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Showing results for tags 'Safe staffing'.
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Content ArticleThis paper asked healthcare workers who are considered to be theatre safety experts—theatre managers, matrons and clinical educators—to take part in the second round of a Delphi study. These individuals work at the coalface in operating theatres and deliver the surgical safety checklist daily. It addresses information raised as part of a Delphi study of NHS hospital operating theatres in England. The aim of the second Delphi study round was to establish the views of theatre users on the theatre checklist and local safety standards for invasive procedures. Likert scale responses and a combination of closed and open-ended questions solicited specific information about current practice and researched literature that generated ideas and allowed participants freedom in their responses of how the World Health Organisation’s (WHO's) Surgical Safety Checklist (SSC) is currently being used in the peri-operative setting as part of a strategy to reduce surgical ‘never events’. The paper is part of a literature review undertaken by the author towards a Doctor of Philosophy (PhD). Read the findings of round one of the Delphi study
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News Article
Hospitals in England pay £5,200 for one agency doctor's shift
Patient Safety Learning posted a news article in News
Hospitals in England have paid out as much as £5,200 for a shift by a doctor through an agency, according to figures obtained by Labour through Freedom of Information requests. That is the latest in an intensifying debate over workforce shortages in the NHS in England. Labour blamed the high agency fees on Conservatives, arguing they had failed to train enough doctors and nurses. A Conservative spokesperson said "record numbers" had been recruited. The most expensive reported shift was £5,234 - paid by a trust in northern England. This covers the agency fee and other employer costs as well as the money going to the doctor. The NHS Confederation said the "staffing crisis" was so "desperate" that NHS trusts were being forced to pay large fees to make sure rotas were "staffed safely". Matthew Taylor, chief executive of the NHS Confederation, said: "Trusts are having to breach the caps on how much they pay for agency doctors because of the extremely high levels of demand they are facing for their services. "The staffing crisis is so desperate that they either pay these fees or find that their rotas cannot be staffed safely, leading to reduced services for patients. This is particularly true in parts of the country where the NHS can struggle to recruit new staff." Read full story Source: BBC News, 12 December 2022 -
Content Article
Pulmonary embolism is the third most common cause of cardiovascular death worldwide after stroke and heart attack. Although life-threatening, when diagnosed promptly survival rates are good. This report, authored by risk expert Tim Edwards and published by Patient Safety Learning, highlights serious and widespread patient safety concerns relating to the misdiagnosis of pulmonary embolisms. Drawing on existing data, freedom of information requests and his mother’s case, he outlines nine calls for action to improve pulmonary embolism care. -
Content ArticleThis briefing paper, from the Royal College of Radiologists, was produced to help inform an adjournment debate in the house of commons focusing on pulmonary embolism misdiagnosis. The briefing highlights concerns around staffing gaps, workforce planning and equipment shortages within this area, and the threat this poses to patient safety.
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Content ArticleThis article looks at the potential to use the continuous flow model to tackle unprecedented levels of overcrowding in emergency departments. The continuous flow model, also known as full capacity protocols, was first introduced in North America in the late 1990s. It mandates that a set number of patients are moved at set times from the emergency department to inpatient wards, regardless of whether a bed is available. This might mean putting an extra patient in a bay or two patients in a side room or boarding them in hospital corridors. In turn, this encourages wards to discharge existing patients, allows ambulances to offload new patients in the space created in the emergency department, and relieves pressure on the whole system. This article looks at the fact that evidence to support the continuous flow model is scarce, although positive, and that there are a number of important factors to consider before implementing the model, to ensure that it does not result in increased patient harm.
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Content ArticleThe King’s Fund and Engage Britain commissioned Bill Morgan, a former Conservative special adviser, to explore what can get in the way of ministers taking meaningful, long-term action to address NHS workforce shortages. In this report, he focuses on the role of politicians in workforce planning and delivery. The report sets out the scale of the workforce crisis and the impact that it has. It also considers the political reasons around why it has been so hard to fix and considers three factors that could contribute to tackling the current shortages: Transparency in workforce forecasts The establishment of an independent workforce-planning organisation Accepting the NHS’s historical reliance on recruitment from outside the UK as explicit future policy and planning accordingly
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Content ArticleHealthcare sector strikes are a relatively recent phenomenon, becoming notable only in the last half of the twentieth century. In this article, Spanish medical ethics expert Gonzalo Herranz, from the Bioethics Department at the University of Navarra, examines the ethical issues and legal implications associated with healthcare worker strikes, as well as looking at the moral duty to try and prevent strikes.
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Content ArticleIn this blog, journalist David Hencke shares his views on the ruling of Judge Anne Martin in the case of NHS whistleblower Dr Chris Day. He argues that Judge Martin was determined to find in favour of Lewisham and Greenwich NHS Trust, glossing over the disclosure of the deliberate destruction of 90,000 emails and the use of false evidence by the Trust. She discredited the evidence of Dr Day’s witnesses, including the present Chancellor of the Exchequer, Jeremy Hunt and two senior medical experts, on the basis that they were biased.
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Content ArticleThis article for Vogue explores the experience of a midwife working in an overstretched maternity unit in England. Melissa Newman, who has been a midwife for nearly six years, highlights the impact of staff shortages on midwives—she describes how she does not have time to eat, avoids drinking because she will not have time to go to the toilet, and sometimes works fifteen hours without any break. She calls on the Government for more funding to fix the crisis facing NHS maternity services, and the NHS more widely.
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News Article
End rules stopping thousands of doctors working in GP surgeries, says GMC chief
Patient Safety Learning posted a news article in News
Thousands of doctors are being prevented from working in overstretched GP surgeries across the UK because of unnecessary “red tape”, leaving NHS patients experiencing “unprecedented” waits for care, the head of the doctors’ regulator in the UK has said. Charlie Massey, the chief executive of the General Medical Council, said barriers that stopped medics from being deployed to meet areas of high demand, such as in primary care, must be removed urgently if the NHS workforce crisis was to be resolved and access to care improved. “Red tape is stopping the UK from making the most of many of its skilled and experienced doctors,” he said. “Without action, patients will suffer.” The regulator will on Tuesday call for a relaxation of rules so the fastest-growing part of the medical workforce – skilled doctors in non-training roles – can undertake a wider range of work beyond hospitals, such as in GP surgeries. “There are no easy answers to the challenges facing the NHS. There is no army of new doctors coming over the horizon, so part of the solution must be to make sure that we have more doctors in the places that patients need them,” Massey said. “The government should make a start immediately by changing the performers list criteria so more doctors are allowed to work alongside GPs. That needs to be done urgently. “But beyond technical changes there is also a need for fresh thinking in the way our health services are structured and in how teams of health professionals work together. We can’t keep doing things the same way they have always been done, or nothing will change." Read full story Source: BBC News, 18 October 2022 -
Content ArticleThis article published by the Royal College of Nursing (RCN) aims to explain how health services in the UK protect patient safety during industrial action by nurses. It describes the principle of derogations, an exemption from taking part in strike action given to particular RCN members or services. Any RCN industrial action must follow the life-preserving care model. This exempts: emergency intervention for the preservation of life or the prevention of permanent disability. care required for therapeutic services without which life would be jeopardised or permanent disability would occur. urgent diagnostic procedures and assessment required to obtain information on potentially life-threatening conditions or conditions that could potentially lead to permanent disability. The article goes on to explain the process by which derogations are granted, and talks about balancing the need to maximise the impact of the strike while keeping patients safe.
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News Article
Four of UK’s top countries for nurse recruitment on WHO ‘red list’
Patient Safety Learning posted a news article in News
Three of the top seven countries from which the UK recruits overseas nurses are on the World Health Organization’s (WHO) ‘red list’ where active recruitment should not be used. Nigeria, Ghana and Nepal are the third, fifth and seventh highest respectively in the list of countries that provided the largest number of overseas staff joining the Nursing and Midwifery Council (NMC) register between April 2021 and March 2022. All three were on the red list during this period, which is derived by the WHO and identifies countries facing the most pressing health workforce shortages, meaning they should not be targeted for systematic recruitment by international employers. Nepal has since moved off the red list following of a government-to-government agreement between the Department of Health and Social Care (DHSC) and the Government of Nepal in the summer. But the agreement has raised concerns among health leaders, including those reported in The Observer which suggested Nepali recruitment agencies carried out abusive practices, such as charging illegal fees. Royal College of Nursing general secretary and chief executive Pat Cullen said the “overreliance” on international recruitment showed that the government had “no grip on the nursing workforce crisis”. “It’s deeply concerning that four ‘red list’ countries appear amongst the top 20 most recruited from countries,” she said. “This approach is unsustainable. Ministers must invest in growing the domestic nursing workforce. “They need to give nursing staff the pay rise they deserve to retain experienced nurses and attract new people to the profession.” Read full story Source: Nursing Times, 4 October 2022 -
Content ArticleIn this blog for The House, Jeremy Hunt MP outlines how tackling long-term challenges in the health system will improve staff morale. While celebrating some short-term measures announced by the new Health Secretary Thérèse Coffey, he argues that longer term reforms are needed to "break the cycle of long waits, burned-out staff and declining standards." The key priority he outlines is workforce reform, including workforce projections and investment in training new healthcare workers for the future. He suggests that this will also encourage NHS staff to remain in their roles by restoring trust and confidence.
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News Article
Record number of NHS staff hand in resignation
Patient Safety Learning posted a news article in News
The latest NHS workforce figures have shown that a record number of staff voluntarily resigned from their jobs during the first quarter of this financial year. According to the data, almost 35,000 NHS workers resigned voluntarily, which was up from 28,105 during the same period in 2021, and 19,380 in 2020. It is also higher than in any equivalent first quarter over the last 10 years. The most common reason for leaving during quarter one of 2021-22 was ‘work-life balance’, with almost 7,000 NHS workers citing this as their reason for leaving their jobs. Close to 2,000 NHS workers also left in the same period in search of a ‘better reward package’, with almost 1,000 reporting ‘incompatible working relationships’. In it unclear from the NHS digital data whether they left the NHS altogether. Read full story (paywalled) Source: HSJ, 3 October 2022 -
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 ArticleMost of the contact that people have with the NHS is with general practice: there are an estimated 300 million appointments each year. These services provide the first step in diagnosing and treating most patients’ health conditions. Due to changes in the data, trends in general practice staff are limited to 2015 at the earliest. The data do not include staff working in prisons, army bases, educational establishments, specialist care centres including drug rehabilitation centres and walk-in centres. From July 2019, primary care networks (PCNs) will offer services to patients and employ new specialist staff such as clinical pharmacists, social prescribing link workers, physiotherapists, physician associates and paramedics. NHS Digital has started to publish information on the PCN workforce, but the data does not presently cover all PCNs. Based on the PCN data that is available, the Nuffield Trust has estimated the number of certain primary care staff groups employed by PCNs across England,.
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Content ArticleThe Francis Inquiries in 2010 and 2013 highlighted nurse staffing as a patient safety factor contributing to the care failings identified at Mid Staffordshire NHS Trust. The reports and government response led to the development of national ‘safe staffing’ policy. This two-year study by the University of Southampton and Bangor University examined the impact of safe staffing policies nationally and explored variation in local responses. The authors concluded that: Policies provided leverage and raised the profile of nursing workforce issues at board level, contributing to a willingness to invest in increasing nursing numbers. However, a lack of assessment of the likely scale of investment (and human resources) required nationally to achieve ‘safe staffing’ led to financial considerations becoming a barrier to achieving the policy vision. External pressures, such as lack of workforce supply and reduced access to temporary staffing, have constrained Trusts’ abilities to fully implement policies aimed at ensuring safe staffing on acute wards.
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News Article
GPs warn of ‘tsunami of demand’ this winter as patient contacts surge 200%
Patient Safety Learning posted a news article in News
GPs have warned of a ‘tsunami of demand’ this winter as patient contacts surged 200% during the pandemic. One of the largest GP providers in the UK, Modality Partnership, told The Independent it received 4.8 million calls from patients in one year alone with around a quarter going unanswered every day. The provider, which covers 500,000 patients across the country, said its practices were now working above “safe levels” with 50 appointments a day per GP, far higher than the 35 advised by the British Medical Association. Speaking with The Independent, Vincent Sai, chief executive and partner at Modality said the new health secretary Therese Coffey must “not point fingers” and “not find a scapegoat” as “every part of the system is under pressure. Every player in the health system is under the cosh.” Dr Sai said: “We believe patient contacts have increased 200 per cent, over the last few years. The expectation is that GP practices have maybe four to five patient contacts per year, but if you just look at just the number of phone calls alone, it’s showing that it’s much more now. “So something is broken somewhere...there’s more work, there are fewer people. People say I can’t get access to my GP and the hypothesis is they’re just lazy and not working, but it’s not the case.” Read full story Source: The Independent, 7 September 2022 -
News Article
Ministers to make it easier for foreign nurses and dentists to work in NHS
Patient Safety Learning posted a news article in News
Ministers will introduce legislation as soon as parliament returns on Monday to tackle the NHS’s worsening staffing crisis by making it easier for overseas nurses and dentists to work in the UK. The move is part of a drive by the health secretary, Steve Barclay, to increase overseas recruitment to help plug workforce gaps in health and social care. Barclay believes thousands of extra health professionals will come as a result of new rules making it easier for medical regulators to register those who have qualified abroad. If the change proves successful it will help pave the way for more nurses and dentists coming to work in Britain from countries such as India, Sri Lanka, Kenya, the Philippines and Malaysia. However, critics claim the policy is a stop-gap that is no substitute for ramping up the supply of homegrown staff and risks worsening the lack of health workers in other countries that are struggling with shortages of their own. Read full story Source: The Guardian, 5 September 2022 -
Content ArticleThe NHS often appears to be in a state of permanent crisis. Recently, there've been headlines about long waiting times for ambulances and the huge backlog for routine surgery. Before that, the NHS faced a two-year pandemic which may rear its head again this winter. But the NHS also has a big underlying problem that it has tens of thousands of vacancies for doctors, nurses and other medical workers – and that makes all the other pressures on the NHS even harder to handle. So why does the NHS have a staffing problem? And what can be done to fix it?
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News Article
NHS vacancies in England at ‘staggering’ new high as almost 10% of posts empty
Patient Safety Learning posted a news article in News
The number of posts lying vacant across the NHS in England has reached a “staggering” record high of 132,139 – almost 10% of its planned workforce. The number at the end of June was up sharply from three months earlier when there were 105,855 vacancies, quarterly personnel figures show. NHS leaders said the huge number of empty posts showed why the health service is in a state of deepening crisis, with patients facing long waits for almost every type of care. The previous highest number of vacancies for full-time-equivalent staff was 111,864, recorded at the end of June 2019. The new number represents 9.7% of the NHS’s planned staffing levels – a new high. As recently as March 2021 there were 76,082 vacancies. Danny Mortimer, the chief executive of NHS Employers, said: “These figures paint a bleak picture. A jump in nearly 30,000 staff vacancies – equivalent to the entire staffing of a large NHS hospital – show an alarming trend across the NHS of rising levels of vacancies.” Read full story Source: The Guardian, 1 September 2022 -
Content Article“The National Health Service and the adult social care sector are facing the greatest workforce crisis in their history”, said Parliament’s Health and Social Care Select Committee in July. The aspirations to rebuild services post-Covid, and tackle rising waiting times and other access challenges, are limited by the same challenge: there are simply not enough staff, writes Richard Murray in this article for the Independent.
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Content ArticleThis report by the Institute for Fiscal Studies (IFS) looks at which staff are more likely to leave the NHS acute sector. There is still little analysis available on the reasons why staff leave the NHS, but increasing our understanding of the complex factors that cause people to leave the health service would allow the NHS to develop more effective retention strategies. The report uses the Electronic Staff Record, the monthly payroll of directly employed NHS staff, to analyse the leaving rates of consultants, nurses and midwives, and health-care assistants (HCAs) between 2012 and 2021. The authors highlight that many other factors that influence retention remain unknown, and much more research is needed in this area.
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Content ArticleThis study in BMJ Open examines the impacts of the four episodes of industrial action by English junior doctors in early 2016. The authors looked at the impact of the strikes on A&E visits, outpatient appointments and cancellations, admitted patients and all in-hospital mortality. The study concluded that industrial action by junior doctors during early 2016 had a significant impact on the healthcare provided by English hospitals. It also found that t here were regional variations in how these strikes affected providers, and that there was not a measurable increase in mortality on strike days.
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News Article
Liz Truss: I’ll halt NHS doctor exodus
Patient-Safety-Learning posted a news article in News
Liz Truss has pledged to halt the exodus of doctors from the NHS to tackle the Covid backlog and surging waiting lists. The frontrunner in the Conservative leadership race is planning to unveil a series of radical reforms that will stop doctors from retiring early and entice retirees to return. One in 10 consultants and GPs is expected to retire in the next 18 months because of pension rules that mean they are "paying to work". A source close to her said she would deal with it by “cutting red tape and dealing with issues in the pension and tax system that currently act as barriers for people wanting to return”. It comes amid concerns that the NHS backlog after lockdown is causing more than 1,000 excess deaths per week - more than the figure now killed each week by coronavirus. A source close to Liz Truss also said: “The Covid pandemic put unprecedented strain on our NHS, and the resulting backlog is seeing people struggling to get appointments and treatments. We must act to tackle it, and we will. We will make it easier for doctors and nurses who have recently left or are planning to leave the NHS but want to return or stay to do so.” Read full story (paywalled) Source: The Telegraph (20 August 2022)
