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Found 84 results
  1. Content Article
    The adrenal glands are found in the fatty tissue at the back of the abdomen above each kidney, and produce steroid and adrenaline hormones. Surgery on tumours of the adrenal gland is uncommon compared with surgery for other tumours such as those of the breast, bowel, kidney and lung. Research has shown that the more adrenal operations a surgeon undertakes per year, the better the overall outcomes for patients undergoing that type of surgery. In this study, the outcomes from adrenal operations recorded over 18 years in the national adrenal surgical registry were analysed. The results confirmed previous findings showing that postoperative complications and length of hospital stay were reduced for patients operated by surgeons who did more adrenal operations per year. Operations done by keyhole surgery had better outcomes. Operations done either in older patients, or for the rare adrenal cancer tumours had worse outcomes, as did operations in which both adrenal glands were removed. The authors recommended that all surgeons performing adrenal surgery should monitor the outcomes of their operations, ideally in a national registry, and discuss these with patients before surgery; and undertake a minimum of six adrenal operations per year, but a minimum of 12 per year if doing surgery for adrenal cancer or surgery to remove both adrenal glands.
  2. Content Article
    A new guide to innovation implementation, readiness and resourcing has been published sharing practical learning from the Health Innovation Network’s successful adoption and spread of the national Focus ADHD programme. 
  3. Content Article
    On 8 November 2023, NHS England wrote to health leaders and staff with a focus on addressing the significant financial challenges created by industrial action in 2023/24, and immediate actions to take. Follow the link below for full details.
  4. Content Article
    “Almost every Gynecologic surgeon I know has a story about being told that they were wasting their talent". It was this tweet from US-based gynaecology surgeon Jocelyn Fitzgerald that caught my eye a few months ago. I’m passionate about women’s health and immediately wanted to find out more about how this translated in terms of patient safety. So, in August we met, and Dr. Fitzgerald explained some of the barriers and challenges she faces in delivering safe and equitable care. 
  5. Community Post
    This case study focuses on a North Staffordshire Combined NHS Trust project. The lead consultant for the service was concerned that the clinical pathways were not optimised and bottlenecks were delaying access, assessment and diagnosis of patients. As a result there were delays to initiating treatment. In addition to potential harm to patients this was resulting in inefficient and wasteful use of resources. Following pathway changes, value and efficiency impact was noted in the following areas: Because head CT scans are provided by a neighbouring acute trust, reducing the number of patients referred had a direct impact on service cost as well as releasing capacity in the wider system. Comparing baseline activity with the review period showed a 30% reduction in CT scan referrals and a £7,800 direct cost saving. The number of patients not attending appointments reduced from 572 in the baseline period to 379 after implementing pathway changes. While not a cash releasing saving this improved overall efficiency and productivity for the service and contributed to a reduction in overall unit price per attendance. At the start of the project, the average unit price for patients attending the memory service was £280.93. Through a combination of direct cost savings and efficiency and productivity gains arising from the revised pathway, this figure had reduced to £205.12 in the review period. Do you have a cost-saving or efficiency case study to share? What were the patient safety implications? Do you have resources or knowledge to share that can help others make positive changes? Comment below (sign in or register here for free first), or get in touch with us at content@pslhub.org to tell your story.
  6. Content Article
    Engagement Value Outcome (EVO) promotes collaborative working between clinical and finance teams to enhance their collective understanding of patient level costing. It provides the NHS with a framework to ensure resources are used in the most effective way possible to provide high-quality care to patients. This clinical transformation case study focuses on the North Staffordshire Combined NHS Trust EVO project. The lead consultant for the service was concerned that the clinical pathways were not optimised and bottlenecks were delaying access, assessment and diagnosis of patients. As a result there were  delays to initiating treatment. In addition to potential harm to patients this was resulting in inefficient and wasteful use of resources
  7. Content Article
    When many people think about NHS services they often think about clinical staff, such as doctors or nurses, and how they deliver care and interact with patients and families. However, in the context of patient safety, there is often more to see ‘behind-the-scenes’ in non-patient facing services. These services may be less visible, but they play a vital part in ensuring patient safety. Understanding the importance of these services, and how they are crucial to the ability of the NHS to operate effectively, is often underestimated. In this blog for the Healthcare Safety Investigation Branch (HSIB), National Investigators Russ Evans and Craig Hadley highlight how 'behind-the-scenes' services are crucial to help the NHS operate effectively and safely.
  8. Content Article
    Even before the Covid-19 pandemic, rural and remote health services in England faced long-standing workforce, financial and capacity issues. This report by the Nuffield Trust explores the impact the pandemic has had on the delivery of rural and remote health services, highlighting the underlying challenges faced by these services. It outlines how the challenges faced are different for rural areas when compared to more urban areas. The authors also discuss how performance could be monitored to signal the risk of any significant service pressures over the coming months.
  9. Content Article
    The NHS and social care system in the UK are under immense strain, and this is increasingly causing harm to patients. This is seen in the current crisis in urgent and emergency care, but is present throughout the system. This BMJ article looks at a collaborative document produced by the Royal College of Physicians (RCP), Royal College of Emergency Medicine (RCEM), Royal College of General Practitioners (RCGP), Royal College of Psychiatrists (RCPsych) and the Society for Acute Medicine (SAM). The document highlights key actions and priorities that may help mitigate part of the crisis facing the NHS. As part of these recommendations, the authors call on the UK governments to increase and prioritise investment in primary care, social care, mental health and ambulance services.
  10. News Article
    GPs are struggling to cope with as many as 90 appointments and consultations a day – more than three times a recommended safety limit. General practices in England are carrying out more appointments than before the pandemic but face severe workforce shortages. More than 1.45 million patients waited at least 28 days to see a GP in September, according to the most recent NHS figures. GPs who spoke to the Observer last week say that almost every day they breach the BM) guideline of “not more than 25 contacts per day” to deliver safe care. One doctor said he had more than 90 consultations on one day. A conference of local medical committee representatives in England this week will highlight the growing pressures faced in general practice. Surgeries are being urged to impose stricter caps on the number of patient appointments for each GP. One of the proposed motions submitted to the conference by Kensington and Chelsea local medical committee says “focusing on patient safety” is more appropriate than meeting high patient demand. It says the NHS should focus on “safe capacity”. Such a move would mean longer waits for GP appointments, but doctors say it would help safeguard patient care and the welfare of staff in general practice. Read full story Source: The Guardian, 20 November 2022
  11. Content Article
    This standard operating procedure (SOP) for Leicester Royal Infirmary Children's Hospital outlines the process to be followed at times of increased pressure on services caused by increased acuity or activity in the pathway for non-elective care.
  12. News Article
    Nurses will start voting on Thursday on whether to strike over pay amid warnings that record numbers are leaving the profession. Around 300,000 members of the Royal College of Nursing (RCN) are being asked if they want to mount a campaign of industrial action in the union’s first UK-wide ballot. The RCN said new analysis by London Economics to coincide with the ballot launch showed that pay for nurses has declined at twice the rate of the private sector in the last decade. It is the first time in its 106-year history that the RCN has balloted members across the UK on strike action and it is urging them to vote in favour. RCN general secretary Pat Cullen said in a message to those being balloted: “This is a once-in-a-generation chance to improve your pay and combat the staff shortages that put patients at risk. “Governments have repeatedly neglected the NHS and the value of nursing. We can change this if together we say ‘enough is enough’. “Record numbers are feeling no alternative but to quit and patients pay a heavy price. We are doing this for them too." Read full story Source: The Independent, 6 October 2022
  13. News Article
    Specialist nurses at an NHS hospital have been told they may be taken off clinical shifts to help clean wards, it has emerged. Bedfordshire Hospitals NHS Foundation Trust has said it asked nursing staff to help clean wards as the hospital faced the “most challenging circumstances” it has ever faced. Clinical specialist nurses, who are advanced nurses and can usually have hundreds of patients under their care, were among those asked to spend entire shifts helping other wards “cleaning”, “tidying” and “decluttering”. The news has prompted criticism from unions, however, multiple nurses have reported that the requests happen “often” during winter. Alison Leary professor of healthcare and workforce at South Bank University warned that asking specialist nurses to drop their work was “very risky”. She said: “This problem keeps cropping up-as soon as there is pressure on wards they are expected to abandon their patients. It usually happens in winter and so it’s concerning that it has now started to happen in summer. “This also shows very little respect for nursing generally and will not help retention. Trusts need to plan workforces accordingly and should ensure they have the right amount of cleaning, administrative and housekeeping staff-all staff groups which contribute to patient safety and care quality." Read full story Source: The Independent, 8 August 2022
  14. News Article
    The large number of unfilled NHS job vacancies is posing a serious risk to patient safety, a report by MPs says. It found England is now short of 12,000 hospital doctors and more than 50,000 nurses and midwives, calling this the worst workforce crisis in NHS history. It said a reluctance to decisively plug the staffing gap could threaten plans to tackle the Covid treatment backlog. The government said the workforce is growing and NHS England is drawing up long-term plans to recruit more staff. Former Health Secretary Jeremy Hunt, who chairs the Commons health and social care select committee that produced the report, said tackling the shortage must be a "top priority" for the new prime minister when they take over in September. "Persistent understaffing in the NHS poses a serious risk to staff and patient safety, a situation compounded by the absence of a long-term plan by the government to tackle it," he said. It said conditions were "regrettably worse" in social care, with 95% of care providers struggling to hire staff and 75% finding it difficult to retain existing workers. "Without the creation of meaningful professional development structures, and better contracts with improved pay and training, social care will remain a career of limited attraction, even when it is desperately needed," the report said. Read full story Source: BBC News, 25 July 2022
  15. Content Article
    Expanding workforce capacity, and allowing staff to recover, is going to be fundamental in achieving the ambitions set out in the elective recovery delivery plan. To help support, protect and retain staff, this letter from NHS England details a number of high impact enablers that providers should consider implementing to help improve staff experience. It also sets out a number actions being taken forward at a national level with the aim of making the workload more sustainable for staff.
  16. Content Article
    An article* from Ehi Iden, hub topic leader, discussing the Nigerian healthcare workforce crisis.
  17. News Article
    NHS dentistry is "hanging by a thread" with some patients facing two-year waits for check-ups, the British Dental Association has said. Department of Health data analysed by the BBC shows almost 1,000 dentists working in 2,500 roles across England and Wales left the NHS last year. One woman told how she had been in pain for more than a year while waiting to have root canal surgery. NHS England said patients who most needed care should be prioritised. Pamela Carr, 58, from Carlisle, has been looking for an NHS dentist to fix her root canal since November 2020. "I've become used to the pain," she said. "I can't afford the private care, and I've tried every practice within 30 miles. I phoned NHS England too." "They said there's nothing they can do because there are no NHS dentists. That was the end of the conversation." Clinical Commissioning Group North Cumbria, which covers the area, lost 4% of its dentists in the last year. The worst-affected area was NHS Portsmouth CCG, which lost 26% of its NHS dentists over 12 months. At least 10% of NHS dentists were lost in 28 other English CCGs. Read full story Source: BBC News, 19 January 2022
  18. News Article
    The number of Covid patients in hospitals in England and Scotland has continued to rise this week, as NHS England reached a deal with private hospitals to free up beds amid the outbreak of Omicron cases. Meanwhile, Covid staff absences in England rose to their highest level since the introduction of the vaccine. The number of NHS workers in England off sick because of Covid was up by 41% in the week to 2 January, according to the latest figures. Five health workers describe some of the challenges they are facing, including understaffing, waiting times and bed-blocking. Read full story Source: The Guardian, 14 January 2022
  19. News Article
    “Protect the NHS” sounds like the team name for an illegal Downing Street quiz, but it won’t be winning any prizes for patient safety, writes Dr Phil Hammond in The Times. The fact is, the NHS, as was the case long before the pandemic, is woefully understaffed. Even more billions have been thrown at the system, but, as ever, so little of it finds its way to the frontline carers we all clapped for. The NHS is always fighting a losing battle. When the government first asked us to protect the NHS, it may as well have said: “Stay at home, die alone, protect the NHS.” Thousands of people have done just that since the pandemic started, for reasons not fully understood. They may have had Covid or non-Covid diseases, or both. They didn’t ask for, or couldn’t find, help when they were seriously ill. They followed their “stay at home” orders. Many died. "The NHS does some amazing things but the truth is it has never had the staff nor capacity — and sometimes not the culture — to provide safe, effective and timely care to all its citizens," says Hammond. "We also have appalling levels of public health inequality. The rich live a decade longer than the poor, and the poor suffer 20 more years of chronic disease and NHS dependency. No health service can cope with such high demands, many of them avoidable." Today, many people can’t even access care, never mind the quality of it. But we don’t need to dismantle the NHS, we need to staff it safely. We need to start with a proper, costed workforce plan for now and the future. If we put even more money into healthcare, we need to prove it’s being spent on frontline care that is proven to work. Just as we didn’t plan properly for Covid, we have never had a proper workforce plan for the NHS to estimate what staff increases we need to cope with an ageing, anxious and increasingly isolated population chock full of chronic diseases. How did we get in this mess? There is good evidence that safe staffing levels deliver better care, and that continuity of care and a long-standing relationship with your GP or nurse is hugely beneficial to your health. It’s much more rewarding for health professionals too. Alas, they don’t grow on trees and there’s a global shortage. There’s a limit to how many we can steal from countries who may need them more. No matter how much money we throw at the NHS in a pandemic panic, this tanker won’t be turned around quickly. Read full story (paywalled) Source: The Times, 18 December 2021
  20. News Article
    Former health secretary Jeremy Hunt has warned extra funding for the NHS “will unravel quickly” without the extra doctors and nurses needed. The health committee chair said today that the lack of any mention of workforce training budgets in the Chancellor’s speech on Wednesday was “the big gap” in news for the NHS. Before the budget, Mr Hunt, who served as health secretary for six years and who has accepted he did not do enough to increase staffing levels in the NHS, said a workforce plan for the NHS was needed. In the budget documents, released after the Chancellor Rishi Sunak had finished speaking, the Treasury confirmed only that it would continue to fund workforce training and repeated existing promises around 50,000 extra nurses. But many experts including the Health Foundation and think tanks as well as NHS leaders have said what is needed is a properly costed long term workforce plan so that the NHS can train enough staff to meet future patient demand. Read full story Source: The Independent, 28 October 2021
  21. Content Article
    It can be difficult to turn down requests to cover rota gaps. However, you must balance your own needs against those of the service discusses Emmeline Lagunes-Cordoba, Partha Kar and Tharusha Gunawardena in this BMJ article.
  22. News Article
    The trust at the centre of a maternity scandal does not have enough midwifery staff to keep women and babies safe, a Care Quality Commission (CQC)inspection has revealed. East Kent Hospitals University Foundation Trust relied on community midwives to fill slots at its acute unit, with some of them working 20-hour days after being called in to help cover and feeling outside of their competence. The trust had suspended a midwife-led unit and diverted women in labour to other hospitals – and when the CQC raised the understaffing issue at its inspection in July, it suspended its home birth service. But the CQC found that the number of midwives and maternity workers on duty rarely matched planned numbers and managers rarely calculated staffing numbers accurately, with some elements of the workload not being factored in. Lack of staff meant there was a risk to the safe assessment and monitoring of women and babies at the trust’s William Harvey Hospital in Ashford. Unqualified staff were having to deal with telephone queries from women who needed advice and support. Read full story (paywalled) Source: HSJ, 15 October 2021
  23. Content Article
    While the NHS delivered a remarkable amount of elective treatment during the pandemic, the pressure of caring for large numbers of patients seriously unwell with COVID-19 has led to the waiting list for elective care reaching the highest level since current records began. This analysis from The Health Foundation looks in detail at the impact of the pandemic on the waiting list for elective care in England. It highlights that: 6 million fewer people completed elective care pathways between January 2020 and July 2021 than would have been expected based on pre-pandemic numbers the backlog of elective care is not evenly distributed across England patients living in socioeconomically deprived areas faced more disruption and delays than those in England’s least deprived areas. It also looks at the difficulty in predicting how long the backlog will take to clear and how much it will cost. One unknown factor that complicates this task is 'missing' patients - those who did not or could not seek care during the pandemic. These patients may present at a healthcare setting requiring more urgent, intensive treatment as a result of missing out on earlier intervention.
  24. Content Article
    The Emergency Department Safer Nursing Care Tool is now available to use in NHS emergency departments in England. Developed by the Shelford Group chief nurses, licenced by Imperial College London and supported by the NHS England Chief Nursing Officer, the Emergency Department Safer Nursing Care Tool (ED SNCT) calculates nurse staffing requirements for emergency departments based on patients’ needs (acuity and dependency). Together with professional judgement, the tool supports emergency department managers and chief nurses in their safe staffing decisions. The Safer Nursing Care Tools (SNCT), including the Mental Health Optimal Staffing Tool (MHOST), are free to use by NHS trusts in England.
  25. Event
    until
    Anchor institutions are large organisations, connected to their local area, that can use their assets and resources to benefit the communities around them. Health and care organisations, as well as providing healthcare services, are well-placed to use their influence and resources to improve the social determinants of health, health outcomes and reduce health inequalities. This King's Fund event will explore what anchor institutions are, what they look like in practice and how we can embed some of those ways of working within health and care. We will look at how health and care organisations, working in partnership with other local anchor institutions, are leveraging their role as large employers and purchasers of goods and services and playing an active role in protecting the health, wellbeing and economic resilience of their local communities. Register
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