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Showing results for tags 'Staff factors'.
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Content ArticleIn this BMJ article, Ryan Essex and colleagues consider whether patients have more to gain than to lose from healthcare worker strikes in poorly functioning health systems Available research on the relationship between strikes and patient harm is limited and offers mixed results, most of which are not widely generalisable across different care settings, researchers said. Overall, the researchers in the study observed a substantial decrease in the number of admissions or care visits during strikes, with broader care delivery changes varying based on who is striking. For example, when early-career physicians strike, research suggests wait times and length of stay are unaffected or become shorter. "While patient safety obviously matters, the overly narrow framing of strikes as harmful to patients is not supported by current evidence; this also shifts focus away from the structural failings that drive strike action in the first place," "When health workers lack other avenues to enact change, failing to strike against suboptimal working conditions may actually be more harmful to patient health in the long run."
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News ArticleAn 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
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News Article
‘Deliberate attempts’ to conceal racism at NHS agency, says leaked report
Patient Safety Learning posted a news article in News
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 -
News Article
Trust CEO apologises to staff subjected to racist behaviour
Patient Safety Learning posted a news article in News
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 -
News Article
How doctors are exposed and vulnerable due to the current 'blame culture'
Patient Safety Learning posted a news article in News
The patient lay slumped next to a pile of pills and a personally signed note reading: 'do not resuscitate me'. His breathing was agonal, his skin mottled, his pupils fixed, no pulse discernible. The attending doctor, in agreement with both paramedics and family member, decided to respect his wishes. Yet, this GP was placed under investigation for gross negligence manslaughter by the Crown Prosecution Service (CPS) for not resuscitating the patient, setting in motion a sequence of investigations, including by the coroner and the General Medical Council (GMC), that were triggered by the statement of one policeman at the scene. All investigations and allegations were eventually dismissed but not until the GP had been through years of significant physical and mental stress. Still today, questions remain unanswered – in particular, concerning the actions of the police and the CPS. Speaking under the condition of anonymity, the GP spoke to Medscape News UK, and said that now, over 7 years after that fateful home visit, she remained resolute that she made the correct clinical decisions at the time. "It has all been very stressful for me. What was behind this case? What was driving this potential prosecution? And throughout, the patient, the family and their concerns were completely forgotten in the pursuit of so-called justice," she pointed out. Read full story Source: Medscape News, 9 March 2023 -
Content ArticleIn this article, published by the Betsy Lehman Center, the author reviews Dr. René Amalberti's work which explains in detail why and how groups of workers can fall into risky habits over time.
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News ArticleA review into the culture at Birmingham's biggest hospitals trust amid allegations of bullying and undue pressure on staff has found 'substantial issues' of concern, a brief report has revealed. A short briefing for councillors by NHS Birmingham and Solihull chief executive David Melborne offers the first insight into the findings of Professor Mike Bewick and his review team who were tasked with investigating damning allegations made by current and former staff at University Hospitals Birmingham. More than 50 medics, including some with decades of experience, came forward to criticise a 'toxic' working culture at the trust, many sharing their experiences with MP Preet Kaur Gill (Birmingham Edgbaston). Among the most serious claims that emerged were that whistleblowers concerned about patient safety were silenced with threats of disciplinary action. In a written report to Birmingham and Solihull councils' joint health overview and scrutiny committee, meeting Monday, Mr Melborne says the rapid review into the Newsnight allegations and subsequent complaints has found 'no fundamental safety issues at the Trust'. However, he goes on: "That said, there are substantial issues around culture, behaviour, leadership and governance that will need to be addressed". Read full story Source: Birmingham Live, 10 March 2023
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News ArticleNHS staff are significantly less comfortable raising concerns and are less confident in their organisation to address them, the service’s annual staff survey has revealed. The 2022 results, with a response rate of 46%, showed a decline on all measures relating to raising concerns about clinical safety and speaking up more generally, with the greatest deterioration seen in the percentage of staff who would feel secure raising concerns about unsafe clinical practice. Helen Hughes, chief executive of charity Patient Safety Learning, warned an “alarmingly high” number of staff could not say they felt safe raising concerns. Ms Hughes continued: “If we are to effectively learn from and prevent future incidents of avoidable harm, staff need to feel safe to raise and discuss patient safety incidents. “This year’s staff survey results are a clear indication that too often this is still not the case. This is reinforced by the experiences and testimonies of many whistleblowers and the findings of numerous inquiries into major patient safety scandals.” She added there were a lack of “tangible measures” in place to create a safety culture where staff feel safe to speak up and called for “more resources to support improvement and evaluate their impact”. Read full story (paywalled) Source: HSJ, 9 March 2023
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News ArticleWhich trusts receive the highest recommendations from staff as a place to work? HSJ has analysed the full results of today’s 2022 NHS Staff Survey for general acute and acute/community trusts. HSJ has also analysed the results for mental health trusts and ambulance and community trusts. More than 630,000 staff responded to the NHS staff survey between September and December 2022 – a 46% response rate, down from 48% in 2021. Nationally, across all trust types, 57.4% said they would recommend their organisation as a place to work in 2022. That was down from 59.4% in 2021, and from 63.4% in 2019. Read full story (paywalled) Source: HSJ, 9 March 2023
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Content Article
NHS Staff Survey Results 2022 (9 March 2023)
Patient Safety Learning posted an article in Culture
The NHS Staff Survey is one of the largest workforce surveys in the world and is carried out every year to improve staff experiences across the NHS. It asks staff in England about their experiences of working for their respective NHS organisations. 636,384 staff responded to the survey in 2022. The full results of the 2022 NHS Staff Survey are published on the NHS Staff Survey website. -
News Article
NHS backlog progress at risk from junior doctors' strike in England
Patient Safety Learning posted a news article in News
Progress being made on tackling the hospital waiting backlog will be put at risk by next week's junior doctors' strike, NHS bosses are warning. NHS England medical director Prof Sir Stephen Powis said there had been huge achievements over the winter. But he said it was inevitable the 72-hour walkout in England, which starts on Monday, would have an impact. It comes as the annual NHS staff survey shows a falling number happy to recommend the care at their service. The poll found 63% would be happy to see a friend or relative treated - down by five percentage points in the past year and 11 over two years. Meanwhile, latest performance data shows NHS emergency services are continuing to miss their targets, although the situation is not getting worse. Dr Tim Cooksley, president of the Society for Acute Medicine, said despite the situation not getting worse it still presented a "damning" picture, and warned it was "increasingly causing harm to patients". Read full story Source: BBC News, 9 March 2023 -
News Article
Trust spent £680k in failed attempt to fight whistleblower
Patient Safety Learning posted a news article in News
A trust spent £460,000 on legal fees trying to fight a patient safety whistleblowing case that it lost, it can be revealed. An employment tribunal judge rejected the idea that a consultant nephrologist had done anything to bring about her dismissal from Portsmouth Hospitals University Trust. Jasna Macanovic was subjected to what the tribunal earlier this year called “a campaign of harassment”, after she warned colleagues that a procedure they were using was harming patients. After relationships broke down in the Wessex Kidney Unit, she was referred to a disciplinary panel at which two board members – the former nursing director and the current medical director – offered her a good reference if she would resign. She refused and was dismissed in March 2018. The judge noted the offer was clear evidence that the disciplinary process was a foregone conclusion. Read full story Source: HSJ, 8 March 2023 -
News Article
‘Significant escalation’ in strike action, warns ambulance chief
Patient Safety Learning posted a news article in News
Ambulance chiefs have warned of a ‘significant escalation’ in the strike action being planned by unions next week – saying the flexibilities that helped deal with previous walk-outs will no longer be available. In a letter to local NHS leaders, seen by HSJ, North West Ambulance Service said unions are “becoming more stringent in their approach”, and the trust’s ability to respond to incidents will be severely weakened. For the last day of strike action in February, the GMB union told NWAS it was abandoning exemptions (derogations) for category 2 calls, which include heart attacks and strokes. The NWAS letter, sent yesterday, said the Unite union also now intends to take this approach on 6 March. Last month the head of the London Ambulance Service said the reduced level of service in the capital “causes harm to our patients” Read full story (paywalled) Source: HSJ, 2 March 2023 -
News Article
BMA ‘rate card’ wipes out elective recovery gains, claims trust
Patient Safety Learning posted a news article in News
A struggling acute trust says its failure to hit its elective care targets is directly linked to doctors’ demanding overtime rates in line with the British Medical Association’s rate cards, as national tensions around the issue intensify. University Hospitals of Morecambe Bay Foundation Trust’s January performance report said its elective activity was down by around 1,000 cases over a two-month period, due to the issue. Last summer, the BMA published a “rate card” outlining the “minimum” hourly pay consultants should receive for additional work, such as waiting list initiatives and weekend shifts. Some accused the union of “acting like football agents” by trying to inflate their members’ pay. NHS chiefs have long been warning of the risk the rate card poses to elective recovery. But there are few examples of a trust making such an explicit link between their struggle to staff overtime shifts because of the rate card and subsequent failure to hit their elective targets, and placing a number on how many patients they were forced to add to the list because of the issue. Read full story (paywalled) Source: HSJ, 1 March 2023 -
News Article
‘Toxic working environment’ exposed at troubled unit
Patient Safety Learning posted a news article in News
Staff endured a “toxic and difficult working environment” at a maternity unit an employment tribunal has found. The tribunal panel said that the case of a black midwife, Kemi Akinmaji, who partially won her case against East Kent Hospitals University Foundation Trust for racial discrimination showed “there were wider issues beyond the specific allegations before us and which were possibly related to race”. The tribunal judgment said: “The evidence we heard reflected a toxic and difficult working environment generally where the claimant and colleagues were shouted and sworn at over differences of professional opinion. There was some evidence before us that there were wider issues beyond the specific allegations before us and which were possibly related to race… “There is evidence of wider bullying of the claimant in the way the group of colleagues treated the claimant… We’ve also heard that the previous grievance had highlighted risks in respect of unconscious bias and identified recommendations which were not actioned. “The race champion was not appointed and the unconscious bias training not sufficiently followed through. We also heard evidence of staff being wary of further such complaints. These matters were all concerning but we had to limit ourselves to the specific allegations brought by the claimant and which the respondent had been given an opportunity to address.” Read full story (paywalled) Source: HSJ, 1 March 2023 -
Content ArticleVictoria Vallance, Director of Secondary and Specialist Care, provides an update on the Care Quality Commission (CQC)’s ongoing national maternity inspection programme and offers early insight into the emerging themes, including good practice examples to support wider learning across all trusts.
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Content ArticleThis study from Jones et al. identified wide variability in the implementation of the Guardian role and concluded that optimal implementation has six components.
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News Article
Woman died after breathing tube put in food pipe
Patient Safety Learning posted a news article in News
A mother-of-one died after a breathing tube was put into her food pipe, despite staff raising concerns it was inserted incorrectly, an inquest heard. Emma Currell, 32, had just received dialysis and was heading home to Hatfield, Hertfordshire, in an ambulance when she had a seizure. An anaesthetic team was called to sedate her as her tongue had swelled and she was bleeding from the mouth. Dr Sabu Syed, who was a trainee anaesthetist, told the hearing: "I used suction to remove blood and I was able to push the tongue to the side and got a partial view." She said she believed she inserted the tube into the trachea - the windpipe - and had asked her senior colleague Dr Prasun Mukherjee to check the position of the tube. "Dr Mukherjee was busy doing other tasks," she added. Technician Nicholas Healey said he flagged his concerns when there was no carbon dioxide reading on the ventilator, which was not faulty. He said that both he and Dr Syed had raised concerns about the tube being in the wrong place. The court heard the hospital had drawn up a guideline checklist for trachea procedures since Ms Currell's death and staff were due to have "no trace = wrong place" training on the warning signs of incorrect insertion. Read full story Source: BBC News, 27 February 2023 -
Content ArticleThis cross-sectional study, published in Workplace Health & Safety, used secondary survey data sent to approximately 7,100 health care workers at a large academic medical centre in the United States. Instruments included: the Hospital Survey on Patient Safety Culture a WPV scale measuring physical and verbal violence perpetrated by patients or visitors the Emotional Exhaustion scale from the Maslach Burnout Inventory. Findings suggest that improvements in hospital strategies aimed at patient safety culture, including team cohesion with handoffs and transitions, could positively influence a reduction in physical and verbal violence perpetrated by patients or visitors, and burnout among health care workers.
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Content ArticleIn light of NHS England recently losing an employment tribunal case against a senior black nurse on grounds of race discrimination and whistleblowing, Roger Kline casts light on learnings from the case for NHS board members and HR departments.
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Content ArticleThe Healthcare Safety Investigation Branch (HSIB) have published a third interim report for this investigation which focuses on staff wellbeing across the urgent and emergency care systems and the impact that this has on patient safety.
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News ArticleNHS Ambulance service have a “fear of speaking up” amid pervasive “cliquey”, sexist, racist and homophobic cultures, a watchdog has warned. A national guardian has warned of negative cultures in trusts preventing workers from raising concerns as she called for a “cultural review” of ambulance organisations. The review into whistleblower concerns, by the Freedom to Speak Up Guardian’s office, has found widespread cultural issues including clique-like behaviour and bullying and harassment. Dr Jayne Chidgey-Clark, the NHS National Freedom to Speak Up Guardian, has now called on ministers and the NHS to independently review ambulance services, after speaking with ambulance staff across five NHS trusts. The report has called for a cultural review of the ambulance service by NHS England, the Care Quality Commission, the Association of Ambulance Chief Executives and ministers. Read full story Source: The Independent, 24 February 2023
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Content ArticleThe National Guardian’s Office has published Listening to Workers – the report following its Speak Up review of NHS ambulance trusts in England. The review found the culture in ambulance trusts did not support workers to speak up and that this was having an impact on worker wellbeing and ultimately patient safety.
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News Article
‘Institutionalised’ staff ‘perpetuating long hospital stays’
Patient Safety Learning posted a news article in News
Nearly half of NHS patients with a learning disability or autism are still being kept inappropriately in hospitals, several years into a key programme to reduce inpatient care, a national review reveals. The newly published review by NHS England suggests 41% of inpatients, assessed over an eight-month period to May 2022, should be receiving care in the community. Reasons given for continued hospital care in the NHSE review included lack of suitable accommodation, with 19% having needs which could be delivered by community services; delays in moving individuals into the community with appropriate aftercare; legal barriers, with one region citing “ongoing concerns for public safety” as a barrier for discharge; and no clear care plans. In some cases, individuals were placed in psychiatric intensive care units on a long-term basis, because “there was nowhere else to go”, while another instance cited a 20-year stay in hospital. Other key themes included concerns about staff culture, particularly “institutionalisation” and suggestions that discharge delays were not being sufficiently addressed. The report adds: “While the process around discharge can be time consuming, staff may perpetuate this by accepting such delays as necessary or inevitable.” Read full story (paywalled) Source: HSJ, 22 February 2023 -
Content ArticleThis report details the findings of a thematic review of Safe and wellbeing reviews (SWRs) between October 2021 and May 2022. SWRs are undertaken for children, young people and adults that are autistic and/or have a learning disability who are being cared for in a mental health inpatient setting. SWRs are part of the NHS response to the safeguarding adults review concerning the tragic deaths of Joanna, Jon, and Ben at Cawston Park Hospital, who were each detained for a long period of time and did not receive appropriate care.
