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Found 844 results
  1. News Article
    Staff were suspended by their trust after they were found to have been sleeping in a patient’s bed, a Care Quality Commission (CQC) report has revealed. The regulator inspected acute wards for adults and psychiatric intensive care units at Black Country Healthcare Foundation Trust in February, after safeguarding concerns were raised. As HSJ revealed earlier this year, inspectors investigated a series of incidents, while a referral was also made to the police. As well as reports of staff using a mental health inpatient’s bed, there were complaints involving alleged inappropriate sexual behaviour and a governance breach. The concerns were said to relate to Hallam Street hospital in West Bromwich and Penn Hospital in Wolverhampton. The CQC inspection report said it inspected the service following allegations that “abuse had occurred” and a “multi-agency safeguarding meeting was convened to discuss the investigations of these”. Read full story (paywalled) Source: HSJ, 18 May 2023
  2. News Article
    Hospitals are deploying staff with less training than nurses – wearing the same uniforms – a conference has heard. Nurses said trusts trying to make “cost savings” were using cheaper nursing associates, and treating student nurses as free labour, to try to plug gaps that should be filled by more qualified staff. They are trained in similar basic skills to nurses, but have two years of training and a foundation degree qualification, compared to three years studying and a university degree for registered nurses. Nurses at the RCN annual congress in Brighton said the associate workers are frequently being given equally complex tasks, as pressures mounted. In some cases, they were even being given the same uniforms, meaning patients cannot distinguish between nurses and less-qualified staff, nurses said. Meanwhile, student nurses, who should be shadowing trained staff to learn new skills, were increasingly being asked to fill in for healthcare assistants, the conference heard. Read full story (paywalled) Source: The Telegraph, 16 May 2023
  3. News Article
    School-leavers could receive on-the-job training as part of an attempt to help address NHS workforce shortages, under plans to allow tens of thousands of doctors and nurses to join the health service via apprenticeships. Up to 1 in 10 doctors and a third of nurses could be trained through this vocational path in the coming years under the NHS workforce plan. The NHS’s doctor apprenticeship scheme is due to start in September, where medics in training will be able to earn money while they study. The concept was first introduced as an alternative route into medicine circumventing the standard undergraduate or graduate university programmes. Dr Latifa Patel, workforce lead for the British Medical Association, said innovative approaches to education and training are welcome but there were huge question marks over how far medical apprenticeships can solve the recruitment crisis. Patel said: “We don’t know if medical schools and employing organisations are going to be able to produce medical degree programmes to meet individual apprenticeship needs while also meeting the same high standards of training experienced by traditional medical students. “We have little evidence on whether the apprentice model will work at scale, and whether employers will want to take the investment risk with no guarantee of a return." Read full story Source: The Guardian, 10 May 2023
  4. News Article
    Young doctors just out of medical school working as resident physicians, fellows and interns at major US hospitals are organising unions at an increasing rate, citing long-running problems highlighted by the Covid-19 pandemic and a need to rethink the struggles young doctors face in the profession. The Committee of Interns and Residents, an affiliate of SEIU, added five unionised sites in 2022 compared with about one a year before the pandemic and the surge has continued in 2023 with multiple union election filings. It currently represents over 25,000 residents, fellows and interns across the US, comprising about 15% of all resident and fellow physicians. Hospital management has opposed the unionisation effort, declining to voluntarily recognise the union, encouraging residents not to sign union authorisation cards ahead of the election filing and writing local op-eds in opposition to unionisation. Since going public with their union plans, staff have been sent emails and been invited to meetings to try to dissuade residents from unionising, “often counting on myths around what unionizing would mean”, said Dr Sascha Murillo, a third-year internal medicine resident at Massachusetts general hospital. The unionising campaign took off after vulnerabilities in the healthcare system were exposed by the Covid-19 pandemic, she said, with residents working on the frontlines and bearing the brunt of staffing shortages, an influx of Covid-19 patients, and patients who deferred medical care. Read full story Source: The Guardian, 27 April 2023
  5. News Article
    Two former senior managers at a large mental healthcare provider have told the BBC they had concerns about the safety of patients and staff. The whistleblowers claim they felt pressure to cut costs and fill beds. The Priory Group, which receives more than £600m of public money each year, is the biggest single private provider of mental health services to the NHS. The company denies the claims and says it successfully treats tens of thousands of patients each year. It adds its services "remain amongst the safest in the UK". The former members of the Priory Group's senior management said that, when they were working for the company, they found it difficult to recruit or retain staff, due to poor pay and conditions. They believe this resulted in patients being placed on wards that did not have staff equipped with the right skills to handle their conditions. Read full story Source: BBC News, 26 April 2023
  6. News Article
    Many care home staff worked extra hours without extra pay to prop up the system during the pandemic, a study suggests. Public money helped stabilise UK care homes during the first wave of Covid-19 but it was withdrawn too soon and not focused on staff, says the research, led by Warwick Business School. The researchers studied the accounts of more than 4,000 UK care home companies, from just before the pandemic and during the first year of the health crisis. They found nearly two thirds (60%) of care homes were already financially fragile as the pandemic took hold. The report concludes: "The decision by government to end financial support for care home companies after the peak of the pandemic had passed has likely contributed to the current financial and operational difficulties experienced by the sector." It states the financial plight of many staff and the immense pressure they were under "means it is not surprising the care home sector has struggled to both recruit and retain staff once lockdown restrictions were removed and the wider economy re-opened". Read full story Source: BBC News, 12 April 2023
  7. News Article
    More than three quarters of NHS workers are seriously considering leaving their jobs amid the ongoing strain on the health service. According to research from the worker-led network Organise – which surveyed 2,546 NHS staff in March – 78.5% are thinking about packing it all in. Only a fifth (21.5%) said they had no plan to give up their NHS job any time soon. And the survey shows this sentiment is shared across a range of professions within the health service – with nurses, healthcare assistants, paramedics, doctors, health visitors and more all struggling with their jobs right now. This comes after years of public concerns about the longevity of the health service, amid funding cuts, staff shortages and burnout – not to mention the additional strain from the Covid pandemic. The findings also show that in the last three years: 79% of respondents experienced stress 62% reported anxiety 55% reported burnout. More than half (55%) of respondents said they needed to take time off from their jobs as a result, with a quarter saying this meant a month or more away from work. Read full story Source: Huffington Post, 29 March 2023
  8. News Article
    The leaders of acute trusts across England have told HSJ the second junior doctor’s strike ‘feels very different’ from the first stoppage, and services are much more vulnerable because of ‘thinner’ consultant coverage. They also reported that the instruction from NHS England not to proactively cancel elective procedures and apppointments has been largely ignored by trusts. The chief executive of a large trust in the east of England said they were “more concerned about clinical safety than at any time during covid surges”. A trust CEO in the North West told HSJ this week’s stoppage “feels much more risky than the previous strike. We have managed to cover rotas but we are very stretched and concerned about short notice cancellation from agencies and short term sickness after bank holiday.” Read full story (paywalled) Source: HSJ, 11 April 2023
  9. News Article
    The four-day strike by junior doctors in England will have a “catastrophic impact” on NHS waiting lists, with up to 350,000 appointments and operations likely to be cancelled, the chief executive of the NHS Confederation has said. Matthew Taylor said the industrial action this week posed risks to patient safety and called on the public to avoid “risky behaviour”. “These strikes are going to have a catastrophic impact on the capacity of the NHS to recover services,” he told Sky News. “The health service has to meet high levels of demand at the same time as making inroads into that huge backlog that built up before Covid, but then built up much more during Covid." He said he hoped everyone who needed urgent care would get it, but added: “There’s no point hiding the fact that there will be risks to patients – risks to patient safety, risks to patient dignity – as we’re not able to provide the kind of care that we want to.” He called on the public to use NHS services responsibly. Read full story Source; The Guardian, 10 April 2023
  10. News Article
    The government is actively considering whether to give full legal powers to an independent inquiry investigating the deaths of mental health patients. Roughly 2,000 deaths at the Essex Partnership University NHS Foundation Trust (EPUT) are being examined. The BBC understands Conservative Health Secretary Stephen Barclay is minded to make the inquiry statutory, which would compel witnesses to come forward. Only 11 current and former trust staff have agreed to give live evidence. Melanie Leahy, whose son Matthew died aged 20 while an inpatient at the Linden Centre in Chelmsford, said families were "definitely" a step closer to what they had campaigned for. "We just need it converted [to a statutory inquiry] - it's just delay after delay after delay and we need those powers," she told BBC Essex. Read full story Source: BBC News, 3 April 2023
  11. News Article
    Repeated cases of bullying and a toxic environment at one of England's largest NHS trusts have been found in a review. The Bewick report was ordered after a BBC Newsnight investigation heard from staff at University Hospitals Birmingham (UHB) saying a climate of fear had put patients at risk. A first phase of the rapid review, headed by independent consultants IQ4U and led by Prof Mike Bewick, was published Tuesday. It is one of three major reviews into the trust, commissioned following a series of reports by Newsnight and BBC West Midlands in which current and former staff raised concerns. Summarising the findings, Prof Bewick, a former NHS England deputy medical director, said: "Our overall view is that the trust is a safe place to receive care. "But any continuance of a culture that is corrosively affecting morale and in particular threatens long-term staff recruitment and retention will put at risk the care of patients across the organisation - particularly in the current nationwide NHS staffing crisis. "Because these concerns cover such a wide range of issues, from management organisation through to leadership and confidence, we believe there is much more work to be done in the next phases of review to assist the trust on its journey to recovery." The West Midlands trust said it fully accepted the report's recommendations. Read full story Source: BBC News, 28 March 2023
  12. News Article
    Last year the World Health Organization (WHO) released a report warning of a “ticking time bomb” threatening health systems in Europe and Central Asia: a growing shortage of health workers. With quickly ageing populations and an ageing health workforce—40% of doctors in Europe are close to retirement in a third of countries—along with a surge in chronic illnesses and the ongoing effects of the covid pandemic, WHO warned that many countries could soon see their healthcare systems collapse unless they take urgent action. Six months on, the situation has worsened, as healthcare workers throughout Europe increasingly resort to industrial action over pay and conditions. Hans Kluge, WHO regional director for Europe, said, “The health workforce crisis in Europe is no longer a looming threat—it is here and now. Health providers and workers across our region are clamouring for help and support... “We cannot wait any longer to address the pressing challenges facing our health workforce. The health and wellbeing of our societies are at stake—there is simply no time to lose.” Read full story (paywalled) Source: BMJ, 24 March 2023
  13. News Article
    US clinical and nonclinical healthcare workers have an upward-trending perception of safety culture, but physicians and leaders do not agree, according to a Press Ganey report. Press Ganey, a US company that focuses on patient satisfaction surveys, found in its annual safety culture trends report that senior management perceptions of all safety culture metrics are lower. Overall safety scores are down 0.04 points, prevention and reporting decreased 0.02 points, pride and reputation declined 0.05 points, and resources and teamwork are down 0.04 points. The report analysed 2022 data from 813,900 healthcare workers across 194 systems and 3,279 facilities. "Senior management safety culture scores are typically higher than those of operational management, suggesting a more positive perspective among those at the highest levels of provider organizations," the report said. "Yet the continued downward trajectory of senior management scores stands out as significant." Among physicians, pride and reputation fell 0.12 points. Their perceptions of overall safety declined 0.06 points, prevention and reporting is down 0.03 points, and resources and teamwork is down 0.05 points. Other healthcare employees had higher perceptions of these metrics except for pride and reputation. Also, "fewer employees today say they would recommend their organization for care than in previous years," Press Ganey found. Read full story Source: Becker's Hospital Review, 21 March 2023
  14. News Article
    An ambulance trust that was the subject of a documentary involving covert filming by an employee has warned staff they could be subject to ‘disciplinary action and even prosecution’ if they take this type of action. East of England Ambulance Service Trust sent an all staff email yesterday outlining the potential consequences of filming covertly and reminding staff they must adhere to the trust’s social media and digital guidelines. The email, seen by HSJ, followed Channel 4 broadcasting a documentary called Undercover ambulance: NHS Chaos – Dispatches which featured footage filmed covertly by one of the trust’s apprentice emergency technicians, and laid bare the extreme pressures on hospital and ambulance staff. The message sent on Thursday by the trust’s interim officer Melissa Dowdeswell, said the apprentice who carried out the filming had since resigned and then set out what support staff could access from the trust if they had been affected by “an incredibly difficult couple of weeks”. Read full story (paywalled) Source: HSJ, 17 March 2023
  15. News Article
    Deliberate attempts were made to “conceal the extent of racial discrimination” at a national NHS agency, according to a report leaked to HSJ. A highly critical internal report at NHS Blood and Transplant (NHSBT) also said fewer than half the recommendations made in 2020 by external mediation experts, around issues of racism, had so far been actioned. A review conducted by Globis Mediation Group in 2020 found “systemic racism” among management at the agency’s large Colindale site in north London, with ethnic minority staff being “ignored, being viewed as ineligible for promotion and enduring low levels of empathy”. It made nine recommendations, including exploring whether similar issues existed at the other 15 NHSBT sites. Read full story Source: HSJ, 16 March 2023
  16. News Article
    A chief executive has apologised after a survey of his trust’s staff from minority ethnic backgrounds found many had been subjected to racist behaviour by colleagues. The staff at East of England Ambulance Service Trust said peers had made monkey noises and referred to banana boats in front of them, excluded them from social events, and assumed they could speak Middle Eastern and Asian languages just because of their skin colour, they told researchers. The trust has had substantial cultural problems for several years, and commissioned the survey to “better understand the experience, perceptions and realities of the trust BME staff”, a board paper said. The report on its findings, published this week in trust board papers, warns: “There are risks that a minority of EEAST employees are demonstrating behaviours or using language which could be perceived as racist. Reports of subsequent inaction by managers further risk this behaviour being normalised.” Read full story (paywalled) Source: HSJ, 15 March 2023
  17. Content Article
    Learn how one trust has applied staff engagement techniques as part of its continuous improvement programme.
  18. Content Article
    A significant amount of professional time is wasted during a medical ward round retrieving patient notes from the ward trolley. If the efficiency of this non-clinical, non-functional interaction could be improved it would save time, maintain continuity and have financial implications. One identified constraint was the structure of the traditional ward trolley; a stationary filing tray with vertical sleeves. During ward round, time is spent returning and retrieving each patients notes from outside the patient bay and additional time may be wasted if the notes are misplaced or in use elsewhere. To resolve this, the ‘Vista 90’ trolley with horizontal, transparent trays, is portable and has an ergonomic writing surface was selected as a potential second generation replacement. An assessment of the impact of the Vista 90 trolley over the traditional trolley in the clinical setting was carried out on Erringham (medical) Ward, Worthing Hospital, West Sussex Hospital Trust, UK. This was by way of qualitative analysis performed by semi-structured interview of 12 doctors and other healthcare professionals who regularly interacted with the Vista 90 and traditional trolley in December 2012. The audit found that those interviewed preferred using the Vista 90 trolley over its predecessor as it improved the efficiency of the ward round and subsequent clinical work. It’s mobility allowed it to be easily transported with the ward round, reducing disruption during a consultation and between consecutives ones. The ergonomic writing surface was noted to improve legibility of documentation due to greater comfort and if placed appropriately, did not interfere with the doctor-patient interaction. The financial savings of this greater efficiency was found to be of significance and justify the cost of the Vista 90 within two weeks.
  19. 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
  20. Content Article
    At times of crisis, healthcare workers (e.g., nurses, advanced practice nurses, physicians, nursing assistants, etc.) continue to provide care, despite ever challenging work demands, including higher influx of critically ill patients, increased work stress, and a frequent need for overtime. These work demands can compound already challenging work schedules (i.e. 12-hour shifts, night shifts), making it more difficult to obtain regular shift breaks and enough time off between shifts for adequate recovery. All of these work factors (i.e. physical, emotional, and/or mental demands) combined with insufficient sleep, contribute to fatigue. This article from the Centers for Disease Control and Prevention (CDC) gives tips and resources on managing fatigue in times of crisis.
  21. 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.
  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. Content Article
    Sleep deprivation due to extended work hours and circadian disruption has long been a concern in medicine. The levels of continuous duty and work hours for health care personnel are much greater than those allowed in the transportation and nuclear-power industries. The problem is most severe for residents in training but extends to experienced physicians and nurses. Clinicians who have been deprived of sleep are part of a health care system in trouble. A report from the Institute of Medicine concluded that the system fails to ensure that patients are safe or that the quality of care they receive is high. In this article, David Gaba and Steven Howard discuss current and proposed policies concerning clinicians' work hours and fatigue.  
  24. Content Article
    Providing an overview of the work of the Group and its key findings, the Report of the Strategic Workforce Advisory Group on Home Carers and Nursing Home Health Care Assistants presents a suite of 16 recommendations spanning the areas of areas of recruitment, pay and conditions of employment, barriers to employment, training and professional development, sectoral reform, and monitoring and implementation.
  25. Content Article
    This video and written summary from the Institute of Health and Social Care Management (IHSCM) look at the principles of running virtual wards, where patients are monitored and cared for in their own homes with the help of remote treatment options and supported by technology. Hosted by health policy analyst Roy Lilley, speakers include: Professor Alison Leary Elaine Strachan-Hall Steph Lawrence Alexandra Evans Dr Elaine Maxwell
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