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Found 1,323 results
  1. News Article
    Trust leaders have been asked to “self-assess” the quality of their “improvement culture” as part of an initiative launched by NHS England chief executive Amanda Pritchard in the spring to lead the service's new improvement drive. The call came from NHS Impact, led by former Modernisation Agency chief David Fillingham, who along with NHS Impact’s deputy chair – University Hospitals Coventry and Warwickshire Foundation Trust CEO Andy Hardy – has written to service leaders, setting out the first stage in the improvement drive. They have asked the boards and CEOs of trusts and integerated care boards to “engage directly” with a new self-assessment tool and maturity matrix created by NHS Impact. This is designed to gauge their progress on adopting the five practices that NHS IMPACT claim “form the DNA of an improvement culture”. Those five practices are: A shared purpose and vision which are widely spread and guide all improvement effort. Investment in people and in building an improvement focused culture. Leaders at every level who understand improvement and practise it in their daily work. The consistent use of an appropriate suite of improvement methods. The embedding of improvement into management processes so that it becomes the way in which we lead and run our organisations and systems. Read full story (paywalled) Source: HSJ, 29 September 2023 .
  2. News Article
    The U.S. Department of Health and Human Services (HHS), through the Agency for Healthcare Research and Quality (AHRQ), announced nine grant awards of $1 million each for up to 5 years to support existing multidisciplinary Long COVID clinics across the country to expand access to comprehensive, coordinated, and person-centered care for people with Long COVID, particularly underserved, rural, vulnerable, and minority populations that are disproportionately impacted by the effects of Long COVID. The grants are a first of their kind. They are designed to expand access and care, develop, and implement new or improved care delivery models, foster best practices for Long COVID management, and support the primary care community in Long COVID education. This initiative is part of the Biden-Harris Administration's whole-government effort to accelerate scientific progress and provide individuals with Long COVID the support and services they need. “The Biden-Harris Administration is supporting patients, doctors and caregivers by providing science-based best practices for treating long COVID, maintaining access to insurance coverage, and protecting the rights of workers as they return to jobs while coping with the uncertainties of their illness,” said Secretary Xavier Becerra. “Treatment of Long COVID is a major focus for HHS, and AHRQ is helping lead the way through grants to investigate best practices and get useful guidance to doctors, hospitals, and patients.” Read full story Source: AHRQ, 20 September 2023
  3. Content Article
    Extensive cultural change is needed in the NHS to tackle sexual violence and prevent further institutional harm to patients and staff, writes Philippa Greenfield, co-presidential lead for women and mental health, consultant general adult psychiatrist, named doctor for adult safeguarding and trauma informed lead.
  4. Content Article
    The 15th annual HSJ Patient Safety Congress brings together more than 1000 attendees with the shared goal of advancing the national agenda for patient safety across health and social care. In this blog, Samantha Warne, the hub's Lead Editor, captures some of the key highlights and messages from day one of HSJ’s Patient Safety Congress.
  5. Content Article
    This blog from the Institute for Healthcare Improvement (IHI) looks at the importance of embedding quality control (QC) measures into everyday work. QC methods sustain improvements for the long-run and promote stable systems to produce reliable outcomes. When effectively used, they can internally monitor performance, assess progress towards goals and allow systems to direct improvement resources to where they are needed most. 
  6. Content Article
    The Patient Safety Partner (PSP) is a new and evolving role developed by NHS England to help improve patient safety across health care in the UK. This web page outlines Mersey Care NHS Foundation Trust plans to develop a team of PSPs to work alongside staff, patients, service users and families to influence and improve safety within its services. PSPs can be patients, service users, carers, family members or other lay people (including NHS staff from another organisation). The page contains answers to frequently asked questions (FAQs) about the PSP role, including: What is the role of a Patient Safety Partner? What kinds of projects will I get involved with? Will I have any support? How much will I get paid for this role? What training will I receive? What is the time commitment? How long will I hold this role for? Do I need any experience? How will my work help the NHS? Do I have to live locally? Who should apply for this role?
  7. Content Article
    In this opinion piece for the BMJ, Partha Kar, NHS England National Specialty Advisor for Diabetes, shares his observations on why leaders fail to speak out on things that clearly aren't good for patient care. He identifies five key reasons: Keeping the job Fear Rhetoric about 'the bigger picture' The idea that 'I'll be rewarded' Genuine belief that the issue isn't real Partha highlights that speaking up about issues needs to become the norm if we are to see a culture shift in healthcare. Leaders need to be at the forefront of this, using their privilege to bring about change.
  8. Content Article
    MEG interviews Patient Safety Learning's Chief Executive, Helen Hughes, for this year's World Patient Safety Day. Helen discusses how Patient Safety Learning contributes to improving patient safety, the 'Blueprint for Action', how the new LFPSE service will impact patient engagement and the role leadership plays in patient safety.
  9. Content Article
    The NHS-Virginia Mason Improvement Partnership was a five-year programme where five NHS organisations implemented organisation-wide improvement. The evaluation, led by Dr Nicola Burgess of University of Warwick - Warwick Business School offers profound lessons on how to create a culture and system for continuous improvement. The six lessons from the evaluation are now available in a free eBook.
  10. Content Article
    This article by Jesse Lyn Stoner, argues that leading without relying on authority is a higher evolutionary skill. It supports developing adult relationships based on mutual objectives and creates work environments grounded in respect for human dignity. Stoner outlines “The 8 Portals of Influence” – Ways to Influence Without Authority.
  11. Content Article
    This Newsnight report looks at the case of Rebecca Wight, an advanced nurse practitioner who raised concerns about a colleague at at Manchester’s Christie cancer hospital and felt her treatment by Trust management as a whistleblower was poor. She is now taking The Christie to an employment tribunal for constructive dismissal. The video also features an interview with Helené Donnelly, a nurse who tried to raise the alarm more than 100 times at Mid Staffs and went on to be a key witness in the subsequent Francis inquiry. She calls for failing NHS managers to be struck off, highlighting that a decade on from one of the worst failings in NHS history, those raising concerns were still not being listened to.
  12. Content Article
    Report from HSJ, in association with Allocate Software, on why patient safety should be the core business of healthcare.
  13. News Article
    A trust facing a police investigation into one of the NHS’s largest ever maternity scandals is no longer rated ‘inadequate’ by the Care Quality Commission in its well-led and maternity domains. Nottingham University Hospitals Trust was rated “inadequate” for its leadership and maternity services during inspections in 2021 and 2022, following serious care failings exposed by staff and patients during this period. The Nottinghamshire police confirmed last week they were opening an investigation. But the regulator noted improvements after its well-led and maternity inspections which took place in April and June. The well-led rating has gone up from “inadequate” to “requires improvement” and maternity services at both hospitals have also gone up to “requirements improvement”. Greg Rielly, CQC deputy director of operations in the Midlands, said: “During this inspection, we saw a team that consistently led with integrity who were open and honest in their approach.” However, he stressed that while the culture across the trust was improving, some staff still didn’t feel able to raise concerns without fear of retribution. “Leaders were aware of this and were working to create a workplace that is free from bullying, harassment, racism, and discrimination so we hope to see an improved picture soon,” he said. Read full story (paywalled) Source: HSJ, 13 September 2023
  14. News Article
    MPs will investigate the sexual harassment and sexual assault of female surgeons taking place within the NHS. BBC News reported women being sexually assaulted even in the operating theatre, while surgery took place. And the first major report into the problem found female trainees being abused by senior male surgeons. The Health and Social Care Committee said it would look into the issue and its chair, Steve Brine, said the revelations were "shocking". "The NHS has a duty to ensure that hospitals are safe spaces for all staff to work in and to hold managers to account to ensure that action is taken against those responsible," Mr Brine said. "We expect to look into this when we consider leadership in the NHS in our future work." Read full story Source: BBC News, 13 September 2023
  15. Content Article
    On 18 August 2023, Lucy Letby was found guilty of murdering seven babies and convicted of trying to kill six other infants at the Countess of Chester Hospital. Looking ahead to the forthcoming independent inquiry into this case, Patient Safety Learning, reflecting on the inquiries of the past, sets out some key patient safety themes and issues that should be considered as part of this.
  16. News Article
    The British Medical Association has written to trust chief executives warning of ‘concerns regarding the safety of our members and the patients they serve’ due to flawed concrete beams. The BMA has written to trust chiefs, copying in their medical committee leads, in the wake of a wave of publicity around reinforced autoclaved aerated concrete in recent weeks. The letter said: “The HSJ has reported that many NHS hospital buildings have been constructed with RAAC, which is in some cases reaching the end of safe use and causing danger to staff and patients. “Unfortunately, your trust may be one of the affected hospitals. We have concerns regarding the safety of our members and the patients they serve, and would appreciate answers to the following.” It also requested the trusts provide answers, under the Freedom of Information Act, to questions including whether they had identified RAAC, what assessments they had made, what mitigations were planned or in place, and emergency plans such as evacuation. It is thought the letter was sent to all or most provider trusts. Read full story (paywalled) Source: HSJ, 12 September 2023
  17. News Article
    A trust which hired the former chief executive of the Countess of Chester Hospital as an interim CEO has launched a review of decisions about safety and whistleblowing taken under his leadership. Jacqui Smith, chair-in-common at Barts Health and Barking, Havering and Redbridge University Hospitals trusts, made the announcement at a board meeting, following the nurse Lucy Letby’s conviction for murdering seven babies, and attempting to murder six more, during a year-long period between June 2015 and June 2016. Tony Chambers was Countess of Chester Hospital Foundation Trust CEO for six years from December 2012 to September 2018, and resigned shortly after Letby’s initial arrest. His role – and that of fellow senior managers in Chester – in responding to concerns raised by doctors, has come under intense scrutiny since the verdicts. Mr Chambers served as BHRUT’s interim chief from January 2020 until August 2021, and Ms Smith told BHRUT’s board: “In the light of concerns, particularly around listening to staff and patients, and given the seriousness of the events, we will undertake a look at the periods of Tony Chambers’ tenure. “To see whether there are, firstly, any significant decisions taken regarding quality and safety that we need to look at again, and [secondly], checking our log of whistleblowing cases and other concerns to make sure that they have been appropriately followed up." Read full story Source: HSJ, 8 September 2023
  18. News Article
    The government is to investigate claims an ambulance service covered up details of the deaths of patients following mistakes by paramedics. It follows the Sunday Times report that North East Ambulance Service (NEAS) withheld information from coroners. Labour's shadow health secretary Wes Streeting described the alleged cover-up as "a national disgrace". Health minister Maria Caulfield said she was "horrified" and there would be a further investigation. The newspaper reported that concerns were raised about more than 90 cases and whistleblowers believed NEAS had prevented full disclosure to relatives of people who died in 2018 and 2019. Speaking in the House of Commons, Mr Streeting asked why the regulator - the Care Quality Commission (CQC) - had failed to take action. Ms Caulfield said that while both the NEAS and the CQC had both reviewed the allegations, further investigation was required. The minister said non-disclosure agreements have "no place in the NHS", adding: "Reputation management is never more important than patient safety." Read full story Source: BBC News, 23 May 2022
  19. News Article
    Junior doctors have been prevented from returning to scandal hit heart surgery unit previously criticised over “toxic” culture, The Independent has learned. A coroner defended cardiac surgery at St George’s University Hospital, criticising an NHS-commissioned review into 67 deaths that warned of poor care. However, The Independent has learned the unit received a critical report from Health Education England (HEE), the body responsible for healthcare training, just last year. The NHS authority was so concerned about culture problems and “inappropriate behaviour” within the unit that it took away the junior doctors working there. This is the third time HEE has intervened since 2018, when the unit was criticised in an independent review for having a “toxic” culture. In a statement, Professor Geeta Menon, postgraduate dean for South London at Health Education England, said: “HEE carried out a review of cardiac surgery at St George’s University Hospital in July 2021 and concluded that further improvements were required to create a suitable learning environment for doctors in training. "Unfounded’ NHS criticism and investigation caused unnecessary deaths at London heart surgery unit “We continue to work closely with the trust to implement our requirements and recommendations and will reassess their progress this summer. HEE is committed to ensuring high quality patient care and the best possible learning environment for postgraduate doctors at St George’s.” The Independent understands that a report issued in December, following the HEE visit, identified problems of “inappropriate behaviour”, poor team working from consultants and raised concerns the culture problems previously identified at the unit persisted. Read full story Source: The Independent, 14 May 2022
  20. News Article
    A trust chief who blew the whistle on her predecessor’s ‘aggressive’ behaviour and lack of interest in patient safety says it was the hardest thing she has had to do in her career. Janelle Holmes, who is now chief executive of Wirral University Teaching Hospital Foundation Trust, was among four Wirral University Teaching Hospital Foundation Trust senior executives who wrote to regulators in 2017 about the behaviour of the trust’s then CEO David Allison. They said he would react with “dismay and aggression” to concerns being raised about service quality, and staff were afraid to speak up as a result. The intervention led to Mr Allison’s departure and a subsequent independent investigation found “deep systemic cultural issues”. Mr Allison always denied his behaviour was inappropriate. In an interview with HSJ, Ms Holmes talked of the difficulties in taking those actions, and the subsequent efforts to overhaul the trust’s culture. She said: “From a personal integrity perspective, it was the right thing to do…and I [also] felt I had a personal responsibility to make it right afterwards. “But yes, it was the most difficult thing I’ve ever had to do.” She said: “I remember watching Sir David Dalton (the ex-Salford CEO) probably more than 10 years ago… say ‘we are harming patients’.. it was like ’you can’t say that’. “But actually [there was a] complete sea change and [it became] an organisation where [speaking out] was the right thing to do. That’s the only way you can ensure you’re delivering good quality high standard services. If you’re acknowledging mistakes happen, you’re learning from them, you’re correcting things… I think that then starts to shape how our clinicians and staff feel. Read full story (paywalled) Source: HSJ, 12 May 2022
  21. News Article
    The culture at a long-troubled ambulance trust is ‘worsening, not improving’, its staff have told a health watchdog. Concerns about culture and patient safety at East of England Ambulance Service Trust (EEAST) were raised to inspectors at the Care Quality Commission (CQC) during an inspection of the trust last month, according to public documents. In a feedback letter to the trust following the inspection, the CQC said staffing at EEAST’s control room was below planned levels, and the inspectors were “not assured that staffing levels met the demands within the service and this may impact on patient safety when managing the high volume of calls”. The trust, which is in the equivalent of special measures and currently rated “requires improvement” by the CQC, has had long-standing cultural problems and last year signed a legal agreement with the Equality and Human Rights Commission on how it would protect staff from sexual harassment. According to the feedback letter, staff described a “worsening, not improving, culture” and said the workforce was “tired” and not receiving mandatory training, one-to-ones with managers or appraisals. The letter, published in the trust’s latest board papers, also reported inspectors raising concerns about potential risks to patients over the management of the trust’s call stack and a lack of consistency over “standard operating procedures”. Additionally, some staff in the control room on an accelerated training programme were unable to undertake full patient assessments and had to call for assistance from others. Read full story (paywalled) Source: HSJ, 11 May 2022
  22. News Article
    Sir Robert Francis has announced he is to step down as chair of Healthwatch England 20 months early, claiming funding cuts mean the patient watchdog could soon struggle “to fulfil its vital role”. The prominent QC has also announced he will quit his position as a non-executive director of the Care Quality Commission on November 15 2022. In a letter to Mr Javid, Sir Robert said it had been an “honour and a privilege” to serve on the CQC’s board and a “great pleasure” to support Healthwatch England. He added: “I believe [Healthwatch England] has proved its worth to your department and the system more generally and is now in an ideal position to help you take forward your agenda for improving the patient’s voice. “However, if I have one regret about my time as chair[man], it is that we have been unable as yet to find a way of reversing the alarming decline in the resources available to Healthwatch – I am afraid there is a growing risk the network will be unable to fulfil its vital role unless urgent attention is paid to this issue.” Sir Robert has chaired a number of independent inquiries involving the NHS, most notably the inquiry into poor care and high mortality rates at Stafford Hospital – which was published in February 2013. Last June, Sir Robert was appointed by the government to undertake an independent study into a framework for compensation for victims of the infected blood scandal. Read full story (paywalled) Source: HSJ, 3 May 2022
  23. News Article
    An NHS mental health trust that has been the worst performing in England has been warned it must improve after failing another inspection. Norfolk and Suffolk NHS Foundation Trust (NSFT) has been rated "inadequate" in the latest Care Quality Commission (CQC) report. The CQC said it had served the trust with a warning notice that it had to act on to improve patient care. The trust has been rated "inadequate" on three previous occasions by the health watchdog, as well as being the only one currently within the NHS's improvement regime for not meeting standards. Following the latest inspection, its overall rating was downgraded from "requires improvement" - and three out of five measures assessed by the CQC, for safety, leadership and effectiveness, met its lowest grading. The report said two wards were immediately closed to new patients following a CQC visit in November, after the trust was threatened with enforcement action if urgent measures were not taken. Significant staffing problems, including an annual nurse vacancy rate of more than 17%, were also highlighted. Staff at an adult long stay ward did not complete regular checks on patients supposed to happen every 30 to 60 minutes, which meant they were unaware if somebody needed help for periods of up to seven hours. Inspectors also said there had been a severe deterioration on the trust's inpatient ward for children and young people - the Dragonfly Unit in Carlton Colville, Suffolk. They found it was reliant on agency workers and lacked a permanent doctor. Read full story Source: BBC News, 27 April 2022
  24. News Article
    NHS management and leadership are overly ‘task focused’, according to briefings by the senior military leader who has carried out a major review of health and care for the government. General Sir Gordon Messenger has nearly completed the work, which had been due to be published shortly before Easter but was delayed by the government, and has briefed several senior leaders on several of his main observations. According to several senior figures, he has said NHS management and leadership are heavily “task focused” — a management term referring to an approach devoted to completing certain tasks or meeting certain short-term objectives; in contrast to an approach which focuses on people, relationships or skills. HSJ has spoken to several senior sources who have been briefed on Sir Gordon’s findings so far. One said the former military figure had observed that “NHS leadership is… very focused on getting things done, and not focused enough on how things get done – which I think is very fair if you think particularly what the last 10, 15 years have been like”. Another finding, according to those briefed, is the need for better support for NHS leaders running the most difficult local organisations, including providing what has been described as “support packages”. Read full story Source: HSJ, 26 April 2022
  25. News Article
    The chief executive of a mental health trust grappling with care quality failures has described his anger at ‘disrespectful’ staff who have ‘now had to leave the organisation’. In a message to staff, seen by HSJ, Brent Kilmurray, chief executive of Tees Esk and Wear Valleys Foundation Trust, said a number of staff had “stepped away from our values”. HSJ has heard reports of 12 staff members within the trust’s forensic secure inpatient services being suspended in recent weeks, and some dismissed, after being caught sleeping on shifts and using electronic devices while meant to be observing patients. The reports are unconfirmed, but appear to be referenced in a message sent by Brent Kilmurray on 14 March, which said: “I’m sorry to say, there’s been a handful of people who have stepped away from our values and in doing so have now had to leave the organisation." Mr Kilmurray said the staff were in a “minority” and that when the trust investigated these matters “we have found far more excellent caring practice”. He added the trust is working with service leaders “to ensure that they understand their accountabilities for ensuring that services are safe”. Read full story (paywalled) Source: HSJ, 14 April 2022
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