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News Article
Using temporary nurses can increase risk of patients dying, warns new study
Patient Safety Learning posted a news article in News
Patients are more likely to die on wards staffed by a high number of temporary nurses, a study has found. Researchers say the findings, published in the Journal of Nursing Scholarship, are a warning sign that the common practice by many hospitals of relying on agency nurses is not a risk-free option for patients. The University of Southampton study found that risk of death increased by 12 per cent for every day a patient experienced a high level of temporary staffing – defined as 1.5 hours of agency nursing a day per patient. For an average ward, this increased risk could apply when between a third and a half of the staff on each shift are temporary staff, according to Professor Peter Griffiths, one of the study’s authors. He told The Independent: “We know that patients are put at risk of harm when nurse staffing is lower than it should be. “One of the responses to that is to fill the gaps with temporary nursing staff, and that is an absolutely understandable thing to do, but when using a higher number of temporary staff there is an increased risk of harm. “It is not a solution to the problem.” Read full story Source: The Independent, 10 December 2019 -
News ArticleThe first publication of data from the Royal College of Emergency Medicine’s 2019-20 Winter Flow Project shows that existing data does not reflect the true scale of the problem of 12 hour stays in A&E. RCEM data shows that in the first week of December over 5,000 patients waited for longer than 12 hours in the Emergency Departments of 50 Trusts and Boards across the UK. The sample of trusts and boards from across the UK is the equivalent to a third of the acute bed base in England. From the beginning of October 2019 over 38,000 patients have waited longer than 12 hours for a bed at the sampled sites across the UK – yet data from NHS England reports that in England alone a total of only 13,025 patients experienced waits over 12 hours since 2011-12. President of the Royal College of Emergency Medicine, Dr Katherine Henderson said: “In a nine-week period, at only a third of trusts across the UK, we’ve seen nearly three times the number of 12 hour waits than has been officially reported in eight years in England. This must be fixed." Read full story Source: Royal College of Emergency Medicine, 9 December 2019
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Content ArticleKeren Levy was fit and healthy when she first felt pain in a molar. After numerous dentists and doctors left it untreated, there were knock-on effects throughout her body. Today she is in constant pain and look almost unrecognisable She went to the dentist a number of times but X-rays showed nothing untoward. However, Karen started to develop a horribly rotting taste and knew the tooth was necrotic. She begged her dentist to give her root canal treatment or extract it, but without a visible sign this was needed she was refused. Instead she was referred to her GP, implying her distress was bereavement due to her mother recently dying. Many months later, Keren was referred to a different dentist who gave her a 3D scan that showed the original tooth to be necrotic, as she had said five months before. Evidence of the infection was clear in the surrounding bone. Her dentist records that the delay in treating the original dental infection appears to have triggered a systemic response in my body’s autonomic or endocrine system. Having had perfect health, eventually I had to have 12 root canals; all those teeth were necrotic. Confronted by the facts, the first dentist Keren saw said that, had he been in his Athens surgery, he would have carried out a root canal on the original tooth. But here, in the UK, he had been concerned he could be held to account by General Dental Council (GDC) regulations, given the X-ray image had not been “definitive”. An editorial in the British Dental Journal (BDJ) as long ago as 2014 described a climate of “fear and distrust” that had led to defensive dentistry because of the prospect of legal action or disciplinary procedures if anything goes wrong. Karen's case is a horrific example of excessive diagnostic testing delay, instead of treatment. Months of referrals to neurologists, maxillo-facial specialists, psychologists, GPs, oral medicine departments and other dentists went against common sense and ensured responsibility could never be laid at a particular dentist’s door. Invariably, the first question was: “What did the last dentist say?”
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Content ArticleNigeria is projected to become one of the most populous countries in the world, and is rightly taking its place on the world stage. The Lancet Nigeria Commission tells the story of the country through a health lens, and details recommendations that will enable the country and its people to fulfil their potential, and seize the opportunity ahead. It has been led by Nigerians for Nigerians. The Commissioners call for the creation of a new social contract that redefines the relationship between citizen and state. They argue that health has, to date, been neglected by successive governments and consequently the citizens of Nigeria, and must be recentred as a vital investment in the population – one that will reap political and economic benefits. Nigeria is poised to define the future of West Africa, the African continent, and the whole world. This Commission lays out how best to realise that ambition.
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Content ArticleIn this article published by Economics By Design, Colin Lewry and Jacque Mallender argue that, despite recent history, treating healthcare staff as a cost and not an asset needs to be reversed when developing workforce plans and approaches in 2022.
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Content ArticleThe Covid-19 pandemic has rapidly accelerated a trend of decline in access to and outcomes in healthcare. This situation means that people who have the means to do so are opting for faster, private care, creating a two-tier healthcare system. However, IPPR polling shows that near-universal public support remains for retaining a universal, free, comprehensive and tax-funded NHS. The public highly values the principles of the NHS as a system that universalises the benefits of the best healthcare and shares the cost across the population. This report by The Institute for Public Policy Research (IPPR) think tank proposes policies based on three aims: recovery, building back better and increased sustainability facing an uncertain future.
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Content ArticleIf the NHS is to meet the challenges ahead, the people profession, which comprises human resources and organisational development practitioners, has a key role to play in shaping the future. This includes steering organisations towards the vision set out within the People Plan: more people, working differently, in a compassionate and inclusive culture. The Government recently announced that additional funding will be invested in the NHS over the next three years, funded by a new Health and Social Care Levy and a rise in dividend tax. The people profession – working alongside other decision-makers in the NHS – will have a key role in optimising available resources and maximising the value of taxpayer investment, to support recovery of routine services, to tackle waiting lists, and to deliver the care that NHS patients need. This report sets out a vision for how the people profession will develop and work differently over the coming decade. It draws on the diversity of voices from across the profession and beyond. It also sets out a roadmap for action.
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Content ArticleTCC-CASEMIX has created a unique infrastructure to provide total traceability of medical device performance. This infrastructure is supported by The Association of British HealthTech Industries [ABHI]. We refer to it as an 'Open Registry Infrastructure' for medical devices. It is 'open', because unlike existing clinically focused registries, which are 'closed', we enable wide searches across the registries connected into it. It is 'open' because registries will 'declare the content' (I don't know what I don't know, so how can I search for what I don't know?) Access to this infrastructure is through a Data Access Portal which is being configured for the specific needs of each stakeholder group. We are seeking interest from patient groups who would like to join an Advisory Board to help specify how data should be presented to patients in a way that is relevant and meaningful. Our vision is to link this portal into an enhanced pre-operative assessment process, and to transform patient informed consent.
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Content ArticleIntegrated care systems (ICSs) are geographically based partnerships that bring together providers and commissioners of NHS services with local authorities and other local partners to plan, co-ordinate and commission health and care services. They are part of a fundamental shift in the way the health and care system is organised – away from competition and organisational autonomy and towards collaboration, with health and care organisations working together to integrate services and improve population health. ICSs have been developing for several years – the Health and Care Bill will put them on a statutory footing from April 2022.
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Content ArticleIt 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.
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Content ArticleMany elective orthopaedic procedures were cancelled due to the Covid-19 pandemic and the number of patients on waiting lists for surgery is rising. This study looks at the disparities between inpatient and day-case orthopaedic waiting list numbers and the ‘hidden burden’ that exists due to reductions in elective secondary care referrals. The authors looked at elective procedures at a single District General Hospital in the UK between 1 April and 31 December 2020 and compared data with the same nine-month period from 2019. The study found: a 52.8% reduction in elective surgical workload in 2020 the total number of patients on waiting lists had risen by 30.1% in just 12 months inpatient waiting lists have risen by 73.2%, compared to a 1.6% rise in the day-case waiting list new patient referrals from primary care and therapy have reduced by 49.7%. The authors highlight the disparity between inpatient and day-case waiting lists and predict an influx of new referrals as the pandemic eases. They call for robust planning and allocation of adequate resources to deal with the backlog.
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Content ArticleSubstantial evidence indicates that patient outcomes are more favourable in hospitals with better nurse staffing. One policy designed to achieve better staffing is minimum nurse-to-patient ratio mandates, but such policies have rarely been implemented or evaluated. In 2016, Queensland (Australia) implemented minimum nurse-to-patient ratios in selected hospitals. In a study published in the Lancet, McHugh et al. aimed to assess the effects of this policy on staffing levels and patient outcomes and whether both were associated.
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Content Article
HPMA newsletters
Patient Safety Learning posted an article in Leadership for patient safety
The Healthcare People Management Association (HPMA) is the professional voice of HR in healthcare. Set up over 40 years ago, it has over 4,000 members ranging from HR directors and deputy directors through to trusts and CCGs. Its aim is to support and develop HR staff to improve the people management contribution in healthcare and ultimately improve patient care. -
Content ArticleThere is a prevailing popular belief that expenditure on management by healthcare providers is wasteful, diverts resources from patient care, and distracts medical and nursing staff from getting on with their jobs. There is little existing evidence to support either this narrative or counter-claims. Asaria et al. explore the relationship between management and public sector hospital performance. They found no evidence of association either between quantity of management and management quality or directly between quantity of management and any of the measures of hospital performance. However, there is some evidence that higher-quality management is associated with better performance. NHS managers have limited discretion in performing their managerial functions, being tightly circumscribed by official guidance, targets, and other factors outside their control.
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Event
SHOT: Transfusing wisely webinar
Patient-Safety-Learning posted an event in Community Calendar
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EventuntilThe concerns about the state and stability of the NHS were deeply entrenched before 2020 and then of course the pandemic hit. The additional pressures and longer waiting times for appointments and treatment have only grown following a time when the NHS staff have experienced stresses like they never have before. The situation has led to increased fears of privatisation and increasing staff shortages as so many seek work elsewhere. But where does this leave our national health service and what does the future hold for a life saving institution which is struggling to survive itself? Join the Independent’s latest panel discussion as part of our virtual event series where our health correspondent Rebecca Thomas will ask a panel of experts including Dr Alexis Paton, director at the Centre for Health and Society, Hannah Barham-Brown, a GP and also deputy leader of the Women’s Equality Party and Dr Suzanne Tyler, RCM's Executive Director, Trade Union, about how they think the NHS can be healed and how it’s future can be secured. Register for the event
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EventuntilThe health and care sector is undergoing fundamental change and facing profound challenges. As it continues to deal with the impact of Covid-19, which has exacerbated the workforce crisis and health inequalities, the Health and Care Act introduces changes to how health and care services are organised and delivered with the aim of integrating care for people in England. The King’s Fund annual conference 2022 will bring together leaders from across the health and care system. Through keynote speeches, panel debates and interactive workshops, you can join peers to explore the impact of current reforms on service delivery and share experiences of the reality of working on the ground in this complex and challenging system. The agenda provides a key opportunity to hear from influential speakers about an inclusive approach to recovery and the impact of integrated care systems (ICSs) in the six months since they have become statutory bodies. Amanda Pritchard, Chief Executive Officer at NHS England recently setting out her reflections on the wider challenges and opportunities for the NHS around the theme of the four Rs: recovery, reform, resilience and respect. The agenda provides a key opportunity to hear from influential speakers about what this approach means in reality, what capacity and resource a system which has been under severe strain has to meet these challenges, how we can practically work to ensure an inclusive approach. Register
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Community Post
Can the NHS learn from healthcare systems overseas?
Steve Turner posted a topic in Organisational
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Is it time to change the way England's healthcare system is funded? Is the English system in need of radical structural change at the top? I've been prompted to think about this by the article about the German public health system on the BBC website: https://www.bbc.co.uk/news/health-62986347.amp There are no quick fixes, however we all need to look at this closely. I believe that really 'modernising' / 'transforming' our health & #socialcare systems could 'save the #NHS'. Both for #patients through improved safety, efficiency & accountability, and by making the #NHS an attractive place to work again, providing the NHS Constitution for England is at the heart of changes and is kept up to date. In my experience, having worked in healthcare for the private sector and the NHS, and lived and worked in other countries, we need to open our eyes. At present it could be argued that we have the worst of both worlds in England. A partially privatised health system and a fully privatised social care system. All strung together by poor commissioning and artificial and toxic barriers, such as the need for continuing care assessments. In my view a change, for example to a German-style system, could improve patient safety through empowering the great managers and leaders we have in the NHS. These key people are held back by the current hierarchical crony-ridden system, and we are at risk of losing them. In England we have a system which all too often punishes those who speak out for patients and hides failings behind a web of denial, obfuscation and secrecy, and in doing this fails to learn. Vast swathes of unnecessary bureaucracy and duplication could be eliminated, gaps more easily identified, and greater focus given to deeply involving patients in the delivery of their own care. This is a contentious subject as people have such reverence for the NHS. I respect the values of the NHS and want to keep them; to do this effectively we need much more open discussion on how it is organised and funded. What are people's views? -
Content ArticleThis is the report of a review into how the executive leadership of the NHS could be better supported and empowered to ensure the best possible service is delivered for patients. Sir Ron Kerr was commissioned by the Department of Health and Social Care (DHSC) to conduct the review, which focused on three issues in particular: The expectations and support available for leaders - particularly those in challenging organisations and systems The scope for further alignment of performance management expectations at the organisational and system level The options for reducing the administrative burden placed on executive leaders The report describes the methodology of the review, outlines its findings and makes a number of recommendations around these issues.
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Content ArticleWhen 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.
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Content ArticleThe government’s long term workforce plan, developed by NHS England, was finally published on 30 June, having first been promised more than five years ago by the then secretary of state for health and current chancellor, Jeremy Hunt. The plan is a welcome and necessary step towards solving the workforce challenges that have vexed the health service, although it is more of a jigsaw puzzle than a masterplan. The overall picture of a future NHS workforce with many more staff, increasingly working in more diverse multidisciplinary teams, and with greater support from technology, is encouraging but several pieces are missing from the vision and roadmap for its delivery, writes William L Palmer and Rebecca Rosen in this BMJ Editorial.
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Content ArticleThe presentation was held following the inaugural William Rathbone X Lecture, given by Professor Alison Leary, who spoke on the highly topical subject, ‘Thinking differently about nursing workforce challenges.’ The presentation can be watched from The Queen's Nursing Institute website.
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Content Article
NHS Long Term Workforce Plan (30 June 2023)
Patient Safety Learning posted an article in NHS England
The first comprehensive workforce plan for the NHS, putting staffing on a sustainable footing and improving patient care. It focuses on retaining existing talent and making the best use of new technology alongside the biggest recruitment drive in health service history. -
Content ArticleThis report assesses why NHS hospitals are failing to deliver higher activity despite higher spending on the service and higher levels of staffing over the last couple of years. It argues that politicians need to urgently focus on capital investment, staff retention and boosting management capacity, and sets out key questions for policy makers to address if they want to solve the NHS crisis. The NHS has been on a longer-term negative trajectory: most of the challenges identified in the report existed before the pandemic and have been exacerbated since.
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Content ArticleThe King's Fund compared the healthcare systems in different countries by doing three things: Reviewed the research literature and assessed previous attempts to rank and compare health care systems. Interviewed academic experts in international health care policy and experts who had extensive knowledge of the UK, German and Singaporean healthcare systems. Analysed the latest quantitative performance data for the UK health care system and the health systems of 18 higher-income peer countries. They analysed data in three main domains: the context the health system operates in (eg, the health status and behaviours of the population) the resources a health system has (eg, levels of staffing, equipment and health care spending) how well the health care systems uses its resources and what it achieves as a result (eg, measures of efficiency in delivering services, quality of care, financial protection from the costs of ill health, and health care outcomes).
