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Content ArticleAhead of the government's medium-term fiscal plan, the annual Institute for Government/Chartered Institute of Public Finance and Accountancy (CIPFA) public services stocktake reveals that public services won’t have returned to pre-pandemic performance by the next election, which in most cases was already worse than when the Conservatives came to power in 2010. Performance Tracker reviews the state of nine public services – general practice, hospitals, adult social care, children’s social care, neighbourhood services, schools, police, criminal courts and prisons – and their comparative and inter-connected problems.
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Content ArticleWith emergency departments beyond capacity throughout the country, some hospitals have been trialling an approach of moving a set number of patients into inpatient wards each hour, regardless of bed availability. Is this a viable solution to the problems faced throughout the system? Dr Louella Vaughan assesses the evidence and argues for further caution before rolling out such a model.
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Content Article
The Social Care Institute for Excellence (SCIE) and Think Local Act Personal have been facilitating a Community of Practice (CoP) for commissioners looking to work with co-operatives and community businesses. The CoP brings together nine local councils with a shared ambition to move away from large scale ‘time and task’ home care. This report details learnings from phase one of the CoP which has concentrated on sharing the ambition, opportunities, risks and barriers to developing community businesses and co-operatives. -
Content ArticleDespite the constant pressures and chronic shortages, the number of nurses leaving the NHS had flatlined over recent years. Now our analysis of new data shows there has been a large increase in nurses leaving the NHS, and that this trend is being driven by younger workers. The last year's data (June 2021 - June 2022) saw a 25% increase in the number of NHS nurses leaving their role, with an additional 7,000 leaving compared to the previous year. The largest increase in numbers leaving was seen among the younger nurses, two thirds of leavers were under 45 years of age. In this article, Jonathon Holmes explores why there is a sudden increase in vacancies.
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Content ArticleThe National Association for Healthcare Quality® (NAHQ) has conducted research on the advancement of the quality and safety agenda and has published the results in a new workforce report. NAHQ’s Healthcare Quality and Safety Report answers the question: “Is today’s healthcare workforce doing the work that will advance clinical priorities of quality, safety, equity, value, and system sustainability?”
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Content ArticleNursing is the single largest profession in the NHS, but it suffers from substantial staffing shortages. This analysis from Billy Palmer and Lucina Rolewicz for the Nuffield Trust reflects on the rate at which the health service is losing nurses, and considers the reasons why.
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Content ArticleThe number of people waiting for NHS treatment in England has risen rapidly during the Covid-19 pandemic, with more than 6.8 million people waiting for treatment in July 2022. Read the Institute for Fiscal Studies' analysis of NHS waiting lists.
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Content ArticleElderly people in care homes in Cornwall were abused and neglected while failings led to reports of concerns not being investigated, a new Safeguarding Adults Review has found. The Morleigh Group, which operated seven homes in Cornwall and has since shut down, was exposed in a BBC Panorama investigation in 2016. A new Safeguarding Adults Review which was commissioned as a result of the TV show has been published making a number of recommendations to all agencies which were involved in the case. The review was completed in April 2019 but has only just been made public - Rob Rotchell, Cornwall Council Cabinet member for adult social care said that this was due to the number of agencies being involved.
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Content ArticleThis report, from Deloitte, examines how the healthcare workforce is responding to the inexorable rise in demand for healthcare and the challenge of meeting this demand with the right numbers of appropriately skilled staff. It provides actionable insights and evidence-based case solutions to these challenges.
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Content ArticlePatient Safety Learning’s formal response to the Health and Social Care Committee inquiry report Delivering core NHS and care services during the pandemic and beyond, which calls for urgent action to assess and tackle a backlog of appointments and an unknown patient demand for all health services, specifically across cancer treatments, mental health services, dentistry services, GP services and elective surgery.
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Content ArticleUrgent action is needed in the NHS to meet a ballooning backlog of procedures put on hold during the pandemic and build a more resilient health care system. This report from Reform, produced jointly with Edge Health, shows the scale of the challenges the NHS faces: 6 million fewer patients were referred to treatment in 2020 than in 2019 • 10 million patients could be on a waitlist by April By April, 52-week waits for care are projected to have risen 12,008% since March 2020 (by December they had already risen by 7139%) Cancellations of diagnostic testing and delayed treatment may lead to 1,660 extra deaths from lung cancer alone.
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Content ArticleWhile individual countries have gained considerable knowledge and experience of COVID-19 management, an international, comparative perspective is lacking, particularly regarding the measures taken by different countries to tackle the pandemic. This paper from Tartaglia et al. elicits the views of health system staff, tapping into their personal expertise on how the pandemic was initially handled.
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Content ArticleThe scale of the challenge facing the NHS after the first wave of COVID-19 in England is only just coming to light. The NHS adapted at speed to redeploy staff, change estate configurations, reduce non-COVID-19 face-to-face appointments and redesign patient pathways. The deployment of the NHS physician workforce provides an insight into the NHS response. In the middle of May, 32% of Royal College of Physicians (RCP) members reported working in a clinical area that was different from their normal practice.By the start of June this had reduced by 10% to 22%, but that still means one-fifth of the workforce were working outside their usual area. This has knock-on effects for patients and the resumption of services. The RCP, in partnership with our specialist societies, has been working with NHS England to plan specialty-specific restart activity. This is based on different scenarios regarding specialty capacity across the country, and the impact of COVID-19 is being felt unevenly. Consultants in respiratory medicine and gastroenterology expect it to take 2 years to recover from the backlog created by COVID-19, while those in cardiology are expecting it to take 18–21 months. Providing accurate estimates and projections about what the next 12 months hold for the NHS is difficult, as we can’t be certain about whether there will be future outbreaks and waves of COVID-19. This report highlights just why it is so important that the government, the NHS and politicians openly discuss the significant unmet need in the patient population.
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Content ArticleThis study, published in BMJ Open, aimed to review the empirical literature to identify the activities, time spent and engagement of hospital managers in quality of care.
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Content ArticleHealth and social care faces a conflict between safe and appropriate staffing and the (government) directive to be cost efficient. In a time of clinical and support staff shortages, increasing demand for services and financial austerity, there is a need for a consistent approach to workforce analysis, benchmarking and planning across the health and social care to enable informed decision-making across finance, HR and nursing management to put the patient and their safety at the centre of all we do. 'Establishment Genie' is an online workforce planning, safe staffing and benchmarking tool. It has been co-developed and tested with more than 300 teams across acute, community, residential care, hospice and independent providers of care. This has been supported by input from NHSE, NHS Professionals, The Florence Nightingale Foundation, Safe Staffing Alliance, Royal College of Nursing, Health Education England, Queen’s Nursing Institute and academic nurse staffing experts.
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Content ArticleThe Clinical Excellence Commission in New South Wales, Australia, is driving person-centred care by stimulating districts to compete to provide it. Karen Luxford and Stephanie Newell describe the integrated approach, its uptake, and encouraging early evidence of change.
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Content ArticleWe tend to think of burnout as an individual problem, solvable by “learning to say no,” more yoga, better breathing techniques, practicing resilience — the self-help list goes on. But evidence is mounting that applying personal, band-aid solutions to an epic and rapidly evolving workplace phenomenon may be harming, not helping, the battle. With “burnout” now officially recognised by the World Health Organization (WHO), the responsibility for managing it has shifted away from the individual and towards the organisation.
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Content ArticleThis article, published by Forbes, looks at the airline industry and discusses the value in not only studying what pilots do wrong, but also what they do right. This can be translated into healthcare, we know lots about what has gone wrong in healthcare but not so much about the small, quiet things that go right. 'In aviation safety, it’s like we’ve been trying to learn about marriage by only studying divorce.' Written by Kirsty Kiernan a professor at Embry-Riddle Aeronautical University who teaches and conducts research in unmanned systems and aviation safety.
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Content ArticleIn this blog published in the New York Times, Theresa Brown explains why American healthcare has become one giant workaround. "The nurses were hiding drugs above a ceiling tile in the hospital — not because they were secreting away narcotics, but because the hospital pharmacy was slow, and they didn’t want patients to have to wait." These 'work arounds ' pose a significant patient safety risk. What work around problems do you have in your department? Theresa Brown is a clinical faculty member at the University of Pittsburgh School of Nursing.
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Content ArticleTransport of patients from the intensive care unit (ICU) to another area of the hospital can pose serious risks if the patient has not been assessed prior to transport. The Department of Critical Care Medicine, Calgary Health Region, experienced two adverse events during transport. A subgroup of the Department's Patient Safety and Adverse Events team developed an ICU patient transport decision scorecard. This tool was tested through Plan-Do-Study-Act cycles and further revised using human factors principles. Staff, especially novice nurses, found the tool extremely useful in determining patient preparedness for transport.
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Content ArticleThis is the fourth annual NHS workforce trends report published by the Health Foundation. In it, they analyse the changes in the size and composition of the NHS workforce in England in the context of long-term trends, policy priorities and future projected need.
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Content ArticleThere are a number of fundamental weaknesses in governance around patient safety and the quality of care at Cwm Taf Morgannwg University Health Board, a joint review by Healthcare Inspectorate Wales (HIW) and the Wales Audit Office found. Following well-publicised concerns about maternity services at the Health Board, the joint review examined the organisation’s overall approach to quality governance. It found that whilst there has been a strong focus on financial balance and meeting key targets, less attention has been paid to the overall quality and safety of its services. The report highlights the need for stronger and broader leadership in respect of quality and patient safety and worryingly, points to a culture of fear and blame in some parts of the organisation that has prevented staff from speaking out and raising concerns.
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Content ArticleIn 2016, medical error was reported as the third greatest cause of death. The introduction of ergonomic science into healthcare will help overcome this; however, healthcare frameworks are resistant to change, particularly ergonomic initiatives. The PatientSafe Network exists to address this.
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Content Article
Freedom to Speak Up Guardian job description (March 2018)
Claire Cox posted an article in Speak Up Guardians
This is the Freedom to Speak Up Guardian job description. Use it for reference or for a template to advertise for a Freedom to Speak Up Guardian in you trust/sector. -
Content ArticleThis improvement resource set out by the National Quality Board is to help standardise safe, sustainable and productive staffing decisions in maternity services. This is an improvement resource to support staffing in maternity settings. It describes the principles for safe maternity staffing across the multiprofessional team to ensure women and their families receive joined-up care appropriate to their needs and wishes. The purpose of this resource is to help providers of NHS-commissioned services, boards and executive directors to support their head/director of midwifery and other lead professionals in implementing safe staffing for maternity settings. NHS provider boards are accountable for ensuring their organisation has the right culture, leadership and skills for safe, sustainable and productive staffing.
