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Found 163 results
  1. News Article
    Bupa is set to cut 85 dental practices amid a national shortage of dentists, in a move that will affect 1,200 staff across the UK. The group said patients at some practices were unable to access the NHS dental service they need. Bupa, which provides NHS and private care, said the 85 practices would be closed, sold or merged later this year. The healthcare group's boss said the industry faced "systematic challenges" and the decision was a "last resort". In August the BBC revealed 9 in 10 NHS dental practices across the UK were not accepting new adult patients for treatment under the health service. Bupa has not been able to recruit enough dentists to deliver NHS care in many practices for months and in some cases years, it said. Read full story Source: BBC News, 30 March 2023
  2. 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
  3. News Article
    Last year the World Health Organization (WHO) released a report warning of a “ticking time bomb” threatening health systems in Europe and Central Asia: a growing shortage of health workers. With quickly ageing populations and an ageing health workforce—40% of doctors in Europe are close to retirement in a third of countries—along with a surge in chronic illnesses and the ongoing effects of the covid pandemic, WHO warned that many countries could soon see their healthcare systems collapse unless they take urgent action. Six months on, the situation has worsened, as healthcare workers throughout Europe increasingly resort to industrial action over pay and conditions. Hans Kluge, WHO regional director for Europe, said, “The health workforce crisis in Europe is no longer a looming threat—it is here and now. Health providers and workers across our region are clamouring for help and support... “We cannot wait any longer to address the pressing challenges facing our health workforce. The health and wellbeing of our societies are at stake—there is simply no time to lose.” Read full story (paywalled) Source: BMJ, 24 March 2023
  4. 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
  5. News Article
    The NHS’s efforts to prop up emergency departments with thousands of additional medical staff has been the wrong approach to solving the crisis in these services, experts have argued. Analysis of NHS staffing data by HSJ shows the emergency care medical workforce has grown by almost two-thirds since 2016, far outstripping the growth in other specialties. Despite this, waiting times in accident and emergency have deteriorated significantly over the same period. John Appleby, chief economist at the Nuffield Trust think tank, said: “Cramming the A&E department with more doctors doesn’t look like it’s having the intended effect over the last four to five years. Waiting times have got worse and we have more staff. “Increasing staffing has helped with waiting times in the past, but maybe we have reached a point where it’s not staffing in A&E which is the issue. The issue is the front door and the backdoor of the A&E.” Read full story (paywalled) Source: HSJ, 17 March 2023
  6. News Article
    A trust has been issued with a warning notice after the Care Quality Commission (CQC) raised concerns about parts of its maternity services. Following a focused inspection at University Hospitals Dorset Foundation Trust in September and November last year, the CQC has rated maternity services at Poole Hospital “inadequate”, down from “good”. The service was also rated “inadequate” in the safety and well-led domains. The CQC report warned that Poole Hospital’s maternity unit did not always have enough midwifery or medical staff to keep mothers and babies safe. The inspectors noted this had led to delays to induction of labour and caesarian sections, including emergency sections. A warning notice was also issued over concerns about the unit’s emergency call bell system, which worked “intermittently” due to poor wireless signal, and processes used to summon help during an emergency. The trust said it had since “taken action to address this risk”. Read full story (paywalled) Source: HSJ, 10 March 2023
  7. News Article
    A staffing crisis in children’s dentistry has prompted the urgent removal of junior doctors from Great Ormond Street Hospital NHS Foundation Trust (GOSH. GOSH has struggled to recruit consultants for its paediatric dentistry services for at least two years, which has led to trainee doctors going unsupervised, according to a new report by regulator Health Education England. A report seen by The Independent said the service was running with just one part-time consultant but needed at least two. The news comes amid a national “crisis” in dentistry, with the latest data from the government showing that half of all children’s tooth extractions in 2021-22 were due to “preventable tooth decay”. GOSH told The Independent it was struggling with a “limited pool” of paediatric dentists and, as a result of shortages, many patients were waiting longer than the 18-week standard. Read full story Source: The Independent, 8 February 2023
  8. News Article
    Nursing shortages are contributing to children waiting up to three times longer for spinal surgery than pre-pandemic, a top surgeon has claimed. Chris Adams says up to one in four operations are cancelled at NHS Lothian, with staffing the main reason. Mr Adams also claims that some children are not being put on waiting lists as early as they should be. NHS Lothian disputes some of Mr Adams' statements but says "significant pressures" are affecting waiting times. The senior clinician, one of Scotland's three paediatric spinal surgeons, said he was speaking out of behalf of spinal patients and their families The surgeon's claims appear in a new BBC Disclosure investigation into Scotland's NHS, which reveals that some children are waiting up to three times longer than pre-pandemic for spinal surgery, with some waiting more than a year. At least 51 out of a possible 190 planned spinal surgeries at RHCYP were cancelled at short notice in 2022, with nursing shortages understood to be the main cause Read full story Source: BBC News, 7 March 2023
  9. Content Article
    In February 2022, NHS England published a plan to recover elective and cancer care over three years from April 2022 to March 2022. Analysing the implementation of this plan to date, the Public Accounts Committee’s has come to the following conclusions and recommendations: Cancer waiting times are at their worst recorded level and NHS England (NHSE) will not meet its first cancer recovery target. Recommendation: NHS England should be able to treat 85% of people with cancer within 62 days of an urgent GP referral and no one should ever have to wait more than 104 days for cancer treatment. It is unacceptable that 8,100 people waited over 104 days in the first five months of 2022–23. As a matter of urgency, the Department of Health and Social Care and NHS England should do whatever is required to bring cancer treatment back to an acceptable standard. NHS England was over-optimistic about the circumstances in which the NHS would be trying to recover elective and cancer care. Recommendation: NHS England and the Department of Health and Social Care should revisit their planning assumptions for the recovery and publicly report any updates to targets so that patients and NHS staff can see a clear and realistic trajectory to achieve the 62-day cancer backlog target, the 52-week wait target for elective care, and, ultimately, the 18-week legal standard for elective care. NHS funding has increased, but to deliver key priorities such as elective and cancer recovery it will need to be spent in the most cost-effective way. Recommendation: NHSE should transparently describe how the additional funds for elective recovery have been allocated. Alongside the Treasury Minute response, it should also write to us providing details of the programmes on which it expects the £14 billion to be spent, the independent evaluations it has put in place to monitor the effectiveness of additional spending, and how it expects additional spending to improve NHS productivity. NHS England’s elective recovery programme partly relies on initiatives which have potential but for which there is so far limited evidence of effectiveness. Recommendation: NHS England should know more about the conditions necessary for individual programmes to make the greatest contribution possible to recovery. Alongside its Treasury Minute response to this report, it should write to us more fully describing the real-world impact of community diagnostic centres, surgical hubs, increased use of the independent sector, and the advice and guidance programme. It should set out its understanding of the extent to which these initiatives have so far generated genuinely additional activity, rather than simply displacing activity elsewhere in the NHS. NHSE started 2022–23 with a strategy but spent most of the year dealing with tactical issues and its strategic and programme management of the recovery must improve. Recommendation: NHS England must lift its sights and refocus on its strategic duty to offer direction to the whole NHS. This should involve making difficult trade-offs to address historical inequalities between areas, and by having a clear set of actions to improve leadership. To demonstrate progress, NHS England should write to us by the Summer recess setting out the action is has taken to address variation in elective and cancer performance and provide evidence of the impact this has had on patient waiting lists. The NHS’s recovery cannot succeed without comprehensive, realistic and sustainable plans for the future of the workforce and the capacity of adult social care. Recommendations: The Department of Health and Social Care should work with NHS England to reassess the achievability of elective and cancer recovery targets following the publication of its workforce plan in 2023, and planned improvements to the discharge of patients into adult social care. It should write to us as soon as possible describing the conclusions of this achievability assessment. The Department should publish the underlying assumptions of its workforce projections alongside the forecasts in the workforce plan. This should include quantification of key assumptions, particularly on productivity, domestic training and overseas recruitment and, in full, the independent reviewer’s assessment.
  10. News Article
    A struggling acute trust says its failure to hit its elective care targets is directly linked to doctors’ demanding overtime rates in line with the British Medical Association’s rate cards, as national tensions around the issue intensify. University Hospitals of Morecambe Bay Foundation Trust’s January performance report said its elective activity was down by around 1,000 cases over a two-month period, due to the issue. Last summer, the BMA published a “rate card” outlining the “minimum” hourly pay consultants should receive for additional work, such as waiting list initiatives and weekend shifts. Some accused the union of “acting like football agents” by trying to inflate their members’ pay. NHS chiefs have long been warning of the risk the rate card poses to elective recovery. But there are few examples of a trust making such an explicit link between their struggle to staff overtime shifts because of the rate card and subsequent failure to hit their elective targets, and placing a number on how many patients they were forced to add to the list because of the issue. Read full story (paywalled) Source: HSJ, 1 March 2023
  11. News Article
    A criticised maternity service needs 37 more midwives, about a fifth of its total midwifery workforce. The Care Quality Commission has said Northampton General Hospital did not always have enough qualified and experienced staff to keep women safe from avoidable harm. Figures obtained by the BBC show that 49 serious incidents have occurred in its maternity services in four years. The hospital said it had undertaken "a lot of work" in the past 18 months and a recruitment process was under way. According to a Freedom of Information Act response, between November 2018 and November 2022, the hospital had 278 serious incidents, with the highest level coming across maternity services, including gynaecology and obstetrics. There are currently 37 vacancies for midwives but the trust said it manages staffing levels "closely and ensure that all shifts are covered by bank or midwives working altered shift patterns, to ensure that we are able to provide a safe maternity experience". Read full story Source: BBC News, 27 February 2023
  12. News Article
    Only half the recommended number of medical staff were on duty at the O2 Brixton Academy on the night of a crush at the south-west London venue. Industry guidelines suggest there should have been medical cover of at least 10 people, including a paramedic and a nurse, but no paramedics or nurses were present. Rebecca Ikumelo, 33, and security guard Gaby Hutchinson, 23, died in hospital following the crowd surge on 15 December 2022 at the concert. The medical provider, Collingwood Services Ltd, said it was "fully confident" its team had "responded speedily, efficiently and with best practice". Two whistleblowers who regularly work for Collingwood Services Ltd at Brixton told BBC Radio 4's File on 4 programme that medical cover at the south London gig had been "inadequate". Neither of them was there when the crush happened, but one said he had spoken to colleagues who were. "[They] had two student paramedics, so they're basically unqualified," said one whistleblower. "They have to be supervised by a paramedic, not by anybody of a lower grade. They didn't have appropriate supervision." Read full story Source: BBC News, 23 February 2023
  13. News Article
    Britain could double the number of doctors and nurses it trains under NHS plans to tackle a deepening staffing crisis, according to reports. The proposal to increase the number of places in UK medical schools from 7,500 to 15,000 is contained in a draft of NHS England’s long-awaited workforce plan, which is expected to be published next month. Labour has already announced this policy as a key element of its plans to revive the NHS. However, it could face opposition from the Treasury because of how much it would cost, according to the Times, which reported on the plan. The NHS in England alone is short of 133,000 staff – equating to about a tenth of its workforce – including 47,000 nurses and 9,000 doctors, according to the most recent official figures. There are also shortages of midwives, paramedics and operating theatre staff. Staff groups say routine gaps in NHS care providers’ rotas are endangering patients’ safety, increasing workload and costing the service money. Read full story Source: The Guardian, 22 February 2023
  14. News Article
    Millions of people in England with mental ill-health are not seeking NHS help, and many who get it face long delays and a “poor experience”, a report says. Long waits for care will persist for years because soaring demand, exacerbated by Covid, will continue to outstrip the ability of severely understaffed mental health services to provide speedy treatment, the National Audit Office (NAO) found. The report found that “NHS mental health services are under continued and increasing pressure and many people using services are reporting poor experiences”. Under-18s, the LGBT+ community, minority ethnic groups and people with more complex needs are most likely to find the system inadequate. “While funding and the workforce for mental health services have increased and more people have been treated, many people still cannot access services or have lengthy waits for treatment,” the NAO said. It found: An estimated 8 million people with mental health needs are not in contact with NHS services. There are 1.2 million people waiting for help from community-based mental health services. While the mental health workforce grew by 22% between 2016-17 and 2021-22, the NHS recorded a 44% increase in referrals over the same period. In 2021-22, 13% of mental health staff quit. Read full story Source: The Guardian, 9 February 2023
  15. Content Article
    Key findings Introducing access and waiting time standards for mental health services was an important step towards parity of esteem with physical health services. Overall, the number of people treated by NHS mental health services has increased, but some access targets are not being met. The NHS has achieved its waiting times standards, which aim to get people into treatment quickly, for talking therapy services and early intervention in psychosis services, but not yet for eating disorders services for children and young people. NHS mental health services are under continued and increasing pressure and many people using services are reporting poor experiences. NHS England’s ambitious plan for community-based mental health services is still at an early stage. The impact of initiatives to reduce inequalities in mental health is not yet clear. Although the NHS mental health workforce has increased, staff shortages remain the major constraint to improving and expanding services. The share of funding for mental health services has increased slowly, reflecting the pace set by NHSE’s targets Improvements to mental health data and information are taking longer than planned in many areas. DHSC and NHSE have not defined what achieving full parity of esteem between mental and physical health services would mean. Plans for service expansion up to 2023-24 still leave a sizeable gap between the number of people with mental health conditions and how many people the NHS can treat. The national programme, led by NHSE, has maintained a consistent focus on expanding services. Increased demand and disruption following the pandemic mean it is likely to take longer for the NHS to close treatment gaps.
  16. News Article
    The NHS faces an alarming mass exodus of doctors and dental professionals, health chiefs have said, as a report reveals 4 in 10 are likely to quit over “intolerable” pressures. Intense workloads, rapidly soaring demand for urgent and emergency healthcare and the record high backlog of operations are causing burnout and exhaustion and straining relationships between medics and patients, according to the report by the Medical Defence Union (MDU), which provides legal support to about 200,000 doctors, dental professionals and other healthcare workers in the UK. In an MDU survey of more than 800 doctors and dental professionals across the UK, conducted within the last month and seen by the Guardian, 40% agreed or strongly agreed they were likely to resign or retire within the next five years as a direct result of “workplace pressures”. Medical leaders called the report “deeply concerning”. There are already 133,000 NHS vacancies in England alone. NHS chiefs said it laid bare the impact of the crisis in the health service on staff, and MPs said it should serve as a “wake-up call” to ministers on the urgent need to take action to persuade thousands of NHS staff heading for the exit door to stay. Read full story Source: The Guardian, 29 January 2023
  17. News Article
    Thousands of extra hospital beds and hundreds of ambulances will be rolled out in England this year in a bid to tackle the long emergency care delays. The 5,000 new beds will boost capacity by 5%, while the ambulance fleet will increase by 10% with 800 new vehicles. Details of the £1bn investment will be set out later in a joint government and NHS England two-year blueprint. Questions have also been raised about how the extra resources will be staffed - 1 in 10 posts in the NHS is vacant. The government believes the measures, which will be introduced from April, will help the NHS to start getting closer to its waiting time targets. It has set goals that by March 2024: 76% of A&E patients will be dealt with in four hours. Currently fewer than 70% are. The official target is 95% An average response time of 30 minutes for emergency calls such as heart attacks and strokes. In December patients waited over 90. The official target is 18. Prime Minister Rishi Sunak said cutting NHS waiting times was one of his five main priorities. Read full story Source: BBC News, 30 January 2023
  18. News Article
    Experienced emergency department nurses are “leaving in droves” because they feel unable to do their jobs properly under the current conditions, a doctor has warned. Giving evidence to the Health and Social Care Select Committee yesterday, Dr Adrian Boyle, president of the Royal College of Emergency Medicine, raised concern about nurse retention and morale in emergency departments. “We are haemorrhaging experienced emergency nurses because they are finding it very frustrating" He said: “What I'm also seeing is that a lot of nurses, particularly the experienced nurses, they're almost like the [non-commissioned officers] of the health service, the sergeants who know how to get things done, are leaving in droves.” Dr Boyle added: “We are haemorrhaging experienced emergency nurses because they are finding it very frustrating. “The problem is not because there's too much work but they're unable to do the work that they're trained to do." Read full story Source: Nursing Times, 25 January 2023
  19. Content Article
    The census had responses from all 12 major Emergency Departments in Wales and found: There is one WTE Consultant per 7784 annual attendances, considerably less than the RCEM recommended figure of 1:4000. Of these 101 consultants, 19 are planning to retire in the next six years – a fifth of the consultant workforce. There were 90 gaps in the consultant rota, 33 in the middle grade rota and eight in the junior rota. Inability to recruit was the primary reason for rota gaps. This is leading to departments in Wales not meeting RCEM best practice recommendations of having an EM consultant presence for at least 16 hours a day in all medium and large systems. When asked for future staffing needs, departments across Wales reported needing an increase of 75% consultants, 120% increase in the ACP/ANP/PA workforce, 44% increase in the ENP workforce, 30% increase in the Higher Specialist Trainees/ Non-consultant Senior Decision Maker and a 50% increase in Junior Doctors in the next six years. The census also found that junior doctors were also being overstretched: At the time of collection there were 52 trainees in the ST1-6 programme as well as 95 non- Emergency Medicine trainees working in EDs across Wales Junior doctors work one weekend every three weekends, consultants work one weekend every 6.2 weekends. Junior doctors in training also do the most night shifts with an average of 52 per year.
  20. Content Article
    Changes in the way staff work, including staff taking on new roles and responsibilities, is a well-known policy solution in the NHS, and there are some really good instances where skill mix works well and has real benefits. But are there downsides to the drive to employ new types of staff to help doctors and nurses? What are the implications for continuity of care, staff experience and outcomes? Is the idea of ‘top of the licence’ working a reason for concern in terms of burnout, the fragmentation of care or is it an unavoidable response to the workforce crisis? Chair: Nigel Edwards, Chief Executive, Nuffield Trust Prof Alison Leary, Chair of Healthcare and Workforce Modelling, London South Bank University Dr Louella Vaughan, Senior Clinical Fellow, Nuffield Trust