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Found 1,324 results
  1. News Article
    “There’s a gap today that no locum filled, so I am carrying both bleeps and doing the work of two people.” That recent tweet, by a children’s doctor, is one of many examples posted on social media by medics illustrating how NHS staff shortages affect them, patients, the smooth running of important services – and, sometimes, the safety of those who are receiving care. It is a concern shared by every organisation that represents frontline staff, by regulators such as the Care Quality Commission (CQC), and by NHS England, the body that oversees the service. In January the CQC reported that an inspection it had undertaken of Colchester hospital in Essex found patients were missing out on meals because there were too few staff on duty to feed them. Some patients were wearing dirty dressings, and others did not have their call bells answered promptly, for the same reason. In a letter to the trust that runs the hospital, it said: “All wards’ actual staffing levels and skill mix meant staff were often overstretched. All staff we spoke with expressed concern about the impact on patient care and personal wellbeing. “Some staff we spoke to were tearful, reported feeling exhausted and concerned that they were unable to care for patients well enough to keep them safe.” Read full story Source: The Guardian, 26 March 2023
  2. News Article
    The NHS in England needs a massive injection of homegrown doctors, nurses, GPs and dentists to avert a recruitment crisis that could leave it short of 571,000 staff, according to an internal document seen by the Guardian. A long-awaited workforce plan produced by NHS England says the health service is already operating with 154,000 fewer full-time staff than it needs, and that number could balloon to 571,000 staff by 2036 on current trends. The 107-page blueprint, which is being examined by ministers, sets out detailed proposals to end the understaffing that has plagued the health service for years. It says that without radical action, the NHS in England will have 28,000 fewer GPs, 44,000 fewer community nurses and an even greater lack of paramedics within 15 years. However, the Guardian understands that the chancellor, Jeremy Hunt, is playing a key role in behind-the-scenes moves by the Treasury to water down NHS England’s proposals to double the number of doctors that the UK trains and increase the number of new nurses trained every year by 77% – because it would cost several billion pounds to do that. A senior NHS leader said: “Jeremy Hunt has been very resistant to the numbers in the workforce plan. The Treasury and Hunt don’t want numbers in it. They want it to be not very precise. They want the numbers to be projected in a different way that would be less expensive and to not commit to training specific numbers of doctors, nurses and others. “While intellectually Hunt gets it, and emotionally he gets the patient safety argument, it seems that his priority, if the government has any financial headroom, is to use that for tax cuts or giving the army more money rather than training more doctors, nurses and speech and language therapists. Read full story Source: The Guardian, 26 March 2023
  3. News Article
    US clinical and nonclinical healthcare workers have an upward-trending perception of safety culture, but physicians and leaders do not agree, according to a Press Ganey report. Press Ganey, a US company that focuses on patient satisfaction surveys, found in its annual safety culture trends report that senior management perceptions of all safety culture metrics are lower. Overall safety scores are down 0.04 points, prevention and reporting decreased 0.02 points, pride and reputation declined 0.05 points, and resources and teamwork are down 0.04 points. The report analysed 2022 data from 813,900 healthcare workers across 194 systems and 3,279 facilities. "Senior management safety culture scores are typically higher than those of operational management, suggesting a more positive perspective among those at the highest levels of provider organizations," the report said. "Yet the continued downward trajectory of senior management scores stands out as significant." Among physicians, pride and reputation fell 0.12 points. Their perceptions of overall safety declined 0.06 points, prevention and reporting is down 0.03 points, and resources and teamwork is down 0.05 points. Other healthcare employees had higher perceptions of these metrics except for pride and reputation. Also, "fewer employees today say they would recommend their organization for care than in previous years," Press Ganey found. Read full story Source: Becker's Hospital Review, 21 March 2023
  4. News Article
    Governments should set aside 10% of health spending for preventive and public measures such as cycle lanes and anti-obesity strategies, a thinktank has said, warning that “political short-termism” over health is making the UK increasingly ill and unequal. The report by the Tony Blair Institute argues that a centralised NHS model “almost entirely focused on treating sickness” rather than on wider objectives is not only harming people’s health but hampering the economy, with more than 2.5 million people out of the labour market because of long-term ailments. The report emphasises the human cost as well, noting that the effect of diseases caused or exacerbated by lifestyle means UK life expectancy is stagnating, while men living in the London borough of Kensington and Chelsea can now expect to live 27 years longer than their peers in Blackpool, Lancashire. Along with a coherent central plan, the authors stressed the need for effective localism, with accountable regional bodies working to improve public health, rather than “the existing top-down and reactive approach of the NHS”. Read full story Source: The Guardian, 24 March 2023
  5. News Article
    Trust executives and senior managers have been criticised by a former national director for their lack of support for an under-pressure A&E. An independent review described York Hospital as “reluctant” to trigger internal escalation processes, and suggested it should be quicker to admit extra patients to inpatient wards during busy periods. Professor Matthew Cooke, a former national clinical director for emergency care who conducted the review, said that during his two-day visit to the department he witnessed a 60-hour delay for a patient to be admitted: “I was surprised not to see any senior managers or executives in the ED, despite such long delays. ED staff reported they rarely saw the executive team.” Professor Cooke also warned of uncertainty over escalation processes, including for reducing pressure in the emergency department by “boarding” patients on wards beyond normal capacity. He said: “On the second morning, there were multiple patients on oxygen in ordinary seats in majors waiting room, cared for by a single nurse. I find it difficult to understand how this is safer than boarding one extra patient on several wards.” “Staff perceived that the organisation was reluctant to move to higher escalation levels and I sensed this meant staff no longer pushed for such actions.” Read full story (paywalled) Source: HSJ, 23 March 2023
  6. News Article
    Leaders at a mental health trust tolerated high levels of safety incidents and accepted verbal assurance with ‘insufficient professional curiosity’, a critical report has found. An NHS England-commissioned review into governance at Tees, Esk and Wear Valleys Foundation Trust has been published, reviewing the organisation’s response to serious safety concerns flagged at the former West Lane Hospital in Middlesbrough. It follows separate reports identifying “systemic failures” over the deaths of inpatients Christie Harnett, Nadia Sharif and Emily Moore. The new report, conducted by Niche Consulting, criticises board and service leaders’ handling of concerns about the regular occurrence of restraint and self-harm. More than a dozen incidents of inappropriate restraint, some seeing patients dragged along the floor, were identified in November 2018, resulting in multiple staff suspensions and some dismissals. Niche found there was a “lack of accountable leadership at all levels” and lack of evidence for decisions in response to the November 2018 incidents. Read full story (paywalled) Source: HSJ, 21 March 2023
  7. News Article
    The patient safety commissioner has complained to MPs that she does not have enough staff to cope with her ‘significant workload’, it has emerged. Henrietta Hughes’ concerns are revealed in a letter from Commons health and social care committee chair Steve Brine to health and social care secretary Steve Barclay. Mr Brine asks for assurances over the commissioner’s resources and says he was “concerned” Dr Hughes had told him her current funding was “too little to make the necessary improvements” to safety oversight. Mr Brine wrote on 6 March: “I am in regular contact with Dr Hughes and the matter of resources for her office is something that she has raised with me. She tells me that her office is under extreme pressure, with a significant workload, including correspondence from patients.” Mr Brine told Mr Barclay he shared Dr Hughes’ concerns that without “sufficient resourcing” there was a risk that the safety commissioner role would – according to Dr Hughes – “let down the hopes of patients that were raised by the publication of Baroness Cumberlege’s report”. Read full story (paywalled) Source: HSJ, 14 March 2023
  8. Content Article
    This short blog highlights the situations where patients, carers, parents and relatives are failed by healthcare systems and by the leadership. They are left to stand alone against powerful institutions, because when staff speak up and 'blow the whistle' it often results in retaliation. Investigating and resolving the patient safety issue then becomes buried under an employment issue.
  9. Content Article
    System working (which includes health and care) is the only way the NHS can address the interlinked problems of struggling primary care, elective backlog, ambulance and emergency department overload, and delayed discharge. In this HSJ article, Len Richards explains how system working grows from the right culture, clinical leadership and systemwide joined up, real-time data.
  10. Content Article
    Dr Nabarro’s recent comment made on Independent Sage 2 December, that Covid-19 is primarily a droplet-borne infection, flies in the face of overwhelming international scientific consensus that the pandemic is driven by airborne transmission of the SARS-CoV-2 virus. Despite airborne transmission being accepted as the dominant mode of spread in almost every other arena, within official infection prevention and control (IPC) bodies in the World Health Organization (WHO) and many national authorities including the UK, there is denial or minimising of airborne spread, and continuing adherence to the droplet theory of transmission. This has meant rejection of airborne mitigations within healthcare, with profound consequences for the lives and health of healthcare workers, as well as for patients in hospitals and care homes. It is now clear that the IPC authorities will not be persuaded, no matter how much evidence is presented to them that SARS-CoV-2 is primarily airborne, and that efforts by aerosol scientists, engineers and health experts to provide further evidence of this, are futile.  This statement from Doctors in Unite explores these issues in detail, and highlights the disastrous record of droplet-only precautions in our hospitals and care homes. It also asks why the critically important “precautionary principle” was not applied throughout healthcare from the outset, to keep workers and patients safe, while the mode of transmission of the virus was being fully elucidated, despite this being official WHO policy. 
  11. Content Article
    Against the backdrop of the Covid-19 pandemic, ensuring the safety of health and social care services remains a serious, ongoing challenge. This report examines how patient safety governance mechanisms in Organisation for Economic Co-Operation and Development (OECD) countries have withstood the test of Covid-19. It provides recommendations for further improving patient safety governance and strengthening health system resilience in OECD countries. This working paper was produced by the OECD for the 5th Global Ministerial Summit on Patient Safety, held in Montreux, Switzerland in February 2023.
  12. Content Article
    The Healthy Leadership Framework was developed by the NHS Leadership Academy, out of recognition of the impact good leadership and management have on employee wellbeing. The aim was to identify a behavioural framework that could be used flexibly to support healthy leadership development and help leaders promote positive wellbeing in the workplace. The organisation HWBInspiration was commissioned to undertake scope the relationship between health and wellbeing and leadership, while exploring the leadership behaviours that enable and encourage employee health and wellbeing in the workplace. Their final report outlines the research and its findings, as well as highlighting practical ways that leaders and organisations can embed the identified Healthy Leadership Framework. 
  13. Content Article
    This National Workforce Implementation Plan outlines a series of practical actions that will act as enablers to accelerate the Welsh Government's ten-year vision for its Workforce Strategy. It addresses the following issues:Governance and accountabilityWhat does our workforce look like now?What will our workforce of the future look like?Fill the workforce gapsRetain our workforce: Engage, support and developPlan for the future
  14. Content Article
    These system leadership behaviour cards have been designed as a practical development tool. Developed by the NHS Leadership Academy, the set of 13 double sided cards are colour coded by theme; each card describes one of the behaviours and includes three question prompts on the reverse. The aim is to consider how the key themes and behaviours ‘play-out’, from an individual, organisational and system perspective. The questions support conversation and prompt self-reflection in the context of system-level working.
  15. Content Article
    The Healthcare Leadership Model (HLM) was developed to help leaders in the health service become better at their day-to-day role. The model is useful for everyone from board members to managers because it describes the things you can see leaders doing at work and demonstrates how you can develop as a leader. This webpage describes how the HLM works and provides a link to the free self-assessment tool.
  16. Content Article
    NHS chairs and non-executive directors play a key role in driving forward transformational change across the health and care sectors. As a vital leadership group they hold executive teams to account and in doing so build patient, public and stakeholder confidence in the NHS. The NHS North West Leadership Academy (NHS NWLA) have curated a range of development support and useful resources tailored to support those in non-executive roles. This webpage contains information on: system leadership modules NHS NWLA Executive Coaching leadership masterclasses the Non-executive Leaders Network the Next Director scheme. It also contains links to the following reports and resources: Non-executive directors and integrated care systems: What good looks like Strengthening NHS board diversity Healthcare Leadership Model (HLM) self-assessment and 360 feedback System leadership behaviours framework and conversation cards Healthy leadership framework.
  17. Content Article
    This report by The Queen's Nursing Institute presents the findings of a survey of community nurses (also known as district nurses) conducted in 2022 to look at how digital technologies are used in community nursing. The survey found that: 43.1% respondents reported problems with lack of compatibility between different computer systems, compared to 32.7% in 2017 87% respondents reported issues with mobile connectivity, compared to 85% in 2017 53%.respondents reported problems with device battery life, compared to 29.5% in 2017 The report concludes that overall, the community nursing workforce has a high level of digital literacy and that poor user experience frequently appears to be around design and function rather than a lack of literacy or enthusiasm for technology. The workforce also has an appetite for high functioning technology and can see the potential of new applications, for example, in managing wound care or long-term conditions.
  18. Content Article
    Integrated care systems are now legally responsible for leading a localised approach that brings multiple aspects of the healthcare system closer together, and for working better with social care and other public services. However, this is not a new aspiration, so why should it be any different this time? The Nuffield Trust hosted a series of roundtables to discuss concerns with stakeholders and experts to try and understand how to ensure the aims are achieved. This report summarises these findings and offers ways forward as the new era gets underway.
  19. Content Article
    Delivering the future hospital is an account of the successes, challenges and learning from the Future Hospital Programme. The Future Hospital Programme (FHP) was established to implement the recommendations of the Future Hospital Commission. These recommendations were based on the very best of our hospital services, taking examples of existing innovative and patient-centred services to develop a comprehensive model of care. The FHP worked with eight Future Hospital development sites, comprising multidisciplinary teams of physicians, nurses, managers, allied health professionals, social workers and patients on discrete projects aligned to the vision of the FHC. Delivering the future hospital contains an overview of the improvement journey, outcomes and learning from each development site. In addition, to mark the end of their collaboration with the FHP, development site teams prepared a more detailed account of their experiences and learning. Both the summary and long-form reports are available from the link below.
  20. Content Article
    To support recovery of the NHS by improving waiting times and patient experience, a joint Department of Health and Social Care (DHSC) and NHS England plan sets out a number of ambitions, including: Patients being seen more quickly in emergency departments: with the ambition to improve to 76% of patients being admitted, transferred or discharged within four hours by March 2024, with further improvement in 2024/25. Ambulances getting to patients quicker: with improved ambulance response times for Category 2 incidents to 30 minutes on average over 2023/24, with further improvement in 2024/25 towards pre-pandemic levels. NHS England has engaged with a wide range of stakeholders to develop the plan, and it draws on a diverse range of opinion and experience, as well as views of patients and users. The Department of Health and Social Care, who produced the content on actions being taken in social care, have led on engagement with the sector.
  21. Content Article
    This poster produced by researchers at Warwick Medical School summarises a qualitative research project that examined attitudes and behaviours related to patient safety culture at a single West Midlands Trust. The study's objective was to gain an understanding of staff’s views regarding the culture within the Trust and of their attitudes and behaviours when reviewing clinical incidents and mortality and morbidity. The poster was a winner at the HSJ Patient Safety Congress 2022 in the category 'A just culture for learning and change'. Read the full research paper.
  22. Content Article
    How can leaders move from understanding to taking actions? Listen to the Dementia UK podcast on moral injury in nursing.
  23. Content Article
    This research by the Nuffield Trust looked at how smaller hospitals have fared over the pandemic. Smaller hospitals are sometimes overlooked when system planning gets done, so this report focuses on the operational responses and management approaches taken by staff from 10 smaller hospitals over the course of the first and second waves of the pandemic. It aims to tell the stories of those working in small hospitals in order to understand what happened to acute and emergency care in these institutions during the pandemic. The authors interviewed staff in smaller hospitals around the country during 2021 to understand their key concerns. The report makes a set of recommendations for future crisis planning and response.
  24. Content Article
    Dr Henrietta Hughes, England's Patient Safety Commissioner, discusses how the experiences of people from Black and minority ethnic groups has worsened since the pandemic and how this has impacted on patient safety, in a blog for the NHS Race & Health Observatory.
  25. Content Article
    In this article for NHS Confederation, Sir Chris Ham reflects on progress made against his recommendations on the conditions ICSs need to succeed and on next steps for the Hewitt review. He argues that progress has been made in acting on some of the recommendations in the report Governing the Health and Care System in England. This can be seen in plans to create a new NHS England (NHSE), reduce staffing at the centre and regions and co-produce the operating framework. However, he highlights that more work is needed to reduce the number of national NHSE programmes, ensure greater consistency in how these programmes work and bring an end to constant bidding for funds tied to specific priorities. He recommends that high priority be given to an organisational development (OD) programme to support the development of collaboration, mutual respect and trust and determine how peer support, shared learning and improvement collaboratives can play a bigger part in improving performance in future. Sir Chris highlights that the Hewitt review offers an opportunity for these and other issues to be addressed with priority being given to ensuring that planning guidance for 2023/24 is short and focused on a small number of national priorities, leaving scope for ICSs to add local priorities. Leaders in the DHSC and NHSE must recognise the exceptional pressures facing the health and care system and set out what a realistic set of medium-term objectives for ICSs looks like under current circumstances.
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