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Content ArticleThe climate and ecological crises are both driven by human activities. They each have catastrophic implications for human health and their strong interconnection creates a vicious circle where each is reinforced by the other. A stable natural environment is critical for limiting global warming and achieving the UN’s Sustainable Development Goals (SDGs). Conversely, the loss of biodiversity is a major threat to human, animal, and environmental health. In order to mitigate harm and maximise the co-benefits of action, it is important that policies tackle both climate change and biodiversity loss together. This policy report by the UK Health Alliance on Climate Change, describes the impacts of biodiversity loss on land and oceans for human health and puts forward recommendations to reduce biodiversity loss, restore nature, and achieve climate goals for the benefit of health.
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Content ArticleIt is important that people who work in health and care are trained, skilled and treat patients and service users well. Regulators and accredited registers help to keep you safe by ‘registering’ health and care practitioners - you should check a practitioner’s registration when you: Pay for private services from a health or care practitioner. Employ a health or care practitioner. Commission services from a health or care practitioner. Have concerns about a practitioner. The link below allows you to search for a practitioner.
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Content ArticlePhysician associates (PAs) are healthcare professionals who work as part of a multidisciplinary team under the supervision of a named senior doctor (a General Medical Council (GMC)-registered consultant or GP). While they are not medical doctors, PAs can assess, diagnose and treat patients in primary, secondary and community care environments within their scope of practice. PAs are part of NHS England’s medical associate professions (MAPs) workforce grouping. MAPs add to the breadth of skills within multidisciplinary teams, to help meet the needs of patients and enable more care to be delivered in clinical settings. PAs do not fall under the allied health professions (AHPs) or advanced practice groups. The Faculty of Physician Associates has created this guidance to provide clarity around the role of PAs. It provides practical examples of how physician associates should describe their role and is aimed at increasing understanding for patients, employers, other healthcare professionals and the public. It is important that PAs take all reasonable steps to inform patients and staff of their role and to avoid confusion of roles. This includes considering the potential for verbal and written role titles to be misunderstood and taking the time to explain their role in any clinical interaction.
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Content ArticleThis report presents findings from a rapid evidence review into improvement cultures in health and adult social care settings. The review aims to inform CQC’s approach to assessing and encouraging improvement, improvement cultures and improvement capabilities of services, while maintaining and strengthening CQC’s regulatory role. It also identifies gaps in the current evidence base.
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Content ArticleThe Safety Case is a regulatory technique that requires organisations to demonstrate to regulators that they have systematically identified hazards in their systems and reduced risks to being as low as reasonably practicable. It is used in several high-risk sectors, but only in a very limited way in healthcare. This multisite case study in BMJ Quality and Safety examined the first documented attempt to apply the Safety Case methodology to clinical pathways. The study found that the Safety Case approach was recognised by those involved in the Safer Clinical Systems programme as having potential value. However, it is also fraught with challenge, highlighting the limitations of efforts to transfer safety management practices to healthcare from other sectors.
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Content ArticleThe report from the International Labour Organization describes the results of a special analysis of data from the Labour Force Surveys (LFS) of 56 countries which provided data about health and social care workers in sufficient detail to distinguish between different occupational groups within the workforce. The report covers analyses for 29 countries in Europe and 27 from other regions of the world. This analysis can help to highlight specific occupation groups and countries which are at heightened risk of decent work deficits and demographic imbalances.
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Content Article
Patient-led assessments of the care environment (PLACE)
Patient Safety Learning posted an article in Environmental
PLACE assessments will provide motivation for improvement by providing a clear message, directly from patients, about how the environment or services might be enhanced. The 2023 programme is planned for launch in early September 2023. -
Content ArticleIn this article in the Irish Times, Niall discusses his book, Oops! Why Things Go Wrong, and explores why error is inevitable, how it affects many different industries and areas of society, sometimes catastrophically, and most importantly, what we can do about it. You can also listen to an interview with Niall on BBC Radio Ulster’s Talkback (Listen from 38 mins to 57 mins). Related reading on the hub: Oops! Why things go wrong – a blog by Niall Downey
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News Article
USA: Why are so many kids losing Medicaid coverage?
Patient Safety Learning posted a news article in News
At the end of the COVID pandemic, more than half (54%) of US children were covered by Medicaid or CHIP; the vast majority by Medicaid. So, the lifting of the pandemic-related Medicaid continuous enrolment protection this spring is a really big deal, putting low-income children at risk of losing access to health care and/or exposing their families to medical debt. In fact, researchers at federal Office of the Assistant Secretary for Planning and Evaluation (ASPE) projected that just shy of three-quarters of children losing Medicaid would be disenrolled despite remaining eligible. Children are most at risk of losing coverage during the unwinding despite being eligible and the likelihood that the child uninsured rate will go up if states do not take care in the process. Over half a million children have lost Medicaid already in 21 states where there is data. And that large number doesn’t include Texas, a state that disenrolled more than 500,000 people on June 1st, and where state agency employees recently blew the whistle on systems errors that caused inappropriate terminations. The Biden Administration must take swift and definitive action to pause all terminations in states with systemic problems. Governors who see large numbers of children losing coverage must pause the process. Coverage must be reinstated for those who lose coverage inappropriately. The time for action to protect children is now. Read full story Source: McCourt School of Public Policy at Georgetown University, 23 August 2023 -
EventuntilIn this Patient Partnership Week webinar, the Patients Association will be talking about their work with patients, the Royal College of Physicians and NHS England to explore what the future of outpatient care should look like. The webinar will be chaired by Sarah Tilsed, Head of Patient Partnership. Joining her are: Dr Fiona McKevitt, Clinical Director for Outpatient Recovery and Transformation, NHS England Dr Theresa Barnes, Clinical Lead for Outpatients, Royal College of Physicians Irene Poku, Representative Patient and Public Involvement and Engagement with experience of using outpatient services. Sarah champions the voice of patients in our work and the work of other organisations. As outpatients is such a pivotal part of the NHS and is visited by millions of patients, it really is important that patients feed into the design and delivery of this service, as they know what is and isn’t working for them in terms of their care. The webinar will explore how patients have been involved. Register
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Event
SEIPS masterclass in healthcare
Sam posted an event in Community Calendar
The Patient Safety Incident Response Framework (PSIRF) encourages investigations across the NHS to apply SEIPS. This 3 hour masterclass will focus upon using SEIPS in healthcare. The SEIPS trainer Dr Dawn Benson has extensive experience of using and teaching SEIPS, as a Human Factors tool, in health and social care safety investigation. She will be joined in these masterclass sessions by clinical subject experts. Morning session: 9.30-12.30 Afternoon session: 1.30-4.30 Register -
News Article
Healthcare services in Northern Ireland 'on its knees'
Patient Safety Learning posted a news article in News
Waiting times for outpatient appointments, hospital procedures, emergency care, GPs and community health services have all hit record levels in Northern Ireland, with health care staff and patients declaring it the "worst ever" crisis to hit health services in the region. The impact of the COVID-19 pandemic, ever-growing patient demand, staff shortages, and the failure to put together a new Executive government following the recent Northern Ireland elections are being cited as the key drivers of the crisis, with health care staff now at breaking point. Speaking to Medscape UK, British Medical Association Northern Ireland (BMA NI) council chair Dr Tom Black said the current crisis in Northern Ireland's health services essentially boils down to "workload and workforce" issues. Waiting lists to access hospital appointments in Northern Ireland were already long before COVID-19, but the pandemic has significantly exacerbated the situation, he noted. Northern Ireland has the worst waiting lists in the UK, with more than 350,000 people currently waiting for a consultant-led appointment – more than half of them waiting over a year, with many waiting two, three, and even more years for an appointment. "We're now heading towards nearly 400,000 on hospital waiting lists, which is a huge number when you consider that is one-in-five of the total population," Dr Black commented. This week a judicial review is due to get underway at the High Court in Belfast after two patients initiated a legal case against the health services over excessive waiting times for access to care. One of the women has been waiting over five years to see a neurologist after being referred by her GP for suspected multiple sclerosis. The case is seeking a judicial declaration that the length of the waiting lists are unlawful and breached their human rights. Read full story Source: Medscape UK, 24 May 2022 -
News Article
Government progress against commitments made on workforce to be evaluated
Patient Safety Learning posted a news article in News
The Health and Social Care Committee examines the Government’s progress against its pledges on the health and social care workforce and will be the focus of a new independent evaluation by the Health and Social Care Committee’s Expert Panel. Professor Dame Jane Dacre, Chair of the Expert Panel, said: “We’ll be looking at commitments the Government has made on workforce – the people who deliver the health and social care services we rely on. “We’ve identified a recurrent theme in our evaluations to date – whether in maternity, cancer or mental health services, progress is dependent on having the right number of skilled staff in the right place at the right time. Shortages have a real impact on the delivery of services and undermine achievements. “Our panel of experts will evaluate progress made to meet policy pledges in this crucial area - whether it’s about getting workforce planning right, training, or ensuring staff well-being.” The Expert Panel will focus on three areas: Planning for the workforce – including how targets are set, recruitment, and retention. Building a skilled workforce – including incorporating technology and professional development of staff. Wellbeing at work – including support services for staff, and reducing bullying rates. Four specialists have been appointed for this evaluation, bringing their subject specific expertise and experience. They will work alongside the core members of the Expert Panel in identifying a set of Government commitments on workforce and evaluate progress made against them. The findings will support the work of the Health and Social Care Committee which is carrying out a separate inquiry: Workforce: recruitment, training and retention in health and social care. Read full story Source: UK Parliament, 20 April 2022 -
News Article
Government launches landmark review of health and social care leadership
Patient Safety Learning posted a news article in News
The government has launched a review of leadership in health and social care. The review will be led by former Vice Chief of the Defence Staff General Sir Gordon Messenger, and will report back to Secretary of State for Health and Social Care Sajid Javid, in early 2022. The Health and Social Care Leadership Review will look to improve processes and strengthen the leadership of health and social care in England. Working with the health and care systems, retired General Sir Gordon Messenger will have a team from DHSC and the NHS to support him led by Dame Linda Pollard, chair of Leeds Teaching Hospital. The review comes as the government invests a record £36 billion to put health and social care on a sustainable financial footing and deliver the biggest catch-up programme in NHS history. Any recommendations made as the review progresses will be considered carefully and could be rapidly implemented to make every penny of taxpayer’s money count. Secretary of State for Health and Social Care, Sajid Javid, said: "I am determined to make sure the NHS and social care delivers for the people of this country for years to come and leadership is so important to that mission. We are committed to providing the resources health and social care needs but that must come with change for the better. This review will shine a light on the outstanding leaders in health and social care to drive efficiency and innovation. It will help make sure individuals and families get the care and treatment they need, wherever they are in the country, as we build back better." Read full story Source: Department of Health and Social Care, 2 October 2021 -
News Article
Delayed NHS patients will be able to choose private ops online
Patient Safety Learning posted a news article in News
Patients whose operations have been delayed will be able to shop online for hospitals with the shortest waiting times in the public and private sector, under plans being announced by the health secretary this week reports The Times. Sajid Javid will unveil a three-point plan to transform the NHS as part of efforts to tackle a record backlog of more than six million people. Under the proposals, patients referred for hospital care will be able to go online to look up the waiting time at their local hospital, and compare it with times at any hospital in the country, including those in the private sector. The website will allow patients to book their treatment at any unit in the country and there are plans to make the service available on the NHS app. The proposals will be set out in a speech on Tuesday. Javid said: “The NHS constitution says already that you as a patient have the right to ask for an alternative provider for your treatment." However, is this just a distraction? writes Roy Lilley in his latest newsletter. Shopping on-line for treatment depends on getting a website organised that can collect real-time data from all Trusts, for every specialty, that can take into account staffing, rota-gaps and clinical priorities. Software might be able to cope but has the potential to throw the NHS into chaos. People arriving from ‘out of area’ will need video-out-patient consultations, some way of doing blood, imaging and other tests. And post-op? The same again for out-patients and physio, OT, aids, adaptations, pharmacy and social care support... ... to say nothing of the stress on patients and their families. None of this is impossible but the NHS is nowhere near geared up for it. Sources: The Times, 6 March 2022 (paywalled) Roy Lilley's newsletter, 7 March 2022 -
News Article
Private healthcare boom adds to fears of two-tier system in UK
Patient Safety Learning posted a news article in News
Growing numbers of Britons are paying for private medical treatment in a shift that could undermine the NHS and create a “two-tier” health system, a report has warned. Declining access to and quality of NHS care, both worsened by the Covid-19 pandemic, have begun to “supercharge” the trend, with one in six people prepared to go private instead of waiting. That is among the findings of a report by the left-leaning IPPR thinktank, which warns that in future getting fast, high-quality care on the NHS could become as difficult as the situation that already exists in regards to state-funded dental treatment, which has become a postcode lottery. “People are not opting out of the NHS because they have stopped believing in it as the best and fairest model of healthcare,” said Chris Thomas, the IPPR’s principal research fellow and co-author of the report. “Rather, those who can afford it are being forced to go private by the consequences of austerity and the pandemic on NHS access and quality, and those without the funds are left to ‘put up or shut up’.” The report says that unless the NHS starts performing better “people who can and are willing to do so will supplement their entitlement to NHS care with private healthcare products”. “With NHS waiting lists now at record levels, it is not surprising that more patients across the country are looking at private healthcare,” said David Hare, chief executive of the Independent Healthcare Providers Network, a trade body that represents about 100 private providers across the UK. Read full story Source: The Guardian, 2 March 2022 -
News Article
NHS not ‘human’ enough to get greater role in social care, says government review
Patient Safety Learning posted a news article in News
The NHS should not be given greater control of social care because it is ‘hierarchical, centralised and not person-centred’, according to a government-commissioned review which is repeatedly scathing about the health service. The review was ordered by then health and social care secretary Matt Hancock in June 2020. Cross-bench peer, writer and former Number 10 adviser Baroness Camilla Cavendish was asked “to make recommendations for social care reform and integration with health in the wake of the Covid-19 pandemic, which could fit alongside the funding reforms planned by the department in the context of the NHS long-term plan.” In her final report, Baroness Cavendish wrote that “one answer” to the problems facing the sector “would be to let the NHS take over social care. On paper, this would join up the care continuum.” However, she rejected the idea because of the NHS’ “hierarchical” and “centralised” nature. Baroness Cavendish also suggested the NHS’ role should be limited because it is “still struggling to join up primary and secondary care”. In contrast to the NHS, she claimed: “Social care is more innovative, more responsive and human.” She added: “The culture of the NHS is still largely one of ‘doing to’ patients, and the NHS has much to learn from social care about how to be responsive and human facing.” Referencing “recent attempts to import the successful [Buurtzorg] model of self-managing teams into the NHS”, the cross-bench peer said these “have foundered, because the NHS culture cannot seem to cope with giving staff the autonomy required”. Read full story (paywalled) Source: HSJ, 23 February 2022 -
News Article
'My child is in pain - but I'm helpless'
Patient Safety Learning posted a news article in News
Thomas Hebbron is one of the forgotten victims of the pandemic. He was diagnosed with leukaemia in February 2019 - a year before Covid hit the UK. The eight-year-old, from Leeds, has been treated with chemotherapy which has continued throughout the pandemic, but his health has suffered in other ways - and his mother believes the unrelenting focus on the virus is to blame. Pre-pandemic he was seen in person by doctors every two weeks. But that changed to monthly video calls, and liver and urinary problems went undetected. His treatment also affected his fine motor skills and has weakened his legs, but he has not seen an occupational therapist since before the pandemic. "I want to take this pain away from him," says his mother, Gemma. "I don't want to sit and watch him in this pain, but I can't do anything. I just feel completely helpless." Thomas's story is not unique. An analysis by the Nuffield Trust and Health Foundation has for the first time laid bare how access to core health services in England has been squeezed, threatening to leave behind a generation of young people. The review has looked at both physical and mental health services and come to the same conclusion - support has been badly disrupted and the plight of children overlooked. The Nuffield Trust and Health Foundation have been joined by the Royal College of Paediatrics and Child Health (RCPCH) in calling for a dedicated plan for children to help them recover from the pandemic. Dr Camilla Kingdon, RCPCH president, said the figures "do not take into account the many other 'hidden' waiting lists of children waiting for community therapies and diagnostic assessments, especially for autism". She added that children are "struggling" and, despite services being stretched, no-one should be deterred from speaking to a health professional. Read full story Source: BBC News, 18 February 2022 -
News Article
Met wins battle with NHS over not attending mental health calls
Patient Safety Learning posted a news article in News
The Metropolitan police has won its battle to stop attending most of the mental health calls it receives after a tense behind-the-scenes row with the health service, the Guardian has learned. From 31 October the Met will start implementing a scheme that aims to stop officers being diverted from crime fighting to do work health staff are better trained for. In May, the Guardian revealed that the Met commissioner, Sir Mark Rowley, had written to health and social care leaders setting a deadline of 31 August – leading to furious reaction from health chiefs who wrote to the commissioner protesting that it would put vulnerable people at risk. The agreement means Rowley will push his deadline for the start of the changes back by two months, before a phased introduction. Health services will not publicly criticise the police decision, and will race to put measures in place to pick up the work. The scheme is called Right Care Right Person (RCRP), and has been agreed nationally by government departments and national police and health bodies. The letter sent on Thursday says: “In practice, this means that police call handlers will receive a new prompt relating to welfare checks or when a patient goes absent from health partner inpatient care. The prompt will ask call handlers to check that a police response is required or whether the person’s needs may be better met by a health or care professional.” Read full story Source: The Guardian, 17 August 2023 -
News Article
‘A future worth fighting for’: five health experts on the state of the NHS at 75
Patient Safety Learning posted a news article in News
As the NHS turns 75, it is under unprecedented pressure: record waiting lists, demand for care and delays in discharging patients who are well enough to go home are putting all parts of the health service under immense strain. Sickness absence is at record levels, while nearly 170,000 NHS workers in England quit their jobs last year. Recent strikes by nurses, ambulance staff and junior doctors, coupled with the historic decision by consultants and radiographers to strike, too, show the depth of anger. Five experts spell out what’s needed to make the health service thrive again. Read full story Source: The Guardian, 3 July 2023 -
News Article
NHS’s mounting failures and political neglect laid bare in sobering report
Patient Safety Learning posted a news article in News
What would the NHS see if it looked in a mirror, asks Siva Anandaciva, author of the King’s Fund’s study comparing the health service with those of 18 other rich countries, in the introduction to his timely and sobering 118-page report. The answer, he says, is “a service that has seen better days”. Britons die sooner from cancer and heart disease than people in many other rich countries, partly because of the NHS’s lack of beds, staff and scanners, a study has found. The UK “underperforms significantly” on tackling its biggest killer diseases, in part because the NHS has been weakened by years of underinvestment, according to the report from the King’s Fund health thinktank. It “performs poorly” as judged by the number of avoidable deaths resulting from disease and injury and also by fatalities that could have been prevented had patients received better or quicker treatment. The comparative study of 19 well-off nations concluded that Britain achieves only “below average” health outcomes because it spends a “below average” amount for every person on healthcare. Read full story Source: The Guardian, 26 June 2023 -
News Article
Health groups call for global fossil fuel non-proliferation treaty
Patient Safety Learning posted a news article in News
The World Health Organization (WHO) and almost 200 other health associations have made an unprecedented call for a global fossil fuel non-proliferation treaty. A call to action published on Wednesday, urges governments to agree a legally binding plan to phase out fossil fuel exploration and production, similar to the framework convention on tobacco, which was negotiated under the WHO’s auspices in 2003. “The modern addiction to fossil fuels is not just an act of environmental vandalism. From the health perspective, it is an act of self-sabotage,” said the WHO president, Dr Tedros Adhanom Ghebreyesus. Diarmid Campbell-Lendrum, the head of the WHO’s climate change department, said the letter was a watershed moment. “This is the first time the health sector has come together to issue such a statement explicitly about fossil fuels,” he told the Guardian. “The current burden of death and disease from air pollution is comparable to that of tobacco use, while the long-term effects of fossil fuels on the Earth’s climate present an existential threat to humanity – as do nuclear weapons.” Read full story Source: The Guardian, 14 September 2022 Further reading Climate change: why it needs to be on every Trust's agenda -
News Article
PM Truss appoints new health secretary
Patient Safety Learning posted a news article in News
Thérèse Coffey has been appointed as the new health and social care secretary. Ms Coffey, previously work and pensions secretary, has been appointed to the role by the new prime minister, Liz Truss. A close ally of Ms Truss, Ms Coffey has also been appointed as her deputy prime minister. The new prime minister, in her first speech in the role, said that putting “our health service on a firm footing” was one of her “three early priorities”. She pledged to improve access and build “hospitals”. Ms Coffey said this evening her priorities were “ABCD”, representing “ambulances, backlogs, care, doctors and dentists”. Read full story (paywalled) Source: HSJ, 6 September 2022 -
News Article
No new London hospitals until at least 2027
Patient-Safety-Learning posted a news article in News
Two new London hospitals will not open until 2027 at the earliest, the BBC has been told. In 2019, the government pledged to build a new hospital in Sutton and another at Whipps Cross in east London. The St Helier complex in Sutton in south London dates back to the 1930s and much of the Epsom site is about 40 years old. But Dr Ruth Charlton, chief medical officer at Epsom and St Helier Hospital, said: "Our working conditions... are not fit for 21st century healthcare. We really feel that our patients and or staff deserve facilities that would allow them to deliver the quality of healthcare that we all wish to receive." A Department of Health and Social Care spokesperson said: "We have committed to deliver 40 new hospitals by 2030, backed by an initial £3.7bn. We are working closely with all the schemes in the programme and providing funding to develop their plans - final funding allocations are only confirmed once business cases have been fully reviewed and agreed. By taking a more centralised approach, we will reduce the overall time taken to build the hospitals and provide better value for money for the taxpayer." Read full story Source: BBC News (25 August 2022) -
News Article
NHS and care homes in England to pause routine Covid testing
Patient-Safety-Learning posted a news article in News
Most hospital patients and care home residents in England will no longer be tested for Covid unless they have symptoms, the government has said. From 31 August, NHS and social care staff will also not be offered lateral flow tests unless they fall sick. Free testing for the general public ended in April in England, but continued in some high-risk settings. Health Secretary Steve Barclay said: "This reflects the fact case rates have fallen and the risk of transmission has reduced, though we will continue to closely monitor the situation and work with sectors to resume testing should it be needed." Read full story Source: BBC News (25 August 2022)
