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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. 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
  8. 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
  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. 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.
  11. 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
  12. 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
  13. News Article
    NHS People Plan provides a stop-gap but leaves glaring omissions 'Two years after it was first promised, the NHS is still waiting for a long-term workforce plan. Some of the measures announced in today’s People Plan are positive. As the plan acknowledges, it is important to learn from the impressive changes made by NHS staff during the pandemic. And improving support for people from black and minority ethnic communities – who make up one fifth of the NHS workforce – is rightly a top priority. 'But there are glaring omissions. The NHS went into the pandemic with a workforce gap of around 100,000 staff, yet the plan does not say how this will be addressed in the medium term. This is particularly concerning at a time when our recruitment of nurses from abroad has dropped dramatically. These details are missing because the NHS is still waiting on government to set out what funding will be available to expand the NHS workforce – without which the NHS cannot recruit and retain the doctors, nurses and other staff it needs. 'While this plan at least provides a stop-gap to help get the NHS through the winter, there is no equivalent plan for social care – a sector suffering from decades of political neglect and the devastating impact of COVID-19 on care users and staff. A comprehensive workforce plan for both the NHS and social care is needed now more than ever'.
  14. News Article
    "We are the NHS: People Plan 2020/21 – action for us all, along with Our People Promise, sets out what our NHS people can expect from their leaders and from each other. It builds on the creativity and drive shown by our NHS people in their response, to date, to the COVID-19 pandemic and the interim NHS People Plan. It focuses on how we must all continue to look after each other and foster a culture of inclusion and belonging, as well as take action to grow our workforce, train our people, and work together differently to deliver patient care. This plan sets out practical actions for employers and systems, as well as the actions that NHS England and NHS Improvement and Health Education England will take, over the remainder of 2020/21. It includes specific commitments around: Looking after our people – with quality health and wellbeing support for everyone Belonging in the NHS – with a particular focus on tackling the discrimination that some staff face New ways of working and delivering care – making effective use of the full range of our people’s skills and experience Growing for the future – how we recruit and keep our people, and welcome back colleagues who want to return The arrival of COVID-19 acted as a springboard, bringing about an incredible scale and pace of transformation, and highlighting the enormous contribution of all our NHS people. The NHS must build on this momentum and continue to transform – keeping people at the heart of all we do."
  15. News Article
    Nurses' leaders want all healthcare employers - including the NHS - to "care for those who have been caring" during the coronavirus crisis. The Royal College of Nursing (RCN) is calling for better risk assessments; working patterns and mental health care for those on the front line. It warns many may be suffering from exhaustion, anxiety and other psychological problems. The Department of Health and Social Care said support was a "top priority". The RCN has released an eight-point plan of commitments it wants to see enforced to mark the 100 days since the World Health Organization (WHO) declared a pandemic. Amongst its suggestions are a better COVID-19 testing regime for healthcare workers and more attention paid to the risks posed to ethnic minority nurses. It says employers and ministers "must tackle the underlying causes which have contributed to worse outcomes for Bame staff". Read full story Source: BBC News, 19 June 2020
  16. News Article
    Intensive care units (ICU) will be advised how to improve their staffing-to-patient ratios shortly as the number of patients admitted to hospital with COVID-19 falls across the country. In expectation that the pandemic would put intense pressures on ICUs, staff ratios were relaxed. NHS England told trusts to base their staffing models on one critical care nurse for every six ICU patients, supported by two non-specialist nurses, and one senior ICU clinician for every 30 patients, supported by two middle-grade doctors. Before the pandemic, guidance from the Faculty of Intensive Care Medicine recommended a ratio of one non-specialist nurse per patient. For senior clinicians the ratio was 1:10 New guidance, expected as early as next week, will encourage trusts to reduce the number of patients per ICU specialist nurses and senior clinicians on a localised basis as part of “transitional arrangements” aimed at moving staffing models back towards normal standards of care, HSJ has been told. The new guidance, drawn up by NHS England, the Faculty of Intensive Care Medicine and the British Association of Critical Care Nurses, will give trusts recommended staffing ratios based on the occupancy rates of their ICUs. It will tell trusts the existing ratios should be applied if their ICUs are running at four times their normal capacity. For ICUs running at double capacity, this ratio would be reduced to 1:2 for ICU nurses, and 1:15 for senior clinicians. Read full story Source: HSJ, 8 May 2020
  17. News Article
    The staff-to-patient ratios for intensive care are being dramatically reduced as the NHS seeks to rapidly expand its capacity to treat severely ill covid-19 patients, HSJ has learned. Acute trusts in London have been told to base their staffing models for ICU on having one critical care nurse for every six patients, supported by two non-specialist nurses and two healthcare assistants. Trusts have also been told by NHS England and NHS Improvement’s regional directorate to plan for one critical care consultant per 30 patients, supported by two middle grade doctors. The normal guidance is the consultant-to-patient ratio “should not exceed a range between 1:8-1:15”. Nicki Credland, chair of the British Association of Critical Care Nurses, confirmed the plans had been agreed today nationally. She told HSJ: “There will absolutely be a lot of concern about this in the profession, but it’s the only option we’ve got available. We simply don’t have the capacity to increase our staffing levels quickly enough." “It will dilute the standard of care but that’s absolutely better than not having enough critical care staff. There’s also a massive issue around the ability of critical care nurses not only to care for their patients but also monitor what the non-specialists in their teams are doing.” Read full story (paywalled) Source: HSJ, 24 March 2020
  18. News Article
    A major London hospital has declared a “critical incident” due to a surge in patients with coronavirus, with one senior director in the capital calling the development “petrifying”. In a message to staff, Northwick Park Hospital in Harrow said it has no critical care capacity left and has contacted neighbouring hospitals about transferring patients who need critical care to other sites. The message, sent last night and seen by HSJ, said: “I am writing to let you know that we have this evening declared a ‘critical incident’ in relation to our critical care capacity at Northwick Park Hospital. This is due to an increasing number of patients with Covid-19. “This means that we currently do not have enough space for patients requiring critical care. “As part of our system resilience plans, we have contacted our partners in the North West London sector this evening to assist with the safe transfer of patients off of the Northwick Park site” Read full story (paywalled) Source: HSJ, 20 March 2020
  19. News Article
    System leaders are telling hospitals to prepare for a potential suspension of all non-emergency elective procedures which could last for months, as they get ready for a surge in coronavirus patients. Senior sources told HSJ NHS England had asked trusts to risk stratify elective patients in readiness for having to suspend non-emergency work to free up capacity. HSJ understands trusts have been told to firm up their plans for how they would incrementally reduce and potentially suspend non-emergency operations, while also protecting “life saving” procedures such as cancer treatment. An announcement is expected soon, with patients affected given at least 48 hours notice. It has not been decided how long it might last for, as the duration of any surge in cases and acute demand is unknown. But HSJ has been told it could stretch out for several months, with three or four months discussed, which would potentially mean tens of or even hundreds of thousands of cancelled operations. Read full story (paywalled) Source: HSJ, 12 March 2020
  20. News Article
    NHS national leaders are set to reassure doctors they should not fear regulatory reprisals, within reason, if they end up working outside their areas of expertise during the coronavirus outbreak. HSJ understands the UK’s four chief medical officers and the General Medical Council are drafting a letter to be sent to all UK doctors, which will contain the reassurances, as the system braces for a sharp rise in covid-19 cases. The letter will also urge doctors to be flexible and not to resist new ways of working, with senior figures expecting many clinicians working in other specialities or locations during the outbreak. The letter will say doctors, while still expected to follow good medical practice, should not fear reprimand from their employers or national bodies such as the GMC, NHS England or other regulators. Read full story (paywalled) Source: HSJ, 11 March 2020
  21. News Article
    Third year undergraduate trainee nurses will be invited into clinical practice to support the coronavirus effort, while routine care quality inspections are “going to need to be suspended”, the Chief Executive of NHS England has said. Speaking at the Chief Nursing Officer’s summit event in Birmingham this morning, Sir Simon Stevens told delegates NHSE was working with the Nursing and Midwifery Council to “see how many of the 18,000 [relevant] undergraduates are available”. It is understood they would be paid, and follows government moves to pass emergency legislation to relax rules around working in healthcare. Asked about Care Quality Commission inspections during the outbreak, Sir Simon said: “There will be a small number of cases where it would be sensible to continue for safety related reasons… but the bulk of their routine inspection programmes is clearly going to need to be suspended and many of the staff who are working as inspectors need to come back and help with clinical practice.” Read full story (paywalled) Source: HSJ, 11 March 2020
  22. News Article
    NHS leaders have urged Boris Johnson’s government to build 100 new hospitals and give the service an extra £7bn a year for new facilities and equipment. They want the Prime Minister to commit to far more than the 40 new hospitals over the next decade that the Conservatives pledged during the general election. So many hospitals, clinics and mental health units are dilapidated after years of underinvestment in the NHS’s capital budget that a spending splurge on new buildings is needed, bosses say. Too many facilities are cramped and growing numbers are unsafe for patients and staff, they claim. Johnson has promised £2.7bn to rebuild six existing hospitals and pledged to build 40 in total and upgrade 20 others, although has been criticised for a lack of detail on the latter two pledges. The call has come from NHS Providers, which represents the bosses of the 240 NHS trusts in England that provide acute, mental health, ambulance and community-based services. Read full story Source: The Guardian, 3 February 2020
  23. News Article
    Critically ill children are being rushed from one part of England to another because NHS hospitals are running short of intensive care beds in which to treat them, the Guardian has revealed. An increase in severe breathing problems in children driven by winter viruses and infections, including flu, means some are having to be transferred sometimes many miles from their home area because there are not enough paediatric intensive care (PICU) beds locally. Specialist doctors who staff the units say the situation is “dangerous and rotten for the families” involved and that staff are firefighting to handle the number of children needing sometimes life-saving care, many of whom are on a ventilator to help them breathe. In the past few weeks, young patients have been sent from the Midlands to Sheffield, from London to Cambridge, and from one side of the Pennines to the other in order to get them a place in a PICU. One doctor at a PICU in the Midlands said: “PICU beds are always in high demand. But since winter hit this year, around six weeks ago, the situation feels like we are simply firefighting. Many days I come on shift to find there are no beds in [our] region and the patients referred to us end up in Southampton, Sheffield, Oxford and other centres far away." “The PICU network is overstretched. There aren’t enough beds, nurses or skilled doctors.” Read full story Source: The Guardian, 29 December 2019
  24. News Article
    Hospitals will be required to employ patient safety specialists from next April as part of efforts by the health service to reduce thousands of avoidable errors every year. NHS trusts will be told to identify staff who will be designated as the safety specialist for each organisation. These workers, who will get specific training and work as part of a network across the country, will help to tackle a fragmentation in the way safety issues are dealt with in the NHS and ensure nationwide action on key safety risks is coordinated. The proposals are part of a national patient safety strategy which is aiming to save 928 lives and £98.5m across the NHS, as well as reducing negligence claims by £750m by 2025. The specialists will be identified from existing staff, with part of the role focused on embedding a so-called “just culture” approach to safety. This means reducing blame, supporting staff who make honest errors and tackling systemic causes of mistakes. Read full story Source: The Independent, 26 December 2019 What do you think? Join the conversation on the hub.
  25. News Article
    Nurses in Northern Ireland have announced their plans for further strike action in the new year. Earlier this month, more than 15,000 nurses took to the picket lines over pay and staffing levels. It was the first time in the 103-year history of the Royal College of Nursing (RCN) that its members had taken such action. It has announced nurses will strike on 8 January and 10 January 2020, unless a resolution is reached. Read full story Source: BBC News, 24 December 2019
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