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Patient Safety Learning

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  1. Patient Safety Learning
    A top teaching hospital has blamed covid measures for a dramatic rise in the number of trolley waits in its accident and emergency department.
    In October, 111 patients at Cambridge University Hospitals (CUH) Foundation Trust, which runs Addenbrooke’s Hospital, waited more than 12 hours for admission, despite the region’s relatively low covid rates. 
    CUH recorded just nine 12-hour waits in September and 27 in August. It had no 12-hour waits in either June or July this year, and in October 2019, it had only one. 
    The trust also had 761 patients who waited more than four hours from the decision to admit to admission last month, out of a total of 2,998 emergency admissions. 
    CUH director of operations Holly Sutherland said: “We have had to reorganise the hospital to meet infection control requirements and to reduce the risk of covid-19 transmission. With limited side room availability due to the age of our facilities, this has reduced the number of beds in the hospital by around 100 and has impacted on patient flow from the emergency department."
    “We would like to apologise to anyone affected by this, and to reassure our patients that their safety is our utmost priority and we are doing everything we can to treat them as quickly as possible.”
    Read full story (paywalled)
    Source: HSJ, 18 November 2020
  2. Patient Safety Learning
    Expectant mothers are being warned about potentially confusing guidance on consuming caffeine while pregnant, as research suggests energy drinks could have potentially deadly consequences for their babies.
    A new report by Tommy’s Maternal and Fetal Health Research Centre claims to have established a 27 per cent rise in the risk of stillbirth for each 100mg of caffeine consumed.
    Researchers compared stillbirths to ongoing pregnancies among 1,000 women across 41 hospitals from 2014 to 2016 as well as interviewing women about their consumption of caffeinated drinks. They adjusted for demographic and behavioural factors, such as age and alcohol consumption, to determine whether stillbirth was linked to caffeine.
    One in 20 women were found to have increased their caffeine intake while pregnant in spite of evidence some caffeinated drinks put babies lives at risk. However, experts say that calculating precise intake can be difficult, and guidance on limiting caffeine is not consistent
    The NHS recommends pregnant women keep their daily caffeine intake below 200mg whereas the World Health Organization stipulates 300mg as the safe amount to consume.
    Tommy’s, a leading baby charity, called for both the NHS and the World Health Organisation to rethink such guidelines, but refused to outline a specific limit - saying it was the NHS and World Health Organisation’s responsibility to decide the recommendations in light of their new study.
    Professor Alexander Heazell, an author of the study, said: “Caffeine has been in our diets for a long time, and, as with many things we like to eat and drink, large amounts can be harmful – especially during pregnancy. It’s a relatively small risk, so people shouldn’t be worried about the occasional cup of coffee, but it’s a risk this research suggests many aren’t aware of."
    Read full story
    Source: The Independent, 18 November 2020
  3. Patient Safety Learning
    Coronavirus cases in the US will spike after Thanksgiving, further stressing health care systems and prompting new restrictions, an emergency physician said Saturday, as states continued to report soaring numbers of new cases, hospitalizations and deaths.
    Dr. James Phillips, chief of disaster medicine at George Washington University Hospital, told CNN's Erica Hill he is "terrified" about what's going to happen this holiday season.
    "We're going to see an unprecedented surge of cases following Thanksgiving this year, and if people don't learn from Thanksgiving, we're going to see it after Christmas as well," Phillips said.
    Already, grim indicators offer a glimpse of what's to come. A little more than a week after the US first topped 100,000 daily infections, it reported a record of more than 184,000 new cases Friday. Hospitalisations also hit a new high – for the fourth consecutive day – with more than 68,500 COVID-19 patients nationwide, according to the COVID Tracking Project. And the country's daily death toll has topped 1,300 at least three times this week.
    "Things are going to get much, much worse," said Dr. Leana Wen, a CNN medical analyst and former Baltimore Health Commissioner. She expressed concern over the impact on the already-strained health care system when the new cases added in recent days are reflected in hospitalisations.
    Read full story
    Source: CNN, 15 November 2020
  4. Patient Safety Learning
    Mothers are being needlessly separated from their babies under strict hospital restrictions introduced to stop the spread of COVID-19, doctors and charities have warned.
    The measures preventing UK parents from staying with their babies when one or both require hospital treatment are causing trauma and increasing the risk of physical and mental health problems, it is claimed.
    Some parents of sick babies are also being barred from seeing their child in neonatal units, which is causing distress and preventing bonding.
    Campaigners have written to the health secretary, Matt Hancock, to raise their concerns. They want hospitals to review these policies urgently and have called for a working group to draw up national standards to meet families’ needs during pregnancy, birth and breastfeeding.
    Read full story
    Source: The Guardian, 16 November 2020
  5. Patient Safety Learning
    "It's a full-time job that you can't quit. It's a massive burden that you didn't ask for, didn't expect."
    Diagnosed with type 1 diabetes at the age of 19, Naomi, now 33, says she reached a point where she simply could not handle "the physical or mental challenges of diabetes any more", a condition known as "diabetes burnout".
    About 250,000 people in England have type 1 diabetes, which means the body cannot produce insulin, the hormone that controls blood sugar levels. It can lead to organ damage, eyesight problems and - in extreme cases - limb amputation. But for many there is also a significant psychological impact of learning to manage the condition.
    Naomi felt she could no longer bear testing her blood sugar levels many times each day to calculate how much insulin she needed to inject, even though she knew she was risking her long-term health and putting herself in extreme danger, at risk of developing diabetic ketoacidosis (DKA), which can lead to a coma. She became so ill she was admitted to an eating disorder unit even though she was not struggling to eat.
    The head of the unit, Dr Carla Figueirdo, says of her diabetes patients: "These people are seriously unwell, seriously unwell. They are putting themselves at harm every day of their lives if they don't take their insulin."
    Naomi's consultant at the Royal Bournemouth Hospital, Dr Helen Partridge, says the psychological impact of a diabetes diagnosis should not be underestimated. 
    The hospital is hosting one of two NHS England pilot projects looking at how to treat type 1 diabetes patients whose chronic illness affects their mental health.
    NHS England diabetes lead Prof Partha Kar says: "The NHS long-term plan commits strongly on getting mental and physical health together. If we do tackle these two together, it will help improve outcomes."
    Read full story
    Source: BBC News, 16 November 2020
     
  6. Patient Safety Learning
    Hospital food standards are set to be put on a statutory footing, with trusts held to account by the Care Quality Commission, according to the chair of a government-commissioned review.
    Philip Shelley, who led the review into hospital food following seven patient deaths from listeria last year, told HSJ the incident was an “absolute condemnation” and that trusts must use the review to improve food standards.
    The review, published last month, also calls for capital investment to refurbish hospital kitchens and replace old and inefficient equipment, which is likely to cost several hundreds of millions of pounds.
    The government has accepted the recommendations and Mr Shelley will lead a group of experts to oversee the review’s implementation across the NHS during the next three years.
    Among the review’s recommendations is the “enhanced role” for the CQC when it inspects NHS trusts.
    The review states there is currently “very little evidence to prove that food and drink standards are being monitored closely enough” and it therefore recommends placing the standards on a statutory footing from which the CQC can hold trusts to account.
    Read full story (paywalled)
    Source: HSJ, 17 November 2020
  7. Patient Safety Learning
    Several patients were harmed after leaders at an acute trust failed to act on multiple concerns being raised about a surgeon, documents obtained by HSJ suggest.
    The documents reveal a catalogue of governance and safety concerns over the trauma and orthopaedics department at University Hospitals of Morecambe Bay Foundation Trust in the last three years.
    They include an external review which described the process for investigating clinical incidents as akin to “marking your own homework” and found the T&O department at Royal Lancaster Infirmary driven by “internecine squabbles”.
    It comes as the trust, which is widely known for a patient safety scandal within its maternity department, also faces a major investigation into whistleblowing concerns over its urology services.
    Read full story (paywalled)
    Source: HSJ, 17 November 2020
  8. Patient Safety Learning
    More than three-quarters of midwives think staffing levels in their NHS trust or board are unsafe, according to a survey by the Royal College of Midwives (RCM).
    The RCM said services were at breaking point, with 42% of midwives reporting that shifts were understaffed and a third saying there were “very significant gaps” in most shifts.
    Midwives were under enormous pressure and had been “pushed to the edge” by the failure of successive governments to invest in maternity services, said Gill Walton, the chief executive of the RCM.
    “Maternity staff are exhausted, they’re demoralised and some of them are looking for the door. For the safety of every pregnant woman and every baby, this cannot be allowed to continue,” she said.
    “Midwives and maternity support workers come into the profession to provide safe, high-quality care. The legacy of underfunding and underinvestment is robbing them of that – and worse still, it’s putting those women and families at risk.”
    RCM press release
    Read full story
    Source: The Guardian, 16 November 2020
  9. Patient Safety Learning
    A key expansion of services for patients recovering from coronavirus has been delayed by several months, HSJ has learned.
    In July, NHS England hailed a “ground breaking” new service with the launch of a website with information for patients on how to recover from covid following hospital discharge. It promised a second phase of the service would allow patients to be connected with health professionals for more tailored support, to be launched “later this summer”.
    But in a memo sent to professional bodies on 30 October, NHSE said the national roll-out was delayed until at least January 2021, with no date confirmed for the launch beyond that.
    Documents on the website itself said a “first cohort of patients from Leicester will begin to work through the programme” in November, with a further rollout scheduled for early December, followed by a “refresh” in January 2021 and a “full national rollout accessible across the country” at an unspecified date beyond that.
    The second phase is seen as vital for ensuring that people with covid receive personalised support to help them recover from its debilitating effects, especially as a separate face-to-face rehabilitation programme was scrapped due to costs.
    Read full story (paywalled)
    Source: HSJ, 16 November 2020
  10. Patient Safety Learning
    Eight months after phrases such as “stay at home,” “flatten the curve” and “social distancing” started to become part of our daily vocabulary, people are experiencing a type of burnout experts call COVID-19 fatigue.
    “By this point, we know people are tired — tired of missing family and friends, tired of not having a routine, of not going into the office,” said Jeanne Marrazzo, M.D., director of the University of Alabama at Birmingham (UAB) Division of Infectious Diseases. “Whatever disruptions to a person’s normal life have occurred, there is no denying the mental, physical and emotional toll people are experiencing. What we’ve learned — and what we keep learning — is how to combat burnout in safe ways that minimize the spread of the virus and enable us to feel some sense of normalcy.”
    Figuring out how to safely navigate the new normal is more important than ever, explain UAB experts, particularly heading into more vulnerable and trying winter months that present unique challenges.
    Read full story
    Source: University of Alabama at Birmingham, USA, 6 November 2020
  11. Patient Safety Learning
    An official review carried out for the health secretary, leaked to HSJ,  reveals plans to bolster the law to require greater sharing of patient data, saying it would help improve safety for those wrongly prescribed drugs.
    A draft of the report on overprescribing, carried out for Matt Hancock by NHS England, says a major problem is that clinicians in different parts of the system can’t see what’s been prescribed and dispensed elsewhere. It says “wider access” should be given, which would also ensure “many eyes” are looking at the data to detect patterns or problems.
    This should include making it a requirement that prescribing apps make their data openly available, according to the report by chief pharmaceutical officer Keith Ridge.
    Read full story (paywalled)
    Source: HSJ, 16 November 2020
  12. Patient Safety Learning
    The NHS will launch a network of more than 40 ‘long COVID’ specialist clinics within weeks to help thousands of patients suffering debilitating effects of the virus months after being infected.
    The clinics, due to start opening at the end of November, will bring together doctors, nurses, therapist and other NHS staff to physical and psychological assessments of those experiencing enduring symptoms.
    NHS England has provided £10 million to fund the pioneering clinics, which will see patients who have been hospitalised, officially diagnosed after a test or reasonably believe they had COVID-19.
    Ten sites have been earmarked for the Midlands, seven in the North East, six in the East of England, South West and South East respectively, five in London and three in the North West.
    Patients will be able to access services through a GP referral or referral from other healthcare professional, allowing doctors an opportunity to rule out any other possible underlying causes for symptoms, such as suspected stroke, lung cancers or respiratory conditions.
    The NHS has also launched a new taskforce, with patients, charities, researchers and clinicians, to help manage the NHS approach to ‘long COVID’ and produce information and support materials for patients and healthcare professionals to develop a wider understanding of the condition.
    NHS Chief Executive Sir Simon Stevens said: “Long COVID is already having a very serious impact on many people’s lives and could well go on to affect hundreds of thousands.
    “That is why, while treating rising numbers of patients who are sick with the virus and many more who do not have it, the NHS is taking action to address those suffering ongoing health issues."
    “These pioneering ‘long COVID’ clinics will help address the very real problems being faced by patients today while the taskforce will help the NHS develop a greater understanding of the lasting effects of coronavirus.”
    Read full press release
    Source: NHS England, 15 November 2020
  13. Patient Safety Learning
    Young and previously healthy people with ongoing symptoms of COVID-19 are showing signs of damage to multiple organs four months after the initial infection, a study suggests.
    The findings are a step towards unpicking the physical underpinnings and developing treatments for some of the strange and extensive symptoms experienced by people with “long Covid”, which is thought to affect more than 60,000 people in the UK. Fatigue, brain fog, breathlessness and pain are among the most frequently reported effects.
    On Sunday, the NHS announced it would launch a network of more than 40 long Covid specialist clinics where doctors, nurses and therapists will assess patients’ physical and psychological symptoms.
    The Coverscan study aims to assess the long-term impact of COVID-19 on organ health in around 500 “low-risk” individuals – those who are relatively young and without any major underlying health complaints – with ongoing Covid symptoms, through a combination of MRI scans, blood tests, physical measurements and online questionnaires.
    Preliminary data from the first 200 patients to undergo screening suggests that almost 70% have impairments in one or more organs, including the heart, lungs, liver and pancreas, four months after their initial illness.
    “The good news is that the impairment is mild, but even with a conservative lens, there is some impairment, and in 25% of people it affects two or more organs,” said Amitava Banerjee, a cardiologist and associate professor of clinical data science at University College London.
    Read full story
    Source: The Guardian, 15 November 2020
  14. Patient Safety Learning
    Lawyers have begun legal action on behalf of 200 UK women against the makers of a sterilisation device, after claims of illness and pain.
    The device, a small coil called Essure, was implanted to prevent pregnancies.
    Manufacturer Bayer has already set aside more than $1.6bn (£1.2bn) to settle claims from almost 40,000 women in the US. It has withdrawn the device from the market for commercial reasons but says it stands by its safety and efficacy.
    The metal coil was inserted into the fallopian tube to cause scarring, blocking the tube and preventing pregnancy. 
    Introduced in 2002, it was promoted as an easy, non-surgical procedure - a new era in sterilisation. But many women who had the device fitted have now either had hysterectomies or are waiting for procedures to remove the device.
    Tracey Pitcher, who lives in Hampshire, felt she had completed her family and did not want any more children.
    Her doctor strongly encouraged her to have an Essure device fitted, she says. But after it had been, she began to feel very unwell.
    "I just started to have heavy periods, migraines, which I had only ever had when I was pregnant so they were hormonal," she says. "My back was so painful I'd wake up crying in the middle of the night with pains in my hips and my back."
    Tracey says she battled to persuade doctors to take her symptoms seriously. But the only information she received was from a Facebook group.
    "... there's nobody there, there's no support apart from people that we've found ourselves, no-one will listen, because it's just 'women's things'."
    Read full story
    Source: BBC News, 15 November 2020
  15. Patient Safety Learning
    Thousands of frontline workers delivering treatments where the risk of transmitting coronavirus is heightened are still being denied personal protective equipment (PPE), according to multiple unions and professional bodies.
    Eleven organisations, including Unison and the British Association of Stroke Physicians, believe numerous procedures have been “wrongly excluded” from the list of 13 “aerosol generating procedures” that require PPE, despite the NHS now having adequate supplies.
    They say their members are “facing illness and even death” while performing procedures such as chest physiotherapy, introducing feeding tubes, and assessing whether a patient can swallow safely.
    The unions have formed an alliance to lobby on the issue, and its chair Dr Barry Jones told HSJ: “We’ve asked ministers and the Department of Health and Social Care again and again to take action and provide PPE to frontline NHS staff carrying out procedures which are not currently listed as AGPs but which the scientific evidence shows should be.
    Read full story
    Source: HSJ, 13 November 2020
  16. Patient Safety Learning
    Black and Asian people are up to twice as likely to be infected with COVID-19 compared to those of white ethnicities, according to a major new report.
    The risk of ending up in intensive care with coronavirus may be twice as high for people with an Asian background compared to white people, data gathered from more than 18 million individuals in 50 studies across the UK and US also suggests.
    The report, published in the EClinicalMedicine by The Lancet, is the first-ever meta-analysis of the effect of ethnicity on patients with COVID-19.
    The scientists behind it said their findings should be of "importance to policymakers" ahead of the possible roll out of a vaccine.
    Read full story
    Source: The Independent, 12 November 2020
  17. Patient Safety Learning
    People with learning disabilities are dying of coronavirus at more than six times the rate of the general population, according to “deeply troubling” figures that have prompted a government review.
    A report from Public Health England (PHE) found that 451 in every 100,000 people registered as having learning disabilities died after contracting Covid-19 in the first wave of the pandemic, when the figures were adjusted for age and sex.
    Because not all Covid deaths among people with learning disabilities are registered as such, the true figure is likely to be 692 in every 100,000, or 6.3 times the UK average, the report estimated.
    Campaigners said the figures showed the government had failed to protect the most vulnerable.
    The report found that Covid deaths among those with learning disabilities were also more widely spread across age groups, with far greater mortality rates among younger adults. Those aged 18-34 were 30 times more likely to die with the virus than their counterparts in the general population.
    The higher death rate is likely to reflect the greater prevalence of health problems such as diabetes and obesity among those with learning disabilities, the report said. It also noted that some learning disabilities, such as Down’s syndrome, can make people more vulnerable to respiratory infections.
    People with learning disabilities are also likely to have difficulty recognising symptoms and following advice on testing, social distancing and infection prevention, the report said. It may also be harder for those caring for them to recognise symptoms if these cannot be communicated, it added.
    Read full story
    Source: The Guardian, 12 November 2020
  18. Patient Safety Learning
    A community trust was told to urgently review prescribing of stimulant medications for children after concern that some were posted to families but never arrived.
    Bridgewater Community Healthcare Foundation Trust was told that sending prescriptions through the post may be a potentially unsafe practice by the Royal College of Paediatrics and Child Health. The warning came in a report from the college after it was invited by the trust to review its community paediatrics service
    The trust was urged to work with primary care and clinical commissioning groups to establish shared care for children who needed these medications. Stimulant medicines are often used for children with attention deficit hyperactivity disorder.
    The review also found there was a “a very significant risk for patient care” with letters, reports and prescriptions being delayed or going missing due to “recurrent issues” with the post in the building used by the team covering St Helen’s.
    It highlighted issues with the safeguarding procedures at the trust, with each locality team having its own processes and handling a small number of cases, and called for urgent work to streamline services.
    Read full story (paywalled)
    Source: HSJ, 11 November 2020
  19. Patient Safety Learning
    A trust in the south east is coming under increasing pressure from a growing number of covid patients, leading to long delays in ambulance handovers.
    HSJ has been told that ambulances have been waiting up to five hours to hand over patients at Medway Foundation Trust, which has around 90 covid patients. 
    The trust is currently continuing with elective work but covid patients are taking up close to 20% of its beds. Sources have told HSJ that bed occupancy at the trust is already very high – with a high proportion of acutely ill patients - and there are issues with discharging patients into nursing homes which is affecting the ability to admit patients swiftly through A&E.
    Read full story (paywalled)
    Source: HSJ, 11 November 2020
  20. Patient Safety Learning
    Patients, including those with the coronavirus, are being kept “head to toe” on trolleys in accident and emergency departments in Manchester, with some forced to wait up to 40 hours for a bed.
    The “dangerous” situation has sparked warnings from the president of the Royal College of Emergency Medicine over the “potentially lethal” crowding of patients in A&Es across the country this winter. 
    Katherine Henderson said she was “absolutely terrified” by what was happening in some departments. She said she had warned NHS England about the dangers of crowding patients in A&E but that not enough action had been taken.
    She told The Independent: “Crowding in A&E is unsafe, but with coronavirus it is potentially lethal. We have said this endlessly to NHS England."
    “Everyone agrees crowding is bad, but what they’re not doing is translating that into action.”
    After hearing of the situation in Manchester, she added: “Exactly what we said should not happen is happening. I am absolutely terrified by this. What more can I do? I have highlighted this risk everywhere I can over the past few months.”
    Read full story
    Source: The Independent, 11 November 2020
  21. Patient Safety Learning
    An acute trust’s record of eight never events in the last six months has raised concerns that quality standards have slipped since it was taken out of special measures.
    The never events occurred at Royal Cornwall Hospitals Trust. They included three wrong site surgeries within the same speciality and an extremely rare incident in which a 30cm (15 inch) wire was left in a cardiology patient.
    Kate Shields, chief executive of the trust, said the incidents have led to a “great deal of soul searching”.
    Prior to the incidents the trust had gone 13 months without recording a never event, and Ms Shield acknowledged that pressure created by the pandemic was likely to have been a contributing factor behind the cluster of never events.
    She stressed that none of the patients affected had suffered physical harm.
    Read full story (paywalled)
    Source: HSJ, 12 November 2020
  22. Patient Safety Learning
    A nurse is due in court charged with eight counts of murder following an investigation into baby deaths at the Countess of Chester hospital neonatal unit in Cheshire.
    Lucy Letby, 30, is due to appear at Warrington magistrates court on Thursday. She was arrested for a third time on Tuesday as part of the investigation into the hospital, which began in 2017.
    A force spokesman said: “The Crown Prosecution Service has authorised Cheshire police to charge a healthcare professional with murder in connection with an ongoing investigation into a number of baby deaths at the Countess of Chester hospital.”
    He said Letby was facing eight charges of murder and 10 charges of attempted murder relating to the period from June 2015 to June 2016.
    On Tuesday, police said parents of all the babies involved were being kept fully updated on developments and were being supported by officers.
    Read full story
    Source: The Guardian, 11 November 2020
  23. Patient Safety Learning
    Early results from trials of a Covid vaccine developed in Russia suggest it could be 92% effective.
    The data is based on 20 cases of COVID-19 from 16,000 volunteers given the Sputnik V vaccine or a dummy injection.
    While some scientists welcomed the news, others said the data had been rushed out too early. It comes after Pfizer and BioNTech said their vaccine could prevent 90% of people getting Covid-19, based on a study of 43,500 people.
    Although the Sputnik data is based on fewer people being vaccinated and fewer cases of Covid developing during the trial, it does confirm promising results from earlier research.
    The Sputnik V vaccine, developed at the National Research Centre for Epidemiology and Microbiology in Moscow, is currently going through phase III clinical trials in Belarus, UAE, Venezuela and India.
    So far there are no safety issues, with Russian researchers saying there were "no unexpected adverse events" 21 days after volunteers received their first of two injections.
    Read full story
    Source: BBC News, 11 November 2020
  24. Patient Safety Learning
    A Tory peer has attacked the Department of Health and Social Care’s ‘woeful’ response to the patient safety review she authored and has revealed she intends to create a cross-party group to force action.
    Baroness Julia Cumberlege - who led the “First Do No Harm” report on device and medicine safety– has said she has “not had a whisper” from the department over the report’s key recommendations since it was published in July.
    She told HSJ’s Patient Safety Congress she is setting up a cross-party parliamentary group to “pressure” the department to adopt the report’s recommendations.
    The report arose from The Independent Medicines and Medical Devices Safety Review, which spoke to more than 700 people, mostly women, who suffered avoidable harm from surgical mesh implants, pregnancy tests and the anti-epileptic drug sodium valproate.
    The report discovered “a culture of dismissive and arrogant attitudes” including the unacceptable labelling of many symptoms as “attributable to ‘women’s problems’”. It concluded that the NHS has “either lost sight of the interests of all those it was set up to serve or does not know how best to do this.”
    Health and social care secretary Matt Hancock and minister Nadine Dorries have apologised to the women who were harmed but the department has so far not responded to the report’s other eight recommendations in detail.
    Baroness Cumberlege said the cross party group would “[try] to open up a firmly shut departmental door. A department that doesn’t seem to get it.” She said: “We have been disappointed [in the department’s response] because we hoped by now we would have some sort of inclination about what’s going on."
    “The response from the department on the other key recommendations has been woeful. The reason they give is ‘there is a terrible amount of work to do’”.
    Read full story (paywalled)
    Source: HSJ, 11 November 2020
  25. Patient Safety Learning
    Planning around what the NHS can deliver this winter must be based on how many nursing staff are available and the workload they can safely take on, the Royal College of Nursing (RCN) has warned.
    Amid widespread nursing shortages, the union has called on the government to “be honest” about nurse vacancies and address what steps need to be taken to keep staff and patients safe.
    “It is essential that learning is applied to planning for this winter, including what service can be delivered safely with the workforce available”
    Last week NHS England moved to its highest level of emergency preparedness. But the RCN warned it still had grave concerns around how services would be safely staffed, claiming it was too late to find the nurses needed to meet the anticipated demands of the incoming winter.
    Despite an increase in the number of nurses registered with the Nursing and Midwifery Council this year, the college said there were still around 40,000 nurse vacancies in the NHS in England alone.
    These shortages, which were felt across all areas of nursing, had been exacerbated because of staff self-isolating or being off sick because of COVID-19, the RCN noted.
    The impacts of workforce shortages meant there was “enormous responsibility” on the nurses working and “intolerable pressure” on senior nursing leaders, it said. Unless local staffing plans prioritised safe and high-quality care, the few nurses in post were at risk of “burn out” this winter, the college added.
    Read full story (paywalled)
    Source: Nursing Times, 9 November 2020

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