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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 Follow on Twitter @HCUK_Clare #HospitalatNight hub members receive a 20% discount. Email info@pslhub.org for discount code.
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Content Article
Speak Up Listen Up Follow Up podcast (October 2023)
Patient Safety Learning posted an article in Speak Up Guardians
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. -
News ArticleFormer 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
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Content ArticleThis 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.
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News Article
University Hospitals Birmingham: Half of staff felt bullied
Patient Safety Learning posted a news article in News
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 -
Content ArticleThe 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.
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Content Article
The Local Rationality Principle
Patient_Safety_Learning posted an article in Staff safety
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. -
Content ArticleUnable to work or to play with their children, forced to sell their homes or facing insolvency—doctors with Long Covid deserve more support from the government and the NHS, writes Adele Waters in this BMJ article.
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Content ArticleIn a world where most people wake up with the sun and head to their ‘9 to 5’, night shift work can be a challenge – but can it also be bad for your health? What do those health effects mean for your risk of cancer? Can working night shifts cause cancer? Worldwide Cancer Research presents the evidence.
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Content ArticleA recent report found that a third of female surgeons have been sexually harassed at work. In this opinion piece, Dr Liz O’Riordan speaks out about the abuse she suffered from male colleagues while working for the NHS. She describes her experiences, highlighting that incidents of sexual harassment are common amongst female surgical trainees who fear speaking out as it may affect their careers. She also draws attention to the fact that it is not just an issue amongst surgeons, but that many other healthcare professionals experience inappropriate sexual comments and behaviour while at work.
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Content ArticleAs awareness of the importance of psychological safety in the workplace increases, there is a corresponding increase in the number of psychometric tools, applications and services that attempt to measure psychological safety. This post on the blog Psychological Safety outlines some helpful principles for organisations to apply when choosing a psychometric tool. It lays out the following key principles, stating that in choosing a psychometric tool, we should ensure that we understand the methods and algorithms the tool uses. it’s usable and accessible for everyone. it’s secure. people retain ownership of their own data. the questions and statements actually correlate with psychological safety. it doesn’t make assumptions based upon majority culture. the tool doesn’t create perverse incentives.
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Content ArticleFor surgical teams, high reliability and optimal performance depend on effective communication, mutual respect, and continuous situational awareness. Surgeons who model unprofessional behaviours may undermine a culture of safety, threaten teamwork, and thereby increase the risk for medical errors and surgical complications. This article in JAMA Surgery aimed to assess whether patients of surgeons with a higher number of coworker reports about unprofessional behaviour experience a higher rate of postoperative complications than patients whose surgeons have no such reports. The authors found that patients whose surgeons had a higher number of coworker reports had a significantly increased risk of surgical and medical complications. These findings suggest that organisations interested in ensuring optimal patient outcomes should focus on addressing surgeons whose behaviour toward other medical professionals may increase patients’ risk for adverse outcomes.
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News Article
Female surgeons sexually assaulted while operating
Patient Safety Learning posted a news article in News
Female surgeons say they are being sexually harassed, assaulted and in some cases raped by colleagues, a major analysis of NHS staff has found. The Royal College of Surgeons said the findings were "truly shocking". Sexual harassment, sexual assault and rape have been referred to as surgery's open secret. There is an untold story of women being fondled inside their scrubs, of male surgeons wiping their brow on their breasts and men rubbing erections against female staff. Some have been offered career opportunities for sex. Nearly two-thirds of women surgeons that responded to the researchers said they had been the target of sexual harassment and a third had been sexually assaulted by colleagues in the past five years. Women say they fear reporting incidents will damage their careers and they lack confidence the NHS will take action. It is widely accepted there is a culture of silence around such behaviour. Surgical training relies on learning from senior colleagues in the operating theatre and women have told us it is risky to speak out about those who have power and influence over their future careers. Read full story Source: BBC News, 12 September 2023 Related reading on the hub: Breaking the silence: Addressing sexual misconduct in healthcare Calling out the sexist and misogynist culture within healthcare: a blog by Dr Chelcie Jewitt, co-founder of the Surviving in Scrubs campaign GMC's Good medical practice 2024 -
Content ArticleResearch published in the British Journal of Surgery demonstrates that sexual harassment and sexual assault are commonplace within the surgical workforce and rape happens. This report from the Working Party on Sexual Misconduct in Surgery is a call to action, with a series of recommendations, for healthcare institutions to face up to the shocking reality of sexual misconduct within their organisations. Further reading: Sexual harassment, sexual assault and rape by colleagues in the surgical workforce, and how women and men are living different realities: observational study using NHS population-derived weights Calling out the sexist and misogynist culture within healthcare: a blog by Dr Chelcie Jewitt, co-founder of the Surviving in Scrubs campaign GMC's Good medical practice 2024
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Content ArticleThis research examined sexual misconduct occurring in surgery in the UK, so that more informed and targeted actions can be taken to make healthcare safer for staff and patients. A survey assessed individuals’ experiences with being sexually harassed, sexually assaulted, and raped by work colleagues. Individuals were also asked whether they had seen this happen to others at work. Compared with men, women were much more likely to have seen sexual misconduct happening to others, and to have it happen to them. Individuals were also asked whether they thought healthcare-related organizations were handling issues of sexual misconduct adequately; most did not think they were. The General Medical Council (GMC) received the lowest evaluations. The results of this study have implications for all stakeholders, including patients. Sexual misconduct was commonly experienced by respondents, representing a serious issue for the profession. There is a widespread lack of faith in the UK organizations responsible for dealing with this issue. Those organizations have a duty to protect the workforce, and to protect patients. Further reading: Breaking the silence: Addressing sexual misconduct in healthcare Calling out the sexist and misogynist culture within healthcare: a blog by Dr Chelcie Jewitt, co-founder of the Surviving in Scrubs campaign GMC's Good medical practice 2024
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Content ArticleIn this article in the Scotsman, former whistle blower, Iain Kennedy, writes about the culture of fear and blame in Scotland's NHS and how NHS staff must feel free to speak up about problems that affect patient safety.
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News Article
NHS staff to be asked about sexual harassment for the first time
Patient Safety Learning posted a news article in News
NHS staff will be asked if they have experienced sexual harassment or inappropriate behaviour in the workplace for the first time. In a letter, NHS England chief delivery officer Steve Russell said the upcoming annual staff survey would include the following question: “In the last 12 months, how many times have you been the target of unwanted behaviour of a sexual nature in the workplace? This may include offensive or inappropriate sexualised conversation (including jokes), touching or assault.” Mr Russell said the anonymous answers to the new question would “help us understand the potential prevalence of sexual misconduct in your organisation and inform further action to protect and support staff across the NHS”. It comes as NHSE launches the health service’s first sexual safety charter to help protect staff from harassment and inappropriate behaviour. The charter is an agreement comprising 10 pledges, including commitments to provide staff with clear reporting mechanisms, training, and support from managers. Read full story (paywalled) Source: HSJ, 6 September 2023 -
Content ArticleIn this article for Health Services Insight, NHS consultant David Oliver examines why most comments on articles in the Health Services Journal (HSJ) are posted anonymously. He highlights that this tendency towards anonymity from commenters who are clearly in influential, senior NHS posts, indicates that the culture in the NHS management community, from NHS England down, is one that makes most people fearful of saying anything in their own name in case of reprisal. He also points out that a culture where people are afraid to make comments and criticisms in their own name is in conflict with the Nolan Principles of 'selflessness', 'integrity', 'objectivity', 'accountability', 'openness', 'honesty' and 'leadership' that senior NHS managers and officials are supposed to be guided by.
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Content ArticleIn the wake of the conviction of Lucy Letby, a neonatal nurse who has been found guilty of the murder of seven babies and attempted murder of six babies, the focus of the nation is on the multiple tragedies that the families have faced, the healthcare staff who tried to blow the whistle, and safety issues in hospitals. NHS England has responded to the conviction by stating that trusts should look at whistleblowing policies, that those unfit to hold directorships should not be appointed, and with that well worn phrase “lessons will be learned.” But will they? In this BMJ opinion piece Alison Leary, professor of Healthcare and Workforce Modelling at London South Bank University, looks at why the NHS has failed to learn lessons from patient safety tragedies spanning the last fifty years. She highlights that unlike other safety critical industries, healthcare is still wedded to concepts that effectively deny the complexity of work and the social structures that surround work. This includes a failure to see the value in retaining experienced staff and a hierarchical approach to the value of work. She also outlines that more focus should be placed on management listening, rather than on staff having to find the courage to speak up when they have concerns: "When workers are listened to and constructive dissent is encouraged and normalised, along with the reporting of incidents, there is little need for whistleblowing. A workforce that must resort to whistleblowing is a symptom of poor safety culture."
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Content ArticleDr Chris Day has for the last ten years pursued a legal battle against Greenwich and Lewisham NHS Trust (GWT), claiming his whistleblowing action about unsafe staffing while working in ICU was used against him by the Trust and Health Education England. Following a 2022 employment tribunal involving Dr Day and GWT, consultancy firm KPMG was commissioned by the Trust to conduct an independent review of the Trust's governance and media strategy. In this LinkedIn blog, Dr Chris Day outlines the context of a Byline Times article that questions the independence of this review, due to director of corporate affairs at the Trust, Kate Anderson, being a former employee of KPMG.
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Content Article
During the pandemic, reports of abuse directed at doctors’ surgery staff and community pharmacy teams across West Yorkshire have increased. In response, the West Yorkshire Health and Care Partnership has launched a new insight driven campaign called ‘leaving a gap’ to make people think about the consequences of abusive behaviour. Co-produced with staff and patients, the campaign recognises that services are extremely busy, and it can be frustrating for people accessing care. The campaign reminds people we’re all here to help each other and the importance of all round understanding and kindness. A series of striking images created as part of the campaign aim to make people think about the gap that will be left if staff leave their role due to abuse. Please share the 'Leaving a gap' campaign message by displaying it in your public spaces, publishing it on your website and via social media. You can use the assets provided on this page to help; there are A4 and A5 size posters as well as social media images, a website banner and hero image and an animated video you can download. -
Content ArticleThe case of Lucy Letby, who was convicted of the murder of seven babies and attempted murder of another six in August 2023, has shocked both the public and the healthcare community. In this BMJ editorial, independent investigator Bill Kirkup and James Titcombe, Chief Executive of Patient Safety Watch, outline how the failure to listen to healthcare professionals raising concerns in the case may have contributed to further deaths. They highlight that when doctors at the Countess of Chester Hospital had concerns that they were seeing more deaths than expected, managers failed to take seriously their instinct that there might be a specific underlying cause. The doctors were even pressured into apologising to Letby. They argue that in spite of efforts by the NHS to create a culture where it is safe for staff to speak up about concerns, whistleblowers are still often ostracised and threatened when they highlight patient safety concerns. The article calls for health organisations to adopt the voluntary charter around candour currently being signed by police services and other bodies, pending the implementation of the proposed Public Authorities (Accountability) Bill, which would place a much-needed enduring duty of candour on NHS staff and organisations.
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Content ArticleThe Health and Safety (Sharp Instruments in Healthcare) Regulations 2013 aimed to: minimise burdens on public, independent and third sector employers and ensure businesses in UK are not placed at competitive disadvantage relative to EU counterparts offer good standards of protection to healthcare workers from risk of sharps injury at work see a fall in sharps injury numbers. This post implementation review (PIR) aimed to assess the success of these objectives. It found that: stakeholder consultation provided evidence of the increasing use of safer sharps across all healthcare sectors. evidence from RCN research and HSE inspections indicates that risks to healthcare workers from sharps injuries remains high. The policy conclusion from this evidence is that the Regulations are still required, and that the Regulations’ objectives cannot be met with a system that imposes less burden to business.
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News Article
Attacks in Wales on workers up to almost 3,000
Patient Safety Learning posted a news article in News
"I shouldn't have to work out my escape route when I walk into a property." Paramedic Joanna Paskell was a victim of one of the near-3,000 attacks on emergency workers in Wales last year. The patient who punched her got a 12-month community order, but it left the 45-year-old suffering with anxiety and meant she was off work for four months. "It took four security guards to calm her down so she could be treated," said Mrs Paskell, who has worked with the ambulance service for more than 25 years. She said at first she tried to laugh it off, but it was only when getting ready for her next shift, five days later, that she felt the emotional toll. "All I want to do is make a difference - that's why I joined this job. We can't do that if we're working in fear of our own safety." Last year there were 2,838 assaults against police officers, firefighters, ambulance staff, NHS workers and prison staff - a 4.9% rise. Read full story Source: BBC News, 30 May 2022 -
News Article
Safety regulator refused to investigate some NHS staff Covid deaths
Patient Safety Learning posted a news article in News
Britain’s safety at work regulator refused to investigate reports from NHS trusts that 10 frontline staff had died as a result of catching Covid-19 during the pandemic. The Health and Safety Executive (HSE) declined to look into at least 89 dangerous incidents that NHS trusts said involved healthcare workers being exposed to Covid, including 10 deaths. The stance taken by the HSE, which oversees workplace health and safety and can bring prosecutions, is disclosed in freedom of information requests by the Pharmaceutical Journal. It has prompted concern that the regulator is too strict in its definition of workplace harm. It found that 173 trusts in England submitted at least 6,007 reports about employees’ exposure to Covid-19 in the course of their duties to the HSE between 30 January 2020 and 11 March 2022, under the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations (RIDDOR). They included 213 “dangerous occurrences”, which are incidents that have the potential to cause significant harm; 5,753 cases where a staff member had caught Covid-19; and 41 deaths among people who had been exposed to the disease at their workplace. However, the HSE refused to look into five Covid deaths reported under the RIDDOR scheme by the Yorkshire ambulance service (YAS) because of what it considered a lack of evidence. The regulator also decided not to look into the Covid deaths of five staff at University College London hospital acute trust, despite the trust’s belief they had caught it at work. “The HSE found that there was no reasonable evidence that the infection was contracted at work,” a trust spokesperson said. Shelly Asquith, the health, safety and wellbeing officer at the Trades Union Congress, said the HSE’s decisions and claimed lack of evidence was “really concerning”. It suggested a continued “element of denial about Covid being airborne and it not being possible to necessarily pinpoint where exactly somebody was exposed once it’s in the air”, she added. Read full story Source: Guardian, 26 May 2022
