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Content ArticleThis US study in BMJ Quality & Safety aimed to assess whether limiting the hours worked by first-year resident doctors' had an impact on patient safety. In 2011, The Accreditation Council for Graduate Medical Education (ACGME) enacted a policy that restricted first-year resident doctors in the USA to working no more than 16 consecutive hours. This policy was rescinded in 2017, and this study assessed the impact of the policy change by comparing the number of medical errors reported by first-year doctors in the five years before the ACGME was enacted (2002/2007) and in the three years following its implementation. The authors found that the 2011 work-hour policy was associated with a: 32% reduced risk of resident physician-reported significant medical errors 34% reduced risk of reported preventable adverse events 63% reduced risk of reported medical errors resulting in patient death They conclude that rescinding the policy in 2017 may be exposing patients to preventable harm.
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Content ArticleThere are an estimated 3.8 million people with a wound being managed by the NHS, which is equivalent to 7% of the UK population. The impact of wounds on patients is significant and can lead to deteriorating mental health as well as further physical health issues. In addition, the cost to the NHS of providing wound care services is around £8.3 billion annually. This report by Mölnlycke and the Patients Association provides an outline of the state of wound care services in England by mid-2021. It features patient stories and data analysis on the following topics: Wound care in the health service The impact of Covid-19 Supported self-care Getting wound care right first time What next for wound care?
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Content ArticleRichard Murray, Chief Executive of The King's Fund, writes about what the recent passing of the Health and Care Act 2022 tells us about the government's approach to health and care, and highlights key issues the system faces. He highlights two areas of focus, workforce and social care, and looks at how problems in these areas are affecting the people who work in and use health and care services.
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News Article
Hospitals urged to use retired staff to cut backlog
Patient Safety Learning posted a news article in News
NHS bosses in England are urging hospitals to offer staff more overtime and tempt retired employees back, to help tackle waiting lists. A letter sent by NHS England said tackling the backlog that had grown during the pandemic would require a "number of high impact actions". And many hospitals were already taking innovative approaches to the issue. More than six million people are on waiting lists for treatment such as knee and hip surgery. According to the General Medical Council, 21,000 doctors are due to retire in September. And part of the plan would be to tempt some of those back by offering part-time opportunities to: train students run virtual consultations help with follow-up check-ups. Other measures recommended by NHS England are: removing caps on consultant hours - in some places senior doctors are limited to 40 hours a week - to offer extra shifts where safe offering more bank shifts - overtime opportunities for trust rather than agency staff increasing the use of NHS reservists - members of the public who have signed up to work for the NHS for at least 30 days a year - to help run wards, feed patients and provide support for the Covid-vaccination programme exploring taking simple procedures, such as cataract surgery, out of operating theatres and into other parts of the hospital. Read full story Source: BBC News, 5 May 2022 -
Content ArticleAlthough compensation increases have played a key role in retaining and recruiting healthcare employees amid a major workforce shortage, perks such as mental health services and education financial assistance have also helped meet staff needs. Six health system CEOs and CFOs share with Becker's Hospital Review their best tips for retention and recruitment that go beyond compensation:
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News Article
GPs won’t see us unless it’s ‘life or death’, complain pensioners
Patient Safety Learning posted a news article in News
A 94-year-old man has said his GP refuses to see him “unless it’s life or death”. Dennis Baker, from North Hampshire, said he felt “put off” by his doctor's surgery, which is a three-minute walk from his house. The pensioner, who lives with his wife who has advanced dementia and is bed-bound, said he found it “quite difficult to carry on a conversation with a doctor” and cannot get one to visit him at home. “The chances are [the receptionist] will say… ‘you're not dying, a doctor will phone you at some stage today’, that’s the usual response,” he told BBC Radio 4’s World at One. It comes as the president of the Royal College of GPs (RCGP) said family doctors should start “saying no” to extra work to tackle the crisis in primary care. Speaking at Pulse Live last week, Professor Dame Clare Gerada said the workload crisis was not the fault of GPs and they “cannot innovate [their] way out”. “When you’re in debates and people are saying to you 'you’ve got to work harder and smarter' - no, the rest of the system has to adapt,” she told the conference. “You have to start saying no.” Read full story (paywalled) Source: The Telegraph, 3 May 2022 -
Content ArticleIn its 2019 manifesto the government pledged to increase the full-time equivalent number of nurses working in the NHS by 50,000 by March 2024. But although data suggests that the NHS will hit that target, Ruth May, England's Chief Nursing Officer, has stated publicly that there are still substantial shortages in spite of this increase. This analysis by the King's Fund highlights that the supply of nurses to the NHS is not keeping up with demand, with vacancy levels remaining static in spite of an increase to the raw number of nurses. It also highlights wide regional variation in nurse shortages.
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Content ArticleMuch research has been done into the causes, extent and impact of health inequalities that affect rural and coastal populations. Health services in these areas currently face serious challenges due to a combination of factors, including social deprivation, ageing populations and workforce staffing issues. In this blog, Patrick Mitchell, Director of Innovation, Digital and Transformation at Health Education England (HEE), describes a new HEE programme that aims to help tackle health inequalities in rural and coastal areas.
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Content Article
HSJ Primer: Breaking point (25 April 2022)
Patient Safety Learning posted an article in Workforce and resources
Recently the Financial Times health and data reports produced an incisive piece showing the world what is all too readily apparent to people in the NHS: bed capacity has been stretched to breaking point. The report said this “calls into question [the NHS’s] ability to meet a commitment to increase non-urgent hospital treatment by 30 per cent above pre-pandemic levels over the next three years”. It also demonstrates the dangerous congestion that is causing ambulances to stack up outside emergency departments and medically fit patients to languish in vital beds past their due time for discharge. This congestion is causing dangerous delays, leading to a rising number of serious incidents in ambulances queuing to get to the front door of the ED. There is doubtless much that can be done inside hospitals to improve efficiency, alleviate bottlenecks and improve patient flow. -
Content ArticleRebuild General Practice is a campaign that represents GPs from across England, Scotland and Wales, to call for support to address the severe pressures currently faced by primary care. Rebuild GP is calling for Government action on: Recruitment: The UK Government delivering on its commitment of an additional 6,000 GPs in England by 2024 Retention: Tackling the factors driving GPs out of the profession such as burn out Safety: A plan to reduce GP workload and in turn improve patient safety This video shows highlights of a press conference held to launch the campaign. It features accounts from GPs about the pressures they face and how this is affecting staff and patients, as well as a statement from Jeremy Hunt MP, former Health Secretary. Dr Kieran Sharrock, deputy chair of the BMA GP Committee, calls on the Government to work with GPs to find a solution to the issues faced by primary care.
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News Article
Nurses reveal shocking abuse from patients as backlog rises
Patient Safety Learning posted a news article in News
Nurses have spoken of the shocking abuse they face from patients as the NHS struggles to cope with a rise in demand for care. Both patients and staff are becoming increasingly frustrated with the situation the NHS is in, with staff shortages and a patient backlog of six million people causing already stretched services extra strain. "As we are the faces that the public see we do get the brunt of a lot of their anger as they are becoming increasingly frustrated with the situation that the NHS is in," one nurse wrote on Nursing Standard’s Facebook page. "Staff are equally frustrated with the whole situation and knackered from working long hours and covering for the many staff still absent." Nurses given the task of conveying ‘unwelcome messages about the limitations of resources’ Another said: "Working in an ED abuse occurs on a daily basis… it is not acceptable but even when you Datix these incidents nothing gets done, staff are reduced to tears and frightened to walk into patient waiting areas, it is not acceptable." It comes as former chief inspector of social services Lord Herbert Laming accused health service managers of putting nursing staff in the public firing line during a House of Lords debate on reducing abuse of nurses in the NHS. Read full story Source: 12 April 2022, Nursing Standard -
News ArticleMums who have given birth at Sheffield's largest maternity unit have revealed all about the "horrible" conditions, with some parents saying they feared for their baby's lives. One mum - a midwife herself - was so concerned about her unborn baby's welfare that she and her partner temporarily moved to London just weeks before her due date. "I felt like my son and I might have died if we had the pregnancy in Sheffield," she said. Several mums have spoken to Yorkshire Live about their stories after a scathing report uncovered the scale of the issues on the Jessop Wing. CQC inspectors highlighted all manner of major issues about the care given at Sheffield Teaching Hospital's specialist maternity unit, including examples of emergency help not arriving when staff called for it. Distraught mums said they were left naked and covered in bodily fluids while others complained about being ignored for hours despite begging for pain relief. Dangerously low staffing levels exposed patients to the risk of serious harm, while midwives themselves revealed a toxic environment of a "bullying and intimidating culture" from senior management. As a Trust spokesperson said "we are very sorry" and vowed to make big improvements, we spoke to some of the families worst affected by the problems as they explained how "basic dignity and care have gone out the window". Read full story Source: 12, April 2022, Yorkshire Live
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Content ArticleDr Katherine Henderson is a senior A&E consultant in London and the president of the Royal College of Emergency Medicine. In this article for The Guardian, she describes the deep crisis facing urgent and emergency care in the UK. She describes hospital warnings of dangerous delays that have seen vulnerable patients waiting hours to be seen and admitted to hospital. This is dangerous, frustrating and undignified for patients, but also distressing for staff, who are finding themselves unable to offer the quality of care they want to deliver. Dr Henderson attributes the issues to shortfalls in healthcare staff and hospital beds, but also a lack of capacity in community care that is delaying patients being discharged from hospital. The situation is exacerbated by staff absence due to Covid-19. To tackle the crisis, she calls for clear plan to increase bed capacity and a robust, fully funded long-term workforce plan.
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Content ArticleThis report by the Health and Social Care Commons Select Committee examines why cancer outcomes in England remain behind other comparable countries. For example, 58.9% of people in England diagnosed with colon cancer will live for five years or more, compared to 66.8% in Canada and 70.8% in Australia. The report identifies key issues in early diagnosis, access to treatment, variation in services and research and innovation, and makes recommendations aimed at improving cancer survival rates in England.
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News Article
Public satisfaction with NHS drops to 25-year low
Patient Safety Learning posted a news article in News
Public satisfaction with the NHS has dropped to its lowest level for 25 years after a sharp fall during the pandemic, a survey suggests. The British Social Attitudes poll, seen as the gold standard measure of public opinion, found 36% of the 3,100 asked were satisfied in 2021. That is a drop from 53% the year before - the largest fall in a single year. Only once have satisfaction levels been lower since the poll started in 1983. That was in 1997, and shortly after that the Blair government started increasing the budget by record amounts. The public said it was taking too long to get a GP appointment or hospital care, and there was not enough staff. Satisfaction with GP care and hospital services were both at their lowest levels since the survey began. Dan Wellings, senior fellow at the King's Fund, described them as "extraordinary". He said the NHS initially saw a "halo" effect early on in the pandemic, with satisfaction rates being maintained as the NHS battled through the first wave. But he said it was clear that had now gone. "People are often struggling to get the care they need. These issues have been exacerbated by the extraordinary events of the past two years, but have been many years in the making following a decade-long funding squeeze, and a workforce crisis that has been left unaddressed for far too long." Read full story Source: BBC News, 30 March 2022 -
Content ArticlePrimary care is a crucial part of every healthcare system, but the US spends less on primary care and more on specialty care than other high-income countries. The results of this are burnout, high staff turnover and physician shortages. These were all major problems before Covid-19, that have been worsened by the pandemic. In this episode of The Commonwealth Foundation's podcast The Dose, host Shanoor Seervai asks Asaf Bitton, MD, executive director of the health innovation center at Ariadne Labs, what it will take to rebuild the USA's broken primary care system.
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Content ArticleEarlier this month The BMJ and the Nuffield Trust hosted a roundtable discussion about the workforce crisis. It took in a wide range of perspectives, but the message was clear: the workforce crisis is urgent, it is affecting staff morale and wellbeing, it is damaging patient care, and it requires immediate action. It’s not just a UK problem; it’s a global crisis, but some countries are better at recognising the relation between staff morale and wellbeing, better patient care and economic growth. Simply put, your economy won’t grow if your population is unhealthy; your population won’t be healthy if your health professionals are demoralised and unwell.
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Content ArticlePutting patients in tents outside hospitals is a completely unacceptable ‘solution’ to the ambulance handover problems and the funding would be far better spent on staff in the community, says Royal College of Emergency Medicine president Katherine Henderson in this HSJ opinion piece.
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Content Article
BMA - On the edge: GPs in despair (18 March 2022)
Patient-Safety-Learning posted an article in GP and primary care
This article by the British Medical Association (BMA) looks at the pressures GPs face that are leading to an increasing number leaving the profession. Several GPs from around the UK share their personal experience of unsustainable workloads and burnout, and the impact this has had on their health and wellbeing. The article highlights the impact of changes to the system on doctors at different career stages, including the increasing number of older GPs who are retiring early due to the intense pressure of their role. -
Content ArticleThis blog for The Kings Fund looks at how chronic excessive workload is damaging staff health, patient care and healthcare workers' long-term ability to provide high-quality and compassionate care for people in their communities. The authors argue that the issue of excessive workload is the major barrier preventing improvements in patient satisfaction, staff retention, financial performance and care outcomes.
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Content ArticleThis investigation by the Healthcare Commission examined the cases of ten women who died during pregnancy or within 42 days of delivery at Northwick Park Hospital, North West London Hospitals NHS Trust, between April 2002 and April 2005. This number of maternal deaths was significantly higher statistically when compared with other trusts that serve similar populations.
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News Article
Top oncologist says Tayside cancer crisis was 'avoidable tragedy'
Patient Safety Learning posted a news article in News
A crisis in cancer care at NHS Tayside could have been averted if the health board had publicly supported doctors who were criticised by an official report, according to a top oncologist. The last remaining breast radiotherapy specialist left at the end of January, with the board unable to replace him. Patients must now travel to Aberdeen, Glasgow or Edinburgh for radiotherapy. The situation has emerged three years after an investigation into chemotherapy treatment at Ninewells Hospital. NHS Tayside apologised to patients in 2019 after an investigation found doctors deviated from national standards on chemotherapy dosages given to breast cancer patients after surgery. A subsequent review found that the lower dosages were highly unlikely to have led to the deaths of any patients. Last year the doctors involved were cleared of any wrongdoing by the General Medical Council (GMC), who also found no fault with the treatment patients received. Some clinicians close to those involved told BBC Scotland the cancer doctors felt they had no choice but to leave because they did not have the backing of the board. Colleagues who support the oncologists say none of this needed to happen. Prof Alastair Munro, emeritus professor of radiation oncology at Dundee University, who previously worked as a cancer doctor in the department, said: "It's a totally avoidable tragedy, this should not have happened. "The first thing the health board need to do is to come clean, and say we got it wrong, we put our hands up, we want to start again with a clean slate and we want to attract good people to come to Tayside to deliver breast cancer services to the patients whose needs we serve." Read full story Source: BBC News, 9 February 2022 -
Content ArticleRichard Murray, Chief Executive of The King’s Fund, comments on the NHS elective recovery plan.
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Content ArticleThe Covid-19 pandemic has had a significant impact on the amount of planned care the NHS has been able to provide. This delivery plan sets out how the NHS will recover elective care over the next three years. It has been developed with a wide range of expert partners and explains how the NHS will capitalise on current success and embed new ideas to ensure elective services are fit for the future.
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Content ArticleBarrie Housby had a medical history that included frailty, Parkinson’s disease and macular degeneration. During a stay at Clifton Hospital he was known to be at high risk of falls and at the beginning of the nightshift on 12 July 2021, it was advised that he should be cared for on a one to one basis and not left unattended. During the shift, a member of staff allocated to monitor him left the bay to attend to other duties, and in this time Mr Housby left his bed and fell. He was transferred to a hospital emergency department but subsequently died on 13 July 2021 as a result of a traumatic subdural haemorrhage following a fall. In his report, the Coroner Alan Wilson highlights the impact of staffing shortages at the Trust and their contribution to Mr Housby’s death, stating that this poses an ongoing risk to patient safety.
