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Found 447 results
  1. News Article
    Leaked results from a national survey of NHS staff has revealed a sharp drop in those who believe their health and wellbeing is being supported by their employer. The People Pulse is a national, monthly survey launched in 2020. It enables provider and commissioner organisations to monitor the NHS workforce’s health and wellbeing. According to a snapshot of the results recorded between May and August seen by HSJ, there was a drop of 9.6 percentage points in “perceptions of wellbeing support”, with “positivity” sitting at 57.3%. Almost a quarter of the survey respondents reported a “negative” experience of health and wellbeing support. The survey results also revealed almost a third of respondents said they wanted to speak up about a specific issue during the pandemic, especially on issues of staff safety, health and wellbeing, but they did not because they feared repercussions or believed nothing would happen. Read full story (paywalled) Source: HSJ, 21 September 2021
  2. News Article
    A trust’s maternity services were rated ‘good’ despite an independent report finding ‘weaknesses in the culture’ and ‘defensive and fractious’ behaviours, HSJ has learned. As previously reported, former staff at Sandwell and West Birmingham Hospital Trust had raised concerns with the Care Quality Commission (CQC) over what they described as a “toxic management culture” and “unsafe” staffing levels in the trusts maternity service. Particular concerns were raised around community midwifery services. This prompted an unannounced inspection by the CQC in May, which found “low morale and negative culture” in the services. However, the CQC ultimately concluded the trust was taking positive steps to address the problems and rated its maternity services “good” overall, as well as for leadership and safety. Some frontline staff in the service have questioned those findings, however, and pointed to an independent review which was conducted in the early months of 2021. This review, carried out by independent consultant Debbie Graham and seen by HSJ, concluded there was “evidence of weaknesses in the culture; evidenced in the behaviours of some staff which appears to go unaddressed; a lack of strong, visible leadership; a lack of a shared vision; the finding that some staff have a fear of ‘speaking up’; and poor communication systems.” Read full story (paywalled) Source: HSJ, 20 September 2021
  3. News Article
    A culture of bullying and racial discrimination has been found at a hospital trust, according to an inspection report. The Care Quality Commission (CQC) said there was a bullying culture across Nottingham University Hospitals (NUH) Trust, with many staff too frightened to speak up. The trust has been told it requires improvement as a result of the report. NUH said it was working to address the concerns. The report said a number of the bullying cases were directly attributable to racial discrimination. It said the trust's latest staff survey showed the organisation was above average for black, Asian and minority ethnic staff experiencing bullying. Sarah Dunnett, the CQC's head of hospital inspection, said they were told of bullying incidents that had not been addressed. "We were concerned about the culture of bullying across the trust with many staff being too frightened to speak up," she said. She said the CQC would "monitor the service closely" to ensure changes were made. Read full story Source: BBC News, 15 September 2021
  4. News Article
    A trust facing serious questions about its working culture has had a dramatic rise in the number of concerns raised about issues such as harassment and bullying. In the first quarter of 2021-22, staff raised 84 incidents to East of England Ambulance Service Trust’s Freedom to Speak Up guardian, compared with only eight in the first quarter of 2020-21. Half of the cases raised to the guardian this year involved issues of harassment, bullying or concerns about behaviours or relationships, according to a report to the trust board. However, the biggest single area of concern — with 35 cases — was “the inconsistent applications of processes in policies” and only one out of 84 cases involved patient safety or quality. The report said: “Staff across the organisation are exhausted and express concern at continuing under this pressure… staff continue to report that the slow pace of change leaves them with little confidence of lasting change.” Read full story (paywalled) Source: HSJ, 8 September 2021
  5. Event
    until
    This event for Speak Up Month brings the themes of Speak Up, Listen Up and Follow Up together to focus on culture. This event, in association with the Institute of Business Ethics, will be chaired by Mark Chambers, Associate Director at the IBE and Non-executive director at the Care Quality Commission. The panel will discuss what a "Speaking Up Culture" means and how to foster an environment where people can speak up and be confident they will listened to and the action will follow for learning and improvement. Mark will be in conversation with Katy Steward, Head of Culture and Transformation and NHS England/Improvement with other guests to be confirmed. Register
  6. Event
    until
    Sir Robert Francis QC, Retired Barrister (specialising in medical law) and Queen’s Counsel. Before his retirement from full-time practice earlier this year, Sir Robert sat as a Recorder (part-time Crown Court judge) and as a Deputy High Court Judge. Sir Robert will be joining Professor Roger Kirby (RSM President) for an interesting discussion on his wide-ranging legal career, including previous inquiries such as the Freedom to Speak Up Review. He will also be talking about patient quality and care in the UK, and his view on the COVID-19 pandemic. Register
  7. Content Article
    In this episode of Speak Up, Listen Up, Follow Up, Dr Jayne Chidgey-Clark, National Guardian for the NHS, speaks to Chris Hopson and Saffron Cordery, Chief executive and Deputy Chief executive of NHS Providers, about speaking up’s role in work force retention and how they will use speaking up in their new roles.
  8. Content Article
    In this blog, student midwife Sophie Dorman describes some of the issues that have led to a chronic shortage of midwives, including a culture of fear, poor pay and conditions and a lack of basic facilities for maternity staff. She highlights the impact this is having on the safety of maternity services and argues that valuing and looking after midwives will make pregnancy and childbirth safer and better for everyone.
  9. Content Article
    Healthcare is traditionally a hierarchical industry. This structure can foster a culture of division amongst staff that is sometimes made worse by significant differences in background and training. However, in order to make sure care is safe and of a high quality, healthcare teams must develop good teamwork and communication. This is only possible if every member of the team feels respected and is free to speak up when they think something is wrong. In this podcast, host David Feldman speaks to Michael Brodman, Professor and Chair Emeritus in the Department of Obstetrics, Gynecology, and Reproductive Science at the Icahn School of Medicine at Mount Sinai in the US. They discuss how mutual respect is essential for any institution developing a culture of safety and how the problems presented by medical hierarchy can be overcome.
  10. Content Article
    Sexism, sexual harassment, and sexual assault are commonplace in the healthcare workforce. Too many healthcare staff have witnessed or been subject to it… the female med student asked to stay late lone working with a senior male doctor, being looked over for opportunities at work, unwelcome touching at conferences, comments on your looks… the list goes on. A 2021 survey from the BMA reported 91% of women doctors had experienced sexism in the last 2 years and 47% felt they had been treated less favourably due to their gender. Over half of the women (56%) said that they had received unwanted verbal comments relating to their gender and 31% said that they had experienced unwanted physical conduct. Despite these statistics these issues remain endemic in healthcare. The Surviving in Scrubs campaign, created by Dr Becky Cox and Dr Chelcie Jewitt, aims to tackle this problem, giving a voice to women and non-binary survivors in healthcare to raise awareness and end sexism, sexual harassment, and sexual assault in healthcare. You can share your story through the Submit Your Story page anonymously and the story will be published on the Your Stories page. This will create a narrative of shared experiences that cannot be ignored.
  11. Content Article
    Psychological safety is a belief that one will not be punished or humiliated for speaking up with ideas, questions, concerns, or mistakes. More than 20 years of research demonstrates that organisations with higher levels of psychological safety perform better on almost any metric or key performance indicator (KPI) in comparison to organisations that have low psychological safety. However, achieving psychological safety is a challenge in the complex, ever-evolving health and care systems in which we operate. In this guide, Professor Amy C. Edmondson shares insights that emerged from exploring the experience of differing Integrated Care Systems; a range of case studies, and a wealth of tools and resources. This guide is not a 'how to' for how to create psychological safety; it is more of a reflection on the opportunities and challenges in our health and care system, and how you might seek to work with them.
  12. Content Article
    Pretty soon there won’t be a trust without an associate director or even board level director fully dedicated to all things equality, diversity and inclusion; relatively new senior roles that must have a purpose, job description and performance indicators. They will spend energy on yet more strategies, start from the top and hope something trickles down. Or they could start where the work is done, and build the tools to make equality, diversity and inclusion (EDI) everyone’s responsibility. Trusts are full of people passionate about EDI. So many roles, so many champions. They meet, share stories, and champion the importance of EDI. All this busyness typically outside a governed frame without the necessary reporting, investigating, actions, outcomes, learning, and measurable improvement. To normalise EDI and make it everyone’s responsibility will involve enabling reporting of EDI incidents, investigating it, taking action, and learning from it, writes Dr Nadeem Moghal in an article for HSJ.
  13. Content Article
    This article in the Journal of Interprofessional Care highlights the challenges experienced by programme leaders and healthcare professionals as they work to improve patient safety. It discusses the complexities of translating organisation-wide speaking-up policies to local practices and settings.
  14. Content Article
    Several accidents have shown that crew members’ failure to speak up can have devastating consequences. Despite decades of crew resource management (CRM) training, this problem persists and still poses a risk to flight safety. This study aimed to understand why crew members choose silence over speaking up. The authors explored past speaking up behaviour and the reasons for silence in 1,751 crew members, who reported to have remained silent in half of all speaking up episodes they had experienced. Reasons for silence mainly concerned fear of damaging relationships, fear of punishment and operational pressures. The study identified significant group differences in the frequencies and reasons for silence and recommends interventions to specifically and effectively foster speaking up.
  15. Content Article
    This improvement tool is designed to help NHS organisations identify strengths their leadership team and organisation, and any gaps that need work, in seeking to create an environment where people feel safe to speak up with confidence. It should be used alongside Freedom to speak up: A guide for leaders in the NHS and organisations delivering NHS services, which provides full information about the areas addressed in the statements, as well as recommendations for further reading.
  16. Content Article
    This guide provides ideas for how an organisation can adhere to the NHS principles for leaders and managers in seeking to create an environment where people feel safe to speak up with confidence. This guide is designed to be used by any senior team, owner or board in any organisation that delivers NHS commissioned services. This includes all aspects of primary care; secondary care; and independent providers.
  17. Content Article
    This policy provides the minimum standard for local freedom to speak up policies across the NHS, so those who work in the NHS know how to speak up and what will happen when they do. All NHS organisations and others providing NHS healthcare services in primary and secondary care in England are required to adopt this policy. This includes a template where organisations can incorporate their own local information into the policy document.
  18. Content Article
    In a series of blogs, Gina Winter-Bates, Associate Nurse Director Quality and Safety at Solent NHS Trust, shares her experience of implementing Safety Chats. In this final blog of the series, Gina shares the next steps for Safety Chats in her Trust and how they will be building more ways of supporting staff to discuss safety, to seek advice and support, and to receive clear assistance when things have gone wrong.
  19. Content Article
    Since the seminal report by the Institute of Medicine, To Err Is Human, was issued in 1999, significant efforts across the health care industry have been launched to improve the safety and quality of patient care. Recent advances in the safety of health care delivery have included commitment to creating high-reliability organisations (HROs) to enhance existing quality improvement activities. This article will explore key elements of the HRO concept of deference to expertise, describe the structural elements that support nurses and other personnel in speaking up, and provide examples of practical, evidence-based tools to help organizations support and encourage all members of the health care team to speak up.
  20. Content Article
    In this letter to the Guardian newspaper, a specialist nurse writes on an NHS service that puts women in control of pain relief, Sara Davies on the torturous pain she endured to have an intrauterine device fitted, and Lee Bennett on why it pays to speak up persistently. Have you experienced pain during a medical procedure? Share your experience along with hundreds of women to one of our community forums: Do women experience poorer medical attention when it comes to pain? Pain during IUD fitting Painful hysteroscopy
  21. Content Article
    In a series of blogs, Gina Winter-Bates, Associate Nurse Director Quality and Safety at Solent NHS Trust, shares her experience of implementing Safety Chats. In Part 3, Gina shares with us how the Safety Chats were conducted and the key themes that came out of them, and what empowers and blocks staff in improving safety.
  22. Content Article
    Safety voice is the act of speaking up about safety in order to prevent accidents and physical harm. This systematic review in the journal Safety Science aimed to determine how safety voice differs conceptually from employee voice, is described across levels of analysis and could be best investigated. The authors found that there are important challenges for safety voice in terms of developing methodologies and interventions.
  23. Content Article
    Already familiar to a number of NHS Trusts, Work In Confidence is a platform providing anonymity to those who wish to raise concerns.
  24. Content Article
    "Shaming and punishing healthcare workers when an incident occurs sets a dangerous precedent for the industry. This will lead to a culture where healthcare workers avoid reporting near misses or errors for fear of repercussions, allowing process inefficiencies and systemic problems to occur." In this letter, Michael Ramsay, CEO of the Patient Safety Movement Foundation, highlights the negative ways in which criminalising healthcare workers who make mistakes will affect patient safety. He refers to the case of RaDonda Vaught, a nurse who was convicted of criminally negligent manslaughter in March 2022 for a medication error made while working at Vanderbilt University Medical Center in Nashville.
  25. Content Article
    “Freedom to Speak Up requires leadership commitment throughout the health and care system,” writes Dr Jayne Chidgey-Clark in a blog for the Health Service Journal. “In this way, we can foster the speak up, listen up, follow up culture, which will give workers, and ultimately those who use our services, the health and care sector they deserve.” She encourages all senior leaders to under take training to understand their role in forster a good speaking up culture that promotes organisational learning and improvement. 
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