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News ArticlePatients may be found guilty of discrimination if they refuse the care of a transgender medic, according to new NHS guidance. Health bosses have been warned that patients have no right to be told a healthcare worker’s assigned sex at birth. However, transgender health workers can choose not to treat patients if they feel uncomfortable doing so, the report by NHS Confederation says. The report, published earlier this month in partnership with the LGBT Foundation, says patients can only request care from a same-sex staff member in limited circumstances, such as if they are having an intimate examination. It states that when a patient requests an employee administering care to be a woman or a man, “the comfort of the staff member should be prioritised”. Read full story Source: Telegraph, 9 June 2023
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Approach to tackling violence raises concern among NHS England staff
Patient Safety Learning posted a news article in News
There has long been an acknowledgment by ministers and NHS leaders that violence against staff by patients was an issue that needed addressing, with a strategy to tackle it announced nearly five years ago. The health service’s 2019 long-term plan included a pilot for the use of body-worn cameras by paramedics in a bid to “de-escalate” situations. The following year the Crown Prosecution Service announced an agreement with the police and NHS England to “secure swift prosecutions” of those who assault staff, and the maximum penalty for assaulting emergency workers, including doctors and nurses, was also doubled to two years. Despite these measures, there have been internal disagreements within NHS England about the best approach to the problem, which affected almost 15% of staff last year, according to the latest national survey of the health service workforce. The Guardian understands that senior managers in NHS England told staff in its violence prevention and reduction (VPR) team last April that prosecutions of those who assaulted healthcare workers and dismissals of abusive staff should be a last resort. Instead, the focus should be on improving the culture of the NHS and staff wellbeing. It is also understood that managers cautioned against using the term “zero tolerance” because they said it did not take into account that some people who abuse NHS staff might lack capacity, an apparent reference to mentally ill patients. Read full story Source: The Guardian, 23 May 2023- Posted
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Intervention at major trust as junior doctors flag patient safety risks
Patient Safety Learning posted a news article in News
Trainee medics in a troubled maternity department have flagged concerns with national regulators over the safety of patients, it has emerged. Last year the General Medical Council said it had concerns about the treatment of obstetric and gynaecology trainees at University Hospitals Birmingham and placed medics at Good Hope Hospital and Heartlands Hospital under intensive support known as “enhanced monitoring”. The GMC’s review flagged serious concerns about emergency gynaecology cover arrangements and said there was a real risk trainees would become hesitant and reluctant to call on consultant support. In September it placed additional restrictions on training, due to “ongoing significant concerns about the learning environment and patient safety”. Now it has emerged in board papers for Birmingham and Solihull integrated care board that Health Education England, now part of NHS England, and the GMC carried out a follow-up visit to UHB in late March to review progress. Board documents state that “several patient safety concerns [were] reported by postgraduate doctors in training to the visiting team”, with a subsequent feedback letter from HEE urging immediate changes to dedicated consultant time and job plans. Read full story (paywalled) Source: HSJ, 17 May 2023- Posted
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Majority of NHS trusts provide no dedicated training to prevent sexual harassment
Patient Safety Learning posted a news article in News
Only one NHS trust in England provides dedicated training to prevent sexual harassment, according to research, raising concerns that the NHS is failing to adequately protect staff and patients. According to health union figures, sexual harassment of staff is pervasive. A 2019 survey by Unison found that one in 12 NHS staff had experienced sexual harassment at work during the past year, with more than half saying the perpetrator was a co-worker. In a recent BMA survey, 91% of female doctors reported sexism, 31% had experienced unwanted physical contact and 56% unwanted verbal comments. Yet research by the University of Cambridge, published in the Journal of the Royal Society of Medicine found that the vast majority of NHS trusts did not provide any dedicated training to prevent sexual harassment. The report analysed data from freedom of information requests from 199 trusts in England and found that just 35 offered their workers any sort of active bystander training (ABT), while only one NHS trust had a specific module on sexual harassment. ABT is designed to give individuals the skills to call out unacceptable behaviour, from workplace bullying to racism and sexual misconduct. It is widely used by the military, universities and Whitehall, including the Home Office. Read full story Source: The Guardian, 5 May 2023- Posted
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Almost one in three doctors investigated by GMC ‘have suicidal thoughts’
Patient Safety Learning posted a news article in News
Almost one in three UK doctors investigated by the General Medical Council (GMC) think about taking their own life, a survey has found. Many doctors under investigation feel they are treated as “guilty until proven innocent” and face “devastating” consequences, the Medical Protection Society (MPS) said. Its survey of 197 doctors investigated by the GMC over the last five years found: 31% said they had suicidal thoughts. 8% had quit medicine and another 29% had thought about doing so. 78% said the investigation damaged their mental health. 91% said it triggered stress and anxiety. The MPS, which represents doctors accused of wrongdoing, accused the GMC of lacking compassion, being heavy-handed and failing to appreciate its impact on doctors. Read full story Source: The Guardian, 27 April 2023- Posted
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‘More than half of my paycheck goes to rent’: young US doctors push to unionise
Patient Safety Learning posted a news article in News
Young doctors just out of medical school working as resident physicians, fellows and interns at major US hospitals are organising unions at an increasing rate, citing long-running problems highlighted by the Covid-19 pandemic and a need to rethink the struggles young doctors face in the profession. The Committee of Interns and Residents, an affiliate of SEIU, added five unionised sites in 2022 compared with about one a year before the pandemic and the surge has continued in 2023 with multiple union election filings. It currently represents over 25,000 residents, fellows and interns across the US, comprising about 15% of all resident and fellow physicians. Hospital management has opposed the unionisation effort, declining to voluntarily recognise the union, encouraging residents not to sign union authorisation cards ahead of the election filing and writing local op-eds in opposition to unionisation. Since going public with their union plans, staff have been sent emails and been invited to meetings to try to dissuade residents from unionising, “often counting on myths around what unionizing would mean”, said Dr Sascha Murillo, a third-year internal medicine resident at Massachusetts general hospital. The unionising campaign took off after vulnerabilities in the healthcare system were exposed by the Covid-19 pandemic, she said, with residents working on the frontlines and bearing the brunt of staffing shortages, an influx of Covid-19 patients, and patients who deferred medical care. Read full story Source: The Guardian, 27 April 2023 -
News Article
Covid: Staff propped up care homes without extra pay, says report
Patient Safety Learning posted a news article in News
Many care home staff worked extra hours without extra pay to prop up the system during the pandemic, a study suggests. Public money helped stabilise UK care homes during the first wave of Covid-19 but it was withdrawn too soon and not focused on staff, says the research, led by Warwick Business School. The researchers studied the accounts of more than 4,000 UK care home companies, from just before the pandemic and during the first year of the health crisis. They found nearly two thirds (60%) of care homes were already financially fragile as the pandemic took hold. The report concludes: "The decision by government to end financial support for care home companies after the peak of the pandemic had passed has likely contributed to the current financial and operational difficulties experienced by the sector." It states the financial plight of many staff and the immense pressure they were under "means it is not surprising the care home sector has struggled to both recruit and retain staff once lockdown restrictions were removed and the wider economy re-opened". Read full story Source: BBC News, 12 April 2023- Posted
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Whistleblowers ‘frustrated and disappointed’ by CQC, review finds
Patient Safety Learning posted a news article in News
The Care Quality Commission’s follow-up of whistleblowing concerns from health and care staff has been poor and inconsistent, and there is a “widespread lack of competence and confidence” on dealing with race and racism at the organisation, two reviews have found. A “Listening, learning, responding to concerns” review was published by the Care Quality Commission, alongside a linked independent review into how the regulator failed Shyam Kumar, a consultant orthopaedic surgeon in the North West, who was also a CQC specialist professional adviser. The wider review looked at a range of issues including how the CQC deals with racism; how well it listens to whistleblowers in providers; and how it deals with its own staff, including as part of a recent restructure, and its internal “Freedom to Speak Up” process. It followed concerns bring raised, in addition to Mr Kumar’s case, about these issues. Scott Durairaj, a CQC director who joined it last year and led the review work along with a panel of advisers, reported there was “clear evidence, during the scoping, design phase and throughout the review, of a widespread lack of competence and confidence within CQC in understanding, identifying and writing about race and racism”. Read full story (paywalled) Source: HSJ, 29 March 2023- Posted
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Two-thirds of UK workers with Long Covid have faced unfair treatment, says report
Patient Safety Learning posted a news article in News
UK ministers should act to ensure Long Covid sufferers receive the support they need from employers, with as many as two-thirds claiming they have been unfairly treated at work, a report argues. The report, from the TUC and the charity Long Covid Support, warns that failing to accommodate the 2m people who, according to ONS data, may be suffering from long Covid in the UK will create, “new, long-lasting inequalities”. The analysis is based on responses from more than 3,000 long Covid sufferers who agreed to share their experiences. Two-thirds said they had experienced some form of unfair treatment at work, ranging from harassment to being disbelieved about their symptoms or threatened with disciplinary action. One in seven said they had lost their job. The report makes a series of recommendations, including urging the government to designate Long Covid as a disability for the purposes of the 2010 Equality Act, to make clear sufferers are entitled to “reasonable adjustments” at work; and to classify Covid-19 as an occupational disease to allow people who contracted it through their job to seek compensation. Read full story Source: The Guardian, 27 March 2023- Posted
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UK GPs have the highest stress levels, finds survey of 10 countries’ doctors
Patient Safety Learning posted a news article in News
GPs in the UK have some of the highest stress levels and lowest job satisfaction among family doctors, a 10-country survey has found. British GPs suffer from high levels of burnout, have a worse work/life balance and spend less time with patients during appointments than their peers in many other places. Heavy workloads, seemingly endless paperwork and feelings of emotional distress are prompting many GPs to stop seeing patients regularly or even retire altogether, the research found. Seven in 10 (71%) NHS family doctors find their job “extremely” or “very stressful”, the joint-highest number alongside GPs in Germany among the countries analysed. The Health Foundation, which undertook the survey, said its “grim” findings showed that the “unsustainable” pressures on GPs and number of them quitting pose a threat to the NHS’s future.- Posted
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Steve Barclay accused of breaking pledge over NHS staff abuse data
Patient Safety Learning posted a news article in News
NHS staff have accused Steve Barclay of breaking a pledge to publish details of how many of them are abused and assaulted in the course of their work. In 2018, when Barclay was a junior minister in the Department of Health and Social Care (DHSC), he promised he would resume publication of those statistics in the following year. However, five years later, Barclay has not fulfilled his pledge, despite being in his second stint as health secretary. Health unions and NHS leaders have warned that frontline staff have been on the receiving end of increased abuse, threats, aggression and assaults since the first outbreak of Covid. Long waiting times for care appear to be a particular source of frustration for some patients or their relatives. Growing numbers of ambulance crew personnel have begun using body-worn cameras in recent years to deter assaults and record any that do occur. In 2022, the London ambulance service recorded 877 reports of verbal abuse or threats of violence, 516 physical assaults – including kicking, punching, head-butting and use of a weapon – and 49 sexual assaults on staff. Read full story Source: The Guardian, 16 March 2023- Posted
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Content ArticleThe Covid-19 pandemic has thrown a spotlight on the treatment of NHS staff and their perceived value to their employers. An estimated two million people in the UK have Long Covid, including many thousands of NHS workers, so why do we hear so little about it? In this BMJ article, a doctor in the NHS who has Long Covid explains why he is disappointed by the collective silence and the lack of protections and support mechanisms in place.
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Content ArticleLearn how one trust has applied staff engagement techniques as part of its continuous improvement programme.
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Content ArticleLast year we published a blog from Dr Chelcie Jewitt on the Surviving in Scrubs campaign. The campaign was created by Dr Becky Cox and Dr Chelcie Jewitt to give a voice to women in healthcare to raise awareness and end sexism, sexual harassment and sexual assault in healthcare. On their Surviving in Scrubs website they share the awful stories from women working in healthcare of sexism, sexual harassment and sexual assault.
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Content ArticleIn this BMJ opinion piece, Scarlett McNally discusses the revised National Safety Standards for Invasive Procedures (NatSSIP2). The original NatSSIPs were designed to prevent “never events”—yet more than 300 occurrences of wrong site surgery, retained objects after procedure, or wrong implant insertion still occur yearly in the UK. NatSSIP2 brings in safety science and human factors, with expectations for organisations including standardisation, harmonisation, training, and audit. "The biggest danger is if the new standards sit on the shelf. With their benefits for patient safety and teamworking, we must accept the repetitive elements and consistently apply these new standards, every time, in every department", writes Scarlett.
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Content Article
Behaviour change techniques cards
Patient Safety Learning posted an article in Culture
Behaviour Change Techniques are the ‘active ingredients’ of activities that lead to behaviour change. These cards were developed by Lucie Byrne-Davis, Eleanor Bull and Jo Hart to help those who work with people to try to change their behaviour, and particularly for educators, trainers, leaders and those involved in organisational development, quality improvement or implementation. This was was funded by Health Education England- Posted
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Safety for All: 2022 Conference Report
Mark Hughes posted an article in Improving patient safety
This report provides an overview of speeches, presentations and panel sessions held at the inaugural Safety for All conference, which took place at the Royal College of Physicians in London on Wednesday 7 December 2022. It has been published by the Safety for All campaign, which calls for improvements in, and between, patient and healthcare worker safety to prevent patient safety incidents and deliver better outcomes for all. The campaign is supported by Patient Safety Learning and the Safer Healthcare and Biosafety Network.- Posted
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Content ArticleAt times of crisis, healthcare workers (e.g., nurses, advanced practice nurses, physicians, nursing assistants, etc.) continue to provide care, despite ever challenging work demands, including higher influx of critically ill patients, increased work stress, and a frequent need for overtime. These work demands can compound already challenging work schedules (i.e. 12-hour shifts, night shifts), making it more difficult to obtain regular shift breaks and enough time off between shifts for adequate recovery. All of these work factors (i.e. physical, emotional, and/or mental demands) combined with insufficient sleep, contribute to fatigue. This article from the Centers for Disease Control and Prevention (CDC) gives tips and resources on managing fatigue in times of crisis.
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Content ArticleSleep deprivation due to extended work hours and circadian disruption has long been a concern in medicine. The levels of continuous duty and work hours for health care personnel are much greater than those allowed in the transportation and nuclear-power industries. The problem is most severe for residents in training but extends to experienced physicians and nurses. Clinicians who have been deprived of sleep are part of a health care system in trouble. A report from the Institute of Medicine concluded that the system fails to ensure that patients are safe or that the quality of care they receive is high. In this article, David Gaba and Steven Howard discuss current and proposed policies concerning clinicians' work hours and fatigue.
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Content ArticleHealth workers, hailed as heroes during the pandemic, say they’re being abandoned by the NHS and the government. Some are living with Long Covid and say it’s having a devastating impact on both their personal and professional lives. For Panorama, the BBC’s health correspondent, Catherine Burns, meets staff struggling to return to work and reveals how some are now facing financial hardship and the prospect of having to retire early or, worse, being sacked.
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Content ArticleThis article in BMJ Open Quality aimed to improve patient safety by examining the organisational and individual factors that contribute to adverse events, enabling corrective action so that errors are not repeated. Using interviews and observations of Trust meetings at a single Hospital Trust in the Midlands, England, this qualitative study: analysed whether the attitudes and behaviours of clinicians and managers are aligned with a Just Culture. identified barriers and enablers to an organisation adopting a Just Culture. The study found evidence of a fair incident management process within the Trust; however, there was no agreed vision of a Just Culture and the majority of the staff were unfamiliar with the term. Negative perspectives relating to clinical incidents and their management persist among staff with many having concerns about being the subject of an investigation and doubts about whether they drive improvement.
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Content ArticleHow can leaders move from understanding to taking actions? Listen to the Dementia UK podcast on moral injury in nursing.
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Content ArticleThe pandemic has highlighted several longstanding, systemic issues in healthcare, and clinician burnout is chief among them. From regulatory-related constraints to inefficient EHR workflows, a day in the life of a provider looks very different than what many envisioned when deciding to pursue a career in medicine. Additionally, the rate of staff departures and early retirements has put even more pressure on overburdened care teams. No single solution can solve this complex issue. In this Becker's Hospital Review eMagazine, experts share actionable strategies and industry trends that can help healthcare organizations support the providers. How to recognize early signs of burnout. Three ways AI can reduce providers’ administrative burdens. Using human-centered design to address burnout. How a 'platform of health' can dismantle burnout and increase collaboration. You will need to fill out the form on Becker's Hospital Review website to download the whitepaper.
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Content ArticleYou can now watch the recording of the Nuffield Trust event: 'Does the rush for new types NHS staff have a dark side?'
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Content ArticleIn this interview for The Guardian, Pat Cullen, General Secretary of Royal College of Nursing (RCN), talks about how RCN members are being forced to use food banks, her frustration with the government and how she learned to be a tough negotiator. She discusses the issues that led to nurses balloting to strike—violence, sexual assault, unsafe staffing levels and pay that has not kept up with inflation—and outlines the difficult realities of being a nurse in the NHS. She also describes the negotiations with the Government, who according to Cullen, refused to discuss nurses' pay.
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