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Content ArticleIt's now a decade since the Francis Report, which outlined the causes of serious failures in care at Mid Staffordshire NHS Foundation Trust. The report and prior media coverage exposed a wide set of issues surrounding the culture and transparency of health care, and these topics remain of major concern today. In this article for the Nuffield Trust, Shaun Lintern has interviewed Sir Robert Francis KC about the weight of those patient stories and treatment of the NHS's staff, then and now.
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Content ArticleHealthcare is a $4 trillion component of the US economy, and the well-being of the clinician workforce is a major factor determining its effectiveness. Extensive evidence indicates that inefficiency, poorly designed workflows and processes, suboptimal teamwork, work overload, isolation, problems with work-life integration, and a professional culture that expects perfection and discourages help-seeking are currently contributing to high levels of occupational distress among clinicians. Although the problem and its impact on the health care delivery system are well defined, there is minimal evidence regarding effective interventions to drive progress. This knowledge gap is, in large part, due to the near-complete absence of federal funding for research to address one of the critical challenges facing the US health care delivery system.
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Content ArticleThis article by Katherine Virkstis, Managing Director of the US health thinktank Advisory Board, looks at the growing problem of a nursing 'skills gap' in the US. She argues that this area is often overlooked, but needs to be tackled to ensure patients are safe. A recent boom in new nurses graduating means that the balance of the nursing workforce is now less experienced than it has previously been. The growing complexity of patients and care approaches in healthcare systems also means that the demand for highly-trained nurses with specific skills has increased. The author explains this as a widening 'experience-complexity gap' and suggests four strategies to close the gap: Bolster emotional support and show staff your own vulnerability as a leader Dramatically scope the first year of practise Differentiate practice for experienced nurses Reinforce experienced nurses' identity as system citizens
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Content ArticleVictoria Vallance, Director of Secondary and Specialist Care, provides an update on the Care Quality Commission (CQC)’s ongoing national maternity inspection programme and offers early insight into the emerging themes, including good practice examples to support wider learning across all trusts.
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Content ArticleThis study from Jones et al. identified wide variability in the implementation of the Guardian role and concluded that optimal implementation has six components.
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Content ArticleSecond victims are healthcare workers who experience emotional distress following patient adverse events. This mixed method study in BMJ Open looks at how the RISE (Resilience In Stressful Events) programme was developed at the Johns Hopkins Hospital to provide this support. It examined: developing the RISE programme recruiting and training peer responders pilot launch in the Department of Paediatrics hospital-wide implementation.
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News Article
NHS staff cried in safety interviews, says watchdog
Patient Safety Learning posted a news article in News
The health safety watchdog has said that doctors, ambulance dispatchers and other NHS staff in England have faced "significant distress" and harm over the past year as a result of long delays in urgent and emergency care. The Healthcare Safety Investigation Branch (HSIB), which monitors safety in the health service in England, said many staff it interviewed for a national investigation "cried or displayed other extreme emotions" when asked about their working environment. "The bad sides [of my job] give me nightmares, flashbacks and fear, but they can also make me hyperactive, sleepless and sometimes not care about the danger I put myself in," one paramedic told the BBC. Sarah, not her real name, has worked in the ambulance service for more than a decade, but describes the last 12 months as the most difficult she can remember. "Over the winter I have witnessed and helped with cardiac arrests in the corridors of hospitals and in the back of ambulances," she said. "I spent four hours with an end-of-life patient. There was no hospice or district nurse available, so I had to make the choice to give them meds for a peaceful, expected death and prepare the family. "I felt ashamed that I could not stay till the end, but I had to move on to the next job as I had done all I could." The HSIB found NHS staff were reporting increased levels of stress, worry and exhaustion because they were not always able to help the sickest patients. HSIB has now urged trusts to do more to protect workers’ mental health, saying there is an “intrinsic link” between patient safety and staff wellbeing. Read full story Source: BBC News, 27 February 2023 -
Content ArticleThe Healthcare Safety Investigation Branch (HSIB) have published a third interim report for this investigation which focuses on staff wellbeing across the urgent and emergency care systems and the impact that this has on patient safety.
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Content ArticleThis document by the Joint Commission provides an overview of the issues faced by healthcare workers who are negatively affected by their involvement in a patient safety incident—second victims. It highlights the prevalence of second victims, summarises the key problems they face and outlines recommendations to ensure staff receive adequate support from healthcare organisations when they are involved in an incident.
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Content Article
Leadership in the NHS (BMJ Leader, 20 December 2019)
Patient-Safety-Learning posted an article in Leadership
In healthcare, leadership has a big influence on quality of care and the performance of hospitals. How staff are treated significantly influences care provision and organisational performance, so understanding how leaders can help ensure staff are cared for, valued, supported and respected is important. Research suggests ‘inclusion’ is a critical part of the answer. In this article, Roger Kline looks at how creating a compassionate, inclusive culture improves patient safety—and by contrast, how a culture of fear and bullying has a negative effect. He examines why toxic leadership cultures develop and what can be done to transform leadership in NHS organisations. -
News ArticleRecord levels of NHS staff are seeking mental health help as clinicians warn the “crisis” facing workers is “worse than the pandemic”. Hundreds of staff are being referred to the specialist mental health service, NHS Practitioner Health, with 842 workers referred in October 2022 – up from 534 in the same month the year before and 371 in 2020. Around 40% of the staff seeking the service are GPs and 50% are hospital doctors. The news comes as The Independent reported that the NHS and government are set to axe funding for 40 mental health hubs set up for health and social care workers following the pandemic. Amandip Sidhu, of Doctors in Distress, which offers workers mental health support, said: “Health workers believe that the crisis they are currently dealing with is worse than during the pandemic and exacerbated by the fact there is no end in sight, with little evidence that decision-makers are taking steps to improve the situation. “The fact that the public, their patients, lack sympathy or understanding is making many medics feel isolated and completely unappreciated.” Read full story Source: The Independent, 23 February 2023
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News Article
Suicidal NHS staff left in ‘dangerous limbo’ as mental health help ends
Patient Safety Learning posted a news article in News
Suicidal NHS staff will be left in “dangerous” situations without support when national funding for mental health hubs ends next month, health leaders have warned. The hubs, set up with £15 million of government funding for NHS workers following Covid, are being forced to close or reduce services as neither the Department for Health and Social Care nor the NHS has confirmed ongoing funding for 2023-24. This will leave thousands of NHS staff, some of whom are described as “suicidal” in “complete limbo”, The Independent has been told. The British Psychological Society (BPS) and the Association of Clinical Psychologists (ACP) said the failure to continue the funding was an “irresponsible” way to treat vulnerable health and care workers. Professor Mike Wang, chair of ACP, said: “There is a clinical responsibility, not to remove a service from individuals who are vulnerable, and in difficulty … the problem with that is that the funding ceases at the end of March and that’s absolutely no time at all to make any [future] provision. So, it’s clinically irresponsible to simply halt a service. Some of these individuals are, you know, carrying suicide risk.” He said it was “dangerous” and “astonishing” that funding for the hubs was ending “given the present circumstances of continuing effects of the pandemic, clear evidence of underfunding of health care in this country”. Read full story Source: The Independent, 22 February 2023 -
Content ArticleIn July the Health and Care Act 2022 introduced a requirement that regulated service providers ensure their staff receive training on learning disability and autism which is appropriate to the person’s role. The Oliver McGowan Mandatory Training on Learning Disability and Autism is the standardised training that was developed for this purpose and is the government's preferred and recommended training for health and social care staff to undertake. It is named after Oliver McGowan, whose death shone a light on the need for health and social care staff to have better training. It is the only training with permission to include Paula McGowan OBE, telling Oliver's story and explaining why the training is taking place. An elearning package is the first part of both Tier 1 and Tier 2 of the Oliver McGowan Mandatory Training and is now live. Everyone will need to do the elearning no matter where they work and what tier they need to complete. The next part is either a live one hour online interactive session for those needing Tier 1,or, a 1-day face to face training for people who require Tier 2.
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News Article
Health workers ‘shattered’, says Jeremy Farrar as more NHS strikes loom
Patient Safety Learning posted a news article in News
Healthcare workers are “absolutely shattered” and unless something is done to address the crisis in morale, staffing and training then “they won’t be there when you need them”, one of the world’s leading scientists has warned. Speaking to the Guardian, Prof Jeremy Farrar, the director of Wellcome and soon to be chief scientist of the World Health Organization, warned that healthcare workers would not be ready should another crisis hit. “This is a global issue, which I think is hugely concerning. It’s certainly true in this country,” he said. “The resilience of healthcare workers, broadly defined from ambulance drivers to nurses to doctors, to care workers in social care, etc. They’re shattered. They are absolutely shattered." Farrar said: “I think we have to address the morale, staffing, the training, everything from public health physicians to care workers, to doctors and nurses and physios and everybody in between because there’s very little spare capacity in any system globally. It’s particularly true in the UK. As you can see from the strikes, morale and resilience is very thin.” Read full story Source: The Guardian, 20 February 2023 -
News Article
British Medical Association calls government reckless over pay talks
Patient Safety Learning posted a news article in News
The British Medical Association has accused the government of "reckless" behaviour ahead of the results of a strike ballot by junior doctors. The BMA's Professor Philip Banfield said the prime minister and health secretary were refusing to enter meaningful negotiations with unions. The Department of Health and Social Care said it had met with the BMA and other unions to discuss pay. Professor Banfield, the BMA's chair of council, said that Rishi Sunak and Health Secretary Steve Barclay were "standing on the precipice of an historic mistake". He accused the government of "guaranteeing escalation", adding that officials were "reckless" for thinking they could stay silent and wait it out. Professor Banfield also accused the government of "letting patients down", adding: "All NHS staff are standing up for our patients in a system that seems to have forgotten that valuing staff and their well-being is directly linked to patient safety and better outcomes of care." Read full story Source: BBC News, 19 February 2023 -
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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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. hub members receive a 20% discount. Email info@pslhub.org for discount code. Follow on Twitter @HCUK_Clare #HospitalAtNight
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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 -
Content Article
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. -
News Article“Frustration with the system was why I went off in the end,” said Conor Calby, 26, a paramedic and Unison rep in southwest England, who was recently off work for a month with burnout. “I felt like I couldn’t do my job and was letting patients down. After a difficult few years it was challenging.” While he usually manages to keep a distinct divide between work and home life, burnout eroded that line. He also lost his sleep pattern and appetite. The final straw came when what should have been a 15-minute call resulted in three hours on the phone trying to persuade the services that were supposed to help a suicidal patient to come out. “I was on a knife edge. That was due to the system being broken. That’s the trigger.” Doctors and nurses are struggling under the strain too. After her third time with burnout - the last resulting in her taking six months off work – Amy Attwater, an A&E doctor, considered leaving the profession altogether. Attwater, 36, said in the Covid crisis, during which a colleague killed himself, she started having suicidal thoughts and doubting her own abilities. She twice reported that she was being bullied but said no action was taken. “The only thing I was left with was to take time off work. I ended up having therapy, seeing a psychiatrist and being on two antidepressants,” said Attwater, the Midlands-based committee member for Doctors’ Association UK. Read full story Source: The Guardian, 5 February 2023
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Content ArticleThe purpose of this assessment is to ensure that all Theatre Practitioners are fully compliant with current Trust Policy with regard to swabs, instruments, sharps and disposables items. All Theatre staff must be assessed and deemed competent.
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News Article
Minister calls for staff evidence in deaths inquiry
Patient Safety Learning posted a news article in News
A health minister has called for more staff to take part in an inquiry into deaths at a mental health trust. An independent review into 1,500 deaths at the Essex Partnership University Trust (EPUT) over a 21-year period was launched in 2020. It emerged earlier this month that 11 out of 14,000 staff members had come forward to give evidence to an independent inquiry. The trust said it was encouraging staff to take part in the inquiry. During a parliamentary debate, Health Minister Neil O'Brien said the trust was being given a "last chance" before the government intervened and instigated a statutory inquiry. A statutory inquiry would allow staff to be compelled to give evidence. In December, a further 500 deaths were made known to the review chair, Dr Geraldine Strathdee. She said the inquiry could not continue without full legal powers. Chelmsford MP Vicky Ford said she had been told by the chief executive of EPUT that staff were "very scared" to give evidence. Read full story Source: BBC News, 31 January 2023
