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Found 183 results
  1. Content Article
    Hospital command and control centres (CCCs) are central locations within a hospital where staff can coordinate and manage the response to emergencies, disasters and other critical events. They are also often used to track and monitor the location and status of hospital staff and resources, such as beds, equipment and supplies, in order to ensure that they are used efficiently and effectively. This blog by Sukhmeet Panesar, Chief Health Officer at Monstar Labs, acts as an introduction to CCCs in healthcare. It includes information on the different types of CCC, the benefits of CCCs and the challenges they may face.
  2. Content Article
    Many cross-sectional studies and reviews have demonstrated that higher registered nurse staffing levels are associated with better patient outcomes. The aim of this study was to identify and assess the evidence for an association between nurse staffing levels, including the composition of the nursing team, and patient outcomes in acute care settings from longitudinal studies.
  3. Content Article
    Peter Griffiths and Chiara Dall'Ora, in this BMJ Editorial, discuss the staffing shortages in the NHS and what needs to be done.
  4. News Article
    There is no significant relationship between the number of managers or the amount spent on management and the quality of NHS hospital services, research has concluded. Researchers at the London School of Economics studied the performance of all 129 non-specialist acute trusts between 2012-13 and 2018-19. They measured hospital performance on five indicators covering financial position, elective and emergency waiting times, level of admissions and mortality. This was then compared to the number of managers each trust employed and the amount spent on management staff. The researchers also attempted to measure the quality of management based on answers given to relevant questions in the annual NHS staff survey. Reviewing the evidence they analysed, the LSE team state: “We find no evidence of an association between our measures of quantity of managerial input and quality of management… Furthermore, we find no associations between our measures of quantity of management input and five measures of hospital performance.” They add: “This holds, irrespective of how we define managerial input, whether by number of managers or expenditure on management. These results are generally robust to how we account for variation between hospitals and within hospitals over time.” This leads the researchers to conclude: “Hospitals hiring more managers do not see an improvement in the quality of management leading to better performance, and increasing the numbers of managers does not appear to improve hospital performance through any other direct or indirect mechanism.” Read full story (paywalled) Source: HSJ, 17 January 2022
  5. News Article
    The national chief for the Covid vaccination programme has warned that the NHS cannot become a vaccination service every few months. Emily Lawson also told healthcare staff in a briefing on Wednesday: “I have fed back to the Department of Health yesterday that I think realistically we don’t have the capacity to do anything else new over the next two-and-a-half weeks. “And that when we plan for things and have the right lead-up to them, we deliver them more effectively, which in the end is very critical for public confidence.” Her warning comes after the government announced plans on Sunday to rapidly accelerate the national Covid vaccination programme by offering all adults a booster jab by the new year. On Monday, NHS England sent letters to hospital chiefs, GPs and local healthcare leaders setting out plans to speed up the programme, and said the first priority for primary care would be delivering vaccines. Healthcare leaders were told they could drop non-urgent care in efforts to support the vaccine drive, however specific details on what treatments can be dropped are yet to be finalised. Read full story Source: The Independent, 15 December 2021
  6. News Article
    Eight highly skilled intensive care (ICU) nurses have resigned from one trust in the past two weeks and more could follow, a leading nurse has warned. More resignations expected as working conditions remain unsustainable Belfast Health and Social Care Trust in Northern Ireland has confirmed it is redeploying non-specialist nursing staff to fill the gaps in staffing on ICU wards, with experienced ICU nurses expected to provide supervision. RCN Northern Ireland director Rita Devlin said the college has heard others at the trust are ‘considering their position’. "These are highly skilled nurses who are difficult to replace and this is a very worrying situation," she said. "Nursing staff are doing everything they can to keep services going, but it is not sustainable to work under such pressure for long periods of time without a break." The resignations come just months after it was revealed that 182 nurses and 50 healthcare assistants had quit their jobs at the trust between January and July. Read full story Source: Nursing Standard, 23 November 2021
  7. News Article
    Hospital chiefs in the South West have warned the region will not avoid the extreme pressures felt by other parts of the NHS amid rapidly rising numbers of COVID-19 inpatients. The region was the least affected area of England during the pandemic’s first wave, but the medical director of two acute trusts yesterday predicted a “tidal wave” of COVID-19 coming to the West Country. Adrian Harris, medical director at Royal Devon and Exeter Foundation Trust and Northern Devon Healthcare Trust (NDHT), said the region faced an “absolute crisis” and individual trusts would be “hanging on by their fingernails”. His comments, made at NDHT’s board meeting, came on the same day HSJ revealed the South West region now has the fastest growth in COVID-19 inpatients. Although the region is England’s least densely populated, it also has the lowest hospital capacity per capita in the country. Dr Harris said: “We hope and we pray that the lockdown has come in time for Devon. My personal view — and of my colleagues around the country — is that there’s a tidal wave of COVID-19 coming to the West Country." “We are preparing to be hit as hard as the East of England. If we are hit as hard, we will be hanging on by our fingernails and we are planning accordingly.” Read full story (paywalled) Source: HSJ, 8 January 2021
  8. News Article
    The government is being pressed to urgently pay care homes to take on thousands of patients from hospitals, many of which are on course to be overwhelmed by COVID-19 patients. Hospitals, particularly in London and the surrounding areas, are seeing very high and rapidly growing numbers of covid-19 admissions, and are running out of options to free up beds. Multiple senior NHS leaders said they need to discharge more patients to care homes, but that this had become increasingly difficult. Beds in many care homes are lying empty, but many care providers are refusing to accept residents where there is a risk of introducing covid-19 and fear of repeating the disaster of the spring in the sector. Part of the problem is some care providers which would otherwise become covid-designated homes say they are not insured for the risk of doing so. HSJ understands national officials in the NHS and government are now considering options to try to alleviate the problem, amid urgent requests from local NHS leaders, including paying for the additional insurance cost. However, sources said the Treasury had not yet been willing to foot the bill. Read full story Source: HSJ, 7 January 2021
  9. News Article
    A hospital trust in Bristol has been accused of risking lives after raising its patient-to-nurse ward ratio to dangerously high levels, having allegedly dismissed staff concerns and national guidance on safe staffing. University Hospitals Bristol and Weston NHS Foundation Trust (UHBW) has introduced a blanket policy across its hospitals that assigns one nurse to 10 patients (1:10) for all general adult wards. This ratio, which previously stood at 1:6 or 1:8 depending on the ward, rises to 1:12 for nights shifts. The new policy, which is applicable to Bristol Royal Infirmary (BRI) and Weston General Hospital, also extends to all specialist high-care wards, which treat patients with life-threatening conditions such as epilepsy and anaphylaxis. Nurses at the trust have expressed their anger over the decision, saying they were never fully consulted by senior officials. Many are fearful that patient safety will be compromised as the second coronavirus wave intensifies, culminating in the unnecessary loss of life. “Patients who would have extra nursing staff because they are very acutely unwell and need close observation I think are going to unnecessarily die,” one nurse at BRI told The Independent. “Or if they survive, they’ll suffer long-term conditions because things were missed as they don’t have the staff at their bed side to watch the deterioration.” Read full story Source: The Independent, 18 November 2020
  10. News Article
    A mental health unit where a patient was found dead has been placed into special measures over concerns about safety and cleanliness. Field House, in Alfreton, Derbyshire, was rated "inadequate" by the Care Quality Commission (CQC) following a visit in August. A patient died "following use of a ligature" shortly after its inspection, the CQC said. Elysium, which runs the unit for women, said it was "swiftly" making changes. The inspectors' verdict comes after the unit was ordered to make improvements, in January 2019. Dr Kevin Cleary, the CQC's mental health lead, said: "There were issues with observation of patients, a lack of cleanliness at the service and with staffing. "There were insufficient nursing staff and they did not have the skills and experience to keep patients safe from avoidable harm. Bank and agency staff were not always familiar with the observation policy." "It was also worrying that not all staff received a COVID-19 risk assessment, infection control standards were poor, and hand sanitiser was not available in the service's apartments." The CQC said a follow-up inspection on Monday had showed "areas of improvement" but it would continue to monitor the service. Read full story Source: BBC News, 22 October 2020
  11. News Article
    New research examining the effect of minimum nurse-to-patient ratios has found it reduces the risks of those in care dying by up to 11%. The study, published in The Lancet, also said fewer patients were readmitted and they had shorter stays in hospital. It compared 400,000 patients and 17,000 nurses working in 27 hospitals in Queensland, Australia to 28 other hospitals. The state has a policy of just one nurse to every four patients during the day and one to seven at night, in a bid to improve safety and standards of care. The research said savings made from patients having a shorter length of stay, which fell 9%, and less readmissions were double the cost of hiring the extra nurses needed to achieve the ratios. NHS England has resisted moves towards minimum nurse to patient ratios, suspended work by the National Institute for Health and Care Excellence (NICE) on safe nurse staffing in 2015. This came as the watchdog was preparing to call for minimum ratios in accident and emergency departments. It has advised that eight or more patients to one nurse is the point at which harm can start to occur. Read full story Source: The Independent, 12 May 2021
  12. News Article
    Just 10% of money allocated to help treat young people with eating disorders reached the NHS frontline, a new analysis has revealed. The latest data on NHS mental health spending comes amid concern the pandemic has exacerbated eating disorders in young people, sparking a rise in demand. A report commissioned by MPs compiled by the eating disorder charity Beat, using NHS data, shows local clinical commissioning groups (CCGs), who purchase NHS services on behalf of NHS England, spent just £1.1m of the £11m they were given for community eating disorder services in 2019-20. The money was set aside by NHS England to try and tackle increasing referrals and to ensure young people could get treatment. Wera Hobhouse MP, chair of the All-Party Parliamentary Group on Eating Disorders, and which commissioned the work said: “Eating disorders are serious mental illnesses, and we know that early intervention and access to specialist treatment saves lives." “NHS England has continued to allocate extra funding to clinical commissioning groups for children and young people’s community eating disorder services, but this report shows that much more needs to be done to ensure this money reaches the frontline services, particularly now as they face unprecedented numbers of referrals.” Read full story Source: The Independent, 11 May 2021
  13. News Article
    NHS maternity units have been told they have until next April to increase the numbers of midwives on wards to expected levels after a near £100 million investment. NHS England has told hospitals they must bring staffing levels for midwives up the levels needed to meet their planned demand from mothers and to ensure women get safe care. In a letter to NHS trusts, England’s chief nurse Ruth May said she expected hospitals to use their share of a recent £96 million investment by NHS England to boost staffing levels along with extra spending from local budgets. NHS England has carried out an analysis of demand and supply with Health Education England as part of a four year plan to boost the number of midwives. Hospitals are expected to set the level of midwives needed to deliver more one-to-one care and to try and ensure more than half of women see the same midwife throughout their pregnancy. Read full story Source: The Independent, 13 April 2021
  14. News Article
    A quarter of NHS workers are more likely to quit their job than a year ago because they are unhappy about their pay, frustrated by understaffing and exhausted by COVID-19, a survey suggests. The findings have prompted warnings that the health service is facing a potential “deadly exodus” of key personnel just as it tries to restart normal care after the pandemic. A representative poll of 1,006 health professionals across the UK by YouGov for the IPPR thinktank found that the pandemic has left one in four more likely to leave than a year ago. That includes 29% of nurses and midwives, occupations in which the NHS has major shortages. Ministers must initiate a “new deal” for NHS staff that involves a decent pay rise, better benefits, more flexible working and fewer administrative tasks, the IPPR said. “The last 12 months have stretched an already very thin workforce to breaking point. Many are exhausted, frustrated and in need of better support. If the government does not do right by them now, more many leave their jobs,” said Dr Parth Patel, an NHS doctor and IPPR research fellow who co-wrote its new report on how the NHS can retain and recruit more staff. Read full story Source: The Guardian, 30 May 2021
  15. News Article
    A hospital A&E department has been downgraded by regulators amid fears of “significant risk of harm” to patients after inspectors found some were crammed “head to toe” on trolleys during a surge in coronavirus cases. The Care Quality Commission (CQC) has told bosses at the Royal Oldham Hospital to urgently improve its A&E service after the November inspection found staff were not following infection rules and patients were at risk of catching the virus. The inspection confirms reports, revealed by The Independent last year, that patients in the A&E unit were being forced to wait close together for long periods. Whistleblowers from the trust said the practice was unsafe and the president of the Royal College of Emergency Medicine, Katherine Henderson, said it was a “potentially lethal” situation. The CQC visited the emergency department on 30 November after it said concerns were raised over the safety of patients. Read full story Source: The Independent, 10 February 2021
  16. News Article
    NHS England has asked hospitals across the country to open hundreds more intensive care beds so they can take in patients from the hardest hit areas, to prevent those patches having to ration access. A letter sent to dozens of acute trusts today by NHS England asks them to enact their “maximum surge” for critical care from tomorrow, opening up hundreds of beds, which will rely on them redeploying staff and cancelling more planned care. The letter is to trusts in the Midlands but HSJ understands a similar approach is being taken in the other regions where critical care is not currently under as much pressure as London, the East of England and the South East. The message to surge capacity to support a “national critical care service” was reinforced to trusts nationwide in a call with Keith Willett, NHS England covid incident director, also on Wednesday. The letter, from the NHSE Midlands regional team, said there had been a national request for the region to surge beyond its own needs to support London and the East of England. “Significant” numbers are likely to be transferred, HSJ was told. Read full story (paywalled) Source: HSJ, 13 January 2021
  17. News Article
    Patients are starting to suffer because health and care workers are unable to purchase fuel. The fuel crisis is starting to have an effect on the care of vulnerable patients, community and mental health service providers have warned. Many petrol stations are running short of fuel as a result of panic buying, after the oil firm BP warned that it would have to close some of its petrol stations because of the lack of lorry drivers. Currently there is a shortage of about 100,000 HGV drivers. Crystal Oldman, chief executive for the Queen’s Nursing Institute, which represents community nurses, told the journal HSJ that the fuel shortage was already affecting them: “This potentially means nurses cannot get to the patients they need to if they are unable to access fuel. At the very least, it will mean more time searching for petrol stations that have a supply, taking valuable time from their working day and more unpaid overtime will be undertaken as nurses will always prioritise their patient care.” Patient transport has also been affected. A source at a patient transport provider in the West Midlands told HSJ that it had been “a bit of a nightmare”. The provider had had to turn down a request for a patient going to London because of the fuel shortage and because of climate protesters disrupting motorway transport: “Ultimately those patients are either at home and distressed carrying a big risk in the community or [accident and emergency] departments which [are not] the right settings.” Read the full article here Source: Future Care Capital
  18. News Article
    New analysis published by the Health Foundation shows that while the waiting list for hospital care continues to grow, so too does the number of ‘missing' patients who have not yet been added to the list. There were 7.5 million fewer people referred for routine hospital care between January 2020 and July 2021 than would have been expected based on numbers prior to the pandemic. These ‘missing patients’ are in addition to the record 5.6 million people already on the waiting list. This lower than expected number of people referred for hospital care, including for routine procedures such as hip or knee surgery, is likely to be due to a number of reasons. Some people may not have sought treatment for health concerns during the pandemic, while others may have seen their GP but not yet been referred due to the pressure on hospital services during the pandemic. In some instances, care may no longer be needed. The analysis comes alongside a BBC Panorama documentary (Monday 27 September) revealing the scale of the elective care backlog and the impact delays are having on people’s lives. The Health Foundation analysis, shared with Panorama, also shows that the pandemic had a much worse effect on the hospital care provided in some areas of England than it did in others. The analysis of 42 local integrated care systems (ICSs) shows that the pandemic significantly reduced the level of routine hospital care performed across the country – in the worst affected area routine hospital care dropped by 37% while in the least affected area there was a 13% reduction. Read the full article here Source: The Health Foundation
  19. News Article
    More needs to be done to bring maternity units at a city's two main hospitals up to scratch, inspectors have said. In 2020 the Care Quality Commission (CQC) found serious concerns at Nottingham University Hospitals NHS Trust and labelled the units "inadequate". A new report concluded the trust still has "some areas to address". In October a coroner said the death of Wynter Andrews minutes after she was born was "a clear and obvious case of neglect". Nottinghamshire assistant coroner Laurinda Bower also revealed a 2018 whistle-blowing letter from midwives to trust bosses outlining concerns over staffing levels as "the cause of a potential disaster". In the same month "in response to concerns raised... and coronial inquests", the CQC carried out an unannounced inspection at the hospital and found some staff had not completed training and "did not always understand how to keep women and babies safe", and issued a warning notice over its concerns. Its latest report, based on an inspection in April, found improvements in the way women at risk of deterioration were identified and found documentation and monitoring had improved. However the CQC found a disconnect between online and paper record-keeping and said there were multiple systems in place that led to duplication and errors at times. Read full story Source: BBC News, 28 May 2021
  20. Event
    until
    The Safety for All campaign has organised this webinar in partnership with NHS Supply Chain and Patient Safety Learning. It will look at the challenges in healthcare supply chain and patient and staff safety. As we emerge from Covid restrictions, it is timely to look back and forward at the challenges facing the supply chain in healthcare, but also to ensure that safety for both patients and staff are prioritised amongst the other challenges facing the NHS and social care in the future. The webinar will be chaired by Jonathan Hazan, Chair of Patient Safety Learning, and will feature a keynote speech from the Chair of NHS Supply Chain, Heather Tierney-Moore. Heather will discuss Supply Chain’s role in supporting the NHS to deliver safe and excellent patient care, safety, sustainability, resilience and efficiency. This will be followed by a panel discussion with representatives from supply chain, patient safety, industry and the MHRA and a further session on how human factors need to be integrated into the process of delivering safety in healthcare. Finally, there will be a case study on a patient and staff safety issue in perioperative care and how better procurement can help deliver better care and safety in infection prevention. The webinar will be hosted on Microsoft Teams, join the webinar using this link. Full Webinar Programme
  21. Event
    until
    One of the great opportunities for ICSs may be around reducing future demand for healthcare by ensuring that people remain healthy or are helped to reduce the chances of deteriorating if they do develop an illness or long-term condition. Prevention and early intervention underlie much of the NHS Long Term Plan, with a recognition that the NHS can no longer simply be an “ill health” service and instead bends to think about prevention and reducing health inequalities. Many ICSs are keen to develop this role and bring together the organisations they represent – across both the NHS and local authorities –to work collaboratively on this. But with resources and time limited, they may need to concentrate their efforts on particular areas. The second wave of covid – and the prospect of widespread vaccination starting within weeks - has added a new dimension to this with an urgent need to reduce the pressure covid places on the NHS and on normal life in general. This webinar will ask: has covid helped focus the NHS’s eyes on prevention? where are the “easy wins” for ICSs where interventions are most likely to have significant results within a reasonable timeframe? what key steps do ICSs need to take to get the maximum benefit from these? How can they build common purpose among their members to ensure these happen? how can public health be made “business as usual” for everyone working in the NHS – including those in hospitals? how can ICSs balance the preventative interventions which deliver short-term benefits with those which take longer to offer a “return on investment”? Register
  22. Event
    The New Existence Webinar Series will take an in-depth look at The New Existence framework from The Beryl Institute. Helping to link core ideas and apply practices, each session in the series will focus on a key aim and corresponding actions of The New Existence. This webinar series will help to explore how lead together into the future of healthcare. The full webinar series is listed below. Webinars are scheduled from 2:00-3:00pm ET/1:00-2:00pm CT. Participants are not required to attend each webinar in the series. Click on a title below to register for the individual webinars in the series. Care teams Redefine and advance the integrated nature of and critical role patients and their circle of support play on care teams. January 28: Redefine the care team February 25: Invite and activate partnership March 25: Commit to care team well-being Governance & leadership Reimagine, redefine and reshape the essential role of leadership in driving systematic change. April 22: Create transparency across the healthcare ecosystem May 27: Restore and nurture confidence June 24: Transform healthcare in collaboration with diverse voices Models of care & operations Co-design systems, processes and behaviors to deliver the best human experience. July 22: Co-design intentional, innovative and collaborative systems August 26: Innovate processes of care to transform behavior Policy & systemic issues Advocate for equitable institutional, governmental and payor policies, incentives and funding to drive positive change. September 23: Hardwire human partnership in the healthcare ecosystem October 28: Research, measure and dismantle the structures and systems that lead to disparities November 23: Modernise the surveys and democratise the data
  23. Content Article
    With talk of tax cuts proving popular in the race to become the next Conservative party leader, and pay rise expectations significantly higher than budgets allow, the NHS could be caught in the crossfire of conflicting demands. Sally Gainsbury describes how the health service is already having to deal with Covid, alongside rising levels of demand for care, with substantially less money than before.
  24. Content Article
    The consultancy firm McKinsey & Company explored the effects of the Covid-19 pandemic on the nursing workforce in a global survey that included nurses from United States, the United Kingdom, Singapore, Japan, Brazil and France. The survey findings show a consistency around how nurses feel in their roles today, despite the different healthcare systems and delivery networks in each of the six countries. A substantial population of nurses are expressing a desire to leave direct patient care, with between 28% and 38% of nurse respondents in the United States, the United Kingdom, Singapore, Japan and France indicating that they were likely to leave their current role in direct patient care in the next year. This article explores in detail some of the reasons why nurses are choosing to leave direct patient care, and highlights approaches that might encourage retention, including positive leadership initiatives.
  25. Content Article
    The NHS in England is about to be reorganised. In April 2022, government passed the Health and Care Act 2022 – the biggest legislative overhaul of the NHS in a decade. The centrepiece of the legislation are integrated care systems (ICSs) – area-based agencies responsible for planning local services to improve health and reduce inequalities. From July 2022, England will be formally divided into 42 ICSs, covering populations of around 500,000 to 3 million people. ICSs have existed informally since 2016, but – until now – lacked formal powers. ICSs face a mammoth task. Staffing shortages in the NHS are chronic, record numbers of people are waiting for routine hospital treatment, and health inequalities in England are wide and growing. But these challenges are not evenly distributed between ICSs – and some systems are better equipped to deal with them than others. Policymakers have allowed some flexibility in how local systems have been developed and organised, which means they vary widely in size, structure, and other characteristics. In this long read, The Health Foundation analyses publicly available data on some of the characteristics of ICSs and context in each area – including the organisational and policy context, health challenges, and capacity within the health care system to address them. It compares areas and discusses implications for policy.
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