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Showing results for tags 'Safe staffing'.
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Content ArticlePeople in Place highlights the fundamental skills and people issues which will determine the future of health and care in the UK. The Covid-19 pandemic has made these issues clearer and more pressing, but it has also revealed an appetite for change and resulted in innovative ways of working. This report argues that building effective collective leadership into systems and places is vital to overcome staffing and governance issues in the NHS. Focusing on building long-term frameworks for change rather than responding to immediate pressures, it suggests practical tools and resources that could be used to bring about transformation within the system.
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Content ArticleOn 24 March 2021, an investigation into the death of Hazel Fleur Wiltshire was opened. The conclusion of the inquest was that Mrs Wiltshire died from pneumonia caused by a fall and by COVID-19 that she acquired in hospital. The fall was caused by her trying to relieve herself without assistance in the context of long delays in answering calls bells at the time.
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Content Article
NHS Emergency Department Safer Nursing Care Tool
Patient Safety Learning posted an article in Safe staffing levels
The Emergency Department Safer Nursing Care Tool is now available to use in NHS emergency departments in England. Developed by the Shelford Group chief nurses, licenced by Imperial College London and supported by the NHS England Chief Nursing Officer, the Emergency Department Safer Nursing Care Tool (ED SNCT) calculates nurse staffing requirements for emergency departments based on patients’ needs (acuity and dependency). Together with professional judgement, the tool supports emergency department managers and chief nurses in their safe staffing decisions. The Safer Nursing Care Tools (SNCT), including the Mental Health Optimal Staffing Tool (MHOST), are free to use by NHS trusts in England. -
Content ArticleHealthcare settings are inherently hazardous places, with very unpredictable and complex working environments. These hazards and risks not only result in a range of injuries and ill-health among workers but also jeopardise the safety of patients. The COVID-19 crisis has amplified the importance of ensuring that the healthcare that is provided is safe—for patients and health workers alike. A sufficient, and capable, workforce, is the foundation of resilient systems. Policy makers need to focus now on how to build and support an appropriate workforce to respond to future shocks. This includes health workers beyond the hospital—including those in community, long-term, and primary care. The safety of both patients and health workers should be protected through appropriate mechanisms to ensure the safety of protective equipment and sufficient supplies, appropriate staffing levels, training and support at the workplace. These governance mechanisms are even more relevant when policy makers face trade-offs between health, safety and economic concerns. This is part of series of health working papers from the OECD on the economics of patient safety. The preceding paper, focusing on Long-term care, can be found here.
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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 ArticleIn July 2020, the Academy of Medical Royal Colleges in conjunction with the BMA, NHS Confederation, NHS Providers, RCN and UNISON produced a joint statement on the NHS workforce. The statement concluded that addressing the NHS and social care workforce issues is the best possible recognition of the hard work and dedication of staff during the pandemic. It will also be essential if the NHS and social care are to deliver for the public in the months and years ahead. The NHS led Covid vaccination programme has given the nation hope and we are now able to look ahead and think about life beyond the pandemic. It is now the time to take practical steps to provide long term and sustainable workforce solutions for the NHS and care system. This Academy statement focuses on the need for a clear process for workforce planning which aims for consensus over requirements. There is genuine enthusiasm for looking differently at how we do things throughout the NHS and care system post-pandemic and we must not let this opportunity to embed changes that improve the quality of care for patients, the health of the public and the experience for staff pass by.
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Content ArticleThis guidance has been designed to support providers of care homes, premises based support services, school care accommodation, secure care and premises based offender accommodation to ensure they are appropriately assessing and providing staffing levels to meet the needs of people in their care, following the removal of staffing schedules. Inspectors may also refer to this guidance on inspection, for instance where intelligence may lead us to believe that staffing levels are not being appropriately assessed. Examples of this may be evidence of poor outcomes for people, an increase in incidents, number of complaints, staff absence, or a complaint investigation.
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Content ArticleThe Covid-19 pandemic has both laid bare and exacerbated the strain the cancer workforce has been under for many years. When the pandemic hit, some services were forced to pause, whilst others had to quickly adapt and many have still not ‘returned to normal’. Some cancer nurses were also deployed to care around the clock for the half a million people admitted to hospital with coronavirus. The practical and emotional impact of this disruption on people living with cancer has been profound. Macmillan’s new research establishes that cancer nurses are being stretched too thinly, trying to be there at our time of greatest need, and coping with the physical and emotional toll of the pandemic. Cancer and the devastating impact it has on lives should not be forgotten, and neither should our nurses and NHS. In this report, Cancer nursing on the line: why we need urgent investment across the UK, Macmillan is calling for Governments across the UK to invest a total of around £170 million to fund the training costs of creating nearly 4,000 additional cancer nurses required by 2030 to provide the care people need.
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Content ArticleThis document sets out guidelines for recommended nurse/midwife to patient ratios in the Kingdom of Saudi Arabia. It describes the rationale for introducing national regulations for safe staffing ratios, considers concerns and challenges in this respect, and then outlines specific ratios in different areas of care. This has been produced by the Saudi Patient Safety Center, in collaboration with the Saudi Commission for Health Specialties and the Saudi Nurses Association.
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Content ArticleThis study, published in the Journal of Advanced Nursing, investigates the processes through which personnel understaffing and expertise understaffing jointly shape near misses among nurses during the Covid-19 pandemic. It looks at survey data collected from 120 nurses in the United States of America working in hospitals during the pandemic. The authors conclude that the challenges created by understaffing of nurses have been amplified by the pandemic. They suggest that understanding the mechanisms through which safety outcomes are affected by understaffing can help healthcare organisations be better prepare for safety challenges that may arise when staffing shortages are experienced.
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Written evidence submitted by Donna Ockenden (EPE0025)
PatientSafetyLearning Team posted an article in Maternity
In this written evidence, submitted to the Health and Social Care Select Committee, the Independent Maternity Review Team provides commentary on the following commitment: "The majority of women will benefit from the ‘continuity of carer’ model by 2021, starting with 20% of women by 2019." They outline a number of concerns around the safe implementation of Continuity of Carer, particularly where there are significant staff shortages and/or inadequate funding. -
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The gap between doctor supply and patient need is widening each year. This report, from the British Medical Association: illustrates how severe medical workforce shortages in England have become demonstrates how the situation will worsen based on anticipated population growth and demographic changes without significant and swift intervention from Government analyses trends in the medical workforce up to 2021 highlights the value of the doctor to the health of patients. -
Content ArticleImproving 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.
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Content ArticleBarrie 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.
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Content ArticleThis study from Cho et al. examined the association of nurse staffing and education with the length of stay of surgical patients in acute care hospitals in South Korea. They found that nurse staffing and nurses’ education levels were significantly associated with the length of stay of surgical patients in South Korean hospitals. The findings from this study suggest that the South Korea healthcare system should develop appropriate strategies to improve the nurse staffing and education levels to ensure high-quality patient care in hospitals.
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Content ArticleThis 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.
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Content ArticleThis 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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Content Article
Implementing a District and Community Nursing workload tool, to determine safe staffing levels and skill mix in a community care provider organisation. An economic assessment of potential benefits for workforce planning (February 2016)
Patient Safety Learning posted an article in Safe staffing levels
Achieving safe district and community nurse caseloads, staffing levels and skill mix in order to deliver the increasing demand for care close to or in the home are a key challenge for primary and community care organisations in the UK. However there is a national crisis in relation to robust workforce evidence due to a lack of tools available to capture the complexity of care being delivered in different geographical locations to meet rural and urban patient population need. This paper presents a case study to illustrate the potential benefits of implementing Cassandra, a community workload analysis tool in one community provider organisation in the south of England. The Cassandra tool provides potential to: i) model the multidimensional complexity of care in different contexts and populations; ii) develop a potential blueprint for robust monitoring of decisions related to safe caseloads, staffing levels and skill mix; iii) when triangulated with other metrics, provides additional value to organisations as it enables an accurate picture to be created to monitor safe caseload, staffing levels, skill mix and competence and impacts on quality of patient care and commissioning of services in different geographies. As a place based demand tool this offers real opportunity to improve the evidence base of workforce planning and development driven by the needs of community populations. -
Content ArticleThe Royal College of Nursing (RCN) has created an information hub containing resources related to their campaign for safe staffing, including: principles for staffing for safe and effective care: accountability, numbers, strategy, plans, education. information about safe staffing law and the RCN's campaigning work across England, Northern Ireland, Scotland and Wales. RCN Nursing Workforce Standards. advice for nurses in dealing with unsustainable pressure at work.
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Content ArticleIn 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.
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Content ArticleA 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.
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RCM - Midwife number slumps (7 February 2022)
Patient-Safety-Learning posted an article in Maternity
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. -
Content Article
BBC Sounds podcast - The Backlog (9 February 2022)
Patient-Safety-Learning posted an article in Exit strategies
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. -
Content ArticleThis 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.
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Content ArticleGeorgia Stevenson discusses NHS England’s Long Term Workforce Plan, evaluating its potential to alleviate staffing shortages, enhance training routes, and ultimately improve care quality in maternity and neonatal services.
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