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News Article
Trust top team was ‘least cohesive I’ve ever joined’, says new CEO
Patient Safety Learning posted a news article in News
A review into how a reporting error came about has uncovered tension among an ambulance trust’s previous senior leaders, including that its new CEO felt it was ‘the least cohesive team I have ever joined’. Management consultancy Verita was commissioned by London Ambulance Service Trust to carry out a review of how it came to be misreporting category 1 (the most serious) response times. The report, published in board papers on Thursday, said it was caused by a contractor’s programming error going unnoticed and concluded it was “impossible to typify the events of August 2020 as other than an avoidable failure of governance and process”. Daniel Elkeles, who joined the trust as CEO in August 2021, told the review that when he joined the senior team it was “the least cohesive team I have ever joined” and said the organisation was not “psychologically safe” for those who wanted to speak up. Read full story (paywalled) Source: HSJ, 26 May 2023- Posted
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News ArticleThe health secretary is set to signal a major delay to one of the headline promises in the last Conservative manifesto by suggesting the delivery of 40 new hospitals in England is likely to be pushed back until after 2030. In a move that will spark anger among MPs who wanted “spades in the ground” before the next election, government sources said Steve Barclay would make the announcement today. The pledge to build and fund “40 new hospitals over the next 10 years” was one of the major headlines of Boris Johnson’s pitch to the electorate in 2019. Sources indicated the government had been ready to make the announcement about the probable delay for some time, but it was repeatedly pushed back because of fears about a backlash from Tory MPs. Rundown NHS hospitals have become a danger to patients, warn health chiefs Read full story Source: The Guardian, 25 May 2023
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World must prepare for disease more deadlier than Covid, WHO chief warns
Patient Safety Learning posted a news article in News
The head of the World Health Organisation warned on Tuesday that governments need to prepare for a disease even deadlier than Covid-19. Dr Tedros Adhanom Ghebreyesus, director general of WHO, told its annual health assembly in Geneva that it was time to advance negotiations on preventing the next pandemic. He warned that nation states cannot “kick this can down the road” and that the next global disease was bound to “come knocking”. Dr Tedros said: “If we do not make the changes that must be made, then who will? And if we do not make them now, then when?” He added: “The threat of another variant emerging that causes new surges of disease and death remains. And the threat of another pathogen emerging with even deadlier potential remains.” Read full story Source: The Independent, 24 May 2023 -
News Article
Trust execs accused of creating a ‘cult of the individual’
Patient Safety Learning posted a news article in News
Regulators are probing a series of whistleblowing claims about the leadership culture of a trust which is rated ‘outstanding’ for its management, HSJ has learned. It is understood multiple current and former staff members at Bolton Foundation Trust, including people in senior positions, have been in contact with NHS England and the Care Quality Commission in recent months. The claims include a dramatic worsening in leadership culture at the trust, particularly around the FTSU process and people who speak up being bullied, side-lined and silenced. And investigations and meetings are stage-managed and tightly controlled by executives, with constant “sugar-coating” and positive spin on board reports, and intolerance of people who disagree. Read full story (paywalled) Source: HSJ, 22 May 2023- Posted
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Labour vows to reverse rise in suicides in England and Wales within five years
Patient Safety Learning posted a news article in News
A Labour government would reverse the rise in the number of deaths from suicide as part of a health plan to replace pain and anxiety with a “hope of a renewed NHS”, Keir Starmer will pledge. In a speech today, the Labour leader will say his plan for reforming the NHS will focus on the biggest causes of death in the UK including suicide. He will point to coroners’ statistics showing that deaths from suicides have been rising since 2008, and reached a record high last year in England and Wales. If the party takes power Labour will reverse this rise within five years, Starmer will say. A segment of his speech previewed by the party says: “Suicide is the biggest killer of young lives in this country. The biggest killer. That statistic should haunt us. And the rate is going up. Our mission must be and will be to get it down.” Labour has not provided details on how it proposes to meet this pledge other than an aspiration to shift from “sickness to prevention”. Starmer will also propose introducing new NHS targets on cutting deaths in England from heart disease and strokes by a quarter over 10 years. Read full story Source: The Guardian, 21 May 2023- Posted
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‘Pathetic and dishonest’: trust’s deputy CEO blasts NHSE approach to cancer
Patient Safety Learning posted a news article in News
NHS England’s approach to recovering cancer services has been described as ‘pathetic and dishonest’ by the deputy chief executive of a major trust. Andy Welch, deputy chief executive and medical director of Newcastle Hospitals Foundation Trust, has publicly criticised comments made in November by NHSE’s national cancer director Dame Cally Palmer, who said “we have our foot on the gas” towards reaching cancer waiting time targets. Mr Welch is an outspoken figure who has also slammed NHSE for “destroying” the morale of midwives through its “failed ‘continuity of care’ concept”, and described the potential “toppling” of the government as “brilliant” within the last three weeks alone. The Newcastle medic is the chair of the Northern Cancer Alliance. His criticism of Dame Cally comes as performance against the flagship cancer target remains largely unchanged since last year. Read full story (paywalled) Source: HSJ, 18 May 2023- Posted
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Intervention at major trust as junior doctors flag patient safety risks
Patient Safety Learning posted a news article in News
Trainee medics in a troubled maternity department have flagged concerns with national regulators over the safety of patients, it has emerged. Last year the General Medical Council said it had concerns about the treatment of obstetric and gynaecology trainees at University Hospitals Birmingham and placed medics at Good Hope Hospital and Heartlands Hospital under intensive support known as “enhanced monitoring”. The GMC’s review flagged serious concerns about emergency gynaecology cover arrangements and said there was a real risk trainees would become hesitant and reluctant to call on consultant support. In September it placed additional restrictions on training, due to “ongoing significant concerns about the learning environment and patient safety”. Now it has emerged in board papers for Birmingham and Solihull integrated care board that Health Education England, now part of NHS England, and the GMC carried out a follow-up visit to UHB in late March to review progress. Board documents state that “several patient safety concerns [were] reported by postgraduate doctors in training to the visiting team”, with a subsequent feedback letter from HEE urging immediate changes to dedicated consultant time and job plans. Read full story (paywalled) Source: HSJ, 17 May 2023- Posted
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Trust’s A&E ‘effectively running primary care service’, says chair
Patient Safety Learning posted a news article in News
An acute trust chair has said its emergency department is effectively operating as a primary care service. Hattie Llewelyn-Davies, who has chaired The Princess Alexandra Hospital Trust since late 2021, told HSJ: “We’ve done an awful lot of changes in the way we run out A&E and same day emergency care service to try and get the flow through working better… “We have particular problems with the Princess Alexandra because we are right in the middle of Harlow. And we have a GP service and primary care service which is under massive pressure. We have very high levels of deprivation in Harlow. “When somebody is sick in Harlow and can’t get a doctor’s appointment on the spot, they walk into us. We have a very high level of people coming in, so a very high level of footfall but a very low level of admissions. “We are therefore running effectively a primary care service through our A&E.” Read full story (paywalled) Source: HSJ, 15 May 2023- Posted
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News ArticleAn ‘outstanding’ trust’s Care Quality Commission rating has been dropped to ‘requires improvement’, after inspectors found potential safety risks and a disconnect between board and ward. A highly critical report on University Hospitals Sussex Foundation Trust also downgraded its well-led rating to “inadequate” and recommended the trust be placed in segment four – the bottom tier – of NHS England’s system oversight framework. Its main tertiary centre – the Royal Sussex County Hospital – was also rated “inadequate”, including for safety. Deanna Westwood, Care Quality Commission’s director of operations in the South, said “staff and patients were being let down by senior leaders, especially the board, who often appeared out of touch with what was happening on the wards and clinical areas and it was affecting people’s care and treatment”. Read full story (paywalled) Source: HSJ,12 May 2023
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News Article
World-renowned NHS centre downgraded by watchdog
Patient Safety Learning posted a news article in News
A world-renowned cancer centre hit by whistleblowing concerns over alleged bullying has been downgraded by the health watchdog. The Care Quality Commission (CQC) told The Christie NHS Foundation Trust in Manchester it "requires improvement" in safety and leadership. A former trust nurse told the BBC leaders had intimidated staff to stop them voicing concerns to inspectors. Rebecca Wight worked at The Christie - Europe's largest cancer centre - from 2014 but quit her role as an advanced nurse practitioner in December, claiming her whistleblowing attempts had been ignored. She told BBC Newsnight the trust had attempted to manipulate the inspection by intimidating those who wished to paint an honest picture. Roger Kline, an NHS workforce and culture expert from Middlesex University Business School, told BBC Newsnight there was a culture at The Christie which was "unwelcoming of people raising concerns". He said: "The trust response is more likely... to see the person raising the concerns as the problem rather than the issues they have raised," adding this was "not good for patient care". Read full story Source: BBC News, 12 May 2023- Posted
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News Article
Hospital boss claims unfair dismissal after chairman 'bullied' her
Patient Safety Learning posted a news article in News
A former NHS chief executive is suing her employer, saying she was "bullied, harassed, intimidated and undermined" by the hospital trust's chairman. In legal papers, seen by BBC News, Dr Susan Gilby alleges she was effectively unfairly dismissed by the Countess of Chester NHS Foundation Trust, after she made a formal complaint. Dr Gilby claims the chairman was "highly aggressive and intimidatory" in meetings, that he banged his hand on a desk to emphasise his point, and oversaw a climate where "offensively sexist comments and ferocious and repetitive criticisms" were made by either him or his associates. Dr Gilby's complaint accuses the chairman of putting finance above patient safety at the hospital trust She made a formal whistle-blowing complaint against the chairman in July 2022, raising her concerns about his behaviour to both the trust and NHS England. The trust responded to her concerns, Dr Gilby claims, by proposing that she be seconded to a senior advisory role within NHS England on the condition she withdrew her allegations. Read full story Source: BBC News, 12 May 2023- Posted
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News ArticleA key government pledge to reduce the size of the NHS’s record-breaking care backlog has been broken, the health secretary has admitted. Steve Barclay slipped out the news in a Commons statement on Tuesday about a totally unrelated area of NHS policy – his new plan to improve access to GP care. He disclosed to MPs that the NHS in England had missed its target to ensure that all patients who had been waiting 18 months for an operation in hospital would be treated by April. It is thought that about 10,000 people who had been waiting for at least 78 weeks were still languishing on the 7.2 million-strong waiting list at the end of April. The failure to eradicate 18-month waits for care is embarrassing for Rishi Sunak, who made “cut waiting lists” one of his five key pledges and insisted as recently as January that the promise, which NHS England and the then health secretary Sajid Javid first made in the elective surgery recovery plan last year, would be honoured. Read full story Source: The Guardian, 9 May 2023
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News Article
Regulator clears trust to bring back junior doctors
Patient Safety Learning posted a news article in News
Up to 10 junior doctor posts will be reinstated at a small district general hospital after regulators agreed it had improved its learning environment. In 2021, Health Education England removed 10 doctors from Weston Hospital over concerns they were being left without adequate supervision on understaffed wards. The unusual move prompted University Hospitals Bristol and Weston Foundation Trust to launch a “quality improvement approach” to improve its learner and clinical supervision environment. The regulator said the trust had made significant improvements that included: Better staff engagement with the trust leadership at all levels. Better clinical supervision, particularly around shift handovers and senior oversight of clinical decisions. Better learner experience in new training settings in rheumatology and intensive care medicine. Read full story (paywalled) Source: HSJ, 10 May 2023- Posted
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News Article
Barclay refusing to approve diagnostic centres that cannot be opened this year
Patient Safety Learning posted a news article in News
Steve Barclay has refused to approve about 30 proposed community diagnostic centres (CDCs) – designed to speed up cancer treatment – unless they can be delivered in 2023, HSJ has learned. Mr Barclay’s stance means the CDCs which were due to open in 2024, and which officials say cannot be brought forward, have been left in limbo. NHS England and local systems are now exploring workarounds, such as temporarily using mobile imaging units while the CDCs are established in attempt to win Mr Barclay’s backing. Cancer Research UK director of evidence and implementation Naser Turabi said: “Community diagnostic centres can help the NHS diagnose cancers more quickly, but they require capital investment and funding for staff if they are to meet rising demand. “Restricting the promised expansion of these centres will only lead to longer waits and worse outcomes for cancer patients in England.” Read full story (paywalled) Source: HSJ, 9 May 2023- Posted
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News Article
NHS managers covering up issues - whistleblower
Patient Safety Learning posted a news article in News
Managers at a medical rehabilitation unit are "covering it up" when issues are raised, a whistleblower has said. The whistleblower claimed Cambridge Rehabilitation Unit (CRU) management bullied staff who flagged concerns over shortages and unsafe practice. Documents detail claims of "dangerous" staffing levels, patients left in bed all day without therapy and a one-star food hygiene rating. Through the Freedom of Information Act, the BBC discovered three whistleblowing complaints were made to the Care Quality Commission (CQC) between May and August last year. The first said wards "run on dangerous levels of staff" and no action was taken when staff flagged concerns. The second stated there was "bullying occurring from management when staff raise concerns regarding short staffing and unsafe practice". They said: "When issues relating to patient safety are raised... management are 'covering it up'." Read full story Source: BBC News, 9 May 2023- Posted
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Watchdog hits out at DHSC ‘ambiguity and delay’
Patient Safety Learning posted a news article in News
The national patient safety commissioner has hit out at government for failing to confirm her budget a month into the financial year, warning that she is ‘incredibly limited’ in what she can achieve. In an strongly worded letter released today, Henrietta Hughes states: “Despite it now being the end of April the Department has still not provided me with a budget for this financial year.” She added: “This ambiguity and delay is impacting on my ability to arrange patient engagement events as these require a budget”. It appears to be an almost unprecedented public intervention from an official who is appointed and hosted by the DHSC. In the letter to Commons Health and Social Care Committee chair Steve Brine, she also says she does not have enough resources to fulfil the role, and is only able to employ four members of staff. Read full story (paywalled) Source: HSJ, 3 May 2023- Posted
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News Article
Six systems pulled up by NHSE over poor cancer diagnosis performance
Patient Safety Learning posted a news article in News
NHS England has demanded recovery plans from six systems with a poor record on delivering urgent cancer checks. NHS England has told the chief executives of the six integrated care boards they must “present and deliver a plan” to make more use of their diagnostic facilities for patients who need urgent cancer checks. The “facilities” referred to are all community diagnostic centres. The six were selected because they diagnosed or ruled out fewer than 70% of urgent cancer referrals within 28 days during February. This benchmark is known as the “faster diagnostic standard”. A letter to the chief executives said: “improving waiting times for patients referred for urgent suspected cancer will be a critical priority for the NHS over the coming year”. It adds: “it is essential… our national investments in diagnostic capacity are more clearly prioritised for patients being investigated for urgent suspected cancer”. Read full story (paywalled) Source: HSJ, 28 April 2023- Posted
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Nurses' strike in England to be cut short after court ruling
Patient Safety Learning posted a news article in News
A 48-hour strike by nurses in England over the Bank Holiday weekend will be cut short by a day after a High Court judge ruled it was partly unlawful. The walkout in a row over pay by the Royal College of Nursing, due to start on Sunday, will now end on Monday. RCN chief Pat Cullen said this was "the darkest day" of the dispute so far and the government needed to negotiate. Downing Street said it was "regrettable" the government had to go to court and it had tried to avoid it. Health Secretary Steve Barclay took legal action after NHS Employers said the last day of the planned strike was not covered by the mandate as the ballots closed on 2 November at midday. The judge Mr Justice Linden ordered the RCN to pay the costs of the hearing, saying the union had showed "a high degree of unreasonableness", the outcome was "inevitable" and "instead of grasping the nettle and conceding" it had forced the case to court. Read full story Source: BBC News, 27 April 2023- Posted
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Deficit trusts face ‘intimidating conversations’ and orders to hold down staffing
Patient Safety Learning posted a news article in News
NHS England has told many trusts and systems they are not allowed to increase their staffing establishment in the next 12 months, HSJ has learned. Trust leaders said NHS England and the government were treating money as the “first priority” and one director, speaking anonymously, said: “The tone of the conversation [with NHSE about finance] has become intimidating and I worry that this will lead boards to take unsafe risks, and head into Mid Staffs territory.” Board papers seen by HSJ, and several senior sources, confirmed many trusts had been told by NHS England during the planning process that they were not permitted to increased their total number of planned posts, known as staffing “establishment”, for 2023-24. A chief nurse at one large acute provider said the pressure on staff numbers “doesn’t triangulate” with messages on safer staffing from regulators, including NHSE, such as the drive to increase midwife numbers over maternity safety concerns. It also contrasts with plans to expand clinical staff numbers in the promised national long-term workforce plan, the chief nurse said. Read full story (paywalled) Source: HSJ, 25 April 2023- Posted
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News Article
Ministers in legal move to cut nurse strike short
Patient Safety Learning posted a news article in News
Health Secretary Steve Barclay is to ask judges to rule whether part of the next nurse strike is unlawful. The government wants the High Court to assess whether Tuesday - the last day of the walkout in England - falls outside the Royal College of Nursing's six-month mandate for action. It believes the mandate will have lapsed by Tuesday - the 48-hour strike is due to start at 20:00 BST on Sunday. The RCN accused ministers of using "draconian anti-union legislation". Mr Barclay's decision to take legal action follows a request from hospital bosses. The RCN argues the strike falls within the required six-month period from when votes were cast in its ballot for industrial action. But NHS Employers said it had legal advice that the action would be unlawful. Read full story Source: BBC News, 24 April 2023- Posted
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News ArticleUnannounced and out-of-hours spot-checks on mental health services are set to ramp up following a string of abuse scandals, The Independent can reveal. The Care Quality Commission’s new mental health chief Chris Dzikiti said he was “saddened” by “unacceptable” scandals in the last six months, warning the regulator “will use the powers [it has] to hold people to account.” He said the organisation will be carrying out more unannounced inspections of providers, including inspections launched out of normal hours, with the aim to have the “majority” of spot-checks carried out this way. In his first interview since joining the regulator in November Mr Dzikiti, who is mental health nurse by background, said: “I talk to chief execs of mental health services, I talk about [how] as a regulator, we will use the power we have, when [we] see poor practice, we will definitely hold people to account. “In our inspection programmes, we are also increasing the unannounced inspections out of hours inspections, because we need to try and get really deep into the culture of mental health services, especially those areas where we think there’s a higher risk of poor practice. “I will not rest until we get people safe.” Read full story Source: The Independent, 24 April 2023
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‘National improvement board’ to be set up by NHS England
Patient Safety Learning posted a news article in News
NHS England has launched a new framework for quality improvement and delivery, including a national board that will pick a “small number of shared national priorities”. The new document says NHSE will “establish a national improvement board, to agree the small number of shared national priorities on which NHS England, with providers and systems, will focus our improvement-led delivery work”. The review says NHSE will, among other actions: Create a “national improvement board” to “agree a small number of shared national priorities and oversee the development and quality assure the impact of the NHS improvement approach”. Set an expectation that all NHS providers, working in partnership with integrated care boards, will embed a quality improvement method aligned with the NHS improvement approach”. Incentivise a universal focus on embedding and sustaining improvement practice”, including with “regulatory incentives alongside clearer and more timely offers of support. Work with the [Care Quality Commission] to align the revised CQC well-led [inspection method] with the improvement approach. Read full story (paywalled) Source: HSJ, 21 April 2023- Posted
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NHS threatens legal action to block second day of nurses’ strike
Patient Safety Learning posted a news article in News
The NHS has launched a legal challenge that could end in the high court to block the second day of an upcoming strike by tens of thousands of nurses. Officials at NHS Employers wrote to the Royal College of Nursing (RCN) on Wednesday saying the union’s plans for a two-day strike were unlawful. In response, it is understood the RCN has said it will “forcibly resist” employers’ attempts to seek a high court injunction designed to block the strike, which they insist is lawful. The threat raises the possibility of a high court clash between NHS lawyers backed by the government and those of the nursing union. It also highlights the increasingly bitter relationship between the government and those representing workers on the frontline of the health service. Read full story Source: The Guardian, 20 April 2023- Posted
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Top scientists warn ‘the next pandemic is coming and we’re not ready’
Patient Safety Learning posted a news article in News
The UK is not ready for the next global pandemic because public services are being dismantled and key research is being defunded, experts have claimed. More than three years after the global outbreak of coronavirus, top scientists have warned that the UK is no better prepared for a pandemic than it was in 2020. They say another epidemic on the scale of Covid-19 is inevitable, but that disinvestment in infection-monitoring services, dismantling of key infrastructure, and the state of the NHS mean the country is “losing ground”. Sir John Bell, a leading immunologist and a member of the UK’s Covid vaccine taskforce during the pandemic, said it was too easy to dismiss Covid-19 as a “once in a generation crisis”. Writing in The Independent, he warned that it is “a question of when, not if, another pandemic strikes”, adding that the nation needs to adopt an “always on” approach that includes building a more resilient healthcare system, carrying out better surveillance, and identifying future threats. Read full story Source: The Independent, 18 April 2023- Posted
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Medical leaders call for arbitration to resolve junior doctors’ dispute
Patient Safety Learning posted a news article in News
Medical leaders have called for third-party arbitration to break the impasse on a pay dispute between junior doctors and the government after hundreds of thousands of procedures and appointments were cancelled as a result of last week’s strike in England. The “colossal impact” of the four-day stoppage compounded by a health service already stretched by the coronavirus pandemic and facing workplace shortages has led the Academy of Medical Royal Colleges (AoMRC) to intervene and urge both parties to engage with an independent organisation. The AoMRC, the membership body for the UK and Ireland’s 24 medical royal colleges and faculties, said in a statement it was “concerned that a solution has not yet been reached and about the anticipated impact on NHS services and patients that will potentially follow any future action”. It added: “Both parties need to rapidly engage with an independent organisation to work out how the deadlock can be broken for the sake of patients and the wider NHS.” Read full story Source: The Guardian, 20 April 2023- Posted
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