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Content Article'State of Care' is the Care Quality Commission's annual assessment of health care and social care in England. The report looks at the trends, shares examples of good and outstanding care, and highlights where care needs to improve.
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EventuntilThe concerns about the state and stability of the NHS were deeply entrenched before 2020 and then of course the pandemic hit. The additional pressures and longer waiting times for appointments and treatment have only grown following a time when the NHS staff have experienced stresses like they never have before. The situation has led to increased fears of privatisation and increasing staff shortages as so many seek work elsewhere. But where does this leave our national health service and what does the future hold for a life saving institution which is struggling to survive itself? Join the Independent’s latest panel discussion as part of our virtual event series where our health correspondent Rebecca Thomas will ask a panel of experts including Dr Alexis Paton, director at the Centre for Health and Society, Hannah Barham-Brown, a GP and also deputy leader of the Women’s Equality Party and Dr Suzanne Tyler, RCM's Executive Director, Trade Union, about how they think the NHS can be healed and how it’s future can be secured. Register for the event
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News Article
End rules stopping thousands of doctors working in GP surgeries, says GMC chief
Patient Safety Learning posted a news article in News
Thousands of doctors are being prevented from working in overstretched GP surgeries across the UK because of unnecessary “red tape”, leaving NHS patients experiencing “unprecedented” waits for care, the head of the doctors’ regulator in the UK has said. Charlie Massey, the chief executive of the General Medical Council, said barriers that stopped medics from being deployed to meet areas of high demand, such as in primary care, must be removed urgently if the NHS workforce crisis was to be resolved and access to care improved. “Red tape is stopping the UK from making the most of many of its skilled and experienced doctors,” he said. “Without action, patients will suffer.” The regulator will on Tuesday call for a relaxation of rules so the fastest-growing part of the medical workforce – skilled doctors in non-training roles – can undertake a wider range of work beyond hospitals, such as in GP surgeries. “There are no easy answers to the challenges facing the NHS. There is no army of new doctors coming over the horizon, so part of the solution must be to make sure that we have more doctors in the places that patients need them,” Massey said. “The government should make a start immediately by changing the performers list criteria so more doctors are allowed to work alongside GPs. That needs to be done urgently. “But beyond technical changes there is also a need for fresh thinking in the way our health services are structured and in how teams of health professionals work together. We can’t keep doing things the same way they have always been done, or nothing will change." Read full story Source: BBC News, 18 October 2022 -
Content ArticleThis joint report by the APPG on Baby Loss and the APPG on Maternity is a culmination of over 100 submissions to an open call for evidence from staff, service users and organisations, on the maternity staffing crisis. It paints a picture of a service that is at breaking point and staff that are over-worked, burnt out and stressed.
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News Article
Social care ‘on its knees’ as vacancies hit record high
Patient Safety Learning posted a news article in News
Social care services face an “absolute crisis” over record vacancies as unfilled jobs have risen by more than 50% in a year, a new analysis reveals. New data on social care workers shows at least 165,000 vacancies across adult social care providers at the end of 2021-22. This is the highest on record according to the charity Skills for Care, which has collected the data since 2012. Leading think tanks have warned the figures to point to the “absolute crisis” facing social care with the “system on its knees”. At the same time the demand for care has risen, highlighting that social care is facing a complex challenge with recruitment and retention which will be impacting on the lives of people who need social care. The annual report by Skills for Care predicts social care services will need an extra 480,000 workers by 2035 to meet the demand but could be set to lose 430,000 staff to retirement over the next decade. Simon Bottery, senior fellow at The King’s Fund, said the report was evidence “of the absolute crisis social care faces when trying to recruit staff, a crisis that has profound consequences for people needing care”. He added: “A key reason for that is pay, which continues to lag behind other sectors including retail and hospitality, as well as similar roles in the NHS. Our recent analysis found that nearly 400,000 care workers would be better paid to work in most supermarkets." Read full story Source: The Independent, 11 October 2022 -
Content ArticleThis report from Skills for Care provides a comprehensive analysis of the adult social care workforce in England and the characteristics of the 1.50 million people working in it. Topics covered include recent trends in workforce supply and demand, employment information, recruitment and retention, demographics, pay, qualification rates and future workforce forecasts.
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Content ArticleThis article published by the Royal College of Nursing (RCN) aims to explain how health services in the UK protect patient safety during industrial action by nurses. It describes the principle of derogations, an exemption from taking part in strike action given to particular RCN members or services. Any RCN industrial action must follow the life-preserving care model. This exempts: emergency intervention for the preservation of life or the prevention of permanent disability. care required for therapeutic services without which life would be jeopardised or permanent disability would occur. urgent diagnostic procedures and assessment required to obtain information on potentially life-threatening conditions or conditions that could potentially lead to permanent disability. The article goes on to explain the process by which derogations are granted, and talks about balancing the need to maximise the impact of the strike while keeping patients safe.
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News Article
Four of UK’s top countries for nurse recruitment on WHO ‘red list’
Patient Safety Learning posted a news article in News
Three of the top seven countries from which the UK recruits overseas nurses are on the World Health Organization’s (WHO) ‘red list’ where active recruitment should not be used. Nigeria, Ghana and Nepal are the third, fifth and seventh highest respectively in the list of countries that provided the largest number of overseas staff joining the Nursing and Midwifery Council (NMC) register between April 2021 and March 2022. All three were on the red list during this period, which is derived by the WHO and identifies countries facing the most pressing health workforce shortages, meaning they should not be targeted for systematic recruitment by international employers. Nepal has since moved off the red list following of a government-to-government agreement between the Department of Health and Social Care (DHSC) and the Government of Nepal in the summer. But the agreement has raised concerns among health leaders, including those reported in The Observer which suggested Nepali recruitment agencies carried out abusive practices, such as charging illegal fees. Royal College of Nursing general secretary and chief executive Pat Cullen said the “overreliance” on international recruitment showed that the government had “no grip on the nursing workforce crisis”. “It’s deeply concerning that four ‘red list’ countries appear amongst the top 20 most recruited from countries,” she said. “This approach is unsustainable. Ministers must invest in growing the domestic nursing workforce. “They need to give nursing staff the pay rise they deserve to retain experienced nurses and attract new people to the profession.” Read full story Source: Nursing Times, 4 October 2022 -
News ArticleNurses will start voting on Thursday on whether to strike over pay amid warnings that record numbers are leaving the profession. Around 300,000 members of the Royal College of Nursing (RCN) are being asked if they want to mount a campaign of industrial action in the union’s first UK-wide ballot. The RCN said new analysis by London Economics to coincide with the ballot launch showed that pay for nurses has declined at twice the rate of the private sector in the last decade. It is the first time in its 106-year history that the RCN has balloted members across the UK on strike action and it is urging them to vote in favour. RCN general secretary Pat Cullen said in a message to those being balloted: “This is a once-in-a-generation chance to improve your pay and combat the staff shortages that put patients at risk. “Governments have repeatedly neglected the NHS and the value of nursing. We can change this if together we say ‘enough is enough’. “Record numbers are feeling no alternative but to quit and patients pay a heavy price. We are doing this for them too." Read full story Source: The Independent, 6 October 2022
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Content ArticleIn this blog for The House, Jeremy Hunt MP outlines how tackling long-term challenges in the health system will improve staff morale. While celebrating some short-term measures announced by the new Health Secretary Thérèse Coffey, he argues that longer term reforms are needed to "break the cycle of long waits, burned-out staff and declining standards." The key priority he outlines is workforce reform, including workforce projections and investment in training new healthcare workers for the future. He suggests that this will also encourage NHS staff to remain in their roles by restoring trust and confidence.
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Content ArticleThis article in the Manchester Evening News details the experience of Amy, whose daughter Harper was stillborn following failings in Amy's care. After being induced, Amy was left on her own in a room at the Royal Oldham Hospital's maternity unit overnight, without any monitoring. She had raised concerns about her baby's reduced movements but was denied additional checks. When Amy was finally checked in the morning, Harper had no heartbeat. An internal investigation conducted by The Royal Oldham Hospital found that if Amy had received appropriate monitoring, CTG abnormalities would have been noticed. This would have led to an escalation in her care, earlier delivery and Harper is likely to have been born alive.
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Content ArticleThe National Association for Healthcare Quality® (NAHQ) has conducted research on the advancement of the quality and safety agenda and has published the results in a new workforce report. NAHQ’s Healthcare Quality and Safety Report answers the question: “Is today’s healthcare workforce doing the work that will advance clinical priorities of quality, safety, equity, value, and system sustainability?”
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Content ArticleThis article tells the story of Baby E, who died two hours after delivery following issues with the management of her labour. The maternity unit was short-staffed on the night of Baby E's birth and there were delays in getting her mother to theatre for a caesarean section. Baby E's parents felt that the hospital withheld information from them, failing to inform them of internal investigations that had taken place following Baby E's death. At the inquest, the coroner concluded that errors had been made, including the fact that Baby E's low heart rate had been missed. She also criticised the decision-making process in the management of labour, but concluded that she was unable to say whether this had made a difference to whether or not Baby E lived.
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News Article
‘Perilous’ shortage of homecare workers leaves patients trapped in hospitals
Patient Safety Learning posted a news article in News
A “perilous” shortage of homecare workers is the biggest reason thousands of people are languishing longer in hospital than needed, driving up waiting lists and making people sicker, figures reveal. Almost one in four people unable to be discharged – sometimes for weeks – were trapped in hospital because they were waiting for home care, as agencies hand back contracts because staff are quitting owing to low pay, leaving 15% of jobs vacant. A fifth of people unable to be discharged were also waiting for short-term rehabilitation and 15% were waiting for a bed in a care home, according to analysis of data obtained using freedom of information requests and public records by Nuffield Trust and the Health Foundation. It estimated that in April this year, one in six patients were in hospital because of delayed discharge, and the discharge of patients with a hospital stay of more than three weeks was delayed by 14 days on average. “People are ending up in hospital for malnutrition and dehydration, problems which, even if you supported people a little bit at home, would stop,” said Jane Townson, the director of the Homecare Association. “More providers are having to turn down work than usual and some are having to hand back people because they can’t do it.” Read full story Source: The Guardian, 3 October 2022 -
News Article
Record number of nurses quitting the NHS
Patient Safety Learning posted a news article in News
Record numbers of nurses are quitting the NHS in England, figures show. More than 40,000 have walked away from the NHS in the past year - one in nine of the workforce, an analysis by the Nuffield Trust think tank for the BBC revealed. It said many of these were often highly skilled and knowledgeable nurses with years more of work left to give. And the high number of leavers is nearly cancelling out the rise in new joiners that has been seen. There were just 4,000 more joiners than leavers in the year to the end of June. But a Department of Health and Social Care spokesman said progress was being made and the government was already halfway to meeting its target to increase the numbers of nurses working in the NHS in England during this Parliament by 50,000. He said a workforce strategy would be published soon, setting out how the NHS will continue to recruit and retain nurses in the coming years. Read full story Source: BBC News, 30 September 2022 -
Content ArticleNursing is the single largest profession in the NHS, but it suffers from substantial staffing shortages. This analysis from Billy Palmer and Lucina Rolewicz for the Nuffield Trust reflects on the rate at which the health service is losing nurses, and considers the reasons why.
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Content ArticleIn this blog, Jeremy Hunt MP, Founder of Patient Safety Watch, argues against introducing more targets for GPs. The new Health Secretary, Therese Coffey MP, plans to introduce a target to ensure that all patients see their GP within two weeks. The blog highlights two issues with this approach: Setting a new target won’t make it a reality Having too many targets result is a system that depersonalises patients, deprofessionalises frontline staff and means it is difficult for health services to prioritise It then proposes that the health system should learn from the UK education system's approach to regulatory oversight, which is aimed at driving up standards, rather than achieving grades.
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News Article
Coffey accused of leaving NHS 'in limbo' on A&E target
Patient Safety Learning posted a news article in News
The four-hour emergency care target is “not the right answer” long term, but services have been left “in limbo” by Therese Coffey’s promise that it will no longer be scrapped, the president of the Royal College of Emergency Medicine has said. Katherine Henderson said RCEM was “delighted” there could be more focus on the four-hour target in the short term following the health and social care secretary’s surprise comment last week, as emergency care has been “in a performance policy vacuum since before the pandemic”. But Dr Henderson said that in the long term there should be performance metrics that account for the “journey” of the most acutely unwell patients, and should be a further review of NHS England’s clinical review of standards – which proposed a suite of new measures to replace the totemic four-hour target. She added that more than a dozen A&Es which are involved in trialling the new measures have been “left in limbo”. Dr Henderson, whose term as RCEM president ends in October, said plans to use virtual wards and urgent community response teams to improve patient flow and prevent emergency admissions would have limited impact this winter due to a lack of staff. Read full story (paywalled) Source: HSJ, 26 September 2022 -
News Article
NHS staff shortages are ‘biggest’ sepsis risk this winter, charity warns
Patient Safety Learning posted a news article in News
The looming NHS staffing crisis could lead to more patients dying from sepsis, a major UK charity has warned. Doctors have told the UK Sepsis Trust that staff shortages and high numbers of patients to treat are two of the most common factors preventing them from following national sepsis guidance. The chief executive of the UK Sepsis Trust, Dr Ron Daniels, warned that the NHS was in a “fragile” state and said workforce shortages were some of the “biggest potential causes of harm” in the context of diagnosing the condition. In a report by the trust, shared with The Independent, 65 out of 100 doctors in the UK warned that they had missed cases of sepsis. The most common reason for this was staff shortages alongside “high patient caseloads”, they said. Dr Daniels warned that staff might find it increasingly difficult to spot sepsis in the coming months as the staffing crisis intensifies. He told The Independent: “The NHS is in a fragile state after the pandemic... and staff absence is a fact of life within the NHS at the moment. That’s partly because staff have left, it is partly because we have high caseloads, but it is also because staff are still off sick". “It is my view that staff shortages are one of the biggest potential causes of harm that our public face in the context of developing sepsis, and we need to urgently address it.” Read full story Source: The Independent, 26 September 2022 -
News Article
Staffing shortages force NHSE to abandon safety target
Patient Safety Learning posted a news article in News
NHS England has this week told trusts it is abandoning a patient safety target ‘until maternity services in England can demonstrate sufficient staffing levels’ to meet it. The Midwifery Continuity of Care model was designed to ensure expectant mothers would be cared for by the same small team of midwives throughout their pregnancy, labour and postnatal care. It was a key recommendation of 2016’s Better Births review of English midwifery services. NHSE’s chief midwifery officer for England Jacqueline Dunkley-Bent championed the policy and guidance on its implementation was issued in October. However, in her report on the care failures at Shrewsbury and Telford Hospital Trust’s maternity department, Donna Ockenden said the Midwifery Continuity of Care model should be suspended until more evidence was gathered about its effectiveness and there were enough midwives to meet minimum staffing requirements. Ms Ockenden said patient safety had been “compromised by the unprecedented pressures that Continuity of Care models of care place on maternity services already under significant strain”. Read full story (paywalled) Source: HSJ, 23 September 2022 -
News Article
Why Coffey's NHS plan has left many unimpressed
Patient Safety Learning posted a news article in News
Tinkering around the edges, the King's Fund said. A few short-term fixes, according to the Health Foundation. And a plan that will have minimal impact, the Royal College of GPs added. These were just a handful of the reactions from those involved with the NHS. And they were not even from organisations usually at the front of the queue when it comes to criticising government policies. So why has Therese Coffey's first announcement as Health Secretary for England received such a negative response? The fact is the problems the health and care system are facing are deep-rooted. Much is made of the impact of the pandemic but the health service was already struggling before Covid hit. The pandemic has simply exacerbated the situation. At the heart of it all is a lack of staff. Addressing this is not easy and cannot be done overnight. It takes five years to train a doctor, three a nurse, which is why there is a big push on international recruitment at the moment. To free up GP appointments, pharmacists are being asked to take on some of their workload, while funding rules are being relaxed to allow GPs to use more of their money to recruit senior nurses. But there is nothing in the plan about where these new senior nurses are going to come from, which is why the Royal College of GPs has been so dismissive. It is a similar story for hospitals services, where accident-and-emergency waits, ambulance response times and the backlog in routine treatments such as knee and hip replacements have all worsened in recent years. Coffey is also introducing a £500m fund to get thousands of medically fit patients out of hospital as soon as possible. Local areas will decide how to spend the money and it could allow hospitals to pay for extra help at home for patients who need it. But it amounts to little more than a sticking plaster and is an approach already used to relieve the pressure during the pandemic. The real issue is the care sector is short of staff, with even more vacancies than in the NHS. Read full story Source: BBC News, 22 September 2022 -
Content ArticleThis letter from NHS Confederation to Thérèse Coffey MP, the new Secretary of State for Health and Social Care, sets out what needs to be done to support the delivery of an emergency winter plan for health and social care services. It outlines the views of NHS Confederation members on what will be needed to deliver the ‘ABCD’ highlighted as priorities by the Secretary of State: ambulances, backlogs, care and doctors and dentists.
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Content ArticleIn this blog, Jeremy Hunt MP, Founder of Patient Safety Watch, outlines six priorities for the new Health Secretary, Therese Coffey MP. He argues that these patient safety priorities will help reduce elective and emergency pressures and save money.
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Content ArticleThis Expert Panel evaluation was commissioned by the House of Commons Health and Social Care Committee. It reviews evidence to determine whether the Government’s policy commitments relating to the health and social care workforce in England are appropriate and have been effectively implemented. The Expert Panel consists of members with recognised expertise in research and policy evaluation, complemented by experts with research expertise and practical experience in the health and social care workforce.
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News Article
Largest private-sector nurses strike in U.S. history begins in Minnesota
Patient Safety Learning posted a news article in News
About 15,000 nurses in Minnesota walked off the job Monday to protest understaffing and overwork — marking the largest strike of private-sector nurses in U.S. history. Slated to last three days, the strike spotlights nationwide nursing shortages exacerbated by the coronavirus pandemic that often result in patients not receiving adequate care. Minnesota nurses charge that some units go without a lead nurse on duty and that nurses fresh out of school are delegated assignments typically held by more experienced nurses, across some 16 hospitals where strikes are expected. The nurses are demanding a role in staffing plans, changes to shift scheduling practices and higher wages. “I can’t give my patients the care they deserve,” said Chris Rubesch, the vice president of the Minnesota Nurses Association and a nurse at Essentia Health in Duluth. “Call lights go unanswered. Patients should only be waiting for a few seconds or minutes if they’ve soiled themselves or their oxygen came unplugged or they need to go to the bathroom, but that can take 10 minutes or more. Those are things that can’t wait.” Read full story (paywalled) Source: Washington Post, 12 September 2022
