Latest news with #emergencydepartments
Medscape
4 days ago
- Health
- Medscape
Nontargeted Hepatitis C Screening Yields More Diagnoses
TOPLINE: Nontargeted hepatitis C virus (HCV) screening in emergency departments (EDs) was superior to targeted screening for identifying new HCV infections in a prospective randomized screening trial. However, only a small proportion of diagnosed patients achieved sustained virologic response at 12 weeks, emphasizing the need for better HCV treatment models. METHODOLOGY: A prospective, multicenter, randomized DETECT HCV clinical trial was conducted at three urban EDs in the US, involving 147,498 adult patients (median age, 41 years; 51.5% men) with diverse racial demographics (42.3% Black, 20.9% Hispanic, and 32.2% White). clinical trial was conducted at three urban EDs in the US, involving 147,498 adult patients (median age, 41 years; 51.5% men) with diverse racial demographics (42.3% Black, 20.9% Hispanic, and 32.2% White). From November 2019 to August 2022, 73,847 patients (50.1%) were randomized to undergo nontargeted HCV screening (HCV testing offered regardless of risk). Among the 73,651 patients (49.9%) randomized to targeted HCV screening (testing offered on the basis of risk assessment), 23,400 (31.8%) were identified as having increased risk. The primary outcome was a newly diagnosed HCV infection with detectable RNA and no known prior HCV diagnosis. Secondary outcomes included repeat diagnoses; HCV test offer, acceptance, and completion rates; HCV genotype and fibrosis staging; components of the HCV care continuum; and 18-month all-cause mortality. TAKEAWAY: Nontargeted screening resulted in significantly more new HCV diagnoses than targeted screening (154 vs 115; relative risk [RR], 1.34; P = .02). Nontargeted HCV screening yielded higher testing rates than targeted screening, with 3.1 times more participants in the nontargeted group being offered testing (89.0% vs 28.5%; P < .001), a higher percentage accepting testing (22.4% vs 9.7%; P < .001), and 2.1 times more participants completing the test (13.4% vs 6.3%; P < .001). Differences in linkage to care remained nonsignificant between the groups (19.5% vs 24.3%; P = .37), with similar rates of treatment initiation (15.6% vs 17.4%; P = .74), treatment completion (12.3% vs 12.2%; P > .99), sustained virologic response at 12 weeks (9.1% vs 9.6%; P > .99), and all-cause mortality at 18 months (5.2% vs 4.3%; P > .99). Among 269 newly diagnosed patients, the 112 (41.6%) with ongoing risk — such as injection drug use — had lower linkage to care (16.1% vs 25.5%; P = .06), lower completion of direct-acting antiviral treatment (5.4% vs 17.2%; P = .004), and lower sustained virologic response (5.4% vs 12.1%; P = .06) than those without recent injection drug use. IN PRACTICE: "This multicenter randomized clinical trial determined a nontargeted screening approach was superior to targeted screening for identifying new HCV infections among patients seen in three urban EDs. The substantial decrease in patients who went from diagnosis to SVR12 [sustained virologic response at 12 weeks] highlights an urgent need for innovative models of HCV treatment," the authors concluded. SOURCE: The study was led by Jason Haukoos, MD, MSc, Department of Emergency Medicine, Denver Health, Denver. It was published online on July 09, 2025, in JAMA. LIMITATIONS: The generalizability of the study outcomes was limited by the inclusion of only three EDs experienced in infectious disease screening. Changes in ED workflows, screening implementation, and the HCV care continuum during the COVID-19 pandemic likely contributed to delays in secondary outcomes. The study was further limited by the exclusion of a large number of ED visits due to high acuity or lack of consent, potential misclassification bias, and the inability to draw clear inferences from the HCV care continuum and secondary outcomes. DISCLOSURES: The study was funded by the National Institute on Drug Abuse. Rothman reported receiving grants from the Gilead Sciences FOCUS program and the Baltimore City Health Department during the conduct of the study. Additional disclosures are noted in the original article. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
BreakingNews.ie
6 days ago
- Health
- BreakingNews.ie
Number of people waiting on trolleys in emergency department down by 10%
There was a 10 per cent reduction in the number of people waiting on trolleys in emergency departments last year, according to the latest HSE annual report. Over 108,000 people were recorded on trolleys in emergency departments last year, according to HSE figures, which represents a reduction. Advertisement The fall was recorded amid an 8 per cent increase in people attending and a rise of 7 per cent in admissions to emergency departments. HSE chief executive Bernard Gloster said one of the most 'challenging' aspects for the HSE was wait times for healthcare, and said tackling 'unacceptably long' waits in emergency departments was an area of focus. The HSE annual report for 2024 analyses the health service's performance and health trends among Irish people. It outlined a 4.6 [er cent improvement in the number of outpatients seen within 10 weeks and a 5.5 per cent increase in the number of inpatients and day case patients seen within 12 weeks. Advertisement 'Addressing waiting lists for scheduled care and unacceptably long waits in emergency departments (EDs) remains a priority focus area, especially for older people and those with complex needs,' Mr Gloster said in the foreword. 'My plan for 2025 is to continue to bring trolley numbers down and to improve how our health and social care system works across seven days to allow consistent access to care.' Requests for assessments of need for children spiked by 26 per cent last year compared to a year previous, and were 33 per cent above expected demand in 2024 There were 8,400 such requests in 2023 and more than 10,600 in 2024, in figures which had previously been shared by Children's Minister Norma Foley in the Dáil. Advertisement Although there was a slight uptake on the measles, mumps, rubella (MMR) vaccine compared to the previous year, the 89.9 per cent figure was below the target for 2024. The chairman of the HSE's board, Ciaran Devane, said in an introductory statement to the report that Ireland's population is ageing 'faster than that of any other country in the EU'. Since 2015, the number of people aged 65 years and over has increased by 37 per cent. Although life expectancy in Ireland, at 82.6 years, is ahead of the EU average, the burden of cancer is higher and accounts for a quarter of all deaths of those aged over 65. Advertisement Ireland Organised €14 million 'darknet' crypto crime trial... Read More Mr Gloster, who is to step down from his role in March 2026, said 2024 was a year of 'real progress'. 'We reduced the number of people waiting on trolleys by over 10 per cent, expanded community services and improved access to scheduled care with an additional 24,000 patients seen within target timeframes. 'Our focus in 2025 will be to build on this momentum, improve patient flow and continue to reform how care is delivered across seven days.'
The Independent
22-07-2025
- Health
- The Independent
NHS England approach to doctors' strike ‘seriously risky', BMA warns
A senior doctors' union leader has warned NHS England's approach to the upcoming five-day strike by resident doctors is 'seriously risky' and could lead to patient harm in emergency departments. British Medical Association (BMA) deputy chairwoman Dr Emma Runswick told BBC Radio 4's Today programme on Tuesday that guidance issued by the health service to keep most planned care running during the walkout could cause dangerous confusion and overstretch staff. 'We've had proven systems over the last decade that have made sure that where we have to take strike action, senior doctors cover urgency and critical care,' she said. 'This time round, NHS England are pushing for the continuation of non-urgent and scheduled care in a way that we think at best is confusing and will create on-the-day cancellations – and at worst could be risky and lead to harm in emergency departments and on wards, because senior doctors cannot physically be in two places at once. 'We think that a notional guidance from NHS England which is saying that basically all scheduled work should continue to go ahead has potential to be seriously risky for patients.' Her comments come amid an escalating row between NHS bosses and the BMA over how hospitals should respond to the strike, which is due to begin at 7am on Friday. During previous rounds of industrial action in 2023 and 2024, NHS England told trusts to cancel large volumes of non-urgent care so that consultants could step in to cover emergency services. But under the leadership of new NHS England chief executive Sir Jim Mackey, hospitals have now been instructed to cancel non-urgent work only in 'exceptional circumstances' – and only with prior approval. The BMA argues this new approach risks spreading non-striking doctors too thinly, with Dr Runswick warning: 'Senior doctors are needed to be freed up in order to provide urgency and critical care. 'We think the vast majority of planned and unscheduled care should be shifted. 'There are always, in every hospital, local medical managers, local clinical leaders, who will make decisions about what is safe to go ahead – but trying to maintain scheduled care during this strike is not safe in many cases.' When asked why the union could not avoid strikes altogether, she said walkouts can be delivered safely if planned properly. 'Strikes by doctors do not have to be risky,' she said. 'Strikes by doctors have been run safely in 2016 and 2022, 2023, 2024. 'We are entirely capable of running strikes safely – they just have to be planned for with local medical leadership, and we've done that before. We can do it again.' She said the BMA was still hopeful a resolution could be reached before the walkout begins and was 'keen to work with NHS England to ensure they are best planned for the safest care'. Talks between the Government and the BMA have continued in recent days, with Health Secretary Wes Streeting ruling out any additional pay rise this year but indicating other aspects of the contract – such as student debt, exam fees and working conditions – may be up for negotiation. Resident doctors, formerly known as junior doctors, were awarded an average 5.4% pay increase this financial year, following a 22% rise over the previous two years. However, the BMA says real-terms pay has still fallen by around 20% since 2008, and is pushing for full 'pay restoration'.
Yahoo
22-07-2025
- Health
- Yahoo
NHS England approach to doctors' strike ‘seriously risky', BMA warns
A senior doctors' union leader has warned NHS England's approach to the upcoming five-day strike by resident doctors is 'seriously risky' and could lead to patient harm in emergency departments. British Medical Association (BMA) deputy chairwoman Dr Emma Runswick told BBC Radio 4's Today programme on Tuesday that guidance issued by the health service to keep most planned care running during the walkout could cause dangerous confusion and overstretch staff. 'We've had proven systems over the last decade that have made sure that where we have to take strike action, senior doctors cover urgency and critical care,' she said. 'This time round, NHS England are pushing for the continuation of non-urgent and scheduled care in a way that we think at best is confusing and will create on-the-day cancellations – and at worst could be risky and lead to harm in emergency departments and on wards, because senior doctors cannot physically be in two places at once. 'We think that a notional guidance from NHS England which is saying that basically all scheduled work should continue to go ahead has potential to be seriously risky for patients.' Her comments come amid an escalating row between NHS bosses and the BMA over how hospitals should respond to the strike, which is due to begin at 7am on Friday. During previous rounds of industrial action in 2023 and 2024, NHS England told trusts to cancel large volumes of non-urgent care so that consultants could step in to cover emergency services. But under the leadership of new NHS England chief executive Sir Jim Mackey, hospitals have now been instructed to cancel non-urgent work only in 'exceptional circumstances' – and only with prior approval. The BMA argues this new approach risks spreading non-striking doctors too thinly, with Dr Runswick warning: 'Senior doctors are needed to be freed up in order to provide urgency and critical care. 'We think the vast majority of planned and unscheduled care should be shifted. 'There are always, in every hospital, local medical managers, local clinical leaders, who will make decisions about what is safe to go ahead – but trying to maintain scheduled care during this strike is not safe in many cases.' When asked why the union could not avoid strikes altogether, she said walkouts can be delivered safely if planned properly. 'Strikes by doctors do not have to be risky,' she said. 'Strikes by doctors have been run safely in 2016 and 2022, 2023, 2024. 'We are entirely capable of running strikes safely – they just have to be planned for with local medical leadership, and we've done that before. We can do it again.' She said the BMA was still hopeful a resolution could be reached before the walkout begins and was 'keen to work with NHS England to ensure they are best planned for the safest care'. Talks between the Government and the BMA have continued in recent days, with Health Secretary Wes Streeting ruling out any additional pay rise this year but indicating other aspects of the contract – such as student debt, exam fees and working conditions – may be up for negotiation. Resident doctors, formerly known as junior doctors, were awarded an average 5.4% pay increase this financial year, following a 22% rise over the previous two years. However, the BMA says real-terms pay has still fallen by around 20% since 2008, and is pushing for full 'pay restoration'.
RNZ News
14-07-2025
- Health
- RNZ News
Auckland's public hospitals at the 'upper limit' of capacity
Te Whatu Ora Northern acting deputy chief executive Vanessa Thornton. Photo: RNZ / Dan Cook Auckland's public hospitals are at the "upper limit" of their capacity as winter illnesses hit hard. Ambulances were delayed off-loading patients at Auckland City and Middlemore hospitals on Monday, and all four of the city's public hospitals were under pressure The acting deputy chief executive of Te Whatu Ora Northern, Vanessa Thornton, said hospitals are very full and many people are turning up to emergency departments with respiratory illnesses. "Coughs, colds, pnemonias, flu - influenza A and B, these are the things that are ... increasing the number of presentations at this time of year," she said. Monday was very busy - Mondays often are - but not the busiest this winter, she said. Even though ambulance patients were delayed at Middlemore and Auckland, the hospitals did not need to escalate to emergency reponse mode where ambulances might take patients to other hospitals to reduce the load, she said. That had happened at times in the past few weeks, Thornton said. When wards were very full with sick people, the pressure mounted on emergency departments because it was harder to move people out and admit them to a hospital bed. "At this time of the year we are always generally full at the acute services - medicine, surgery, orthopaedics, they're all very full," she said. "Our capacity is at its upper limit but we have got some escalation capacity which some of the hospitals have needed to employ to ensure flow." Hato Hone St John Ambulance Auckland operations manager Andy Everiss said the service worked with the hospitals to manage demand yesterday, including taking patients to non-hospital clinics where appropriate. It was working to ensure those who needed time-critical care got it without delay, he said. Thornton, who is an ED doctor herself, said patients should not hesitate to come to hospital if they needed emergency care at any time of the day or night. Those who needed urgent care would be seen urgently, she said. Sign up for Ngā Pitopito Kōrero , a daily newsletter curated by our editors and delivered straight to your inbox every weekday.
