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Found 831 results
  1. Content Article
    Claire Cox, Patient Safety Lead at Kings College Hospital NHS Foundation Trust, shares a recent technique she used to explain the difference between 'work as imagined' and 'work as done'. Claire's example (a pathway for a patient coming to A&E, who also has a mental health issue) highlights the safety risks of competing guidance and the importance of co-production moving forward.
  2. Content Article
    Physician associates (PAs) are healthcare professionals who work as part of a multidisciplinary team under the supervision of a named senior doctor (a General Medical Council (GMC)-registered consultant or GP). While they are not medical doctors, PAs can assess, diagnose and treat patients in primary, secondary and community care environments within their scope of practice. PAs are part of NHS England’s medical associate professions (MAPs) workforce grouping. MAPs add to the breadth of skills within multidisciplinary teams, to help meet the needs of patients and enable more care to be delivered in clinical settings. PAs do not fall under the allied health professions (AHPs) or advanced practice groups. The Faculty of Physician Associates has created this guidance to provide clarity around the role of PAs. It provides practical examples of how physician associates should describe their role and is aimed at increasing understanding for patients, employers, other healthcare professionals and the public. It is important that PAs take all reasonable steps to inform patients and staff of their role and to avoid confusion of roles. This includes considering the potential for verbal and written role titles to be misunderstood and taking the time to explain their role in any clinical interaction.
  3. News Article
    The impact of successive doctors’ strikes is now ‘causing significant disruption and risk to patients’, including to those needing urgent heart and cancer treatment, NHS England leaders have told the BMA in their strongest warnings yet. A letter to the union’s council chair on Tuesday evening, leaked to HSJ, said: “We are increasingly concerned that the cumulative impact of this action is causing significant disruption and risk to patients… “We are extremely concerned that Christmas Day cover is insufficient to ensure appropriate levels of patient safety are being maintained across local health systems. This is particularly the case in the current period of industrial action, with three consecutive Christmas Day levels of service.” Although Christmas Day includes cover for emergency care, the officials said that in practice – with demand above Christmas Day levels, and with successive days and repeated strikes – it was not protecting patients needing urgent care. The letter, signed by NHSE leaders including chief medical officer Sir Steve Powis, and chief nurse Dame Ruth May, goes on: “Secondly, we are becoming increasingly concerned that combined periods of industrial action are impacting on our ability to manage individuals who require time-sensitive urgent treatment, for example cardiac, cancer or cardiovascular patients, or women needing urgent caesarean sections.” Read full story (paywalled) Source: HSJ, 3 October 2023
  4. News Article
    A consultant obstetrician has claimed he was sacked from his hospital for raising whistleblowing concerns about patient safety over fears they would cause “reputational damage”. Martyn Pitman told an employment tribunal in Southampton that managers dismissed his concerns and he was “subjected to brutal retaliatory victimisation” after he criticised senior midwife colleagues. He said: “On a daily basis there was evidence of deteriorating standards of care. We were certain that the situation posed a direct threat to both patients’ safety and staff wellbeing. Concern was expressed that there was a genuine risk that we could start to see avoidable patient disasters.” Rather than addressing these, Pitman said the trust had considered it “the path of least resistance to take out [the] whistleblower”. Pitman was dismissed this year from his job at the Royal Hampshire County hospital (RHCH) in Winchester, where he had worked as a consultant for 20 years. He is claiming he suffered a detriment due to exercising rights under the Public Interest Disclosure Act. He said he “fought against [an] absolute barrage of completely unprofessional assaults on me” after he raised concerns about foetal monitoring problems that resulted in the death of a baby and the delivery of another with severe cerebral palsy. Read full story Source: The Guardian, 26 September 2023
  5. Content Article
    Harold Pedley, known as Derek, attended his GP surgery during the late afternoon on 21.12.22 and after spending most of that day feeling unwell with symptoms including abdominal pain and vomiting. He was appropriately referred to the hospital and travelled there with his friend after his GP had discussed his case with doctors. Due to a lack of available beds in the assessment unit, Derek needed to remain in the emergency department. Following his arrival at 20.07 hours, doctors were not notified of his attendance. He remained in the emergency department waiting area for almost two hours during which time due to significant pressures faced by the department he was not assessed or spoken to by a medical professional. At 21.59 hours a triage nurse called for him. By then, Derek had been unresponsive for some time and had died, his death confirmed at 22.26 hours. A subsequent post mortem examination revealed he died from the effects of non-survivable extensive small bowel ischaemia caused by a significantly narrowed mesenteric artery. His death was contributed to by heart disease.
  6. News Article
    More than half of staff at a hospital trust that has been under fire for its "toxic culture" have said they felt bullied or harassed. The findings come from an independent review commissioned by University Hospitals Birmingham (UHB) NHS Trust. It has been at the centre of NHS scrutiny after a culture of fear was uncovered in a BBC Newsnight investigation. UHB has apologised for "unacceptable behaviours". It added it was committed to changing the working environment. Of 2,884 respondents to a staff survey, 53% said they had felt bullied or harassed at work, while only 16% believed their concerns would be taken up by their employer. Many said they were fearful to complain "as they believed it could worsen the situation," the review team found. Read full story Source: BBC News, 27 September 2023
  7. Content Article
    The report from the International Labour Organization describes the results of a special analysis of data from the Labour Force Surveys (LFS) of 56 countries which provided data about health and social care workers in sufficient detail to distinguish between different occupational groups within the workforce. The report covers analyses for 29 countries in Europe and 27 from other regions of the world. This analysis can help to highlight specific occupation groups and countries which are at heightened risk of decent work deficits and demographic imbalances.
  8. Content Article
    The Forgiveness Project shares stories of forgiveness in order to build hope, empathy and understanding.
  9. Content Article
    Achieving shared interpersonal understanding between healthcare professionals, patients and families is a core patient safety challenge around the world. The SACCIA model promotes safe communication practice amongst healthcare teams and between providers patients. It was developed by Professor Annagret Hannawa, Director of the Center for the Advancement of Healthcare Quality & Safety in Switzerland. The interpersonal processes that are captured in the SACCIA acronym are considered 'safe' because they lead to a shared understanding between all care participants: Sufficiency Accuracy Clarity Contextualization Interpersonal Adaptation The five SACCIA competencies emerged from a communication science analysis of hundreds of critical healthcare incidents. They were identified as common deficient interpersonal processes that often cause and contribute to preventable patient harm and insufficient care. They therefore represent an evidence-based set of core competencies for safe communication, which constitute the vehicle to patient care that is safe, efficient, timely, effective and patient-centred.
  10. News Article
    The family of a student who died after hospital staff missed that she had developed sepsis despite a string of warning signs have claimed she was the victim of a “lack of care”, as a coroner ruled there were “gross” failures in her treatment. Staff at Southmead hospital in Bristol failed to carry out the sepsis screening and observations needed to keep 20-year-old Maddy Lawrence safe after she was taken to hospital with a dislocated hip sustained in a rugby tackle. Outside court, the student’s mother, Karen Lawrence, said: “It has been a constant struggle to understand how a healthy, strong and fit 20-year-old could lose her life to sepsis which was allowed to develop under the care of professionals. “Her screams of pain and our pleas for help were merely managed, temporarily quietened with painkillers while the infection progressed unnoticed by hospital staff. “Our daughter was failed by a number of nurses and medical staff; symptoms were ignored, observations were not taken, on one occasion for 16 hours. There was no curiosity, basic tests were not completed even when hospital policy required them. “Maddy herself expressed concern on multiple occasions but her pain was not being taken seriously. As well as failing to fulfil their duty, those nurses and medical staff offered no sympathy, no compassion and little attention. “This failure meant Maddy was not given the chance to beat sepsis. Significant delays in its discovery meant the crucial window for treatment was missed. Maddy did not die due to under-staffing or a lack of money. Her death was the result of a lack of care.” Read full story Source: The Independent, 8 September 2023
  11. News Article
    YouTube has launched a verification system for healthcare workers in the UK as it battles disinformation online. In 2022, health videos were viewed more than three billion times in the UK alone on the video-sharing platform. Doctors, nurses and psychologists have been applying for the scheme since June and must meet rigorous criteria set by the tech giant to be eligible. Successful applicants will have a badge under their name identifying them as a genuine, licensed healthcare worker. But YouTubers have warned the system is only meant for education purposes, not to replace medical advice from your GP. Vishaal Virani, who leads health content for YouTube, said it was important simply due to the sheer number of people accessing healthcare information on the video-sharing platform. "Whether we like it or not, whether we want it or not, whether the health industry is pushing for it or not, people are accessing health information online," he told the BBC. "We need to do as good a job as possible to bring rigour to the content that they are subsequently consuming when they do start their care journey online." Read full story Source: BBC News, 8 September 2023
  12. News Article
    Junior doctors and consultants in England are to coincide strikes during the autumn in an escalation of the pay dispute with the government. It will be the first time in this dispute they have walked together and comes after junior doctors voted in favour of continuing with strikes. In the British Medical Association ballot 98% voted in favour, giving the union a fresh six-month mandate. Junior doctors have already staged five walkouts this year. They will strike on 20 to 22 September - the first day of which coincides with a walkout by consultants. They will then walkout on 2 to 4 October, which is when consultants will also be striking. When the two groups strike together cover will be provided to staff emergency services as well as a small amount of cover on the wards. Read full story Source: BBC News, 31 August 2023
  13. News Article
    More than half of NHS staff believe bosses would ignore whistleblowers amid fresh concerns hospitals could be covering up potential scandals following the Lucy Letby case. New national figures seen by the The Independent reveal that in the majority of hospitals, most doctors and nurses do not believe their concerns would be acted upon if they were raised with senior managers. It comes after The Independent revealed that NHS bosses accused of ignoring complaints about Letby were the very same people later appointed to act on whistleblower concerns at the hospital where she murdered seven babies and tried to kill six more. Several doctors who worked alongside her during the killing spree say they attempted to raise the alarm with hospital managers – only to have their pleas ignored. They believe the lack of action by bosses resulted in more babies being killed, stating managers who failed to act were “grossly negligent” and “facilitated a mass murderer”. In nearly three-quarters of general hospitals – such as the Countess of Chester where Letby worked – fewer than half of staff believed their trust would act on a concern, according to results from the latest NHS staff survey. Read full story Source: The Independent, 27 August 2023
  14. Content Article
    Following the Lucy Letby case, letters to the Times discuss workplace rights and safety in hospitals. Keith Conradi, former chief investigator, Healthcare Safety Investigation Branch, highlights a current NHS workforce too frightened to raise safety concerns, working in a toxic and bullying culture, where the predominance of HR approaches undermine the culture of safety. And Andrew Harris, professor of coronial law, William Harvey Research Institute, Queen Marys University London, writes that there is a duty on medical practitioners to report the circumstances of a death and not to limit disclosure to avoid investigation. In his letter he questions whether medical examiners across the country are acting independently of their trusts and properly notifying such cases.
  15. Content Article
    In the early 21st century, the patient safety movement began to talk about system safety. Recognising that people are inherently fallible, advocates for patient safety proposed that it was wrong to blame individual clinicians for poorly designed systems that were full of error traps. However, in a 2013 BMJ editorial, Kaveh G Shojania and Mary Dixon-Woods argue that we must also take seriously the performance and behaviours of individual clinicians if we are to make healthcare safer for patients. They draw on research showing that ‘bad apples’—individuals who repeatedly display incompetent or grossly unprofessional behaviours—clearly exist. This is never more evident than today, when we read about the conviction of nurse Lucy Letby.
  16. Content Article
    The Maternity Survey 2022, run by Ipsos on behalf of the Care Quality Commission, looked at the experiences of women and other pregnant people who had a live birth in early 2022. In this article Anita Jefferson from Ipsos looks at the results of this and considers what they tell us about experiences of maternity services.
  17. News Article
    An 11-year-old boy suffered permanent brain damage after birth because of negligence by hospital midwives who then fabricated notes, a high court judge has ruled. Jayden Astley’s challenges in life include deafness, motor impairments, cognitive difficulties and behavioural difficulties, his lawyers said. After a five-day trial at the high court in Liverpool, Mr Justice Spencer ruled that staff at the Royal Preston hospital in Lancashire were negligent in their treatment of Jayden in 2012. The brain injury was caused by prolonged umbilical cord compression that resulted in acute profound hypoxia – lack of oxygen – sustained during the management of the birth, the court found. Midwives failed to accurately monitor Jayden’s heart rate when he was born and failed to identify his bradycardic, or slow, heart rate during delivery. The judge also found that some entries in notes were fabricated. In his judgment Spencer said it was agreed that all permanent damage to Jayden’s brain would have been avoided if he had been delivered three minutes earlier. Read full story Source: The Guardian, 2 August 2023
  18. News Article
    The NHS is on trajectory to fall short of a flagship pledge to have around 24,000 “virtual ward beds” in place by December 2023, internal data has revealed. NHS England’s figures from March, seen by HSJ, suggest the system is instead more likely to have created around 18,500 virtual beds by the 2023 deadline. Senior clinicians, including the Royal College of Physicians and the Society of Acute Medicine, have recently raised concerns about the speed and timing of the roll-out and staffing implications. And now fresh concerns are also being raised about the programme following publication of a new academic study which suggests virtual wards set up by the NHS during Covid made little impact on length of stay or readmissions rates. Alison Leary, professor of healthcare and workforce modelling, London South Bank University, was one of the first senior leaders to publicly voice concerns about the NHS’s virtual wards programme. Professor Leary told HSJ: “I am not surprised [systems are falling] short. Since Elaine [Elaine Maxwell, visiting professor, London South Bank University] and I published our piece in HSJ, I have been contacted by several clinicians who have serious concerns over virtual wards and staffing them.” Read full story (paywalled) Source: HSJ, 31 March 2022
  19. News Article
    Donna Ockenden, the midwife who investigated the Shopshire maternity scandal, has been appointed to lead a review into failings in Nottingham following a dogged campaign by families. The current review will be wound up by 10 June after concerns from NHS England and families that it is not fit for purpose. It was commissioned after revelations from The Independent and Channel Four News that dozens of babies had died or been brain-damaged following care at Nottingham University Hospitals Foundation Trust. In a letter to families on Thursday, NHS England chief operating officer David Sloman said: “I want to begin by apologising for the distress caused by the delay in our announcing a new chair and to take this opportunity to update you on how the work to replace the existing Review has been developing as we have taken on board various views that you have shared with us.” “After careful consideration and in light of the concerns from some families, our own concerns, and those of stakeholders including in the wider NHS that the current Review is not fit for purpose, we have taken the decision to ask the current Review team to conclude all of their work by Friday 10 June.” “We will be asking the new national Review team to begin afresh, drawing a line under the work undertaken to date by the current local Review team, and we are using this opportunity to communicate that to you clearly.” Ms Ockenden said: “Having a baby is one of the most important times for a family and when women and their babies come into contact with NHS maternity services they should receive the very best and safest care." “I am delighted to have been asked by Sir David Sloman to take up the role of Chair of this Review and will be engaging with families shortly as my first priority. I look forward to working with and listening to families and staff, and working with NHS England and NHS Improvement to deliver a Review and recommendations that lead to real change and safer care for women, babies and families in Nottingham as soon as possible.” Read full story Source: BBC News, 26 May 2022
  20. News Article
    Doctors are receiving "inadequate" training about the risk of sepsis after a mother-of-five died following an abortion, a coroner has warned. Sarah Dunn, 31, died of "natural causes contributed to by neglect" in hospital on 11 April 2020, an inquest found. Assistant coroner for Blackpool and Fylde, Louise Rae, said Ms Dunn had been treated as a Covid patient even though the "signs of sepsis were apparent". Her cause of death was recorded as "streptococcus sepsis following medical termination of pregnancy". In her record of inquest, the coroner noted Ms Dunn was admitted to Blackpool Victoria Hospital in Lancashire on 10 April 2020. She was suffering from a streptococcus infection caused by an early medical abortion on 23 March, which had produced sepsis and toxic shock by the time she was admitted to hospital. The coroner said "signs of sepsis were apparent" before and at the time of Ms Dunn's hospital admission but she was instead treated as a Covid-19 patient. "Sepsis was not recognised or treated by the GP surgery, emergency department or acute medical unit and upon Sarah's arrival at hospital, the sepsis pathway was not followed," she added. Read full story Source: BBC News, 19 May 2022
  21. News Article
    A private hospital facing a police investigation following a patient’s death has been given an urgent warning by the care regulator due to concerns over patient safety. The Huntercombe Hospital in Maidenhead, which treats children with mental health needs, was told it must urgently address safety issues found by the Care Quality Commission (CQC) following an inspection in March. The CQC handed the hospital a formal warning due to concerns over failures in the way staff were carrying out observations of vulnerable patients. The move comes as The Independent revealed police are investigating the hospital in relation to the death of a young girl earlier this year. In a report published last week, the care watchdog said it had received “mainly negative” feedback from young people at the hospital’s Thames ward, a psychiatric intensive care unit which treats acutely unwell children. Commenting on the hospital overall, the report said: “Young people told us that staff did not follow the care plans in relation to their level of observations. They told us that if there was an incident the staff stopped doing intermittent observations. Staff in charge of shifts on wards asked new staff members to do observations before they understood how to do it. Staff had to ask the young person how to carry out their observations as they did not always understand what was expected of them in carrying out different levels of observations.” Read full story Source: The Independent, 19 May 2022
  22. News Article
    More than 27,000 nurses and midwives quit the NHS last year, with many blaming job pressures, the Covid pandemic and poor patient care for their decision. The rise in staff leaving their posts across the UK – the first in four years – has prompted concern that frontline workers are under too much strain, especially with the NHS-wide shortage of nurses. New figures show the NHS is also becoming more reliant on nurses and midwives trained overseas as domestic recruitment remains stubbornly low. In a report on Wednesday, the Nursing and Midwifery Council (NMC) discloses that the numbers in both professions across the UK has risen to its highest level – 758,303. However, while 48,436 nurses and midwives joined its register, 27,133 stopped working last year – 25,219 nurses, 1,474 midwives and 304 who performed both roles. That was higher than the 23,934 who did so during 2020 after Covid struck, and 25,488 who left in 2019. Andrea Sutcliffe, the NMC’s chief executive, said that while the record number of nurses and midwives was good news, “a closer look at our data reveals some worrying signs”. She cited the large number of leavers and the fact that “those who left shared troubling stories about the pressure they’ve had to bear during the pandemic”. Read full story Source: The Guardian, 18 May 2022
  23. News Article
    Junior doctors have been prevented from returning to scandal hit heart surgery unit previously criticised over “toxic” culture, The Independent has learned. A coroner defended cardiac surgery at St George’s University Hospital, criticising an NHS-commissioned review into 67 deaths that warned of poor care. However, The Independent has learned the unit received a critical report from Health Education England (HEE), the body responsible for healthcare training, just last year. The NHS authority was so concerned about culture problems and “inappropriate behaviour” within the unit that it took away the junior doctors working there. This is the third time HEE has intervened since 2018, when the unit was criticised in an independent review for having a “toxic” culture. In a statement, Professor Geeta Menon, postgraduate dean for South London at Health Education England, said: “HEE carried out a review of cardiac surgery at St George’s University Hospital in July 2021 and concluded that further improvements were required to create a suitable learning environment for doctors in training. "Unfounded’ NHS criticism and investigation caused unnecessary deaths at London heart surgery unit “We continue to work closely with the trust to implement our requirements and recommendations and will reassess their progress this summer. HEE is committed to ensuring high quality patient care and the best possible learning environment for postgraduate doctors at St George’s.” The Independent understands that a report issued in December, following the HEE visit, identified problems of “inappropriate behaviour”, poor team working from consultants and raised concerns the culture problems previously identified at the unit persisted. Read full story Source: The Independent, 14 May 2022
  24. News Article
    Thousands of patients have been left without vital healthcare after nearly 1 in 10 physiotherapists was prevented from practising after their regulator removed them from its register. Exactly 5,311 physiotherapists were deregistered by the Health and Care Professions Council (HCPC) on 1 May because they had not renewed their registration after the HCPC decided not to send out reminder letters. Ash James, director of practice and development at the Chartered Society of Physiotherapy (CSP), said its helpline had been swamped with calls from distressed physiotherapists, concerned for their patients and worried about dramatic losses in income. “In one of the trusts in Liverpool, 23 physios were sent home in one day, and obviously the implication for patients is huge,” he said. “At a time when the workforce is stretched by the Covid backlog, it’s obviously not ideal that we’ve lost 9% of the workforce overnight.” Physiotherapists have many roles but play a crucial part in helping people leave hospital after long stays, because lengthy bed rest leads to muscle wastage that leaves patients needing physiotherapy to learn to walk again. So far, only about 2,300 physios have been re-registered. With most practitioners seeing at least five patients a day, the number of cancelled NHS and private appointments in the past two weeks could range between 50,000 to 100,000. Read full story Source: The Guardian, 14 May 2022
  25. News Article
    Jeremy Hunt has been accused of ignoring serious NHS staff shortages for years and driving medics out of the profession while health secretary after he intervened this weekend to warn of a workforce crisis. Promoting his new book, 'Zero: Eliminating Unnecessary Deaths in a Post-Pandemic NHS', Hunt said tackling the “chronic failure of workforce planning” was the most important task in relieving pressure on frontline services. Now the chair of the health and social care committee, he said the situation was “very, very serious”, with doctors and nurses “run ragged by the intensity of work”. But his comments drew sharp criticism from healthcare staff, who said Hunt – the longest-serving health secretary in the 74-year history of the NHS – failed to take sufficient action to boost recruitment while in the top job between 2012 and 2018. Instead, critics said, his tenure saw health workers quit the NHS in droves for jobs abroad or new careers outside medicine. There are now 100,000 vacancies in the NHS, and the waiting list for treatment has soared to 6.4 million. “There’s an avalanche of pressure bearing down on the NHS. But for years Jeremy Hunt and other ministers ignored the staffing crisis,” said Sara Gorton, the head of health at Unison, the UK’s largest health union. “The pandemic has amplified the consequences of that failure. Experienced employees are leaving at faster rates than new ones can be recruited.” “Hunt has recently been an articulate analyst of current issues, particularly workforce shortages, but these haven’t come out of the blue,” said Dr Colin Hutchinson, the chair of Doctors for the NHS. “At the time he could have made the greatest impact, his response was muted. We have to ask: was the service people were receiving from the NHS better, or worse, at the end of his time in office? At the time when it most mattered, he was found wanting.” Read full story Source: The Guardian, 15 May 2022
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