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Content ArticleA number of serious concerns were raised about the University Hospitals Birmingham NHS Foundation Trust, relating to patient safety, governance processes and organisational culture. The Trust has been under review by the Birmingham and Solihull Integrated Care Board (ICB), following a junior doctor at the trust, Dr Vaishnavi Kumar, taking her own life in June 2022. In response to these concerns, a series of rapid independently-led reviews have been commissioned at the Trust. A follow up report into concerns raised about University Hospitals Birmingham NHS Foundation Trust has now been published showing the progress made against the recommendations made in the clinical safety (phase 1) report. It also collates the evidence from phase 2 and 3 of the review and assesses how the lessons learned can at this point be incorporated into the recovery and development plan that the Trust is already progressing. It also takes account of any other concerns that have arisen or been communicated to the review team.
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News ArticleThe head of NHS England has warned that July's planned strikes in the health service could be the worst yet for patients. Amanda Pritchard said industrial action across the NHS had already caused "significant" disruption - and that patients were paying the price. This month's consultant strike will bring a "different level of challenge" than previous strikes, she said. Junior doctors and consultants will strike for a combined seven days. Ms Pritchard told the BBC's Sunday with Laura Kuenssberg programme that the work of consultants - who are striking for the first time in a decade - cannot be covered "in the same way" as junior doctors. "The hard truth is that it is patients that are paying the price for the fact that all sides have not yet managed to reach a resolution," she said. Read full story Source: BBC News, 2 July 2023
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News ArticleNearly 170,000 workers left their jobs in the NHS in England last year, in a record exodus of staff struggling to cope with some of the worst pressures ever seen in the country’s health system, the Observer can reveal. More than 41,000 nurses were among those who left their jobs in NHS hospitals and community health services, with the highest leaving rate for at least a decade. The number of staff leaving overall rose by more than a quarter in 2022, compared to 2019. The figures in NHS workforce statistics of those leaving active service since 2010 analysed by the Observer show the scale of the challenge facing prime minister Rishi Sunak. He launched a new workforce plan on Friday to train and keep more staff. Sir Julian Hartley, chief executive of NHS Providers, said: “Staff did brilliant work during the pandemic, but there has been no respite. The data on people leaving is worrying and we need to see it reversed. “We need to focus on staff wellbeing and continued professional development, showing the employers really do care about their frontline teams.” Read full story Source: The Guardian, 1 July 2023
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News Article
Trust leadership rated ‘inadequate’ as CQC accuses staff of ‘ignoring’ problems
Patient Safety Learning posted a news article in News
An acute trust’s leadership has been downgraded to ‘inadequate’ after some staff ignored concerns raised directly by CQC inspectors, while others said bullying was ‘rife’. The Care Quality Commission (CQC) found multiple reports of staff raising concerns at York and Scarborough Foundation Trust, but that staff felt they were “ignored”, dismissed or “swept under the carpet”. The trust’s leadership has been rated as “inadequate”, down from “requires improvement”, although its overall rating remains “requires improvement”. The CQC said “poor leadership was having an impact across all of the services” and there were occasions “where leaders displayed defensiveness or appeared to tolerate poor behaviours from staff.” The trust said it had been under “sustained pressure” but had already begun to make improvements, including a new information system in maternity services and a review of nursing establishment numbers. Read full story (paywalled) Source: HSJ, 30 June 2023 -
News ArticleHealthcare staff from the European Union can join or continue to work in the NHS for the next five years without undergoing additional exams or further assessments, the government has decided. The “standstill provisions”, which were put in place after the UK left the European Union in 2020, have been extended by government until 2028. The NHS has become increasingly reliant on recruiting staff from overseas, particularly nurses, but has seen a significant drop in the number of staff joining from the European Union post-Brexit. The review by the Department of Health and Social Care said: “Retaining the standstill provisions for a temporary period of five years will support the [DHSC’s] ambition to attract and recruit overseas healthcare professionals, without introducing complex and burdensome registration routes. “[European Economic Area]-qualified healthcare professionals will be able to continue to register with the relevant professional regulator, without the need to sit additional professional exams, mitigating delays to registration and employment in the NHS.” Read full story (paywalled) Source: HSJ, 29 June 2023
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News Article
NHS staff sickness hits record high in England
Patient Safety Learning posted a news article in News
Staff sickness in the NHS in England has reached record levels. Figures for 2022 show an absence rate - the proportion of days lost - of 5.6%, meaning the NHS lost the equivalent of nearly 75,000 staff to illness. This is higher than during the peak pandemic years of 2020 and 2021 - and a 29% rise on the 2019 rate. Mental health problems were the most common cause, responsible for nearly a quarter of absences, the Nuffield Trust analysis of official NHS data shows. Big rises were also seen in cold, coughs, infections and respiratory problems, likely to be linked to the continued circulation of Covid as well as the return of flu last year. The think tank warned the NHS was stuck in a "seemingly unsustainable cycle" of increased work and burnout, which was contributing to staff leaving. The analysis, exclusively for BBC News, comes ahead of the publication of the government and NHS England's long-awaited workforce plan. Read full story Source: BBC News, 29 June 2023 -
News Article
Nurses strikes to end but now senior doctors vote to walk out
Patient Safety Learning posted a news article in News
Nurses strikes are set to end but the disruption for NHS patients will continue as senior doctors are the latest to vote to walk out. The Royal College of Nursing failed to reach the threshold needed to hold further action, with just 43% of the required 50% of members returning a ballot to hold fresh walkouts. But more than 24,000 members of the British Medical Association (BMA) backed industrial action by 86% on a turnout of 71%, well above the legal threshold of 50%, with senior doctors set to strike on 20 and 21 July. It comes after the union last week announced a five-day strike by junior doctors will be held from 13 July. NHS leaders have said consecutive walkouts from junior doctors and now consultants presents a “huge risk” for the health service. Read full story Source: The Independent, 27 June 2023 -
News Article
Black patients worst affected by 2016 junior doctors’ strike
Patient Safety Learning posted a news article in News
Black patients at trusts most affected by 2016’s junior doctors’ strike suffered significantly more than their white or Asian counterparts, a new analysis has suggested. Research by the Institute for Fiscal Studies analysed 30-day readmission rates after the 48-hour junior doctors’ strike in April 2016. The co-authors of the research, George Stoye and Max Warner, said: “We find that patients treated in hospitals that were more exposed to the strike did not, on average, experience worse outcomes.” However, they added that black patients were “more negatively affected by exposure to the strikes than white patients in the same hospitals”. The April 2016 strike affected both elective and emergency care and was the last before the dispute ended. The current junior doctors’ strike has been ongoing since March. It also affects emergency and elective care but stoppages have been longer, with a five-day strike planned in July. Read full story (paywalled) Source: HSJ, 27 June 2023 -
News ArticleJunior doctors will take part in what is “thought to be the longest single period of industrial action in the history of the health service” for five days next month. The British Medical Association junior doctor committee announced this morning there would be a walkout from 7am on Thursday 13 July and 7am on Tuesday 18 July in its ongoing pay dispute with government. It comes amid growing expectation that a Royal College of Nursing ballot on further strike action over the Agenda for Change pay award, which ends this week, is likely to fail to secure a mandate. But junior doctors’ strikes are continuing to hit elective recovery, and strain relationships, with workload on other groups increased as they are asked to provide cover. Junior doctors have allowed no “derogations” (exemptions) from the action, as they say other staff groups can cover emergency care, and one move to call them in to a busy hospital in the south west, in an earlier round, was abandoned. Read full story (paywalled) Source: HSJ, 23 June 2023
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News Article
Survey shows high levels of abuse of UK doctors by patients
Patient Safety Learning posted a news article in News
More than half of UK doctors have seen or experienced abuse by patients or their relatives in the last year, including incidents in which they have been spat at and threatened. Doctors have variously had their hair ripped out, been backed up against a wall and been racially abused, a survey and dossier of testimonies collated by a medical organisation has revealed. Long delays for care and staff shortages are cited as the main triggers for what NHS leaders say is an increased readiness by the public to be aggressive towards frontline staff. The research by the Medical Protection Society (MPS) found that 56% of the doctors questioned had experienced or witnessed a situation involving verbal or physical abuse over the last year. Almost half said incidents had occurred because of a lack of staff, while 45% blamed it on patients’ frustration at having to wait a long time to be treated. One doctor told the MPS how a “patient’s partner threatened to kill me as he felt his wife had waited too long to be seen”, while another said: “I had a handful of my hair ripped out despite the patient being in handcuffs and with the police.” Read full story Source: The Guardian, 22 June 2023 -
News Article
Cardiff: Women 'treated differently' due to ethnicity at hospital
Patient Safety Learning posted a news article in News
There is evidence of black, Asian and minority ethnic women being treated differently at the University Hospital of Wales, Healthcare Inspectorate Wales (HIW) has said. HIW completed an inspection of UHW's maternity services in November 2022 and served an urgent improvement notice. A follow up inspection in March found continuing issues with patient safety. The inspectorate said in November that it identified issues which meant that patients were not consistently receiving an "acceptable standard of timely, safe, and effective care". Although "some improvements had been made in many areas... there remained significant challenges, and overall, the improvements were not progressing at the pace required", it said. The report added: "We found low morale amongst staff that we spoke to, and similar comments were received following a staff survey. Read full story Source: BBC News, 22 June 2023 -
Content ArticleAuthors of this article, published by Anaesthesia Patient Safety Foundation, look at various factors that exacerbate alarm fatigue and subsequent effects of nonoptimal medical alarms. They provide examples of a novel alarm versus a traditional alarm and conclude by saying: "By focusing on patient and provider safety, clinical workflow, and alarm technology, researchers, and policy makers can transform the medical alarm realm into one that is evidence-based and personnel-focused."
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News ArticleA trust has been told to not “shut down” staff who raise concerns by a former employee whom a tribunal found was racially discriminated against. Moorfields Eye Hospital Foundation Trust racially discriminated, victimised and harassed Samiriah Shaikh, who worked at the trust as an ophthalmic technician, according to a recent judgment. Judges said Ms Shaikh was described as “aggressive” by her boss Peter Holm, and stereotyped by managers as a “loud ethnic female” after she and fellow colleagues raised allegations of racism in the promotion of in-house staff. Mr Holm, who is listed as a chief ophthalmic and vision science practitioner at the trust, is said to have responded to staff members’ concerns by making jokes during a team meeting. It is unclear whether he is still at the trust. Read full story (paywalled) Source: HSJ, 20 June 2023
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News ArticleJunior doctors could indefinitely withdraw labor, and strike for three days a month until next year, the medics’ union leaders have warned. Hundreds of junior doctors gathered outside the largest NHS conference of the year, NHS Confedexpo, on Thursday chanting “pay us fair, pay right, we don’t want to have to strike”. The British Medical Association’s junior doctor committee co-chair Dr Rob Laurenson warned junior doctors may next escalate strike action in an “indefinite withdrawal of labour”. NHS England boss Amanda Pritchard said the strike is a “serious risk to patient safety” and industrial action “creates risk and upheaval”. She said tens of thousands of appointments will be affected. Read full story Source: The Independent, 15 June 2023
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News Article
Three-day strike by doctors in England expected to have ‘enormous impact’
Patient Safety Learning posted a news article in News
Almost all routine NHS care in England will be disrupted for three days this week when junior doctors strike in their latest attempt to force ministers to increase their pay. Prof Stephen Powis, NHS England’s national medical director, said the stoppage would have an enormous impact and lead to huge numbers of patients missing out on planned care. Many thousands of junior doctors are due to stage a 72-hour walkout starting at 7am on Wednesday and continuing until 7am on Saturday. “The NHS has been preparing extensively for this next set of strikes,” said Powis. “But we know that – with the sheer number of appointments that need to be rescheduled – it will have an enormous impact on routine care for patients and on the waiting list, as procedures can take time to rearrange with multiple teams involved.” Read full story Source: The Guardian, 13 June 2023 -
Content ArticleAn NHS consultant who was sacked after whistleblowing says it was because he raised concerns that “normal birth” ideology was putting the lives of women and babies at risk. Martyn Pitman, a respected obstetrician and gynaecologist, became a whistleblower to prevent “avoidable disasters” in NHS maternity care, but it cost him his career. Pitman lost his job last month after more than 20 years as a consultant at Royal Hampshire County Hospital in Winchester. His bosses cited an “irretrievable breakdown in his relationship with management”. His dismissal caused outrage from hundreds of former patients and doctors’ leaders, who say it highlights an NHS culture of “punishing those who dare to speak out”.
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News ArticleHealth leaders have blamed staff shortages for waiting lists reaching another record high, with 7.4 million people in England waiting to start treatment as of the end of April. One NHS leader said the figures showed that unsustainable “pressure continues to pile on an overstretched NHS”, and urged the government to speed up publication of its long-awaited workforce plan, which has been repeatedly postponed. Waiting list figures in England have crept up again after showing signs of improvement in recent months, despite Rishi Sunak citing bringing numbers down as one of the government’s top five priorities for 2023. Downing Street on Thursday insisted the NHS was “continuing to make progress to ensure patients are seen more quickly”, pointing to record numbers of doctors and nurses in the NHS. Read full story Source: The Guardian, 8 June 2023
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Content ArticleThe NHS Staff Survey is an essential tool for assessing the experiences and opinions of NHS workers in Trusts in England. It also provides valuable insights to help understand the speaking up culture in the NHS. In this report the National Guardian’s Office analyse the results of the 2022 NHS Staff Survey, focusing on questions relating to speaking up.
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News ArticleTwo new healthcare workforce surveys outline widespread reports of discrimination, racism and workplace violence in the USA perpetuated by patients and coworkers alike. Among the findings were acknowledgments from respondents that incidents of discrimination are rarely reported to management or law enforcement. Additionally, more than half of the respondents to one survey said that they believed that incidents of workplace violence have increased over the course of their tenure, while nearly half of the nurses who responded to the other survey said they believe “a culture of racism/discrimination” was present as early as in nursing school. “If we are to truly provide just and equitable care to our patients, we as nurses must hold ourselves accountable for our own behavior and work to change the systems that perpetuate racism and other forms of discrimination,” said Beth Toner, RN, director of program communications at the Robert Wood Johnson Foundation (RWJF). Read full story Source: Fierce Healthcare, 2 June 2023
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News Article
Inadequate maternity unit handed safety warning
Patient Safety Learning posted a news article in News
An NHS maternity department has been handed a warning notice by the health regulator because of safety failings. The Care Quality Commission (CQC) said it was taking the action over the James Paget Hospital in Norfolk to prevent patients coming to harm. Inspectors found the unit did not have enough staff to care for women and babies and keep them safe. The maternity department has been deemed "inadequate" by the CQC, which meant the overall rating for the hospital has now dropped from "good" to "requires improvement". Between June and November 2022 there were 30 maternity "red flags" that the inspectors found, of which more than half related to delays or cancellations to time-critical activity. In one instance, there was a delay in recognising a serious health problem and taking the appropriate action. The report also highlighted the service did not have enough maternity staff with the right qualifications, skills, training and experience "to keep women safe from avoidable harm and to provide the right care and treatment". Read full story Source: BBC News, 31 May 2023 -
Content ArticleBurnout is a workplace syndrome characterised by three core attributes: 1) energy depletion or exhaustion, 2) a cynical or negative attitude toward one’s job, and 3) reduced professional efficacy. That second attribute, workplace cynicism, may be the least-understood aspect of burnout in part because of its complexity. In contrast to exhaustion and diminished efficacy, whose causes and effects are relatively straightforward, cynicism can be caused by a number of workplace factors, and it can be expressed in a broad range of emotional states and behaviours. Cynicism is dangerous to both individual and organisational health and can also spread rapidly throughout teams through a phenomenon known as “emotional contagion.” It’s possible to improve even deep-seated cynicism — and better yet, to prevent it from infecting your organization in the first place. The author of this Harvard Business Review article offers strategies to help reverse existing cynicism and to create an anti-cynical culture at work.
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News Article
Child died at mental health hospital ‘while staff were meant to be watching her’
Patient Safety Learning posted a news article in News
A 14-year-old girl who should have been under constant supervision at a mental health hospital died after a member of staff on his first shift left her unattended, an inquest has heard. Ruth Szymankiewicz died at Taplow Manor Hospital in Maidenhead on 12 February 2022 after a care worker responsible for her one-to-one supervision “sporadically” left his post, the hearing was told. It also emerged at the hearing that the care worker, who is now abroad, was allegedly using a fake name. Detectives are investigating him as part of a fraud investigation although he has not yet been interviewed by police. After Ruth’s death, the Care Quality Commission launched a criminal investigation. In an update to the coroner, it said that the investigation was looking at whether the provider had “brought about avoidable harm or exposure to risk” in relation to the young girl’s death. Read full story Source: The Independent, 26 May 2023 -
News ArticleAmbulance chiefs have warned a controversial piece of legislation could lead to legal action against their trusts by patients denied an ambulance. The Strikes (Minimum Service Levels) Bill, which is currently going through Parliament, would enable the health and social care secretary to set minimum levels of staffing for ambulance call centres and crews. Employers would be able to issue “work notices” compelling staff to provide cover during any strike. But, in its response to the government consultation on how the system would work, the Association of Ambulance Chief Executives has said it does not support the legislation in its current form as it does not believe it will deliver an improvement for patients, or offer a practical means of delivering minimum service levels. It said the proposed legislation appears to pass responsibility for the service levels to employers, which could leave them “exposed to patient liability risks to a greater extent than before”. Read full story (paywalled) Source: HSJ, 22 May 2023
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Content ArticleThis toolkit from NHS Employers aims to support the reduction in turnover of international staff in the NHS by improving their experience at work. It is hoped that this will then enable them to stay, thrive and build lasting careers in the NHS. It is for line managers and employers and should be used alongside the International Recruitment Toolkit and the Improving Staff Retention Guide to support your overall approach to recruiting and retaining international and domestic staff. The good practice principles and examples throughout can be applied to all professions.
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Content ArticleMany 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.
