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Found 187 results
  1. Content Article
    This study in the journal Health and Social Care Delivery Research aimed to assess the scale, scope and impact of changing the type and number of different healthcare practitioners in general practice in England. The authors undertook an analysis of employment trends, looked at motivations behind employment decisions, examined staff and patient experiences, and assessed how skill mix changes are associated with outcome measures and costs. They found that: employing clinicians who are not GPs did not reduce GPs’ workload or improve their job satisfaction. patients appreciated the longer appointments they had with other clinicians. patients wanted better information about what other practitioners can do, and how to use new booking systems.
  2. Content Article
    The workforce crisis engulfing the health and care system is well documented. In the NHS, increases in staff numbers are not keeping pace with demand for staff and services; in 2021/22, for the first time, the number of people working in adult social care in England fell, and there are now 165,000 vacancies.  In this long read, Sally Warren, Director of Policy at The King's Fund, looks at a report by Bill Morgan, commissioned by The King's Fund and Engage Britain, to consider why politicians have failed to act, where only they can, to deliver the workforce that the health and care system needs. The article covers the following areas: Transparency in workforce planning assumptions   Training and international recruitment Retention: it’s not just about pay More than a numbers game, getting the culture and leadership right Productivity and skill mix Action at all levels Service improvement ambitions matched to the available workforce
  3. Content Article
    Standard operating procedures (SOPs) should improve safety in the operating theatre, but controlled studies evaluating the effect of staff-led implementation are needed. Morgan et al. evaluated three team process measures (compliance with WHO surgical safety checklist, non-technical skills and technical performance) and three clinical outcome measures (length of hospital stay, complications and readmissions) before and after a 3-month staff-led development of SOPs.  They found that SOPs when developed and introduced by frontline staff do not necessarily improve operative processes or outcomes. The inherent tension in improvement work between giving staff ownership of improvement and maintaining control of direction needs to be managed, to ensure staff are engaged but invest energy in appropriate change.
  4. Content Article
    We often hear the mesh scandal blamed on poor surgeon skill. We also hear the argument that high use mesh implanting surgeons are likely to have fewer patients suffering mesh complications, than a less experienced surgeon. However, this study published in JAMA in October 2018, based on NHS data, shows that high mesh implanting surgeons produce the same or even more mesh complications compared to low volume implanters.
  5. Content Article
    The eagerly anticipated Hewitt Review into integrated care systems (ICSs), led by former Health Secretary Patricia Hewitt set prevention decentralisation and cross government co-production as key priorities. What have we learned so far? David Duffy discusses the key takeaways.
  6. Content Article
    Surgeons' News is a magazine for surgical, dental and allied healthcare professionals. Published quarterly by the Royal College of Surgeons of Edinburgh, it features comment and opinion from leading professionals, plus reviews and reports on subjects relevant to all career levels. Two articles in this month's issue we want to highlight are the Surgical safety update (p.10) on cases from the Confidential Reporting System for Surgery (CORESS) and Safe passage (p.18) discussing the National Patient Safety Syllabus.
  7. Content Article
    The purpose of this assessment is to ensure that all Theatre Practitioners are fully compliant with current Trust Policy with regard to swabs, instruments, sharps and disposables items. All Theatre staff must be assessed and deemed competent.
  8. Content Article
    Watch Professor Alison Leary discuss the huge value of specialist nursing at the hFRenDs event in July 2022.
  9. Content Article
    The Clinical Human Factors Group have created a sample template for Trusts looking to recruit a Human Factors and Ergonomics specialist. Please feel free to use and adapt this template to your organisation’s needs.
  10. News Article
    A major British medical school is leading the drive to eliminate what it calls "inherent racism" in the way doctors are trained in the UK. The University of Bristol Medical School says urgent action is needed to examine why teaching predominantly focuses on how illnesses affect white people above all other sections of the population. It comes after students pushed for reform, saying gaps in their training left them ill-prepared to treat ethnic minority patients – potentially compromising patient safety. Hundreds of other UK medical students have signed petitions demanding teaching that better reflects the diversity of the country. The Medical School Council (led by the heads of UK medical schools) and the regulator, the General Medical Council, say they are putting plans in place to improve the situation. A number of diseases manifest differently depending on skin tone, but too little attention is given to this in training, according to Dr Joseph Hartland, who is helping to lead changes at the University of Bristol Medical School. "Historically medical education was designed and written by white middle-class men, and so there is an inherent racism in medicine that means it exists to serve white patients above all others," he said . "When patients are short of breath, for example, students are often taught to look out for a constellation of signs – including a blue tinge to the lips or fingertips – to help judge how severely ill someone is, but these signs can look different on darker skin." "Essentially we are teaching students how to recognise a life-or-death clinical sign largely in white people, and not acknowledging these differences may be dangerous," said Dr Hartland. Read full story Source: BBC News, 17 August 2020
  11. News Article
    All medical students at the National University of Singapore will be taught patient safety through a virtual reality (VR) game, a move prompted by the COVID-19 social distancing rules. The game, called PAtient Safety aS Inter-Professional Training (PASS-IT), will use VR to get all 1,500 of them acquainted with the proper procedures in operating theatres. It was developed by the NUS Yong Loo Lin School of Medicine (NUS Medicine). The school has 12 such VR stations. Each has a 15-minute game with various medical scenarios that will require the students to "act out" the standard operating procedures. These range from how to check for a patient's consent and verify their identity as well as the correct ways to handle surgical tools and what must be done if a team member accidentally cuts himself. "This VR system is a good tool to help the students consolidate their learning despite increased clinical restrictions," said Associate Professor Alfred Kow, assistant dean of education of NUS Medicine. Read full story Source: The Straits Times, 5 August 2020
  12. News Article
    NHS People Plan provides a stop-gap but leaves glaring omissions 'Two years after it was first promised, the NHS is still waiting for a long-term workforce plan. Some of the measures announced in today’s People Plan are positive. As the plan acknowledges, it is important to learn from the impressive changes made by NHS staff during the pandemic. And improving support for people from black and minority ethnic communities – who make up one fifth of the NHS workforce – is rightly a top priority. 'But there are glaring omissions. The NHS went into the pandemic with a workforce gap of around 100,000 staff, yet the plan does not say how this will be addressed in the medium term. This is particularly concerning at a time when our recruitment of nurses from abroad has dropped dramatically. These details are missing because the NHS is still waiting on government to set out what funding will be available to expand the NHS workforce – without which the NHS cannot recruit and retain the doctors, nurses and other staff it needs. 'While this plan at least provides a stop-gap to help get the NHS through the winter, there is no equivalent plan for social care – a sector suffering from decades of political neglect and the devastating impact of COVID-19 on care users and staff. A comprehensive workforce plan for both the NHS and social care is needed now more than ever'.
  13. News Article
    Lego could be used as a practical tool to train doctors in anesthetic skills according to new research that has shown a simple task using the building bricks can help improve technical skills—a finding that could improve medical training and patient safety. Scientists from the University of Nottingham's School of Psychology and School of Medicine developed a task where people copied shapes using bricks that they could see in a mirror. They found this simple training improved student performance in an ultrasound-guided regional anesthesia task. The results of the study have been published in British Journal of Anesthesia Read the full article here
  14. News Article
    Regulators have uncovered multiple examples of patients being put at risk when junior doctors are left with tasks they are not trained for, lacking support, and facing bullying and inappropriate behaviour. Inspection teams have had to intervene – in some cases contacting senior trust staff – to ensure urgent issues are addressed, after the inspections. Health Education England oversees training nationally, which includes making the checks at trusts which have been put under “enhanced monitoring” by the professional regulator, the General Medical Council, because of concerns from trainees. HSJ has obtained and examined 20 reports, all produced since the beginning of 2019. Themes running through the reports included: Lack of support from consultants. Trainees struggled to contact consultants out of hours. Bullying and inappropriate behaviour was reported at several trusts. Inspectors found a reluctance to report concerns and/or a lack of knowledge of how to do it. Teaching was often of poor quality or cancelled – and sometimes trainees struggled to attend sessions because of how their shifts and rotations were scheduled. Trainees in several trusts reported IT problems, such as being locked out of systems so being unable to access clinical notes and blood tests, and IT systems taking up to 30 minutes to start up, sometimes delaying patient care. Read full story (paywalled) Source: HSJ, 29 June 2020
  15. News Article
    A hospital A&E department has been rated "inadequate" after inspectors found patients at "high risk of avoidable harm". The Care Quality Commission (CQC) reported a "range of regulation breaches" and a shortage of nurses at Stepping Hill hospital's A&E unit. It also criticised maternity and children's services. Stockport NHS Foundation Trust's chief executive said the trust had taken "immediate steps" to improve. The CQC inspected Stepping Hill Hospital in January and February and found A&E performance "had deteriorated significantly" since its last inspection in 2018. Inspectors found shortcomings "relating to patient-centred care, dignity and respect, safe care and treatment, environment and equipment, good governance, and staffing". Their report said the service "could not assure itself that staff were competent for their roles" and patient outcomes "were not always positive or met expectations in line with national standards". Read full story Source: BBC News, 19 May 2020
  16. News Article
    Medical students who are employed in the NHS as part of efforts to swell staff numbers to tackle covid-19 should not be expected to “step up” and act outside of their competency, says the BMA in new guidance. This is the first set of guidance released by the BMA specifically for medical students, who have had placements and exams cancelled and are uncertain about how they might be employed in the NHS in the current crisis. It says that any employment should be voluntary and within the competency of the student, who should have adequate access to personal protective equipment. The BMA refers to General Medical Council guidance that states that plans are not currently in place to move provisional registration forward from the normal August date. It warns that there are concerns around the boundaries of practice and the level of supervision that students who take on roles in the NHS would have, which could lead to unsafe working practices. The BMA is in talks to negotiate a safe national contract for such roles. Read full story Source: BMJ, 24 March 2020
  17. News Article
    NHS national leaders are set to reassure doctors they should not fear regulatory reprisals, within reason, if they end up working outside their areas of expertise during the coronavirus outbreak. HSJ understands the UK’s four chief medical officers and the General Medical Council are drafting a letter to be sent to all UK doctors, which will contain the reassurances, as the system braces for a sharp rise in covid-19 cases. The letter will also urge doctors to be flexible and not to resist new ways of working, with senior figures expecting many clinicians working in other specialities or locations during the outbreak. The letter will say doctors, while still expected to follow good medical practice, should not fear reprimand from their employers or national bodies such as the GMC, NHS England or other regulators. Read full story (paywalled) Source: HSJ, 11 March 2020
  18. News Article
    Third year undergraduate trainee nurses will be invited into clinical practice to support the coronavirus effort, while routine care quality inspections are “going to need to be suspended”, the Chief Executive of NHS England has said. Speaking at the Chief Nursing Officer’s summit event in Birmingham this morning, Sir Simon Stevens told delegates NHSE was working with the Nursing and Midwifery Council to “see how many of the 18,000 [relevant] undergraduates are available”. It is understood they would be paid, and follows government moves to pass emergency legislation to relax rules around working in healthcare. Asked about Care Quality Commission inspections during the outbreak, Sir Simon said: “There will be a small number of cases where it would be sensible to continue for safety related reasons… but the bulk of their routine inspection programmes is clearly going to need to be suspended and many of the staff who are working as inspectors need to come back and help with clinical practice.” Read full story (paywalled) Source: HSJ, 11 March 2020
  19. News Article
    Nurses will be trained to perform surgery under new NHS measures to cut waiting times. Nursing staff will be urged to undertake a two year course to become “surgical care practitioners” as part of the drive to slash waiting times but critics have warned it will worsen the nursing shortage. Nurses who qualify will be tasked with removing hernias, benign cysts and some skin cancers, according to the Daily Mail. They will also assist during major surgeries such as heart bypasses and hip and knee replacements. The re-trained nurses will be tasked with closing up incisions after operations. The proposals are contained within the NHS’s People Plan, due to be unveiled next month. Lib Dem health spokesman Munira Wilson said: "This is a sticking plaster solution to very serious staffing crisis across our NHS workforce.'" However the proposals were backed by Professor Michael Griffin, president of the Royal College of Surgeons of Edinburgh. He said: "We are totally supportive of this. We have very little anxiety about this.” Read full story Source: 24 February 2020
  20. News Article
    Almost half of hospitals have a shortage of specialist stroke consultants, new figures suggest. One charity fears "thousands of lives" will be put at risk unless action is taken, with others facing the threat of a lifelong disability. In 2016, Alison Brown had what is believed to have been at least one minor stroke, but non-specialist doctors at different hospitals repeatedly told her she did not have a serious health condition. One even described it as an ear infection. Ten months later, aged 34, she had a bilateral artery dissection - a common cause of stroke in young people, where a tear in a blood vessel causes a clot that impedes blood supply to the brain. She was admitted to hospital - but again struggled for a diagnosis. A junior doctor found an issue with blood flow to the brain but she says their comments were dismissed and she was told it was a migraine. It was only when she collapsed again, days later, and admitted herself to a hospital with a dedicated stroke ward that a specialist team was able to give her the care she needed. Alison's case highlights the importance of being seen by stroke specialists. However, according to new figures from King's College London's 2018-19 Snapp (Sentinel Stroke National Audit Programme) report, 48% of hospitals in England, Wales and Northern Ireland have had at least one stroke consultant vacancy for the past 12 months or more. This has risen from 40% in 2016 and 26% in 2014. The Stroke Association charity - which analysed the data - says the UK is "hurtling its way to a major stroke crisis" unless the issue is addressed. Read full story Source: BBC News, 17 January 2020
  21. News Article
    Hospitals will be required to employ patient safety specialists from next April as part of efforts by the health service to reduce thousands of avoidable errors every year. NHS trusts will be told to identify staff who will be designated as the safety specialist for each organisation. These workers, who will get specific training and work as part of a network across the country, will help to tackle a fragmentation in the way safety issues are dealt with in the NHS and ensure nationwide action on key safety risks is coordinated. The proposals are part of a national patient safety strategy which is aiming to save 928 lives and £98.5m across the NHS, as well as reducing negligence claims by £750m by 2025. The specialists will be identified from existing staff, with part of the role focused on embedding a so-called “just culture” approach to safety. This means reducing blame, supporting staff who make honest errors and tackling systemic causes of mistakes. Read full story Source: The Independent, 26 December 2019 What do you think? Join the conversation on the hub.
  22. News Article
    Hospitals are so short of doctors and nurses that patients’ safety and quality of care are under threat, senior NHS leaders have warned in a dramatic intervention in the general election campaign Nine out of 10 hospital bosses in England fear understaffing across the service has become so severe that patients’ health could be damaged. In addition, almost six in 10 (58%) believe this winter will be the toughest yet for the service. The 131 chief executives, chairs and directors of NHS trusts in England expressed their serious concern about the deteriorating state of the service in a survey conducted by the NHS Confederation. The findings came days after the latest official figures showed that hospitals’ performance against key waiting times for A&E care, cancer treatment and planned operations had fallen to its worst ever level. However, many service chiefs told the confederation that delays will get even longer when the cold weather creates extra demand for care. “There is real concern among NHS leaders as winter approaches and this year looks particularly challenging,” said Niall Dickson, the chief executive of the confederation, which represents most NHS bodies, including hospital trusts, in England." “Health leaders are deeply concerned about its ability to cope with demand, despite frontline staff treating more patients than ever." Read full story Source: 19 November 2019
  23. Content Article
    Learn how to change important behaviours in your personal or professional life in this course from UCL.
  24. Content Article
    This month an inquiry will deliver its verdict on the failures of maternity care at the Shrewsbury and Telford Hospital NHS Trust, the largest maternity scandal in NHS history, involving 1,862 families. The result of this inquiry will highlight how we may need to reconfigure maternity services to ensure the highest standard of care.  But what does good really look like? Is there really a way to be a safe maternity unit?  At last year's Patient Safety Congress, one of the sessions aimed to answer these questions. The panel discussed behaviours and practices that constitute safe care in hospital-based maternity units, and how organisations can take practical steps to make these features a reality. Click on the video below to watch the full session.
  25. Content Article
    All health and care professionals have an ethical responsibility to be open and honest with service users and their employers when things go wrong with a person’s care. This is otherwise known as the professional duty of candour. Learn more about the Duty of Candour on the Health and Care Professions Council website.
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