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Content ArticleFatigue is more than a personal wellbeing issue: it is a proven contributor to clinical and laboratory errors, delays, and compromised decision-making. In transfusion practice, where accuracy and vigilance are critical, unmanaged fatigue can lead to serious harm. Organisations and individuals must have capacity plans which actively identify fatigue signals and embed safeguards into daily work. The practical solutions highlighted in this document outline how teams can recognise fatigue early, take appropriate actions to reduce risk, strengthen safety culture, and improve patient outcomes. This document was produced by SHOT (Serious Hazards of Transfusions), the UK’s independent, professionally-led haemovigilance scheme.
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Content ArticleStaff fatigue is a critical but under-recognised threat to transfusion safety. While clinical and laboratory staff may recognise fatigue as a personal challenge, it is rarely acknowledged as a system-level safety hazard that requires organisational risk mitigation. This document highlights why fatigue matters in transfusion practice, explores its contribution to safety incidents, and provides practical approaches to integrating fatigue risk management into incident investigations and daily practice. This document was produced by SHOT (Serious Hazards of Transfusions), the UK’s independent, professionally-led haemovigilance scheme.
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Content ArticleFatigue is widely accepted as a feature of working life across healthcare. Long hours, shift work and high workload mean that many staff regularly experience some degree of fatigue. Fatigue is associated with increased risk of error and reduced performance and therefore has negative impacts on both patient safety and staff wellbeing. Fatigue is also linked to broader workforce challenges including staff physical and mental health, burnout, absenteeism and retention. Although these risks are well documented, the extent to which they are addressed through structured and systematic approaches within healthcare remains less clear. The Clinical Human Factors Group recently reviewed the literature to explore how fatigue is currently managed across healthcare and what strategies are being used in practice. The findings provide an overview of how fatigue is understood and addressed and highlight a gap between the well-established risks associated with fatigue and the ways in which those risks are mitigated in practice.
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News article
Women with autoimmune conditions are up to 74% more likely than men to be told their symptoms are psychological or psychosomatic, and face much longer waits for a diagnosis and treatment, a study suggests. Hundreds of millions of people – about one in 10 globally – are affected by autoimmune conditions, which can cause a range of health issues including fatigue, muscle pain and rashes. But research by the University of Cambridge and University of East Anglia suggests a stark gender divide when it comes to how signs of the conditions are handled by doctors. Women are more likely to have their conditions wrongly attributed to psychiatric causes, more likely to have symptoms misdiagnosed as psychosomatic, and more likely to experience delays in getting a diagnosis, according to the study. The lead author, Melanie Sloan, said: “The damage caused to women by these types of misdiagnosis can be very long lasting in terms of trusting doctors and their own self-esteem.” Sloan, a researcher in the department of public health and primary care at Cambridge and UEA, said some women were forced to wait years before finally getting a diagnosis, causing long delays to treatment for their condition. Read full story Source: The Guardian, 13 October 2026 -
Content Article
In this Guardian article, George Monbiot argues that people with ME/CFS (myalgic encephalomyelitis/chronic fatigue syndrome) have been systematically neglected, disbelieved and harmed by healthcare systems despite the severe, life-limiting nature of the condition. In the UK, an estimated 400,000 people live with the condition. It affects women far more than men, by a ratio of about 4:1, according to a study in England. The number of people with long Covid, some of whom meet the diagnostic criteria for ME/CFS, was estimated in 2024 at 2 million in England and Scotland. Drawing on hundreds of patient testimonies, he describes experiences of being dismissed and denied support: “I’ve just been completely abandoned”; “a 10-year waiting list for treatment”; “we’ve given up seeking medical support”; “stuck in limbo”; “I just felt utterly unheard, invalidated”. Further reading on the hub: Exploring the barriers that impact access to NHS care for people with ME and Long Covid Improving healthcare services for people with ME and Long Covid: Patients share their challenges, and the actions needed -
Content Article
Sickle cell disease can affect people of all backgrounds but is more common in African and Caribbean communities. It has become one of the fastest growing genetic conditions in England, with 250 new cases every year. People living with sickle cell disease may experience painful crises, fatigue and an increased risk of serious health complications. Despite this, the condition is often not well understood. At Patient Safety Learning we believe that sharing insights and learning is vital to improving outcomes and reducing harm. That's why we created the hub; to provide a space for people to come together and share their experiences, resources and good practice examples. We have pulled together 8 useful resources about sickle cell disease that have been shared on the hub. They include recommendations on tackling inequalities, recognising and managing sickle cell disease in hospital, and managing pain. -
EventHealthcare is delivered through complex and constantly changing systems. Staff make difficult decisions while managing high workloads, interruptions, time pressures, new technology and competing demands. Human factors enables organisations to examine how these conditions interact with people, tasks, equipment, environments and organisational processes — and to redesign care so that safe practice is supported rather than dependent on individuals overcoming weaknesses within the system. The conference will also consider the growing human factors implications of electronic patient records, automation, ambient documentation and artificial intelligence. While digital technology can improve safety, productivity and access to information, poor usability, alert fatigue, automation bias and disrupted workflows can introduce new risks. Safe implementation requires technology to be designed around patients and staff, with frontline users involved in its design, testing and evaluation. For further information and to book your place visit https://www.healthcareconferencesuk.co.uk/virtual-online-courses/a-practical-guide-to-human-factors-in-healthcare or email [email protected]. Follow the conference on X @HCUK_Clare #HumanFactors hub members receive a 20% discount. Email [email protected] for discount code.
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News article
“It’s really frustrating to be in this cycle of continuous surgery. It makes you feel helpless,” says Natalie Greenwood, of a condition that affects her so badly she is “non-functioning most of the time because of the constant fatigue”. Greenwood, 36, needs to have an operation every few years to limit the impact of the endometriosis that gives her chronic pelvic pain, as well as extreme tiredness and brain fog. She says the trouble with depending on surgery is not just having an invasive procedure and then having to recover afterwards. It’s more that the benefit gained – the relief from persistent pain – is brief. She is not alone in her lack of belief in surgery and hormonal medication being effective for chronic pelvic pain. A study has found that dual approach, which is the NHS’s usual way of treating the condition, does not improve quality of life for female patients. Dr Jasmine Hearn, a reader in health psychology at Manchester Metropolitan University who co-led the research in the new study, said: “Sadly patients are often left struggling due to current pain management strategies not sufficiently alleviating pain. “Chronic pelvic pain is often invisible but its impact can be profound. Our findings highlight that women with pelvic pain report poorer quality of life when they’ve had surgery and hormonal medication for pelvic pain and better quality of life when psychological support is part of treatment.” Read full story Source: The Guardian, 15 September 2026 -
Community PostDigital health technologies have transformed many aspects of healthcare, from electronic health records and telemedicine to remote patient monitoring and AI-assisted decision support. While these innovations have the potential to improve patient outcomes, many healthcare professionals also report challenges such as alert fatigue, increased documentation, and workflow disruptions. I'm interested in hearing from others working in healthcare: Which digital health tools have had the biggest positive impact on patient safety in your organisation? Have you experienced situations where technology created new risks or made clinical workflows more complicated? What strategies have helped balance innovation with usability for frontline staff? How can healthcare providers ensure that digital transformation genuinely supports clinicians rather than adding administrative burden? It would be great to hear real-world experiences, lessons learned, and examples of digital solutions that have successfully improved both patient safety and efficiency.
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Community PostEndometriosis is a common gynecological condition in which tissue similar to the lining of the uterus grows outside the uterus. It can cause significant pain and may affect daily activities, relationships, and fertility. One important concern is that severe period or pelvic pain can sometimes be considered “normal,” which may delay proper medical evaluation. Women experiencing persistent or worsening symptoms should feel comfortable discussing them with a healthcare professional. Symptoms that may need medical assessmentSome symptoms associated with endometriosis can include: Severe or worsening menstrual pain Chronic pelvic pain Pain during or after sexual intercourse Pain during bowel movements or urination, particularly around menstruation Heavy or irregular menstrual bleeding Difficulty becoming pregnant Persistent fatigue or symptoms that interfere with daily activities However, these symptoms can have several possible causes, so they should not automatically be assumed to indicate endometriosis. Why early assessment mattersThere is no single symptom that confirms endometriosis, and diagnosis can require a detailed medical history, physical examination, and appropriate investigations. A healthcare professional can help determine whether further evaluation is needed and discuss treatment options according to the individual's symptoms, fertility plans, and overall health. Patients should also be encouraged to describe how their pain affects their everyday life, rather than simply reporting that they have “painful periods.” Keeping a record of menstrual symptoms, pain severity, bleeding patterns, and other related symptoms can make conversations with healthcare professionals more productive. When to seek urgent careSevere or sudden pelvic pain, fainting, very heavy bleeding, fever, or other concerning symptoms should receive prompt medical attention, as these may have causes other than endometriosis that require urgent assessment. As healthcare professionals, we can contribute to safer women's healthcare by listening carefully to patients, taking persistent pain seriously, explaining diagnostic and treatment options clearly, and encouraging patients to seek further assessment when symptoms continue. I’m Dr. Tazeen Ashraf, a gynecologist, and I’m interested in contributing to discussions that improve awareness and patient-centered care for women's health conditions, including endometriosis.
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News article
Nearly 200 doctors at a major teaching hospital have told a “listening exercise” prompted by a major care scandal that they feared raising patient safety concerns. The doctors at Cambridge University Hospitals Foundation Trust raised fundamental concerns about the organisation’s culture, with one alleging they had seen “colleague[s’] professional lives destroyed… for speaking up”. The trust commissioned the exercise, undertaken by the NHS’s internal consultancy, Transformation Partners in Health and Care, as part of its response to an investigation into a failing paediatric surgeon. Kuldeep Stohr is accused of harming numerous children over a 10-year period at the trust, while many staff feared speaking up about their concerns about the now-suspended consultant. In February 2025, CUH confirmed nine children were so far found to have received substandard care from Kuldeep Stohr, with a wider review of 800 further cases, due to be published this year. The “listening exercise” report, published by the trust and sent to staff this week, suggests fears about speaking up about patient safety – which arose in the case of Ms Stohr – are not confined to a single department. Three-quarters (175) of the 233 senior doctors who responded described either “fear associated with speaking up [and] concern about repercussions; emotional fatigue; or low confidence that concerns would be addressed”. Departments with the most concerns included “neurosciences; emergency medicine; paediatrics, and some surgical specialties”, but across all areas “most participants described either direct or indirect concern about repercussions” from speaking up. And when patient harm matters were raised, “the vast majority of participants perceived ‘nothing’ had happened once concerns were raised”. Read full story (paywalled) Source: HSJ, 16 July 2026 Related reading on the hub: Speaking up for patient safety: A new interview series about raising concerns and whistleblowing Key themes emerging from our ‘Speaking up for patient safety’ interview series The whistleblower playbook -
EventAimed at Clinicians and Managers, this national virtual conference will provide a practical guide to human factors in healthcare, and how a human factors approach can improve patient care, quality, process, and safety. The conference delves into integrating human factors into healthcare systems and processes, clinical decision making, healthcare system design, quality of patient experience, medication safety, and workload, fatigue, and stress management. Throughout the day there will be interactive sessions, small breakout groups, and collaborative exercises, fostering a dynamic learning experience. This conference will enable you to: Network with colleagues who are working to embed a human factors approach. Learn from outstanding practice in using human factors and ergonomics to improve patient safety and quality. Reflect on national developments and learning including the patient safety syllabus and the role of human factors within the new Patient Safety Incident Response Framework (PSIRF). Understand the tools and methodology. Develop your skills in training and educating frontline staff in human factors. Understand how you can improve patient safety incident investigation by using a human factors approach. Learn from case studies demonstrating the practical application of human factors to improve patient care and safety. Understand the role of human factors in improving culture and delivering psychological safety. Self assess and reflect on your own practice. Supports CPD professional development and acts as revalidation evidence. This course provides 5 Hrs training for CPD subject to peer group approval for revalidation purposes. Register We are pleased to offer hub members a free place using the code HCUK00HFPSL
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Content ArticleDespite improving patient safety in some perioperative settings, some checklists are not living up to their potential and complaints of “checklist fatigue” and outright rejection of checklists are growing. Problems reported often concern human factors: poor design, inadequate introduction and training, duplication with other safety checks, poor integration with existing workflow, and cultural barriers.
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Content ArticleWearable smartwatches present a novel approach to continuous patient monitoring in ICU settings. This study evaluated the impact of smartwatch use on alarm response rates and clinical outcomes in a 27-bed intensive care unit (ICU). Nurses in the ICU wore smartwatches in wards and researchers evaluated their response to alarms and the efficiency of their nursing work. Their findings suggest that using wearable smartwatches can significantly improve alarm response rates, reduce alarm response times and the number of alarms, and decrease alarm fatigue and adverse events.
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Content ArticleThis Health Services Safety Investigations Body (HSSIB) report follows on from HSSIB's launch report, ‘Fatigue risk in healthcare and its impact on patient safety’, which introduced the concept of fatigue and outlined the risk posed to patient safety from staff fatigue. The International Civil Aviation Organization’s definition of fatigue was adopted by this investigation, where fatigue is defined as: “A physiological state of reduced mental or physical performance capability resulting from sleep loss, extended wakefulness, circadian phase [the natural daily internal body clock], and/or workload (mental and/or physical activity) that can impair a person’s alertness and ability to perform safety related operational duties.” The investigation engaged with a wide range of healthcare staff to learn what impact fatigue had on patient safety in acute NHS hospitals. The investigation explored the NHS systems and processes in place to capture and learn from the risk posed by fatigue on patient safety and staff safety. It also considered the main factors that contribute to healthcare staff being fatigued. The investigation shares findings from staff interviews, discussions and observational visits to several acute hospital trusts, combined with evidence from national bodies, forums and networks with insight on this topic. The report also refers to supporting surveys and literature. While the investigation focused on staff working in acute hospitals, the findings wi
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Content ArticlePeople with Myalgic Encephalomyelitis (ME/CFS; sometimes referred to as chronic fatigue syndrome) experience poor health-related quality of life and only rarely recover. ME/CFS has no curative treatment, and no single diagnostic test. Public health and policy decisions relevant to ME/CFS require knowledge of its prevalence and barriers to diagnosis. The research, published in BMC Public Health, analysed NHS data from more than 62 million people in England to identify people who had been diagnosed with myalgic encephalomyelitis (ME)/chronic fatigue syndrome or post-viral fatigue syndrome. The data was examined by gender, age and ethnicity, and grouped by different areas of England. The findings showed that the lifetime prevalence of chronic fatigue for women and men in England may be as high as 0.92% of the population for women, and 0.25% for men. This is equivalent to about 404,000 people overall.
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Content ArticleThe catastrophic wildfires that devastated Los Angeles County in January 2025 were caused by an unprecedented combination of extreme weather conditions and urban vulnerability. Within a span of hours, the Palisades and Eaton fires, propelled by record-breaking Santa Ana winds reaching 150 miles per hour, consumed more than 37,000 acres, destroyed more than 16,000 structures and claimed 29 lives. The increasing frequency and severity of wildfires present new challenges to healthcare systems, particularly in regions prone to these disasters. Staffing shortages, burnout and disaster fatigue are all major issues. This analysis in JAMA examines important aspects of health care system response during wildfire emergencies, offering evidence-based recommendations for institutional preparedness and adaptation.
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C39b6347258260205c33eab440c7e5a7It is quite clear from all the reading that I have done on staff fatigue that there is much more that needs to be done to identify how best to manage the effects that staff fatigue has on patient safety. it is a personal responsibility as well as an organisational responsibility. Personal is how you manage your life and organisational is about appropriate skill mix, length of shifts and appropriate breaks within shifts, staff retention, having a just culture to enable staff to speak up about any issues that affects patient safety without reprisal etc.
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Content ArticleIn this interview, Dana Edelson, an expert in cardiac resuscitation at the University of Chicago, discusses how hospitals can best use early warning score tools to risk stratify patients—without adding to clinicians’ alarm fatigue. Dana recently co-authored a study which compared six different early warning scores designed to recognise clinical deterioration in hospitalised patients, including three proprietary AI tools.
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Content ArticleFatigue has been explored by other healthcare professions for many years and is acknowledged as a potential risk factor for incidents of unintended harm as well as for the wellbeing of the healthcare team. As dentistry is a profession and service that has a central focus of patient safety, it could be perceived as irresponsible not to consider fatigue in risk strategies.
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Content ArticleLyme disease is a tick-borne, bacterial infection that causes chronic fatigue, headaches, swollen joints and fever, among other symptoms. Following the actor Miranda Hart's having recently shared that she has been living with the effects of Lyme disease for years, Zoë Beaty looks at the issues surrounding diagnosis and treatment of the condition. She outlines why some doctors believe the condition does not exist, or that people with ME/chronic fatigue syndrome are being misdiagnosed with it. The lack of research and evidence around the condition means that many of the people who live with its symptoms—a large proportion of which are female—struggle to access effective treatment.
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Content ArticleHuman factors such as fatigue and poor communication can increase the risk of safety incidents. This new book is the first to address the specific needs in this area of nurses and allied health professionals, who make up the majority of the workforce. The aim of the book is to support understanding of human factors and the role they play in quality and safety. It will help the reader identify risks, understand human error, and develop non-technical skills (social, cognitive and personal) that will support them in their practice across a range of clinical environments. With contributions by leading experts in this emerging area, many of whom remain in practice, Human Factors for Healthcare is an ideal textbook for teaching and learning in both academic and clinical settings. Covers the basic concepts right through to the most up-to-date research on human factors, including: Patient safety Human error Human factors for non-medical practitioners Human Factors in urgent, unscheduled and emergency care Non-technical skills The role of communication Teamwork Leadership Situation Awareness and Decision Making Workplace culture Stress and fatigue Resilience Reflects the requirements of the 2018 NMC Standards of Proficiency for RNs and HCPC (2023) Standards of Proficiency for AHPs. Features experts in the field from a variety of settings Embraces a broad range of sp
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Content ArticleFollowing the publication of Chartered Institute of Ergonomics & Human Factors (CIEHF) white paper on Fatigue Risk Management in Health and Social Care, this webinar explored the background to the issues and CIEHF's recommendations for a roadmap to manage the challenges. Learn how historically, fatigue has not been identified as an organisational risk in the same way as other risks, even though it has a significant impact on patient and staff safety. Find out how this is being turned around and how organisations can identify the right people, the right data and the right way to recognise and address this risk.
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Content Article
The Covid-19 pandemic continues to have a big impact on the NHS and society. Among those most heavily affected are up to two million adults and children affected by Long Covid. Over 1.5 million people report their daily activities being limited by Long Covid and a significant proportion of Long Covid patients meet the diagnostic criteria for myalgic encephalomyelitis (ME) sometimes referred to as Chronic Fatigue Syndrome (CFS). Patients with ME have faced decades of inadequate care and insufficient funding for biomedical research, which have shaped the NHS care available to Long Covid patients. This report was written by Karen Hargrave and Emma Gore-Lloyd, founders of ThereForME, a campaign calling for an NHS that works for people with Long Covid and ME. The report outlines the results of a survey of over 300 people living with Long Covid and ME which aimed to evaluate parts of the new Government's mission plan for the NHS against their experiences. The survey focused on the following three Labour commitments that could have the biggest impact, where people with Long Covid and ME highlight current shortcomings: An NHS that is there when people need it Change so that more people get care at home in their community The promise to introduce a revolution in technology Read the full report Read the executive summary Find out more about the ThereForME campaign -
Content ArticleIncidental imaging findings (IIFs) are things that show up on a diagnostic image that are not related to the reason a healthcare professional ordered the test. Inadequate follow-up of IIFs can result in poor patient outcomes, patient dissatisfaction and provider malpractice. In an effort to improve awareness of IIFs, this study aimed to investigate communication of IIFs on inpatient discharge summaries after implementation of a new electronic health record (EHR) notification system. The results showed that IIFs were included in 51% of discharge summaries. The authors identified that lack of inclusion of IIFs on discharge summaries could be related to transitions of care within hospitalisation, provider alert fatigue and many diagnostic testing results to distil. The findings demonstrate the need to improve communication of IIFs and the need for care coordinators to follow up on IIFs. This year’s World Patient Safety Day on 17 September 2024 (WPSD 2024) is focused on the theme “Improving diagnosis for patient safety”. Find out more.
