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Found 253 results
  1. Content Article
    Peter Griffiths and Chiara Dall'Ora, in this BMJ Editorial, discuss the staffing shortages in the NHS and what needs to be done.
  2. News Article
    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
  3. News Article
    The number of Covid patients in hospitals in England and Scotland has continued to rise this week, as NHS England reached a deal with private hospitals to free up beds amid the outbreak of Omicron cases. Meanwhile, Covid staff absences in England rose to their highest level since the introduction of the vaccine. The number of NHS workers in England off sick because of Covid was up by 41% in the week to 2 January, according to the latest figures. Five health workers describe some of the challenges they are facing, including understaffing, waiting times and bed-blocking. Read full story Source: The Guardian, 14 January 2022
  4. News Article
    Just under 6 million people in England are now waiting for hospital treatment – a record high – as latest performance figures show how the NHS was struggling even before the Omicron Covid variant emerged. A total of 5,995,156 patients were on the waiting list for an operation in November, of whom more than 2 million had already waited longer than the maximum standard of 18 weeks for routine treatment. Figures published by the NHS underlined its growing inability to provide timely care. They also showed that more than 300,000 people have been waiting more than a year for surgery and that performance against the crucial four-hour A&E target is the worst ever. The figures led to warnings from the Health Foundation thinktank that the NHS was “being stretched to its limits” and from the Liberal Democrat health spokesperson Daisy Cooper that “patients are being catastrophically let down by this government’s woeful neglect of the NHS”. “With the NHS now in the thick of one of the most uniquely challenging periods in its history, unacceptably long waits for hospital care are becoming increasingly commonplace,” said Siva Anandaciva, the chief analyst at the King’s Fund. Read full story Source: The Guardian, 13 January 2022
  5. News Article
    The trust at the centre of a maternity scandal does not have enough midwifery staff to keep women and babies safe, a Care Quality Commission (CQC)inspection has revealed. East Kent Hospitals University Foundation Trust relied on community midwives to fill slots at its acute unit, with some of them working 20-hour days after being called in to help cover and feeling outside of their competence. The trust had suspended a midwife-led unit and diverted women in labour to other hospitals – and when the CQC raised the understaffing issue at its inspection in July, it suspended its home birth service. But the CQC found that the number of midwives and maternity workers on duty rarely matched planned numbers and managers rarely calculated staffing numbers accurately, with some elements of the workload not being factored in. Lack of staff meant there was a risk to the safe assessment and monitoring of women and babies at the trust’s William Harvey Hospital in Ashford. Unqualified staff were having to deal with telephone queries from women who needed advice and support. Read full story (paywalled) Source: HSJ, 15 October 2021
  6. News Article
    London’s hospitals are less than two weeks from being overwhelmed by covid even under the ‘best’ case scenario, according to an official briefing given to the capital’s most senior doctors this afternoon. NHS England London medical director Vin Diwakar set out the stark analysis to the medical directors of London’s hospital trusts on a Zoom call. The NHS England presentation, seen by HSJ , showed that even if the number of covid patients grew at the lowest rate considered likely, and measures to manage demand and increase capacity, including open the capital’s Nightingale hospital, were successful, the NHS in London would be short of nearly 2,000 general and acute and intensive care beds by 19 January. The briefing forecasts demand for both G&A and intensive care beds, for both covid and non-covid patients, against capacity. It accounts for the impact of planned measures to mitigate demand and increase capacity. Read full story (paywalled) Source: HSJ, 6 January 2021
  7. News Article
    More needs to be done to tackle safe staffing levels in Northern Ireland's health service, according to the Royal College of Nursing (RCN). A year on from the nurses' strike, the union has warned that problems caused by poor workforce planning and chronic underfunding have not been addressed. Instead they have been exacerbated by the CoOVID-19 pandemic, said the RCN. The Department of Health said dealing with staff shortfalls was a "key priority" for the health minister. Pat Cullen, the Northern Ireland director of the RCN, said "very little has actually changed" since about 15,000 healthcare workers took to the picket line in December last year for a series of protests over pay and safe staffing levels. "We need to remind the government that many of these issues have sadly not gone away," she added. Read full story Source: BBC News, 18 December 2020
  8. News Article
    A hospital trust in Bristol has been accused of risking lives after raising its patient-to-nurse ward ratio to dangerously high levels, having allegedly dismissed staff concerns and national guidance on safe staffing. University Hospitals Bristol and Weston NHS Foundation Trust (UHBW) has introduced a blanket policy across its hospitals that assigns one nurse to 10 patients (1:10) for all general adult wards. This ratio, which previously stood at 1:6 or 1:8 depending on the ward, rises to 1:12 for nights shifts. The new policy, which is applicable to Bristol Royal Infirmary (BRI) and Weston General Hospital, also extends to all specialist high-care wards, which treat patients with life-threatening conditions such as epilepsy and anaphylaxis. Nurses at the trust have expressed their anger over the decision, saying they were never fully consulted by senior officials. Many are fearful that patient safety will be compromised as the second coronavirus wave intensifies, culminating in the unnecessary loss of life. “Patients who would have extra nursing staff because they are very acutely unwell and need close observation I think are going to unnecessarily die,” one nurse at BRI told The Independent. “Or if they survive, they’ll suffer long-term conditions because things were missed as they don’t have the staff at their bed side to watch the deterioration.” Read full story Source: The Independent, 18 November 2020
  9. News Article
    Almost half of all staff absence linked to coronavirus in parts of northern England Tens of thousands of NHS staff are off sick or self-isolating because of coronavirus, according to data shared with The Independent as the second wave grows. In some parts of northern England, more than 40% – in some cases almost 50% – of all staff absences are linked to COVID-19, heaping pressure on already stretched hospitals trying to cope with a surge in virus patients. The problem has sparked more calls for wider testing of NHS staff from hospital leaders and nursing unions who warned safety was being put at risk because of short staffing on wards. Across England, more than 76,200 NHS staff were absent from work on Friday – equivalent to more than 6% of the total workforce. This included 25,293 nursing staff and 3,575 doctors. Read full article Source: The Independent, 1 November 2020
  10. News Article
    A trust being investigated over maternity care failings was urged six years ago to strengthen its neonatal staffing, HSJ can reveal. An external review into East Kent Hospitals University Foundation Trust — conducted in 2015 and kept under wraps until now — said it had insufficient staffing, and that medical consultants felt a lack of engagement with senior managers. The trust released the review yesterday after its existence became public for the first time earlier this month. Last year, the trust was heavily criticised at the inquest of baby Harry Richford, who died seven days after he was born at the Queen Elizabeth, the Queen Mother, Hospital in Thanet. The Care Quality Commission is taking the trust to court over the case, and is the subject of an external inquiry. Among the recommendations of the review, carried out by the Royal College of Paediatrics and Child Health, were that consultants and junior doctors covering the neonatal intensive care unit “should have responsibilities solely to that specialty”. Such a move would improve the quality and safety of the service, the review suggests. Read full story (paywalled) Source: HSJ, 22 March 2021
  11. News Article
    NHS England has asked hospitals across the country to open hundreds more intensive care beds so they can take in patients from the hardest hit areas, to prevent those patches having to ration access. A letter sent to dozens of acute trusts today by NHS England asks them to enact their “maximum surge” for critical care from tomorrow, opening up hundreds of beds, which will rely on them redeploying staff and cancelling more planned care. The letter is to trusts in the Midlands but HSJ understands a similar approach is being taken in the other regions where critical care is not currently under as much pressure as London, the East of England and the South East. The message to surge capacity to support a “national critical care service” was reinforced to trusts nationwide in a call with Keith Willett, NHS England covid incident director, also on Wednesday. The letter, from the NHSE Midlands regional team, said there had been a national request for the region to surge beyond its own needs to support London and the East of England. “Significant” numbers are likely to be transferred, HSJ was told. Read full story (paywalled) Source: HSJ, 13 January 2021
  12. News Article
    More than a third of critical care units in the East of England are either at or have exceeded their maximum surge capacity, information leaked to HSJ reveals, and all but one are above their normal capacity. Data from the region’s critical care network shows that as of 11 January, seven of the region’s 19 critical care units were either at 100% of, or had exceeded, what is known as ”maximum safe surge” capacity. This represents the limit of safe care, mostly based on available staffing levels. The units have opened more beds, but they require dilution of normal staffing levels. Across the East of England, 482 of the region’s current 491 intensive care beds, after the opening of surge capacity, were occupied. This included 390 patients in intensive care with confirmed covid-19, six with suspected covid and 86 non-covid patients. It gives a regional occupancy rate of 91 per cent against total “safe surge” capacity. Published government figures show the rapid increase in demand for intensive care in the East of England in the last two weeks — the number of patients with covid in mechanical ventilation beds is more than double what it was just after Christmas. Read full story (paywalled) Source: HSJ, 11 January 2021
  13. Content Article
    This document summarises the findings of The Health Foundation's analysis on workforce supply and demand in general practice in England up to 2030/31. It focuses on patient care staff including GPs and general practice nurses. The Health Foundation developed three scenarios of potential workforce supply through a mix of in-house modelling and publicly available data: a scenario based on current policy, a more optimistic scenario and a pessimistic scenario. The analysis demonstrates that in all three scenarios, the supply of GPs and general practice nurses is projected to fall short of demand. Under current policy, the NHS faces a shortfall of over 1 in 4 GP and general practice nurse posts by 2030/31. In the pessimistic scenario this increases to around 1 in 2 GP and nurse posts, raising concerns about patient safety, quality of care and equity of access. In the optimistic scenario, the GP shortfall can be substantially mitigated by 2030/31, but this would require sustained and concerted policy action to boost GP retention and integrate newer roles within multidisciplinary practice teams.
  14. Content Article
    Since the Covid-19 pandemic, staff shortages have worsened in health systems around the world, with an increasing number of healthcare workers leaving the workforce coinciding with increased patient demand. In this blog, Jens Hooiveld, International Marketing Manager at the Patient Safety Company, examines the patient safety issues caused by staffing shortages. He highlights tools that can help nurses manage patient safety in this pressured climate by decreasing the burden of admin associated with reporting adverse incidents.
  15. Content Article
    This 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.
  16. Content Article
    There 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?
  17. Content Article
    Richard 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.
  18. Content Article
    Although 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:
  19. Content Article
    In 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.
  20. Content Article
    This 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.
  21. Content Article
    In 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.
  22. Content Article
    This 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.
  23. Content Article
    In a television studio in Stoke-on-Trent last month, Liz Truss and Rishi Sunak traded blows over everything from credit card economics to Channel migrants to the accessories chain Claire’s. The list of issues the pair clashed over was dizzyingly long. There was one glaring omission, however. In the hour-long debate there was not a single mention of the NHS – despite being engulfed in its biggest ever crisis. The NHS now shares the same traits as many of those relying upon it to keep them alive and well: it is elderly, has multiple comorbidities, and is in dire need of emergency care. Summer has left it on its knees. Worse is expected this winter. “The new prime minister will inherit an NHS in its worst state in living memory,” says Matthew Taylor, the chief executive of the NHS Confederation, which represents the healthcare system in England, Wales and Northern Ireland. “There is no escaping that the NHS is in a state of crisis.”
  24. Content Article
    The importance of nurse staffing to the delivery of high-quality patient care was a principal finding in the landmark report of the Institute of Medicine’s (IOM) Committee on the Adequacy of Nurse Staffing in Hospitals and Nursing Homes: “Nursing is a critical factor in determining the quality of care in hospitals and the nature of patient outcomes”. Nurse staffing is a crucial health policy issue on which there is a great deal of consensus on an abstract level (that nurses are an important component of the health care delivery system and that nurse staffing has impacts on safety), much less agreement on exactly what research data have and have not established, and active disagreement about the appropriate policy directions to protect public safety. Researchers have generally found that lower staffing levels are associated with heightened risks of poor patient outcomes. Staffing levels, particularly those related to nurse workload, also appear related to occupational health issues (like back injuries and needlestick injuries) and psychological states and experiences (like burnout) that may represent precursors for nurse turnover from specific jobs as well as the profession. This chapter from the Patient Safety and Quality: An Evidence-based Handbook for Nurses summarises and discusses the state of the science examining the impact of nurse staffing in hospitals and other health care organisations on patient care quality, as well as safety-focused outcomes. To address some of the inconsistencies and limitations in existing studies, design issues and limitations of current methods and measures will be presented. The chapter concludes with a discussion of implications for future research, the management of patient care and public policy.
  25. Content Article
    The NHS often appears to be in a state of permanent crisis. Recently, there've been headlines about long waiting times for ambulances and the huge backlog for routine surgery. Before that, the NHS faced a two-year pandemic which may rear its head again this winter. But the NHS also has a big underlying problem that it has tens of thousands of vacancies for doctors, nurses and other medical workers – and that makes all the other pressures on the NHS even harder to handle. So why does the NHS have a staffing problem? And what can be done to fix it?
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