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Content ArticleWith talk of tax cuts proving popular in the race to become the next Conservative party leader, and pay rise expectations significantly higher than budgets allow, the NHS could be caught in the crossfire of conflicting demands. Sally Gainsbury describes how the health service is already having to deal with Covid, alongside rising levels of demand for care, with substantially less money than before.
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Content ArticleIn July 2021, the UK Government lifted all Covid protections, meaning people were no longer legally obliged to take infection control measures such as wearing face masks in designated places. Twelve months on, the UK is facing high levels of infection and hospitalisations from Covid-19. In this opinion piece for The BMJ, members of Independent SAGE—a group of scientists working together to provide independent scientific advice about Covid-19 to the UK government and public—propose a series of measures to help people make informed decisions that will reduce the risk of illness and disruption to them, their families and their communities. The authors accuse the government of ignoring published scientific advice from their own advisory group, SPI-B, and call for action to give people the information they need to make responsible personal choices as part of the plan to 'live with Covid'.
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Content ArticleToday may be the most difficult day the NHS has ever experienced. The headlines will focus on the pressures created by the heatwave and that most visible sign of healthcare failure – ambulances queuing outside hospitals. But, as we know all too well, this brutal situation is the culmination of many factors, which include but are not limited to prolonged periods of underfunding in the past decade, lack of an adequate workforce plan, and a cowardly and short-sighted failure to undertake social care reform, writes Dr Kamran Abbasi, editor of the BMJ, and HSJ editor, Alastair McLellan, in this joint editorial.
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Content ArticleNursing workforce shortages are an issue of international concern, with the gap between demand for services and the limited numbers of nurses widening. Recruiting nurses internationally is one solution that is helping to bridge this gap in some health systems. This systematic review in the International Journal of Nursing Studies Advances aimed to explore the lived experiences of international nurses working and living in different countries globally. The authors identified factors that can help nurses from other countries to adapt culturally to the UK health system, and that may support retention of international staff. The authors found that in order to improve the long term retention of international nurses, cultural integration and language barriers should be sensitively managed to enable effective acculturation. Culturally sensitive leadership should also be promoted to ensure zero tolerance of inappropriate racist and discriminatory behaviours.
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Content ArticleOn his last day in office as Chief Investigator at the Healthcare Safety Investigation Branch (HSIB), Keith Conradi sent this letter to the Secretary of State for Health and Social Care, outlining his concerns about the approach of the Department of Health and Social Care (DHSC) and NHS England to patient safety work carried out by HSIB. In his letter, Keith highlights a lack of interest in HSIB investigations and activity from leaders in both NHS England and DHSC, and describes how this attitude permeates both organisations. He also draws attention to a lack of priority and support for patient safety at a structural level, and calls on government and healthcare leaders to take a new approach and introduce a regulated safety management system with appropriate accountability. Patient Safety Learning has written a blog reflecting on Keith Conradi's letter, highlighting the ways in which his concerns align with those consistently raised by Patient Safety Learning.
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Content ArticleThe government recently appointed Dame Lesley Regan, professor of obstetrics and gynaecology at Imperial College London, as the first women’s health ambassador for England. The new role has been created to help close the gender health gap. Shakila Thangaratinam, Professor of Maternal and Perinatal health, University of Birmingham, reflects on what Dame Regan should focus on in this blog for The Conversation.
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Content ArticleThis consensus statement is founded on the policies articulated in numerous global and regional resolutions and decisions on patient safety adopted by governing bodies of the World Health Organization (WHO) and other international organisations. It is based on the proceedings of the WHO Policy Makers’ Forum, highlighting the central and specific role of policy-makers and healthcare leaders in implementation of the Global Patient Safety Action Plan 2021–2030 at all levels in all countries. Approximately 310 participants from around 90 countries across the world – including senior policy-makers, healthcare leaders, patient safety experts at national, subnational, regional, organisational and healthcare facility levels, patient safety advocates, and representatives of key international organisations – met (virtually) on 23–24 February 2022 to participate in the Policy Makers’ Forum organised by the Patient Safety Flagship unit, WHO headquarters, Geneva, Switzerland.
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Content Article“A real nightmare, vindictive, arrogant, a bully, hostile to the NHS and all its works, a micro-manager of the wrong things, views NHS management as bloated and profligate.” As this amalgam of quotes from senior NHS leaders makes clear, never has a politician arrived in the post of health secretary (or health and social care secretary) trailing a worse reputation than Steve Barclay.
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Surviving in Scrubs campaign
Patient Safety Learning posted an article in Staff safety
Sexism, sexual harassment, and sexual assault are commonplace in the healthcare workforce. Too many healthcare staff have witnessed or been subject to it… the female med student asked to stay late lone working with a senior male doctor, being looked over for opportunities at work, unwelcome touching at conferences, comments on your looks… the list goes on. A 2021 survey from the BMA reported 91% of women doctors had experienced sexism in the last 2 years and 47% felt they had been treated less favourably due to their gender. Over half of the women (56%) said that they had received unwanted verbal comments relating to their gender and 31% said that they had experienced unwanted physical conduct. Despite these statistics these issues remain endemic in healthcare. The Surviving in Scrubs campaign, created by Dr Becky Cox and Dr Chelcie Jewitt, aims to tackle this problem, giving a voice to women and non-binary survivors in healthcare to raise awareness and end sexism, sexual harassment, and sexual assault in healthcare. You can share your story through the Submit Your Story page anonymously and the story will be published on the Your Stories page. This will create a narrative of shared experiences that cannot be ignored. -
Content ArticleThis is the report of the Health and Social Care Select Committee endorsing the appointment of Dr Henrietta Hughes as the first Patient Safety Commissioner for England. The publication of this report follows a formal meeting (oral evidence session) of the Committee which took place Tuesday 5 July 2022.
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Content ArticlePsychological safety is a belief that one will not be punished or humiliated for speaking up with ideas, questions, concerns, or mistakes. More than 20 years of research demonstrates that organisations with higher levels of psychological safety perform better on almost any metric or key performance indicator (KPI) in comparison to organisations that have low psychological safety. However, achieving psychological safety is a challenge in the complex, ever-evolving health and care systems in which we operate. In this guide, Professor Amy C. Edmondson shares insights that emerged from exploring the experience of differing Integrated Care Systems; a range of case studies, and a wealth of tools and resources. This guide is not a 'how to' for how to create psychological safety; it is more of a reflection on the opportunities and challenges in our health and care system, and how you might seek to work with them.
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Content ArticleThe emotion of the team is a sum-total of emotions and feelings that members of the team experience. Left unnoticed, unexpressed, and unattended, these emotions can grow toxic to harm relationships or grossly undermine team’s potential. Leaders have a choice of either noticing those emotions intentionally and intervening constructively when needed or just ignore the emotions to focus only on the outcomes and the process. Tuning into team emotions, fostering productive relationships, building trust, and a conducive environment within the team is the constant work of leadership.
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Draft Code of governance for NHS provider trusts (May 2022)
Patient Safety Learning posted an article in Boards
This code sets out a common overarching framework for the corporate governance of trusts, reflecting developments in UK corporate governance and the development of integrated care systems. -
Content ArticleIn this editorial, published in the British Journal of Hospital Medicine, Dr Paul Grime reviews the report 'Mind the implementation Gap: The persistence of avoidable harm in the NHS', which calls on the government, parliamentarians and NHS leads to take action to address the underlying causes of avoidable harm in healthcare.
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Content ArticleThe consultancy firm McKinsey & Company explored the effects of the Covid-19 pandemic on the nursing workforce in a global survey that included nurses from United States, the United Kingdom, Singapore, Japan, Brazil and France. The survey findings show a consistency around how nurses feel in their roles today, despite the different healthcare systems and delivery networks in each of the six countries. A substantial population of nurses are expressing a desire to leave direct patient care, with between 28% and 38% of nurse respondents in the United States, the United Kingdom, Singapore, Japan and France indicating that they were likely to leave their current role in direct patient care in the next year. This article explores in detail some of the reasons why nurses are choosing to leave direct patient care, and highlights approaches that might encourage retention, including positive leadership initiatives.
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Content ArticlePretty soon there won’t be a trust without an associate director or even board level director fully dedicated to all things equality, diversity and inclusion; relatively new senior roles that must have a purpose, job description and performance indicators. They will spend energy on yet more strategies, start from the top and hope something trickles down. Or they could start where the work is done, and build the tools to make equality, diversity and inclusion (EDI) everyone’s responsibility. Trusts are full of people passionate about EDI. So many roles, so many champions. They meet, share stories, and champion the importance of EDI. All this busyness typically outside a governed frame without the necessary reporting, investigating, actions, outcomes, learning, and measurable improvement. To normalise EDI and make it everyone’s responsibility will involve enabling reporting of EDI incidents, investigating it, taking action, and learning from it, writes Dr Nadeem Moghal in an article for HSJ.
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Content ArticleThe King’s Fund was commissioned by NHS England to undertake a review of the leadership and culture of the Healthcare Safety Investigation Branch (HSIB), including the culture and leadership needed for success as the organisation moves towards a steady state of independence. This report contains the authors' findings, obtained from individual interviews, focus groups and staff survey results, previous reports and other relevant information. It also contains HSIB staff members' responses to the findings, reflections from The King’s Fund review team about what needs to change, and a plan for the future.
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Content ArticleClinical engagement has supplemented clinical governance in healthcare to strengthen the contribution of medical professionals to the assessment of clinical outcomes for patients. Assessments of clinical engagement have, until now, been qualitative; this case study in the journal Australian Health Review introduces the concept of quantitative assessment of clinical engagement by measuring the number of patients managed according to specialist society guidelines. Such an assessment engages all staff (medical, nursing, allied health and pharmacy) involved in patients receiving treatment according to such guidelines and provides an assessment of individual and organisational compliance with those guidelines. Clinical engagement is then quantified as the percentage of patients that have been documented to receive specialist society- or college-approved guideline-compliant treatment, relative to the total number who could receive such treatment, in any healthcare organisation.
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Content ArticleThis improvement tool is designed to help NHS organisations identify strengths their leadership team and organisation, and any gaps that need work, in seeking to create an environment where people feel safe to speak up with confidence. It should be used alongside Freedom to speak up: A guide for leaders in the NHS and organisations delivering NHS services, which provides full information about the areas addressed in the statements, as well as recommendations for further reading.
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Content ArticleThis guide provides ideas for how an organisation can adhere to the NHS principles for leaders and managers in seeking to create an environment where people feel safe to speak up with confidence. This guide is designed to be used by any senior team, owner or board in any organisation that delivers NHS commissioned services. This includes all aspects of primary care; secondary care; and independent providers.
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Content ArticleMuch progress in the world depends on the spread of ideas, says Steven Shorrock in his new blog. There is no shortage of good ideas, and no shortage of bad ones, but ‘good’ and ‘bad’ are relative to our positions, and success and failure are not dependent on either. The success of an idea depends on a multitude of factors, such as the the multiverse of contexts in which it is introduced, the dominant paradigm, the nature of the related problem situation or opportunity, the quality of the idea itself, the communication of the idea, possible unwanted consequences, and the characteristics of the proponents and detractors.
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In a series of blogs, Gina Winter-Bates, Associate Nurse Director Quality and Safety at Solent NHS Trust, shares her experience of implementing Safety Chats. In this final blog of the series, Gina shares the next steps for Safety Chats in her Trust and how they will be building more ways of supporting staff to discuss safety, to seek advice and support, and to receive clear assistance when things have gone wrong. -
Content ArticleThe Belfast Health Trust failed to intervene quickly enough in the practice of a doctor which led to Northern Ireland's largest ever patient recall, the Independent Neurology Inquiry has found. More than 5,000 former patients of neurologist Michael Watt were invited to have their cases examined for possible misdiagnoses. Among the conditions being treated were stroke, Parkinson's disease and multiple sclerosis (MS). The inquiry found "numerous failures". The Independent Neurology Inquiry concluded that the combined effect of the failures ensured that patterns in the consultant's work were missed for a decade.
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Content ArticleEvery day we use tools and resources to manage our lives, both personally and professionally. As a healthcare professional, you are committed to providing safe quality healthcare to all individuals. The checklists in this book are designed to help you succeed in that effort. You may be a first-time reader who has not had the opportunity to put these tools to the test, or you could be a returning reader interested in what new checklists you can use. In either instance, if you’re reading this book, then you are searching for tools to help your healthcare organisation navigate the increasing complexities of providing quality health care and maintaining the physical environment where healthcare is delivered.
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Content ArticleMany people sense that the way organisations are run today has been stretched to its limits. In survey after survey, business people make it clear that in their view, companies are places of dread and drudgery, not passion or purpose. Organisational disillusionment afflicts government agencies, nonprofits, schools, and hospitals just as much. Further, it applies not just to the powerless at the bottom of the hierarchy. Behind a facade of success, many top leaders are tired of the power games and infighting; despite their desperately overloaded schedules, they feel a vague sense of emptiness. In this article, Frederic Laloux discusses and gives examples of 'teal' organisations.
