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Found 233 results
  1. Community Post
    I am interested in what colleagues here think about the proposed patient safety specialist role? https://improvement.nhs.uk/resources/introducing-patient-safety-specialists/ https://www.independent.co.uk/news/health/nhs-patient-safety-hospitals-mistakes-harm-a9259486.html Can this development make a difference? Or will it lead to safety becoming one person's responsibility and / or more of the same as these responsibilities will be added to list of duties of already busy staff? Can these specialist be a driver for culture change including embedding a just culture and a focus on safety-II and human factors? What support do trusts and specialists need for this to happen? Some interesting thoughts on this here: https://twitter.com/TerryFairbanks/status/1210357924104736768
  2. Community Post
    I can’t find any guidance for safe staffing here in the UK. I would like to know how Trusts decide their staffing template. Who decides, how it’s decided and if that is adhered to.
  3. Content Article
    The presentation was held following the inaugural William Rathbone X Lecture, given by Professor Alison Leary, who spoke on the highly topical subject, ‘Thinking differently about nursing workforce challenges.’ The presentation can be watched from The Queen's Nursing Institute website.
  4. Content Article
    This report assesses why NHS hospitals are failing to deliver higher activity despite higher spending on the service and higher levels of staffing over the last couple of years. It argues that politicians need to urgently focus on capital investment, staff retention and boosting management capacity, and sets out key questions for policy makers to address if they want to solve the NHS crisis. The NHS has been on a longer-term negative trajectory: most of the challenges identified in the report existed before the pandemic and have been exacerbated since.
  5. Content Article
    This is the 15th annual clinical radiology census report by The Royal College of Radiologists. The census received a 100% response rate, meaning this report presents a comprehensive picture of the clinical radiology workforce in the UK as it stood in October 2022. Key findings The workforce is not keeping pace with demand for services. In 2022, the clinical radiology workforce grew by just 3%. In comparison, demand for diagnostic activity is rising by over 5% annually, and by around 4% for interventional radiology services.  The UK now has a 29% shortfall of clinical radiologists, which will rise to 40% in five years without action. By 2027, an additional 3,365 clinical radiologists will be needed to keep up with demand for services.   This will have an inevitable impact on the quality-of-care consultants are able to provide. Only 24% of clinical directors believe they had sufficient radiologists to deliver safe and effective patient care.   Interventional radiologists are still limited with the care they can provide. Nearly half (48%) of trusts and health boards have inadequate IR services, and only 1/3 (34%) of clinical directors felt they had enough interventional radiologists to deliver safe and effective patient care.   Stress and burnout are increasingly common among healthcare professionals, risking an exodus of experienced staff. 100% of clinical directors (CDs) are concerned about staff morale and burnout in their department. 76% of consultants (WTE) who left in 2022 were under 60.  We are seeing increasing trends that the workforce is simply not able to manage the increase in demand for services. 99% of departments were unable to manage their reporting demand without incurring additional costs.   Across the UK, health systems spent £223 million on managing excess reporting demand in 2022, equivalent to 2,309 full-time consultant positions.
  6. Content Article
    Appeals to give better resources to the NHS ‘front line’ are problematic when they divert attention away from more serious issues, especially when spending on more staff comes at the price of investing in other areas where the money may have a greater impact, emphasises Steve Black in this article published by HSJ.
  7. Content Article
    Huge issues are facing the UK’s medical workforce: angst among staff, battles for training opportunities, a lack of basic amenities, discrimination, shortages of posts, roles with no career progression, and a failure to support workers asking for pay reviews. In this BMJ opinion piece, Partha Kar says we need fresh leadership to lead basic changes with support from the royal colleges and unions, and other external organisations need to step up now.
  8. Content Article
    The Bucharest Declaration is the outcome of a World Health Organization (WHO) high-level regional meeting on health and care workforce in Europe that took place in Bucharest 22-23 March 2023. It makes 11 statements relating to the workforce crisis facing countries across Europe about retention, recruitment and staff safety.
  9. Content Article
    Health and care workers in all parts of Europe are experiencing overwork, with high levels of burnout. This opinion piece in the BMJ looks at the issue of healthcare professionals leaving European health systems to take early retirement or work in other countries where pay and conditions are better. It highlights the causes of this exodus, including increasing patient complexity, salary erosion and work-life balance. It argues that policies should prioritise retaining existing staff, as increased training numbers offer only a partial, long term answer.to the crisis, highlighting potential approaches governments can take to retain highly qualified healthcare staff.
  10. 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.
  11. Content Article
    This is part of our series of Patient Safety Spotlight interviews, where we talk to people working for patient safety about their role and what motivates them. Stephen talks to us about his time as turnaround Chair of Mid Staffordshire NHS Foundation Trust, how NHS boards can ensure they live their values and why creating a safe space to share concerns improves patient safety.
  12. Content Article
    The aim of this Australian study was to assess the impact of adding assistants in nursing to acute care hospital ward nurse staffing on adverse patient outcomes using administrative health data. The results suggest that the introduction of assistants in nursing into ward staffing in an additive role should be done under a protocol which clearly defines their role, scope of practice, and working relationship with registered nurses, and the impact on patient care should be monitored.
  13. 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.
  14. Content Article
    The nature of patient needs and ward activity is changing. Inpatients tend to be more ill than they used to be, many with complex needs often arising from multiple long-term conditions. At the same time, hospitals face the challenges of a shortage and high turnover of registered nurses. This review presents recent evidence from National Institute for Health Research (NIHR)-funded research, including studies on the number of staff needed, the support workforce and the organisation of care on the wards. While few research studies have explored the similar pressures that occur in community and social care, the learning from hospitals may be useful to decision makers in these areas.
  15. 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
  16. 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
  17. 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
  18. 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
  19. News Article
    Patient safety in the NHS in England is being put at “unacceptably high” risk, with severe staff shortages leaving hospitals, GP surgeries and A&E units struggling to cope with soaring demand, health chiefs have warned. The health service has hit “breaking point”, the leaders say, with record numbers of patients seeking care. Nine in 10 NHS chief executives, chairs and directors have reported this week that the pressures on their organisation have become unsustainable. The same proportion is sounding “alarm bells” over staffing, with the lack of doctors, nurses and other health workers putting lives of patients at risk. Sajid Javid, the health secretary, has come under fire for recently claiming, at a No 10 press conference, that he did not believe the pressure on the NHS was unsustainable. But the survey of 451 NHS leaders in England finds the health service already at “tipping point”. The results of the poll, conducted by the NHS Confederation, which represents the healthcare system in England, Wales and Northern Ireland, show that 88% of the leaders think the demands on their organisation are unsustainable, and 87% believe a lack of staffing in the NHS as a whole is putting patient safety and care at risk. Matthew Taylor, the chief executive of the NHS Confederation, said: “Almost every healthcare leader we’ve spoken to is warning that the NHS is under unsustainable pressure, and they are worried the situation will worsen, as we head into deep midwinter, unless action is taken. They are also sounding alarm bells over risks to patient safety if their services become overwhelmed, on top of a severe workforce crisis." Read full story Source: The Guardian, 10 November 2021
  20. 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
  21. 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
  22. News Article
    Logan Giesbrecht left his dream job as an emergency room nurse when the mental health strain of an understaffed department became unbearable, even before the pandemic's fourth wave hit and anti-vaccination protesters began gathering outside hospitals. “The biggest frustration, and what I'm taking home from work, was basically doing the job of more than one nurse,” said Giesbrecht, who feared low staffing levels would risk patient safety. He quit working at Royal Inland Hospital in Kamloops, Canada, last April. Representatives for nurses around the country are calling on the federal government to come up with a national plan to attract and retain nurses during a “crisis” they say needed action long before the uptick in cases from the Delta variant. Statistics Canada released data this week from the second quarter of 2021 showing a steep rise in job vacancies for both registered nurses and registered psychiatric nurses, which are part of a single category in its analysis. Those professions had the largest increase in vacancies of all occupations over a two-year period, up by 10,400 to 22,400 - a hike of nearly 86 per cent, the agency said, adding nearly half of the vacancies had been open for 90 days or more, compared with 24 days across all occupations. Linda Silas, president of the Canadian Federation of Nurses Unions, said it's not uncommon for some registered nursing positions to be vacant for a couple of weeks, as workers switch jobs within a hospital or health region, but having vacancies unfilled for 90 days or longer is unsustainable. Read full story Source: CP24 News, 24 September 2021
  23. News Article
    Labour is to push for key changes to the government’s NHS reforms, with new laws on transparency in the NHS and a demand for safe staffing levels on hospital wards, following a series of scandals relating to failures in patient care. Amendments to the government’s Health and Care Bill will also include plans for the investigation of stillbirths by medical examiners, and for limits on the power of the health secretary to interfere in investigations. Labour’s shadow health secretary Jonathan Ashworth believes the changes – which also include giving local NHS regions the ability to object to some spending limits if they consider them to pose a risk to patient safety – will attract the support of Conservative MPs. In an exclusive interview with The Independent ahead of the Labour Party conference in Brighton, Mr Ashworth said it was vital that the NHS learned from mistakes and improved its record on safety, which he said could only be achieved through greater transparency. “Patient safety has been forgotten in this bill. The patient voice has been ignored. Patients are like the ghosts in the machine,” he said. “The bill is going through parliament, and we are putting down amendments to improve it as best we can. We want to put in the bill a framework to deliver greater patient safety, because after all, it should be the golden thread running through every aspect of healthcare delivery." Read full story Source: The Independent, 26 September 2021
  24. News Article
    NHS trusts in London are looking to dilute their intensive care nurse-to-patient ratios due to workforce shortages, according to a leading critical care nurse. Nicki Credland, chair of the British Association of Critical Care Nurses, told HSJ’s Patient Safety Congress that trust leaders in London have discussed relaxing the ratios from one nurse per patient, to one nurse per 1.75 patients. ICU staffing ratios have been intermittently diluted throughout the covid pandemic, but this has previously been used as a temporary measure. Ms Credland, a keynote speaker at the event on Tuesday, suggested some trusts are now looking at a permanent shift away from one-to-one care. She added: “What we are seeing now is that certain trusts in the country are doing exactly what we were worried about." “Starting to move away from those [guidelines for the provision of intensive care services] standards that we have, that protect both us as nurses but also protect the patient’s safety as well." Read full story (paywalled) Source: HSJ, 24 September 2021
  25. News Article
    Changes to vascular services in north Wales must be reversed urgently after a report highlighted safety risks, campaigners warned. Services were centralised from Ysbyty Gwynedd to Ysbyty Glan Clwyd - about 30 miles away - in April 2019. An independent report, by the Royal College of Surgeons, highlights bed shortages and confusion over staffing levels. Betsi Cadwaladr health board said it was making urgent changes to services. In the report, commissioned by BCUHB after patients and staff raised fears about the new service, the Royal College of Surgeons makes nine "urgent recommendations to address patient safety risks". The report sets out issues, including too many patients being transferred to the hub hospital at Glan Clwyd, and a lack of vascular beds leading to frequent delays in transfers. The report also refers to a lack of clarity regarding the availability of consultant vascular surgeons. Read full story Source: BBC News, 20 May 2021
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