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Content ArticleIn this episode of Speak Up, Listen Up, Follow Up, Dr Jayne Chidgey-Clark, National Guardian for the NHS, speaks to Chris Hopson and Saffron Cordery, Chief executive and Deputy Chief executive of NHS Providers, about speaking up’s role in work force retention and how they will use speaking up in their new roles.
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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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Content ArticleNursing workforce shortages are an issue of international concern, with the gap between demand for services and the limited numbers of nurses widening. Recruiting nurses internationally is one solution that is helping to bridge this gap in some health systems. This systematic review in the International Journal of Nursing Studies Advances aimed to explore the lived experiences of international nurses working and living in different countries globally. The authors identified factors that can help nurses from other countries to adapt culturally to the UK health system, and that may support retention of international staff. The authors found that in order to improve the long term retention of international nurses, cultural integration and language barriers should be sensitively managed to enable effective acculturation. Culturally sensitive leadership should also be promoted to ensure zero tolerance of inappropriate racist and discriminatory behaviours.
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News Article
Medical expert witnesses ‘should not scapegoat doctors’
Patient Safety Learning posted a news article in News
Medical experts in cases involving doctors should have a mandatory duty to consider systems issues such as inadequate staffing levels to avoid them being scapegoated for wider failures, the Medical Protection Society (MPS) has said. The MPS, which supports the the professional interests of more than 300,000 healthcare professionals around the world, says medical expert reports focus on scrutinising the actions of the individual doctor even when failings are a result of the setting in which they work. Its report on the issue, shared with the Guardian before publication, points out that for doctors “adverse opinion can lead to loss of career or liberty”. It references the case of Dr Hadiza Bawa-Garba who was convicted of gross negligence manslaughter in 2015 and handed a 24-month suspended sentence for her part in the death of six-year-old Jack Adcock from sepsis. She was later struck off by the General Medical Council before the court of appeal overturned the GMC’s decision. Dr Rob Hendry, the MPS medical director, said: “In giving an opinion on whether or not the care provided by a doctor has fallen short of a reasonable standard, it would seem fair to the doctor that the medical expert considers all relevant circumstances. Any individual performance concerns must of course be addressed, but doctors should not be scapegoats for the failings of the settings in which they work. Sadly, we see this all too often in cases against doctors … “Many expert reports focus solely on the actions of the individual without considering the wider context. In reality, patient harm arising from medical error is rarely attributable to the actions of a single individual. Inadequate staffing levels, lack of resources, or faulty IT systems are just some issues which can contribute to adverse incidents. Doctors confront these issues every day and have little influence over them.” Read full story Source: The Guardian, 18 July 2022 -
Content ArticleThe NHS is not in a place where it can lose staff, but many workers in the health service have faced almost unimaginable difficulties during the pandemic. How worried should we be about NHS staff health and wellbeing? Nigel Edwards and Andy Cowper look at how bad the situation is and what can be done to improve things.
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News Article
More support needed for people with mental health difficulties at work
Patient Safety Learning posted a news article in News
Being in a productive and supportive work environment is linked to better mental health. However, those experiencing mental health problems are often either excluded from the workplace or not supported appropriately when in work, according to new guidance from the Royal College of Psychiatrists. As many as one in six people of working age are diagnosed with a mental health condition. Mental health problems are a leading cause of absence from work, but ‘good’ work can improve overall wellbeing. This is achieved by improving self-esteem, feeling useful, building a routine, and importantly, avoiding poverty, which adversely impacts health in many ways. ‘Good’ work should offer standard benefits such as job security, an appropriate wage, positive work/life balance, and opportunities for career progression as well as supportive mental health and wellbeing policies. These practices should support employees with existing mental health disorders while minimising the risk of developing issues with mental health and well-being. This includes flexible working policies, use of appropriate reasonable adjustments to help people maintain employment and access to counselling and support services as needed. The Royal College of Psychiatrists is calling for better support for people with mental health problems to find, return to, and remain in good work, and for employers and Government to recognise the valuable contribution these people make to the workforce. Dr Adrian James, President of the Royal College of Psychiatrists, said: “We all need to do more if the workplace is to consistently play a positive role in a person’s mental health and wellbeing. We know that issues such as insecure work and unemployment can have a disproportionate impact on the wellbeing of people with mental health conditions. “Psychiatrists and occupational therapists can play a key role between employers and patients, ensuring staying in good work is seen as an important outcome of treatment. We must put in place better support for people with mental health problems to find, return to, and remain in good work and for employers and Government to recognise the valuable contribution these people make to the workforce.” Read press release Source: Royal College of Psychiatrists, 14 July 2022 -
Content ArticleMany people don’t receive enough support both to find and stay in work when experiencing mental health difficulties. The Royal College of Psychiatrists (RCPsych) have launched a new occupational mental health guidance with recommendations for the government, NHS, and psychiatrists. The guidelines highlight the crucial, positive role that ‘good work’ can have on an individual’s mental health, and how poor experience of work both risks exacerbating pre-existing poor mental health and/or contributing to the emergence of a mental health condition. It provides advice and recommendations to the key organisations and individuals who have a role in ensuring work makes a positive impact on mental health.
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Content ArticleEven before the pandemic struck, there was a shortage of nurses in the UK. In January 2020, a survey by the Royal College of Nursing (RCN) found that almost three-quarters of nurses said the staffing level on their last shift was not sufficient to meet the needs of patients safely and effectively. Yet this month NHS England predicted that the government will not meet its manifesto pledge to boost the NHS’s nursing workforce by 50,000 by March 2024. The key reason? NHS workers are quitting in droves, citing burnout, fatigue and pay as factors. Filling these gaps are nurses from overseas. Recently released figures for 2021 and 2022 from the Nursing and Midwifery Council (NMC) show that record numbers of nurses trained overseas are coming to work in the UK – almost half of new registrations. The Guardian spoke to four of them about their experience working in the UK.
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News Article
Female doctors launch campaign against harassment in UK healthcare
Patient Safety Learning posted a news article in News
Female doctors have launched an online campaign that they say exposes shocking gender-based discrimination, harassment and sexual assault in healthcare. Surviving in Scrubs is an issue for all healthcare workers, say the campaign’s founders, Becky Cox and Chelcie Jewitt, who are encouraging women to share stories of harassment and abuse to “push for change and to reach the people in power”. The campaign has called for the General Medical Council (GMC), which regulates doctors, to explicitly denounce sexist and misogynistic behaviour towards female colleagues and “treat them with respect”. More than 40 stories have been shared on the campaign’s website, ranging from sexual harassment by patients to inappropriate remarks and sexual advances from supervisors. The campaign is bolstered by evidence that shows 91% of female respondents had experienced sexism at work within the past two years. The findings are a result of nearly 2,500 surveyed doctors working in the NHS – the majority of whom were women – published in a 2021 report by the British Medical Association (BMA). Read full story Source: The Guardian, 11 July 2022 -
Content Article
Surviving in Scrubs campaign
Patient Safety Learning posted an article in Staff safety
Sexism, sexual harassment, and sexual assault are commonplace in the healthcare workforce. Too many healthcare staff have witnessed or been subject to it… the female med student asked to stay late lone working with a senior male doctor, being looked over for opportunities at work, unwelcome touching at conferences, comments on your looks… the list goes on. A 2021 survey from the BMA reported 91% of women doctors had experienced sexism in the last 2 years and 47% felt they had been treated less favourably due to their gender. Over half of the women (56%) said that they had received unwanted verbal comments relating to their gender and 31% said that they had experienced unwanted physical conduct. Despite these statistics these issues remain endemic in healthcare. The Surviving in Scrubs campaign, created by Dr Becky Cox and Dr Chelcie Jewitt, aims to tackle this problem, giving a voice to women and non-binary survivors in healthcare to raise awareness and end sexism, sexual harassment, and sexual assault in healthcare. You can share your story through the Submit Your Story page anonymously and the story will be published on the Your Stories page. This will create a narrative of shared experiences that cannot be ignored. -
Content ArticleDuring COVID-19, clinical teams faced disruption, having to respond to challenging circumstances and high uncertainty, whilst providing quality care to patients. We know that staff psychological wellbeing affects team effectiveness and patient experience and resilience is fostered by connections between (not just within) individuals. New collaborations between clinical, service improvement and psychology teams recognised the value of introducing the psychologically-informed ‘Start Well>End Well’ team procedure into routine team processes. This evidence-based approach consists of 1) an enhanced safety briefing, 2) peer-to-peer debrief guidance and signposting for trauma-focused support, and 3) team check-out. Initially launched as a general procedure across all wards with variable uptake, a more tailored co-design and coaching approach was then piloted on 2 neurology wards over 3 PDSA cycles. Formative evaluation (focus groups and written feedback) demonstrated staff felt “cared for” whilst achieving “positive impact” through improved ways of working within new teams.
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Content ArticleOne of the reasons why patient safety may be put at risk during healthcare interventions is a lack of staff adherence to patient safety guidelines. There could be a relationship between staff’s adherence to patient safety guidelines and their perceived level of reward for their work and/or motivation. This study from Asmoro et al. examined the relationship between reward and adherence to patient safety guidelines, and between motivation and adherence to patient safety guidelines, among nurses working in emergency departments (EDs) in Indonesia. They found that ensuring ED nurses are motivated for their work by offering rewards – such as a decent salary, a supportive workplace environment and career progression opportunities – is important to enhance their adherence to patient safety guidelines.
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Content ArticlePsychological safety is a belief that one will not be punished or humiliated for speaking up with ideas, questions, concerns, or mistakes. More than 20 years of research demonstrates that organisations with higher levels of psychological safety perform better on almost any metric or key performance indicator (KPI) in comparison to organisations that have low psychological safety. However, achieving psychological safety is a challenge in the complex, ever-evolving health and care systems in which we operate. In this guide, Professor Amy C. Edmondson shares insights that emerged from exploring the experience of differing Integrated Care Systems; a range of case studies, and a wealth of tools and resources. This guide is not a 'how to' for how to create psychological safety; it is more of a reflection on the opportunities and challenges in our health and care system, and how you might seek to work with them.
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Content ArticleOver the past year, delays in transferring patients from an ambulance to a hospital have risen exponentially. In April 2022 there were over 41,000 delays of over 60 minutes, up over a staggering 450 per cent in 12 months. This equates to 71,000 hours lost, with a significant risk of harm to patients, even though the proportion being taken to hospital by ambulance has fallen thanks to successful initiatives such as “hear and treat” and “see and treat”. These delays mean that, too often, ambulance crews are not able to respond to 999 calls from critically ill patients. Instead they are being held in “stacks” of hundreds each day – as ambulance control room teams strive to prioritise overstretched resources. The current reality is that crews are often waiting with patients in hospital corridors or outside, hearing urgent calls to which they are unable to respond. In addition to the direct impact on patients, this is incredibly demoralising, even traumatising, for many staff involved. So why is this happening? In an article for the Independent, Daren Mochrie, chair of AACE – the Association of Ambulance Chief Executives, and Saffron Cordrey, interim chief executive at NHS Provider, discusses what is happening in the NHS.
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News Article
Government set to cut enhanced sick pay for NHS staff off work with Covid
Patient Safety Learning posted a news article in News
The government is to cut special sick pay for NHS staff off work with Covid from next week – even as cases soar – The Independent has learnt. The Department of Health and Social Care is set to announce an end to the enhanced pay arrangements provided during the pandemic, meaning that staff who go off sick with either Covid or Long Covid will be subject to normal sick-pay rules. In response to the pandemic, the government announced special arrangements for staff to be paid if they were isolating because of Covid, and to receive a full 12 months’ pay if they were suffering from Long Covid. Arrangements will now revert to the normal NHS sick-pay rules, which give workers six months’ full pay and six months’ half pay. A senior healthcare source said: “They have agreed to end the arrangement for new people from next week, and then have an implementation period where people who are currently off on this sort of scheme revert back to normal sick-pay entitlement from September.” The Royal College of Nursing’s director for England, Patricia Marquis, speaking about the cut in sick pay, said: “This decision is hugely disappointing, given that Covid-19 clearly hasn’t gone away, and nursing staff continue to be disproportionately affected by the virus as they face a higher risk of exposure." Read full story Source: The Independent, 2 July 2022 -
Content Article
Impact of adverse events on surgeons (April 2022)
Patient Safety Learning posted an article in Surgery
Surgeons are affected negatively when things go wrong. They may experience guilt, anxiety and reduced confidence following adverse events, which may lead to formal investigation and sanction. Medical errors have been linked with burnout, depression, suicidal ideation and reduced quality of life. This research from Turner et al. explores the impact of adverse events on UK surgeons’ health and wellbeing. Surgeons completed an online survey that involved recalling an error-based or complication-based event and answering questions regarding health, wellbeing and support seeking. -
Content ArticleReducing stress is an organisational imperative since workplace pressures continue to be one of the main causes of short and long-term absence. According to research undertaken by CIPD based on responses from 804 organisations, 79% of respondents report some stress-related absence in their organisation over the last year. Healthcare settings have an even higher rate of absence due to stress, yet there is reason to be optimistic that this could start to change when a new policy from NHS England is implemented, which recommends the use of After Action Review (AAR). In this blog, Judy Walker explains how AARs can play a key role in reducing stress for those who have been involved in clinical incidents.
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EventThis on-demand conference focuses on supporting staff who have been involved in patient safety incidents, or are the subject of complaints or claims. Involvement in an incident, complaint or claim can have severe consequences on staff who may experience a range of reactions including stress, depression, shame and guilt. This conference will enable you to: Network with colleagues who are working to support staff following incidents, complaints or claims. Understand national developments including the requirements in the 2020 Patient Safety Incident Response Framework. Reflect on how we can better support staff experiencing these issues through Covid-19. Deliver a just culture that supports consistent, constructive and fair evaluation of the actions of staff involved in patient safety incidents. Reflect on a healthcare’s professionals personal experience of being the subject of an incident investigation. Improve immediate support and debriefing when an incident occurs. Develop your skills in providing the staff member involved in a patient safety incident specific individual support or intervention to work safely. Understand how you can improve processes for ensuring candour and supporting staff. Identify key strategies for interviewing staff and taking statements and preparing staff for Coroner’s Inquests. Ensure you are up to date with the latest developments in psychological support for staff including building resilience. Self assess and reflect on your own practice. Gain CPD accreditation points contributing to professional development and revalidation evidence. For more information https://www.healthcareconferencesuk.co.uk/on-demand-training/patient-safety-incident-complaint-claim or email kerry@hc-uk.org.uk hub members receive a 20% discount. Email info@pslhub.org for discount code. Follow on Twitter @HCUK_Clare #SupportingClinicians
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Content ArticleShared decision making involves ensuring patients are able to contribute meaningfully to decisions about their care. Healthcare professionals ensure patients are informed of the options available to them and fully involve patients in making treatment decisions. This report by the Patients Association sets out the views of 1,416 healthcare professionals on shared decision making, expressed in an online survey in Spring 2022. Respondents included GPs, consultants, specialist nurses and practice nurses. The survey found that most healthcare professionals are positive about shared decision making, but feel their ability to practice it regularly is limited by the current situation in the NHS. Many said that lack of time, gaps in the workforce and large caseloads prevented them partnering with patients to make decisions about treatment and care together.
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Content ArticleThis improvement tool is designed to help NHS organisations identify strengths their leadership team and organisation, and any gaps that need work, in seeking to create an environment where people feel safe to speak up with confidence. It should be used alongside Freedom to speak up: A guide for leaders in the NHS and organisations delivering NHS services, which provides full information about the areas addressed in the statements, as well as recommendations for further reading.
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Content ArticleThis guide provides ideas for how an organisation can adhere to the NHS principles for leaders and managers in seeking to create an environment where people feel safe to speak up with confidence. This guide is designed to be used by any senior team, owner or board in any organisation that delivers NHS commissioned services. This includes all aspects of primary care; secondary care; and independent providers.
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Content ArticleThis policy provides the minimum standard for local freedom to speak up policies across the NHS, so those who work in the NHS know how to speak up and what will happen when they do. All NHS organisations and others providing NHS healthcare services in primary and secondary care in England are required to adopt this policy. This includes a template where organisations can incorporate their own local information into the policy document.
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News Article
RCGP warns 19,000 GPs could quit in 'mass exodus' over next five years
Patient Safety Learning posted a news article in News
Polling by the Royal College of General Practice (RCGP) as part of a campaign to make NHS GP services sustainable for the future found that 42% of 1,262 GPs and trainees who took part said they were likely to quit the profession in the next five years. A workforce exodus on this scale would strip the health service of nearly 19,000 of the roughly 45,000 headcount GPs and GP trainees currently working in general practice. RCGP chair Professor Martin Marshall warned that general practice was a profession in crisis - with the intensity and complexity of GP workload rising as the workforce continued to shrink. He warned that 'alarming' findings from the RCGP poll must serve as a stark warning to politicians and NHS leaders over the urgent need for solutions to begin to tackle the crisis facing general practice. Four in five respondents told the RCGP they expect working in general practice to get worse over the next few years - while only 6% expected things to improve. Nearly two in five respondents said GP practice premises are not fit for purpose, and one in three said IT for booking systems is not good enough. Professor Marshall said: 'What our members are telling us about working on the frontline of general practice is alarming. General practice is significantly understaffed, underfunded, and overworked and this is impacting on the care and services we’re able to deliver to patients. Read full story Source: GP, 22 June 2022 -
Content Article
In a series of blogs, Gina Winter-Bates, Associate Nurse Director Quality and Safety at Solent NHS Trust, shares her experience of implementing Safety Chats. In this final blog of the series, Gina shares the next steps for Safety Chats in her Trust and how they will be building more ways of supporting staff to discuss safety, to seek advice and support, and to receive clear assistance when things have gone wrong. -
Content ArticleThe Safety culture programme group (SCPG) was a virtual task and finish group established in July 2021 for six sessions to provide recommendations to support and enable organisations to improve their safety culture through embedding a continuous cycle of understanding the issue, developing a plan, delivering the plan and evaluating the outcome with an underpinning foundation of inequalities reduction. This report contains an overview of the discussions undertaken by the Safety culture programme group (SCPG) in 2021. It also includes their recommendations so that safety culture continues to be developed as one of the foundations that underpins the NHS patient safety strategy.
