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Found 994 results
  1. Content Article
    Sentinel Event Alerts from the Joint Commission identify specific types of sentinel event (a patient safety event that results in death, permanent harm or severe temporary harm), describe their common underlying causes and suggest steps to prevent them occurring in the future. This Sentinel Event Alert looks at the well-documented link between health care worker fatigue and adverse events. It looks at: The impact of fatigue Contributing factors to fatigue and risks to patients Actions suggested by The Joint Commission for healthcare organisations
  2. Content Article
    This brief paper reviews the available published literature on shiftwork and safety that allows the estimation of the relative risk of “accidents” or injuries associated with specific features of shift systems. It discusses three main trends in risk: Risk is higher on the night shift, and to a lesser extent the afternoon shift, than on the morning shift Risk increases over a span of shifts, especially so if they are night shifts Risk increases with increasing shift length over eight hours The authors discuss the fact that some of these trends are not entirely consistent with predictions made based on considerations of the circadian variations in sleep propensity or rated sleepiness, and consider factors relating to sleep that may underlie the observed trends in risk. They also discuss the practical implications of the trends in risk for the design of safer shift systems.
  3. Content Article
    Fatigue refers to the issues that arise from excessive working time or poorly designed shift patterns. It is generally considered to be a decline in mental and/or physical performance that results from prolonged exertion, sleep loss and/or disruption of the internal clock. Fatigue results in slower reactions, reduced ability to process information, memory lapses, absent-mindedness, decreased awareness, lack of attention and underestimation of risk. It can lead to errors and accidents, ill-health and injury, and reduced productivity and is often a root cause of major accidents. This guidance from the Health and Safety Executive (HSE) outlines key information about fatigue and signposts to further resources about managing fatigue at work.
  4. Content Article
    Fatigue 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.
  5. Content Article
    These 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.
  6. Content Article
    The guardian of safe working hours ensures that issues of compliance with safe working hours are addressed by the doctor and the employer or host organisation as appropriate. It provides assurance to the board of the employing organisation that doctors' working hours are safe. Access the resources that guardians of safe working hours will need in order to fulfil their roles. It includes, a job role specification, checklist of things to do, templates for annual reports and more.
  7. Content Article
    In 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.
  8. Content Article
    More work is needed on understanding and addressing a lack of sleep in rail workers, a new study has argued. Researchers looked at the difference between when staff were on day shifts and when they were working at night. They discovered a “feast and famine” scenario where 41% reported getting six hours of sleep or less when working days, compared to 63% when working nights. The findings, published in the Applied Ergonomics journal, suggested that many staff weren’t getting enough sleep and having less than six hours was linked to feeling very sleepy during the day. More than one in ten shift workers also reported they had been awake for between 18 and 24 hours by the time they finished work at least once during the past week. This led to fears that their tiredness could have an impact on road safety if they were driving home from work. The report said: “Sleep restriction and sleep deprivation, even in the short term, are known to affect cognitive performance. For a safety critical industry, this data should raise a significant concern.”
  9. News Article
    Busy, noisy, highly stressful - and sometimes violent. This is the reality of A&E as the NHS gears up for what will be an incredibly difficult winter. That much is clear from the experience of staff and patients at Royal Berkshire Hospital's emergency department. Like all units, it is struggling to see patients quickly - more than a third of patients wait more than four hours. The stress and frustration means tempers can easily boil over. Receptionist Tahj Chrichlow says it can get so busy patients end up "packed like sardines". "Sometimes people can be not as nice to us as we like," he adds, explaining how earlier this week the window of the reception office had been smashed by one angry person. The Royal College of Emergency Medicine is warning delays are putting patients at risk. Vice president Dr Ian Higginson says hospitals are "full to bursting". "When our hospitals are full, we can't get patients out of our emergency departments. "That means emergency departments become overcrowded and we see patients waiting for long periods on uncomfortable trollies in corridors or other rubbish places." Dr Higginson says his colleagues are "very worried" and unable to deliver the care they would like to give to patients. Read full story Source: BBC News, 8 December 2022
  10. News Article
    The NHS should “urgently investigate” after Byline Times uncovered “disturbing” figures showing that more than 4,000 patients, visitors and NHS staff were raped or sexually assaulted in hospitals over the past four years, the Shadow Health and Social Care Secretary has said. An investigation by Byline Times has unearthed that 4,100 patients, visitors and NHS staff were raped (1,364) or sexually assaulted (at least 2,744) in a hospital setting between January 2019 and September 2022–with 633 raped or assaulted while on a hospital ward. At least three of the incidents were against a female child aged under 13. Data from 31 police forces in England and Wales based on reported rapes and assaults revealed the scale of sexual violence within hospital settings, with victims including patients and staff members. Labour’s Shadow Health and Social Care Secretary Wes Streeting said, “Hospitals ought to be safe places for patients and staff, but these disturbing findings show that is not the case for far too many people. The NHS should urgently investigate why these disgusting crimes are allowed to happen and on such a widespread scale.” Read more Source: Byline Times, 5 December 2022
  11. News Article
    A major acute trust says it plans to move away from its significant use of agency doctors from overseas, who have been reported to be working on terms and conditions far below their NHS-employed counterparts. East Kent Hospitals University Foundation Trust has a contract with the NES Healthcare agency to supply 47 “resident medical officers (RMO)” across its three main sites to cover trauma and orthopaedics, medical and surgical rotas. HSJ has been told of concerns that RMO's are reporting substantial overworking, and poor terms and conditions, although some of these claims are disputed by NES. East Kent chief medical officer Rebecca Martin has told HSJ: “The well-being of all our colleagues is one of our top priorities and we are working with the agency about how they cover the rota safely". “We are committed to providing a safe workplace environment, where RMOs feel comfortable communicating their feedback and we review working patterns to ensure adequate rest periods between shifts. We are actively working to use substantive staff to fill vacancies, and have already been able to offer some of those positions to current RMOs.” Read full story (paywalled) Source: HSJ, 22 November 2022
  12. News Article
    Following the blistering verdict last week of the independent review into the General Medical Council's (GMC) handling of the notorious 'laptop' case, which highlighted the "worrying trend" of ethnic minority doctors facing disproportionate regulatory action, the GMC has launched a new resource 'hub' to support doctors facing racism at work. A new dedicated area on the GMC website offers advice on how to address racism in the workplace, and sits alongside its existing dedicated whistleblowing webpage as the latest of 12 areas in an 'ethical hub' that brings together resources on how to apply GMC guidance in practice, focussing on areas doctors often query or find most challenging, and helping to address important ethical issues. Announcing the launch, the GMC said: "Tackling discrimination and inequality continues to be an urgent priority for health services." It added: "The GMC has committed to working with organisations to drive forward change, setting targets on tackling inequality." Its equality, diversity, and inclusion targets set last year aimed, inter alia, "to eliminate disproportionate complaints from employers about ethnic minority doctors, by 2026, and to eradicate disadvantage and discrimination in medical education and training by 2031". In March this year it published its first progress report, which showed that the gap between employer referral rates for ethnic minority doctors and international medical graduates, compared with white doctors, had "reduced slightly". Read full story Source: Medscape UK, 15 November 2022
  13. News Article
    The only two female ambulance chief executives in the country have said there is something ‘deeply wrong’ with the culture in ambulance services. Helen Ray, the chief executive of the North East Ambulance Service Foundation Trust, said women working in the ambulance service “accept [inappropriate] banter, they accept sexualised behaviour from their male colleagues, and from patients, and they think it is okay”. She stressed “it is absolutely not [okay]” and said women must be given “safe spaces for talking and speaking up about that”. “There is something deeply wrong with the culture in the ambulance service”, she told the NHS Confederation’s Health and Care Women Leaders Network event on Tuesday. Siobhan Melia, interim chief executive of South East Coast Ambulance Service, said when she joined the trust four months ago on secondment from Sussex Community FT, it felt like she had “landed on a different planet”. Ms Melia said it was a culture “not like any other part of the NHS”. “The gender pay gap in my organisation is significant, so we see men in senior roles are taking it upon themselves to abuse their power, [with] both female students and female lower graded staff.” Read full story (paywalled) Source: HSJ, 10 November 2022
  14. News Article
    In April, when the coronavirus outbreak was at its peak in the UK and tearing through hospitals, junior doctor Rebecca Thornton’s mental health took a turn for the worse and she ended up having to be sectioned. Even now, three months later, she cannot face going back to her job and thinks it will take her a year to recover from some of the horrors she saw while working on a Covid ward in a deprived area of London. “It was horrendous,” Thornton recalls. “It’s so harrowing to watch people die, day in, day out. Every time someone passed away, I’d say, ‘This is my fault’. Eventually I stopped eating and sleeping.” Thornton’s case may sound extreme but her experiences of working through Covid are far from unique. More than 1,000 doctors plan to quit the NHS over the government’s handling of the pandemic, according to a recent survey, with some citing burnout as a cause. A psychologist offering services to NHS staff throughout the UK, who asked to remain anonymous, has witnessed the toll on staff. “I’ve seen signs of PTSD in some healthcare workers,” she says. “Staff really stood up to the plate and worked incredibly hard. It was a crisis situation that moved very quickly ... After it subsided a little bit, the tiredness became very clear.” Roisin Fitzsimons, who is head of the Nightingale Academy, which provides a platform to share best practice in nursing and midwifery, and consultant nurse at Guy’s and St Thomas’ NHS foundation trust, also worries about the looming threat of an uncertain future. “Are our staff prepared? Do they have the resilience to go through this again? That’s the worry and that’s the unknown. Burnout is hitting people now. People are processing and realising what they’ve gone through.” Read full story Source: The Guardian, 8 September 2020
  15. News Article
    We have been coughed on and shouted at by people refusing to wear face masks. We need more protection, says NHS paramedic Jake Jones. The outpouring of appreciation for NHS staff during the COVID-19 crisis has been extraordinary. Yet reports of a recent rise in attacks on emergency workers, including ambulance crews, in England and Wales suggests the Thursday evening applause was hiding a less positive reality. Abuse of emergency workers is a growing issue: a 2018 survey found that 72% of ambulance staff have been attacked on duty, and figures have repeatedly pointed to an upward trend. As an NHS paramedic for 10 years, this aligns with Jake's own experience. The consultation on increasing sentences for assaults on emergency workers seeks to discourage attacks on them. Jake's hope is that it will also challenge what has become an ingrained view – that being abused and assaulted somehow goes with the territory. Read full story Source: The Guardian, 1 September 2020 Read Jake's book 'Can you hear me? An NHS paramedics encounters with life and death'
  16. News Article
    A London acute trust has told its staff they may not be paid for time at home self-isolating if it transpires they were not wearing a mask near someone with coronavirus. Staff at Chelsea and Westminster Hospital Foundation Trust were told that if they have to stay at home self-isolating because they were not wearing a mask, that time would have to be taken as annual or unpaid leave. Chief executive Lesley Watts told all staff in an email today, seen by HSJ, that a worker had tested positive for COVID-19, and that four staff members had spent more than 15 minutes with them “without appropriate [personal protective equipment]” and must all now isolate themselves at home for 14 days. The trust considers it “a serious conduct issue not to wear a mask where you are putting colleagues or our patients at risk – this will be dealt with under our formal processes going forward”, Ms Watts said in the email. “If you are sent home to isolate for two weeks because you have not worn a mask, I am now informing you that you will be required to take this as annual or unpaid leave. The four staff members “would not be having to go home to isolate if the use of face masks and social distancing had been in place appropriately”. A Chelsea and Wesminster Hospital spokesman told HSJ: “The guidance around PPE has changed a number of times over the course of the pandemic and we felt it was important to be clear on the trust’s position and to reiterate how seriously we take staff and patient safety." Read full story (paywalled) Source: HSJ, 28 August 2020
  17. News Article
    Guidance to protect at-risk healthcare workers in Wales from coronavirus infection has been relaxed, the BBC has learned. A risk assessment tool initially recommended high-risk workers should not work in the parts of a hospital where infection was most likely. But it now says their personal protective equipment (PPE) should be reviewed or duties changed. The Welsh government says this reflects latest data and low infection rates. However, healthcare professionals say the change to the all-Wales COVID-19 workforce risk assessment tool was made without consultation, and are concerned it was done to prevent hospitals from losing frontline staff ahead of a potential second wave of the virus. Mr Amol Pandit, a urologist who helped to design the tool, has written to the Welsh government four times seeking clarity on the basis for the changes, and why no one was made aware of them before the tool was rolled out. "The changes could have been made in order to keep as many healthcare workers on the frontline as possible, which is why I sent a specific list of questions to the Welsh government, so that I could have assurances that it wasn't done for that reason, but for clinical, evidence-based reasons," Mr Pandit said. Mr Pandit believes healthcare workers who fall into the high-risk category and work in environments where aerosol-generating procedures are performed - considered to carry a high risk of transmission of the virus - may not be fully protected by the current version of the tool if PPE supplies fall short and additional safeguarding measures aren't put into place. "The government needs to be absolutely sure that there is adequate PPE and that it is going to be available to everybody - we have to trust them on that," he said Read full story Source: BBC News, 27 August 2020
  18. News Article
    At least 6,500 health and care workers may have been infected with coronavirus through their work, including 100 who died, according to data from the Health and Safety Executive (HSE). The regulator told The Independent it was reviewing each case and could launch investigations under the Health and Safety at Work Act if hospitals or care homes are suspected of not taking adequate steps to protect staff from infection. This could result in a hospital or care home being prosecuted. The latest data from the HSE shows between 10 April and 10 August there were a total of 3, 382 healthcare workplace infections, including 50 fatal incidents. In residential care there were 3,168 infections reported to the watchdog with 48 fatal cases. The results of the review, first revealed earlier this month by The Independent, is being kept secret but where a medical examiner finds a worker may have died as a result of a workplace infection the death will have to be reported to the HSE for possible investigation. Coroners may also hold inquests into deaths. It will also make it easier for families to claim compensation from the government’s additional death in service payments of £60,000 which was announced by health secretary Matt Hancock in April. Read full story Source: The Independent, 25 August 2020
  19. News Article
    Women working in the NHS are suffering from serious stress and exhaustion in the wake of the coronavirus crisis, a troubling new report has found. Some 75% of NHS workers are women and the nursing sector is predominantly made up of women – with 9 out of 10 nurses in the UK being female. The report, conducted by the NHS Confederation’s Health and Care Women Leaders Network, warns the NHS is at risk of losing female staff due to them experiencing mental burnout during the global pandemic. Researchers, who polled more than 1,300 women working across health and care in England, found almost three quarters reported their job had a more damaging impact than usual on their emotional wellbeing due to the COVID-19 emergency. Read full story Source: The Independent, 25 August 2020
  20. News Article
    A third of doctors have treated patients with long term COVID-19 symptoms, including chronic fatigue and anosmia, a survey conducted by the BMA has found. Richard Vautrey, chair of the BMA’s GP committee for England, said it was clear that the long term impact of COVID-19 on patients and the NHS would be profound. “With more patients presenting with conditions as the result of infection, it’s essential that sufficient capacity is in place to support and treat them,” Vautrey said. “With the growing backlog of non-COVID-19 treatment, the likelihood of a season flu outbreak, and the possibility of a second wave of infections we need to see a more comprehensive long term plan to enable doctors to care for their patients this winter and beyond.” The survey also asked doctors about their own experiences of COVID-19: 63% said they did not believe they had contracted the virus, 12% had had a diagnosis of COVID-19 confirmed by testing, and 14% believed they had been infected with the virus. David Strain, co-chair of the BMA’s medical academic staff committee, said that the NHS could not afford more failures of quality and supply in personal protective equipment. “Risk assessments should be available to all working in the NHS and appropriate steps should be put in place to mitigate the risk of catching the virus, even in those that have a low risk of a bad outcome from the initial infection,” he said. Read full story Source: BMJ, 13 August 2020
  21. News Article
    A healthcare professional is facing a fitness to practise investigation for delaying attending to a COVID-19 positive patient because of inadequate personal protective equipment (PPE), in what may be the first case of its kind. The revelation came from a healthcare regulatory solicitor, Andrea James, who tweeted, “Was expecting it, but still disgusted to have received first #FitnessToPractise case arising from NHS trust disciplining healthcare professional who expressed concern about/delayed attending to a Covid+ patient without PPE (NHS Trust having failed to provide said PPE). For shame.” Doctors and nurses reacted with outrage to the tweet, and the Medical Protection Society issued a strong statement condemning the move. But James said that her client wanted to remain anonymous and declined to identify the profession or the regulator involved. She said that the treatment in question was expected to be an aerosol generating procedure. Rob Hendry, medical director at the Medical Protection Society (MPS), said, “It is appalling enough that healthcare professionals are placed in the position of having to choose between treating patients and keeping themselves and their other patients safe. The stress should not be compounded by the prospect of being brought before a regulatory or disciplinary tribunal. “MPS members who are faced with regulatory or employment action arising from a decision to not see a patient due to lack of PPE can come to us for advice and representation. However, it should not come to this: healthcare workers should not be held personally accountable for decisions or adverse outcomes that are ultimately the result of poor PPE provision.” Read full story Source: BMJ, 12 August 2020
  22. News Article
    The deaths of hundreds of NHS and social care workers infected with coronavirus are under investigation by medical examiners, The Independent has learnt. Ministers have asked medical examiners in England and Wales to review all deaths of frontline health and social care staff infected with the virus to determine whether the infection was caught as a result of their work. The review, which started last month, is likely to cover more than 620 deaths including nurses, doctors and care home staff across England and Wales, since the beginning of March. It could trigger a number of investigations by hospitals, the Health and Safety Executive, and coroners into the protection, or lack of, for staff during the pandemic when many hospitals ran out of protective masks and clothing for staff. Hospitals have already been ordered to risk assess workers who may be more susceptible to the virus, such as those from a black and minority ethnic backgrounds or those with existing health conditions. Read full story Source: The Independent, 12 August 2020
  23. News Article
    Over 8 out of 10 (84%) of members of the Medical Protection Society thinks a face covering should be mandatory when attending any healthcare setting. This was the finding of a survey including 562 of the GP indemnity providers' members, out of which 473 said masks should be mandated by law as they are on public transport and in shops. Effective from 13 July, PHE guidance says all clinical and non-clinical staff as well as patients should wear a face mask in areas of GP practices that cannot be made 'Covid-secure' through social distancing, optimal hand hygiene, frequent surface decontamination, ventilation and other measures. But NHS England has said GPs cannot refuse to treat patients who present at the practice without a face covering because they are not legally required to wear them. In response to its member survey, MPS has urged political leaders to ‘reconsider’ this decision. Medicolegal lead for risk prevention Dr Pallavi Bradshaw stressed that ‘it cannot be right’ for frontline healthcare workers to be put at ‘unnecessary risk by patients who refuse to wear a face mask’. Read full story Source: Pulse, 8 August 2020
  24. News Article
    Dozens of surgeons have reported being told by the NHS employer to stop discussing shortages of personal protective equipment (PPE) during the coronavirus crisis. The Confederation of British Surgery (CBS) said almost 70 surgeons working in major hospitals around the country had been warned off discussing a lack of PPE by their trust. A third of surgeons said the supply of PPE was inadequate at their hospital, with many complaining of inconsistent guidance, rationing of supplies and poor quality PPE when it was available. When asked if their concerns were dealt with satisfactorily, nearly a third said they were not addressed, or not effectively. A survey of 650 surgeons by the union found many were now considering changes to the way they worked as a result of the crisis – with more than half, 380, saying they would be avoiding face-to-face meetings with patients in the future. More than 40 surgeons, around 7%, said they were now considering leaving surgery altogether. Read full story Source: The Independent, 10 August 2020
  25. News Article
    Hundreds of thousands of NHS patients could lose the ability to see their GP face to face because their doctors may have to protect themselves from coronavirus. An analysis by the Health Foundation charity has found around a third of GPs who run their practice on their own are at high risk from the virus themselves. If they are forced to abandon face-to-face consultations the charity warned it could deny 710,000 patients access to their doctor. Dr Rebecca Fisher, senior policy fellow at the Health Foundation and a GP said: “The ongoing risk of Covid-19 to the safety of both patients and GPs means hundreds of thousands of people may find it much harder to get a face-to-face GP appointment. “It’s particularly worrying that GPs at higher risk from Covid-19 are far more likely to be working in areas of high deprivation. Those are precisely the areas with the greatest health need, the biggest burden from Covid-19, and an existing under-supply of GPs relative to need. Unless urgent action is taken this could become another way in which poorer communities become further disadvantaged, and risks further widening health inequalities.” Read full story Source: The Independent, 6 August 2020
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