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Found 844 results
  1. News Article
    White applicants remain 54% more likely to be appointed from NHS job shortlistings compared to ethnic minority candidates, a metric that has hardly budged since 2016, a NHS England report has revealed. The 2022 NHS workforce race equality standard report, revealed a significant rise in the proportion of staff from ethnic minority backgrounds. And while there had been progress on some key targets since last year, others have stagnated. NHSE’s report showed ethnic minority staff comprise 24.2% of the workforce in 2022, up from 22.4% last year and from 17.7% six years ago. However, it also revealed the likelihood of white applicants being appointed from shortlists was 1.54 in 2022 than minority ethnic applicants – only a very small improvement on 1.57 in 2016, when WRES began Read full story (paywalled) Source: HSJ, 22 February 2023
  2. Content Article
    The 2022 Workforce Race Equality Standard (WRES) report enables organisations to compare their performance with others in their region and those providing similar services, with the aim of encouraging improvement by learning and sharing good practice. It provides a national picture of WRES in practice, to colleagues, organisations and the public on the developments in the workforce race equality agenda The WRES provide detailed analysis to enable employers to understand how their staff experience compares with others in their region and with similar specialism.
  3. Content Article
    Surprises in healthcare are common and can have lasting effects on clinicians. Steven Shorrock asked clinicians to reveal aspects of their experience with implications for learning.
  4. News Article
    NHS England has lost an employment tribunal case against a senior black nurse on grounds of race discrimination and whistleblowing, and has been criticised for serious flaws in its own investigations. A judgement published today found Michelle Cox, a black woman who was an NHS continuing healthcare manager based in NHSE’s North West regional team, was excluded by her manager “at every opportunity”. The case centres on problems between Ms Cox and her line manager, then regional head of continuing healthcare, which took place from around April 2019 to November 2020. The tribunal ruled Ms Cox's line manager– who is now an associate director of nursing in the West Yorkshire integrated care system – had created an “intimidating and hostile and humiliating environment” for Ms Cox, which had the purpose and effect of unlawful harassment. The tribunal also upheld Ms Cox’s complaint of detriment for whistleblowing, including for raising concerns that members of her team were sitting on continuing healthcare “independent review panels”, which she pointed out was a breach of independence and legal obligations. Read full story Source: HSJ, 22 February 2023
  5. News Article
    The London Ambulance Service (LAS) failing on diversity and must implement specific targets for improvements, its leadership has been warned. According to LAS data, just 20% of the workforce is from a Black, Asian or from a minority ethnic background despite almost half of the capital’s population (46.2%) being made up of non-white communities. Of that 20%, 40.9% are in the lowest paid roles, compared to 15.9% who are in the highest wage bands, according to the LAS’ Integrated Performance report. The LAS is in the process of developing a new strategy to help attract more diverse staff, which will be published early next year. Research shows that ethnic minority groups suffer disproportionately higher levels of inadequate ambulance care due to a combination of issues such as a lack of cultural awareness among professionals, language and communication difficulties and a limited understanding of how the healthcare system operates for some minority groups. Read full story Source: The Independent, 21 February 2023
  6. News Article
    Health Secretary Stephen Barclay is to meet Royal College of Nursing bosses for pay talks later, after the union suspended next week's planned strike. In a joint statement, after months of bitter dispute, the two sides said they would begin "intensive talks" on "pay, terms and conditions" and "reforms to enhance productivity". Next week's walkout in England, from 1 to 3 March, was set to be the biggest strike of this winter's pay dispute, with half of frontline services affected. The action would have included nursing staff from intensive care units, cancer care and other services that were previously exempted. RCN general secretary Pat Cullen said: "We will put our plans on the table, they can put their plans on the table - but I'm confident that we will come out with a fair pay settlement for our nursing staff." She added they would make sure no stone was left unturned and a fair pay deal was reached as quickly as possible so they could end the strikes. Read full story Source: BBC News, 22 February 2023
  7. News Article
    Hundreds of thousands of operations and medical appointments will be cancelled in England next month and progress in tackling the huge care backlog will be derailed as the NHS prepares to face the most widespread industrial action in its history. Junior doctors are poised to join nurses and ambulance workers in mass continuous walkouts in March after members of the British Medical Association (BMA) voted overwhelmingly to take industrial action. In only the second such action in the 74-year-history of the NHS, junior doctors will walk out for 72 hours – continuously across three days, on dates yet to be confirmed – after 98% of those who voted favoured strike action. Amid an increasingly bitter row between health unions and the government, NHS leaders expressed alarm at the enormous disruption now expected next month. Read full story Source: The Guardian, 20 February 2023
  8. News Article
    Striking ambulance workers in two regions have said for the first time that they will only answer immediately life-threatening calls — abandoning previous agreements to cover some Category 2 incidents. Agreed exemptions (derogations) from ambulance strike action so far this winter have varied regionally and across different unions; but all have so far included some Category 2 cover. However, GMB told HSJ its members in the North East and North West today would cover only Category 1 calls – defined as “immediately life threatening” – during their action today. Category 2 includes more than any other category, and covers a wide range of incidents including suspected heart attacks and strokes. Read full story (paywalled) Source: HSJ, 20 February 2023
  9. News Article
    The British Medical Association has accused the government of "reckless" behaviour ahead of the results of a strike ballot by junior doctors. The BMA's Professor Philip Banfield said the prime minister and health secretary were refusing to enter meaningful negotiations with unions. The Department of Health and Social Care said it had met with the BMA and other unions to discuss pay. Professor Banfield, the BMA's chair of council, said that Rishi Sunak and Health Secretary Steve Barclay were "standing on the precipice of an historic mistake". He accused the government of "guaranteeing escalation", adding that officials were "reckless" for thinking they could stay silent and wait it out. Professor Banfield also accused the government of "letting patients down", adding: "All NHS staff are standing up for our patients in a system that seems to have forgotten that valuing staff and their well-being is directly linked to patient safety and better outcomes of care." Read full story Source: BBC News, 19 February 2023
  10. Content Article
    Learn how one trust has applied staff engagement techniques as part of its continuous improvement programme.
  11. News Article
    Nurses will walk out of emergency departments, intensive care units and cancer care services for the first time in the next wave of strike action. The Royal College of Nursing (RCN) has announced its members will strike for 48 hours, from 6am on 1 March until 6am on 3 March and that a range of derogations will be removed, including emergency care cover. More than 120 NHS organisations — covering all types of providers, integrated care systems and national organisations (see map below) — will be affected by the RCN’s walkout next month as it represents the most significant escalation of strike action yet by nurses. Previously, quite extensive exemptions (known as “derogations”) have been agreed, but the RCN has this time indicated they will be much more limited. HSJ asked the RCN what services will remain subject to national derogations, but a spokesman said discussions are continuing at a national level as part of a commitment to “life and limb care”. He added services will be reduced to an “absolute minimum” and hospitals will be asked to rely on members of other unions and clinical professions instead. Read full story (paywalled) Source: HSJ, 16 February 2023
  12. News Article
    Workforce problems in US hospitals are troublesome enough for the American College of Healthcare Executives to devote a new category to them in its annual survey on hospital CEOs' concerns. In the latest survey, executives identified "workforce challenges" as the number one concern for the second year in a row. Although workforce challenges were not seen as the most pressing concern for 16 years, they rocketed to the top quickly and rather universally for US healthcare organisations in the past two years. Most CEOs (90%) ranked shortages of registered nurses as the most pressing within the category of workforce challenges, followed by shortages of technicians (83%) and burnout among non-physician staff (80%). Read full story Source: Becker Hospital Review, 13 February 2023
  13. News Article
    GPs are attempting to deal with up to 3,000 patients each, amid worsening staff shortages, according to new analysis. The research shows that the number of patients per GP has risen sharply, as rising numbers of doctors reduce their hours, or opt for early retirement. Daisy Cooper, spokeswoman for Liberal Democrat Health and Social Care, said: “This ever-worsening GP shortage is having a terrible human cost, as people face delayed or missed diagnoses and A&Es fill up with desperate patients looking for treatment." Read full story (paywalled) Source: Telegraph, 14 February
  14. News Article
    Ambulance staff will need to respond to category 2 calls during strike action under new government proposals. The Department of Health and Social Care has launched a consultation on minimum service levels in ambulance services. It comes as industrial action continues across the NHS and as legislation to ensure minimum services levels in key industries during strikes is making its way through Parliament. The consultation document read: “Our proposal is that calls classed as life-threatening and emergency incidents would always receive an appropriate clinical response when there is strike action. “In England, currently, these calls are classified as category 1 (immediately life-threatening) and category 2 (emergency) calls… “On strike action days, some workers would continue their work to ensure that these calls can be answered and responded to appropriately to protect the life and health of patients.” The proposals added services must also have “adequate capacity and resourcing” in call control rooms, to ensure all emergency 999 calls to ambulance services were answered. Read full story (paywalled) Source: HSJ, 13 February 2023
  15. News Article
    Nurses in England are preparing to escalate their dispute with the government by involving staff from NHS A&E departments, intensive care and cancer wards in a series of 48-hour strikes. The Royal College of Nursing (RCN) is understood to be planning to announce walk outs for two consecutive days and nights, rather than limiting action from 8am to 8pm as they have done so far. NHS leaders warned the looming strike could be the “biggest impact” on patients yet seen, with the union preparing to end a process where the RCN had agreed to exemptions with hospitals. The RCN told NHS leaders on Friday it is preparing to step up its dispute by asking its members working in emergency departments, intensive care units and oncology to join the strike. But the union, expected to announce the strike this week, will make a very limited set of provisions for the most urgent clinical situations as part of a legal obligation not to endanger life. Saffron Cordery, deputy chief executive at NHS Providers said: “A continuous 48-hour strike that includes staff from emergency departments, intensive care units and cancer care services would likely have the biggest impact on patients we’ve seen.” Read full story Source: The Independent, 12 February 2023
  16. Content Article
    Behaviour Change Techniques are the ‘active ingredients’ of activities that lead to behaviour change. These cards were developed by Lucie Byrne-Davis, Eleanor Bull and Jo Hart to help those who work with people to try to change their behaviour, and particularly for educators, trainers, leaders and those involved in organisational development, quality improvement or implementation. This was was funded by Health Education England
  17. News Article
    Mental health sick days cost the NHS almost half a million pounds as staff anxiety and stress levels haved skyrocketed. Costs have almost doubled compared to before the pandemic from £279 million to £468 million. The sickness data shared with The Independent by GoodShape, an employee well-being and performance analysis company, shows the number of staff sick days increased in 2022 to 12 million from 7.21 million in 2019. That is despite the overall number of people working in the NHS increasing from 1.2 to 1.3 million. The overall cost to the NHS of absences for the five most common reasons – which includes mental health – increased to a “staggering” £1.85 billion from £1.01 billion between 2019 to 2022, according to figures from GoodShape. Covid was still the most common reason for staff sickness last year, according to the analysis, accounting for 4.4 million lost days, while mental health was a close second driving 3 million days off due to illness. Pat Cullen, chief executive and general secretary for the Royal College of Nursing said in response: “These figures are shocking but not surprising. With 47,000 vacant nurse posts in England alone, the pressures on staff are unrelenting. Read full story Source: The Independent, 8 February 2023
  18. Content Article
    NHS trusts have often reported emergency department doctors having low levels of satisfaction and high rates of burnout, leading to a high turnover. In 2017, Brighton and Sussex University Hospitals (BSUH) and Western Sussex Hospitals merged to form University Hospitals Sussex NHS Foundation Trust. The Trust found that the organisation of shifts at Royal Sussex County Hospital (RSCH) and Princess Royal Hospital (PRH) and lack of flexibility were adding to the strain already felt by doctors working in the high pressure emergency department. To combat the pressure consultants and other doctors were under, the Trust implemented a system to help improve rota design and flexible working. The hope was that the system would help the trust retain and recruit staff, whilst saving locum costs and improving patient care.
  19. News Article
    NHS waiting lists are unlikely to fall in 2023, and the backlog is unlikely to be significantly tackled until mid-2024 despite being one of Rishi Sunak’s priorities for this year, research suggests. The NHS has struggled to increase the number of people it is treating from its waiting lists each month due to ongoing pressures from Covid-19, although there have been signs of improvement in the past month, analysis from the Institute for Fiscal Studies (IFS) has found. Max Warner, an IFS economist and one of the report’s authors, said that although the NHS had made “real progress” to reduce the number of patients waiting a very long time for care, efforts to increase overall treatment volumes had “so far been considerably less successful”. The NHS Providers’ chief executive, Julian Hartley, urged the government to introduce a fully funded workforce plan and to talk to unions about pay for this financial year as strikes were causing huge disruption to services, and risked undoing hard-won progress made on care backlogs. “Mounting pressures on acute, ambulance, mental health and community services, such as chronic workforce shortages, could hamper efforts to cut the backlog further if left unchecked,” he said. Read full story Source: The Guardian, 8 February 2023
  20. News Article
    East Kent Hospital University Foundation Trust has been criticised for failures in services by the Care Quality Commission, after an unannounced inspection last month, years after major problems began to come to light. The Care Quality Commission has highlighted: Issues with processes for fetal monitoring and escalation at the William Harvey Hospital, Ashford. There had been “incidents highlighting fetal heart monitoring” problems in September and October, and the trust’s measures to improve processes were not “embedded and understood by the clinical team”; Slow maternity triage, due to staffing problems, and infection control problems at the William Harvey. The trust is reviewing how issues with infection prevention and control and cleanliness were not identified or escalated; and Fire safety issues at the Queen Elizabeth, the Queen Mother Hospital, in Thanet with problems linked to fire doors and an easily accessible secondary fire escape route. Three years ago issues with reading and acting on fetal monitoring were highlighted at the inquest into baby Harry Richford, whose poor care by the trust led to an independent inquiry into widespread failings in its maternity services, led by Bill Kirkup. Read full story (paywalled) Source: HSJ, 6 February 2023
  21. News Article
    Rana Abdelkarim died at Gloucestershire Royal Hospital in March 2021 after suffering a bleed post-birth. The Healthcare Safety Investigation Branch (HSIB) found there were delays in calling for specialist help. Her husband, Modar Mohammednour, said that in March 2021 his wife attended the maternity unit at 39 weeks into her pregnancy for what she thought was a routine check-up. Mr Mohammednour said due to language barriers his wife thought she was going "for a scan and to check on her health" and then "come back home", but in fact she was being sent to be induced. "Immediately" after the labour, Ms Abdelkarim suffered heavy bleeding and her condition deteriorated - something Mr Mohammednour said he was "unaware of", until he was eventually called into the hospital to speak to a doctor. According to the investigation by the HSIB, the obstetric team of senior doctors were not told about the drastic change in her condition for almost 30 minutes. An investigation into her death by the HSIB found that once Ms Abdelkarim had been given a drip to speed up labour, regular support from midwives and assessments could not be given to her because the maternity ward was so busy. It also found there was a 53-minute delay from the point of bleeding to administering the first blood transfusion. HSIB also found Ms Abdelkarim was "uninformed" about the reason for her admission, "consent to induce labour was not given" and because she was thin and small, staff underestimated how much relative blood volume she was losing. Read full story Source: BBC News, 7 February 2023
  22. Content Article
    In this study, Hawkins and Morse explored nurses’ work in the context of medication administration, errors and the organisation. Secondary analysis of ethnographic data included 92 hours of non-participant observation, and 37 unstructured interviews with nurses, administrators, and pharmacists. Think-aloud observations and analysis of institutional documents supplemented these data. Findings revealed the nature of nurses’ work was characterised by chasing a standard of care, prioritising practice and renegotiating routines. The rich description identified characteristics of nurses’ work as cyclical, chaotic and complex, shattering studies that explained nurses’ work as linear. A new theoretical model was developed, illustrating the inseparability of nurses’ work from contextual contingencies and enhancing our understanding of the cascading components of work that result in days that spin out of the nurses’ control. These results deepen our understanding why present efforts targeting the reduction of medication errors may be ineffective and places administration accountable for the context in which medication errors occur.
  23. News Article
    Nurses could refuse to carry out any further strikes alongside other health workers because of fears over patient safety, The Independent has learnt. A mass walkout billed as the largest strike in NHS history is due to take place on Monday as tens of thousands of nurses, paramedics and 999 call handlers walk out in a bid to force ministers to the negotiating table. But the coordinated strikes could be a one-off if nurses feel that the decision to take part in direct action compromises patient safety, The Independent has been told. One union source said walkouts are not carried out on a “come what may” basis, and that the unions would have to assess whether striking together was “helpful” or not. Unions have been escalating their industrial action in recent weeks in an attempt to secure higher pay rises. Any de-escalation in tactics will be seen as a blow to their campaign and a boost to Rishi Sunak’s hopes of riding out the wave of protests. With patient safety the priority, sources insisted there are strong local controls that will pull nurses from picket lines if they think there is an issue. Read full story Source: The Independent, 5 February 2023
  24. News Article
    “Frustration with the system was why I went off in the end,” said Conor Calby, 26, a paramedic and Unison rep in southwest England, who was recently off work for a month with burnout. “I felt like I couldn’t do my job and was letting patients down. After a difficult few years it was challenging.” While he usually manages to keep a distinct divide between work and home life, burnout eroded that line. He also lost his sleep pattern and appetite. The final straw came when what should have been a 15-minute call resulted in three hours on the phone trying to persuade the services that were supposed to help a suicidal patient to come out. “I was on a knife edge. That was due to the system being broken. That’s the trigger.” Doctors and nurses are struggling under the strain too. After her third time with burnout - the last resulting in her taking six months off work – Amy Attwater, an A&E doctor, considered leaving the profession altogether. Attwater, 36, said in the Covid crisis, during which a colleague killed himself, she started having suicidal thoughts and doubting her own abilities. She twice reported that she was being bullied but said no action was taken. “The only thing I was left with was to take time off work. I ended up having therapy, seeing a psychiatrist and being on two antidepressants,” said Attwater, the Midlands-based committee member for Doctors’ Association UK. Read full story Source: The Guardian, 5 February 2023
  25. News Article
    Deadlock over NHS pay is putting patients in danger and risks hardening the position of unions, 10 chief nurses have warned. Unions have warned that the government is making no moves towards resolving the strikes, with one general secretary accusing the government of lying about the state of negotiations. In a joint statement shared with the Guardian, chief nurses from 10 leading hospitals known as the Shelford group highlighted their concern that patients’ health could suffer as a direct result of the increasing disruption the stoppages are causing. Tens of thousands of nurses and ambulance workers in England will stage what will be the biggest strike in the NHS’s 75-year history on Monday. In a plea to the government and health unions, but especially ministers, the 10 Shelford group chief nurses stress that they want both sides to end their standoff as a matter of urgency “because of the impact on the patients and communities we serve. “Industrial action means appointments cancelled, diagnostics delayed [and] operations postponed. The longer industrial action lasts, the greater the potential for positions to harden, waits for patients to grow, and risks of harm to accumulate.” This week will see just one day – Wednesday – when there are no NHS strikes. Nurses will strike again on Tuesday, physiotherapists will stage their second walkout on Thursday and ambulance personnel will stage a further stoppage on Friday. Read full story Source: The Guardian, 5 February 2023
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