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A locum responsible pharmacist has been issued a warning after a patient died when he dispensed the wrong strength of oxycodone during a staffing crunch, the regulator has revealed. Paresh Gordhanbhai Patel supplied 120mg rather than the prescribed 20mg of oxycodone hydrochloride to an “elderly” patient while working two locum shifts as responsible pharmacist at Crompton Pharmacy at Whitley House Surgery in Chelmsford. After taking one tablet, the patient died from an “accidental” oxycodone “overdose”, the General Pharmaceutical Council’s (GPhC) fitness-to-practise (FtP) committee heard at a hearing held on 11-13 September. Mr Patel admitted that he was “stressed and overtired” when he failed to notice a “discrepancy” between the prescribed strength of oxycodone and what he ordered and dispensed, The regulator heard that Mr Patel was “over-conscientious” and felt compelled “at a human level” to help out at the under-staffed pharmacy, despite the fact that it was “not safe to do so”, it added. Mr Patel admitted that his errors “amounted to misconduct” and conceded to the committee that his fitness to practise was “impaired” because he “breached one of the fundamental principles of the pharmacy profession.” The regulator heard that Mr Patel had “immediately” admitted his mistake to the pharmacy and did so again at the coroner’s inquest, where he also publicly apologised to the patient’s family. Read full story Source: Chemist and Druggist, 12 October 2023

The number of doctors seeking help for mental health issues has risen by more than three quarters within two years, according to figures from a specialist treatment service for NHS staff. For one GP, the relentless stress of the job led to him taking three months off work with burnout. David Triska is no stranger to high-pressure situations. As an army medic, he served two tours of Afghanistan. But mounting workloads at his village GP surgery left him feeling "hollowed out and spent". Simple tasks, like unlocking his car or making a meal, became a challenge - an experience he describes as leaving him feeling "like a husk of a human". "At that extreme point, I couldn't see why I needed to be here anymore," Dr Triska said. He is not alone. Since the year ending March 2021, there has been a 77% rise in the number of doctors seeking help for mental health issues, according to figures shared with the BBC by a confidential support service for NHS staff. More than 5,600 doctors used the NHS Practitioner Health programme in England in 2022/23, with about a third having thought about taking their own lives. Read full story Source: BBC News, 5 October 2023

Steve Gulati, Associate Professor and Director of Healthcare Leadership at HSMC (University of Birmingham) discusses the concept of "time to care" within healthcare. A UK-wide poll of healthcare workers revealed that most NHS staff think they have too little time to help patients and the quality of care that services provide is falling. This reported reduction in the time to care is perhaps inevitable after almost a decade of health funding failing to keep up with increases in demand, and is a cause for concern for all of us – patients, carers or those working in the NHS. Where does this fit in to the wider picture – and can anything be done about it? It is not just NHS workers who are feeling the pinch – levels of public satisfaction with the NHS are at an all-time low. Interestingly, the two most cited reasons relate to access (difficulties or delays in getting appointments) and, tellingly, to staff shortages. Even against this gloomy backdrop, the collectivised funding model upon which the NHS is founded continues to find significant public support. All of this points towards a painful congruence – NHS staff feel that they do not have enough time to care, and the public is noticing. Is ‘time to care’ an outdated concept, harking back to an age of long patient stays, a paternalistic bedside manner and unrealistic expectations? Both staff and patient experience suggest not. Although technology plays an increasing role in healthcare diagnostics, treatment and recovery, delivering care remains a deeply human phenomenon and is essentially a relational and personal task. Recognising that frontline healthcare workers need time to care is not a new phenomenon. Influenced by service improvement methodologies, the ‘productive ward’ initiative in the mid-2000s placed an explicit emphasis on using efficiency techniques for the express purpose of releasing nursing staff to have “time to care”. It was acknowledged that productivity was more than metrics around bed occupancy and throughput, for example, and that the driving purpose of service improvement was to time to care. Whilst research indicated a nuanced impact, the principle is long recognised. If solutions to these problems were easy, they would have been implemented by now. There is no doubt that on one level, it really is a matter of resources – no system can carry a vacancy factor of around 10% for any length of time without there being an evident impact. However, even within an environment of constrained resources, choices are made every day by caregivers and leaders alike about what receives attention and what is allowed to move into the ‘important but not urgent’ category. That is in no way to blame the hard-pressed caregivers, but instead to indicate that even when it really does not feel like it, every individual has a level of agency. Feeling as though one does not have time to do one’s job is, put simply, unpleasant for all workers but should especially concern us in care environments. The impact on clinical safety and quality is an obvious starting point, but it is also important to recognise the impacts on care workers themselves with regard to emotional labour and the impact on the psychological contract that working in a caring profession, when people feel that they don’t have enough time to care, must have. As eloquently stated by the Vice-President of the Royal College of Physicians in Wales, it is “…very clear that good clinicians, be they nurses, doctors, therapists or pharmacists, need time to train, time to care and time to rest”. Even in challenging times, self-care and compassionate, values driven leadership can make a difference. Caring is everyone’s business. Link to original article: https://www.birmingham.ac.uk/news/2023/healthcare-workers-need-more-time-to-care

A director at a major acute trust said it needs to stop “caving in” to demand pressures by opening extra escalation beds. Board members at Mid and South Essex were discussing a recent report from the Care Quality Commission (CQC), which rated medical services as “inadequate”. The CQC flagged significant staffing shortages and repeated failures to maintain patient records, among other issues. Deputy chair Alan Tobias told yesterday’s public board meeting: “We have just got to hold the line on these [escalation] beds. We never do. Every year we cave in… “We have just got to hold the line with this… Do what some other hospitals do, they shut the doors then. We have never had the bottle to do that.” Barbara Stuttle, another non-executive director, said: “Our staff are exhausted… We don’t have the staff to give the appropriate care to our patients when we have got extra beds. To have extra beds on wards, I know we have had to do it and I know why, [but] you are expecting an already stretched workforce to stretch even further. “And when that happens, something gives. Record keeping, that’s usually the last thing that gets done because they’d much rather give the care to patients.” Read full story (paywalled) Source: HSJ, 28 July 2023

GP trainers are more at risk of burnout than the average for all specialties, according to the GMC’s annual training survey results. The survey of over 70,000 doctors who are trainees or trainers found that 15% of GP trainers are at high risk of burnout, which is higher than the average of 12% and ranked second only to emergency medicine at 24%. The results also showed that 24% of GP trainers said that every working hour is tiring for them, compared to 11% of public health trainers. Last month, GP leaders raised concerns about how trainers and experienced GPs will handle the long-term workforce plan’s expansion of training places, especially given the existing pressures and lack of retention measures. Read full story Source: Pulse, 11 July 2023

NHS England has issued a ‘tokenistic’ and ‘insulting’ funding settlement for staff mental health and wellbeing hubs this year, which is not enough to provide proper support, HSJ has been told. A letter sent by NHSE to its regional directors, and seen by HSJ, confirmed that the hubs have been allocated just £2.3m for 2023-24. NHSE says the funding, which is far below current running costs, must be spent within the financial year. It appears to confirm fears that many of the 40 hubs will need to be shut, if they are not funded locally. One hub lead said: “Day in, day out, we work with colleagues across the NHS who are struggling with a wide range of mental health issues, from anxiety and depression to burnout and dealing with the impacts of moral injury. “Staff are exhausted, overwhelmed by their workload and struggling to give their patients the care they know they deserve. “I urge ministers to speak directly to hub leads to find out exactly what the issues are on the ground, and how the hubs are helping staff who are working at their limits, while supporting staff retention.” Read full story (paywalled) Source: HSJ, 6 July 2023

Nearly 170,000 workers left their jobs in the NHS in England last year, in a record exodus of staff struggling to cope with some of the worst pressures ever seen in the country’s health system, the Observer can reveal. More than 41,000 nurses were among those who left their jobs in NHS hospitals and community health services, with the highest leaving rate for at least a decade. The number of staff leaving overall rose by more than a quarter in 2022, compared to 2019. The figures in NHS workforce statistics of those leaving active service since 2010 analysed by the Observer show the scale of the challenge facing prime minister Rishi Sunak. He launched a new workforce plan on Friday to train and keep more staff. Sir Julian Hartley, chief executive of NHS Providers, said: “Staff did brilliant work during the pandemic, but there has been no respite. The data on people leaving is worrying and we need to see it reversed. “We need to focus on staff wellbeing and continued professional development, showing the employers really do care about their frontline teams.” Read full story Source: The Guardian, 1 July 2023

Staff sickness in the NHS in England has reached record levels. Figures for 2022 show an absence rate - the proportion of days lost - of 5.6%, meaning the NHS lost the equivalent of nearly 75,000 staff to illness. This is higher than during the peak pandemic years of 2020 and 2021 - and a 29% rise on the 2019 rate. Mental health problems were the most common cause, responsible for nearly a quarter of absences, the Nuffield Trust analysis of official NHS data shows. Big rises were also seen in cold, coughs, infections and respiratory problems, likely to be linked to the continued circulation of Covid as well as the return of flu last year. The think tank warned the NHS was stuck in a "seemingly unsustainable cycle" of increased work and burnout, which was contributing to staff leaving. The analysis, exclusively for BBC News, comes ahead of the publication of the government and NHS England's long-awaited workforce plan. Read full story Source: BBC News, 29 June 2023

A paramedic was hallucinating after a traumatic call-out when he crashed into a car, an inquest heard. Jason Allen, 49, and Andrew Ralph, 61, were killed after their car was hit by Kevin Lilwall's ambulance on the A49 in Pengethley, Herefordshire. An inquest heard Mr Lilwall was having flashbacks to the previous day when he had been in the area responding to the sudden death of a baby. The paramedic, who had worked for West Midlands Ambulance Service (WMAS) for 28 years, was driving the ambulance when it crossed the white line into the car. The ambulance dashcam showed it heading directly towards Mr Allen’s car for six seconds before the collision. The families of Mr Allen and Mr Ralph said they had been through hell in the past four years, adding they had never had an apology from Mr Lilwall and only one from WMAS after the inquest. The hearing in Hereford was told Mr Lilwall had spent more than 25 hours on duty in the previous 36 hours, with just a 10-hour break between shifts. Medical experts agreed that the hallucination could have been caused by post traumatic stress disorder. Jason Wiles from WMAS admitted it had been a "missed opportunity" regarding the apology and said it had changed its policy to ensure staff had a break of at least 11 hours between shifts following the crash. Read full story Source: BBC News, 28 June 2023

Many people with Long Covid have a lower health-related quality of life than people with some advanced cancers, research suggests. Fatigue is the symptom with the greatest impact on the daily lives of Long Covid patients, according to a study led by researchers at University College London (UCL) and the University of Exeter. They found that many were seriously ill and had fatigue scores worse than or similar to people with cancer-related anaemia or severe kidney disease. Their health-related quality of life scores were also lower than those of people with advanced metastatic cancers, such as stage 4 lung cancer. Overall, the impact of long Covid on the daily activities of patients was worse than that for stroke patients and comparable to people with Parkinson’s disease. The study co-author Prof William Henley, of Exeter University medical school, said: “Long Covid is an invisible condition, and many people are left trying to manage significant changes to how they can function. “Shockingly, our research has revealed that Long Covid can leave people with worse fatigue and quality of life than some cancers, yet the support and understanding is not at the same level. We urgently need more research to enable the development of evidence-based services to support people trying to manage this debilitating new condition.” Read full story Source: The Guardian, 8 June 2023