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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 this opinion piece for the BMJ, Partha Kar, NHS England National Specialty Advisor for Diabetes, shares his observations on why leaders fail to speak out on things that clearly aren't good for patient care. He identifies five key reasons: Keeping the job Fear Rhetoric about 'the bigger picture' The idea that 'I'll be rewarded' Genuine belief that the issue isn't real Partha highlights that speaking up about issues needs to become the norm if we are to see a culture shift in healthcare. Leaders need to be at the forefront of this, using their privilege to bring about change.
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Content Article
Stephen Ashmore and Tracy Ruthven, Co-Directors of Clinical Audit Support Centre Limited, have created a simple, eye-catching poster to explain the new Patient Safety Incident Response Framework (PSIRF). Here they explain why they created the graphic. You can download the poster by clicking on the image or downloading it from the attachment at the bottom of the page.- Posted
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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 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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Content ArticleLeadership within the NHS has never been more critical. The need to support staff, remain resilient to the ongoing operational challenges create space to develop services which are locally responsive and inclusive are all pre-requisites for organisational success. However, for every leader there is also the need to know when it is time to move on, and the system can make that easier (or harder) to recognise and to act on. In this blog for BMJ Leader, Aqua’s Chief Executive Sue Holden looks at the issues facing senior NHS leaders who are having to function in ever-changing structures and a shifting culture. She asks whether innovative approaches to roles and contracts would allow the NHS to retain their skills and experience, while allowing new leaders to come through to senior positions.
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Content Article
Pieces: Claudia's story of a serious incident
Patient_Safety_Learning posted an article in Maternity
This digital story produced by Patient Voices, hears from Claudia who reflects on the unexpected death of a baby she helped care for in hospital. Claudia describes her own and her team's emotions as they debriefed and embarked on their serious incident report. -
Content ArticleLearn about some of the clinical supervision models used for registered healthcare professionals to enhance personal and professional development.
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News Article
Whistleblowers sacked by NHS fear no change after Lucy Letby case
Patient Safety Learning posted a news article in News
NHS clinicians who were sacked after blowing the whistle about avoidable patient deaths say they fear lessons from the Lucy Letby murder trial have not been learned and the case will make no difference to their own claims for unfair dismissal. They say hospital bosses are still more concerned about reputation than patient safety, despite what emerged in the Letby case about the tragic consequences of ignoring consultants who first raised suspicions about her killing babies. Mansoor Foroughi is appealing against his dismissal by University Hospital Sussex NHS trust in December 2021 after raising concerns about patient deaths. Mansoor Foroughi, a consultant neurosurgeon, was sacked by University Hospital Sussex NHS trust (UHST) in December 2021 for allegedly acting in bad faith when he raised the alarm about 19 deaths and 23 cases of serious patient harm that he said had been covered up in the previous six years. Those deaths and at least 20 others are now being investigated by Sussex police after allegations of medical negligence. Foroughi, whose appeal against his dismissal is due to be held in the coming months, told the Guardian: “I don’t think mine or anyone’s chances of success has increased [after Letby], and only a change in the law will do that.” Read full story Source: The Guardian, 1 September 2023 -
Content ArticleThis is the report of a review into how the executive leadership of the NHS could be better supported and empowered to ensure the best possible service is delivered for patients. Sir Ron Kerr was commissioned by the Department of Health and Social Care (DHSC) to conduct the review, which focused on three issues in particular: The expectations and support available for leaders - particularly those in challenging organisations and systems The scope for further alignment of performance management expectations at the organisational and system level The options for reducing the administrative burden placed on executive leaders The report describes the methodology of the review, outlines its findings and makes a number of recommendations around these issues.
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Content Article
A Kind Life website
Patient-Safety-Learning posted an article in Suggest a useful website
A Kind Life works with NHS organisations to help them shape a culture that cultivates kindness and nurtures high performance. The company offers a range of training courses and programmes focused on areas such as recruitment, leadership, feedback and conflict resolution. -
News Article
Workplace sexual-harassment clampdown for doctors
Patient Safety Learning posted a news article in News
Conduct guidelines for UK doctors are being updated to spell out what constitutes workplace sexual harassment, amid concerns abuse is going unchallenged. The General Medical Council, which regulates doctors to ensure they are safe and fit to care for patients, says it is adopting a zero-tolerance policy. The new advice explains it is not just physical acts that can be a breach. Verbal and written comments or sharing images with a colleague count too. The new guidance will not come into effect until the end of January, after a five-month familiarisation period for staff. And some say there is still a long way to go. Dr Chelcie Jewitt, an emergency-medicine doctor who is part of the Surviving in Scrubs campaign group, which aims to raise awareness of sexism, harassment and sexual assault in the healthcare workforce, said: "We have spoken with the GMC about the guidelines and we do think that they are a step in the right direction - but there is still a long way to go on this journey to eradicating the culture of sexual misconduct within healthcare. "The GMC has the potential to make a real difference and we need to see them supporting victims when they report perpetrators. "We need their reporting processes to be transparent and clearly explained to victims. "We need cases to be thoroughly investigated rather than dismissed. "And we need appropriate, proportionate sanctioning of perpetrators." Read full story Source: BBC News, 22 August 2023 Read a blog Dr Chelcie Jewitt wrote for the hub: Calling out the sexist and misogynist culture within healthcare -
News Article
Government failed health staff in pandemic, says BMA
Patient Safety Learning posted a news article in News
The UK government failed in its duty of care to protect doctors and other healthcare staff from avoidable harm and suffering in its management of the covid-19 pandemic, a major review by the BMA has concluded. Two reports published on 19 May document the experiences of thousands of UK doctors throughout the pandemic, drawing on real time surveys carried out over the past two years, formal testimonies, data, and evidence sessions. The reports will form part of a wider review by the BMA into the government’s handling of the pandemic, with three further instalments to come. The evidence lays bare the devastating impact of the pandemic on doctors and the NHS, with repeated mistakes, errors of judgment, and failures of government policy amounting to a failure of a duty of care to the workforce, the BMA said. Chaand Nagpaul, BMA chair of council, said, “A moral duty of government is to protect its own healthcare workers from harm in the course of duty, as they serve and protect the nation’s health. Yet, in reality, doctors were desperately let down by the UK government’s failure to adequately prepare for the pandemic, and their subsequent flawed decision making, with tragic consequences. “The evidence presented in our reports demonstrates, unequivocally, that the UK government failed in its duty of care to the medical profession.” Read full story Source: BMJ, 19 May 2022 -
News Article
60,000 NHS workers living with PTS after battling pandemic
Patient Safety Learning posted a news article in News
Around 60,000 NHS staff members have post-traumatic stress after working through the Covid-19 pandemic, new research suggests. Nine out of 10 health workers say it will take them years to recover from the ordeal and one in four had lost a colleague to coronavirus, according to NHS Charities Together The charity, NHS staff and mental health experts are now calling for more support from the health service and UK government to support those struggling in the aftermath of the pandemic. “I think it’s quite clear there hasn’t been enough support to help NHS workers recover from their experiences during the pandemic. As a result, a lot of people are feeling incredibly jaded,” said Dr Ed Patrick, an NHS anaesthetist who worked in a Covid-19 intensive care unit from the beginning of the pandemic. On his experiences of working on the front lines of the health service, Dr Patrick said: “Like everyone else in the world, we lost our outlets for release. Everything was shut down and for NHS workers, our lives just became the hospital." He described the long and gruelling hours and the emotional burden of working at the height of the pandemic: “We all had an overwhelming feeling of powerlessness. There was also a deep sadness because everything you would normally do to help patients just wasn’t working. Read full story Source: The Independent, 17 May 2022 -
News Article
Medical director wins 'whistle blowing' unfair dismissal case
Patient Safety Learning posted a news article in News
A former medical director on the Isle of Man, who lost her job when she questioned decisions made on the island during the COVID-19 pandemic, has won her case for unfair dismissal at an employment tribunal. The hearing, which began in January, heard how Dr Rosalind Ranson was victimised and dismissed from her role after making 'protected disclosures' as part of her efforts to persuade the Manx Government to deviate from Public Health England (PHE) advice in the early stages of the pandemic. Dr Ranson, who had extensive experience as a GP and as a senior medical leader in the NHS in England, was appointed to her post as the island's most senior doctor in January 2020 with the aim of tackling what she identified as a disillusioned medical workforce, failings in management, and a bullying culture. She was soon called on to provide expert medical advice and guidance on how the Isle of Man’s health system should respond to the spread of COVID-19. In March, Dr Ranson channelled concerns from the island's doctors that the advice from PHE was flawed, and that a more robust approach should be taken to stem the spread of SARS-CoV-2. That included closing the island’s borders – a move that was initially ignored. Dr Ranson became concerned that her medical advice was not being heeded and that it might not be being passed on to ministers by the then Chief Executive of the Isle of Man’s Department of Health and Social Care (DHSC), Kathryn Magson, who was not medically qualified. The tribunal heard that because Dr Ranson had "blown the whistle" when she spoke out, she was sidelined and eventually dismissed unfairly. Read full story Source: Medscape, 11 May 2022 -
News Article
Dangerous staffing levels in Borders hospitals, says union
Patient Safety Learning posted a news article in News
A trade union has written to every politician representing the Scottish Borders to highlight "dangerous staffing levels" in local hospitals. Unison claims serious breaches of safety guidelines are occurring daily due to a lack of nurses, auxiliaries and porters. The letter says staff are unable to take proper rest breaks or log serious incidents in the reporting system. NHS Borders said patient and staff safety was its number one priority. Unison said working conditions in the area were regularly in breach of regulations. Greig Kelbie, the union's regional officer in the Borders, said: "We are getting regular messages from our members to tell us about the pressure they are under - and that they can't cope. "The care system was under pressure before Covid, but the pandemic has exasperated the situation, particularly at NHS Borders. "The NHS has been stretched to its limits and it is now at the stage where it is dangerous for patients and staff - we're often told about serious breaches of health and safety, particularly at Borders General Hospital where there are issues with flooring and staff falling. "We work collaboratively with NHS Borders to do what we can, but we also wanted to make politicians aware of how bad things have become. "We need our politicians to step up and implement change - we want them to make sure the Health and Care Act is brought to the fore and that it protects our members." Read full story Source: BBC News, 13 May 2022 -
News Article
Concerns flagged over exploitation and poor treatment of overseas nurses
Patient Safety Learning posted a news article in News
A “shocking” number of nurses from overseas are winding up “in trouble” or sanctioned within their first few months of working in the UK partly because of a lack of induction and support, a conference has heard. The issue was raised during a panel session at the Unison health conference in April discussing the importance of ethical recruitment practices in nursing and midwifery. According to Unison, it is supporting “many” overseas nurses who have been “exploited, unfairly treated and subject to racism” since their move. Among the panel was Gamu Nyasoro, a clinical skills and simulation nurse manager in the NHS and an elected member of Unison’s nursing and midwifery occupational group committee. Ms Nyasoro, who is from Zimbabwe and has been working in the NHS for the past two decades, said she herself had been discriminated against and had faced several challenges during her migration. She raised concern that overseas nurses were not given enough information about how to live and work in the UK, including about how to access healthcare services themselves, or about country specific rules and regulations. There was also the issue that UK employers “don’t look at their skills beforehand”, which means nurses were being put in roles or areas they were not confident in. She cited examples of staff who had been specialising in neonatal services before moving, who were then being asked to work with older people, and those who had been practising as a midwife in their home nations and then being required to work in emergency departments in the UK. Read full story Source: Nursing Times, 28 April 2022 -
News Article
Hospital robots are helping combat a wave of nurse burnout in the US
Patient Safety Learning posted a news article in News
Since February, the nurses at Mary Washington Hospital in Fredericksburg, Virginia, USA, have had an extra assistant on their shifts: Moxi, a 4-foot-tall robot that ferries medication, supplies, lab samples, and personal items through the halls, from floor to floor. After two years of battling Covid-19 and related burnout, nurses say it’s been a welcome relief. “There's two levels of burnout: There's ‘we’re short this weekend’ burnout, and then there's pandemic burnout, which our care teams are experiencing right now,” says Abigail Hamilton, a former ICU and emergency room nurse that manages nursing staff support programmes at the hospital. Moxi is one of several specialised delivery robots that has been developed in recent years to ease the strain on healthcare workers. Even before the pandemic, nearly half of US nurses felt that their workplace lacked adequate work–life balance. The emotional toll of seeing patients die and colleagues infected at such a large scale—and fear of bringing Covid-19 home to family—has made feelings of burnout worse. Studies also found that burnout can have long-term consequences for nurses, including cognitive impacts and insomnia years after the exhaustion of their early careers. The world already had a nurse shortage going into the pandemic; now, roughly two out of three nurses in the US say they have considered leaving the profession, according to a survey from the National Nurses United union. Moxi has spent the pandemic rolling down the halls of some of the largest hospitals in the country, carrying objects like a smartphone or beloved teddy bear to patients in emergency rooms when Covid-19 protocol kept family members from bedsides. Read full story Source: Wired, 19 April 2022 -
News Article
Few staff using wellbeing hubs despite rise in sick days
Patient Safety Learning posted a news article in News
Only 53,500 staff have used a flagship NHS staff wellbeing initiative in its first year of operation, HSJ can reveal, while separate analysis finds mental health sick days have soared in the last five years. Figures obtained via Freedom of Information requests reveal the NHS’s staff mental health and wellbeing hubs, set up in February 2021 in response to covid pressures, received 53,549 contacts from NHS and social care staff between then and January 2022. It is the first time such data has been published and it comes as HSJ’s analysis of separate figures shows mental health sick days taken across acute and specialist NHS trusts have risen sharply in the past five years (see box below). The total number accessing the hubs, which is inclusive of social care staff, equates to less than 4 per cent of the NHS workforce as of January 2022. Sean Duggan, mental health chief executive at NHS Confederation, said: “Given what we know about the pandemic and the toll it has paid on NHS staff, I would have expected bigger numbers. “We need to encourage more people to come forward. To me, this number says we certainly need to sustain the hubs with funding for years to come.” Read full story (paywalled) Source: HSJ, 3 May 2022 -
News Article
Whistleblowing Bill launched in Parliament to widespread support
Patient Safety Learning posted a news article in News
The Doctors’ Association UK (DAUK) has expressed its support for the Whistleblowing Bill launched in Parliament last week, with its first reading in the House of Commons by Mary Robinson MP, Chair of the All Party Parliamentary Group for Whistleblowing. DAUK urged people to tweet their MP to show their support for the Bill. DAUK Chair Dr Jenny Vaughan said: "Healthcare staff need to be able raise patient safety issues all of the time. We’re trained to do that, expect it, point this out as best we can. But sometimes poor safety arises because of the way we are told to work. Then, it can be just as hard for staff to speak up as it is for anyone else, because we can also be threatened, sanctioned, isolated, ignored and bullied. "Blowing the whistle for us means saving lives, in the end. But we stand to lose as much as anyone. DAUK has supported many doctors who have been made to suffer because they spoke out, and there are many more who feel they should but are afraid to. That is why this Bill is so important. For all staff within healthcare. And most of all, for patients - the public. Stopping the greater harm for the greater good.” The most important changes in the private members bill, led by Baroness Kramer would: Require disclosures to be acted upon and whistleblowers protected. Provide criminal and civil penalties for organisations and individuals failing to do so. Establish a fully independent parliamentary body on whistleblowing, and provide easy access to redress. Read full story Source: Medscape UK, 26 April 2022 -
News Article
GMC tackles bullying and sexual harassment for doctors
Patient Safety Learning posted a news article in News
New responsibilities for doctors regarding their use of social media and tackling toxic workplace behaviours and sexual harassment are among key proposals in the General Medical Council’s (GMC) planned update to its core ethical guidance. The regulator has launched a 12-week consultation on the draft new content of 'Good medical practice', which outlines the professional values, knowledge and behaviours expected of doctors working in the UK. This represents the first major update of the guidance since it first came into effect in April 2013, with the review process launched last year. The GMC said the draft new update follows months of working with doctor, employer, and patient representatives, as well as other stakeholders, and reflects the issues faced in modern-day healthcare workplaces. Included for the first time in the draft new guidance is a duty for doctors to act, or support others to act, if they become aware of workplace bullying, harassment, or discrimination, as well as zero tolerance of sexual harassment. For the first time, the GMC's ethical guidance proposes 12 commitments, including: Make the care of patients my first concern. Demonstrate leadership within my role, and work with others to make healthcare environments more supportive, inclusive, and fair. Provide a good standard of practice and care, and be honest and open when things go wrong. Ensure my conduct justifies my patients’ trust in me and the public's trust in my profession. Read full story Source: Medscape, 27 April 2022 -
News Article
NHS management overly ‘task focused’, government review finds
Patient Safety Learning posted a news article in News
NHS management and leadership are overly ‘task focused’, according to briefings by the senior military leader who has carried out a major review of health and care for the government. General Sir Gordon Messenger has nearly completed the work, which had been due to be published shortly before Easter but was delayed by the government, and has briefed several senior leaders on several of his main observations. According to several senior figures, he has said NHS management and leadership are heavily “task focused” — a management term referring to an approach devoted to completing certain tasks or meeting certain short-term objectives; in contrast to an approach which focuses on people, relationships or skills. HSJ has spoken to several senior sources who have been briefed on Sir Gordon’s findings so far. One said the former military figure had observed that “NHS leadership is… very focused on getting things done, and not focused enough on how things get done – which I think is very fair if you think particularly what the last 10, 15 years have been like”. Another finding, according to those briefed, is the need for better support for NHS leaders running the most difficult local organisations, including providing what has been described as “support packages”. Read full story Source: HSJ, 26 April 2022 -
News Article
Trust board backs medical director who wrongly dismissed whistleblower
Patient Safety Learning posted a news article in News
A trust board has backed the medical director who oversaw the dismissal of a whistleblower in a case linked to patient deaths. Portsmouth Hospitals University Trust told HSJ John Knighton had the full support of the organisation when asked if he faced any censure over the wrongful dismissal of a consultant who raised the alarm about a surgical technique. Jasna Macanovic last month won her employment tribunal against the trust with the judge calling its conduct “very one-sided, reflecting a determination to remove [her] as the source of the problem”. The judgment found that the disciplinary process Dr Knighton oversaw was “a foregone conclusion” and as such had broken employment rules. The nephrologist was twice offered the opportunity to resign with a good reference, once during her disciplinary hearing and again on the day the outcome of that hearing was delivered. The trust told HSJ nothing in the judgment suggested Dr Knighton should face any action about his conduct and none had been taken. It said there were no reasons to doubt his credibility or probity. The trust did not respond when asked if any apology had been offered to Dr Macanovic. A spokesperson said: “We are committed to supporting colleagues raising concerns, so they are treated fairly with compassion and respect.” Read full story (paywalled) Source: HSJ, 13 April 2022 -
News Article
Huge drop in midwives’ morale amid Ockenden fallout
Patient Safety Learning posted a news article in News
There has been a dramatic fall in morale among midwives across multiple measures within the NHS staff survey. Although general morale deteriorated among most staffing groups in 2021, the results for midwives across numerous key measures have worsened to a far greater degree than average. It comes amid the final Ockenden report into the maternity care scandal at Shrewsbury and Telford Hospitals Trust, which raised serious concerns about short staffing and people wanting to leave the profession. The survey results, published on 31 March, suggest 52% of midwives are thinking about leaving their organisation, up 16 percentage points on the previous year. In comparison, the number of general nurses thinking of leaving was 33%, up just 5 percentage points. Chris Graham, chief executive of healthcare charity the Picker Institute, which coordinates the staff survey, described the midwifery profession as an “outlier” in the 2021 results, in terms of how their experiences compare to other groups and how their responses have changed over time. “Not only do midwives report worse experiences in many areas, but there is evidence of particularly sharp declines in some key measures,” Mr Graham said. “It appears likely that staffing shortages are a major factor here.” Read full story (paywalled) Source: HSJ, 13 April 2022
