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Found 982 results
  1. Content Article
    A substantial barrier to progress in patient safety is a dysfunctional culture rooted in widespread disrespect. Leape et al. identify a broad range of disrespectful conduct, suggesting six categories for classifying disrespectful behaviour in the health care setting: disruptive behaviour; humiliating, demeaning treatment of nurses, residents, and students; passive-aggressive behaviour; passive disrespect; dismissive treatment of patients; and systemic disrespect. At one end of the spectrum, a single disruptive physician can poison the atmosphere of an entire unit. More common are everyday humiliations of nurses and physicians in training, as well as passive resistance to collaboration and change. Even more common are lesser degrees of disrespectful conduct toward patients that are taken for granted and not recognised by health workers as disrespectful. Disrespect is a threat to patient safety because it inhibits collegiality and cooperation essential to teamwork, cuts off communication, undermines morale, and inhibits compliance with and implementation of new practices. Nurses and students are particularly at risk, but disrespectful treatment is also devastating for patients. Disrespect underlies the tensions and dissatisfactions that diminish joy and fulfilment in work for all health care workers and contributes to turnover of highly qualified staff. Disrespectful behaviour is rooted, in part, in characteristics of the individual, such as insecurity or aggressiveness, but it is also learned, tolerated, and reinforced in the hierarchical hospital culture. A major contributor to disrespectful behaviour is the stressful health care environment, particularly the presence of “production pressure,” such as the requirement to see a high volume of patients.
  2. Content Article
    The pandemic is not gone but it is largely forgotten. Especially the first year, with its two devastating waves in which over 140,000 people died. The NHS reorganised itself completely to deliver care to the thousands of very sick Covid patients, alongside continuing care for other patients throughout. The system strained and buckled and staff were pushed to their limits and beyond. The impact continues today as the NHS is weaker, less resilient and with much longer waits than before. In this article, Christina Pagel looks back at the reality of the first year and its aftermath and hears anonymous testimony from staff at the NHS front line. “Staff sitting in literal cupboards crying alone because staff weren’t allowed to sit together & we couldn’t take all the death around us. It was utterly traumatising”
  3. Content Article
    Nurse bullying has been an issue for decades and continued during the Covid-19 pandemic. Now, in the post-pandemic era, allegations of toxic behaviour are continuing to climb.  Becker's spoke with Jennifer Woods, vice president and chief nursing officer at Baptist Health Hardin in Elizabethtown, Pennsylvania, and Jamie Payne, chief human resources officer at Saint Francis Health System in Tulsa, Oklahoma, to understand the increase in nurse bullying and how their health systems are working to address it. 
  4. News Article
    The Hospital Consultants and Specialists Association (HCSA), a hospital doctors union, has called for an independent body to register and monitor cases where doctors raise safety concerns and for criminal charges to be brought against trusts when whistleblowers suffer harm. Naru Narayanan, president of HCSA, called for the changes after a survey found that doctors worry that speaking up about patient safety will put their careers at risk and that the creation of freedom to speak up guardians in 2016 has not increased their confidence. Read full story (paywalled) Source: BMJ, 13 November 2023
  5. Content Article
    During the bleak early years of the Covid pandemic, if there was one thing we were all doing, it was “following the science”. This, we were repeatedly assured, was what was driving all the government’s tough decisions. We might not like all its policies but we shouldn’t, it was implied, argue. After all, it was – always – just “following the science”. But was it really? In her evidence to the Covid inquiry, former civil servant Helen MacNamara revealed that in April 2020, the then prime minister, Boris Johnson, asked the former chief executive of the NHS in England, Simon Stevens, about reports that female frontline healthcare workers were struggling with PPE that had been designed for men. Stevens is said to have “reassured” the prime minister that there was “no problem”. However, as Caroline Criado Perez highlights, report after report over decades has found that while PPE is usually marketed as gender-neutral, the vast majority has in fact been designed around a male body, and therefore neither fits nor protects women. In fact, more often than not, it’s a hindrance.
  6. News Article
    Three in five foreign doctors in the NHS face “racist microaggressions” at work, such as patients refusing to be treated by them or having their abilities doubted because of their skin colour. The widespread “thinly veiled, everyday instances of racism at work” experienced by medics trained overseas has been uncovered by a survey of more than 2,000 UK doctors and dentists. Almost three in five (58%) said they had encountered such behaviour, from colleagues as well as patients, although most did not report it because they thought that no action would be taken. Doctors affected can feel upset, humiliated, marginalised and not taken seriously as a result. The findings have raised fears that international medical graduates may choose not to work in the NHS, which is increasingly reliant on their skills given the service’s shortage of doctors. Dr Naeem Nazem, the head of medical at the medical defence organisation MDDUS, which acts for doctors accused of wrongdoing, said: “These findings show us that a worryingly large number of overseas-trained doctors working in the NHS face racist microaggressions in the course of their work, from both patients and colleagues, and that many do so regularly.” Read full story Source: The Guardian, 8 November 2023
  7. Content Article
    Medical defence organisation MDDUS's latest annual member attitude survey has found that many have experienced or witnessed persistent racist microaggressions at work. Almost two-thirds of International Medical Graduate members report they’ve been subject to racist microaggressions and have little faith in being heard and the issue being taken seriously. MDDU's 'We hear you' campaign aims to be a catalyst for positive change and help rebuild confidence in the way such abuses can be reported.
  8. Content Article
    In this opinion piece, BMJ journalist Clare Dyer examines how the healthcare system is grappling with the question of how Lucy Letby was allowed to get away with killing babies in plain sight for so long. She looks at culture and governance issues that meant that concerns raised by consultants were not appropriately acted on.
  9. Content Article
    In this issue of Psychological Safety, Tom Geraghty, shares some stories of “bad” management that newsletter readers have shared with him, so we can all learn from them. A selection of the stories, chosen because they highlight key themes. Geraghty highlights the importance of self reflection and learning from our own mistakes in order to improve. Also noting that when we share our mistakes and what we’ve learned from them, the potential for learning extends beyond ourselves to everyone around us.
  10. Content Article
    Changes of all kinds can have a profound effect on us, both in terms of our wellbeing and performance. David Murphy has worked therapeutically with people, including front-line professionals, for over 20 years, helping them to change, and adapt to change. David talks to Steven Shorrock about dealing with traumatic events and more mundane changes.
  11. News Article
    A hospital trust has dismissed three members of staff following complaints of sexual harassment. The sackings by University Hospitals Birmingham (UHB) NHS Trust were revealed at the launch of its sexual safety charter on Monday. Sexual safety was one of the areas highlighted in a review of the trust's culture. UHB said sexism, misogyny and sexual harassment would not be tolerated in the workplace. The trust has been subject to three enquiries following a BBC investigation into its culture. The second of these investigations, by Prof Mike Bewick, identified a new line of inquiry into allegations of misogynistic behaviour and sexual harassment. Prof Bewick said the trust had begun formal investigations and there was a widening of the scope of the enquiry to accommodate the sensitive nature of these concerns. Read full story Source: BBC News, 19 October 2023
  12. News Article
    Thousands of complaints made against nurses and midwives were rejected by the watchdog without investigation last year as it battles a huge backlog amid concerns rogue staff are being left unchecked. The Nursing and Midwifery Council has rejected hundreds more cases a year since 2018, including 339 where nurses faced a criminal charge, 18 for alleged sexual offences and 599 over allegations of violence in 2022-23, according to data shared exclusively with The Independent. The new figures come after The Independent revealed shocking allegations that nurses and midwives accused of serious sexual, physical and racial abuse are being allowed to keep working because whistleblowers are being ignored and that the NMC was failing to tackle internal reports of alleged racism. And now, a new internal document, obtained by The Independent, reveals more staff have come forward to raise concerns since our expose. Former Victims’ Commissioner Dame Vera Baird KC said the backlog of complaints was “worryingly high” and called for urgent action to tackle it. Read full story Source: The Independent, 19 October 2023
  13. Event
    until
    This session is aimed at understanding what causes burnout, the impact and how to prevent/overcome it. Listening to stories from 2 Doctors and understanding the emotions, impact and consequence of burnout can help others look out for the signs and try to prevent it. Through talking and opening up, we hope to raise the awareness of burnout. It is real, can cause trauma and is linked to our wellbeing needs in the workplace. Guest speakers are: Dr Jess Morgan, Paediatrician Dr Chris Healey, Gastroenterologist Please join this session to learn from each other, listen and talk about wellbeing needs in the workplace. This is an open session to everyone, it will be healthcare based but is transferable. It is a free space and a social movement that has one agenda: To help staff flourish in the workplace. Sign up for the session. Joining instructions for this virtual event will be emailed directly to you closer to the date The basic needs at work campaign is based on research and simple QI methodology to address basic needs. It doesn't need to be complicated, but it does need to stick! The Basic Needs at Work resources can be found here
  14. Content Article
    Healthcare services regularly receive patient feedback, most of which is positive. Empirical studies suggest that health services can use positive feedback to create patient benefit. This study in Plos One aimed to map all available empirical evidence for how positive patient feedback creates change in healthcare settings. The researchers included 68 papers describing research conducted across six continents, with qualitative (n = 51), quantitative (n = 10), and mixed (n = 7) methods. Only two studies were interventional. Most outcomes described were desirable. These were categorised as: short-term emotional change for healthcare workers (including feeling motivated and improved psychological wellbeing) work-home interactional change for healthcare workers (such as improved home-life relationships) work-related change for healthcare workers (such as improved performance and staff retention). Some undesirable outcomes were described, including envy when not receiving positive feedback. The impact of feedback may be moderated by characteristics of particular healthcare roles, such as night shift workers having less interaction time with patients. The researchers called for further interventional research to assess the effectiveness and cost-effectiveness of receiving positive feedback in creating specific forms of change such as increases in staff retention. They also suggest that healthcare managers may wish to use positive feedback more regularly, and to address barriers to staff receiving feedback.
  15. Content Article
    Doctors are dying by suicide at higher rates than the general population—somewhere between 300 to 400 physicians a year in the US take their own lives. This article in The Guardian looks at why so many surgeons are dying to suicide and what can be done to stop the trend. It examines how the culture of working long hours and the expectation to be 'superhuman' leads surgeons to suppress their symptoms and avoid seeking help for mental health issues. The article also tells the story of US surgeon and President of the Association of Academic Surgery Carrie Cunningham, who has lived with depression, anxiety and a substance abuse disorder for many years.
  16. Content Article
    The Association of Ambulance Chief Executives (AACE) and the Office of the Chief Allied Health Professions Officer (CAHPO) have launched three publications aimed at reducing misogyny and improving sexual safety in the ambulance service.
  17. News Article
    The ambulance sector has signed up to a consensus statement in a bid to tackle misogyny and improve sexual safety for its staff and patients. The statement – which chief allied health professions officer for England Suzanne Rastrick launched at this week’s Ambulance Leadership Forum – commits the service to a “cultural transformation”. Several ambulance trusts have been criticised for a culture which includes “highly sexualised banter” in recent years, with reports highlighting sexual harassment, often of younger female staff. The statement’s guiding principles include: a focus on protecting staff from misogyny and inappropriate sexual behaviour; removing barriers to speaking up and supporting those affected; and working towards an inclusive culture where staff understand misogyny and come to work feeling “sexually safe”. Read full story (paywalled) Source: HSJ, 5 October 2023
  18. News Article
    The number of doctors seeking help for mental health issues has risen by more than three quarters within two years, according to figures from a specialist treatment service for NHS staff. For one GP, the relentless stress of the job led to him taking three months off work with burnout. David Triska is no stranger to high-pressure situations. As an army medic, he served two tours of Afghanistan. But mounting workloads at his village GP surgery left him feeling "hollowed out and spent". Simple tasks, like unlocking his car or making a meal, became a challenge - an experience he describes as leaving him feeling "like a husk of a human". "At that extreme point, I couldn't see why I needed to be here anymore," Dr Triska said. He is not alone. Since the year ending March 2021, there has been a 77% rise in the number of doctors seeking help for mental health issues, according to figures shared with the BBC by a confidential support service for NHS staff. More than 5,600 doctors used the NHS Practitioner Health programme in England in 2022/23, with about a third having thought about taking their own lives. Read full story Source: BBC News, 5 October 2023
  19. Event
    This 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 Follow on Twitter @HCUK_Clare #HospitalatNight hub members receive a 20% discount. Email info@pslhub.org for discount code.
  20. Content Article
    Throughout October’s Speak Up Month, the National Guardian for the NHS, Dr Jayne Chidgey-Clark will be in conversation with guests who have their own speaking up stories and reflecting on how we can break the barriers they faced to make a better and safer speaking up culture across healthcare in England.
  21. News Article
    Former police officers, including a murder detective, have been hired by NHS hospitals in a move that campaigners have warned risks discouraging whistleblowers. The Sunday Telegraph has revealted that retired officers have been employed by a trust currently under scrutiny for its treatment of doctors who raise patient safety concerns. One of them has taken up a patient safety incident investigator role worth up to £57,349 a year. Meanwhile a senior detective has been called into multiple trusts on an ad hoc basis to conduct investigations. Last night a leading patient group called on the NHS to be transparent about exactly how such personnel are being used, “given the ongoing concerns about how such roles interact with whistleblowers”. Paul Whiteing, chief executive of the charity Action Against Medical Accidents (AvMA), said: “We at AvMA welcome any steps taken by Trusts to professionalise the investigation of patient safety incidents. This is long overdue. “But given the on-going concerns about how such roles interact with whistleblowers, to maintain trust and confidence of all of the staff, trusts need to be clear, open and transparent about why they are making such appointments and the role and duties of those they employ to fulfil them, whatever their backgrounds.” Campaigners have warned that some NHS trusts deliberately seek to conflate patient safety issues with staff workplace investigations. Read full story (paywalled) Source: The Telegraph, 30 September 2023
  22. Content Article
    This post is a transcript of an interview on Times Radio Breakfast on 7 September 2023 in which Dr Jane Somerville, Emeritus professor of cardiology at Imperial College, was asked if the Lucy Letby case has uncovered a problem of the difficulties doctors have of voicing their concerns in hospitals. In the interview, Dr Somerville refers to systemic persecution of NHS staff who speak up about patient safety. She goes on to identify the key issues of power; cover-up culture; suppression of complaints/concerns; career-ending reprisals against staff who speak up; and the almost universal failure of employment tribunals to protect whistleblowers. 
  23. 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
  24. Content Article
    The Culture Review report was published following an independent external review of the organisational culture at University Hospitals Birmingham Trust. The external review was carried out by consultancy firm The Value Circle following a series of investigations into problems at University Hospitals Birmingham Foundation Trust over the last year.
  25. Content Article
    A fundamental premise of psychological safety is the belief that you will not be punished for making a mistake if your intentions were good. A key approach to making this real is through applying the Local Rationality Principle. This article, published by Psychological Safety, explains the concept of Local Rationality and how to put the Local Rationality Principle into practice.
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