily worry many vulnerable people in the run-up to Christmas. Its chief executive, Rachel Power, said the proposals threatened to change the relationship between GPs and patients.

“GPs will be asked to implement guidance involving a complex set of criteria and exceptions,” she said. “Mistakes are bound to happen, and for some patients a GP appointment will come to feel more like a benefits assessment, where they wait to find out at the end whether they will receive support or not – and sadly we know there are major shortcomings with that system.”

She agreed that it was “counterintuitive for the NHS to be paying pounds for something that the individual can buy for pence”, but she called for clarity from NHS England on how the proposal would affect those deemed social vulnerable.

NHS England approved the proposals after the chancellor, Philip Hammond, announced £1.6bn in extra funding for 2018-19 in the budget last month – less than half of the £4bn that Stevens had called for.

Power said the prescription proposal “may or may not be a good idea, but it certainly shouldn’t be motivated by a funding crisis”.

Under the plans, prescriptions could be restricted for treatments for cold sores, conjunctivitis, mild indigestion, dandruff, haemorrhoids, infant colic, minor burns and scalds and minor pain conditions such as headache and back pain.

Remedies for mouth ulcers, nappy rash, ringworm, head lice, mild toothache, travel sickness, and warts and verrucae are also among the items that could also be affected, as well as vitamins and minerals.

Items prescribed for longer-term or more complex conditions would not be affected, and nor would prescriptions for minor illnesses symptomatic of something more serious, NHS England said.

Prof Helen Stokes-Lampard, chair of the Royal College of GPs, said: “What remains imperative – and we will be making this clear in our consultation response – is that no blanket bans are imposed, and GPs will retain the right to make clinical decisions about prescribing appropriately for our patients based on the unique physical, psychological and social factors potentially impacting on their health.”

The consultation comes just weeks after the health service’s board voted to cut a number of items from the NHS prescription list in England.

Officials agreed 13 items deemed “ineffective, over-priced and low value treatments” – including homeopathy, herbal remedies and some painkillers – should no longer be routinely prescribed.

They said an additional five items should only be provided in appropriate circumstances.

NHS England plans to cut indigestion and dandruff prescriptions

NHS England is proposing to cut free prescriptions for over-the-counter remedies such as dandruff shampoo, eye drops and indigestion tablets in an effort to make up a shortfall in its funding.

The plans, which have alarmed the Patients Association, will explore restricting prescriptions for a number of mild ailments.

Promoting the idea, NHS England revealed that it currently spends £4.5m a year on dandruff shampoos – a sum that would fund 1,200 hip replacements. It said 300 community nurses could be funded from the £7.5m spent on treatments for indigestion and heartburn.

Other readily available items such as cough mixtures, laxatives and sun creams would also be reined in, it said.

NHS England said the changes could cut costs by £136m and make money available to help with the treatment of more serious conditions.

Its chief executive, Simon Stevens, said: “This consultation gives the public the opportunity to help family doctors decide how best to deploy precious NHS resources, freeing up money from the drugs bill to reinvest in modern treatments for major conditions such as cancer, mental health and emergency care.”

The Patients Association said the plans would unnecessarily worry many vulnerable people in the run-up to Christmas. Its chief executive, Rachel Power, said the proposals threatened to change the relationship between GPs and patients.

“GPs will be asked to implement guidance involving a complex set of criteria and exceptions,” she said. “Mistakes are bound to happen, and for some patients a GP appointment will come to feel more like a benefits assessment, where they wait to find out at the end whether they will receive support or not – and sadly we know there are major shortcomings with that system.”

She agreed that it was “counterintuitive for the NHS to be paying pounds for something that the individual can buy for pence”, but she called for clarity from NHS England on how the proposal would affect those deemed social vulnerable.

NHS England approved the proposals after the chancellor, Philip Hammond, announced £1.6bn in extra funding for 2018-19 in the budget last month – less than half of the £4bn that Stevens had called for.

Power said the prescription proposal “may or may not be a good idea, but it certainly shouldn’t be motivated by a funding crisis”.

Under the plans, prescriptions could be restricted for treatments for cold sores, conjunctivitis, mild indigestion, dandruff, haemorrhoids, infant colic, minor burns and scalds and minor pain conditions such as headache and back pain.

Remedies for mouth ulcers, nappy rash, ringworm, head lice, mild toothache, travel sickness, and warts and verrucae are also among the items that could also be affected, as well as vitamins and minerals.

Items prescribed for longer-term or more complex conditions would not be affected, and nor would prescriptions for minor illnesses symptomatic of something more serious, NHS England said.

Prof Helen Stokes-Lampard, chair of the Royal College of GPs, said: “What remains imperative – and we will be making this clear in our consultation response – is that no blanket bans are imposed, and GPs will retain the right to make clinical decisions about prescribing appropriately for our patients based on the unique physical, psychological and social factors potentially impacting on their health.”

The consultation comes just weeks after the health service’s board voted to cut a number of items from the NHS prescription list in England.

Officials agreed 13 items deemed “ineffective, over-priced and low value treatments” – including homeopathy, herbal remedies and some painkillers – should no longer be routinely prescribed.

They said an additional five items should only be provided in appropriate circumstances.

NHS England plans to cut indigestion and dandruff prescriptions

NHS England is proposing to cut free prescriptions for over-the-counter remedies such as dandruff shampoo, eye drops and indigestion tablets in an effort to make up a shortfall in its funding.

The plans, which have alarmed the Patients Association, will explore restricting prescriptions for a number of mild ailments.

Promoting the idea, NHS England revealed that it currently spends £4.5m a year on dandruff shampoos – a sum that would fund 1,200 hip replacements. Similarly it said 300 community nurses could be funded from the £7.5m spent on treatments for indigestion and heartburn.

Other readily available items such as cough mixtures, laxatives and sun creams will also be reined in, it said.

NHS England said the changes could cut costs by £136m and make money available to help with the treatment of more serious conditions.

Its chief executive, Simon Stevens, said: “This consultation gives the public the opportunity to help family doctors decide how best to deploy precious NHS resources, freeing up money from the drugs bill to reinvest in modern treatments for major conditions such as cancer, mental health and emergency care.”

But the Patients Association said the plans would unnecessarily worry many vulnerable people in the run-up to Christmas. Its chief executive, Rachel Power, said the proposals threatened to change the relationship between GPs and patients.

She said: “GPs will be asked to implement guidance involving a complex set of criteria and exceptions. Mistakes are bound to happen, and for some patients a GP appointment will come to feel more like a benefits assessment, where they wait to find out at the end whether they will receive support or not – and sadly we know there are major shortcomings with that system.”

She agreed that it was “counterintuitive for the NHS to be paying pounds for something that the individual can buy for pence”. But she called for clarity from NHS England on how the proposal would affect those deemed social vulnerable.

The proposals were approved by NHS England after the chancellor, Philip Hammond, announced £1.6bn extra funding for 2018-19 in the budget last month – less than half of the £4bn that Stevens had called for.

Power said the prescription proposal “may or may not be a good idea, but it certainly shouldn’t be motivated by a funding crisis”.

Under the plans, prescriptions could be restricted for treatments for cold sores, conjunctivitis, mild indigestion, dandruff, haemorrhoids, infant colic, minor burns and scalds and minor pain conditions such as headache and back pain.

Remedies for mouth ulcers, nappy rash, ringworm, head lice, mild toothache, travel sickness, and warts and verrucae are also among the items that could also be affected, as well as vitamins and minerals.

Items prescribed for longer-term or more complex conditions would not be affected, and nor would prescriptions for minor illnesses symptomatic of something more serious, NHS England said.

Prof Helen Stokes-Lampard, chairwoman of the Royal College of GPs, said: “What remains imperative – and we will be making this clear in our consultation response – is that no blanket bans are imposed, and GPs will retain the right to make clinical decisions about prescribing appropriately for our patients based on the unique physical, psychological and social factors potentially impacting on their health.”

The consultation comes just weeks after the health service’s board voted to cut a number of items from the NHS “prescription list” in England.

Officials agreed 13 items deemed “ineffective, over-priced and low value treatments” – including homeopathy, herbal remedies and some painkillers – should no longer be routinely prescribed.

They said an additional five items should only be provided in appropriate circumstances.

Cervical cancer deaths in over-50s predicted to rise sharply in England – study

Cervical cancer diagnoses and deaths in England are predicted to rise steeply among women over the age of 50 in the next two decades, even though deaths from the disease among the young who have been vaccinated are likely to be almost eradicated, according to a new study.

The HPV jab is radically changing the outlook for cervical cancer among women living in countries where it is routinely given to schoolgirls aged 12 or 13, before they become sexually active, and brings hope in the developing world of reducing the deaths where they are highest.

A study of the likely scenario up to 2040 in England, published in the journal Lancet Public Health, says cases are likely to drop by 75% among young women for whom vaccination is now the norm. Deaths from cervical cancer among the generation who were 17 or younger when the programme was introduced in 2008 will virtually disappear.

But there are continuing problems for older women who have never been vaccinated against the human papilloma virus (HPV), which is responsible for triggering most cases of cervical cancer. Approximately 60% of women are infected at some time with HPV. Most clear it from their system, but the vaccine does not work well in women who have ever encountered HPV.

Diagnoses and deaths in the 50 to 64 year-old age group are predicted to go up. The number of cases will rise by 62%, say epidemiologists at Queen Mary University London. That could push deaths up by 143%, from 183 in 2015 to 449 in 2040.

“The main reason for this is that the population is ageing and women currently 25-40 will not benefit from vaccination – and they are in the age range where the likelihood of getting an HPV infection is quite high,” said Dr Alejandra Castanon from Queen Mary, one of the authors.

Sexual practices among the 25 to 40 age group, and particularly having multiple partners, put them at greater risk of infection with the sexually-transmitted virus. “Unfortunately, the risk of acquiring an HPV infection that will progress to cancer has increased in unvaccinated individuals born since 1960, suggesting that current screening coverage is not sufficient to maintain – much less reduce – cervical cancer incidence in the next 20 years,” says the paper.

Cervical cancer may also now be thought of as less of a threat, even among women who have not been vaccinated. The older women get, the more likely they are to feel secure, particularly if they have one long-term partner. Perhaps as a result, fewer women have been going to be screened – but an infection takes at least 10 years to cause cancer.

The authors and the charity Jo’s Cervical Cancer Trust, which funded the research, say there must be more effort to increase screening rates – and that the new more accurate form of screening, a test for HPV infection – is needed earlier than the planned introduction in 2019.

Robert Music, chief executive of the trust, said: “This research should serve as a wakeup call and the need for action. Continued declining cervical screening attendance will cost lives at all ages and must not happen. We are faced with an ageing population and risk among older women rocketing, therefore changes to the programme which could reduce this risk must be explored, including increasing the screening age from 64 and self-testing.”

In an editorial in the journal, Nicolas Wentzensen and Mark Schiffman from the Centers for Disease Control in Bethesda, US, say there is an argument for vaccinating women up to the age of 30 in developing countries, after a test to establish they are not infected with HPV. This can help increase herd immunity, by reducing the amount of virus circulating in the community.

Cervical cancer deaths in over-50s predicted to rise sharply in England – study

Cervical cancer diagnoses and deaths in England are predicted to rise steeply among women over the age of 50 in the next two decades, even though deaths from the disease among the young who have been vaccinated are likely to be almost eradicated, according to a new study.

The HPV jab is radically changing the outlook for cervical cancer among women living in countries where it is routinely given to schoolgirls aged 12 or 13, before they become sexually active, and brings hope in the developing world of reducing the deaths where they are highest.

A study of the likely scenario up to 2040 in England, published in the journal Lancet Public Health, says cases are likely to drop by 75% among young women for whom vaccination is now the norm. Deaths from cervical cancer among the generation who were 17 or younger when the programme was introduced in 2008 will virtually disappear.

But there are continuing problems for older women who have never been vaccinated against the human papilloma virus (HPV), which is responsible for triggering most cases of cervical cancer. Approximately 60% of women are infected at some time with HPV. Most clear it from their system, but the vaccine does not work well in women who have ever encountered HPV.

Diagnoses and deaths in the 50 to 64 year-old age group are predicted to go up. The number of cases will rise by 62%, say epidemiologists at Queen Mary University London. That could push deaths up by 143%, from 183 in 2015 to 449 in 2040.

“The main reason for this is that the population is ageing and women currently 25-40 will not benefit from vaccination – and they are in the age range where the likelihood of getting an HPV infection is quite high,” said Dr Alejandra Castanon from Queen Mary, one of the authors.

Sexual practices among the 25 to 40 age group, and particularly having multiple partners, put them at greater risk of infection with the sexually-transmitted virus. “Unfortunately, the risk of acquiring an HPV infection that will progress to cancer has increased in unvaccinated individuals born since 1960, suggesting that current screening coverage is not sufficient to maintain – much less reduce – cervical cancer incidence in the next 20 years,” says the paper.

Cervical cancer may also now be thought of as less of a threat, even among women who have not been vaccinated. The older women get, the more likely they are to feel secure, particularly if they have one long-term partner. Perhaps as a result, fewer women have been going to be screened – but an infection takes at least 10 years to cause cancer.

The authors and the charity Jo’s Cervical Cancer Trust, which funded the research, say there must be more effort to increase screening rates – and that the new more accurate form of screening, a test for HPV infection – is needed earlier than the planned introduction in 2019.

Robert Music, chief executive of the trust, said: “This research should serve as a wakeup call and the need for action. Continued declining cervical screening attendance will cost lives at all ages and must not happen. We are faced with an ageing population and risk among older women rocketing, therefore changes to the programme which could reduce this risk must be explored, including increasing the screening age from 64 and self-testing.”

In an editorial in the journal, Nicolas Wentzensen and Mark Schiffman from the Centers for Disease Control in Bethesda, US, say there is an argument for vaccinating women up to the age of 30 in developing countries, after a test to establish they are not infected with HPV. This can help increase herd immunity, by reducing the amount of virus circulating in the community.

Cervical cancer deaths in over-50s predicted to rise sharply in England – study

Cervical cancer diagnoses and deaths in England are predicted to rise steeply among women over the age of 50 in the next two decades, even though deaths from the disease among the young who have been vaccinated are likely to be almost eradicated, according to a new study.

The HPV jab is radically changing the outlook for cervical cancer among women living in countries where it is routinely given to schoolgirls aged 12 or 13, before they become sexually active, and brings hope in the developing world of reducing the deaths where they are highest.

A study of the likely scenario up to 2040 in England, published in the journal Lancet Public Health, says cases are likely to drop by 75% among young women for whom vaccination is now the norm. Deaths from cervical cancer among the generation who were 17 or younger when the programme was introduced in 2008 will virtually disappear.

But there are continuing problems for older women who have never been vaccinated against the human papilloma virus (HPV), which is responsible for triggering most cases of cervical cancer. Approximately 60% of women are infected at some time with HPV. Most clear it from their system, but the vaccine does not work well in women who have ever encountered HPV.

Diagnoses and deaths in the 50 to 64 year-old age group are predicted to go up. The number of cases will rise by 62%, say epidemiologists at Queen Mary University London. That could push deaths up by 143%, from 183 in 2015 to 449 in 2040.

“The main reason for this is that the population is ageing and women currently 25-40 will not benefit from vaccination – and they are in the age range where the likelihood of getting an HPV infection is quite high,” said Dr Alejandra Castanon from Queen Mary, one of the authors.

Sexual practices among the 25 to 40 age group, and particularly having multiple partners, put them at greater risk of infection with the sexually-transmitted virus. “Unfortunately, the risk of acquiring an HPV infection that will progress to cancer has increased in unvaccinated individuals born since 1960, suggesting that current screening coverage is not sufficient to maintain – much less reduce – cervical cancer incidence in the next 20 years,” says the paper.

Cervical cancer may also now be thought of as less of a threat, even among women who have not been vaccinated. The older women get, the more likely they are to feel secure, particularly if they have one long-term partner. Perhaps as a result, fewer women have been going to be screened – but an infection takes at least 10 years to cause cancer.

The authors and the charity Jo’s Cervical Cancer Trust, which funded the research, say there must be more effort to increase screening rates – and that the new more accurate form of screening, a test for HPV infection – is needed earlier than the planned introduction in 2019.

Robert Music, chief executive of the trust, said: “This research should serve as a wakeup call and the need for action. Continued declining cervical screening attendance will cost lives at all ages and must not happen. We are faced with an ageing population and risk among older women rocketing, therefore changes to the programme which could reduce this risk must be explored, including increasing the screening age from 64 and self-testing.”

In an editorial in the journal, Nicolas Wentzensen and Mark Schiffman from the Centers for Disease Control in Bethesda, US, say there is an argument for vaccinating women up to the age of 30 in developing countries, after a test to establish they are not infected with HPV. This can help increase herd immunity, by reducing the amount of virus circulating in the community.

Cervical cancer deaths in over-50s predicted to rise sharply in England – study

Cervical cancer diagnoses and deaths in England are predicted to rise steeply among women over the age of 50 in the next two decades, even though deaths from the disease among the young who have been vaccinated are likely to be almost eradicated, according to a new study.

The HPV jab is radically changing the outlook for cervical cancer among women living in countries where it is routinely given to schoolgirls aged 12 or 13, before they become sexually active, and brings hope in the developing world of reducing the deaths where they are highest.

A study of the likely scenario up to 2040 in England, published in the journal Lancet Public Health, says cases are likely to drop by 75% among young women for whom vaccination is now the norm. Deaths from cervical cancer among the generation who were 17 or younger when the programme was introduced in 2008 will virtually disappear.

But there are continuing problems for older women who have never been vaccinated against the human papilloma virus (HPV), which is responsible for triggering most cases of cervical cancer. Approximately 60% of women are infected at some time with HPV. Most clear it from their system, but the vaccine does not work well in women who have ever encountered HPV.

Diagnoses and deaths in the 50 to 64 year-old age group are predicted to go up. The number of cases will rise by 62%, say epidemiologists at Queen Mary University London. That could push deaths up by 143%, from 183 in 2015 to 449 in 2040.

“The main reason for this is that the population is ageing and women currently 25-40 will not benefit from vaccination – and they are in the age range where the likelihood of getting an HPV infection is quite high,” said Dr Alejandra Castanon from Queen Mary, one of the authors.

Sexual practices among the 25 to 40 age group, and particularly having multiple partners, put them at greater risk of infection with the sexually-transmitted virus. “Unfortunately, the risk of acquiring an HPV infection that will progress to cancer has increased in unvaccinated individuals born since 1960, suggesting that current screening coverage is not sufficient to maintain – much less reduce – cervical cancer incidence in the next 20 years,” says the paper.

Cervical cancer may also now be thought of as less of a threat, even among women who have not been vaccinated. The older women get, the more likely they are to feel secure, particularly if they have one long-term partner. Perhaps as a result, fewer women have been going to be screened – but an infection takes at least 10 years to cause cancer.

The authors and the charity Jo’s Cervical Cancer Trust, which funded the research, say there must be more effort to increase screening rates – and that the new more accurate form of screening, a test for HPV infection – is needed earlier than the planned introduction in 2019.

Robert Music, chief executive of the trust, said: “This research should serve as a wakeup call and the need for action. Continued declining cervical screening attendance will cost lives at all ages and must not happen. We are faced with an ageing population and risk among older women rocketing, therefore changes to the programme which could reduce this risk must be explored, including increasing the screening age from 64 and self-testing.”

In an editorial in the journal, Nicolas Wentzensen and Mark Schiffman from the Centers for Disease Control in Bethesda, US, say there is an argument for vaccinating women up to the age of 30 in developing countries, after a test to establish they are not infected with HPV. This can help increase herd immunity, by reducing the amount of virus circulating in the community.

Alarm over sharp rise in ambulance patient deaths in England

A sharp rise in the number of patients dying unexpectedly while under the care of NHS ambulance staff has prompted warnings that the service is under “excessive pressure”.

NHS figures for England obtained under freedom of information (FoI) laws show “serious incidents” resulting in the death of a patient more than doubled from 31 in 2012 to 72 in 2016, rising year on year.

One trust noted that a serious incident meant a three-year-old asthma patient had died, and another death was logged as being caused by a delayed response linked to “no resources”. Deaths were also due to missed diagnoses and long delays, with one patient even taken to the wrong hospital.

Serious incidents are logged when the consequences for patients and staff are so significant they warrant investigations. The number of such reports that involved death, low, moderate or serious harm, injury and abuse rose sharply over the five-year period, almost doubling from 194 in 2012 to 376 last year.

“This deeply concerning news must serve as an urgent wake-up call to the government that our overstretched and underfunded ambulance services are in desperate need of more funds,” said Jonathan Ashworth, the shadow health secretary.

“Despite the heroic efforts of our hardworking paramedics, ambulance targets have been missed for well over two years and unprecedented pressures on ambulance services are placing patient safety at serious risk,” he said.

Alan Lofthouse, the national ambulance officer at the trade union Unison, said: “The government’s own figures show that ambulance demand is running at twice the level of funding. This is an unsustainable situation that places excessive pressure on paramedics, who are doing an incredible job treating people in the community and reducing the strain on A&E departments.”

The Association of Ambulance Chief Executives said the incidents amounted to a “tiny” number of patient journeys.

“The increase in serious untoward incidents reported can be attributed to the unabated increased demand for ambulance services and the success of ambulance services encouraging staff to report incidents that can be learned from,” a spokesperson said.

The associate pointed out there had been an average 5.2% rise in calls year on year since 2011-12. However, unexpected deaths increased at a higher rate than calls.

Seven of the 10 trusts responded to the FoI request with data on serious incident reports, but only five had data on the number of unexpected mortalities.

The highest number of deaths was recorded at East Midlands ambulance service, with six mortalities in 2012 and 25 last year, a fivefold increase. The majority were linked to care management and delayed responses.

The proportion of serious incidents at East Midlands declined marginally against call numbers, while unexpected deaths increased proportionally over time. “After investigation, not all incidents identify anything that should have been done differently. However, reporting and investigating means that we use every opportunity to see if we can improve patient care,” a spokesperson for the service said.

The second highest number of deaths was at North East ambulance service, with 22 reported cases in 2016, up from five in 2012.

Alan Gallagher, its head of risk and regulatory services, said: “North East ambulance service is an open and transparent organisation with a culture of learning by mistakes rather than one of blame. We’ve seen an increase in the reporting of incidents and serious incidents over the last few years but we have also seen our overall demand increase … To be entirely transparent about serious incidents, we record all patient deaths linked to a serious incident, regardless of whether the death was impacted directly by the ambulance service.”

London ambulance service recorded the highest rise in serious incidents, with the service only able to state what harm was caused for the last two years. The number of reported incidents rose from 21 in 2012 to 80 last year. In 2016 there were three deaths, compared with 23 already up to September 2017, an incomplete year. A spokesperson for the service said: “Not all incidents, once investigated, identify anything we should have done differently.”

One death, in May 2017, was because an ambulance was diverted from one hospital to another at the last minute. In the same month another ambulance went to the wrong hospital, resulting in a delay in care. On three instances this year a death was linked to the fact that a London ambulance crew had not recognised ventricular fibrillation, a type of cardiac arrhythmia.

A spokesperson for NHS Improvement, the health service regulator, said: “The safety of patients is a top priority for the NHS. When serious incidents occur we expect NHS providers to investigate and get to the root cause of what happened. The purpose of these patient safety investigations is to establish learning so local, and in some cases national, changes can be made to ensure patients are kept safe and staff are supported to prevent similar incidents occurring.”

Alarm over sharp rise in ambulance patient deaths in England

A sharp rise in the number of patients dying unexpectedly while under the care of NHS ambulance staff has prompted warnings that the service is under “excessive pressure”.

NHS figures for England obtained under freedom of information (FoI) laws show “serious incidents” resulting in the death of a patient more than doubled from 31 in 2012 to 72 in 2016, rising year on year.

One trust noted that a serious incident meant a three-year-old asthma patient had died, and another death was logged as being caused by a delayed response linked to “no resources”. Deaths were also due to missed diagnoses and long delays, with one patient even taken to the wrong hospital.

Serious incidents are logged when the consequences for patients and staff are so significant they warrant investigations. The number of such reports that involved death, low, moderate or serious harm, injury and abuse rose sharply over the five-year period, almost doubling from 194 in 2012 to 376 last year.

“This deeply concerning news must serve as an urgent wake-up call to the government that our overstretched and underfunded ambulance services are in desperate need of more funds,” said Jonathan Ashworth, the shadow health secretary.

“Despite the heroic efforts of our hardworking paramedics, ambulance targets have been missed for well over two years and unprecedented pressures on ambulance services are placing patient safety at serious risk,” he said.

Alan Lofthouse, the national ambulance officer at the trade union Unison, said: “The government’s own figures show that ambulance demand is running at twice the level of funding. This is an unsustainable situation that places excessive pressure on paramedics, who are doing an incredible job treating people in the community and reducing the strain on A&E departments.”

The Association of Ambulance Chief Executives said the incidents amounted to a “tiny” number of patient journeys.

“The increase in serious untoward incidents reported can be attributed to the unabated increased demand for ambulance services and the success of ambulance services encouraging staff to report incidents that can be learned from,” a spokesperson said.

The associate pointed out there had been an average 5.2% rise in calls year on year since 2011-12. However, unexpected deaths increased at a higher rate than calls.

Seven of the 10 trusts responded to the FoI request with data on serious incident reports, but only five had data on the number of unexpected mortalities.

The highest number of deaths was recorded at East Midlands ambulance service, with six mortalities in 2012 and 25 last year, a fivefold increase. The majority were linked to care management and delayed responses.

The proportion of serious incidents at East Midlands declined marginally against call numbers, while unexpected deaths increased proportionally over time. “After investigation, not all incidents identify anything that should have been done differently. However, reporting and investigating means that we use every opportunity to see if we can improve patient care,” a spokesperson for the service said.

The second highest number of deaths was at North East ambulance service, with 22 reported cases in 2016, up from five in 2012.

Alan Gallagher, its head of risk and regulatory services, said: “North East ambulance service is an open and transparent organisation with a culture of learning by mistakes rather than one of blame. We’ve seen an increase in the reporting of incidents and serious incidents over the last few years but we have also seen our overall demand increase … To be entirely transparent about serious incidents, we record all patient deaths linked to a serious incident, regardless of whether the death was impacted directly by the ambulance service.”

London ambulance service recorded the highest rise in serious incidents, with the service only able to state what harm was caused for the last two years. The number of reported incidents rose from 21 in 2012 to 80 last year. In 2016 there were three deaths, compared with 23 already up to September 2017, an incomplete year. A spokesperson for the service said: “Not all incidents, once investigated, identify anything we should have done differently.”

One death, in May 2017, was because an ambulance was diverted from one hospital to another at the last minute. In the same month another ambulance went to the wrong hospital, resulting in a delay in care. On three instances this year a death was linked to the fact that a London ambulance crew had not recognised ventricular fibrillation, a type of cardiac arrhythmia.

A spokesperson for NHS Improvement, the health service regulator, said: “The safety of patients is a top priority for the NHS. When serious incidents occur we expect NHS providers to investigate and get to the root cause of what happened. The purpose of these patient safety investigations is to establish learning so local, and in some cases national, changes can be made to ensure patients are kept safe and staff are supported to prevent similar incidents occurring.”

Alarm over sharp rise in ambulance patient deaths in England

A sharp rise in the number of patients dying unexpectedly while under the care of NHS ambulance staff has prompted warnings that the service is under “excessive pressure”.

NHS figures for England obtained under freedom of information (FoI) laws show “serious incidents” resulting in the death of a patient more than doubled from 31 in 2012 to 72 in 2016, rising year on year.

One trust noted that a serious incident meant a three-year-old asthma patient had died, and another death was logged as being caused by a delayed response linked to “no resources”. Deaths were also due to missed diagnoses and long delays, with one patient even taken to the wrong hospital.

Serious incidents are logged when the consequences for patients and staff are so significant they warrant investigations. The number of such reports that involved death, low, moderate or serious harm, injury and abuse rose sharply over the five-year period, almost doubling from 194 in 2012 to 376 last year.

“This deeply concerning news must serve as an urgent wake-up call to the government that our overstretched and underfunded ambulance services are in desperate need of more funds,” said Jonathan Ashworth, the shadow health secretary.

“Despite the heroic efforts of our hardworking paramedics, ambulance targets have been missed for well over two years and unprecedented pressures on ambulance services are placing patient safety at serious risk,” he said.

Alan Lofthouse, the national ambulance officer at the trade union Unison, said: “The government’s own figures show that ambulance demand is running at twice the level of funding. This is an unsustainable situation that places excessive pressure on paramedics, who are doing an incredible job treating people in the community and reducing the strain on A&E departments.”

The Association of Ambulance Chief Executives said the incidents amounted to a “tiny” number of patient journeys.

“The increase in serious untoward incidents reported can be attributed to the unabated increased demand for ambulance services and the success of ambulance services encouraging staff to report incidents that can be learned from,” a spokesperson said.

The associate pointed out there had been an average 5.2% rise in calls year on year since 2011-12. However, unexpected deaths increased at a higher rate than calls.

Seven of the 10 trusts responded to the FoI request with data on serious incident reports, but only five had data on the number of unexpected mortalities.

The highest number of deaths was recorded at East Midlands ambulance service, with six mortalities in 2012 and 25 last year, a fivefold increase. The majority were linked to care management and delayed responses.

The proportion of serious incidents at East Midlands declined marginally against call numbers, while unexpected deaths increased proportionally over time. “After investigation, not all incidents identify anything that should have been done differently. However, reporting and investigating means that we use every opportunity to see if we can improve patient care,” a spokesperson for the service said.

The second highest number of deaths was at North East ambulance service, with 22 reported cases in 2016, up from five in 2012.

Alan Gallagher, its head of risk and regulatory services, said: “North East ambulance service is an open and transparent organisation with a culture of learning by mistakes rather than one of blame. We’ve seen an increase in the reporting of incidents and serious incidents over the last few years but we have also seen our overall demand increase … To be entirely transparent about serious incidents, we record all patient deaths linked to a serious incident, regardless of whether the death was impacted directly by the ambulance service.”

London ambulance service recorded the highest rise in serious incidents, with the service only able to state what harm was caused for the last two years. The number of reported incidents rose from 21 in 2012 to 80 last year. In 2016 there were three deaths, compared with 23 already up to September 2017, an incomplete year. A spokesperson for the service said: “Not all incidents, once investigated, identify anything we should have done differently.”

One death, in May 2017, was because an ambulance was diverted from one hospital to another at the last minute. In the same month another ambulance went to the wrong hospital, resulting in a delay in care. On three instances this year a death was linked to the fact that a London ambulance crew had not recognised ventricular fibrillation, a type of cardiac arrhythmia.

A spokesperson for NHS Improvement, the health service regulator, said: “The safety of patients is a top priority for the NHS. When serious incidents occur we expect NHS providers to investigate and get to the root cause of what happened. The purpose of these patient safety investigations is to establish learning so local, and in some cases national, changes can be made to ensure patients are kept safe and staff are supported to prevent similar incidents occurring.”