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Found 334 results
  1. News Article
    Hospital doctors are being sent home from daytime shifts and told to come back and work overnight in the latest stark illustration of the NHS’s crippling staff shortage. Medics are having to change their plans at the last minute because hospitals cannot find any others to plug gaps in the night shift medical rota and need to ensure they have enough doctors on duty. Hospital bosses are forcing last-minute shift changes on junior doctors – trainees below the level of consultant up to the level of senior registrar – because staff sickness and the scarcity of locum medics has left them struggling to ensure patients’ safety is maintained overnight. One trainee doctor in south-west of England told how they started their shift as planned at 8am. However, “by mid-morning the doctor that was meant to be working that night, that I would hand over to, had called in ill”. The doctor stopped working at 11am, drove home – an hour away – and came back to work the night shift at 11pm. “By the time I returned I had already worked for three hours and driven for three hours. That’s an extra six hours on top of a busy night shift of 12.5 hours,” they said. Dr Julia Patterson, the chief executive of EveryDoctor, said: “We are hearing of escalating problems with NHS doctors being forced to work unsafe, unfair hours." “Patient safety is of paramount importance to all doctors, but this situation is simply not sustainable. When mistakes occur, staff are blamed. But staff are working in an unworkable system.” Read full story Source: The Guardian, 11 July 2022
  2. News Article
    Polling by the Royal College of General Practice (RCGP) as part of a campaign to make NHS GP services sustainable for the future found that 42% of 1,262 GPs and trainees who took part said they were likely to quit the profession in the next five years. A workforce exodus on this scale would strip the health service of nearly 19,000 of the roughly 45,000 headcount GPs and GP trainees currently working in general practice. RCGP chair Professor Martin Marshall warned that general practice was a profession in crisis - with the intensity and complexity of GP workload rising as the workforce continued to shrink. He warned that 'alarming' findings from the RCGP poll must serve as a stark warning to politicians and NHS leaders over the urgent need for solutions to begin to tackle the crisis facing general practice. Four in five respondents told the RCGP they expect working in general practice to get worse over the next few years - while only 6% expected things to improve. Nearly two in five respondents said GP practice premises are not fit for purpose, and one in three said IT for booking systems is not good enough. Professor Marshall said: 'What our members are telling us about working on the frontline of general practice is alarming. General practice is significantly understaffed, underfunded, and overworked and this is impacting on the care and services we’re able to deliver to patients. Read full story Source: GP, 22 June 2022
  3. News Article
    The COVID-19 crisis has both divided and galvanised Canadians on healthcare. While the last three years have presented new challenges to healthcare systems across the country, the pandemic has also exacerbated existing challenges, most notably the high levels of errors and mistreatment documented in Canadian health care. According to a 2019 report from the Canadian Patient Safety Institute, Canada was already facing a public health crisis prior to the pandemic: a crisis of patient safety. As the report details, patient safety incidents are the third leading cause of death in Canada, following cancer and heart disease. Few studies calculate national data on this topic, but a 2013 report found that patient safety events resulted in just under 28,000 deaths. Many Canadians who have experienced these errors have shared their experiences with media in an effort to raise awareness and demand change. The impact of the COVID-19 pandemic has created a moment of dual crises. First, the pre-existing crisis of patient safety, and second, healthcare overall is now at a breaking point after three years of COVID-19, according to healthcare workers. Edmonton physician Dr. Darren Markland, for example, recently closed his kidney specialist practice after making a few "profound mistakes." In an interview with Global News, he explains he could no longer work at the current pace. He is not alone in this decision. Across the country, there have been waves of resignations in health care, leaving some areas struggling with a system that is "degrading, increasingly unsafe, and often without dignity." Read full story Source: MedicalXpress, 17 June 2022
  4. News Article
    The U.S. is facing high levels of burnout among health care workers, which could lead to serious shortcomings in patient care, a new report from the U.S. Surgeon General has found. Burnout among health care workers was a serious problem even before the COVID-19 pandemic, but the stress caused by the ongoing pandemic has made things much worse, said Surgeon General Dr. Vivek Murthy. “The pandemic has accelerated the mental health and burnout crisis that is now affecting not only health workers, but the communities they serve,” Murthy said. “Already, Americans are feeling the impact of staffing shortages across the health system in hospitals, primary care clinics, and public health departments. As the burnout and mental health crisis among health workers worsens, this will affect the public’s ability to get routine preventive care, emergency care, and medical procedures. It will make it harder for our nation to ensure we are ready for the next public health emergency. Health disparities will worsen as those who have always been marginalized suffer more in a world where care is scarce. Costs will continue to rise.” The report calls for several steps to address the burdens on health care workers. These include: Protecting the health, safety, and well-being of all health workers by ensuring they have proper equipment, training, and are protected against workplace violence. Eliminating punitive policies for seeking mental health and substance abuse care. Reducing administrative and documentation burdens and improving health information technology and payment models. Prioritising health worker well-being on an organizational level—this includes providing competitive wages, paid sick and family leave, rest breaks, educational debt support, and other steps to ease the burden on health workers. Read full story Source: BenefitsPro, 6 June 2022
  5. News Article
    About half of all hospital doctors and nurses have had accidents or experienced near misses while driving home after a night shift. The risks they pose to themselves and other road users have been calculated as the same as those posed by drivers who are over the legal alcohol limit, delegates at a European medical conference were told last week. As a result, health experts have called for doctors and nurses to be allowed to take 20-minute power naps during night shifts. This would make their journeys home safer and would also help to protect patients from mistakes they might make through tiredness when administering drugs or other treatments. “When fatigue sets in, we in the medical and nursing team are less empathetic with patients and colleagues, vigilance becomes more variable, and logical reasoning is affected, making it hard for us to calculate, for example, the correct dose of drugs a patient might need,” consultant anaesthetist Nancy Redfern of Newcastle hospital said last week. “We find it hard to think flexibly, or to retain new information, which makes it difficult to manage quickly changing emergency situations. Our mood gets worse, so our teamwork suffers. Hence, everything that makes us and our patients safe is affected.” Research found that workers who drive home after a 12-hour shift are twice as likely to have a crash as those working eight-hour shifts. Read full story Source: The Guardian, 4 June 2022
  6. News Article
    Most nurses warn that staffing levels on their last shift were not sufficient to meet the needs of patients, with some now quitting their jobs, new research reveals. A survey of more than 20,000 frontline staff by the Royal College of Nursing (RCN) suggested that only a quarter of shifts had the planned number of registered nurses on duty. The RCN said the findings shone a light on the impact of the UK’s nursing staff shortage, warning that nurses were being “driven out” of their profession. In her keynote address to the RCN’s annual congress in Glasgow, general secretary Pat Cullen will warn of nurses’ growing concerns over patient safety. Four out of five respondents said staffing levels on their last shift were not enough to meet all the needs and dependency of their patients. The findings also indicated that only a quarter of shifts had the planned number of registered nurses, a sharp fall from 42% in 2020 and 45% five years ago, said the RCN. Ms Cullen will say: “Our new report lays bare the state of health and care services across the UK. “It shows the shortages that force you to go even more than the extra mile and that, when the shortages are greatest, you are forced to leave patient care undone. Read full story Source: The Independent, 6 June 2022
  7. News Article
    The health safety watchdog has said that doctors, ambulance dispatchers and other NHS staff in England have faced "significant distress" and harm over the past year as a result of long delays in urgent and emergency care. The Healthcare Safety Investigation Branch (HSIB), which monitors safety in the health service in England, said many staff it interviewed for a national investigation "cried or displayed other extreme emotions" when asked about their working environment. "The bad sides [of my job] give me nightmares, flashbacks and fear, but they can also make me hyperactive, sleepless and sometimes not care about the danger I put myself in," one paramedic told the BBC. Sarah, not her real name, has worked in the ambulance service for more than a decade, but describes the last 12 months as the most difficult she can remember. "Over the winter I have witnessed and helped with cardiac arrests in the corridors of hospitals and in the back of ambulances," she said. "I spent four hours with an end-of-life patient. There was no hospice or district nurse available, so I had to make the choice to give them meds for a peaceful, expected death and prepare the family. "I felt ashamed that I could not stay till the end, but I had to move on to the next job as I had done all I could." The HSIB found NHS staff were reporting increased levels of stress, worry and exhaustion because they were not always able to help the sickest patients. HSIB has now urged trusts to do more to protect workers’ mental health, saying there is an “intrinsic link” between patient safety and staff wellbeing. Read full story Source: BBC News, 27 February 2023
  8. News Article
    Healthcare workers are “absolutely shattered” and unless something is done to address the crisis in morale, staffing and training then “they won’t be there when you need them”, one of the world’s leading scientists has warned. Speaking to the Guardian, Prof Jeremy Farrar, the director of Wellcome and soon to be chief scientist of the World Health Organization, warned that healthcare workers would not be ready should another crisis hit. “This is a global issue, which I think is hugely concerning. It’s certainly true in this country,” he said. “The resilience of healthcare workers, broadly defined from ambulance drivers to nurses to doctors, to care workers in social care, etc. They’re shattered. They are absolutely shattered." Farrar said: “I think we have to address the morale, staffing, the training, everything from public health physicians to care workers, to doctors and nurses and physios and everybody in between because there’s very little spare capacity in any system globally. It’s particularly true in the UK. As you can see from the strikes, morale and resilience is very thin.” Read full story Source: The Guardian, 20 February 2023
  9. News Article
    The number of GPs seeing patients outside standard surgery hours in Scotland has dropped by almost a quarter in three years. Nurses and paramedics have had to fill in for doctors in the out-of-hours urgent care centres because GPs could not be found to cover the shifts. Some health boards have had to close their centres and send patients to overstretched A&Es instead because of the GP shortage. Dr Andrew Buist, chairman of the British Medical Association’s Scottish GP committee, said, “Patient demand is outstripping GP capacity across the whole service, including out-of-hours. We simply do not have enough GPs in Scotland. Those who are working in out-of-hours may be doing more hours now than they perhaps did in 2019 which comes as no surprise if there are fewer GPs to go around but it is unsustainable and puts those working in the service at risk of exhaustion and burnout.” Read full story (paywalled) Source: The Times, 15 February 2023
  10. News Article
    Mental health sick days cost the NHS almost half a million pounds as staff anxiety and stress levels haved skyrocketed. Costs have almost doubled compared to before the pandemic from £279 million to £468 million. The sickness data shared with The Independent by GoodShape, an employee well-being and performance analysis company, shows the number of staff sick days increased in 2022 to 12 million from 7.21 million in 2019. That is despite the overall number of people working in the NHS increasing from 1.2 to 1.3 million. The overall cost to the NHS of absences for the five most common reasons – which includes mental health – increased to a “staggering” £1.85 billion from £1.01 billion between 2019 to 2022, according to figures from GoodShape. Covid was still the most common reason for staff sickness last year, according to the analysis, accounting for 4.4 million lost days, while mental health was a close second driving 3 million days off due to illness. Pat Cullen, chief executive and general secretary for the Royal College of Nursing said in response: “These figures are shocking but not surprising. With 47,000 vacant nurse posts in England alone, the pressures on staff are unrelenting. Read full story Source: The Independent, 8 February 2023
  11. News Article
    “Frustration with the system was why I went off in the end,” said Conor Calby, 26, a paramedic and Unison rep in southwest England, who was recently off work for a month with burnout. “I felt like I couldn’t do my job and was letting patients down. After a difficult few years it was challenging.” While he usually manages to keep a distinct divide between work and home life, burnout eroded that line. He also lost his sleep pattern and appetite. The final straw came when what should have been a 15-minute call resulted in three hours on the phone trying to persuade the services that were supposed to help a suicidal patient to come out. “I was on a knife edge. That was due to the system being broken. That’s the trigger.” Doctors and nurses are struggling under the strain too. After her third time with burnout - the last resulting in her taking six months off work – Amy Attwater, an A&E doctor, considered leaving the profession altogether. Attwater, 36, said in the Covid crisis, during which a colleague killed himself, she started having suicidal thoughts and doubting her own abilities. She twice reported that she was being bullied but said no action was taken. “The only thing I was left with was to take time off work. I ended up having therapy, seeing a psychiatrist and being on two antidepressants,” said Attwater, the Midlands-based committee member for Doctors’ Association UK. Read full story Source: The Guardian, 5 February 2023
  12. News Article
    A mental health trust has received a warning from the Care Quality Commission over staff sleeping on duty and other serious concerns. Essex Partnership University Foundation Trust was sent a “letter of intent”, which warns the CQC is considering taking urgent enforcement action, following an unannounced visit in November, according to a board report last week. The trust is already subject to a high-profile inquiry into hundreds of patient deaths. Natalie Hammond, executive nurse, said this would be “a fine tuning of our health roster which will be an early warning system that will determine and flag all staff members that may be at risk of working too much or their hours of working might perform a pattern that means they are at risk more of falling asleep on duty.” She added: “We’ve done learning lessons and videos that link the importance of being fit and alert for work and how when you’re not, what mitigation and what steps you should undertake and what risk there is to patient safety.” Read full story (paywalled) Source: HSJ, 1 February 2023
  13. News Article
    Over a third of doctors say they feel sleep deprived on at least a weekly basis and over a quarter have been in a position where tiredness has impacted their ability to treat patients, a new survey by the Medical Defence Union (MDU) has found. The UK's leading medical defence organisation carried out the survey among its doctor members. Of 532 respondents one in four doctors (26%) said tiredness had affected their ability to safely care for patients, including almost 40 near misses and seven cases in which a patient actually sustained harm. In addition, six in ten respondents said their sleep patterns had worsened slightly or significantly during the pandemic. Dr Matthew Lee, MDU chief executive, said: "Doctors and their healthcare colleagues are running on empty. Our members have come through a period of immense pressure caused by the pandemic and it is affecting all aspects of their life, including sleep patterns. Previous studies have shown that fatigue can increase the risk of medical error and affect doctors' health and wellbeing. In our survey, side effects doctors reported due to sleep deprivation included poor concentration (64%), decision making difficulties (40%), mood swings, (37%) and mental health problems (30%). "Taking regular breaks is vital in the interests of doctors and their patients yet in our survey, three in ten doctors got no breaks at all during the working day despite many working long shifts. In addition, 21% didn't have anywhere to go such as a staff room, or quiet area, to take a break. "Pressures on frontline healthcare workers are likely to get worse for doctors in the coming weeks. At a time of considerable staff absence in the NHS it is more important than ever that those staff who are fit to work are properly supported so they can care for patients safely." Read full story Source: MDU, 17 January 2022
  14. News Article
    TV presenter Dr Hilary Jones has blasted the Prime Minister over his handling of the NHS, warning it is at risk of collapse. Speaking on ITV’s Good Morning Britain, the GP shared the experiences of “heartbroken” frontline doctors and said if the situation “doesn’t change very quickly, the NHS is finished”. Dr Jones referred to a group chat between 13,000 doctors who work on the front line and in primary care, where members are sharing stories that show patients experiencing very long delays in receiving treatment. He described how staff are in tears at the end of their shift “and when they return to the next shift, the same patient is still waiting to be seen after 24 hours”. He added: “For Rishi Sunak and the Government to pretend that this is not a crisis when more than a dozen trusts have announced critical incidents is not only delusional, as the BMA say, I would say at the very best it’s ill-informed misjudgment, at the very worst it’s total irresponsibility and incompetence. I have never known anything like this.” Read full story Source: Independent, 5 January 2023
  15. News Article
    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
  16. News Article
    ICBs should ensure there are ‘formal escalation routes’ in place for GPs after 25 daily clinical contacts, the BMA has said in new guidance. From next week (15 May), GP practices are contractually required to offer an ‘appropriate response’ to patients the first time they get in contact, by offering them an appointment or redirection, rather than asking them to call back at a different time. While GP leaders warned this would lead to increased pressure on NHS 111 and A&E, NHS England attempted to clarify in this week’s recovery plan that GPs should only redirect patients in ‘exceptional circumstances’. It also said practices should inform their ICB on each such occasion. However, conflicting BMA guidance has now been published, warning that practices attempting to adhere to the new requirement ‘may do so at the expense of clinician wellbeing and patient safety’. It reiterates the GP Committee for England’s safe working guidance recommending that clinicians have no more than 25 clinical contacts per day because anything beyond this "can lead to decision fatigue, clinical errors and patient harm, and clinician burn out". Read full story Source: Pulse, 11 May 2023
  17. News Article
    GPs in the UK have some of the highest stress levels and lowest job satisfaction among family doctors, a 10-country survey has found. British GPs suffer from high levels of burnout, have a worse work/life balance and spend less time with patients during appointments than their peers in many other places. Heavy workloads, seemingly endless paperwork and feelings of emotional distress are prompting many GPs to stop seeing patients regularly or even retire altogether, the research found. Seven in 10 (71%) NHS family doctors find their job “extremely” or “very stressful”, the joint-highest number alongside GPs in Germany among the countries analysed. The Health Foundation, which undertook the survey, said its “grim” findings showed that the “unsustainable” pressures on GPs and number of them quitting pose a threat to the NHS’s future.
  18. Content Article
    This study in the British Journal of Nursing aimed to explore whether fatigue, workload, burnout and the work environment can predict the perceptions of patient safety among critical care nurses in Oman. A cross-sectional predictive design was used on a sample of 270 critical care nurses from the two main hospitals in the country's capital, with a response rate of 90%. The authors found a negative correlation between fatigue and patient safety culture (r= -0.240), which indicates that fatigue has a detrimental effect on nurses' perceptions of safety. There was also a significant relationship between work environment, emotional exhaustion, depersonalisation, personal accomplishment and organisational patient safety culture. Regression analysis showed that fatigue, work environment, emotional exhaustion, depersonalisation and personal accomplishment were predictors for overall patient safety among critical care nurses.
  19. Content Article
    This study in The Journal of Nursing Administration aimed to investigate the relationship between sleep deprivation and occupational and patient care errors among staff nurses who work the night shift. A cross-sectional correlational design was used to evaluate relationships between sleep deprivation and occupational and patient care errors in 289 hospital night shift nurses. The study found that more than half (56%) of the sample reported being sleep deprived. Sleep-deprived nurses made more patient care errors. Testing for associations with occupational errors was not feasible because of the low number of occupational errors reported.
  20. Content Article
    At times of crisis, healthcare workers (e.g., nurses, advanced practice nurses, physicians, nursing assistants, etc.) continue to provide care, despite ever challenging work demands, including higher influx of critically ill patients, increased work stress, and a frequent need for overtime. These work demands can compound already challenging work schedules (i.e. 12-hour shifts, night shifts), making it more difficult to obtain regular shift breaks and enough time off between shifts for adequate recovery. All of these work factors (i.e. physical, emotional, and/or mental demands) combined with insufficient sleep, contribute to fatigue. This article from the Centers for Disease Control and Prevention (CDC) gives tips and resources on managing fatigue in times of crisis.
  21. Content Article
    This primer article by the Agency for Healthcare Quality and Research (AHQR) looks at the impact of fatigue and sleep deprivation on patient safety. Fatigue is the feeling of tiredness and decreased energy that results from inadequate sleep time or poor quality of sleep. Fatigue can also result from increased work intensity or long work hours. The article outlines the current context for discussions in the US around mitigating the potential risks of sleep deprivation among healthcare workers, highlighting measures that can be put in place by healthcare organisations including employing optimal practices for scheduling, planned napping and ensuring appropriate spaces are available for rest breaks.
  22. Content Article
    This chapter in Patient Safety and Quality: An Evidence-Based Handbook for Nurses outlines how fatigue and sleepiness impact on the performance of nurses and consequently on patient safety. It highlights safety practices that can be implemented to counter the effects of fatigue, including restrictions on working hours, napping, use of bright lights and exercise.
  23. Content Article
    Sleep deprivation due to extended work hours and circadian disruption has long been a concern in medicine. The levels of continuous duty and work hours for health care personnel are much greater than those allowed in the transportation and nuclear-power industries. The problem is most severe for residents in training but extends to experienced physicians and nurses. Clinicians who have been deprived of sleep are part of a health care system in trouble. A report from the Institute of Medicine concluded that the system fails to ensure that patients are safe or that the quality of care they receive is high. In this article, David Gaba and Steven Howard discuss current and proposed policies concerning clinicians' work hours and fatigue.  
  24. Content Article
    Fatigue and sleep deprivation may affect healthcare professionals' skills and communication style and also may affect clinical outcomes. However, there are no current guidelines limiting the volume of deliveries and procedures performed by a single individual, or on the length of time that they can be on call. This Committee Opinion from the American College of Obstetricians and Gynecologists (ACOG) analyses research relating to fatigue and performance in healthcare professionals in order to make recommendations to doctors and managers to improve staff and patient safety.
  25. Content Article
    The Psychologically informed policy and practice development (PIPP) project investigated current workplace concerns, barriers to change and opportunities for development and growth, and was a collaborative project run by the Royal College of Emergency Medicine, UK Research and Innovation and the University of Bath. This document details specific evidence-based recommendations relating to four key areas identified as prioritised targets in emergency care workforce development: An environment to thrive in Cultivating a better culture A tailored pathway of care Enhanced leadership The recommendations are detailed, supported by evidence, existing guidelines and new empirical data, and are specific to the needs of the emergency care specialty.
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