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Found 237 results
  1. News Article
    The culture at a long-troubled ambulance trust is ‘worsening, not improving’, its staff have told a health watchdog. Concerns about culture and patient safety at East of England Ambulance Service Trust (EEAST) were raised to inspectors at the Care Quality Commission (CQC) during an inspection of the trust last month, according to public documents. In a feedback letter to the trust following the inspection, the CQC said staffing at EEAST’s control room was below planned levels, and the inspectors were “not assured that staffing levels met the demands within the service and this may impact on patient safety when managing the high volume of calls”. The trust, which is in the equivalent of special measures and currently rated “requires improvement” by the CQC, has had long-standing cultural problems and last year signed a legal agreement with the Equality and Human Rights Commission on how it would protect staff from sexual harassment. According to the feedback letter, staff described a “worsening, not improving, culture” and said the workforce was “tired” and not receiving mandatory training, one-to-ones with managers or appraisals. The letter, published in the trust’s latest board papers, also reported inspectors raising concerns about potential risks to patients over the management of the trust’s call stack and a lack of consistency over “standard operating procedures”. Additionally, some staff in the control room on an accelerated training programme were unable to undertake full patient assessments and had to call for assistance from others. Read full story (paywalled) Source: HSJ, 11 May 2022
  2. Content Article
    Although compensation increases have played a key role in retaining and recruiting healthcare employees amid a major workforce shortage, perks such as mental health services and education financial assistance have also helped meet staff needs. Six health system CEOs and CFOs share with Becker's Hospital Review their best tips for retention and recruitment that go beyond compensation:
  3. Content Article
    In its 2019 manifesto the government pledged to increase the full-time equivalent number of nurses working in the NHS by 50,000 by March 2024. But although data suggests that the NHS will hit that target, Ruth May, England's Chief Nursing Officer, has stated publicly that there are still substantial shortages in spite of this increase. This analysis by the King's Fund highlights that the supply of nurses to the NHS is not keeping up with demand, with vacancy levels remaining static in spite of an increase to the raw number of nurses. It also highlights wide regional variation in nurse shortages.
  4. Event
    ECRI has released its newest list of the Top 10 patient safety concerns confronting healthcare organisations. Healthcare providers, regardless of their practice setting, can start with our Top 10 list and use it to guide their own discussions about patient safety and improvement initiatives. This top 10 report highlights patient safety concerns across the continuum of care because patient safety strategies increasingly focus on collaborating with other provider organizations, community agencies, patients or residents, and family members. Each patient safety concern on this list may affect more than one setting. Join ECRI to learn more about the identified concerns and how your organisation can begin to address them. Register
  5. Content Article
    The Independent review of maternity services at the Shrewsbury and Telford Hospital NHS Trust was commissioned in 2017 to assess the quality of investigations relating to newborn, infant and maternal harm at the Trust. When it commenced this review was of 23 families’ cases, but it has subsequently grown to cover cases of maternity care relating to 1,486 families, the majority of which were patients at the Trust between the years 2000 and 2019. Some families had multiple clinical incidents therefore a total of 1,592 clinical incidents involving mothers and babies have been reviewed with the earliest case from 1973 and the latest from 2020.
  6. Content Article
    ECRI's annual Top 10 list helps organisations identify imminent patient safety challenges. The 2022 edition features many first-time topics, and emphasis is on potential risks that could have the biggest impact on patient health across all care settings. The number one topic on this year’s list has been steadily growing throughout the COVID-19 pandemic and impacts patients and staff on all levels: staffing shortages. Prior to 2021, there was a growing shortage of both clinical and non-clinical staff, but the problem has grown exponentially. In early January 2022, it was estimated that 24% of US hospitals were critically understaffed, while 100 more facilitates anticipated facing critical staff shortages within the following week. The list includes diagnostic and vaccine-related errors that can impact patient outcomes. In addition, several topics on this year's list reflect challenges that have arisen as a result of the stresses associated with delivering care during a global pandemic.
  7. Content Article
    The Covid-19 pandemic has stretched healthcare staff like never before. Tom Moberly reports on a roundtable discussion hosted by The BMJ as part of the 2022 Nuffield Trust summit, looking at why workers leave the NHS and how staff wellbeing and retention can be improved.
  8. News Article
    The White House has announced plans to boost nursing home staffing and oversight, blaming some of the 200,000-plus covid deaths of nursing home residents and staff during the pandemic on inadequate conditions. Officials said the plan would set minimum staffing levels, reduce the use of shared rooms and crack down on the poorest-performing nursing homes to reduce the risk of residents contracting infectious diseases. The White House also said it planned to scrutinise the role of private equity firms, citing data that their ownership was linked with worse outcomes and higher costs. Nursing homes have been an epicenter of covid spread during the pandemic, as the virus initially tore through facilities before vaccines were available in 2020, and then continued to sicken and kill residents at an elevated rate last year. Advocates have demanded better policies to ensure the facilities are prepared for emergencies and follow practices to curb the spread of infections. Under Biden’s plan, officials at the Centers for Medicare and Medicaid Services will propose minimum staffing levels within the next year, which the White House said would improve safety by ensuring residents receive sufficient care and attention. The administration also cited a study that found increased staffing levels were linked with fewer covid cases and deaths. The nursing home industry has warned that the pandemic has exacerbated long-running staffing shortages, noting that roughly 420,000 employees in nursing homes and long-term care facilities, many of whom complained about low pay, have departed over the last two years. Read full story (paywalled) Source: The Washington Post, 28 February 2022
  9. News Article
    The NHS is facing a “time bomb” and will be forced to cancel or delay around 8 million operations each year by 2040, due to a lack of consultant anaesthetists across the services. The Royal College of Anaesthetists (RCOA) said the current shortage of at least 1,400 staff across the UK means millions operations will not be able to take place. The college has warned its speciality is facing a “perfect storm” of limited training places, poor retention and an ageing workforce with 39 per cent nearing retirement age. The analysis found as demand for surgeries continue the need for anaesthetists is due to increase by 3.85 per year, meaning the NHS will need around 25,000 doctors in these posts by 2040. Dr Fiona Donald, president of the RCOA said: “The NHS is facing an anaesthetic workforce time bomb. We already have profound workforce shortages that are preventing huge numbers of operations from taking place – and unless urgent action is taken, the problem is going to worsen. “We would welcome government funding for additional anaesthetic training posts. One hundred additional posts per year would start to plug the gap and help get the UK back on a sound footing to be able to address the waiting list backlog. Without this investment, we foresee impacts to patient care and a further impact on the mental health of our current workforce – they need to be able to prioritise their own health and that of their families alongside the focus they already place on the health of patients and the public.” Read full story Source: The Independent, 22 February 2022
  10. Content Article
    Women have consistently reported lower satisfaction with postnatal care compared with antenatal and labour care. The aim of this research was to examine whether women’s experience of inpatient postnatal care in England is associated with variation in midwifery staffing levels. It found that negative experiences for women on postnatal wards were more likely to occur in trusts with fewer midwives. Low staffing could be contributing to discharge delays and lack of support and information, which may in turn have implications for longer term outcomes for maternal and infant wellbeing. This analysis of survey data supports previous findings that increased midwifery staffing is associated with benefits. This is the first study to examine the effects of organisational staffing on women’s experience of postnatal care.
  11. Content Article
    In this explainer from the Nuffield Trust, Billy Palmer and Lucina Rolewicz take stock of what is known and not known about the numbers of staff leaving NHS and social care roles, and the reasons given for moving on.
  12. Content Article
    In this blog, Stuart Bonar, Public Affairs Advisor at the Royal College of Midwives, looks at the growing midwifery workforce crisis in the UK. For the first time since records began, the number of midwives is falling year-on-year. The impact on those midwives who remain in the NHS is bigger workloads and decreasing wellbeing. The author calls on the government to pay attention to the situation, and suggests that an adequate pay rise for midwives and midwifery assistants should be part of the solution to falling staff numbers.
  13. Content Article
    This is the first episode in a series of podcasts by Natasha Loder, Health Policy Editor at The Economist, about the care backlog currently facing the health service. After more than two years battling Covid-19, the NHS is struggling through its worst winter crisis in living memory and is facing a daunting task to clear the huge backlog exacerbated by the pandemic. Nearly six million people are on the NHS waiting list for routine treatment in England alone. As patients, often with worsening conditions, pour back into the NHS after putting off treatment, health secretary Sajid Javid warns waiting lists could top thirteen million. In this first episode, Natasha speaks to frontline workers, managers, policy experts, and patients to assess the pressure created by the unprecedented demand on the different areas of the NHS from emergency services to GP surgeries.
  14. Content Article
    This toolkit has been created for NHS organisations to help them implement the Living Wage. It includes the accreditation process as well as case studies and advice from existing accredited NHS organisations.
  15. Content Article
    Barrie Housby had a medical history that included frailty, Parkinson’s disease and macular degeneration. During a stay at Clifton Hospital he was known to be at high risk of falls and at the beginning of the nightshift on 12 July 2021, it was advised that he should be cared for on a one to one basis and not left unattended. During the shift, a member of staff allocated to monitor him left the bay to attend to other duties, and in this time Mr Housby left his bed and fell. He was transferred to a hospital emergency department but subsequently died on 13 July 2021 as a result of a traumatic subdural haemorrhage following a fall. In his report, the Coroner Alan Wilson highlights the impact of staffing shortages at the Trust and their contribution to Mr Housby’s death, stating that this poses an ongoing risk to patient safety.
  16. News Article
    Britain’s sickest children are being treated in intensive care units that are struggling with severe shortages of the specialist nurses needed to look after them, a report says. The shortages in the UK’s 30 paediatric intensive care units (PICUs) are so severe that healthcare assistants are covering the work of nurses in an attempt to ensure that staffing levels are maintained. Only one of the PICUs – at the James Cook University hospital in Middlesbrough – was found to have enough nurses to guarantee the standards of care expected. About 15,000 children and young people a year, often with life-threatening conditions, are cared for in PICUs. Clinical standards that prevail in PICUs require them to ensure that seven nurses are on duty for each bed in a 24-hour cycle. However, the report by the Paediatric Intensive Care Audit Network (PICANet), a group of experts from Leicester and Leeds universities, found that 29 of the 30 had too few nurses to do that, and that all 30 had vacancies, sometimes large numbers of them. “Parents will find this extremely alarming”, said Patricia Marquis, the Royal College of Nursing’s England director. “Most people wouldn’t believe that only one paediatric intensive care unit across the whole UK has enough staff to function properly, but this is the reality of the workforce crisis. Key roles in specialist nursing teams are lying vacant for years.” Read full story Source: The Guardian, 23 January 2022
  17. Content Article
    Improving patient safety culture (PSC) is a significant priority for OECD countries as they work to improve healthcare quality and safety—a goal that has increased in importance as countries have faced new safety concerns connected to the COVID-19 pandemic. Findings from this OECD benchmarking work in PSC show that there is significant room for improvement.
  18. News Article
    NHS leaders have raised concerns over the “new mini Nightingales” as hospitals draw up plans for use with “minimal” nursing levels, The Independent has learned. In December the NHS announced it would be launching eight “surge” hubs dubbed “mini Nightingales” to help hospitals manage increased admissions amid the Omicron wave. These facilities would be able to admit about 100 patients and have been set up as temporary sites across eight NHS hospitals. Details around the safety requirements and required staffing levels have yet to be published, however several NHS sources have said some hubs are planning to use a “low” ratio of 1:15 nurses to patients within the units. One trust chief has called the staffing models a “disgrace” and says the hospitals should never be used. Senior sources have questioned the safety of using a 1:15 ratio, although they said the risk would depend on how ill the patients being sent to the units are and whether there would be sufficient health care assistant support. However, sources have said the staffing models have yet to be finalised and so could change. Read full story Source: The Independent, 20 January 2022
  19. News Article
    Ministers have been issued with a stark warning over mandatory Covid vaccines for NHS workers in England, with a leaked document saying growing evidence on the Omicron variant casts doubts over the new law’s “rationality” and “proportionality”. Two jabs will become compulsory for frontline NHS staff from 1 April after MPs voted on the legislation last month. But the document, drawn up by Department of Health and Social Care (DHSC) officials and seen by the Guardian, said the evidence base on which MPs voted “has changed”, creating a higher chance of objections and judicial review. The effectiveness of only two vaccine doses against Omicron, and the lower likelihood of hospitalisations from the milder variant, are cited. More than 70,000 NHS staff – 4.9% – could remain unvaccinated by 1 April, the document says. NHS trusts in England are preparing to start sending dismissal letters from 3 February to any member of staff who has not had their first dose by then. Amid significant pressures on the NHS, last week groups including the Royal College of Nursing urged Sajid Javid, the health secretary, to delay the legislation, known as “vaccination as a condition of deployment” (VCOD2). On Tuesday the Royal College of Nursing said the leaked memo should prompt ministers to call a halt to the imposition of compulsory jabs, which it called “reckless”. “The government should now instigate a major rethink”, said Patricia Marquis, the RCN’s England director. “Mandation is not the answer and sacking valued nursing staff during a workforce crisis is reckless.” Read full story Source: The Guardian, 18 January 2022
  20. News Article
    The number of Covid patients in hospitals in England and Scotland has continued to rise this week, as NHS England reached a deal with private hospitals to free up beds amid the outbreak of Omicron cases. Meanwhile, Covid staff absences in England rose to their highest level since the introduction of the vaccine. The number of NHS workers in England off sick because of Covid was up by 41% in the week to 2 January, according to the latest figures. Five health workers describe some of the challenges they are facing, including understaffing, waiting times and bed-blocking. Read full story Source: The Guardian, 14 January 2022
  21. Content Article
    This analysis from the Nuffield Trust provides facts on staffing and staff shortages in the NHS in England. It provides answers to the following questions: What kinds of staff make up the NHS workforce? How diverse is the NHS workforce? What is the overall shortfall in staff in the NHS? What do the shortages look like within hospital services? What do the shortages look like for staff delivering care close to patients’ homes? What are the implications of these shortfalls? How did we get to this situation? How do we compare to other countries? What is the outlook for the future?
  22. Content Article
    The brief focuses on the nursing workforce at a time when a global pandemic is raging across the world. The year just ended—2021— has seen unprecedented damage inflicted on health systems and on the nursing workforce. The year just begun—2022— marks no change in the continuing relentless pressure of the pandemic on individual nurses, and on the global nursing workforce. This brief was commissioned by the International Centre for Nurse Migration (ICNM). It provides a global snapshot assessment of how the COVID-19 pandemic is impacting on the nursing workforce, with a specific focus on how changing patterns of nurse supply and mobility will challenge the sustainability of the global nursing workforce. It also sets out the urgent action agenda and global workforce plan for 2022 and beyond which is required to support nurse workforce sustainability, and therefore improve health system responsiveness and resilience in the face of COVID-19.
  23. Content Article
    A midwife in England shares their experiences of working in the NHS in 2021. They describe the mental and physical impact of having to work beyond capacity on a daily basis, a situation caused by a staffing crisis in the midwifery workforce. The impact of this is that more midwives are leaving the NHS as they are unable to cope with these pressures, which makes the workload for remaining staff even heavier.
  24. Content Article
    This report by the Health and Social Care Commons Select Committee looks at the catastrophic impact of the Covid-19 pandemic on patients waiting for NHS care and outlines the findings of the Select Committee's inquiry. Waiting lists are at their highest since records began, and the 5.8 million patients waiting to start treatment in September 2021 may be only the tip of the iceberg, with missing patients meaning that the true waiting list could be as high as 13 million. The report highlights the need to carefully plan how to tackle the elective care backlog. It outlines the risks involved, including the danger of prioritising areas that are well suited to numerical targets to the detriment of other areas of care, such as mental health, general practice and community services. It also highlights that the challenges the NHS faces are greater than just tackling elective care. With a record number of 999 calls and waiting times in emergency departments at record levels, work to tackle the backlog is being threatened by pressure on emergency care.
  25. Content Article
    This study, published in BMJ Open, seeks to evaluate variation in Illinois hospital nurse staffing ratios. It attempts to determine how higher nurse workloads are associated with mortality and length of stay for patients, and cost outcomes for hospitals. In their conclusion, the authors suggest that if nurses in Illinois hospital medical–surgical units cared for no more than four patients each, thousands of deaths could be avoided, and patients would experience shorter lengths of stay, resulting in cost-savings for hospitals.
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