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Content ArticleThe UK Covid-19 Inquiry is the independent public inquiry set up to examine the UK’s response to the Covid-19 pandemic, assess the impact of the pandemic and learn lessons for the future. The Inquiry is Chaired by Baroness Heather Hallett, a former Court of Appeal judge. This is a recording of the UK Covid-19 Inquiry's preliminary hearing for its third investigation looking at the impact of the pandemic on healthcare. The agenda includes: introductory remarks from the Chair update from Counsel to the Inquiry including designation submissions from core participants. Read the transcript of the hearing.
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Content ArticleThis presentation by the European Patient Safety Foundation (EPSF) outlines the issues associated with healthcare worker fatigue and highlights case studies of interventions to help fight fatigue in healthcare. It introduces the Fight Fatigue in Europe campaign and outlines its five-year action plan to #FightFatigue.
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- Fatigue / exhaustion
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Content ArticleSecond victims are healthcare workers who experience emotional distress following patient adverse events. This mixed method study in BMJ Open looks at how the RISE (Resilience In Stressful Events) programme was developed at the Johns Hopkins Hospital to provide this support. It examined: developing the RISE programme recruiting and training peer responders pilot launch in the Department of Paediatrics hospital-wide implementation.
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Content ArticleThis presentation on fatigue and shift work is used as an induction session for doctors in training. It covers: Why are we talking about fatigue? What do you need to know? What can we do about fatigue? Improving sleep habits Working well at night How long to nap for Recovery after night shifts Driving tired Rest facilities Individual and organisational responsibilities and standards
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- Fatigue / exhaustion
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Content Article
Fatigue: are you at risk? (Association of Anaesthetists)
Patient-Safety-Learning posted an article in Staff safety
This article by the Association of Anaesthetists (AoA) defines fatigue, looks at its causes and highlights how healthcare worker fatigue can impact on patient safety. It includes a 'High-risk checklist' outlining factors that could contribute to healthcare worker fatigue including recent illness, use of alcohol and medications and stress.- Posted
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- Fatigue / exhaustion
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News Article
Gas and air ban in hospitals leaves mums-to-be in agony
Patient Safety Learning posted a news article in News
When Amy Fantis gave birth to her first child two years ago, the labour was rapid, lasting only about four hours, and she was reliant on gas and air. Her second baby is due in just a few days — but the hospital has, like others around Britain, imposed a ban on the popular form of pain relief. Fantis, 36, from Broxbourne, Hertfordshire, is one of many women affected by the decision of several NHS trusts to suspend the use of the gas because of fears that midwives and doctors have been exposed to unsafe levels for prolonged periods. In some hospitals, levels of the nitrous oxide and oxygen mix are more than 50 times higher than the safe workplace exposure limits. In a survey of more than 16,600 women who gave birth last year, the Care Quality Commission found that 76% of respondents used gas and air at some point during labour. Although short-term use of the gas in childbirth is harmless to women and their babies, long-term exposure for midwives and doctors can affect the body’s ability to absorb vitamin B12, damaging nerves and red blood cells and causing anaemia. It is not believed that any NHS staff have become ill as a result of long-term exposure to gas and air. NHS England and the Health and Safety Executive recently warned other hospitals that they need to check the ventilation on maternity wards and ensure staff are kept safe. NHS England is planning to send out new guidance to trusts on the issue after a series of hospitals had to stop using the gas. Read full story (paywalled) Source: The Times, 25 February 2023 -
Content ArticleThis paper identifies the critical reasons healthcare leaders today must invest in experience leadership and structure. Contributions to this paper were captured from 42 participating organisations through a 50-item survey designed by the Institute’s Experience Leaders Circle. The reveals six reasons why a dedicated experience effort, and a structure to support it, are essential to becoming a provider of choice. The study concludes with seven positive outcomes important for healthcare executives to consider.
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News Article
NHS staff cried in safety interviews, says watchdog
Patient Safety Learning posted a news article in News
The health safety watchdog has said that doctors, ambulance dispatchers and other NHS staff in England have faced "significant distress" and harm over the past year as a result of long delays in urgent and emergency care. The Healthcare Safety Investigation Branch (HSIB), which monitors safety in the health service in England, said many staff it interviewed for a national investigation "cried or displayed other extreme emotions" when asked about their working environment. "The bad sides [of my job] give me nightmares, flashbacks and fear, but they can also make me hyperactive, sleepless and sometimes not care about the danger I put myself in," one paramedic told the BBC. Sarah, not her real name, has worked in the ambulance service for more than a decade, but describes the last 12 months as the most difficult she can remember. "Over the winter I have witnessed and helped with cardiac arrests in the corridors of hospitals and in the back of ambulances," she said. "I spent four hours with an end-of-life patient. There was no hospice or district nurse available, so I had to make the choice to give them meds for a peaceful, expected death and prepare the family. "I felt ashamed that I could not stay till the end, but I had to move on to the next job as I had done all I could." The HSIB found NHS staff were reporting increased levels of stress, worry and exhaustion because they were not always able to help the sickest patients. HSIB has now urged trusts to do more to protect workers’ mental health, saying there is an “intrinsic link” between patient safety and staff wellbeing. Read full story Source: BBC News, 27 February 2023- Posted
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Content ArticleThis document by the Joint Commission provides an overview of the issues faced by healthcare workers who are negatively affected by their involvement in a patient safety incident—second victims. It highlights the prevalence of second victims, summarises the key problems they face and outlines recommendations to ensure staff receive adequate support from healthcare organisations when they are involved in an incident.
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Content ArticleIn this blog, Dr Ciaran Crowe, an ST6 doctor in obstetrics and gynaecology, talks about bullying in the healthcare system and what we can do to tackle unacceptable behaviour. He highlights the results of the 2014 National Training Survey, in which 8% respondents reported being bullied and 13.8% reported witnessing bullying, and points out that certain specialities have a higher than average number of bullying incidents reported. He also examines the triggers for bullying in healthcare settings and looks at ways to tackle the issue.
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- Staff safety
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News ArticleRecord levels of NHS staff are seeking mental health help as clinicians warn the “crisis” facing workers is “worse than the pandemic”. Hundreds of staff are being referred to the specialist mental health service, NHS Practitioner Health, with 842 workers referred in October 2022 – up from 534 in the same month the year before and 371 in 2020. Around 40% of the staff seeking the service are GPs and 50% are hospital doctors. The news comes as The Independent reported that the NHS and government are set to axe funding for 40 mental health hubs set up for health and social care workers following the pandemic. Amandip Sidhu, of Doctors in Distress, which offers workers mental health support, said: “Health workers believe that the crisis they are currently dealing with is worse than during the pandemic and exacerbated by the fact there is no end in sight, with little evidence that decision-makers are taking steps to improve the situation. “The fact that the public, their patients, lack sympathy or understanding is making many medics feel isolated and completely unappreciated.” Read full story Source: The Independent, 23 February 2023
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News Article
Suicidal NHS staff left in ‘dangerous limbo’ as mental health help ends
Patient Safety Learning posted a news article in News
Suicidal NHS staff will be left in “dangerous” situations without support when national funding for mental health hubs ends next month, health leaders have warned. The hubs, set up with £15 million of government funding for NHS workers following Covid, are being forced to close or reduce services as neither the Department for Health and Social Care nor the NHS has confirmed ongoing funding for 2023-24. This will leave thousands of NHS staff, some of whom are described as “suicidal” in “complete limbo”, The Independent has been told. The British Psychological Society (BPS) and the Association of Clinical Psychologists (ACP) said the failure to continue the funding was an “irresponsible” way to treat vulnerable health and care workers. Professor Mike Wang, chair of ACP, said: “There is a clinical responsibility, not to remove a service from individuals who are vulnerable, and in difficulty … the problem with that is that the funding ceases at the end of March and that’s absolutely no time at all to make any [future] provision. So, it’s clinically irresponsible to simply halt a service. Some of these individuals are, you know, carrying suicide risk.” He said it was “dangerous” and “astonishing” that funding for the hubs was ending “given the present circumstances of continuing effects of the pandemic, clear evidence of underfunding of health care in this country”. Read full story Source: The Independent, 22 February 2023- Posted
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- Self harm/ suicide
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Content ArticleThese Guidelines for the Provision of Anaesthetic Services (GPAS) support the development and delivery of high quality anaesthetic services. GPAS chapters have previously focused on a particular aspect of clinical service delivery. However, experience has identified a requirement in GPAS to describe what it is about a department of anaesthesia itself, beyond the different aspects of the clinical service delivery, that contribute to a successful department. The Good Department chapter has been developed to address this requirement, describing current best practice for developing and managing a safe and high quality anaesthesia service in terms of the non-clinical aspects of the service that underpin the clinical provision. The guidance makes recommendations in terms of: leadership, strategy and management workforce education and training clinical governance support services.
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Content ArticleThis is part of our series of Patient Safety Spotlight interviews, where we talk to people working for patient safety about their role and what motivates them. Rob talks to us about his passion for using human factors to improve safety in emergency departments, how allowing doctors to choose their own shifts can make staffing safer and how better integrating technology could help doctors diagnose and treat patients more safely and effectively.
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- Emergency medicine
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Content ArticleFatigue is increasingly considered as one of the most significant hazards to aviation safety and other safety-critical industries. Both the academic community and industry have focused on understanding the phenomenon of fatigue and the factors that contribute to it in order to prevent it, but also to mitigate its possible consequences. As a result, procedures and regulations have been developed for operators to comply with and there is now a requirement for operators to demonstrate that they are actively managing fatigue. The aim of this white paper by Clockwork Research is to provide safety practitioners with a better understanding of the process of investigating fatigue.
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- Investigation
- Fatigue / exhaustion
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Content ArticleIn this opinion piece for the BMJ, Partha Kar, consultant in diabetes and endocrinology, argues that in spite of extensive research and discussion around the need to tackle race inequalities in the medical workforce, little progress has been made at a system level. He highlights the importance of ensuring the Medical Workforce Race Equality Standard (WRES) Action Plan is implemented effectively, with special attention being paid to tracking GMC referrals and competency reviews that appear to be based on ethnicity.
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News Article
Health workers ‘shattered’, says Jeremy Farrar as more NHS strikes loom
Patient Safety Learning posted a news article in News
Healthcare workers are “absolutely shattered” and unless something is done to address the crisis in morale, staffing and training then “they won’t be there when you need them”, one of the world’s leading scientists has warned. Speaking to the Guardian, Prof Jeremy Farrar, the director of Wellcome and soon to be chief scientist of the World Health Organization, warned that healthcare workers would not be ready should another crisis hit. “This is a global issue, which I think is hugely concerning. It’s certainly true in this country,” he said. “The resilience of healthcare workers, broadly defined from ambulance drivers to nurses to doctors, to care workers in social care, etc. They’re shattered. They are absolutely shattered." Farrar said: “I think we have to address the morale, staffing, the training, everything from public health physicians to care workers, to doctors and nurses and physios and everybody in between because there’s very little spare capacity in any system globally. It’s particularly true in the UK. As you can see from the strikes, morale and resilience is very thin.” Read full story Source: The Guardian, 20 February 2023- Posted
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Content ArticleThe Covid-19 pandemic has thrown a spotlight on the treatment of NHS staff and their perceived value to their employers. An estimated two million people in the UK have Long Covid, including many thousands of NHS workers, so why do we hear so little about it? In this BMJ article, a doctor in the NHS who has Long Covid explains why he is disappointed by the collective silence and the lack of protections and support mechanisms in place.
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Content ArticleLearn how one trust has applied staff engagement techniques as part of its continuous improvement programme.
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- Organisational culture
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EventThis Hospital at Night Summit focuses on out of hours care in hospitals delivering high quality safe care at night, and supporting the wellbeing of those working at night. Through national updates, networking opportunities and case studies this conference provides a practical guide to delivering a high quality hospital at night and transforming out of hours services and roles to improve patient safety. The 2023 conference will focus on the developing an effective Hospital at Night service, and focus on the practicalities of supporting staff at night, improving wellbeing and fighting fatigue. For further information and to book your place visit https://www.healthcareconferencesuk.co.uk/conferences-masterclasses/hospital-at-night-summit or email frida@hc-uk.org.uk. hub members receive a 20% discount. Email info@pslhub.org for discount code. Follow on Twitter @HCUK_Clare #HospitalAtNight
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Content ArticleDr Nabarro’s recent comment made on Independent Sage 2 December, that Covid-19 is primarily a droplet-borne infection, flies in the face of overwhelming international scientific consensus that the pandemic is driven by airborne transmission of the SARS-CoV-2 virus. Despite airborne transmission being accepted as the dominant mode of spread in almost every other arena, within official infection prevention and control (IPC) bodies in the World Health Organization (WHO) and many national authorities including the UK, there is denial or minimising of airborne spread, and continuing adherence to the droplet theory of transmission. This has meant rejection of airborne mitigations within healthcare, with profound consequences for the lives and health of healthcare workers, as well as for patients in hospitals and care homes. It is now clear that the IPC authorities will not be persuaded, no matter how much evidence is presented to them that SARS-CoV-2 is primarily airborne, and that efforts by aerosol scientists, engineers and health experts to provide further evidence of this, are futile. This statement from Doctors in Unite explores these issues in detail, and highlights the disastrous record of droplet-only precautions in our hospitals and care homes. It also asks why the critically important “precautionary principle” was not applied throughout healthcare from the outset, to keep workers and patients safe, while the mode of transmission of the virus was being fully elucidated, despite this being official WHO policy.
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- Virus
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News Article
According to medical guidelines, your doctor needs a 27-hour workday
Patient-Safety-Learning posted a news article in News
Some doctors say that however reasonable guidelines may seem, their cumulative burden causes “constant frustration” to medical practice. A team of doctors wrote a study last year for the Journal of General Internal Medicine which suggested that if an American doctor followed all of the guidelines for preventive, chronic and acute disease care issued by well-known medical groups, it would require nearly 27 hours per day. Guidelines have become “a constant frustration,” said Dr. Minna Johansson, a general practitioner in Uddevalla, Sweden, who also directs the Global Center for Sustainable Healthcare at the University of Gothenburg. “A lot of guidelines may seem reasonable when considered in isolation, but the cumulative burden of all guideline recommendations combined is absurd.” Read full story (paywalled) Source: New York Times, 14 February 2022- Posted
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Content ArticleThis article in Nurse Leader examines mounting evidence for nurse and patient safety associated with registered nurse (RN) fatigue. What changes driven by strong evidence are nursing leaders enacting to reduce the impact of RN fatigue on patient and nurse safety?
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News Article
Hospital recorded 50 times birth gas legal limit
Patient Safety Learning posted a news article in News
Nitrous oxide levels on Watford General Hospital's maternity suite far exceeded legal limits during peak periods, a BBC investigation has found. In February 2022, air monitoring showed levels of almost 5,000 parts per million (ppm) - 50 times what is safe. The hospital's trust said it had since installed machines to remove the gas. It was one of a number of nitrous oxide incidents reported by NHS trusts to the Health and Safety Executive (HSE), Freedom of Information data has shown. The HSE disclosed the details following a request for its notifications under the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013 (RIDDOR). There were 11 notifications to the HSE between August 2018 and December 2022 from seven NHS trusts and one private hospital in relation to nitrous oxide - almost all relating to maternity units. Monitoring has led to a string of NHS trusts suspending the use of Entonox - a mixture of nitrous oxide and air used to assist women in labour with pain relief. NHS bosses acknowledge there is "limited research on the occupational exposure to Entonox, and the long-term health risks this may pose", though at least one expert has played down the risk. But staff working in maternity units face uncertainty due to prolonged periods of time spent in affected areas, with particular concerns over Vitamin B deficiency due to exposure. Read full story Source: BBC News, 13 February 2023- Posted
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Content ArticleLast year we published a blog from Dr Chelcie Jewitt on the Surviving in Scrubs campaign. The campaign was created by Dr Becky Cox and Dr Chelcie Jewitt to give a voice to women in healthcare to raise awareness and end sexism, sexual harassment and sexual assault in healthcare. On their Surviving in Scrubs website they share the awful stories from women working in healthcare of sexism, sexual harassment and sexual assault.
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- Speaking up
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