Thousands of patient follow-up letters not sent to GPs

Worcestershire Royal HospitalImage copyright PA Image caption Patients adversely affected will be contacted by the trust

Tens of thousands of hospital appointment follow-up letters have not been sent to GPs due to a computer system issue.

Worcestershire Acute Hospitals NHS Trust said it had a backlog of 22,000 letters, from 2011 to 2017 about patient appointments and care.

Some patients may not have received the follow-up care they should have, the chief executive said.

Patients adversely affected will be contacted by the trust.

Latest reaction, plus more Worcestershire stories[1]

A review is also under way.

Worcestershire Royal Hospital;Kidderminster Hospital and Treatment Centre;and Alexandra Hospital, in Redditch, are all run by the trust.

The trust, which has been rated inadequate since December 2015, was criticised earlier this week by the Care Quality Commission[2].

Image caption Trust chief executive Michelle McKay said an inquiry was under way to determine what had happened

Its latest report found patients were being cared for in emergency department corridors as standard practice and no "tangible improvements" had been made since an earlier inspection in November.

An initial review into the letters error found 11,000 letters require no further medical actions.

The focus is now on the remaining letters, a statement said, which should be completed by September.

Analysis:Michele Paduano, BBC Midlands health correspondent

This issue came to light when the St Stephen's practice, in Redditch, received a letter which was a year old.It was one of 69 letters;fortunately, none of them were critical.

My understanding is this has been known about since at least June and I was told about it because there was some concern the public had not been made aware.

Dr Shaun Pike, the GP who chairs the Worcestershire local medical committee, said there would be a small number of patients who have suffered medically and there may be patients undiagnosed.

The plan is to review the most urgent cases first, but leave any patients who have already died until the end of the process.

Any worried patients should contact the PALS service on 0300 1231732.

Chief executive Michelle McKay apologised that some letters within the trust's management system had not been processed properly.

"We regret that this means some patients may not have received the follow-up care they should have," she said.

"We are working closely with our primary care colleagues and partner health organisations to urgently review the individual cases of these patients and to ensure, where appropriate, patients receive the necessary follow-up care quickly."

She said an inquiry was under way to understand how this had happened.

"This is a serious issue which we are working hard to quickly address.

"However, it is important we reassure our local communities that more than half a million patients are seen in our outpatient departments each year and the vast majority of these patients will have had the appropriate letters sent to ensure they receive the right follow-up care."...

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Hundreds more surviving heart failure in hospital, study shows

A 3D scan of the heartImage copyright Science Photo Library Image caption Fewer patients are dying from heart failure in hospitals in England and Wales, compared with previous years

Hundreds more people are surviving heart failure through better treatment after being admitted to hospital in England and Wales, a study suggests.

The National Heart Failure Audit[1] found that 8.9% of patients had died in 2015-16, down from 9.6% the previous year, saving around 500 lives.

However, it said there were still too many deaths and too much variation across the country.

Heart experts said more patients should get the best possible treatments.

These include access to crucial medicines and being seen by a heart specialist soon after arrival in hospital.

In 2010-11, the death rate was 11.6% and apart from a slight rise in 2013-14, the rate has continued to fall.

The most recent figures are based on more than 66,000 admissions to English and Welsh hospitals where the main diagnosis was heart failure.

This is a condition caused by the heart failing to pump enough blood around the body at the right pressure.

It can cause shortness of breath, exhaustion and ankle swelling - and when these symptoms develop quickly, patients need urgent hospital treatment.

Sudden heart failure is most common among the elderly, making it a particular challenge for the NHS as the population ages.

Heart specialists

In 2015-16, the audit showed, 80% of patients with heart failure had been seen by heart specialists and nine out of 10 patients had had a detailed scan of their heart, called an echocardiogram.

It also found an increase in the percentage of patients prescribed three key medicines for heart failure - but admitted there was still room for further improvement.

The audit said:"This year's report shows modest but important improvements, which are to be celebrated.

"But an 8.9% in-patient mortality cannot be accepted and requires urgent attention within every acute trust admitting patients with heart failure."

Sir Bruce Keogh, national medical director at NHS England, said:"Increasing numbers of patients are getting specialist help and the full range of treatments thanks to years of world-leading scientific and clinical research and the efforts of NHS staff.

"It is a very significant problem, and we recognise that there is scope for even more improvement - but the progress highlighted today will be a spur for us to do even more to improve care and survival rates."

'Promising signs'

Prof Sir Nilesh Samani, medical director at the British Heart Foundation, said heart failure affected the lives of more than half a million people in the UK.

"This audit shows promising signs that the quality of hospital care for heart failure is improving, with fewer people dying as a result," he said.

"However, we need to build on this progress.

"It is imperative we continue to close variations in heart-failure care across hospitals and ensure more patients receive the best possible treatments."...


  1. ^ The National Heart Failure Audit (

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Third of men with poor mental health blame jobs, says Mind

Women working at homeImage copyright Getty Images Image caption Women found home and work equally stressful

Men are more likely than women to suffer mental health problems brought on by work and less likely to seek help, the charity Mind has said.

Its survey of 15,000 employees found 1,763 had poor mental health.A third of men attributed that to their job, 14% said the source was outside work.

In contrast, women found their job and external problems equally stressful.

Men and women, workers and managers, should all be able to come forward and talk about any problems, Mind said.

It said men were less likely to feel they could talk about their jobs' impact on their wellbeing, or to have the tools to support people with mental health problems.

The charity asked employees at 30 companies signed up to its Workplace Wellbeing Index[3].They include large organisations like Deloitte, HMRC, the Environment Agency, Jaguar Land Rover and PepsiCo.

It also found:

  • Men were less likely to seek help or take time off - 29% had been absent for such problems, compared with 43% of women
  • Only a third of men felt their organisation's culture made it possible to speak about mental health issues;38% of women felt this
  • Men were more inclined to try to deal with problems alone
  • Or to cope by watching TV, exercising, or drinking.

Andrew Ormerod told the BBC's Today programme[4] how his problems spiralled at work.

"I was choosing to make myself more stressed.I was taking on more and more projects, working late, working at the weekend.

Image caption Andrew Ormerod says he has learned to tackle work in a more healthy way

"I was working in a way that wasn't sustainable.In the end, I had a breakdown and had to take a substantial amount of time off."

He said while his employer was supportive, he wasn't aware he could get in to such a pattern.Now, he finds part-time work keeps him on an "even keel".

And, a sick leave policy which explicitly states people can take time off for mental health reasons meant people could feel accepted, he said.

"I love working, I like doing a good job.One of the things I've had to learn is how to do that in a way that's healthy and sustainable."

Mind's Madeleine McGivern said:"Women feel more able to come forward.And women as line managers feel more equipped to support people with mental health problems.

"It's about trying to balance the playing field - we need all employers to encourage people at work to be having conversations about mental health, to normalise those conversations."...

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NHS to fund baby Oliver's US heart operation

Oliver Cameron Image caption Oliver's heart condition causes his pulse to race dangerously fast

The family of a baby boy who have been fundraising for him to have life-saving heart surgery in the US has been told the NHS will now fund his treatment.

Doctors in Boston have agreed to operate on Oliver Cameron, who was born with a rare heart tumour, after his first birthday in January.

Earlier, his parents warned time was running out[1] to raise the £150,000 needed for his treatment.

The NHS said it would pay because the procedure was not available in the UK.

Lydia and Tim Cameron, from Wantage in Oxfordshire, have already raised £130,000 for the surgery to have Oliver's tumour removed.

They have not indicated what they intend to do with the funds raised.

'Exceptionally rare'

Previously doctors advised that to maximise Oliver's ability to recover his parents should ideally wait until his first birthday but, if his condition worsened, he may require the operation immediately.

A statement from NHS England said it had "agreed to fund Oliver's treatment abroad" because there was "not currently a surgical service in the UK with experience of treating this exceptionally rare condition".

Oliver's condition - cardiac fibroma - is extremely rare and the number of patients with this type of tumour in England is estimated to be in single figures.

US learning opportunity

He needs around-the-clock care to stabilise his heart rate and an implant under his skin sends readings back to specialists at Southampton General Hospital, where he has been receiving treatment since doctors in Oxford discovered the tumour.

Specialists in Southampton said removing the tumour would be "extremely high risk" because there was limited experience in treating his condition in the UK so they had decided to support his parents' bid to find treatment elsewhere.

The NHS said it was also discussing whether a UK surgeon might accompany Oliver to Boston to learn from the surgeons in the US so the innovative surgery could "potentially be offered in the UK in future"....


  1. ^ his parents warned time was running out (

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