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Content Article
Nuffield Trust: Safety culture in the NHS (25 August 2022)
Mark Hughes posted an article in Culture
A good safety culture in healthcare is one that includes value and respect for diversity, strong leadership and teamwork, openness to learning, and staff who feel psychologically safe. In this article the Nuffield Trust use data from the NHS Staff Survey to look at safety culture in the NHS. -
Content ArticleThe Government's Race Disparity Unit has published data relating to NHS staff reports of discrimination at work. The charts, tables and commentary on this page cover survey data from 2019, and the data from 2020 is available to download without commentary. 300 NHS organisations took part in the staff survey in 2019, including 229 NHS trusts.
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Content ArticleThis webpage highlights press coverage of the Chris Day whistleblowing hearing which took place in June 2022. Dr Day's case originates in 2013, when he initially raised concerns about unsafe staffing levels at Woolwich Hospital ITU, run by Lewisham and Greenwich NHS Trust. Following this, senior management in the Trust made allegations about his conduct, he believes as a result of his whistleblowing action. As a result Health Education England (HEE) deleted Dr Day's training number, meaning he was unable to progress to become a consultant. Dr Day has been campaigning for a public hearing of the case since 2016, and believes HEE, Lewisham and Greenwich NHS Trust and other authorities have spent large amounts of money attempting to 'crush' his case and prevent it from being heard. The tribunal hearing finally took place in June 2022 and featured revelations about Trust staff deliberately deleting emails relevant to the case, partisan briefings made to senior NHS management about Dr Day and inaccurate press statements from the Trust.
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News Article
Lack of ‘psychological safety’ at trust with ‘acceptance of poor behaviours’
Patient-Safety-Learning posted a news article in News
An acute trust has “palpable” cultural problems and staff “at all levels” have described an acceptance of “poor behaviours”, according to the Care Quality Commission. Some staff at Gloucestershire Hospitals Foundation Trust also reported a lack of trust in their senior managers and a “fear of speaking up”. The Care Quality Commission feedback was set out in a post-inspection letter to the trust’s acting chief executive Mark Pietroni last month following an inspection in June. The trust’s CEO Deborah Lee is currently off work as she recovers from a stroke. According to the CQC letter, published in the trust’s board papers ahead of a full inspection report which is due in the autumn, staff “articulated [to inspectors and said they] had observed rudeness and incivility throughout the organisation”. In a written statement, Professor Pietroni told HSJ he “fully recognised” the CQC’s feedback. Read full story (paywalled) Source: HSJ (24 August 2022) -
Content ArticleIn this blog for The King's Fund, Richard Murray examines the issues that are pushing the NHS into crisis and causing the lowest levels of public satisfaction since the 1990s. The primary cause of this emergency is the workforce crisis, an existing trend that has been accelerated by the Covid-19 pandemic. He examines the approaches that have been taken to similar crises in the past, and highlights the importance of the workforce plan that is due to be released by NHS England and Health Education England towards the end of the year.
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Content ArticleThis statement from Chair Peter Wyman addresses allegations of bullying and racism within NHS Blood and Transplant as reported in The Times on 21 August 2022. In the statement, Peter Wyman says, "I cannot overstate the importance we place in ensuring we have a strong, positive and inclusive culture so we can serve the public and patients who need us. “Issues of racism and bullying came to light in parts of our organisation two years ago after an in-depth staff listening exercise. We’ve moved on a lot in the past two years. Our actions have included providing a safe way for staff to raise and discuss issues by appointing a Freedom to Speak Up Guardian, improving recruitment processes to be more inclusive, matured how we manage conflict and grievances and refreshing our code of conduct so we all know the behaviours that are expected of us. We continue to measure progress through ongoing staff engagement. “We are making progress but like every good organisation we should always be challenging ourselves to do even better. In particular, I want to ensure we have a culture that enables each of us to be our best, that encourages everyone to speak up without fear or favour if they see something wrong or something which might be done better. I want a culture where everyone is valued for who they are and what they contribute. "There can be no place for any form of discrimination, bullying or harassment.”
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News ArticleA study of over 1,000 health and social care workers, conducted by Florence, the tech platform providing health & social care workers access to available shifts, found that almost a third of healthcare workers admit to feeling overwhelmed at least once a week, with 17% feeling burnt-out every day. A staggering 97% believe the cost-of-living crisis has caused further stress or burnout among healthcare professionals. It comes after more than half of healthcare workers (56%) admit to working more than 2-3 times a week over their contracted hours, with 7% working overtime every day. Not having enough staff is causing the most pressure in their role (50%), followed by low pay (39%) and high workload (35%). The study revealed nine in ten NHS and social care workers state chronic staff shortages are affecting the quality of care. Analysing this deeper, three quarters of respondents stated that the quality of care is already being ‘severely’ impacted as high vacancy rates sweep across the industry. Dr Charles Armitage, Former NHS doctor and CEO and Founder of Florence, observed: “If you’ve got fewer people there on-shift to look after people, the quality of care decreases because the people that are there are overstretched, they’re trying to do too many things and are suffering from severe burnout. As a result, mistakes are made as they’re not able to just spend as much time with people and provide that really important patient-centred care.” Read full story Source: Hospital Times, 17 August 2022
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News Article
Covid death payments unavailable for staff who died in most recent waves
Patient Safety Learning posted a news article in News
The families of any NHS and social care staff who died from Covid in the most recent waves will not be eligible for the Covid death assurance scheme launched at the start of the pandemic, it has emerged. The scheme closed on 31 March, despite pleas from the Royal College of Nursing (RCN) to keep it open. Since it was set up in April 2020, it has paid out £60,000 lump sums to the estates of 688 workers. A further 42 cases have been declined and 29 applications are still being processed. The RCN wrote to then health and social care secretary Sajid Javid on 30 March, calling for the scheme to be extended. General secretary and chief executive Pat Cullen wrote: “The over-riding principle must be that no member of nursing staff who loses their life this year should be afforded any less respect and family support than one who died in 2020 or 2021… “With a distinct possibility of new variants at any point, staff deserve assurance that they and their loved ones will not go unnoticed should they contract and ultimately lose their life to covid.” Read full story (paywalled) Source: HSJ, 19 August 2022 -
Content Article
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Covid-19 has posed a huge challenge to the delivery of safe care, both when infection rates were at their highest levels and in terms of its long-term impact on health and social care systems.[1] The pandemic has magnified existing patient safety issues, created new ones, and exposed safety gaps which require systemic responses. This month the World Health Organization (WHO) has published a new report, Implications of the Covid-19 pandemic for patient safety: A rapid review.[2] The review aims to create a greater understanding of the impact of the pandemic on patient safety, particularly in relation to diagnostic services, treatment and care management. In this blog, Patient Safety Learning, one of the international organisations who contributed to this review, provides an overview and reflections on some the key themes and issues raised in this review. -
Content Article
NHS East London: Enjoying work project posters
Patient Safety Learning posted an article in Good practice
Here are some useful projects that NHS East London teams from each directorate took part in as part of demonstrating what they have learned from Cohort 3 of the Enjoying Work Learning System. -
Content ArticleGovernments in England, Scotland and Wales recently withdrew covid sick leave for NHS staff. These changes to sick pay provision for staff on Covid-related sick pay is hard to understand at a time when Covid-19 infections are going up exponentially and many NHS organisations are reporting increasing numbers of staff off sick. Evidence is emerging that your chances of on-going issues (Long Covid) following a covid infection increase with each re-infection. Given this you might expect that NHS organisations were ensuring their infection control guidelines guaranteed staff were fully protected against Covid-19. However, in many Trusts this does not appear to be the case. Throughout the pandemic many NHS organisations seem to have focused on following Government guidelines about PPE requirements and ignored their obligations under Health and Safety Legislation. This has resulted in on-going shortcomings in protecting staff at work. This is discussed by Professor Raymond Agius and colleagues in a BMJ blog.
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News Article
Just four out of 1,100 lone worker alarms being used by trust workforce
Patient Safety Learning posted a news article in News
A trust which rented 1,100 lone worker alarms has found just four were in use after a year. Sussex Partnership Foundation Trust rented the system for five years, with the contract starting in early 2021. But a year later only 51 of the units were assigned to a user, and just four were being used. Most of the users had not completed their training and 19 had not even logged into the system to set up a profile, according to an annual health and safety report covering 2021-22. The health and safety report said: “Unfortunately the system has yet to demonstrate value for money as the uptake within services across the trust is very poor, despite the extensive work by the health and safety team to encourage uptake.” This had included demonstrating the system at multiple meetings and trying to raise awareness. A spokesperson from Sussex Partnership Foundation Trust said: “The lone worker system is one of the ways we ensure the safety of our staff who work alone. It has taken time to embed the new system due to the changes in working practices during the pandemic. However, in recent months we have seen the number of staff actively using the system increasing." “There is more we are doing to ensure wider take-up and implementation, through a programme of engagement and training.” Read full story (paywalled) Source: HSJ, 9 August 2022 -
News ArticleMidwife numbers are reaching a dangerous level which could put lives at risk, as records show more staff leaving than joining the profession for the first time in a decade. As a record number suffer burnout and leave, the figures from NHS Digital for 2021/22 show almost 300 more staff abandoned midwifery than joined the service, with 3,440 leaving and only 3,144 coming in. Analysis of the data showed a record 551 resigned in 2021 because of a lack of work-life balance. Midwives working in NHS trust maternity units typically work 12-hour shifts, but many work longer for no additional pay to cover staff shortages and to keep services running. The Royal College of Midwives (RCM) says members are "at the end of their tether' and 'physically and emotionally burnt out" Joeli Brearley, chief executive of campaign group Pregnant Then Screwed, said: "We don't have enough midwives, and those we do have are underpaid, undervalued and overworked." "This is a problem that has been communicated to the Government repeatedly for years. It is putting the lives of women and their babies in danger and causing untold damage to their mental and physical health. The Government needs to get a grip of the situation urgently before there are more tragedies." Read full story Source: Daily Mail, 1 August 2022 .
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Content Article
Joy in work: presentation from Julia Wood (22 July 2022)
Patient Safety Learning posted an article in Culture
Presentation from Julia Wood given to the Patient Safety Manager Network (PSMN) on the importance of finding joy and happiness in work and how you can support your staff. -
Content Article
The NHS whistleblowing crisis (8 February 2022)
Patient Safety Learning posted an article in Whistle blowing
Tommy Greene and David Hencke report on a number of worrying NHS dismissal cases in this Byline Times article. -
Content ArticleThis opinion piece in The BMJ looks at the impact of the government's decision to make the wearing of masks in healthcare settings the decision of local providers, dependent on local risk assessment and prevalence. It highlights reports of patients wearing high-filtration FFP2 or FFP3 respirator—many of who are immunocompromised—being asked to remove and replace them with less effective single-use masks in order to gain entry to NHS facilities for treatment. The authors highlight that Covid-19 is an airborne pathogen and that the likelihood of contracting the virus increases with length of time spent in contaminated air. They argue that downgrading mask use in healthcare settings puts everyone at risk, but that it is a particular issue for patients who are clinically extremely vulnerable due to underlying health conditions or because they are undergoing treatment for cancer. They call on the government to upgrade masks to FFP2 or FFP3 respirators in order to protect staff and patients and reverse the worrying trend of clinically extremely vulnerable patients avoiding attending healthcare services.
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Content ArticlePerioperative practitioners in the UK are universally concerned about the risk surgical smoke plume poses to their health. Yet less than a fifth are aware of any policy being in place to manage this risk within their organisation. The majority of hospitals have plume evacuation equipment in place, but it is only used in the minority of surgical procedures. Almost three-quarters of theatre staff have experienced symptoms associated with exposure to surgical smoke plume. But these symptoms are rarely reported and, when they are, no action is generally taken. These are the findings of a new report published by the Surgical Plume Alliance (SPA), a joint advocacy initiative between the Association for Perioperative Practice (AfPP) and the International Council on Surgical Plume (ICSP). They aimed to gain a greater understanding of the awareness levels, training, management and policy surrounding surgical smoke plume in the UK.
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News Article
NHS in England facing worst staffing crisis in history, MPs warn
Patient Safety Learning posted a news article in News
The large number of unfilled NHS job vacancies is posing a serious risk to patient safety, a report by MPs says. It found England is now short of 12,000 hospital doctors and more than 50,000 nurses and midwives, calling this the worst workforce crisis in NHS history. It said a reluctance to decisively plug the staffing gap could threaten plans to tackle the Covid treatment backlog. The government said the workforce is growing and NHS England is drawing up long-term plans to recruit more staff. Former Health Secretary Jeremy Hunt, who chairs the Commons health and social care select committee that produced the report, said tackling the shortage must be a "top priority" for the new prime minister when they take over in September. "Persistent understaffing in the NHS poses a serious risk to staff and patient safety, a situation compounded by the absence of a long-term plan by the government to tackle it," he said. It said conditions were "regrettably worse" in social care, with 95% of care providers struggling to hire staff and 75% finding it difficult to retain existing workers. "Without the creation of meaningful professional development structures, and better contracts with improved pay and training, social care will remain a career of limited attraction, even when it is desperately needed," the report said. Read full story Source: BBC News, 25 July 2022 -
Content ArticleThe National Guardian’s Office has published its latest annual speaking up data, which summarises the themes and learning from the speaking up data shared by Freedom to Speak Up guardians.
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Content Article'The Staff Support Guide: a good practice resource following serious patient harm' was launched at Parliamentary reception on 29 June 2022. View the presentation about it from Patient Safety Learning and the Safer Healthcare Biosafety Network at the recent Network meeting.
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Content ArticleAfter 12 years of brutal service, Neil Barnard, an NHS emergency medicine consultant, is leaving his NHS post to work abroad. His decision to leave is driven by financial and personal reasons. More than anything, he says he's tired and has little more left to give to the NHS.
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Content ArticleThis article in the Nursing Times Long Covid series discusses how nurses are at high occupational risk of Long Covid and how best to support them.
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Content ArticleDavid Oliver is a consultant in geriatrics and acute general medicine who has worked in the NHS for 33 years. In this blog, he talks about his personal experience of running covid 'hot' wards during the different waves of the pandemic, describing the toll working in these conditions has taken on the health of him and many of his colleagues. He highlights the impact of looking after dying patients without adequate PPE, informing family members of patients' death over the phone, being responsible for many more patients than usual and witnessing colleagues die from Covid-19. The result has been burnout, mental health issues and low morale for a workforce that was already stretched before the pandemic hit the UK. David finally caught Covid-19 himself in March 2022 and he talks about how the virus—plus the cumulative effect of working under such strain for over two years—has meant he is not able to work and has been signed-off sick since mid-May.
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Content Article
In this blog, student midwife Sophie Dorman describes some of the issues that have led to a chronic shortage of midwives, including a culture of fear, poor pay and conditions and a lack of basic facilities for maternity staff. She highlights the impact this is having on the safety of maternity services and argues that valuing and looking after midwives will make pregnancy and childbirth safer and better for everyone. -
Content ArticleUK doctors have submitted an open letter to the BMA requesting their commitment to supporting and actively advocating for its members who are living with Long Covid.
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